PRN medication use in inpatient psychiatry

1. Administration of p.r.n. medications occurs frequently for staff nurses in inpatient psychiatry. 2. The appropriate use of p.r.n. medications is not well addressed in nursing textbooks or hospital policies and procedures. 3. Thorough assessment of patients is an essential step in the safe administration of p.r.n. medications. 4. Concise, accurate clinical evaluations may be the most successful way to determine the best dose of medication for each patient.     

The balancing act. Collaboration between frontline forensic staff and hospital administration

1. Flexibility, creativity, and consistency are critical characteristics for both frontline staff and administrators in the delivery of treatment and care for complex forensic patients who may be difficult to manage. 2. Through collaborative efforts and ongoing communication, plans can be identified and implemented that enhance patient and staff safety and facilitate positive behavioral and rehabilitation outcomes for patients. 3. Effective partnerships among frontline staff, administration, patients, their families, labor unions, and communities contribute significantly to the effective resolution of conflicts and dilemmas in the provision of holistic care to forensic patients.     

Features of occupational rehabilitation systems in Australia: a map through the maze

This review contributes to the limited literature on systems of occupational rehabilitation in Australia. Occupational rehabilitation is defined and features of occupational rehabilitation systems within the workers' compensation framework are described. Common features include: (a) the trend to workplace management, (b) preferred rehabilitation program settings and (c) widespread acceptance of some identified principles of occupational rehabilitation. Other features such as roles of stakeholders and participants, relationship of rehabilitation providers and employers, and the services provided have a number of variations in the Australian systems. Similarities and differences between features of Australian and North American systems are noted. Implications for occupational rehabilitation providers are discussed, and recommendations for practice and future research are made.     

Experience of cumulative trauma disorders on life roles of worker and family member: a case study of a married couple

The prevalence of diagnosed cumulative trauma disorders (CTD) within the workforce comes at a high price for employers burdened with financial losses from missed work and worker's compensation costs. Research has focused primarily on the impact of CTD on the worker role within the workplace, overlooking the impact on roles across multiple environments [24,35,54]. Furthermore, the influence of CTD on life roles of a spouse has not been examined. This single case study illustrated the experience of CTD within a marital relationship through the use of grounded theory. Results indicated that adaptations to CTD symptoms were least altering to the established routines and roles of the couple. With progression of symptoms, the spouse without symptoms was relied on more heavily for adaptations to manage pain. The results of this study indicate that occupational therapists must examine the client's valued roles and incorporate the family into intervention strategies.     

An analysis of VDT monitor placement and daily hours of use for female bifocal users

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are correlated with hours of VDT work and that there appears to be a threshold at approximately five hours for pain symptoms among bifocal wearers. No such correlation can be made for monitor placement     

Women and class structure in contemporary Japan

The main purpose of this study is to examine how to determine the class position of women, especially married women, in Japan. This study examines three different approaches to conceptualizing women's position in the class structure: the conventional approach, the individual approach, and the dominance approach. Since 1975, the overall rate of female labour force participation in Japan has increased, and given this growth, particularly of employees working outside home, I discuss whether the increased entry of women, particularly married women, into the labour market challenges the conventional way of assigning class positions to women by simply deriving them from their husband's class positions. The data set used in this study is derived from the 1995 Japanese Social Stratification and Mobility Survey. An examination of class distributions suggests that the pictures of macro-class structure provided by the conventional approach and the dominance approach show very little difference. Married women who belong to the female-dominant family still form a very small minority of all married women in the society. Furthermore, the male-dominant family shows the greatest stability over the life course whereas the female-dominant family, where the wife experiences withdrawal from the labour market, is least stable. The increasing number of married women in the labour market, thus, has not yet become a major threat to the conventional way of assigning women to a class position in contemporary Japan. Women, even among those working on a full-time basis, perceive their position in the stratification system using not only their own work, but also their husband's. In contrast, men's perception is determined by their own education and employment, not by their wives'. This asymmetry in the effect of the husband's class and of the wife's class on class identification is related not only to gender inequality within the labour market but also to the division of labour by gender within the household.     

Pension prospects of minority ethnic groups: inequalities by gender and ethnicity

Minority ethnic groups have low income in later life from private pensions, partly due to shorter employment records in Britain since migration. Yet disadvantage and discrimination in the labour market, as well as differences in cultural norms concerning women's employment, may lead to persistence of ethnic variation in private pension acquisition. Little is known about the pension arrangements made by men and women in minority ethnic groups during the working life. This paper examines the extent of ethnic disadvantage in private pension scheme arrangements and analyses variation according to gender and specific ethnic group, using three years of the British Family Resources Survey, which provides information on over 97,000 adults aged 20-59, including over 5,700 from ethnic minorities. Both men and women in minority ethnic groups were less likely to have private pension coverage than their white counterparts but the extent of the difference was most marked for Pakistanis and Bangladeshis. Ethnicity interacted with gender, so that Blacks showed the least gender inequality in private pension arrangements, reflecting the relatively similar full-time employment rates of Black men and women. A minority ethnic disadvantage in private pension coverage, for both men and women, remained after taking account of age, marital and parental status, years of education, employment variables, class and income. The research suggests that minority ethnic groups - especially women - will be disproportionately dependent on means-tested benefits in later life, due to the combined effects of low private pension coverage and the policy of shifting pension provision towards the private sector.     

Internal family systems therapy for children in family therapy

This article presents a developmentally supported implementation of Internal Family Systems Therapy for school-age children and their families. Relevant developmental characteristics of children are described. Suggestions for working with parents, child-oriented interventions, and a case example are presented.     

Family therapy saves the planet: messianic tendencies in the family systems literature

It is not unusual occasionally to hear individual family therapists describe their work as an effort to "save the world." The messianic notion that family therapy should be the world's salvation is not simply a fancy of individual clinicians, but is deeply imbedded in several of our field's most fundamental theories. This article explores messianic arguments in the work of some of family therapy's most important thinkers, including von Bertalanffy, Bateson, and Keeney, and then discusses the implications that these arguments have for the clinical and theoretical development of our field.     

Juvenile male sexual offenders: the quality of motivation system of assessment and treatment issues

A group of juvenile male sexual offenders (n=100) completed the Quality of Motivation Questionnaire (QMQ) upon entry into a residential treatment facility. The concepts of Quality of Motivation (QM) Theory are presented to explain the QMQ scores. The scores include Disclosure Level, Sources of Motivation, Life Style Characteristics and Power. The results indicate abnormal motivation scores in the area of Disclosure Resistance, Depression, Primary and Learned Sources of Motivation, and all of the Maladaptive Skills Scores. Recommendations of treatment issues for therapists are prioritized according to QM Theory and presented in a treatment plan format called the Personal Development Plan (PDP). Implications for further research with the QMQ include outcome measurement of changes and comparison with non-offender groups.