Violence prevention and safety training for case management services

Violence inflicted by individuals with mental illness towards healthcare workers has received significant media attention. Though such incidents are relatively infrequent, they inspire reactive responses and contribute to further stigmatization of the mentally ill. Prevention of violence is an important challenge for those who train and supervise mental health workers. Project Link is an outpatient treatment program designed to reduce jail and hospital recidivism among severely mentally ill adults with histories of criminal justice system involvement. Utilizing a Safety and Violence Education (SAVE) curriculum, Project Link has successfully transitioned high-risk mentally ill individuals from the criminal justice system into the community since 1995. The SAVE curriculum uses a preventative strategy to train case managers to identify warning signs of impending violence, and to safely engage patients in community settings. This paper will present an overview of the SAVE curriculum and its development, as well as results from a preliminary evaluation of trainee satisfaction.

Biological terrorism: understanding the threat, preparation, and medical response

The thought of an outbreak of disease caused by the intentional release of a pathogen or toxin in an American city was alien just 10 years ago. Many people believed that biological warfare was only in the military's imagination, perhaps to be faced by soldiers on a far-away battlefield, if at all. The "anthrax letters" and the resulting deaths from inhalation anthrax have changed that perception. The national, state, and local governments in the United States are preparing for what is now called "not if, but when and how extensive" biological terrorism. In contrast to the acute onset and first-responder focus with a chemical attack, in a bioterrorist attack, the physician and the hospital will be at the center of the fray. Whether the attack is a hoax, a small food-borne outbreak, a lethal aerosol cloud moving silently through a city at night, or the introduction of contagious disease, the physician who understands threat agent characteristics and diagnostic and treatment options and who thinks like an epidemiologist will have the greatest success in limiting the impact of the attack. As individual health care providers, we must add the exotic agents to our diagnostic differentials. Hospital administrators must consider augmenting diagnostic capabilities and surveillance programs and even making infrastructure modifications in preparation for the treatment of victims of bioterrorism. Above all, we must all educate ourselves. If done correctly, preparation for a biological attack will be as "dual use" as the facility that produced the weapon. A sound public health infrastructure, which includes all of us and our resources, will serve this nation well for the control of the disease, no matter what the cause of the disease.

Visually enhanced CCTV digital surveillance utilizing Intranet and Internet

This paper describes a solution for integrated plant supervision utilizing closed circuit television (CCTV) digital surveillance. Three basic requirements are first addressed as the platform of the system, with discussion on the suitable video compression. The system configuration is described in blocks. The system provides surveillance functionality: real-time monitoring, and process analysis functionality: a troubleshooting tool. This paper describes the formulation of practical performance design for determining various encoder parameters. It also introduces image processing techniques for enhancing the original CCTV digital image to lessen the burden on operators. Some screenshots are listed for the surveillance functionality. For the process analysis, an image searching filter supported by image processing techniques is explained with screenshots. Multimedia surveillance, which is the merger with process data surveillance, or the SCADA system, is also explained.

Internet safety: adolescents' self-report

We examined the association between adolescents' unsafe experience online, types of Internet activity, and safety practices using a questionnaire returned by 213 private school students (seventh through tenth grades) in spring 1999. One-fourth of respondents reported unsafe experiences. Types of unsafe experience varied with gender, Internet activity, and identity sharing.

Bioterrorism: responding to an emerging threat

Only a few years ago bioterrorism was considered a remote concern but few today are complacent about the possibility of biological agents being intentionally used to cause widespread panic, disruption, disease and death. By its very nature, the biological weapons threat - with its close links to naturally occurring infectious agents and disease - requires a different paradigm than that for conventional terrorism, military strikes or attacks caused by other weapons of mass destruction. This evolving threat presents the medical, public health and scientific communities (importantly including biotechnology) with a set of difficult and pressing challenges. This article provides a brief overview of the threat from biological weapons, the nature of a bioterrorist attack and some of the issues that need to be addressed if we are to make meaningful progress to prevent or contain this disturbing and potentially catastrophic danger.

Public sector risk management: a specific model

Risk management programs for state mental health authorities are generally limited in scope and reactive in nature. Recent changes in how mental health care is provided render it necessary to redirect the risk management focus from its present institutional basis to a statewide, network-based paradigm that is integrated across public and private inpatient and community programs alike. These changes include treating an increasing number of individuals in less-secure settings and contracting for an increasing number of public mental health services with private providers. The model proposed here is closely linked to the Quality Management Process.