Evaluation of behavioral changes and subjective distress after exposure to coercive inpatient interventions

BACKGROUND: There is a lack of evidence to underpin decisions on what constitutes the most effective and least restrictive form of coercive intervention when responding to violent behavior. Therefore we compared ratings of effectiveness and subjective distress by 125 inpatients across four types of coercive interventions. METHODS: Effectiveness was assessed through ratings of patient behavior immediately after exposure to a coercive measure and 24 h later. Subjective distress was examined using the Coercion Experience Scale at debriefing. Regression analyses were performed to compare these outcome variables across the four types of coercive interventions. RESULTS: Using univariate statistics, no significant differences in effectiveness and subjective distress were found between the groups, except that patients who were involuntarily medicated experienced significant less isolation during the measure than patients who underwent combined measures. However, when controlling for the effect of demographic and clinical characteristics, significant differences on subjective distress between the groups emerged: involuntary medication was experienced as the least distressing overall and least humiliating, caused less physical adverse effects and less sense of isolation. Combined coercive interventions, regardless of the type, caused significantly more physical adverse effects and feelings of isolation than individual interventions. CONCLUSIONS: In the absence of information on individual patient preferences, involuntary medication may be more justified than seclusion and mechanical restraint as a coercive intervention. Use of multiple interventions requires significant justification given their association with significant distress

Cost-effective recruitment strategies that attract underrepresented minority undergraduates who persist to STEM doctorates

The paucity of underrepresented minorities (URMs) earning science, technology, engineering, and mathematics (STEM) degrees remains an issue in revitalizing the U.S. biomedical workforce. Due to reductions in federal funding, maintaining the integrity of programs that focus on URM retention and recruitment is crucial. We present data on the mechanisms used to recruit URM students to our program (e.g., email, events, referrals, website), which individually were equally effective in attracting applicants to the program. Recruitment mechanisms were grouped and further classified relative to their cost to implement as lower and higher cost. Our results indicate that lower cost mechanisms, statistically, were as effective as higher cost mechanisms in recruiting students who persisted to PhD programs. Using a binary logistic regression model to predict PhD matriculation, higher cost mechanisms were not significant predictors of PhD matriculation. Collectively, these data demonstrate for the first time that lower cost mechanisms can be as successful in recruiting URM students to summer programs who pursue PhDs in STEM fields. </jats:p

On the risk of studying practices in isolation: Linking what, who and how in strategy research

This paper challenges the recent focus on practices as stand-alone phenomena, as exemplified by the so-called “Practice-Based View of Strategy (PBV)” by Bromiley and Rau (2014). While the goal of “PBV” points to the potential of standard practices to generate performance differentials (in contrast to the Resource Based View), it marginalizes wellknown insights from practice theory more widely. In particular, by limiting its focus to practices, i.e. “what” practices are used, it underplays the implications of “who” is engaged in the practices and “how” the practices are carried out. In examining practices in isolation, the “PBV” carries the serious risk of misattributing performance differentials. In this paper, we offer an integrative practice perspective on strategy and performance that should aid scholars in generating more precise and contextually-sensitive theories about the enactment and impact of practices as well as about critical factors shaping differences in practice outcomes

Novel venom gene discovery in the platypus

Background: To date, few peptides in the complex mixture of platypus venom have been identified and sequenced, in part due to the limited amounts of platypus venom available to study. We have constructed and sequenced a cDNA library from an active platypus venom gland to identify the remaining components.Results: We identified 83 novel putative platypus venom genes from 13 toxin families, which are homologous to known toxins from a wide range of vertebrates (fish, reptiles, insectivores) and invertebrates (spiders, sea anemones, starfish). A number of these are expressed in tissues other than the venom gland, and at least three of these families (those with homology to toxins from distant invertebrates) may play non-toxin roles. Thus, further functional testing is required to confirm venom activity. However, the presence of similar putative toxins in such widely divergent species provides further evidence for the hypothesis that there are certain protein families that are selected preferentially during evolution to become venom peptides. We have also used homology with known proteins to speculate on the contributions of each venom component to the symptoms of platypus envenomation.Conclusions: This study represents a step towards fully characterizing the first mammal venom transcriptome. We have found similarities between putative platypus toxins and those of a number of unrelated species, providing insight into the evolution of mammalian venom

Change escalation processes and complex adaptive systems: from incremental reconfigurations to discontinuous restructuring

This study examines when “incremental” change is likely to trigger “discontinuous” change, using the lens of complex adaptive systems theory. Going beyond the simulations and case studies through which complex adaptive systems have been approached so far, we study the relationship between incremental organizational reconfigurations and discontinuous organizational restructurings using a large-scale database of U.S. Fortune 50 industrial corporations. We develop two types of escalation process in organizations: accumulation and perturbation. Under ordinary conditions, it is perturbation rather than the accumulation that is more likely to trigger subsequent discontinuous change. Consistent with complex adaptive systems theory, organizations are more sensitive to both accumulation and perturbation in conditions of heightened disequilibrium. Contrary to expectations, highly interconnected organizations are not more liable to discontinuous change. We conclude with implications for further research, especially the need to attend to the potential role of managerial design and coping when transferring complex adaptive systems theory from natural systems to organizational systems

Meta-analysis of gender performance gaps in undergraduate natural science courses

To investigate patterns of gender-based performance gaps, we conducted a meta-analysis of published studies and unpublished data collected across 169 undergraduate biology and chemistry courses. While we did not detect an overall gender gap in performance, heterogeneity analyses suggested further analysis was warranted, so we investigated whether attributes of the learning environment impacted performance disparities on the basis of gender. Several factors moderated performance differences, including class size, assessment type, and pedagogy. Specifically, we found evidence that larger classes, reliance on exams, and undisrupted, traditional lecture were associated with lower grades for women. We discuss our results in the context of natural science courses and conclude by making recommendations for instructional practices and future research to promote gender equity

Post-Construction Support and Sustainability in Community-Managed Rural Water Supply

Executive Summary This volume reports the main findings from a multi-country research project that was designed to develop a better understanding of how rural water supply systems are performing in developing countries. We began the research in 2004 to investigate how the provision of support to communities after the construction of a rural water supply project affected project performance in the medium term. We collected information from households, village water committees, focus groups of village residents, system operators, and key informants in 400 rural communities in Bolivia, Ghana, and Peru; in total, we discussed community water supply issues with approximately 10,000 individuals in these communities. To our surprise, we found the great majority of the village water systems were performing well. Our findings on the factors influencing their sustainability will, we hope, be of use to policy makers, investors, and managers in rural water supply

Morale is high in acute inpatient psychiatry

Background: Morale on acute psychiatric wards has been considered to be problematic, and is reported to contribute to low quality patient care. Aim: To assess the relationship of staff morale to patient, service environment, physical environment, patient routines, conflict, containment, staff demographics, and staff group variables. Method: A multivariate cross sectional study was undertaken collecting data on morale and other variables on 136 acute admission psychiatric wards in England. Results: Morale was higher than published comparison samples. Length of time in post was correlated with low morale, and qualified nurses had higher emotional exhaustion but also higher personal accomplishment. The level of verbal abuse on a ward was associated with low morale, as was a higher level of social deprivation among patients. Higher levels of order and organisation correlated with better morale. Conclusions: Clear policies relating to the management of verbal abuse by patients, high levels of order and organisation, and staff rotation and education, may all support high morale. Acute inpatient psychiatry is generally a happy and rewarding work environment, and identified problems are likely to be due to other factors

The Long-Baseline Neutrino Experiment: Exploring Fundamental Symmetries of the Universe

The preponderance of matter over antimatter in the early Universe, the dynamics of the supernova bursts that produced the heavy elements necessary for life and whether protons eventually decay --- these mysteries at the forefront of particle physics and astrophysics are key to understanding the early evolution of our Universe, its current state and its eventual fate. The Long-Baseline Neutrino Experiment (LBNE) represents an extensively developed plan for a world-class experiment dedicated to addressing these questions. LBNE is conceived around three central components: (1) a new, high-intensity neutrino source generated from a megawatt-class proton accelerator at Fermi National Accelerator Laboratory, (2) a near neutrino detector just downstream of the source, and (3) a massive liquid argon time-projection chamber deployed as a far detector deep underground at the Sanford Underground Research Facility. This facility, located at the site of the former Homestake Mine in Lead, South Dakota, is approximately 1,300 km from the neutrino source at Fermilab -- a distance (baseline) that delivers optimal sensitivity to neutrino charge-parity symmetry violation and mass ordering effects. This ambitious yet cost-effective design incorporates scalability and flexibility and can accommodate a variety of upgrades and contributions. With its exceptional combination of experimental configuration, technical capabilities, and potential for transformative discoveries, LBNE promises to be a vital facility for the field of particle physics worldwide, providing physicists from around the globe with opportunities to collaborate in a twenty to thirty year program of exciting science. In this document we provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess.Comment: Major update of previous version. This is the reference document for LBNE science program and current status. Chapters 1, 3, and 9 provide a comprehensive overview of LBNE's scientific objectives, its place in the landscape of neutrino physics worldwide, the technologies it will incorporate and the capabilities it will possess. 288 pages, 116 figure