Well-being of police custody staff: a multi strategy-approach across seven police forces

British police custody is one of the most challenging of police environments, with the treatment of prisoners a source of public and media concern, especially regarding deaths in police custody; and where every action by staff is recorded audibly and visually. These kinds of issues threaten staff well-being (measured as role well-being, low workplace stress, mental and subjective well-being, energy and engagement). To address these issues, the study targeted five roles of custody inspector/sergeant, detention officer (public and private) and custody officer assistant in a four-wave panel survey of seven English police forces (with each separated by a lag of five months). Study engagement was 333 (a response rate of 46.57%) across 33 custody sites which, together with repeated returns, provided a quantitative data set of 370. In addition, self-report open comments at the end of surveys and other communications, numbered 178 (i.e. 131 from the current study and 47 from earlier custody-related research). This provided the study with an original multi-strategy approach that was: 1) Quantitative. Informed by an expanded version of a model first introduced in Werner-de-Sondberg et al. (2018); instrumental in identifying cultural subcomponent tensions, influential mediator and moderator relationships, contrasting role well-being and negatively affective vulnerabilities; 2) Qualitative. Conducted as a thematic analysis of self-report open (survey) comments and other communications, where quantitative results were explained deductively and inductively; and 3) Quantitative and qualitative. Where a single (embedded) case study identified eight propositions to be supported or rejected regarding: police custody (officer and police staff) vulnerability/ability to cope; status of custody; staffing levels; ITS inadequacies; large new-build custody sites; twelve hour shifts and private sector outsourcing. In addition, a multiple case study identified five synthesised crosscases in terms of similarity and difference. The study concluded by discussing a range of issues: theoretical; methodological; reflexive; practical; and future focused

Sector well-being differences among UK police custody staff

The research explores a new model of staff well-being across UK police custodial services (public and private). These services are unique for the fact that police sergeant custody officers are supported by detention officers who can be publicly or privately contracted, with the latter providing a heterogeneous mix never previously researched. The model informs a survey approach conducted across four English police forces. Drawing on a diverse literature which compares health and criminal justice professions, this study explores the possibility that private sector detention officers will report lower levels of emotional exhaustion and workplace stress and higher levels of personal accomplishment than their public sector counterparts. Multilevel analyses, supplemented by ANOVA and t tests, detected statistically significant differences for private sector detention officers regarding higher levels of emotional exhaustion and lower levels of personal accomplishment and workplace stress (with the stress result the only one in the predicted direction). However, results should be interpreted as sample specific linked to privately contracted detention officer disquiet with their then employer (since replaced). That said, the results provide a good exploration of the model's utility together with important lessons for model and survey development in the future

The role of organizational culture and climate for well-being among police custody personnel: a multilevel examination

United Kingdom Police custody is one of the most challenging of work environments, liable to excessive demands and reduced well-being. Being difficult to access, it is also a much-neglected area of research that has focused on one or two roles, rather than the full range available, and on individual-level research, rather than a more comprehensive multilevel understanding of how organizational culture and climate can simultaneously influence a range of well-being outcomes. The present longitudinal study explored all types of roles, in both the public and private sectors, across seven English police forces and 26 custody sites (N = 333, response rate 46.57%, with repeated returns = 370). The Integrated Multilevel Model of Organizational Culture and Climate (IMMOCC) was applied to examine the organizational-level influences on individual well-being. Results indicated that (1) custody sergeants were most vulnerable to low well-being, followed by publicly contracted detention officers; (2) shared leadership (a source of team cohesion) was linked to four of six well-being outcomes; (3) two sub-components of culture reflected tensions never acknowledged before, especially in respect of role; and (4) reverse relationships existed between well-being outcomes and the dimensions of culture and climate. The findings inform practical recommendations , including resilience training and the need to raise the status of police custody, while also highlighting concerns about private sector scrutiny that may be relevant to other professions

Evolução na utilização e nos gastos de uma operadora de saúde

Brazil’s aging population and the rising number of people reliant upon the country’s supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil

Pipamperone Population Pharmacokinetics Related to Effectiveness and Side Effects in Children and Adolescents

Background: Pipamperone is a frequently prescribed antipsychotic in children and adolescents in the Netherlands, Belgium, and Germany. However, pediatric pharmacokinetics and the relationship with side effects and efficacy are unknown. Currently, divergent pediatric dosing recommendations exist. Objectives: The objective of this study was to describe the population pharmacokinetics of pipamperone in children and adolescents; to correlate measured and predicted pipamperone trough concentrations and predicted 24-h area under the curves with effectiveness, extrapyramidal symptoms, and sedation; and to propose dose recommendations based on simulations. Methods: Pipamperone concentrations were collected from Dutch pediatric patients in a prospective naturalistic trial (n = 8), and German pediatric patients in a therapeutic drug monitoring service (n = 22). A total of 70 pipamperone concentrations were used to develop a population pharmacokinetic model with non-linear mixed-effects modeling (NONMEM®). Additionally, an additional random sample of 21 German patients with 33 pipamperone concentrations from the same therapeutic drug monitoring service was used for external validation. Pharmacokinetic parameters were related to clinical improvement, sedation, and extrapyramidal symptoms. Simulations were performed to determine optimal dosages. Results: In a one-compartment model, the apparent volume of distribution was 416 L/70 kg and the apparent clearance was 22.1 L/h/70 kg. Allometric scaling was used to correct for differences in bodyweight. The model was successfully externally validated. The median [25th–75th percentile] measured pipamperone trough concentrations were numerically higher in responders (98.0 µg/L [56.0–180.5 µg/L]) than in non-responders (58.0 µg/L [14.9–105.5 µg/L]), although non-significant (p = 0.14). A twice-daily 0.6-mg/kg dosage was better than a fixed dosage to attain the concentration range observed in responders. Conclusions: Our findings suggest that pipamperone therapeutic reference ranges may be lower for children with behavioral problems than recommended for adults with psychotic symptoms (100–400 µg/L). When dosing pipamperone in children and adolescents, bodyweight should be taken into account

T-Cell Epitope Prediction: Rescaling Can Mask Biological Variation between MHC Molecules

Theoretical methods for predicting CD8+ T-cell epitopes are an important tool in vaccine design and for enhancing our understanding of the cellular immune system. The most popular methods currently available produce binding affinity predictions across a range of MHC molecules. In comparing results between these MHC molecules, it is common practice to apply a normalization procedure known as rescaling, to correct for possible discrepancies between the allelic predictors. Using two of the most popular prediction software packages, NetCTL and NetMHC, we tested the hypothesis that rescaling removes genuine biological variation from the predicted affinities when comparing predictions across a number of MHC molecules. We found that removing the condition of rescaling improved the prediction software's performance both qualitatively, in terms of ranking epitopes, and quantitatively, in the accuracy of their binding affinity predictions. We suggest that there is biologically significant variation among class 1 MHC molecules and find that retention of this variation leads to significantly more accurate epitope prediction