The Psychiatrist\u27s Dilemma: Protect the Public or Safeguard Individual Liberty?

Part I of this Article traces the development and expansion of tort rules governing psychiatric liability and the mental health field. Part II briefly examines the concept of involuntary civil commitment, generally, and in Washington. Part III presents a factual overview and analysis of Petersen v. State, followed by a criticism of the court\u27s decision and legislative response

The Psychiatrist\u27s Dilemma: Protect the Public or Safeguard Individual Liberty?

Part I of this Article traces the development and expansion of tort rules governing psychiatric liability and the mental health field. Part II briefly examines the concept of involuntary civil commitment, generally, and in Washington. Part III presents a factual overview and analysis of Petersen v. State, followed by a criticism of the court\u27s decision and legislative response

Biotic Regulation of CO2 Uptake–Climate Responses: Links to Vegetation Properties

Identifying the plant traits and patterns of trait distribution in communities that are responsible for biotic regulation of CO2 uptake–climate responses remains a priority for modeling terrestrial C dynamics. We used remotely sensed estimates of gross primary productivity (GPP) from plots planted to different combinations of perennial grassland species in order to determine links between traits and GPP–climate relationships. Climatic variables explained about 50% of the variance in temporal trends in GPP despite large variation in CO2 uptake among seasons, years, and plots of differing composition. GPP was highly correlated with contemporary changes in net radiation (Rn) and precipitation deficit (potential evapotranspiration minus precipitation) but was negatively correlated with precipitation summed over 210 days prior to flux measurements. Plots differed in GPP–Rn and GPP–water (deficit, precipitation) relationships. Accounting for differences in GPP–climate relationships explained an additional 11% of variance in GPP. Plot differences in GPP–Rn and GPP–precipitation slopes were linked to differences in community-level light-use efficiency (GEE*). Plot differences in GPP–deficit slopes were linked to differences in a species abundance-weighted index of specific leaf area (SLA). GEE* and weighted SLA represent vegetation properties that may regulate how CO2 uptake responds to climatic variation in grasslands

Improving uptake of seasonal influenza vaccination by healthcare workers: Implementation differences between higher and lower uptake NHS trusts in England

Background Uptake of influenza vaccination by healthcare workers (HCWs) may be related to how influenza campaigns are implemented. This study explores differences in annual influenza campaign implementation between NHS trusts (healthcare organisations) with higher and lower vaccine uptake. Methods A cross-sectional survey with influenza campaign staff in 2016/2017 in 87 NHS trusts in England. The survey measured vaccination policy and uptake target, staff involvement, accessibility, use of peer vaccinators, communication strategies, strategies to address HCW concerns, use of incentives, and management support. The analysis considered implementation differences between higher (n Z 50) and lower (n Z 37) uptake trusts. Results and Conclusions Higher uptake trusts were more likely to set higher uptake targets, involve a broader range of staff groups in the campaign, and make the vaccine easy to access by core or hard-toreach HCWs. Higher uptake trusts were also more likely to use a greater range of communication strategies, provide real-time feedback on uptake, provide a greater range of incentives to be vaccinated, and have vaccine uptake considered important by managers. Successful influenza vaccination programmes are multifaceted and involve implementation factors at a strategic, organisational, logistical, and personnel level. Lower uptake trusts could improve uptake by identifying and implementing examples of best practice from higher uptake trusts

A qualitative study of perceived social barriers to care for eating disorders: Perspectives from ethnically diverse health care consumers

Objective: The study aim was to identify and describe health consumer perspectives on social barriers to care for eating disorders in an ethnically diverse sample. Method: We conducted an exploratory secondary analysis of qualitative data comprising transcripts from semi-structured interviews with past and prospective consumers of eating disorder treatment (n = 32). Transcripts were inputted into NVivo 8 for coding, sorting, and quantifying thematic content of interest within strata defined by ethnic minority and non-minority participants. We then examined the influence of key social barriers—including stigma and social stereotypes—on perceived impact on care. Results: The majority of respondents (78%) endorsed at least one social barrier to care for an eating or weight concern. Perceived stigma (or shame) and social stereotyping—identified both within social networks and among clinicians—had adversely impacted care for 59% and 19% of respondents, respectively. Discussion: Social barriers to care for eating and weight related concerns may be prevalent in the U.S. and impact both ethnic minority and non-minority health care consumers. © 2009 by Wiley Periodicals, Inc

Asking for work adjustments or initiating behavioral changes – what makes a “problematic co-worker” score Brownie points?: An experimental study on the reactions towards colleagues with a personality disorder

People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick-leave, because it impedes reintegration into the former workplace. This study explores colleagues’ reactions towards a problematic worker dependent on the returning person’s reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes the co-worker was depicted as having previously caused problems in the work team. In the first vignette the co-worker asked for workplace-adjustments when she returned to work; in the second, she attempted to change her behaviour in order to cause less problems; the third vignette combined both workplace-adjustments and behavioural changes; and the fourth (control) vignette did not include any change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace-adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace-adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes

Defeating the Developer\u27s Dilemma: An Online Tool for Individual Consultations

This chapter introduces an online consultation tool that helps resolve the tension that developers often experience in consultations between offering quick fixes and providing in-depth but time-consuming conceptual understanding. The tool that the Eberly Center for Teaching Excellence has developed provides instructors with concrete teaching strategies to address common teaching problems, while also educating them about the pedagogical principles informing those strategies. The tool can be used to enhance traditional face-to-face consultations or, by itself, to reach a wider faculty audience, including adjunct and off site faculty

Skill-mix change in general practice : a qualitative comparison of three ‘new’ non-medical roles in English primary care

Background: General practice is currently facing a significant workforce challenge. Changing the general practice skill mix by introducing new non-medical roles is recommended as one solution; the literature highlights that organisational and/or operational difficulties are associated with skill-mix changes. Aim: To compare how three non-medical roles were being established in general practice, understand common implementation barriers, and identify measurable impacts or unintended consequences. Design and setting: In-depth qualitative comparison of three role initiatives in general practices in one area of Greater Manchester, England; that is, advanced practitioner and physician associate training schemes, and a locally commissioned practice pharmacist service. Method: Semi-structured interviews and focus groups with a purposive sample of stakeholders involved in the implementation of each role initiative were conducted. Template analysis enabled the production of pre-determined and researcher-generated codes, categories, and themes. Results: The final sample contained 38 stakeholders comprising training/service leads, role holders, and host practice staff. Three key themes captured participants’ perspectives: purpose and place of new roles in general practice, involving unclear role definition and tension at professional boundaries; transition of new roles into general practice, involving risk management, closing training–practice gaps and managing expectations; and future of new roles in general practice, involving demonstrating impact and questions about sustainability. Conclusion: This in-depth, in-context comparative study highlights that introducing new roles to general practice is not a simple process. Recognition of factors affecting the assimilation of roles may help to better align them with the goals of general practice and harness the commitment of individual practices to enable role sustainability

Status Review for Anadromous Atlantic Salmon (Salmo salar) in the United States

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