Measuring the violence prevention climate:Development and evaluation of the VPC-14

© 2018 Elsevier Ltd. Background: Violence and aggression are common in inpatient mental health hospital settings and cause problems for staff, patients and organisations. An important factor in treatment efficacy is ward atmosphere, and one element of this is the violence prevention climate. Objectives: To develop and test the psychometric properties of a new scale to measure perceptions of the violence prevention climate among staff and patients in mental health inpatient settings. Design: Scale development and cross-sectional validation study. Setting and participants: Three hospital sites within an independent sector provider of secure mental health care. Participants were patients and staff residing in/working on wards in the adult male and female mental health care pathways. Methods: The study was conducted in three stages: scale development, pilot testing and psychometric evaluation. The scale items were developed from systematic literature review, informant interviews (staff) and focus groups (patients) and expert review. The resulting scale was subject to pilot testing with staff and patients (n = 58 and n = 25). The reliability and validity of the scale was examined by administering it to 326 staff and 95 patients. Exploratory factor analysis was used to establish construct validity, and this was further assessed with Rasch modelling. Internal consistency was assessed by calculation of Cronbach's alpha coefficients. Convergent and discriminant validity were measured by comparing results with existing validated instruments. Temporal stability of the items was assessed using test-retest reliability coefficients. Results: The VPC-14 is a 14-item scale demonstrating good psychometric properties. Exploratory factor analysis revealed two subscales, staff actions and patient actions, each demonstrating good internal consistency (Cronbach's alpha.89 and.76). All items demonstrated good temporal stability. Rasch modelling confirmed the unidimensionality of the two subscales, and items demonstrated high construct validity. Moderate correlations were found between subscales of the VPC-14 and the EssenCES, whilst no correlations were found with items in the ACMQ, thus demonstrating good convergent and discriminant validity. Conclusion: The VPC-14 is currently the most robust available measure of the inpatient violence prevention climate. It is quick and easy to administer, considers views of both staff and patients and thus can be introduced as standard practice in a ward setting. Potential uses include tracking the violence prevention climate longitudinally and in evaluation of new policy and procedural interventions

Incremental Validity of Patients’ Self-Reported Anger Beyond Structured Professional Judgment Tools in the Prediction of Inpatient Aggression

Mental health inpatients’ self-reported violence risk predicts actual aggressive outcomes. Anger, for which there are well-evidenced interventions, commonly precedes inpatient aggression. We aimed to determine whether patients’ self-reported anger added incremental validity to violence prediction beyond routinely completed violence risk assessments. A correlational, pseudo-prospective study design was employed. N = 76 inpatients in secure hospitals completed self-report validated anger measures; routinely collected clinicians' ratings on structured professional judgment tools, and aggressive incident data for a 3-month follow-up period were extracted from clinical records. Thirty four (45%) participants were violent; self-reported anger and clinician-risk ratings were significantly positively correlated. Self-reported anger predicted aggressive outcomes but not incrementally beyond relevant risk assessment subscale and item scores. It may not be beneficial for all patients to self-report anger as part of continuous violence risk assessments, but those who score highly on anger-relevant items of risk assessment tools could be considered for further assessment to support risk-management interventions

Light isovector resonances in π-p →π-π-π+p at 190 GeV/c

We have performed the most comprehensive resonance-model fit of π-π-π+ states using the results of our previously published partial-wave analysis (PWA) of a large data set of diffractive-dissociation events from the reaction π-+p→π-π-π++precoil with a 190 GeV/c pion beam. The PWA results, which were obtained in 100 bins of three-pion mass, 0.5<2.5 GeV/c2, and simultaneously in 11 bins of the reduced four-momentum transfer squared, 0.1<1.0 (GeV/c)2, are subjected to a resonance-model fit using Breit-Wigner amplitudes to simultaneously describe a subset of 14 selected waves using 11 isovector light-meson states with JPC=0-+, 1++, 2++, 2-+, 4++, and spin-exotic 1-+ quantum numbers. The model contains the well-known resonances π(1800), a1(1260), a2(1320), π2(1670), π2(1880), and a4(2040). In addition, it includes the disputed π1(1600), the excited states a1(1640), a2(1700), and π2(2005), as well as the resonancelike a1(1420). We measure the resonance parameters mass and width of these objects by combining the information from the PWA results obtained in the 11 t′ bins. We extract the relative branching fractions of the ρ(770)π and f2(1270)π decays of a2(1320) and a4(2040), where the former one is measured for the first time. In a novel approach, we extract the t′ dependence of the intensity of the resonances and of their phases. The t′ dependence of the intensities of most resonances differs distinctly from the t′ dependence of the nonresonant components. For the first time, we determine the t′ dependence of the phases of the production amplitudes and confirm that the production mechanism of the Pomeron exchange is common to all resonances. We have performed extensive systematic studies on the model dependence and correlations of the measured physical parameters

Depth perception in tele-presence systems.

Tele-presence refers to technologies enabling the remote presence of an observer or operator of robotics machines - through the use of monitoring and display devices. This involves the facilitation of 3D space perception on the basis of 2D pictures, a problem which is of interest to engineers, and psychologists who study space and picture perception. From a functional perspective the issue requires the specification of the necessary characteristics of a tele-presence system for effective task performance by a human observer. Since the central problem in picture perception is the conflict between the 3D re-presentation of the scene and the 2D surface of the picture, one possibility for tele-presence systems to reduce this conflict consists in the use of a camera which is slaved to observer movement. Thus the video picture is yoked to the head movement of the observer: changes in the video picture viewed by the observer emulate the changes that would have occurred in the visual field if the observer was viewing the scene directly. The explanation for reduced cue conflict and improved depth perception in pictures lies in the availability of motion parallax information. The main aim of this research was to see whether tele-presence which provides motion parallax information on a video picture improves depth perception compared to static tele-presence. While theoretical claims concerning the usefulness of motion parallax have a long history, the empirical findings are more equivocal. The basic design compared depth perception of a moving observer with that of a stationary observer. Two initial experiments showed that the movement condition leads to more accurate depth perception than the stationary condition, both under tele-presence and direct viewing conditions. Experiments 4 to 7 showed that active observation leads only to non- significantly better accuracy than passive observation. Interrupting the natural link between action and perception by reversing the picture tends to reduce the difference between the movement and the stationary condition. However, combining the analysis of the active, passive and reverse picture conditions did not lead to significant differences. A further experiment using an adjustment task supported the finding that reverse viewing does not reduce accuracy. In general the differences between the movement and the static condition while significant were not very strong which suggested that other sources of information such as visual angle information may have specified depth to a considerable extent. Simulation of fully remote tele-presence was expected to provide stronger differences. However, the differences were small and explainable in terms of short term learning processes resulting in perceptual fixity, i.e. an inability to take advantage of the information available. It was concluded that motion parallax is probably only a weak cue to depth under practical circumstances, and that learning effects in tele-presence systems require further attention. Future attention should be directed at learning processes and at the complexity of the stimulus displays. The study of learning processes may help to understand the consistent finding of large individual differences in using motion parallax information. And the study of more complex stimulus displays would enable a more adequate assessment of the ecological emphasis on the role of motion parallax

Financial incentives reduce smoking and improve wellbeing in pregnant women

Limited data is available on the effectiveness of financial rewards to aid smoking cessation and abstinence in women who are pregnant. In the UK a key milestone is achieving abstinence at four weeks following an initial meeting with midwife and support from stop smoking services. The aim of this study was to evaluate the effects of a generous scheme which provides incentives in a staged schedule, amounting to a total reward of £145 for setting a quit date and staying abstinent for 4 weeks. This pilot feasibility study recruited successfully to target (n = 50 women), focusing on those from disadvantaged backgrounds.

Reducing Stigmatising Barriers to Physical Activity:Findings from a Workplace Health Incentive Programme in England

Stigma associated with overweight and obesity is a barrier to engaging in regular physical activity. Overweight and obese individuals tend to engage less in physical activity due to personal and public perceptions of being ‘fat’, despite the well-established positive physical and psychological health outcomes of physical activity. This study presents a workplace health promotion scheme that encourages people to be more physically active through an organisational incentives programme. The main objectives of this ‘health reward scheme’ are to encourage employees to adopt positive health behaviours through incentive-based motivation. To evaluate the effectiveness of the programme, a comparative pre- and post-intervention trial (N=100) was conducted, using ANOVA analysis adjusted for demographics and baseline characteristics. Follow-up interviews are analysed thematically. Findings presented will include before and after measures of physical activity levels, health and wellbeing, pro-social behaviours and testimonials of successes and challenges. Adopting an inclusive and supportive approach in built environments such as the workplace can reduce stigma-related barriers to physical activit