Does Hub‐and‐Spoke organization of healthcare system promote workers' satisfaction?

The healthcare services network is a recent organizational structure of healthcare services that are interdependent and organized as a network on the basis of the Hub‐and‐Spoke model. This questionnaire‐based study analyzed socio‐psychological well‐being of health workers both in terms of team‐related experience and individual satisfaction and engagement with one's work in a Hub‐and‐Spoke healthcare service in comparison to non‐network healthcare service. Workers from two different public healthcare services involved in the treatment of the same skeletal rare diseases participated in the Study. We expected that working under a Hub‐and‐Spoke healthcare service—involving teamwork and cooperation among different healthcare services within the units, as well as among workers belonging to different units—would lead to greater psychological team‐related and individual benefits. In line with predictions, the findings showed that under a Hub‐and‐Spoke healthcare service, health workers felt highly interdependent by their team fellows and developed shared cognitions (i.e., team mental models) about their integration and their tasks to a higher extent than non‐network ones. They were also individually more satisfied of their job and displayed higher work engagement than non‐network workers. Beneficial team‐related dynamics, such as perceived interdependence, were responsible for the differences between the Hub‐and‐Spoke workers and non‐network ones. The implications of the present findings were discussed in terms of promotion of health workers' satisfaction and well‐being.     

Along the border: affective promotion or inhibition of conduct in urban spaces / A lo largo de la frontera: promoción o inhibición afectiva de la conducta en los espacios urbanos

Abstract

The concepts of borders, tensegrity and goal-oriented meaningful conduct are used to study the conditions in which affects and conducts can (or cannot) emerge in urban spaces. We assume psychological phenomena are liminal and emerge in the border zones between different individual and collective states. The main focus of the study is the process of affective meaning-making that takes place at specific locations (the border zones) in urban living. Through an example of autoethnography, we try to understand how the symbolic space is used in everyday life to produce, maintain and demolish signs that self-regulate and hetero-regulate complex atmospheres, affects and conducts.     

Acute Alcohol Co‐Ingestion and Hospital‐Treated Deliberate Self‐Poisoning: Is There an Effect on Subsequent Self‐Harm?

The aim of this study was to determine the relationship between alcohol co‐ingestion in an index deliberate self‐poisoning (DSP) episode with repeated DSP and subsequent suicide. A retrospective cohort study was conducted involving 5,669 consecutive index presentations to a toxicology service following DSP between January 1, 1996, and October 31, 2010. Records were probabilistically matched to National Coronial Information System data to identify subsequent suicide. Index DSPs were categorized on co‐ingestion of alcohol, and primary outcomes analyzed were repetition of any DSP, rates of repeated DSP, time to first repeat DSP, and subsequent suicide. Co‐ingestion of alcohol occurred in 35.9% of index admissions. There was no difference between those who co‐ingested alcohol (ALC+) and those who did not co‐ingest alcohol (ALC?) in terms of proportion of repeat DSP, number of DSP events, or time to first repeat DSP event. Forty‐one (1.0%) cases were probabilistically matched to a suicide death; there was no difference in the proportion of suicide between ALC+ and ALC? at 1 or 3 years. There was no significant relationship between the co‐ingestion of alcohol in an index DSP and subsequent repeated DSP or suicide. Clinically, this highlights the importance of mental health assessment of patients that present after DSP, irrespective of alcohol co‐ingestion at the time of event.