Simulation to enhance care of patients with psychiatric and behavioral issues: use in clinical settings

Nurses with a medical-surgical clinical focus often care for patients with psychiatric and behavioral issues in acute care hospitals. This article describes how hospital staff and nursing and theater department faculty joined forces to develop realistic simulated psychiatric scenarios for use by practicing nurses.     

Restrictiveness and guidance in support systems

Restrictiveness and guidance have been proposed as methods for improving the performance of users of support systems. In many companies computerized support systems are used in demand forecasting enabling interventions based on management judgment to be applied to statistical forecasts. However, the resulting forecasts are often ‘sub-optimal’ because many judgmental adjustments are made when they are not required. An experiment was used to investigate whether restrictiveness or guidance in a support system leads to more effective use of judgment. Users received statistical forecasts of the demand for products that were subject to promotions. In the restrictiveness mode small judgmental adjustments to these forecasts were prohibited (research indicates that these waste effort and may damage accuracy). In the guidance mode users were advised to make adjustments in promotion periods, but not to adjust in non-promotion periods. A control group of users were not subject to restrictions and received no guidance. The results showed that neither restrictiveness nor guidance led to improvements in accuracy. While restrictiveness reduced unnecessary adjustments, it deterred desirable adjustments and also encouraged over-large adjustments so that accuracy was damaged. Guidance encouraged more desirable system use, but was often ignored. Surprisingly, users indicated it was less acceptable than restrictiveness.     

Habitat selection by an arboreal lizard in an urban parkland: not just any tree will do

The nocturnal, arboreal Marbled Gecko, Christinus marmoratus, is a common reptile in urban areas in southern Australia. This study compared the demographics and the distribution of geckos occupying different tree species in a modified urban park, the Adelaide Parklands, with those of a population occurring in Ferguson Conservation Park, a nearby native vegetation remnant surrounded by suburbia. The geckos in the modified urban and native remnant parks demonstrated different demographic characteristics. These differences were explained by tree circumference and the amount and type of bark cover on the tree trunk. In the Parkland, geckos were limited by the availability of thick exfoliating bark, its clearly preferred microhabitat as demonstrated by a laboratory choice experiment. The preference for trees with larger circumference, more cover, and thick bark were probably linked to thermoregulation, predator avoidance, and food resources. This study supports the premise that to support populations of urban animals, tree species selection needs careful consideration with regard to its microhabitat capabilities as well as food provision and other resource supports it can provide.     

Causation Analysis of Risk Coupling of Gas Explosion Accident in Chinese Underground Coal Mines

The coal mine production industry is a complex sociotechnical system with interactive relationships among several risk factors. Currently, causation analysis of gas explosion accidents is mainly focused on the aspects of human error and equipment fault, while neglecting the interactive relationships among risk factors. A new method is proposed through risk coupling. First, the meaning of risk coupling of a gas explosion is defined, and types of risk coupling are classified. Next, the coupled relationship and coupled effects among risk factors are explored through combining the interpretative structural modeling (ISM) and the NK model. Twenty‐eight representative risk factors and 16 coupled types of risk factors are obtained through analysis of 332 gas explosion accidents in coal mines in China. Through the application of the combined ISM–NK model, an eight‐level hierarchical model of risk coupling of a gas explosion accident is established, and the coupled degrees of different types of risk coupling are assessed. The hierarchical model reveals that two of the 28 risk factors, such as state policies, laws, and regulations, are the root risk factors for gas explosions; nine of the 28 risk factors, such as flame from blasting, electric spark, and local gas accumulation, are direct causes of gas explosions; whereas 17 of the risk factors, such as three‐violation actions, ventilation system, and safety management, are indirect ones. A quantitative analysis of the NK model shows that the probability of gas explosion increases with the increasing number of risk factors. Compared with subjective risk factors, objective risk factors have a higher probability of causing gas explosion because of risk coupling.     

The Importance of Early Childhood Poverty

Most poor children achieve less, exhibit more problem behaviors and are less healthy than children reared in more affluent families. We look beyond correlations such as these to a recent set of studies that attempt to assess the causal impact of childhood poverty on adult well-being. We pay particular attention to the potentially harmful effects of poverty early in childhood on adult labor market success (as measured by earnings), but also show results for other outcomes, including out-of-wedlock childbearing, criminal arrests and health status. Evidence suggests that early poverty has substantial detrimental effects on adult earnings and work hours, but on neither general adult health nor such behavioral outcomes as out-of-wedlock childbearing and arrests. We discuss implications for indicators tracking child well-being as well as policies designed to promote the well-being of children.     

Remarriage patterns among recent widows and widowers

Remarriage is one of the most important determinants of physical and economic well-being among the widowed. The goal of this study is to estimate how hazard rates for remarriage vary among widows and widowers on the basis of both observable and unobservable characteristics. The remarriage estimates rely on nationally representative samples of widows and widowers from the Panel Study of Income Dynamics. Continuous-time hazard rate regressions indicate strong age and duration dependence effects for middle-aged widows and widowers and for older widowers. Among middle-aged widows, blacks and those with dependent children in the home have lower rates of remarriage. For middle-aged widowers, living in urbanized areas limits the prospects of remarriage. For older widowers, education and, to some extent, economic status appear to have positive effects on the remarriage rates. Overall, age and time since widowhood have the strongest and most consistent effects on remarriage rates for different widowed groups.     

Estimates of Lifetime-Absorbed Daily Doses from the Use of Personal-Care Products Containing Polyacrylamide: A Monte Carlo Analysis

Estimates of the lifetime-absorbed daily dose (LADD) of acrylamide resulting from use of representative personal-care products containing polyacrylamides have been developed. All of the parameters that determine the amount of acrylamide absorbed by an individual vary from one individual to another. Moreover, for some parameters there is uncertainty as to which is the correct or representative value from a range of values. Consequently, the parameters used in the estimation of the LADD of acrylamide from usage of a particular product type (e.g., deodorant, makeup, etc.) were represented by distributions evaluated using Monte Carlo analyses.((1-4)) From these data, distributions of values for key parameters, such as the amount of acrylamide in polyacrylamide, absorption fraction, etc., were defined and used to provide a distribution of LADDs for each personal-care product. The estimated total acrylamide LADD (across all products) for males and females at the median, mean, and 95th percentile of the distribution of individual LADD values were 4.7 x 10(-8), 2.3 x 10(-7), and 7.3 x 10(-7) mg/kg/day for females and 3.6 x 10(-8), 1.7 x 10(-7), and 5.4 x 10(-7) mg/kg/day for males. The ratio of the LADDs to risk-specific dose corresponding to a target risk level of 1 x 10(-5), the acceptable risk level for this investigation, derived using approaches typically used by the FDA, the USEPA, and proposed for use by the European Union (EU) were also calculated. All ratios were well below 1, indicating that all the extra lifetime cancer risk from the use of polyacrylamide-containing personal-care products, in the manner assumed in this assessment, are well below acceptable levels. Even if it were assumed that an individual used all of the products together, the estimated LADD would still provide a dose that was well below the acceptable risk levels.     

The Deployment of Partnerships by the Voluntary Sector to Address Service Needs in Rural and Small Town Canada

Service restructuring trends since the 1980s have resulted in the downsizing or closure of many services in rural and small town Canada. In response, voluntary groups have been filling some of the emerging service gaps. Services, however, often are directed at complex problems that demand information, support, or assistance from a range of sources and institutions. For voluntary groups, this underscores a need to partner with other groups, organizations, or service providers. At the same time, voluntary organizations are increasingly encouraged to develop partnerships with public or private partners in order to qualify for government funding. This study tracks 29 voluntary organizations in four rural and small town places across Canada to explore the development and maintenance of partnerships (both local and non-local), as well as the types of networks, resources, and expertise for which partnerships were used. The findings indicate that while voluntary organizations feel that local partnerships are more important, partnerships with groups outside of these places are equally developed. Partnerships were used to expand networks, obtain expertise, and access a range of resources to assist in daily operations and delivery of services. The increase in partnerships with groups outside of these communities, particularly with non-local service providers, will have important implications for voluntary organizations and policy makers.

Psychosocial Correlates of Methamphetamine Use

Methamphetamine (MA) abuse is a devastating problem that has been sweeping the United States from west to east and has reached epidemic proportion in many areas. Literature on the drug itself, its history, and its effects are reviewed. The current project aimed to examine the psychosocial correlates of MA use using Hudson's Multi-Problem Screening Inventory (MPSI). The MPSI was given to a control group consisting of undergraduate social work students (n = 17) and a group of past-year MA users (n = 15). Differences between users and non-users were examined across the 27 domains of the MPSI, and subscales for which MA users exceeded the clinical cutting score were noted. In addition, the correlation between severity of craving for MA and MPSI scores was examined. MA users differed significantly from non-users on the depression, partner, child and neighbor problems, aggression, fearfulness, ideas of reference, phobias, guilt, disturbed thinking, memory loss, and drug abuse subscales. MA users exceeded clinical cutting scores on all of these scales except child problems; fearfulness; ideas of reference; self-esteem; sexual discord; personal stress; friend, school and coworker problems; and confused thinking. Severity of craving was correlated with MPSI score on all MPSI scales except self-esteem; sexual discord; mother, father, friend, coworker, school and family problems; suicide; non-physical abuse; and alcohol abuse. Interesting findings regarding the control group are also discussed.