Effectiveness of Continuity-of-Care Programs to reduce time in hospital in persons with schizophrenia

2011 ◽  
Vol 20 (1) ◽  
pp. 65-72 ◽  
Author(s):  
M. Alonso Suárez ◽  
M.F. Bravo-Ortiz ◽  
A. Fernández-Liria ◽  
C. González-Juárez
Keyword(s):  
Emergency Room ◽  
Continuity Of Care ◽  
Community Mental Health Services ◽  
Care Program ◽  
First Year ◽  
Case Register ◽  
Before And After ◽  
Using Data ◽  
Persons With Schizophrenia ◽  
The Impact

Aims.To assess the impact of the Continuity-of-Care Program (CCP; a clinical case management model) on hospital use of persons with schizophrenia in three Community Mental Health Services in Madrid (Spain).Methods.Using data provided by the Psychiatric Case Register, we analyzed the use of hospitalization in 250 individuals before and after the date of inclusion in this program.Results.During the first year after launching the program, there was a 40–69% reduction in the number of admissions, length of each hospital stay, proportion of admitted patients, total number of days in-hospital, proportion of patients visiting the emergency room, and emergency room visits. This drop was maintained over the subsequent 3 years of program functioning.Conclusions.These results encourage the development and implementation of such programs, even though more studies evaluating the effectiveness of these programs for other endpoints are needed.

scholarly journals Inquiry-based learning to improve student engagement in a large first year topic

2015 ◽  
Vol 6 (2) ◽  
pp. 65-71 ◽  
Author(s):  
Masha Smallhorn ◽  
Jeanne Young ◽  
Narelle Hunter ◽  
Karen Burke da Silva
Keyword(s):  
Student Engagement ◽  
Student Satisfaction ◽  
Learning Outcomes ◽  
Student Learning Outcomes ◽  
Thinking Skills ◽  
Critical Thinking Skills ◽  
First Year ◽  
Before And After ◽  
Multiple Choice Exam ◽  
The Impact

Increasing the opportunity for students to be involved in inquiry-based activities can improve engagement with content and assist in the development of analysis and critical thinking skills. The science laboratory has traditionally been used as a platform to apply the content gained through the lecture series. These activities have exposed students to experiments which test the concepts taught but which often result in a predicted outcome. To improve the engagement and learning outcomes of our large first year biology cohort, the laboratories were redeveloped. Superlabs were run with 100 students attending weekly sessions increasing the amount of contact time from previous years. Laboratories were redeveloped into guided-inquiry and educators facilitated teams of students to design and carry out an experiment. To analyse the impact of the redevelopment on student satisfaction and learning outcomes, students were surveyed and multiple choice exam data was compared before and after the redevelopment. Results suggest high levels of student satisfaction and a significant improvement in student learning outcomes. All disciplines should consider including inquiry-based activities as a methodology to improve student engagement and learning outcome as it fosters the development of independent learners. 

An Exclusive Country Club: The Effects of the GATT on Trade, 1950–94

2005 ◽  
Vol 57 (4) ◽  
pp. 453-478 ◽  
Author(s):  
Joanne Gowa ◽  
Soo Yeon Kim
Keyword(s):  
World War Ii ◽  
Bilateral Trade ◽  
World War ◽  
Trade Blocs ◽  
Country Club ◽  
Before And After ◽  
Bilateral Trade Flows ◽  
Using Data ◽  
Exchange Control ◽  
The Impact

Using data on bilateral trade flows from both before and after World War II, this article examines the impact of the General Agreement on Tariffs and Trade on trade between its members and on the system of interwar trade blocs. It shows that the distribution of the benefits produced by the GATT was much more highly skewed than conventional wisdom assumes. The article also shows that the gold, Commonwealth, Reichsmark, and exchange-control blocs exerted positive and significant effects on trade after 1945. The authors attribute these effects to the bargaining protocol that governed successive rounds of GATT negotiations, the signature element of the postwar trade regime.

scholarly journals A Therapeutic Educational Program in Oral Health for Persons with Schizophrenia: A Qualitative Feasibility Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Audrey Peteuil ◽  
Corinne Rat ◽  
Sahar Moussa-Badran ◽  
Maud Carpentier ◽  
Jean-François Pelletier ◽  
...  
Keyword(s):  
Oral Health ◽  
Educational Program ◽  
Periodontal Diseases ◽  
Level Of Evidence ◽  
Face To Face ◽  
Before And After ◽  
Health Quality ◽  
Persons With Schizophrenia ◽  
High Level ◽  
The Impact

Objective. The aim of this study was to test the feasibility of a therapeutic educational program in oral health (TEPOH) for persons with schizophrenia (PWS). Design. In a qualitative study, we explored the representation of oral health before and after a TEPOH. Clinical Setting: PWS are at greater risk of decayed and missing teeth and periodontal diseases. In a previous publication, we described the different steps in building a TEPOH by taking into account the experiences of PWS concerning oral health quality of life. This TEPOH aimed at promoting a global health approach. Participants: Voluntary PWS and their caregivers were recruited during face-to-face interviews at “Les Boisseaux” (a psychiatric outpatient centre) in Auxerre (France) and were included in the study between November and December 2016. Intervention: We explored the experiences of participants and their perceptions of oral health before and after the TEPOH with focus group meetings. Results. Four females and three males participated in the study, and the mean age was 29.4 ± 5. Before the TEPOH, the PWS produced 28 ideas about oral health perception and 37 after the TEPOH. After the TEPOH, elements relating to the determinants of oral health (smoking and poor diet) emerged. Conclusions. These results show an evolution in oral health representation, and after some adjustments to the TEPOH, the second step will be to test this program in a large sample to generate a high level of evidence of the impact of TEPOH in the long term.

scholarly journals Sea water desalination and removal of iodine: effect on thyroid function

2018 ◽  
Vol 16 (3) ◽  
pp. 472-475
Author(s):  
Gideon Koren ◽  
Yona Amitai ◽  
Meital Shlezinger ◽  
Rachel Katz ◽  
Varda Shalev
Keyword(s):  
Thyroid Function ◽  
Sea Water ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Water Desalination ◽  
Thyroid Function Tests ◽  
School Aged Children ◽  
Before And After ◽  
Using Data ◽  
The Impact

Abstract In Israel, about 55% of drinking water is derived from desalination (DSW) which removes all iodine. A recent study from Israel demonstrated high rates of iodine deficiency among school-aged children and pregnant women. There are concerns that low iodine may lead to impaired thyroid function. However, to date, the impact of consuming DSW on body iodine status has not been studied. The objective was to assess whether the increased use of DSW is associated with increased rates of hypothyroidism. Using data from a large health fund in Israel, we compared proportions of patients with higher than normal thyroid stimulating hormone (TSH), and lower than normal T3 and T4 levels before and after a massive desalination project became operational in August 2013 in areas with high vs. low use of DSW. Over 400,000 cases were compared in 2010–2013 vs. 2014–2016. Overall, there was no increase in the proportion of individuals with higher than normal TSH levels, or lower than normal T3 and T4 levels. In conclusion, in this population-based study, following the introduction of DSW, there was no evidence of increased incidence of low thyroid function tests, and the trends were similar in both areas highly consuming, or not consuming, DSW.

scholarly journals A social-belonging intervention improves STEM outcomes for students who speak English as a second language

2020 ◽  
Vol 6 (40) ◽  
pp. eabb6543
Author(s):  
Jennifer LaCosse ◽  
Elizabeth A. Canning ◽  
Nicholas A. Bowman ◽  
Mary C. Murphy ◽  
Christine Logel
Keyword(s):  
Second Language ◽  
Academic Outcomes ◽  
First Year ◽  
Esl Students ◽  
First Semester ◽  
Social Belonging ◽  
Students First ◽  
Using Data ◽  
Postsecondary Science ◽  
The Impact

Students who speak English as a second language (ESL) are underserved and underrepresented in postsecondary science, technology, engineering, and math (STEM) fields. To date, most existing research with ESL students in higher education is qualitative. Drawing from this important body of work, we investigate the impact of a social-belonging intervention on anticipated changes in belonging, STEM GPA, and proportion of STEM credits obtained in students’ first semester and first year of college. Using data from more than 12,000 STEM-interested students at 19 universities, results revealed that the intervention increased ESL students’ anticipated sense of belonging and three of the four academic outcomes. Moreover, anticipated changes in belonging mediated the intervention’s effects on these academic outcomes. Robustness checks revealed that ESL effects persisted even when controlling for other identities correlated with ESL status. Overall, results suggest that anticipated belonging is an understudied barrier to creating a multilingual and diverse STEM workforce.

scholarly journals Developing checklists to prevent diagnostic error in Emergency Room settings

Diagnosis ◽  
2014 ◽  
Vol 1 (3) ◽  
pp. 223-231 ◽  
Author(s):  
Mark L. Graber ◽  
Asta V. Sorensen ◽  
Jon Biswas ◽  
Varsha Modi ◽  
Andrew Wackett ◽  
...  
Keyword(s):  
Emergency Room ◽  
Diagnostic Errors ◽  
Evaluation Process ◽  
Diagnostic Error ◽  
Error Rates ◽  
Diagnostic Uncertainty ◽  
Maximum Benefit ◽  
Before And After ◽  
The Impact ◽  
Test Ordering

AbstractChecklists have been shown to improve performance of complex, error-prone processes. To develop a checklist with potential to reduce the likelihood of diagnostic error for patients presenting to the Emergency Room (ER) with undiagnosed conditions.Participants included 15 staff ER physicians working in two large academic centers. A rapid cycle design and evaluation process was used to develop a general checklist for high-risk situations vulnerable to diagnostic error. Physicians used the general checklists and a set of symptom-specific checklists for a period of 2 months. We conducted a mixed methods evaluation that included interviews regarding user perceptions and quantitative assessment of resource utilization before and after checklist use.A general checklist was developed iteratively by obtaining feedback from users and subject matter experts, and was trialed along with a set of specific checklists in the ER. Both the general and the symptom-specific checklists were judged to be helpful, with a slight preference for using symptom-specific lists. Checklist use commonly prompted consideration of additional diagnostic possibilities, changed the working diagnosis in approximately 10% of cases, and anecdotally was thought to be helpful in avoiding diagnostic errors. Checklist use was prompted by a variety of different factors, not just diagnostic uncertainty. None of the physicians used the checklists in collaboration with the patient, despite being encouraged to do so. Checklist use did not prompt large changes in test ordering or consultation.In the ER setting, checklists for diagnosis are helpful in considering additional diagnostic possibilities, thus having potential to prevent diagnostic errors. Inconsistent usage and using the checklists privately, instead of with the patient, are factors that may detract from obtaining maximum benefit. Further research is needed to optimize checklists for use in the ER, determine how to increase usage, to evaluate the impact of checklist utilization on error rates and patient outcomes, to determine how checklist usage affects test ordering and consultation, and to compare checklists generally with other approaches to reduce diagnostic error.

The Impact of Visualization Dashboards on Patient Care in the Emergency Room (Preprint)

2020 ◽  
Author(s):  
Doaa Alhabib ◽  
Arwa Alumran ◽  
Saja Alrayes
Keyword(s):  
Emergency Room ◽  
Patient Care ◽  
Cross Sectional Study ◽  
Royal Commission ◽  
Quality And Safety ◽  
Cross Sectional ◽  
Future Studies ◽  
Before And After ◽  
Artery Disease ◽  
The Impact

UNSTRUCTURED Displaying patients’ data on electronic dashboards in the emergency room provides emergency room employees continuous visual monitoring. With this study, we aimed to measure the effects of displaying data on electronic dashboards on the quality and safety of the patient care provided in the emergency room (ER). We used a cross-sectional study design to compare the results of specific quality and safety indicators before and after the implementation of the dashboards in the ER of the Royal Commission Hospital, Jubail, Saudi Arabia. Our results showed statistically significant improvements on the waiting time for all ER patients, the total length of stay in the ER, and the time from arrival until an electrocardiogram test was performed for patients who came to the ER with symptoms suggesting coronary artery disease. Future studies might be conducted to evaluate the end-users’ utilization and satisfaction of the ER dashboards.

Impact of a Sun Awareness Curriculum on Medical Students' Knowledge, Attitudes, and Behaviour

1999 ◽  
Vol 3 (4) ◽  
pp. 182-187 ◽  
Author(s):  
Melinda J. Gooderham ◽  
Lyn Guenther
Keyword(s):  
Medical Students ◽  
Skin Cancer ◽  
Medical Curriculum ◽  
Substantial Improvement ◽  
First Year ◽  
Before And After ◽  
Baseline Knowledge ◽  
Awareness Curriculum ◽  
First Year Medical Students ◽  
The Impact

Background: Physicians teach sun awareness to their patients, but frequently have no formal training in this area. A week-long dermatology curriculum during Sun Awareness Week that included skin cancer and sun awareness education to first-year medical students was introduced in May 1998 at the University of Western Ontario, London, Canada. Objective: The purpose of this study was to determine the baseline knowledge, attitudes, and behaviour of the first-year medical students towards sun awareness before and after the new curriculum. Method: This study used a pre- and post-test design to determine the impact of the curriculum on the medical students' knowledge, attitudes, and intent to change behaviour. It also reports any influence of demographic variables on these parameters. Results: The students demonstrated a substantial improvement in their knowledge of sun-related topics despite some baseline knowledge. Many students reported unhealthy behaviour prior to the curriculum, but demonstrated an intent to adopt more healthy behaviour after the curriculum. Minor differences in knowledge and behaviour due to demographic characteristics disappeared upon completion of the curriculum. Conclusions: An undergraduate medical curriculum with skin cancer and sun awareness education can improve the medical students' knowledge, attitudes, and behaviour towards sun awareness.

scholarly journals Firearm legislation reform in the European Union: impact on firearm availability, firearm suicide and homicide rates in Austria

2007 ◽  
Vol 191 (3) ◽  
pp. 253-257 ◽  
Author(s):  
Nestor D. Kapusta ◽  
Elmar Etzersdorfer ◽  
Christoph Krall ◽  
Gernot Sonneck
Keyword(s):  
Age Groups ◽  
Law Reform ◽  
The European Union ◽  
Firearm Availability ◽  
Before And After ◽  
Firearm Suicide ◽  
Prevention Programmes ◽  
Using Data ◽  
Union Impact ◽  
The Impact

BackgroundThe availability of firearms in homes and at aggregate levels is a risk factor for suicide and homicide. One method of reducing access to suicidal means is the restriction of firearm availability through more stringent legislation.AimsTo evaluate the impact of firearm legislation reform on firearm suicides and homicides as well as on the availability of firearms in Austria.MethodOfficial statistics on suicides, firearm homicides and firearm licences issued from 1985 to 2005 were examined. To assess the effect of the new firearm law, enacted in 1997, linear regression and Poisson regressions were performed using data from before and after the law reform.ResultsThe rate of firearm suicides among some age groups, percentage of firearm suicides, as well as the rate of firearm homicides and the rate of firearm licences, significantly decreased after a more stringent firearm law had been implemented.ConclusionsOur findings provide evidence that the introduction of restrictive firearm legislation effectively reduced the rates of firearm suicide and homicide. The decline in firearm-related deaths seems to have been mediated by the legal restriction of firearm availability. Restrictive firearm legislation should be an integral part of national suicide prevention programmes in countries with high firearm suicide rates.

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