Introduction Aggression and violence are highly complex problems in acute psychiatry that often lead to the coercive interventions. The Safewards Model is an evidence-informed conflict-reduction strategy to prevent and reduce such incidents. The aim of this study was to evaluate the implementation of this model with regard to coercive interventions in inpatient care. Materials and Methods We evaluated outcomes of the implementation of the Safewards Model in two locked psychiatric wards in Germany. Frequency and duration of coercive interventions applied during a period of 11 weeks before and 11 weeks after the implementation period were assessed through routine data. Fidelity to the Safewards Model was assessed by the Organization Fidelity Checklist. Results Fidelity to the Safewards Model was high in both wards. The overall use of coercive measures differed significantly between wards [case-wise: χ 2 (1, n = 250) = 35.34, p ≤ 0.001; patient-wise: χ 2 (1, n = 103) = 21.45, p ≤ 0.001] and decreased post-implementation. In one ward, the number of patients exposed to coercive interventions in relation to the overall number of Patients decreased significantly [χ 2 (1, 281) = 6.40, p = 0.01]. Furthermore, the mean duration of coercive interventions overall declined significantly [ U (55,21) = −2.142, p = 0.032] with an effect size of Cohen’s d = −0.282 (95% CI: −0.787, 0.222) in that ward. Both aspects declined as well in the other ward, but not significantly. Discussion Results indicate that the implementation of the Safewards interventions according to the model in acute psychiatric care can reduce coercive measures. They also show the role of enabling factors as well as of obstacles for the implementation process.

The aim of this study was to investigate whether nurses' efforts and rewards, as well as the effort-reward imbalance (ERI) and burnout, differ between subjects working in psychiatric vs. medical hospitals and between nurses under education and examined nurses respectively. Furthermore, the relationship between ERI and burnout was evaluated. Nursing is associated with high levels of emotional strain and heavy workloads. Burnout and a negative ERI can result in high absenteeism and turnover and have been identified as reasons why nurses leave their profession. In the last decade, working conditions of the nursing profession have changed in Germany, but somatic and psychiatric hospitals developed in different ways. This development may lead to different profiles. A sample of 389 nurses (78.8% female) in four German hospitals was investigated. A total of 147 nurses worked in psychiatric hospitals and 236 nurses worked in medical (somatic) hospitals. Fifty participants were still under education. The Effort-Reward Imbalance Inventory measures effort, reward and overcommitment at job and provides an imbalance score between effort and reward. The Maslach Burnout Inventory with the subscales, emotional exhaustion, lack of accomplishment and depersonalization, was also used. Nurses working in medical hospitals reported more burnout and had higher ERI scores. Subjects under education were comparable to examined nurses in terms of burnout but had lower ERI scores. Multiple regression analyses showed all ERI scales to be significant predictors for emotional exhaustion, while age, field of work and educational status further predict effort or ERI respectively. At present, the working situation of nurses in different settings appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.

Beyond organisms experiencing direct impacts (mortality) from the presence of anthropogenic features, interactive relationships may exacerbate the effects of anthropogenic disturbance within the context of these features. For example, mortality risk may be affected by the road infrastructure associated with energy development by influencing space use of predators including human hunters. To assess these relationships, we conducted research on northern bobwhite Colinus virginianus across a hunted and non-hunted area of Beaver River Wildlife Management Area, Oklahoma, using radiotelemetry from 2012-2015. We found that bobwhite mortality risk decreased as the distance from primary roads (m) increased across weeks (hazard ratio [HR]  1.008, 95% confidence interval [CI]  1.0003 to 1.0013). The interaction between unit (hunted and non-hunted) and distance from primary roads was not significant (HR  1.00, 95% CI  0.999 to 1.001) indicating that hunting pressure was not a likely explanation for the observed decrease in survival related to primary roads. Bobwhite on the hunted unit avoided exposed soil/sparse vegetation ( β  -0.01, CI  -0.02 to -0.002) and bare ground ( β  -0.01, CI  -0.02 to -0.002) more than bobwhite on the non-hunted unit, however these were weak relationships. No other differences in bobwhite space use were detected related to hunting. Though we were limited to estimating theoretical rather than empirical amounts of hunting pressure during our study, we were unable to detect any negative compounding effects of anthropogenic development and hunting pressure on bobwhite ecology during the hunting season.

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