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Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental health-care staff may use restrictive practices. The Six Core Strategies and debriefing exist for managing violence and restrictive practices in different mental health settings. Debriefing is used to get patients’ views on restrictive practices, ensure proper patient care and strengthen the role of patients as experts. This study aims to provide new information on debriefing implementation and how debriefing was used among different patient groups in a forensic hospital.

Quantitative seclusion time and debriefing reports (n = 524) were examined with Poisson regression analysis. Fisher’s exact test was used to determine the associations between debriefing and seclusion/restraint.

Debriefing (n = 524) was provided in 93% of violent episodes, which is an excellent result on an international level. There was significant variation in how often debriefing was used (p < 0.001) among different patient groups, i.e. dangerous, difficult-to-treat patients and criminal offenders whose sentences have been waived. Previous debriefing research has rarely specified what types of psychiatric patients have been subjected to seclusion or restraint.

The implementation of debriefing requires multiprofessional work within the organization and wards.

Debriefing seems to stimulate reflection at every level of a health-care organization, which fosters learning and can ultimately change clinical practices. The use of debriefing can strengthen the role of patients as well as professionals.

This case engages students on a number of issues common to doing business in other countries, specifically in the Middle East. It is intended to be a basis for class discussion rather than to illustrate either effective or ineffective handling of the situation. The case seeks to integrate issues of international management and cross-cultural conflict and negotiation. Students are challenged to diagnose a cross-culturally sensitive situation and develop solutions in a team environment under limiting time restraints. This case is also designed to help students understand the cultural aspects of a situation and how different solutions could have major consequences on the bottom line of a company.

This work sheds new light on the roles of gender, age and expatriation type—self-initiated expatriate (SIE) vs. assigned expatriate (AE)—by applying the transactional theory of stress and coping (and a validated measurement tool) to the expatriation experience.

Based on quantitative data from 448 expatriates, the authors examined the coping mechanisms (cognitions and actions) employed by senior and younger expatriates, females and males and SIE and AEs when they face hardships while working abroad.

Younger expatriates display less active problem-solving coping, planning, and restraint and consume more alcohol and drugs. Female expatriates express their emotions and use social support more than their male counterparts. SIEs rely on emotional social support more than AEs.

Recognizing that individual repertoires of responses to expatriate challenges are bounded by personal characteristics—such as age, gender, and expatriation type—should improve efforts to support expatriates. This research suggests that expatriate support should be tailored. It offers indications on who needs what.

This work provides a fresh perspective and new insights into classic topics (age, gender, and expatriation type). Individuals react differently abroad. They have different resources and face different demands (to a certain extent) that lead to different coping reactions. Older people manage their emotions better, and female expatriates and SIEs gather and use support; these abilities are assets abroad.

Since the development of antipsychotic drugs in the 1950s, a variety of studies and case reports have been published that suggest an association between exposure to typical antipsychotics and venous thromboembolisms (VTE). Therefore, when starting treatment with antipsychotics, especially low-potency typical antipsychotics and clozapine, health-care providers must account for the patient’s existing VTE risk factors.

In this case report, the authors describe the development of a pulmonary embolism associated with use of chlorpromazine in the treatment of an acute manic episode in a 51-year-old female patient with bipolar disorder type 1.

The patient was brought to the emergency room by the police on a legal hold for bizarre behaviors at a bus stop, which included incessantly yelling at bystanders. The patient was found to have disorganized thoughts, poor sleep, rapid speech, labile mood, distractibility, auditory hallucinations and grandiose delusions. During the course of her stay, the patient received extensive IM chlorpromazine for extreme agitation, in addition to chlorpromazine 200 mg IM Q8H, which was later decreased to chlorpromazine 100 mg chlorpromazine IM/PO Q8H. On day 4 of the treatment, the patient experienced difficulty breathing, hypoxia and tachycardia and was found to have bilateral expiratory wheezes. CT angiography showed sub-segmental pulmonary embolus and the patient was transferred to MICU service. The patient was then intubated and started on heparin by the medical team. Over the course of the next day, her respiratory distress resolved and the patient was extubated.

It is possible that chlorpromazine may indeed increase VTEs, and there are various physiological postulations regarding the mechanism of action. However, multiple confounding variables existed in the authors’ report, including venous stasis and the use of restraints, tobacco and valproic acid. Each of these variables has been shown to increase VTE occurrence. Further controlled studies are necessary to identify the true relationship between antipsychotics and VTEs.

The study sought to fit managerial competencies in the metatraits of the Circumplex Personality Metatraits Model (CPM) by Strus, Cieciuch and Rowinski (2014). The authors assumed that managerial competencies would be located in the sector of personality metatraits, specifically, the plus poles: Integration (Gamma-Plus) through Stability (Alpha-Plus) and Self-restraint (Delta-Plus) to Plasticity (Beta-Plus).

A group of 327 managers took part in this study. Managerial competencies related to social skills, problem-solving, management and goal striving, openness to change and employee development were evaluated via the assessment center (AC).

The results revealed a negative relationship between all managerial competencies and negative metatraits of Disharmony (Gamma-Minus) and Passiveness (Beta-Minus). On the other hand, Integration (Gamma-Plus) and Plasticity (Beta-Plus) appeared to be positively related to two competencies only: openness to change and problem-solving.

All managerial competencies fitted well in the CPM pattern with adequate degrees of fit. The discussion indicates the role of managerial competencies and personality assessment in the selection process.