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Aims to determine the bed requirement for a large district general hospital with a four‐bedded surgical high‐dependency unit (HDU). All admissions from 1 December 1997 to 28 February 1998 (aged over 15 years) were used in this study. Overall, the study showed that an estimated 1.6 per cent of adult, in‐patient admissions required HDU care (there were 10,949 admissions to the hospital during the study period). The bed occupancy for the surgical HDU during the study period was 90 per cent (319 actual bed days/356 potential bed days). The average length of stay was four days. The mean, median and modal daily bed requirement was six. The needs assessment study clearly demonstrated that it was essential for the Trust to provide more comprehensive care to a wider range of patients than was currently available in the hospital, particularly those with serious medical conditions, and recommended the provision of an eight‐bedded HDU.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.

The purpose of this paper is to present and provide a critical review of most recent studies inquiring into brain abnormalities in psychopathy.

The authors provide an overview of the findings of neurobiological studies conducted in the last five years. Publications chosen for review were found using Web of Science, PsycINFO and Scopus search engines.

Data in the literature reveal that psychopathy is associated with brain abnormalities in frontal and temporo-limbic regions, i.e. regions responsible for moral decision making, emotional processing and learning. Additionally, interactions between the brain areas have been identified as crucial for the development of psychopathic personality traits. Research findings suggest that the flow of impulses between the frontal cortex and temporo-limbic structures in psychopaths is significantly hindered.

The current paper provides an in-depth review of most recent neurobiological studies inquiring into brain abnormalities associated with psychopathic personality traits. Moreover, a particular attention has been paid to identifying abnormalities in brain structures not previously studied in relation to psychopathy (e.g. mirror neuron system, white matter connections).

This study investigates the complex interaction between properties of some emergent crises and the expertise of particular public sector leaders, who themselves are embedded in particular institutional processes that further constrain identification of these emergent crises. It is suggested that discrepancy in the ability of leaders to detect crises is due not only to their own proficiency in some cognitive skills, but also to their interaction with, and differences in, particular properties of some emergent crises, which render some emergent crises more detectable than others in some institutional environments.

In this chapter, we view team cohesion from a more generalized perspective of team dynamics, and focus on four leadership models for understanding these dynamics in teams in the context of the Mars Mission. Given the long duration of the mission with periods of no or intermittent communication and support, isolation and confinement, and the risk of great physical and psychological harm, having tailored leadership models for this unique team dynamics context is critical. And yet, many of these same dangerous conditions occur in other contexts such as for first responders, crisis management teams, Special Forces operations, and scientific exploration teams in extreme environments. As such, building from a model of leadership and team dynamics for dangerous contexts, for a long-duration space mission involving both Mission Control and the Astronaut Crew, these models of leadership and team dynamics include a collective-level approach for scientists and engineers, a primarily crew-based socioemotional approach, a leader-level crisis/emergency approach, and a dyadic or sortie-level approach. Implications of these models for effective leadership in building and maintaining team dynamics and cohesion for the Mars Mission and across a variety of other dangerous and extreme contexts are discussed.

Models of Child Health Appraised (MOCHA) defines school health services (SHSs) as those that exist due to a formal arrangement between educational institutions and primary health care. SHSs are unique in that they are designed exclusively to address the needs of children and adolescents in this age group and setting.

We investigated SHSs have been provided to schools and how they contribute to primary healthcare services for school children. We did this by mapping the national school health systems against the standards of the World Health Organization, and against a framework measuring the strength of primary care, adapting this from an existing, adult-focused framework.

We found that all but two countries in the European Union and European Economic Area have SHSs. There, however, remains a need for much greater investment in the professional workforce to run the services, including training to ensure appropriateness and acceptability to young people. Greater collaboration between SHSs and primary care services would lead to better coordination and the potential for better health (and educational) outcomes. Involving young people and families in the design of SHSs and as participants in its outputs would also improve school health.

Purpose – The current literature of housework division consistently finds positive consequences of an equitable division of housework (particularly for working women). This study looks to more fully explore the characteristics that predict an egalitarian division of housework.

Methodology – This study integrates three theoretical perspectives – relative resource theory, life course theory, and gender studies – and uses data from a nationally representative data set to investigate couples who divide household labor more evenly and compares them to more traditional couples where the woman performs most of the housework using multivariate and logistic regression.

Findings – This study finds that the more resources a spouse possesses, the more likely that spouse is to engage in housework equitably. From a life course perspective, findings show that the longer a woman waits to marry, the more likely she is to have an egalitarian marriage; and length of marriage is a positive predictor of an inegalitarian marriage. Stronger than any other factor in predicting an egalitarian relationship are men's and women's progressive gender ideologies.

Originality of paper – Past research on the division of housework has focused on how chores are sex-typed and divided between men and women, but little investigation has focused on those couples who practice a more egalitarian housework division. This study uniquely finds a clear and irrefutable link between progressive ideologies and egalitarianism, as well as a link between conservative ideologies and “inegalitarianism.”

By implementing various forms of preference policies, countries around the world intervene in their economies for their own political and economic purposes. Likewise, twenty-five states in the U.S. have implemented in-state preference policies (NASPO, 2012) to protect and support their own vendors from out-of-state competition to achieve similar purposes. The purpose of this paper is to show the connection between protectionist public policy instruments noted in the international trade literature and the in-state preference policies within the United States. This paper argues that the reasons and the rationales for adopting these preference policies in international trade and the states' contexts are similar. Given the similarity in policy outcomes, the paper further argues that the international trade literature provides an overarching explanation to help understand what states could expect in applying in-state preference policies.