'Your personality is the intervention': a grounded theory of mental health nurses’ beliefs about hope and experiences of fostering hope within a secure setting

Hope is an important factor in psychological resilience and change, and recovery from mental health difficulties. Recently, there has been an increased focus on recovery-oriented practice within forensic mental health settings. Several policies include calls for mental health practitioners to inspire hope for recovery in the individuals they work with. However, there is little suggestion of how to implement such recommendations in practice or research exploring how staff foster hope in forensic settings. This study used grounded theory to explore nurses’ perspectives and experiences of hope within a medium secure setting. A model was developed from the data that integrated nurses’ beliefs about hope, practices to develop service users’ hope and the emotional impact of this work. The nurses’ values played a significant role in their work to develop hope. Recommendations are made to help manage the emotional impact and address challenges unique to fostering hope within forensic settings.     

A comparison of seclusion rates between intellectual disability and non-intellectual disability services: the effect of gender and diagnosis

Introduction: The use of seclusion as a means of managing the extreme behaviours forensic patients in secure settings is a controversial yet often common practice, despite there being little evidence that seclusion as a practice has any significant therapeutic value for the patient. The aim of this study was to explore the use of seclusion and whether this differs as a function of gender and diagnosis across secure services. Method: This study collated data from 11 medium and low secure hospitals that admit male and female patients, with some services providing services for patients with intellectual disability (with or without co-morbid disorders), and others for patients with mental illness and/or personality disorder only. Results: Both gender and diagnosis were associated with differential seclusion rates. Seclusions were three times longer for patients in the non-ID compared to the ID service. Male seclusions (for any diagnosis) were around twice as long as those in female services. Female ID patients spent significantly less time in seclusion compared to other groups. Female ID was associated with two to three times the number of seclusion events per patient compared to other groups. No statistically significant association between the type of service and the reason for a patient being secluded. Conclusions: A range of organisational factors that determine the use and duration of seclusion are cited and merit further exploration. High rates of psychiatric co-morbidity and the complexity of patients admitted to services may also mediate risk and use of seclusion. The study supports the use of early intervention techniques and the adoption of positive behaviour support.     

Characteristics of male patients admitted to an adolescent secure forensic psychiatric hospital

This paper examines the characteristics of a group of 64 young men, who were consecutively admitted to Bluebird House, an NHS mixed gender, adolescent forensic, medium secure hospital. The characteristics examined focus on the young men’s clinical presentations, as informed by the Millon Adolescent Clinical Inventory, and their ICD10 (WHO 1992) diagnoses. The paper also examines the males’ route into, and out of, Bluebird House, as well as their risk profiles, especially with regards to others, as informed by Structured Assessment of Violence Risk in Youth findings and staff recorded incidents. Correlational analysis is performed to try and understand this population, with statistically significant findings highlighted. The discussion considers the trajectory for some of these young men into adult personality disorders, their presentation and prognosis compared to their female counterparts, and how their presentation contrasts with adult male forensic populations.     

“Supporting me through emotional times,all different kinds of behaviour.” Forensic mental health service users understanding of positive behavioural support

This service evaluation project explored service users’ experiences of positive behavioural support (PBS) within a medium secure mental health service. Interpretative phenomenological analysis (IPA) was used to analyse interviews with ten service users. Four main themes emerged from the data: My plan; How I understand PBS; How PBS has helped me, the benefits; and Making the plan work. Overall, service users viewed their experience of having a PBS plan positively. They reflected that the plans offered staff greater understanding of their behaviours and needs, enabling them to receive appropriate support. Service users valued the experience of being involved in the process, offering important insights into their experiences. They also expressed frustrations about staff not following the plan and not understanding why they had a plan whilst others did not. Limitations of the study, clinical implications and ideas for future research have been discussed.     

高职高专计算机基础教育考评方法探析

高职高专计算机基础教育的培养目标是为了培养高素质的劳动者,因此在教学考评中应主要考察学生的职业能力。为了达到这样的目的,应尽量探索新的计算机基础教育的考评方法,认真研究考评方法的原理,比较不同考评方法的优劣,权衡不同类型考评方法的得失,构建面向素质教育的新计算机基础教育考评体系。     

论由区分所有权人连带赔偿高空抛物所致损害的法律障碍——兼评《中国民法典草案侵权责任法编》第56条

我国侵权法草案规定侵权人不明的高空抛物致人损害,由“不能证明自己没有过错的建筑物使用人”连带承担全部赔偿责任。这实质上是对建筑物区分所有权人设定了一种对其在住宅内的行为随时举证证明的义务。这种对建筑物区分所有权人自由权利的限制和负担,无法解释和证成其正当性。建筑物区分所有权人实施的抛物行为是其承担侵权责任的根据,侵权行为人不明,受害人就无法按照侵权法获得赔偿。区分所有权人相互之间的监督义务和协助查找义务以及作证义务,乃公法上的义务;以此为根据要求其对受害人承担连带侵权责任,违反了法律关系理论的基本原理。要求建筑物区分所有权人证明没有实施抛物行为,违背了未发生的事实无法证明的证据法原理。推定所有可能实施侵权行为的人实际实施了侵权行为,违背了违法行为不能推定的侵权法原理。所以该条应该删除。     

Does the multi-phased high school entrance program affect the equity of educational opportunity？

The Taiwan Government has proposed many educational reform programs in these years. Since 2000, in addition to the joint high school entrance examination, new ways of entering senior high school have included recommendation, application, register-and-distribution, as well as direct promotion. In 2001, the joint high school entrance examination was further annulled for good. However, contrary to the Taiwan Government＇s anticipation, the multi-phased high school entrance program has been severely criticized due to its controversial operating process. Based on our in-depth interviews and analyses of data collected by the Taiwan Education Panel Survey, the results demonstrate that the multi-phased high school entrance program has divided the selection process into several critical parts. Firstly, students have to face the requisition both on and off campus. Secondly, the selection and recommendation criteria are not uniform among different schools. Thirdly, students with better family backgrounds are still benefiting from the advantages of being recommended to public senior high schools. Finally, the selection process and related criteria can easily be influenced by the parents or relatives of students with higher socio-economic status. We therefore argue that the issues related to the selection and recommendation criteria, timing of assignments, school categorizations, as well as the review process for the multi-phased high school entrance program should all be re-considered.     

危害铁路运输高危人群概念、构成要素及特征之研究

对危害铁路运输高危人群的研究必须植根于对高危人群这一概念内涵及外延的准确把握,因此,研究现有危害铁路运输安全的高危人群的组成结构,对高危人群做一个明确的界定,是"高危人群的识别和控管"这一论题的重要基础。在此基础上通过进一步研究其构成要件、特点,为铁路公安机关实践工作提供客观统一的认定判断标准。这个问题的解决,将有助于铁路公安机关制定有针对性的预防、控制危害铁路运输安全高危人群的对策。     

优质旅游有效供给因素对我国旅游产业效率的影响及区域差异

优质旅游是新时代我国旅游产业发展的必然选择。通过采用三阶段DEA模型等方法,从支撑因素、产业发展及消费需求三个维度构建优质旅游有效供给的环境变量,并采用面板数据实证分析了优质旅游有效供给因素对我国旅游产业效率的影响与区域发展差异。研究结果表明,优质旅游有效供给环境变量对我国旅游产业效率影响显著,其中支撑因素水平和旅游消费水平促进效率提升,产业发展在一定程度上抑制效率增长;目前我国优质旅游有效供给总体水平不高,且不同区域及省份之间表现出一定差异。因此,应通过进一步优化支撑要素水平、建立旅游投资总量调控及质量监督机制、制定积极的消费引导政策、缩小区域差距等,促进产业效率改进,提高优质旅游有效供给总体水平。     

An Anthropological Examination of the Types of Skeletal Fractures Resulting from Fatal High (˃3 m) Free Falls,

Fatal falls from heights (?3 m) often result in blunt force trauma (BFT) to the skeleton. The fracture patterns that result from this BFT mechanism are well understood in forensic anthropology and forensic pathology; however, details of the specific types of fractures that result remain poorly documented. The aim of this study was to provide a detailed examination of the types of fractures that may result from fatal high falls. Fractures were recorded from 95 full‐body postmortem computed tomography scans of individuals known to have died from a high fall. Trauma was then analyzed taking into account the extrinsic and intrinsic variables known to influence a fall using multiple logistic regression. A total of 339 types of fractures were classified, of which 16 were significantly associated with this BFT mechanism. Classified fracture types will augment anthropological interpretations of the circumstances of death from BFT in cases of suspected high falls.