Cognitive model of patient aggression towards health care staff: The patient's perspective

Aggression towards health care staff has become the focus for research as well as for government intervention. Negative effects upon staff and organizations have been established, yet few detailed explanations are offered for this aggression, and none represents the patient's perspective. This paper presents a model from the patient's perspective that takes account of situational variables, while also focusing upon patient cognitions. It also considers physiological responses related to arousal that might underpin aggression in an anxiety-provoking situation. In a previous study the frequency with which aggression was preceded by some anxiety-provoking event and the extent to which assailants displayed diminished cognitive processing were established; these were incorporated into the model. Increased anxiety commonly experienced by patients can have a negative effect upon cognitive processing. Anxiety generates a hyper-vigilance for threatening stimuli, induces selective attentional bias for threat, and causes a narrowing of attention, thus reducing cues and information upon which to make accurate appraisals and attributions. With such impairments, patients may make negative rather than positive attributions regarding actions of staff, which are frequently anxiety provoking. Thus, patients perceive staff behaviour as threatening rather than benign, and in the absence of positive attributions it will invoke an aggressive response. What health care staff perceive as aggression may be seen by patients as a defence against perceived attack. Changes in policy that take this into account may reduce future aggressive incidents.     

Designing Agendas to Reflect Board Roles and Responsibilities: Results of a Study

Over a nine‐month period the board agendas of a community nonprofit organization were redesigned to reflect a particular board agenda tool titled “Strategic Activities, Resource Planning, and Operations.” Feedback from the board members and executive director indicate strong support for the framework in focusing the work of the board. The framework also has implications for how the executive director and board members prepare for meetings and how the shared leadership of the meetings is played out.     

Romanian Adoptees and Pre-adoptive Care: A Strengths Perspective

Ninety-one parents of 120 adopted Romanian children who were part of a longitudinal study were surveyed to determine perceptions of their relationships with their children, their adoption experiences, and the children’s strengths. The Behavioral and Emotional Rating Scale (BERS) was used and parents were easily able to rate their children’s emotional and behavioral strengths. Levels of parent–child relationship satisfaction were the most consistent predictors of child emotional and behavioral strength. The child’s age at the time of the survey was a significant predictor of strengths, indicating overall that younger children had more perceived strengths. Parents identified fewer strengths among children with longer histories of institutional care. The importance of a strong parent–child relationship and resilience after a history of early institutional care are discussed.     

A COMPARISON OF MIXED MODEL SPLINES FOR CURVE FITTING

Three types of polynomial mixed model splines have been proposed: smoothing splines, P‐splines and penalized splines using a truncated power function basis. The close connections between these models are demonstrated, showing that the default cubic form of the splines differs only in the penalty used. A general definition of the mixed model spline is given that includes general constraints and can be used to produce natural or periodic splines. The impact of different penalties is demonstrated by evaluation across a set of functions with specific features, and shows that the best penalty in terms of mean squared error of prediction depends on both the form of the underlying function and the signal:noise ratio.     

Communicating across the work/home border

This article is about how individuals enact their work and home environments to create balance, by communicating with family about work and with work associates about family. Three themes of this type of communication are identified from interviews and a focus group. Questionnaire data from a sample of 179 individuals who work and have family responsibilities are used to examine factors that influence the amount of communication and the effect of communication on work/family balance. Results show that communication with family about work and communication at work about family varies depending on the permeability of the work and home borders. Individuals who engage in these types of communication show greater work satisfaction, higher work functioning, higher satisfaction with home and family activities, and have more functional families. Este artículo se trata de cómo, por mediación de la comunicación con la familia sobre asuntos de trabajo y con colegas sobre asuntos familiares, se puede manejar el ambiente laboral y el ambiente del hogar para crear un equilibrio entre los dos. Se utilizaron entrevistas y un grupo de enfoque para identificar tres temas de este tipo de comunicación. Se emplean datos de una muestra de 179 individuos con responsabilidades laborales y familiares para examinar factores que influyen en la cantidad de comunicación y el efecto de comunicación en el equilibrio laboral/familiar. Los resultados indican que la comunicación con la familia sobre el trabajo, y la comunicación en el trabajo sobre la familia, varían según la permeabilidad de las fronteras entre el trabajo y el hogar. Los individuos que participan en estos tipos de comunicación demuestran niveles mas altos de satisfacción laboral, funcionamiento laboral, satisfacción con actividades familiares/hogareños y tienen familias mas funcionales.     

Therapist abandonment experience in work with families disrupted by protective intervention

The experience of abandonment is central and pervasive for therapists and other professionals involved in work with families disrupted by protective intervention. Abandonment experience is not unique to the protective service situation, nor is it the only important experience in work with disrupted families. However, a combination of factors operate in that situation to activate and emphasize the experience of abandonment in the therapist.This clinical discussion summarizes relevant theory, and identifies factors in the situation which contribute to therapist abandonment experience. It describes and illustrates therapist abandonment experiences in the course of work with a disrupted family, and discusses the impact of these experiences on therapeutic work.He is also in Private practice.     

The role of social and intellectual capital in achieving competitive advantage through enterprise resource planning (ERP) systems

Enterprise resource planning (ERP) software merges a firm's data, information flows and business processes into a single package. Vendors argue that ERP provides an extremely useful strategic resource to enhance competitiveness and make it possible for a firm to leverage its other resources more effectively and efficiently. In addition, they allege that ERP encourages a system-wide perspective that is a basis for collaboration and a systems orientation. However, an examination of ERP systems using criteria established in research on resource-based views of the firm and chaos/complexity theory indicates that these claims are overstated. Observation suggests that even if ERP is necessary to coordinate complicated, multifaceted operations, it is far from sufficient to promote a strong competitive position over the long term. Moreover, ERP systems fit best within mechanistic, clockwork organizations dominated by routine, highly programmed technologies and operations, yet it is the non-routine learning and change processes found in complex, self-organizing systems that enable firms to create distinctive competitive advantages from ERP outputs. ERP makes possible deep changes in relationships, culture, and behaviors that can be crucial sources of advantage in the knowledge economy, but the structures and cultures most able to achieve this level of change are a poor fit with ERP requirements. To reconcile this paradox, we propose a dual-core, loosely coupled organization that views ERP as an enabling technology to build and augment social and intellectual capital, rather than as an information technology (IT) solution for organizational inefficiencies. Propositions for using ERP as a foundation for social and intellectual capital formation are introduced. Implications for research and practice are discussed.