Workplace Violence: An Urgent Call for Integrated Staff Education in Acute Care Hospitals

Problem: Type II workplace violence (WPV) in acute care hospital settings has become an epidemic of costly proportions in the United States. Regulatory mandates and healthcare accreditation standards increasingly require healthcare employers to provide a safe and healthy healing environment for patients and a safe work environment for staff. Implementation of a comprehensive WPV prevention program depends largely on organizational culture, participation and commitment from key stakeholders, and readiness for change. Context: The patient-clinician relationship has drawn urgent attention, as healthcare organizations around the world implement key components of WPV prevention programs. The clinical management of patient aggression in non-emergency department and non-behavioral health settings (e.g., medical-surgical, telemetry, and step-down acute care units) has presented a unique knowledge gap for healthcare staff not traditionally trained to provide care for patients who present with aggression and/or behavioral crises. Interventions: The project interventions focused on quantitative and qualitative evidence to develop, implement, and evaluate an integrated WPV prevention staff education course, to improve staff knowledge about WPV prevention and improve staff attitudes about managing care for aggressive patients. The course integrated organizational policies and protocols for violence risk assessment and behavioral emergency response codes. Outcome Measures: Outcomes were measured by pre- and post-intervention surveys, data analyses, staff education evaluation forms, and anecdotal findings from participant feedback. The outcomes measured showed an improvement in staff knowledge(29.4%, n = 8) and attitudes (14.7%, n = 8) after the WPV prevention education course. The project was successfully implemented in a major healthcare care system in San Diego, California, and provided valuable guidance in the development of integrated frontline nursing education as part of a comprehensive WPV prevention program. Keywords: violence, workplace violence, workplace violence prevention program, crisis intervention, behavioral distress, nursing, psychiatric nursing, nursing leadership, mental health, behavioral health, healthcar

La reforma agraria chilena. Reformismo, socialismo y neoliberalismo, 1964-1980.

El artículo es un análisis empírico de la reforma agraria chilena (1964-1973) y la contrarreforma parcial durante la dictadura militar (1974-1980). Su objetivo es explicar e interpretar su lógica y los cambios que ocasionó en el régimen de propiedad agraria. La reforma agraria expropió los grandes predios del sistema de haciendas. A continuación, bajo la dictadura militar, 1974-1980, la consolidación capitalista reasignó estas propiedades, devolviendo algunas a sus antiguos dueños pero destinando la mayoría a otras manos. La distribución de la tierra agrícola expropiada fomentó la formación de una burguesía agro-industrial, pequeños agricultores comerciales, un mercado de tierra libre y un dinámico sector agrícola.This article offers an empirical analysis of the Chilean agrarian reform (1964‐1973) and subsequent ‘partial’ counter‐reform during the military dictatorship (1974‐1980). Our aim is to explain and interpret their logic and the changes they brought to Chile’s agricultural property regime. Chile’s agrarian reform expropriated the haciendas or great estates of the landed property system. Then, under the military dictatorship of 1974‐1980, the ‘partial’ capitalist counter‐reform reallocated it, returning some land to prior owners but handing over most to new owners. Redistribution of the previously expropriated agricultural land made possible the genesis of an agro‐industrial bourgeoisie, small commercial farming, an open market for land and a dynamic agricultural sector

Mechanical qualification of collagen membranes used in dentistry

The aim of this work is the qualification of commercially available collagen membranes in a comparative manner. The natural origin of collagen makes standardization difficult. Nevertheless, through dimensional and mechanical measures it is possible to mechanically qualify collagen membranes, and compare them.METHODS:Three commercially available collagen membranes used in Guided Bone Regeneration (GBR) and in Guided Tissue Regeneration (GTR) techniques, namely Bio-Gide, Collprotect and Jason, were chosen for the comparison. Quasi-static (tensile tests) and time-dependent (stress relaxation test) mechanical tests together with a functional test (tear test) were done to determine the responses of collagen membranes under different loading conditions. RESULTS: The tested membranes exhibited different behaviours, different deformability values and thickness, Jason being the thinnest and Bio-Gide the thickest. Similar differences were also observed in terms of surface density. DISCUSSION: Even though clinical observations were not within the aim of this study, our findings indicate that a better understanding of the correlation between mechanical properties and thickness could lead to a more rational design and use of these membranes in the face of specific clinical cases

Performance management practices in lean manufacturing organizations: A systematic review of research evidence

This paper provides the first systematic look into the existing research on performance management (PM) practices employed in lean manufacturing organisations (LMOs). It adopts a systematic review method to examine the evidence generated in the period 2004 – 2015 and uses a comprehensive PM framework to synthesise the findings. The results suggest that PM practices that have the most prominent role in LMOs are those that, firstly, are located closest to front-line actions and, secondly, explicitly address operational realities. This calls into question the primacy of accounting-driven controls in LMOs, suggesting that operational controls may be more effective than top-down accounting-based PM practices. The results also confirm the bias towards operational-level issues but suggest that LMOs may integrate the operational and the strategic levels by using PM practices that drive organisational learning through employee involvement and engagement

Administration of the antioxidant n-acetyl-cysteine in pregnant mice has long-term positive effects on metabolic and behavioral endpoints of male and female offspring prenatally exposed to a high-fat diet

A growing body of evidence suggests the consumption of high-fat diet (HFD) during pregnancy to model maternal obesity and the associated increase in oxidative stress (OS), might act as powerful prenatal stressors, leading to adult stress-related metabolic or behavioral disorders. We hypothesized that administration of antioxidants throughout gestation might counteract the negative effects of prenatal exposure to metabolic challenges (maternal HFD feeding during pregnancy) on the developing fetus. In this study, female C57BL/6J mice were fed HFD for 13 weeks (from 5-weeks of age until delivery) and were exposed to the N-acetyl-cysteine (NAC) antioxidant from 10-weeks of age until right before delivery. Body weight of the offspring was assessed following birth, up to weaning and at adulthood. The metabolic, neuroendocrine and emotional profile of the adult offspring was tested at 3-months of age. Prenatal HFD increased mother’s body weight and offspring’s weight at the time of weaning, when administered in conjunction with NAC. In females, NAC administration reduced high levels of leptin resulting from prenatal HFD. Prenatal NAC administration also resulted in greater glucose tolerance and insulin sensitivity while increasing adiponectin levels, as well as increasing exploratory behavior, an effect accompanied by reduced plasma corticosterone levels in response to restraint stress. Analysis of glutathione levels in the hypothalamus and in brown adipose tissue indicates that, while HFD administration to pregnant dams led to reduced levels of glutathione in the offspring, as in the male hypothalamus, NAC was able to revert this effect and to increase glutathione levels both in the periphery (Brown Adipose Tissue, both males and females) and in the central nervous system (males). Overall, results from this study indicate that the body redox milieu should be tightly regulated during fetal life and that buffering OS during pregnancy can have important long-term consequences on metabolic and behavioral endpoints

Macroinvertebrates assembly in a patchy environment: centrality measures for the spatial network of detritus-based communities

Spatial patterns influence the persistence of populations and communities, giving useful insights on the mechanisms that confer robustness to ecological networks. The mechanisms that regulate the spatial distribution of species are related to the ability of populations to respond to spatio-temporal variations of ecological conditions, contributing to network structure and dynamic of persisting communities. We applied the framework of complex network to study the colonization process of Phragmites australis leaf detritus in six different pools in the patchy aquatic environment of Tarquinia saltern (central Italy). We used the colonization data of macroinvertebrates on leaf detritus assigning a link between two taxa if they shared a common pool, and measured their positional importance within the network. We found high clustering and short path lenght among nodes that is representative of small-world pattern, showing the relationship between robustness and nodes synchronicity in network attachment dynamics. Here we show how the identification of local (individual use of substrates by macroinvertebrates) and global (network properties) patterns in community structure could be the key to better understand the ecology, evolution and management of complex ecological network

Land Tenure in Latin America: from Land Reforms to Counter-Movement to Neoliberalism

Latin America, with a Gini coefficient for land of 0.79, is the world's most unequal region in terms of land distribution. Land inequality is one of the greatest impediments to Latin American societies for achieving sustainable development and economic growth. Many studies have demonstrated how an unequal land concentration affects the quality of democracy and social cohesion and inhibits economic growth. Land is the main and in many cases the only asset for millions of rural households in the region and Land tenure can mean the difference between subsistence and extreme poverty. The present work reviews the agrarian reform processes that were experienced in part of Latin America and examines the impacts of the subsequent neoliberal reforms on land tenure, land and capital concentration. Finally it focuses on the need of a new distribution of land in order to achieve higher levels of Socio-Economic equality an also meet the Sustainable Development Goals in the region.O