The Four S Model in action for de-escalation. An innovative state hospital-university collaborative endeavor

In this article, the Four S Model is presented as a working clinical framework for generating structured nursing interventions and treatment plans. The de-escalation process, formalized by the De-escalation/Alternative to Restraint Flowsheet, is one way in which the model is being operationalized to reduce seclusion and restraints. As shown by the flowsheet, the model allows for integration of mental health and mental illness. It spans the scope of nursing practice at all levels, from para-professional to advanced practice nurse, by integrating the mental health concepts of communication, leadership, clinical judgement, critical thinking, and caring within its framework. Most important, the flexibility to individualize treatment that is built into the model allows for generalization to all psychiatric presentations.     

Working children: the health and safety issue

Recent evidence has emerged that in Britain, like the US, many children below the official minimum school leaving age, are working. In many cases, the work is illegal. Research in the US suggests that many working children risk accidents and other hazards to health. Evidence from Britain on the health and safety aspects of child labour is of a more fragmentary nature, but enough exists to suggest a need for greater vigilance.     

Statistical modeling for Bayesian extrapolation of adult clinical trial information in pediatric drug evaluation

Children represent a large underserved population of “therapeutic orphans,” as an estimated 80% of children are treated off‐label. However, pediatric drug development often faces substantial challenges, including economic, logistical, technical, and ethical barriers, among others. Among many efforts trying to remove these barriers, increased recent attention has been paid to extrapolation; that is, the leveraging of available data from adults or older age groups to draw conclusions for the pediatric population. The Bayesian statistical paradigm is natural in this setting, as it permits the combining (or “borrowing”) of information across disparate sources, such as the adult and pediatric data. In this paper, authored by the pediatric subteam of the Drug Information Association Bayesian Scientific Working Group and Adaptive Design Working Group, we develop, illustrate, and provide suggestions on Bayesian statistical methods that could be used to design improved pediatric development programs that use all available information in the most efficient manner. A variety of relevant Bayesian approaches are described, several of which are illustrated through 2 case studies: extrapolating adult efficacy data to expand the labeling for Remicade to include pediatric ulcerative colitis and extrapolating adult exposure‐response information for antiepileptic drugs to pediatrics.     

The perception of occupational stress and its relation to research and teaching among academic staff

Abstract

A sample of full-time teaching staff from a former polytechnic participated in a study to examine the relationships between their perception of occupational stress and their involvement in research. Information was obtained from 60% of staff approached. The mean scores on the Occupational Stress Indicator (OSI) for job satisfaction and stress-related measures of mental health and physical health did not differ significantly from data obtained in previous studies on university academic personnel. Scores on these variables were not significantly related to research activity. The degree of satisfaction and degree of stress emanating from participation in research, in teaching and in administration were separately assessed in structured interviews.     

Friendships under strain: The work–personal life integration of middle managers

Middle managers in today's organisations have reported experiencing longer working hours and intensified work regimes. These increased pressures, in turn, have led to growing difficulty in addressing the integration of their work and personal lives. In an exploratory study of the daily workplace experiences of Australian middle managers and the impacts on their personal lives, one of the key themes to emerge was respondents’ concerns about the negative effects on their friendships. This paper discusses middle managers’ recognition of the value of friendships for their wellbeing, and the resultant anger and sadness reported at the strain on these relationships due to competing time demands. The significant role that friendships play in alleviating some of the stresses of work demands, while concurrently being impeded by these same demands, is an important issue for organisations to consider. These findings indicate the need for middle managers to truly have an ability to engage in activities – and friendships – which will aid them in their working lives. The study also indicates a need for further investigation into the development and maintenance of friendships for both middle managers and other groups of employees.     

Can social workers and police be partners when dealing with bikie-gang related domestic violence and sexual assault?

Welfare and criminal justice systems manifest different goals, cultures, values and working methods. In Australia, the welfare sector has a culture of empowerment and concern for victims’ rights, within which social workers focus on social justice and social change. In contrast, the criminal justice sector (police) is patriarchal and para-military in structure, focusing on enforcing and maintaining community order and safety. These differences can create tension when social workers and police need to work as partners in response to violence against women, in particular violence against women from bikie gangs. This article addresses the issue of partnerships between social workers and police when working with abused bikie-gang women. It presents the findings of recent research into social work practice with such women in South Australia, in conjunction with a brief exploration of the international literature on social work and police cultures, and partnerships. It concludes that whilst there is a great need for genuine collaboration and partnership between social workers and police in the complex context of domestic violence with links to organised crime, the cultures and mandates of these different professions make this difficult.     

Propensity to adopt innovative housing: Development of knowledge indexes

The process by which energy efficient housing alternatives is diffused through society in relation to the information flow is relatively unknown. The major purpose of this study was to validate a continuum of the propensity to adopt alternative housing (passive and active solar, earth sheltered and retrofitted) based on knowledge level. Findings indicate knowledge indices are valid predictors of consumer acceptance of energy efficient housing alternatives. A greater level of knowledge was correlated with respondents willing to adopt an alternative housing type.     

Identity Development in a Transracial Environment: Racial/Ethnic Minority Adoptees in Minnesota

It has been argued that transracially adopted children have increased risk of problems related to self-esteem and ethnic identity development. We evaluated this hypothesis across four groups of transracial adoptees: Asian (n = 427), Latino (n = 28), Black (n = 6), mixed/other (n = 20), and same-race White adoptees (n = 126) from 357 adoptive families. No mean differences were found in adoptees’ ratings of affect about adoption or of curiosity about birth parents. Some differences were found in general identity development and adjustment. There were notable differences in communication about race/ethnicity across groups and between parent and child report.