Scheduling Updates of Probabilistic Risk Assessments: The Arkansas Nuclear One-Unit 1 Experience

This paper presents the results of a study that identified how often a probabilistic risk assessment (PRA)should be updated to accommodate the changes that take place at nuclear power plants. Based on a 7-year analysis of design and procedural changes at one plant, we consider 5 years to be the maximum interval for updating PRAs. This conclusion is preliminary because it is based on the review of changes that occurred at a single plant, and it addresses only PRAs that involve a Level 1 analysis (i.e., a PRA including calculation of core damage frequency only). Nevertheless, this conclusion indicates that maintaining a useful PRA requires periodic updating efforts. However, the need for this periodic update stems only partly from the number of changes that can be expected to take place at nuclear power plants–changes that individually have only a moderate to minor impact on the PRA, but whose combined impact is substantial and necessitates a PRA update. Additionally, a comparison of two generations of PRAs performed about 5 years apart indicates that PRAs must be periodically updated to reflect the evolution of PRA methods. The most desirable updating interval depends on these two technical considerations as well as the cost of updating the PRA. (Cost considerations, however, were beyond the scope of this study.)     

Clinical supervision: Its role in “Containing” countertransference responses to a filicidal patient

This paper illustrates the role of supervision in processing countertransference responses with might have disrupted the therapist's empathy with a patient who had killed her child. The clinical material demonstrates how the therapist's responses of initial denial and subsequent disgust and fear were dealt with in supervision. As a result, the treatment process led to genuine, albeit limited, therapeutic change in a patient with severe character pathology.This paper is developed from a presentation of the case of Mrs. Jay at Department of Psychiatry Grand Rounds, University of Cincinnati College of Medicine, on May 2, 1989.     

Managing Risk as a Duality of Harm and Benefit: A Study of Organizational Risk Objects in the Global Insurance Industry

This study examines how organizations construct and manage risk objects as a duality of harm–benefit within their normal operations. It moves beyond the existing focus on accidents, disasters and crisis. We study the risk‐transfer processes of 35 insurers where they navigate the tension of retaining risk in their insurance portfolio to increase the benefit of making profit and transferring risk to reinsurance to reduce the harm of paying claims. We show that organizations’ constructions of risk are underpinned by everyday risk management practices of centralizing, calculating and diversifying. Through variation in these practices, not all organizations seek balance and we in turn uncover the sensemaking processes of abstracting and localizing that enable organizations to prioritize harm or benefit. This contributes to the risk literature by illuminating the co‐constitutive relationship between risk sensemaking processes and everyday risk management practices. Following the complex linkages involved in the construction of risk objects as sources of harm–benefit, our analysis also contributes to the literature on dualities. It shows that while immediate trade‐offs between harm–benefit occur, prioritizing one element of the duality is ultimately a means for attaining the other. Thus, while initial imbalance is evident, prioritization can be an enabling approach to navigating duality.     

Expanding the Role of Long-Term Care Social Workers: Assessment and Intervention Related to Urinary Incontinence

Urinary incontinence (UI) is a common and stigmatizing problem faced by long-term care (LTC) residents. It is typically addressed by medical professionals, with social work rarely involved. The purpose of this article is to illustrate how social workers can address the psychosocial implications of UI while working with residents and their family members as part of an interdisciplinary team. Using a case example and the NASW objectives for LTC, recommendations on how the role of the LTC social workers can be expanded to better address both the needs of residents, families, and the larger LTC system are provided.     

An Examination of How Supervisors Influence Their Subordinates to Engage in Environmental Behaviors

Employee engagement in environmental behaviors is an important topic in operations management. Drawing upon stakeholder, commitment, and organizational support theories, this study creates and tests an empirical model of how store managers (i.e., supervisors) influence their direct reports (i.e., subordinates) to become engaged in environmental behaviors. Based on a dataset derived from supervisors and their subordinates who are employed at the same grocery store location across a large retail grocery chain, we test our study's nomological model and find support for the linkages proposed. Key research and managerial implications are discussed.     

The Residential Mobility of Seniors Among Different Residential Forms: Analysis of Metropolitan and Rural Issues for Six Contrasted Regions in Québec,Canada

The purpose of this research is to describe and analyze the residential mobility of senior citizens, between 2006 and 2011, among different residential forms in rural and metropolitan areas in the province of Quebec (Canada). A systematic analysis of residential form variability in territories that include both metropolitan and rural areas is performed. First, a typology of residential forms is proposed using a principal component analysis and a hierarchical cluster analysis on environment-related and housing variables. Second, the residential mobility of seniors among these different residential forms is analyzed. The results reveal a certain amount of residential stability among seniors, except where specific conditions are met, such as the death of a spouse or the onset of health problems limiting day-to-day activities. For those who moved, high-rise habitat areas and mixed areas with older rental apartments held the greatest attraction. However, suburban areas attracted the largest number of seniors because these areas account for a sizeable portion of the real estate market.     

The incidence of metabolic risk factors in an inpatient psychiatric setting

Our study examines risk factors for metabolic syndrome on admission to an acute psychiatric facility and the incidence of medical referrals at discharge. Data on demographics, risk factors for metabolic syndrome, other health risk factors, medications, related diagnoses, and primary care providers and referrals were collected from 125 psychiatric patient charts. Comparison analysis was done for two groups: those with two or more risk factors for metabolic syndrome and those with less than two risk factors. Differences between groups were statistically significant for age, waist circumference, body mass index, high-density lipoprotein, triglycerides, and fasting glucose levels. Few patients were referred to their primary care provider for follow-up care. This study has clinical implications for improving assessment of psychiatric patients at risk for developing metabolic syndrome, for designing interventions to help patients adopt lifestyle changes to mitigate these risks, and for working toward fuller integration of psychiatric and primary care.