Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

PURE: a proposal for more retirement income security

Despite large public policy efforts over the past 30 years, a large minority of households remains consistently inadequately prepared for retirement. If policymakers want to address this shortcoming, public policy has to change from its current path. This paper suggests a system of mandatory private pensions funded by a minimum mandatory contribution of 3% of payroll. In addition, a number of institutional changes are suggested to reduce the costs and risks of individual accounts.     

Fatigue and sleep quality in nurses

Fatigue is a critical issue for nurses that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor in fatigue that nurses experience. Therefore, the purpose of this study was to examine the differences in perceptions of fatigue between night-shift and day-shift nurses, as measured by scores on the Brief Fatigue Inventory (BFI) and to examine differences in sleep quality between the two groups, as measured by responses on the Pittsburgh Sleep Quality Index (PSQI). Univariate analysis of variance showed significant differences between the two groups on the BFI, with the night-shift cohort reporting higher mean scores on the BFI. Significant differences were also found between the two groups on PSQI mean scores, with the night-shift cohort reporting higher mean scores. Findings from this study suggest that night-shift nurses, compared with day-shift nurses, perceived a much higher level of fatigue and had poorer sleep quality. Further research is needed to evaluate interventions that might decrease fatigue in nurses and improve their sleep quality.     

Financial Issues Associated with Having a Child with Autism

Data from the Family Experiences with Autism Survey are used to identify factors associated with financial problems in families that have a child with autism. Likelihood of financial problems was positively associated with use of medical interventions, having unreimbursed medical or therapy expenses, and having relatively lower income. Use of speech and language therapy was negatively associated with likelihood of financial problems. Many survey respondents forfeited future financial security and even experienced bankruptcy to provide needed therapy for a child with autism. Specific ways that financial advisors can help families that have a child with autism are outlined.

Predatory online behavior: modus operandi of convicted sex offenders in identifying potential victims and contacting minors over the internet

Sex offenders have used the Internet to identify and contact minors for sexual exploitation (Armagh, 1998; Hernandez, 2000; Lamb, 1998; Lanning, 1998). Yet little is known about how these individuals select their online victims. In order to gain a better understanding of this behavior, the online activity of 31 men who perpetrated or attempted to perpetrate contact sex offenses against minors they communicated with via the Internet, was examined. Three-fourths of the participants monitored chat room dialogue and almost one-half reviewed online profiles of minors in an attempt to identify potential victims. Recommendations to increase the online safety of children and adolescents are discussed.     

Impact of the Olmstead decision five years later:a national perspective for social workers

The Olmstead Decision of 1999 continues to have the potential to radically transform the long-term care system in the United States. This article will review the components of the decision and steps being taken by the federal and state governments to address its challenges and mandates. A number of key areas where social workers can play important roles will be described.     

The Research Environment Norm Inventory (RENI): a study of integrity in research administrative systems

University research administrators have been generally ignored in basic studies of research integrity. Hensley noted that research administrators are "essential... to the achievement of the specific missions of postsecondary institutions... and to science and the academic infrastructure". The following study sought to extend the scope of research on research integrity to research administrative structures with a new instrument called the Research Environment Norm Inventory or RENI. University research administrators and their professional association were targeted for data collection. Evidence suggested that research administration in the United States supports integrity in the research environment through: (1) respect for community; (2) respect for institutional boundaries; (3) professionalism; (4) respect for authority structures; (5) sensitivity to system conflicts. The study suggested that integrity structures are dictated largely by the institutional settings and environments.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.