Storytelling; safeguarding; treatment; and responsibility; attributes of recovery in psychiatric intensive care units

Background and aim In recent years policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery understood by nurses at the frontline of services for people experiencing acute psychiatric distress. Method Data gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings. Results Four defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings. Conclusion The four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

Building resilient communities : creating effective multi-channel communication during disaster response and recovery

Aim: To examine evidence-based strategies that motivate appropriate action and increase informed decision-making during the response and recovery phases of disasters.

Enhancing sense of recovery and self-reflectivity in people with schizophrenia : a pilot study of Metacognitive Narrative Psychotherapy

Objective This study investigated the effectiveness of an innovative, manualized psychotherapy aimed at enhancing recovery and self-experience in people with schizophrenia, Metacognitive Narrative Psychotherapy. Design Treatment effects were assessed using a mixed methodology. Data were quantitatively assessed using a single sample, pre- and post-therapy design and qualitatively assessed using a case-study methodology. Methods Eleven patients diagnosed with schizophrenia received Metacognitive Narrative Psychotherapy over the course of 11 to 26 months. Therapists were seven supervised postgraduate psychology students. On average patients attended 49 sessions over the course of therapy. Patients completed interview-based and self-report measures for general and treatment-specific outcomes at pre-, mid-, and post-treatment. Results Quantitative analyses showed that patients significantly improved on the general outcome of subjective recovery, as well as the treatment-specific outcome of self-reflectivity, with medium to large effect sizes. Case-study evidence also showed improvements for some patients in symptom severity, and narrative coherence and complexity. Conclusions These results are consistent with previous case-study evidence and suggest that this manualized version of Metacognitive Narrative Psychotherapy produces general and approach-specific improvements for people with schizophrenia. Replication is needed to ascertain its effectiveness with a larger sample size and within a controlled design.

Can measures of limb loading and dynamic stability during the squat maneuver provide an index of early functional recovery following unilateral total hip arthroplasty?

Objective: To investigate limb loading and dynamic stability during squatting in the early functional recovery of total hip arthroplasty (THA) patients. Design: Cohort study Setting: Inpatient rehabilitation clinic. Participants: A random sample of 61 THA patients (34♂/27♀; 62±9 yrs, 77±14 kg, 174±9 cm) was assessed twice, 13.2±3.8 days (PRE) and 26.6±3.3 days post-surgery (POST), and compared with a healthy reference group (REF) (22♂/16♀; 47±12yrs; 78±20kg; 175±10cm). Interventions: THA patients received two weeks of standard in-patient rehabilitation. Main Outcome Measure(s): Inter-limb vertical force distribution and dynamic stability during the squat maneuver, as defined by the root mean square (RMS) of the center of pressure in antero-posterior and medio-lateral directions, of operated (OP) and non-operated (NON)limbs. Self-reported function was assessed via FFb-H-OA 2.0 questionnaire. Results: At PRE, unloading of the OP limb was 15.8% greater (P<.001, d=1.070) and antero-posterior and medio-lateral center of pressure RMS were 30-34% higher in THA than REF P<.05). Unloading was reduced by 12.8% towards a more equal distribution from PRE to POST (P<.001, d=0.874). Although medio-lateral stability improved between PRE and POST (OP: 14.8%, P=.024, d=0.397; NON: 13.1%, P=.015, d=0.321), antero-posterior stability was not significantly different. Self-reported physical function improved by 15.8% (P<.001, d=0.965). Conclusion(s): THA patients unload the OP limb and are dynamically more unstable during squatting in the early rehabilitation phase following total hip replacement than healthy adults. Although loading symmetry and medio-lateral stability improved to the level of healthy adults with rehabilitation, antero-posterior stability remained impaired. Measures of dynamic stability and load symmetry during squatting provide quantitative information that can be used to clinically monitor early functional recovery from THA.

Design and test of a custom instrumented leg press for injury and recovery intervention

There is an increasing desire and emphasis to integrate assessment tools into the everyday training environment of athletes. These tools are intended to fine-tune athlete development, enhance performance and aid in the development of individualised programmes for athletes. The areas of workload monitoring, skill development and injury assessment are expected to benefit from such tools. This paper describes the development of an instrumented leg press and its application to testing leg dominance with a cohort of athletes. The developed instrumented leg press is a 45° reclining sled-type leg press with dual force plates, a displacement sensor and a CCD camera. A custom software client was developed using C#. The software client enabled near-real-time display of forces beneath each limb together with displacement of the quad track roller system and video feedback of the exercise. In recording mode, the collection of athlete particulars is prompted at the start of the exercise, and pre-set thresholds are used subsequently to separate the data into epochs from each exercise repetition. The leg press was evaluated in a controlled study of a cohort of physically active adults who performed a series of leg press exercises. The leg press exercises were undertaken at a set cadence with nominal applied loads of 50%, 100% and 150% of body weight without feedback. A significant asymmetry in loading of the limbs was observed in healthy adults during both the eccentric and concentric phases of the leg press exercise (P < .05). Mean forces were significantly higher beneath the non-dominant limb (4–10%) and during the concentric phase of the muscle action (5%). Given that symmetrical loading is often emphasized during strength training and remains a common goal in sports rehabilitation, these findings highlight the clinical potential for this instrumented leg press system to monitor symmetry in lower-limb loading during progressive strength training and sports rehabilitation protocols.

Supervisor conflict management, justice and strain : multi-level relationships

Purpose The purpose of this paper is to test a multilevel model of the main and mediating effects of supervisor conflict management style (SCMS) climate and procedural justice (PJ) climate on employee strain. It is hypothesized that workgroup-level climate induced by SCMS can fall into four types: collaborative climate, yielding climate, forcing climate, or avoiding climate; that these group-level perceptions will have differential effects on employee strain, and will be mediated by PJ climate. Design/methodology/approach Multilevel SEM was used to analyze data from 420 employees nested in 61 workgroups. Findings Workgroups that perceived high supervisor collaborating climate reported lower sleep disturbance, job dissatisfaction, and action-taking cognitions. Workgroups that perceived high supervisor yielding climate and high supervisor forcing climate reported higher anxiety/depression, sleep disturbance, job dissatisfaction, and action-taking cognitions. Results supported a PJ climate mediation model when supervisors’ behavior was reported to be collaborative and yielding. Research limitations/implications The cross-sectional research design places limitations on conclusions about causality; thus, longitudinal studies are recommended. Practical implications Supervisor behavior in response to conflict may have far-reaching effects beyond those who are a party to the conflict. The more visible use of supervisor collaborative CMS may be beneficial. Social implications The economic costs associated with workplace conflict may be reduced through the application of these findings. Originality/value By applying multilevel theory and analysis, we extend workplace conflict theory.

Social Justice Impacts of the Resources Boom

Until the 1970s mining leases were issued by state governments subject to conditions that companies build or substantially finance local community infrastructure, including housing, streets, transport, schools, hospitals and recreation facilities. Townships and communities went hand in hand with mining development. However, in the past thirty years mining companies have moved progressively to an expeditionary strategy for natural resources extraction - operating a continuous production cycle of 12 hour shifts - increasingly reliant on non-resident, fly-in, fly-out or drive-in, drive-out (FIFO/DIDO) workers who typically work block rosters, reside in work camps adjacent to existing communities and travel large distances from their homes. This paper presents the key findings of our survey into the social impacts of this kind of mining development in Qld. Based on the results we argue that the social license to develop new mining projects is strong for projects requiring a 25% or less non-resident workforce, diminishes significantly thereafter and is very weak for projects planning to recruit a non-resident workforce in excess of 75%. This finding is significant because there are at least 67 new mining projects undergoing social impact assessment in Queensland, and many it appears are planning to hire significant proportions of non-resident workers. The paper considers the policy implications of this growing social justice issue concluding there is a clear need for national leadership in formulating a national policy framework for guiding socially responsible and sustainable mining development into the next millennium.

Just what the doctor ordered? Investigating the impact of health service quality on consumer misbehaviour

The growth in demand and expenditure currently being experienced in the Australian health sector is also accompanied by a rise in dysfunctional customer behaviour, such as verbal abuse and physical violence, perpetrated against health service providers. While service failure and poor recovery are known to trigger consumer misbehaviour, this study investigates whether lower than expected perceived service quality generates cognitive and emotional appraisals that trigger two common forms of misbehaviour: refusal to participate and verbal abuse. Data were collected using a 2 × 2 between-subjects experiment administered via online written survey and analysed using path modelling. The findings indicate that perceptions of service encounter quality have an indirect effect on whether consumers refuse to participate in the service and/or verbally abuse the service provider through the mediating effect of anger.

Suicide, statistics and the coroner: A comparative study of death investigations

Australia has a significantly higher suicide rate than England. Rather than accepting that this ‘statistical fact’ is a direct reflection of some positivist truth, this paper begins with the premise that how suicide is counted depends upon what counts as suicide. This study involves semi-structured interviews with coroners both in Australia and England, as well as observations at inquests. Important differences between the two coronial systems include: first, quite different logics of operation; second, the burden of proof for reaching a finding of suicide is significantly higher in England; and third, the presence of family members at English inquests results in far greater pressure being brought to bear upon coroners. These combined factors result in a reduced likelihood of English coroners reaching a finding of suicide. The conclusions are twofold. First, this research supports existing criticisms of comparative suicide statistics. Second, this research adds theoretical weight to criticisms of positivist analyses of social phenomena.

Modes of criminal justice, indigenous youth and social democracy

The political question of how the will of a community is to be democratically formed and adhered to, the question of social democracy, is normatively tied to the mode of criminal justice employed within that democratic public sphere. Liberal, republican, procedural and communitarian forms of democratic will-formation respectively reflect retributive,restorative, procedural and co-operative modes of criminal justice. After first elaborating these links through the critical response of republican and procedural theories of democracy to the liberal practice of democratic will-formation and its retributive mode of justice, our discussion considers the recent practice of restorative and procedural justice with respect to Indigenous youth; and this in the context of a severely diminished role for Indigenous justice agencies in the public sphere. In light of certain shortcomings in both the restorative and procedural modes of justice, and so too with republican and procedural understandings of the democratic public sphere, we turn to a discussion of procedural communitarianism, anchored as it is in Dewey’s notion of social co-operation. From here we attempt a brief formulation of what a socially co-operative mode of justice might consist of; a mode of justice where historically racial and economically coercive injustices are sufficiently recognised.

Evaluation of Indigenous justice programs.: final report / Project D, Safe Aboriginal Youth Patrol Programs in New South Wales and Northbridge Policy and Juvenile Aid Group in Western Australia

The Australian Government has provided funding to evaluate the effectiveness of Indigenous law and justice programs across five subject areas to identify the best approaches to tackling crime and justice issues and better inform government funding decisions in the future. This report presents the findings of subject area "D", which examined two different approaches to delivering community and night patrol services for young people: the Safe Aboriginal Youth Patrol programs in New South Wales, and the Northbridge Policy project (the Young People in Northbridge project), in Western Australia. Night patrols can address crime either directly or indirectly, by prevention work or by addressing the social causes of crime through community development.

Peer leadership and capability building in law and justice

The aim of this project was to create a model mapping the scaffolding and development of: peer leadership opportunities and capacity; and graduate capabilities, work-related skills and outcomes, across the range of peer assisted learning programs offered in the Faculty of Law during 2013. In doing so, it conceptualised Law and Justice students’ roles and opportunities for peer leadership across the whole of their learning experience and aimed to raise awareness of the benefits to leaders of participating in peer programs (relevant to the development of their graduate capabilities and employability). Through the mapping, the project also sought to increase student understanding of the range of peer leader opportunities available across the Faculty and therefore promote participation in such programs.