The Safety First Assessment Intervention: A Whole Family Approach for Young People with High Risk Mental Health Presentations

The following article provides a comprehensive guide to the clinical implementation of the Safety First Assessment Intervention (SFAI). The SFAI is a systemised, whole family approach for young people with high‐risk issues presenting in a mental health crisis. It is underpinned by the Safety First Model (Bickerton et al., 2007 ) and promotes community‐based care. The SFAI operationalises the foundation levels of the Safety First Model (SFM) through a highly structured clinical process. It draws on family systems theory, predominantly the work of Bowen ( 1978 ), to conceptualise distress through a multi‐generational systems lens and to prioritise the young person's natural support system (their family, friends, school and community) as their key resource. The SFAI engages this natural support system and facilitates open communication about symptoms, distress, safety and risk. This promotes a shared understanding of the key issues in a relational context and forms the basis of collaborative risk management. Thus, a system of safety emerges prioritising the family's role in optimising the young person's community‐based recovery. The need for pharmacotherapy and hospitalisation is therefore minimised. The article includes background theory, an outline of the structured assessment intervention and clinical techniques, including strategies for complex family situations. Specific strategies are illustrated with fictional vignettes. The work is based on the authors' accumulated experiences of working with young people and their families and carers in an acute Child and Adolescent Mental Health Service (CAMHS) for over a decade.     

Task analysis of healthcare delivery: A case study

Human error and medical error are highly known as contributors to patient safety [Institute of Medicine (IOM), November 1999. To err is human: building a safer health system. Available at: http://www.nap.edu/openbook/0309068371/html/11.html (accessed 05.03.07); Institute of Medicine (IOM), March 2001. Crossing the quality chasm: a new health system for the 21st century. Available at: http://www.nap.edu/openbook/0309072808/html (accessed 05.03.07); Joint Commission on Accreditation of Healthcare Organizations (JCAHO), 2007. Failure mode, effect, and criticality analysis (FMECA) worksheet. Available at: http://www.jcaho.org (accessed 24.06.07)]. A study was performed to identify the process flow affiliated with elder patients transitioning through different continuums of emergency and non-emergency care. This research is part of a larger research effort to develop and implement a web-based healthcare system that enables hospitals and nursing homes to share patient information resulting in increased knowledge of a patient's medical history, decreased errors and enhanced patient safety. Future research efforts for this study are also presented.     

Autonomy and Compliance: How Qualitative Sociologists Respond to Institutional Ethical Oversight

Prevailing sociological understandings of institutional ethical review tend to homogenize faculty responses to them, and are predominantly speculative. In this research, we conduct interviews with sociologists from 21 Ph.D.-granting departments across Canada, finding three predominant “ethics orientations” among them, with associated cognitive maps and strategic actions. In our analyses, we use these orientations to complicate homogeneous appraisals of social researchers’ responses to new bureaucratic requirements, enriching our understanding of how such requirements affect the ways sociologists think about their occupation, approach their research, and mentor successive generations. These ethics orientations suggest the field of sociology is comprised of distinct political cohorts with diverging understandings of ethical review, and by extension, power and intellectual work. For some, ethical review signals a more consultative and therefore better approach to knowledge production, while for others it marks the end of an era of unfettered (and superior) intellectual pursuit in sociology.     

Learning in manufacturing organizations: what factors predict effectiveness?

This paper argues that it is possible to identify factors which pre-dispose organizations to adopt effective learning strategies and processes. It is hypothesized that effective OL is associated with: profitability, environmental uncertainty, structure, approach to HRM and quality orientation. The study focuses on forty-four manufacturing organizations, and draws on longitudinal data gathered through interviews. The findings suggest that two of these variables - approach to HRM and quality orientation - are particularly strongly correlated with measures of OL. It is concluded that effective learning mechanisms, with the potential to improve the quality of OL processes, are more likely to be established in businesses where HRM and quality initiatives are well established.     

Trapped in Poor Places? An Assessment of the Residential Spatial Patterns of Housing Choice Voucher Holders in 2004 and 2008

ABSTRACT

This study examines the residential spatial patterns of Housing Choice Voucher holders in Western New York in 2004 and 2008 (n = 4,600 and n = 4,759, respectively). It seeks to answer two questions: Has the concentration of voucher holders in impoverished and same race neighborhoods diminished overtime; and are voucher holders, particularly African Americans, relocating in patterns that would lead to reghettoization or the reconcentration of race and poverty? This type of residential pattern puts voucher holders at risk for resettling in neighborhoods that limit economic and social mobility. Data from the public housing agency contracted to distribute Housing Choice Vouchers were examined. Exploratory spatial analysis techniques were used to identify spatial outliers and to form a hypothesis on spatial patterns of relocation. Spatial clustering analyses were conducted to test the hypothesis on the reghettoization of African American voucher holders in recently relocated neighborhoods. Analyses indicate that African American voucher holders are moving out of impoverished, hypersegregated areas into historically White neighborhoods. A limited number of voucher holders are moving in clustered patterns, which lead to reghettoization. Future research is needed that highlights the role that housing assistance providers play in the residential location choices of low-income clients.     

Estimation and Testing of Learning Curves

This article describes a new approach to learning curve estimation. Our approach is to formulate statistical procedures that conform to alternative learning curve theories. This leads to the development of nonlinear statistical models of the learning curves. For the three data sets analyzed, autocorrelation seems to be an important problem. Parameter estimates were derived using the maximum likelihood principle in the presence of first-order autocorrelation. Nonnested tests were used to select the appropriate formulation of the learning curve. Research conclusions are to use unit data when estimating a learning curve and to be prepared to treat autocorrelation if present.     

The relationship between New Zealand's climate,energy, and the economy to 2025

Abstract

This study looks at the effect of current climate variability and projected future climate change to 2025 on New Zealand's energy industry (mainly electricity supply and demand) and at the wider economic implications of these effects. Electricity demand is modulated by climate largely through temperature, while electricity supply is modulated largely through rainfall and inflows to the major hydroelectricity‐generating lakes in the South Island. Six climate scenarios are examined with an energy model to determine the change in the demand for energy and the change in the composition of energy supply, especially with regard to the mix of electricity generation. The output from this model is then used as an input to a multi‐industry general equilibrium model of the New Zealand economy.

The modelling demonstrates that while the expected effects of projected climate change on the energy industry over the next two decades are reasonably significant, the flow‐on effects from the energy to the wider economy are negligible, albeit slightly favourable. Modelling of the effects of climate variability, which includes unusually cold years, unusually warm years, and variable precipitation, however, shows that unexpected adverse events do have a measurable economic impact, particularly if wage rates are inflexible. Export industries are particularly disadvantaged by higher energy costs, implying a need for adequate reserve generation capacity. Just how much reserve capacity is optimal is a topic for further research.

Climate change scenarios to 2050 and 2100 show much greater climatic effects than are expected over the next 20 years. These have not been modelled as the types and costs of electricity generation technologies that might become available beyond 20 years are extremely uncertain.