Preventing and Reducing Coercive Measures—An Evaluation of the Implementation of the Safewards Model in Two Locked Wards in Germany

IntroductionAggression and violence are highly complex problems in acute psychiatry that often lead to the coercive interventions. The Safewards Model is an evidence-informed conflict-reduction strategy to prevent and reduce such incidents. The aim of this study was to evaluate the implementation of this model with regard to coercive interventions in inpatient care.Materials and MethodsWe evaluated outcomes of the implementation of the Safewards Model in two locked psychiatric wards in Germany. Frequency and duration of coercive interventions applied during a period of 11 weeks before and 11 weeks after the implementation period were assessed through routine data. Fidelity to the Safewards Model was assessed by the Organization Fidelity Checklist.ResultsFidelity to the Safewards Model was high in both wards. The overall use of coercive measures differed significantly between wards [case-wise: χ2 (1, n = 250) = 35.34, p ≤ 0.001; patient-wise: χ2 (1, n = 103) = 21.45, p ≤ 0.001] and decreased post-implementation. In one ward, the number of patients exposed to coercive interventions in relation to the overall number of Patients decreased significantly [χ2 (1, 281) = 6.40, p = 0.01]. Furthermore, the mean duration of coercive interventions overall declined significantly [U(55,21) = −2.142, p = 0.032] with an effect size of Cohen’s d = −0.282 (95% CI: −0.787, 0.222) in that ward. Both aspects declined as well in the other ward, but not significantly.DiscussionResults indicate that the implementation of the Safewards interventions according to the model in acute psychiatric care can reduce coercive measures. They also show the role of enabling factors as well as of obstacles for the implementation process

The essential nature of YqfG, a YbeY homologue required for 3′ maturation of Bacillus subtilis 16S ribosomal RNA is suppressed by deletion of RNase R

International audienc

The stress-related, rhizobial small RNA RcsR1 destabilizes the autoinducer synthase encoding mRNA <i>sinI</i> in <i>Sinorhizobium meliloti</i>

<p>Quorum sensing is a cell density-dependent communication system of bacteria relying on autoinducer molecules. During the analysis of the post-transcriptional regulation of quorum sensing in the nitrogen fixing plant symbiont <i>Sinorhizobium meliloti,</i> we predicted and verified a direct interaction between the 5'-UTR of <i>sinI</i> mRNA encoding the autoinducer synthase and a small RNA (sRNA), which we named RcsR1. <i>In vitro</i>, RcsR1 prevented cleavage in the 5'-UTR of <i>sinI</i> by RNase E and impaired <i>sinI</i> translation. In line with low ribosomal occupancy and transcript destabilization upon binding of RcsR1 to <i>sinI</i>, overproduction of RcsR1 in <i>S. meliloti</i> resulted in lower level and shorter half-life of <i>sinI</i> mRNA, and in decreased autoinducer amount. Although RcsR1 can influence quorum sensing via <i>sinI</i>, its level did not vary at different cell densities, but decreased under salt stress and increased at low temperature. We found that RcsR1 and its stress-related expression pattern, but not the interaction with <i>sinI</i> homologs, are conserved in <i>Sinorhizobium</i>, <i>Rhizobium</i> and <i>Agrobacterium.</i> Consistently, overproduction of RcsR1 in <i>S. meliloti</i> and <i>Agrobacterium tumefaciens</i> inhibited growth at high salinity. We identified conserved targets of RcsR1 and showed that most conserved interactions and the effect on growth under salt stress are mediated by the first stem-loop of RcsR1, while its central part is responsible for the species-specific interaction with <i>sinI</i>. We conclude that RcsR1 is an ancient, stress-related riboregulator in rhizobia and propose that it links stress responses to quorum sensing in <i>S. meliloti.</i></p

Changes on Ward Atmosphere and Job Satisfaction after Implementation of the Safewards Model in Two Locked Acute PsychiatricWards - A Multi-Perspective Evaluation

Objective Evaluation of the changes of ward atmosphere and job satisfaction after the implementation of the Safewards model in acute psychiatry in Germany. Method A multi-perspective pre-post study design was conducted in two locked wards among patients (n = 80) and staff (n = 88) before and after the implementation of the Safewards model over a period of 12 months. Results After the implementation of the Safewards model, ward atmosphere and job satisfaction improved. Both correlated positively amongst staff. Furthermore, job satisfaction correlated positively with a high degree of implementation of two interventions. Fidelity to the Safewards model was high. Conclusions Implementing the Safewards model in acute psychiatry with high fidelity can have positive effects on positive ward atmosphere and job satisfaction. Thus, patients as well as staff benefit from this model. With regards to high fluctuation in acute psychiatry, the implementation of the Safewards model can additionally facilitate retention management

Wege zur Reduzierung von Lebensmittelabfällen - Pathways to reduce food waste (REFOWAS) : Maßnahmen, Bewertungsrahmen und Analysewerkzeuge sowie zukunftsfähige Ansätze für einen nachhaltigen Umgang mit Lebensmitteln unter Einbindung sozio-ökologischer Innovationen; Volume 1

With the Sustainable Development Goals (SDG), the countries of the United Nations have set themselves the goal of reducing food waste along the entire value chain by 2030. The aim of the REFOWAS project was to analyze the German agri-food sector with regard to the production of food waste and, in particular, the share of avoidable waste, and to identify and test strategies and starting points for waste reduction measures. The project combines two levels of analysis. The first, a holistic analysis of the German food sector, was carried out with regard to the waste generated by avoidable and unavoidable food waste and the related environmental effects. At the same time case studies were used to examine various subsectors in more detail (fruit and vegetables, baked goods, school meals) and a social empirical study (private households) was carried out. The methods chosen include: technical discussions; round tables; status quo and control measurements; household survey analyses; guided expert interviews; workshops and field tests to validate results and previously established options for action. The sector-wide investigations are largely based on data from the Federal Statistical Office and derived literature values. In the case studies food waste was quantified and reduction measures tested. From the varied and differentiated findings, recommendations for action for actors in politics, business and society could be derived. The results of the project were communicated in particular through the practically tested and evaluated measures, the subsequent information materials such as articles, brochures and video clips, as well as the wide-ranging discussion of results with lectures and workshops (see REFOWAS website - https://refowas.de)

Preventing and Reducing Coercive Measures-An Evaluation of the Implementation of the Safewards Model in Two Locked Wards in Germany

Introduction: Aggression and violence are highly complex problems in acute psychiatry that often lead to the coercive interventions. The Safewards Model is an evidence-informed conflict-reduction strategy to prevent and reduce such incidents. The aim of this study was to evaluate the implementation of this model with regard to coercive interventions in inpatient care. Materials and Methods: We evaluated outcomes of the implementation of the Safewards Model in two locked psychiatric wards in Germany. Frequency and duration of coercive interventions applied during a period of 10 weeks before and 10 weeks after the implementation period were assessed through routine data. Fidelity to the Safewards Model was assessed by the Organization Fidelity Checklist. Results: Fidelity to the Safewards Model was high in both wards. The overall use of coercive measures differed significantly between wards [case-wise: chi(2) (1, n = 250) = 35.34, p <= 0.001; patient-wise: chi(2) (1, n = 103) = 21.45, p <= 0.001] and decreased post-implementation. In one ward, the number of patients exposed to coercive interventions in relation to the overall number of admissions decreased significantly [chi(2) (1, 182) = 9.30, p = 0.003]. Furthermore, the mean duration of coercive interventions overall declined significantly [U(55,21) = -2.142, p = 0.032] with an effect size of Cohen's d = -0.282 (95% CI: -0.787, 0.222) in that ward. Both aspects declined as well in the other ward, but not significantly. Discussion: Results indicate that the implementation of the Safewards interventions according to the model in acute psychiatric care can reduce coercive measures. They also show the role of enabling factors as well as of obstacles for the implementation process

Long Term Evaluation of the Implementation of the Safewards Model - Results of a Follow-Up-Study Among Patients and Staff in Acute Psychiatric Wards

Objective Evaluation of long-term effects of the implementation of the Safewards Model (SM) among staff and patients in acute psychiatry in Germany.Method Assessment of ward atmosphere, job satisfaction, fidelity, and coercive interventions in 2 locked wards directly before and 15 months after implementation of the SM.Results Ward atmosphere was assessed significantly better after implementation, job satisfaction was still above-average at both times, coercive interventions declined significantly in one ward, fidelity and degree of implementation were still high.Conclusions The implementing of the SM in locked wards in acute psychiatry can also have positive effects in long run