Assessing the therapeutic impact of a community group on a secure hospital ward

The constructs of ward staff and patients in a medium secure rehabilitation ward were assessed before and after an eight-month trial of a twice weekly community group. One of the aims of this group was to address day-to-day interpersonal issues and to encourage patients to take social responsibility for their actions and to learn to support one another. Another aim was to encourage staff and patients to consider the possibility of applying some therapeutic community principles on the ward. These aims were assessed using repertory grid techniques. The results were that over the eight-month pilot both staff and patient groups shifted towards viewing their ideal ward as a therapeutic community (TC). However qualitative information suggested that considerable difficulties arose in bringing about the necessary cultural changes. As a result both staff and patients felt confused and disempowered. Future attempts are highly recommended, however better resourcing, particularly in the form of employing a trained full-time individual to co-ordinate activities, is essential.

The relationship between human security, demand for arms and disarmament in the horn of Africa

The drive to find security through possession of weapons is linked to the history and culture of a social group. Amongst pastoralists in the Horn of Africa there is a failure of security through state systems such as police and the recent replacement of less-lethal traditional weapons by small arms and other light weapons. A warrior or vendetta culture with these arms leads to violent inter-clan clashes with many casualties, although traditional methods of weapons control still seem operational within clans. Understanding the drive to seek weapons is essential in finding ways to control their use. Improving the capacities of the police must come hand in hand with human rights training and an end to corruption. Further work is required on how traditional methods of arms control can be co-operatively linked with state controls.

Assaltantes a bordo: violência, insegurança e saúde no trabalho em transporte coletivo de Salvador, Bahia, Brasil

O artigo examina o impacto da criminalidade violenta sobre as condições de trabalho, saúde e segurança de trabalhadores, sem deixar de mencionar a situação dos usuários, do transporte coletivo de Salvador, Brasil. A investigação foi feita com base em entrevistas realizadas com 195 pessoas, entre elas trabalhadores, empresários, sindicalistas, agentes de fiscalização da frota de ônibus e policiais. Nos últimos dez anos, numa frota de 2.400 ônibus, operada por 10.151 rodoviários, ocorreram 20.572 assaltos, com morte de 67 pessoas e prejuízo computado de mais de um milhão de reais somente para as empresas. O perfil social típico dos agressores é de jovens pobres e desempregados, muitos sem antecedentes policiais, que buscam dinheiro rápido para atividades de lazer, principalmente. Analisou-se o assalto como um encontro perigoso que, além de lesões fatais e não fatais, produz medo, conflitos de identidade, tensões com os passageiros e conflitos trabalhistas referentes ao pagamento dos prejuízos. Foi avaliada também a eficiência das medidas de segurança policial, incluindo o emprego da força letal, mostrando-se a necessidade de medidas mais amplas, de curto, médio e longo prazo, para controlar a violência nos ambientes de trabalho.

[Hospital maintenance: management, risks, and responsibilities]

Principal activities of maintenance carried out in hospital, staff required, various type of organization (inside team or global service), management aspects are described. Subjects responsible of maintenance are characterized and the relationships between Service of Maintenance and Service of Prevention and Protection in hospital are specified. Responsibility aspects concerning safety of maintenance workers and main risks which are exposed are defined. The importance of disponibility of a good maintenance handbook and of projects and programs of practice for new hospitals are emphasized.

Conditionally discharged restricted patients and the need for long-term medium security

In the context of a larger investigation of follow-up of a specific group of mentally disordered individuals, the study described here examined the characteristics of all 55 people conditionally discharged for the first time from a medium secure unit in the West Midlands over a 13-year period. A retrospective case note analysis was undertaken. The findings illustrate that these patients are a distinct group. They were mainly single men who had committed a grave offence. The majority had an extensive criminological history with early onset of offending and chronic mental illness. Fifty percent of those with a criminal record had received at least one custodial sentence prior to the index offence. Co-morbid substance misuse was common, as was a history of self-harm. There were high levels of previous contact with psychiatric services and compulsory in-patient treatment. Most were detained under the Mental Health Act category of mental illness. A quarter had been transferred from a special hospital prior to conditional discharge into the community. The characteristics of this sample demonstrate clearly the need for the provision of long-term medium secure facilities and allied services.

Access-control and interlock-signal systems for the LHD experimental hall

An access-control system has been developed and installed at the National Institute for Fusion Science. The system uses an interlock-signal system and a group-access-control system to safeguard the operation of the large helical device. In this paper, the access-control system is described along with its features, advantages and disadvantages, and benefits.

The Privacy Rule: HIPAA standards for the privacy of individually identifiable health information

The main objective of the HIPAA Privacy Rule is to provide a uniform and simplified minimum standard for the privacy of individually identifiable health information. Five broad categories are covered: boundaries, security, consumer control, accountability and public responsibility. Compliance with the Privacy Rule includes appointing a security official, making some basic assessments about a fund's current policies and procedures, assessing security protocols for network systems, developing a participant complaint mechanism and creating an internal grievance procedure for employer action and employee whistle-blowing. At this writing, although the final standards are still under debate, most health care plans should accept the regulation and begin compliance procedures. Successful implementation of the Privacy Rule can streamline fund operations and give participants the added security and peace of mind they demand.