Environmental evaluation for workplace violence in healthcare and social services

PROBLEM: Federal policy recommends environmental strategies as part of a comprehensive workplace violence program in healthcare and social services. The purpose of this project was to contribute specific, evidence-based guidance to the healthcare and social services employer communities regarding the use of environmental design to prevent violence. METHOD: A retrospective record review was conducted of environmental evaluations that were performed by an architect in two Participatory Action Research (PAR) projects for workplace violence prevention in 2000 and, in the second project in 2005. Ten facility environmental evaluation reports along with staff focus group reports from these facilities were analyzed to categorize environmental risk factors for Type II workplace violence. RESULTS: Findings were grouped according to their impact on access control, the ability to observe patients (natural surveillance), patient and worker safety (territoriality), and activity support. DISCUSSION: The environmental assessment findings reveal design and security issues that, if corrected, would improve safety and security of staff, patients, and visitors and reduce fear and unpredictability. IMPACT ON INDUSTRY: Healthcare and social assistance employers can improve the effectiveness of violence prevention efforts by including an environmental assessment with complementary hazard controls.     

Making neighborhoods safer: Examining predictors of residents’ concerns about neighborhood safety

This study examined what factors best predict residents’ concerns about neighborhood safety. One-hundred and twenty-two participants were selected from a large, Midwestern metropolitan area. All participants lived in high crime areas. Participants completed a 22-item questionnaire that assessed their perceptions of neighborhood safety and vigilance. These items were clustered as: 1) Community care and vigilance, 2) neighborhood safety concerns, 3) physical incivilities, and 4) social incivilities. Police crime data were also used in the analyses. Our findings suggest that aspects of the broken window theory, collective efficacy, and place attachments/territoriality play a role in affecting residents’ concerns about neighborhood safety.     

Neighborhood Level Spatial Analysis of the Relationship Between Alcohol Outlet Density and Criminal Violence

Misuse of alcohol is a significant public health problem, potentially resulting in unintentional injuries, motor vehicle crashes, drownings, and, perhaps of greatest concern, serious acts of violence, including assaults, rapes, suicides, and homicides. Although previous research establishes a link between alcohol consumption increased levels of violence, studies relating the density of alcohol outlets (e.g., restaurants, bars, liquor stores) and the likelihood of violent crime have been less common. In this paper we test for such a relationship at the small area level, using data from 79 neighborhoods in the city of Minneapolis, Minnesota. We adopt a fully Bayesian point of view using Markov chain Monte Carlo (MCMC) computational methods as available in the popular and freely available WinBUGS language. Our models control for important covariates (e.g., neighborhood racial heterogeneity, age heterogeneity) and also account for spatial association in unexplained variability using conditionally autoregressive (CAR) random effects. Our results indicate a significant positive relationship between alcohol outlet density and violent crime, while also permitting easy mapping of neighborhood-level predicted and residual values, the former useful for intervention in the most at-risk neighborhoods and the latter potentially useful in identifying covariates still missing from the fixed effects portion of the model.     

Monitoring and reporting attacks on education in the Democratic Republic of the Congo and Somalia

The United Nations' Monitoring and Reporting Mechanism is charged with documenting six grave violations against children in a time of conflict, including attacks on schools. Many of these incidents, however, remain unreported across the globe. This study explores whether or not a local knowledge base of education and child protection actors in North and South Kivu Provinces, Democratic Republic of the Congo, and in Mogadishu, Somalia, could contribute to a more complete record of attacks on education in those areas. Hundreds of semi‐structured interviews were conducted with key informants across the three settings, and in total 432 attacks on education were documented. Purposive samples of these reports were verified and a large majority was confirmed. Local non‐governmental organisations and education institutions were most knowledgeable about these incidents, but most never reported them to a monitoring authority. The study concludes that attack surveillance and response were largely insufficient, and recommends investing in mechanisms that utilise local knowledge to address these shortcomings.     

Violence breeds violence: burnout as a mediator between patient violence and nurse violence

The present study examines whether patient-perpetrated violence triggers anger, hatred and other negative emotions that, under certain circumstances, might motivate nurses to behave violently with patients. In doing so, this study considers burnout as a mediator in the patient violence–nurse violence relationship. To test the causal paths, data were collected from 182 nurses working in two government-sector teaching hospitals of Pakistan's Punjab province. Results confirm that patient violence toward nurses leads to nurse violence toward patients through the mediating effect of burnout. The study advises hospitals to provide wellness and stress management programs to nurses who regularly experience events involving patient violence. Hospitals may consider allowing nurses to take short breaks after an encounter with violently behaving patients. In addition, hospitals should conduct empathy-promoting training, emotional intelligence training and ‘lens of the patient’ training programs to sensitize their nursing staff.     

Interrupting the balance: reconsidering the complexities of conflict in South Sudan

By the start of 2014, violent conflict had erupted across much of South Sudan following initial violence in Juba on 15 December 2013. The speed with which the fighting has spread raises questions regarding the impact of national‐level politics on violence at the local level. This article develops a framework in which violent conflict can be comprehended as a response to the interruption of the negotiation of the balance of power between groups; the negotiation is interrupted when that balance tips in favour of one group, such as through changes in the national political market or government reforms. The article provides two cases studies of attempts to strengthen the state that inadvertently interrupted local power relations between groups. In response, the groups engaged in violent conflict to reinstate a balance of power. Both examples involve conflict among Dinka groups from 2005 to 2008.     

Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo

Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences.     

Violence and complex humanitarian emergencies: implications for livelihoods models

This paper explores the nature of the violence that characterises complex humanitarian emergencies and the related implications for modelling livelihoods systems. While noting the importance of livelihoods approaches in complex humanitarian emergencies, it deliberates the limitations of sustainable livelihoods frameworks when applied in environments marked by protracted instability. Adaptations to the model are discussed, with a particular focus on the relationships among violence, assets and liabilities within livelihoods systems. Political economy of violence theories intimate that the assets on which livelihoods systems are constructed in peaceful times may instead become life-and livelihood-threatening liabilities in periods of conflict. Adaptations to livelihood systems in violent settings require that analysts consider violence from policy, institutional and process perspectives. It is suggested that vulnerability should be re-conceptualised as endogenous to livelihoods systems in violent settings. Building on the work of others, a livelihoods model adapted for complex humanitarian emergencies is presented.     

Phytocenotypes and Ecocenotic Potentials of Meadow Grasses

The systems of Ramenskii's cenobiotic types and Grime's life strategies applied to meadow grasses are compared, and differences between these systems are demonstrated. The parameters of violence of meadow grasses in the aboveground and underground spheres are discussed. The methods for evaluating the degrees of shade tolerance in grasses and their tolerance to sodding are proposed. Two types of explerence are distinguished in meadow grasses (cenophobic and cenofluctuation explerence).     

Exploring differences in the workplace violence experiences of young workers in middle and late adolescence in the United States

Problem: Young workers, typically characterized as 15–24 years of age, are commonly employed in jobs where the risk of workplace violence is high. It is unknown how these young workers, at varying stages of development, might understand and respond to workplace violence differently. We set out to explore whether the experiences and understandings of young workers varied between those in middle (ages 15–17) and late (ages 18–24) adolescence. Method: Separate focus groups were conducted with working students (n = 31), ages 15–17 and ages 18–24, who had either experienced or witnessed workplace violence. A focus group guide was used to facilitate the sessions which were recorded, transcribed, and content analyzed for themes. Results: Those in the older group experienced more severe episodes of sexual harassment and physical assault, reported using formal mechanisms for reporting, and noticed an employer focus on customer satisfaction over employee safety, while the younger participants tended to report to their parents. Both groups reported negative effects of experiencing workplace violence including depression, anxiety, feelings of worthlessness, and spill over into personal life. Discussion: Findings suggest that young workers at different developmental stages may experience and respond to workplace violence differently. Further research is needed to see if these results are generalizable. Summary: It is imperative that we understand the distinct differences between these subsets of young workers and how they experience and respond to workplace violence in order to improve research, policy development, and prevention/intervention mechanisms. Practical Applications: Understanding that differences exist among young workers based on age due to developmental stage, lack of experience, education, and social awareness can enable employers, companies, policy makers, and researchers the opportunity to better address the issue of workplace violence in this population.