Psychiatric nursing & medication adherence

A survey was developed to determine whether the rapidly changing context of mental health care has significantly influenced how psychiatric nurses assess and intervene in issues related to medication adherence. A sample of 126 psychiatric nurses working in Veterans Affairs mental health treatment facilities in northern California, Hawaii, and Nevada identified the most effective methods for tracking medication adherence, as well as successful adherence interventions. Despite the challenge imposed by changing work environments, psychiatric nurses use creative and innovative approaches to improve their patients' medication adherence. Interventions for enhancing patient adherence with prescribed regimens are identified. Essential role dimensions related to medication adherence defined by the nurses in this survey included providing medication education, tracking patient adherence, assessing medication effectiveness, providing individualized, tailored adherence interventions, and collaborating with other health care providers in medication planning. Study findings support using nurses to their full potential and highlight nurses' need for more educational opportunities and consultation with experts (e.g., clinical pharmacists).     

‘We need to start building up what's called herd immunity’: Scientific dissensus and public broadcasting in the Covid-19 pandemic

This article uses content and thematic analyses to examine how UK public service broadcasting (PSB) reported on the Covid-19 pandemic prior to the first lockdown on March 23, 2020. This was a period when the British government's response to the pandemic was being heavily criticised by the World Health Organisation and other parts of the scientific community. This paper finds that in PSB these criticisms were muted and partially given. Instead, broadcasting explained in detail—and directly endorsed—government policy, including the ‘herd immunity’ approach. Most coverage of international responses focused on the United States and Europe with little attention paid to states that had successfully suppressed the virus. When such states were featured their public health measures were not explained nor compared to the UK's strategy with the consequence that PSB was unable to alert the public to measures that could have contained the virus and saved lives. These patterns in PSB coverage can be explained by the close links between key lobby journalists and the government's communication machine as well as the broader political and social contexts surrounding broadcasting at the onset of the pandemic.     

Russian public diplomacy in the 21st century: Structure,means and message

Many studies have focussed upon Western countries, such as the United States and members of the European Union, and how they engage with foreign publics. There is also an increasing amount of attention being paid to non-Western countries. The debate on soft power, for instance, shows that the concept is perceived and applied in a manner that differs from Nye's vision. This present article seeks to examine and analyse how and why the Russian state engages foreign publics with different communicational means and methods. Relations and approaches are much more pragmatic in the current situation, ideology seems to have been discarded. The current foreign policy concept gives context to positioning Russia, which not only gives Russia a certain role, but one that is set in relation to other international actors. Although, not all countries are treated the same, a different approach based upon a different set of assumptions produces a different understanding as to what programmes and means are needed. This produces a difference in approach between Western countries and those countries on the territory of the Former Soviet Union.     

Drivers of soil carbon in residential ‘pure lawns’ in Auburn,Alabama

Urban land area is expanding worldwide and may contribute to long-term carbon (C) storage; however, little is known about potential drivers of soil C in urban areas. Residential areas are one of the largest urban land use zones and lawns can provide stable chronosequences for studying soil C dynamics. In residential lawns containing no trees (n?=?23), the relationships between soil C and four potential drivers [home age (1–51 years), yard maintenance practices (fertilization, irrigation, and bagging or mulching lawn clippings), soil nitrogen (N) and soil texture] were investigated. Soil C increased with home age at 0–15 cm depth by 0.026 kg C m^?2?yr^?1, declined by ?0.011 kg C m^?2?yr^?1 at 15–30 cm depth, and was stable at 30–50 cm depth. Soil C had a positive relationship with soil N (R ²?=?0.55) at the 0–15 cm depth. Soil C and N were not related to yard maintenance practices or soil texture. The low soil C sequestration rate and limited relationships between soil C and home age, yard maintenance, soil N and soil texture may have resulted from the positive influence of Auburn’s humid, subtropical climate on residue decomposition.     

A Bayesian method for safety signal detection in ongoing blinded randomised controlled trials

Sponsors have a responsibility to minimise risk to participants in clinical studies through safety monitoring. The FDA Final Rule for IND Safety Reporting requires routine aggregate safety evaluation, including in ongoing blinded studies. We are interested in estimating the probability that the true adverse event rate in the experimental arm exceeds that in the control arm. We developed a Bayesian approach that specifies an informative meta-analytic predictive prior on the event probability in the control arm and an uninformative prior on that in the experimental arm. We combined these priors with a mixture likelihood that considers each patient in the ongoing blinded study may belong to the experimental or control arm. This allowed us to estimate the quantity of interest without unblinding. We evaluated our method by simulation, pairing scenarios that differed only in whether a safety signal was present or missing, and quantifying the ability of our model to discriminate using signal detection theory. Our approach shows benefit. It detects safety signals more reliably with greater sample sizes and for common rather than rare events. Performance does not deteriorate markedly when historical studies exhibit heterogeneous hazards or non-constant hazards. Our method will allow us to monitor safety signals in ongoing blinded studies with the goal of earlier identification and risk mitigation. Our method could be adapted to use informative priors on both arms or predictive covariates where pertinent data exist. We stress that ongoing safety monitoring should involve a multi-disciplinary team where statistical methods are paired with medical judgement.     

Networks,case managers,and the job-search experiences of unemployed people

Employment services are commonly provided in network settings, but it is rare to find social policy analyses of how unemployed people search for jobs through networks. In a germinal analysis of social networks and employment, Mark Granovetter argued that “weak ties” (less familiar contacts) are more important to finding employment than are “strong ties” (family and friends). This is because weak ties provide more novel job-relevant information. Scholarship since Granovetter has predominantly supported the opposite argument, namely, that strong ties are more important for the unemployed, because they are more plentiful and thus provide more information in aggregate. Findings are also generally coloured by the focus being on “informal” networks or personal contacts. “Formal” networks, as represented most cogently by employment service providers, are absent or underestimated in most social network studies. On the basis of a qualitative study of 80 long-term unemployed people in Australia, incorporating analysis of both informal and formal networks, we argue that although “strong informal” ties are vital to job search, it is also important to consider “weak formal” ties, which can be complementary if and where service organizations are able to supply positive case management experiences.     

Determinants of Migrant Career Success: A Study of Recent Skilled Migrants in Australia

Australia has been aggressively pursuing skilled migrants to sustain its population and foster economic growth. However, many skilled migrants experience a downward career move upon migration to Australia. Based on a survey of recent skilled migrants, this study investigates how individual (age, years of settlement, qualifications), national/societal (citizenship and settlement), and organization-level (climate of inclusion) factors influence their career success. Overall, we found that: (1) age at migration matters more than length of settlement in predicting skilled migrant career success; (2) citizenship uptake and living in a neighbourhood with a greater number of families from the same country of origin facilitate post-migration career success; and (3) perceptions of one's social/informal networks in the workplace – a dimension of perceived organizational climate of inclusion – also have a positive impact on migrant career outcomes.     

Estimation of relative risk for events on a linear network

Motivated by the study of traffic accidents on a road network, we discuss the estimation of the relative risk, the ratio of rates of occurrence of different types of events occurring on a network of lines. Methods developed for two-dimensional spatial point patterns can be adapted to a linear network, but their requirements and performance are very different on a network. Computation is slow and we introduce new techniques to accelerate it. Intensities (occurrence rates) are estimated by kernel smoothing using the heat kernel on the network. The main methodological problem is bandwidth selection. Binary regression methods, such as likelihood cross-validation and least squares cross-validation, perform tolerably well in our simulation experiments, but the Kelsall–Diggle density-ratio cross-validation method does not. We find a theoretical explanation, and propose a modification of the Kelsall–Diggle method which has better performance. The methods are applied to traffic accidents in a regional city, and to protrusions on the dendritic tree of a neuron.