The incidence of metabolic risk factors in an inpatient psychiatric setting

Our study examines risk factors for metabolic syndrome on admission to an acute psychiatric facility and the incidence of medical referrals at discharge. Data on demographics, risk factors for metabolic syndrome, other health risk factors, medications, related diagnoses, and primary care providers and referrals were collected from 125 psychiatric patient charts. Comparison analysis was done for two groups: those with two or more risk factors for metabolic syndrome and those with less than two risk factors. Differences between groups were statistically significant for age, waist circumference, body mass index, high-density lipoprotein, triglycerides, and fasting glucose levels. Few patients were referred to their primary care provider for follow-up care. This study has clinical implications for improving assessment of psychiatric patients at risk for developing metabolic syndrome, for designing interventions to help patients adopt lifestyle changes to mitigate these risks, and for working toward fuller integration of psychiatric and primary care.     

Levels of interventions for MFTs working with family businesses

Family businesses (FBs) are a significant population in the world and therefore part of most practicing marriage and family therapists (MFTs) clientele; however, little is mentioned about FBs in the training of MFTs. This article offers some guidance to practicing MFTs who service this population, as well as MFTs who wish to expand their practice into a focused consultation practices with FB systems. This article uses Doherty's Levels of Family Involvement Model as a road map for MFTs to organize the vast amount of literature on FB systems as well as the many ways in which MFTs might serve FBs. We also offer suggestions for the necessary skills, experiences, and levels of engagement required at each level of intervention provided by MFTs.     

Changing attitudes about self-injury prevention management: lessons learned

In the behavioral health environment, nurses often use continuous staff monitoring and, at times, physical restraints, to manage the severity of patients' self-injury. Both options put staff in control, are the most restrictive in nature, and can be financially draining on the hospital's budget. This can result in negative reactions by both patients and staff. It is important to develop a program that will empower patients to control their behavior and allow staff to be aware of their perceptions and attitudes toward patients who self-injure. This article describes the leadership initiative that drove the development, training, and implementation of a self-injury prevention project and the lessons learned by staff.     

Boom and bust: housing equity withdrawal and consumption decisions and their impacts on household wealth

The authors examine whether the surge in housing refinance and equity withdrawal generated by the housing boom disproportionately affected older households in terms of decisions on whether to refinance, whether to withdraw equity, and how much to withdraw, and how in turn these decisions affected their household wealth. Using the Federal Reserve's Survey of Consumer Finances, the authors found the highest rates of refinancing and cashing out equity among older (although not necessarily the oldest) households. The authors also found that appreciation in house value, being a baby boomer, and having higher household income were the factors that most increased the probability of refinancing and withdrawing equity. Amounts cashed out were higher among older than among younger households. Ordinary least squares (OLS) estimates showed that amounts withdrawn were increased by price appreciation, financial assets, and income, along with being a "pre-boomer" or "early boomer." Older cohorts displayed larger wealth effects than younger ones, but their withdrawn equity was a smaller percentage of total net worth. A relatively small percentage of respondents' dollars was used for consumption, and most dollars were used for home improvement, other investment, or debt repayment. However, massive equity withdrawal and the subsequent collapse of housing prices have caused housing leverage to soar, putting some homeowners "underwater" and jeopardizing others' retirement preparedness. The ensuing housing finance crisis raises numerous policy issues, from reform of mortgage underwriting, securitization, servicing, and foreclosure procedures, to potential limitations on borrowing against unrealized housing equity gains, to enhanced government transfers for distressed older homeowners, to local and state revenue policy changes.     

政府旅游开发方式评析——以土耳其为例

提起旅游,人们脑海里首先浮现的必然是"阳光与海滩"。土耳其是地中海地区的一个主要国家,在历史、文化、自然风光、美食、民俗等方面都具有巨大潜力,并且土耳其人民也非常热情友善。土耳其拥有21世纪的游客所寻求的异国风情。为使土耳其的这种潜力在继续服务于旅游业的同时保持其延续性,就需要认真的自省与科学的研究和规划。旅游业对于一国的社会福利和经济发展有着举足轻重的影响,但也存在毁灭当地资源的可能。理性运用旅游资产、增加游客数量和提高旅游收入,这些都可以通过有效的旅游规划来实现。在此问题上,中央政府、地方政府和非政府组织在相互协作的框架下各司其职显得至关重要。本文通过揭示当前土耳其旅游业的现状,对中央和地方政府扮演的角色做出评析,希望从国家管理的风格和方式角度出发,使土耳其的旅游规划和政策取得实际效果。     

1918—1932年苏联石油出口和石油工业

十月革命胜利后国外武装干涉和国内反动势力严重威胁着新生的布尔什维克政权。1918年起土耳其和英国军队先后占领巴库等石油产区,至1921年初苏俄石油出口量几乎为零。苏维埃政权稳固之后决定以出口石油换取外国设备和其他工业必需品,但收效不大。1923—1925年间西方大石油公司购买苏联石油产品的数量猛增并意欲控制苏联石油产品的出口和销售,苏联政府顺势而为,通过不断努力在世界石油市场上获得了一席之地。1926—1928年间英国等西欧国家在世界市场上排挤苏联石油,苏联遂与美国石油公司建立起伙伴关系,利用美国公司的营销网络与英国分庭抗礼。1929—1932年间英国停止抵制苏联石油产品,意味着英国要求苏联政府补偿企业国有化损失的方案落空,苏联获得了在世界市场上销售石油的合法权利。     

The effect of visualization method on the performance of simulated microsurgery tasks

The operating microscopes may be a significant cause of fatigue and discomfort in surgeons. The need for the microscope to be placed over the operating field forces surgeons to remain at the microscope's eyepieces at an uncomfortable posture for the entirety of the surgery. This study compared the effects on microsurgical task performance for four visualization methods: a monocular microscope, a binocular microscope, a three-dimensional (3D) flat-panel television display and a two-dimensional (2D) flat-panel television display. Eleven subjects each performed two microsurgical tasks and their performance was documented by video camera. The statistical analysis performed indicated utilization of the microscope as a visualization method increased subject performance. No significant difference in performance between the 2D and stereoscopic visualization methods.     

Social firms: Sustainable employment for people with mental illness

Objective: Social firms or enterprises aim to offer sustainable employment in supportive workplaces for people who are disadvantaged in the labour market. Therefore, this study sought to explore employees' views in one social firm about the features of their workplace that they found supportive.Participants: Seven employees were recruited, all of whom experienced persistent mental illness, and had worked in this social firm for between eleven months and six years. Methods: A semi-structured interview, the Work Environment Impact Scale (version 2.0), was used to explore participants' views of their workplace and to rate how its physical and social characteristics impacted them. Participants also rated their job satisfaction with a modified Indiana Job Satisfaction Scale. Results: Features of the social firm workplace identified by these employees as contributing to their sustained employment and satisfaction were the rewards, task demands, work schedule, and workplace interactions with supervisors and other co-workers. From their views, guiding principles for the development of supportive workplaces and evaluation of their capacity to afford sustainable employment were derived. Conclusions: This study adds to current knowledge about workplace supports from an employee perspective, and is of relevance for informing future social firm development, workplace design and evaluation.     

Social firms: Building cross-sectoral partnerships to create employment opportunity and supportive workplaces for people with mental illness

A major barrier to employment for people with mental illness is limited access to supportive and non-discriminatory workplaces. Social firms are businesses committed to employing up to 50% of people with a disability or other disadvantage and to providing supportive work environments that benefit workers. Little research has been conducted to understand the features and social processes that support the vocational experiences of employees with mental health issues in social firms. Objective: This ethnographic study sought to explore the experiences of nine employees at one Australian social firm. Participants: Nine employees of a social firm, with and without mental illness. Methods: Study methods used included participant observation, interviewing and document analysis. Results and conclusions: The study highlights the complexity of running a socially-invested business, and the importance of cross-sectoral partnerships to support their operational success. Natural workplace supports, adequate training and support infrastructure and enabling participation in the business, were identified as important to creating a supportive workplace. Partnerships within the workplace and in support of the workplace are discussed. Future growth and development of partnerships are recommended to support the establishment of social firms.