Care planning for aggression management in a specialist secure mental health service:user involvement

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report forms were examined for all patients in men's and women's mental health care pathways who were involved in aggressive incidents between May and October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation

AISWA literacy working party (Project No.3): a review of the establishment of databases for literacy achievement

Project Three of the AISWA Literacy Research Project reviewed the establishment of databases in Literacy achievement at a systems and schools level with a view to providing resource information for schools. The purpose of Project Three was to provide information to facilitate schools\u27 ability to respond to requests for evidence of literacy achievement. This report begins with a summary of the history of the national, state and territories move to outcomes based learning over the past decade. In 1993, the responsibility for implementing this change was given to the states and territories which has resulted in great variation across Australia. A detailed summary of each state and territory can be found in the Resource Section of this report. In order to map the landscape of AISWA schools\u27 involvement in the creation and maintenance of literacy databases, a survey was conducted with a small sample of AISWA schools. The purpose of the survey was to identify current practice in literacy achievement and performance. The results of this survey are discussed in this report. It is intended that this document provide a resource for schools as they plan for Curriculum Framework implementation. As implementation is a mandated procedure, schools will be asked to report on their progress

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

Incentivised smoking cessation intervention with pregnant women: findings from a pilot program in Northamptonshire, UK

Smoking is understood as the primary cause of preventable morbidity and premature death in the UK. In Northamptonshire, UK, the rate of smoking among adults was 20.9% (approximately 144,607 people) in 2011/12. Among pregnant women, compared to the national average (13.2%), the rate of smoking at time of delivery was higher in Northamptonshire (16%) in 2011/12. In terms of smoking cessation programs during pregnancy, incentivised smoking cessation schemes have been more frequently utilised when attempting to reduce rates of smoking among pregnant women. While smoking cessation interventions broadly accounted for a 6% increase in late-pregnancy abstinence rates compared to control interventions, only those that contained an incentivised component showed a significantly larger effect (RR 0.76, 95% CI 0.71 to 0.81). This paper presents preliminary findings of an incentivised smoking cessation pilot intervention in Northamptonshire which aimed to recruit 50 pregnant women who smoke and evaluate the feasibility of the incentive programme in terms of its: uptake of stop smoking services; numbers of those setting a quit date; effectiveness to reduce smoking following referral to stop smoking services (i.e. 4 weeks after quit date); effectiveness to reduce smoking status at delivery and the psychosocial outcomes of incentivised smoking cessation programs for pre- and post-natal women. This research applied a mixed quantitative and qualitative approach to assess the aggregated effectiveness of the program (through cross-sectional analysis) and understand individual-level positive and negative experiences of the program (through storytelling and in-depth interviews). We will report initial results (data collection currently underway) that will include baseline profile data and uptake of the incentive programme. It is important to note that gendered roles and experiences may make it more difficult for some women to access treatment and support for smoking cessation, given the heightened stigma surrounding smoking during pregnancy and mothers who smoke. This presentation will, therefore, also emphasize findings that report gendered influences on smoking such as partner influence, socioeconomic impact of lone-motherhood and individual, societal and structural stigma surrounding mothers that smoke

How dogs perceive humans and how humans should treat their pet dogs: Linking cognition with ethics

Humans interact with animals in numerous ways and on numerous levels. We are indeed living in an “animal”s world,’ in the sense that our lives are very much intertwined with the lives of animals. This also means that animals, like those dogs we commonly refer to as our pets, are living in a “human’s world” in the sense that it is us, not them, who, to a large degree, define and manage the interactions we have with them. In this sense, the human-animal relationship is nothing we should romanticize: it comes with clear power relations and thus with a set of responsibilities on the side of those who exercise this power. This holds, despite the fact that we like to think about our dogs as human’s best friend. Dogs have been part of human societies for longer than any other domestic species. Like no other species they exemplify the role of companion animals. Relationships with pet dogs are both very widespread and very intense, often leading to strong attachments between owners or caregivers and animals and to a treatment of these dogs as family members or even children. But how does this relationship look from the dogs’ perspective? How do they perceive the humans they engage with? What responsibilities and duties arise from the kind of mutual understanding, attachment, and the supposedly “special” bonds we form with them? Are there ethical implications, maybe even ethical implications beyond animal welfare? The past decades have seen an upsurge of research from comparative cognition on pet dogs’ cognitive and social skills, especially in comparison with and reference to humans. We will therefore set our discussion about the nature and ethical dimensions of the human–dog relationship against the background of the current empirical knowledge on dog (social) cognition. This allows us to analyze the human–dog relationship by applying an interdisciplinary approach that starts from the perspective of the dog to ultimately inform the perspective of humans. It is our aim to thereby identify ethical dimensions of the human–dog relationship that have been overlooked so far