An acute change? Does treatment within a therapeutic community for personality disorders affect local acute service use

2021 ◽  
Vol 42 (3) ◽  
pp. 113-120
Author(s):  
Vafa Pirjamali ◽  
Daniela Ivanova ◽  
Andrew John Howe
Keyword(s):  
Service Use ◽  
Therapeutic Community ◽  
Statistical Significance ◽  
Psychiatric Service ◽  
Service Evaluation ◽  
Treatment Team ◽  
Liaison Psychiatry ◽  
Content Type ◽  
Adult Service ◽  
Patient Groups

Purpose The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to understand if the use of acute services was also affected via a service evaluation project. Design/methodology/approach The authors collected data from electronic records on the use of local services in the two years before, during and the two years after treatment in the TC. Specifically, the authors counted inpatient bed days, Emergency department (ED) presentations and days under home treatment team and liaison psychiatry; the authors used ANOVA to analyse the data. Findings The study included 25 adult service users, 17 female and 8 male, with an average age of 40. Whilst there were reductions in the use of inpatient beds and ED presentations, on analysis, these were not found statistically significant. The small size of the study is a limitation and may limit the generalisability of the findings. The study concludes there may be reductions in acute psychiatric service use during and after treatment in the TC. The findings were not statistically significant; the authors suggest larger multi-centre studies may be able to demonstrate statistical significance. Originality/value PD patients have a relatively high use of acute psychiatric services compared to other patient groups. The authors are not aware of any similar studies in the published literature.

Modelling the predictors of e-service use among information systems users

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Immanuel Ovemeso Umukoro ◽  
Mutawakilu Adisa Tiamiyu
Keyword(s):  
User Satisfaction ◽  
Service Use ◽  
Research Effort ◽  
Information Service ◽  
Service Evaluation ◽  
Content Type ◽  
Demographic Profiles ◽  
System Service ◽  
Multi Stage ◽  
Services Use

PurposeThis paper sought to validate a proposed e-service use model that takes into account system's environment and user factors as plausible determinants of an information system's (IS) use that are not accounted for by previous IS use models. The aim is to establish the applicability of the model for e-services and IS design, implementation and use.Design/methodology/approachThis study adopts a quantitative approach to data collection and analysis. Using a systematic multi-stage random sampling, data were collected from 400 university e-library users and analysed using regression analysis to test the hypothesised relationships.FindingsInternal system factors (particularly service quality), user satisfaction, e-service environment factors and user factors (gender, programme of study, level of study and computer/IT self-efficacy) predicted the use of e-services. These findings are partly similar to and partly different from those of the earlier studies, suggesting that more studies are needed to test the comprehensive model of e-services’ use.Research limitations/implicationsThis is a replicated study and as such made use of a similar population. These findings, therefore, cannot be generalised to other organisations with users of different demographic profiles.Practical implicationsFirst, the use of the services provided through an IS is predicted by factors other than user satisfaction, system, service and information qualities. Second, system administrators, designers, library administrators and managers must ensure that these factors are considered during the design, implementation and use of ISs.Social implicationsThe paper argues for the need to design e-services and ISs with consideration for user attributes that may lead to social exclusion if not considered. This is because the environment where an IS is hosted can be a driver of e-services use, especially if management provides the enabling environment in terms of optimal staffing, training, user support and periodic e-service evaluation.Originality/valueThis paper extends research effort in understanding the predictors of use of ISs beyond the traditional system's attributes (information, service and system qualities) to include system environment and user factors.

Personalized cloud service review analysis based on modularized ontology

2020 ◽  
Vol 44 (5) ◽  
pp. 953-975
Author(s):  
Emna Ben-Abdallah ◽  
Khouloud Boukadi ◽  
Mohamed Hammami ◽  
Mohamed Hedi Karray
Keyword(s):  
Knowledge Base ◽  
Positive Impact ◽  
Cloud Service ◽  
Service Evaluation ◽  
End Users ◽  
Cloud Services ◽  
Limited Information ◽  
Content Type ◽  
Ontology Language ◽  
Modular Ontology

PurposeThe purpose of this paper is to analyze cloud reviews according to the end-user context and requirements.Design/methodology/approachpropose a comprehensive knowledge base composed of interconnected Web Ontology Language, namely, modular ontology for cloud service opinion analysis (SOPA). The SOPA knowledge base will be the basis of context-aware cloud service analysis using consumers' reviews. Moreover, the authors provide a framework to evaluate cloud services based on consumers' reviews opinions.FindingsThe findings show that there is a positive impact of personalizing the cloud service analysis by considering the reviewers' contexts in the performance of the framework. The authors also proved that the SOPA-based framework outperforms the available cloud review sites in term of precision, recall and F-measure.Research limitations/implicationsLimited information has been provided in the semantic web literature about the relationships between the different domains and the details on how that can be used to evaluate cloud service through consumer reviews and latent opinions. Furthermore, existing approaches are lacking lightweight and modular mechanisms which can be utilized to effectively exploit information existing in social media.Practical implicationsThe SOPA-based framework facilitates the opinion based service evaluation through a large number of consumer's reviews and assists the end-users in analyzing services as per their requirements and their own context.Originality/valueThe SOPA ontology is capable of representing the content of a product/service as well as its related opinions, which are extracted from the customer's reviews written in a specific context. Furthermore, the SOPA-based framework facilitates the opinion based service evaluation through a large number of consumer's reviews and assists the end-users in analyzing services as per their requirements and their own context.

scholarly journals Inequalities in psychiatric service use and mortality by migrant status following a first diagnosis of psychotic disorder: a Swedish cohort study of 1.3m people

2021 ◽  
Author(s):  
Dafni Katsampa ◽  
Syeda F Akther ◽  
Anna-Clara Hollander ◽  
Henrik Dal ◽  
Christina Dalman ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Psychotic Disorder ◽  
Service Use ◽  
Psychiatric Service ◽  
Mental Healthcare ◽  
Migrant Status ◽  
Region Of Origin ◽  
Icd 10 ◽  
Sub Saharan ◽  
First Diagnosis

Abstract It is unclear whether inequalities in mental healthcare and mortality following the onset of psychosis exist by migrant status and region-of-origin. We investigated whether (i) mortality (including by major causes of death); (ii) admission type (in- or out-patient), and; (iii) in-patient length of stay at first diagnosis for psychotic disorder presentation, and; (iv) time-to-readmission for psychotic disorder differed for refugees, non-refugee migrants and by region-of-origin. We established a cohort of 1,335,192 people born 1984-1997 and living in Sweden from 1st January 1998, followed from their 14 th birthday or arrival to Sweden, until death, emigration, or 31 December 2016.People with ICD-10 psychotic disorder (F20-33; N=9,399) were 6.7 (95%CI: 5.9-7.6) times more likely to die than the general population, but this did not vary by migrant status (p=0.15) or region-of-origin (p=0.31). This mortality gap was most pronounced for suicide (adjusted hazard ratio [aHR]: 12.2; 95% CI: 10.4-14.4), but persisted for deaths from other external (aHR: 5.1; 95%CI: 4.0-6.4) and natural causes (aHR: 2.3; 95%CI: 1.6-3.3). Non-refugee (adjusted odds ratio [aOR]: 1.4, 95%CI: 1.2-1.6) and refugee migrants (aOR: 1.4, 95%CI: 1.1-1.8) were more likely to receive inpatient care at first diagnosis. No differences in inpatient length of stay at first diagnosis were observed. Sub-Saharan African migrants with psychotic disorder were readmitted more quickly than their Swedish-born counterparts (adjusted sub-HR: 1.2; 95%CI: 1.1-1.4). Our findings highlight the need to understand the drivers of disparities in psychosis treatment and the mortality gap experienced by all people with disorder, irrespective of migrant status or region-of-origin.

scholarly journals Endotoxemia as a Diagnostic Tool for Patients with Suspected Bacteremia Caused by Gram-Negative Organisms: a Meta-Analysis of 4 Decades of Studies

2015 ◽  
Vol 53 (4) ◽  
pp. 1183-1191 ◽  
Author(s):  
James C. Hurley ◽  
Piotr Nowak ◽  
Lars Öhrmalm ◽  
Charalambos Gogos ◽  
Apostolos Armaganidis ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Summary Receiver Operating Characteristic ◽  
Detection Rates ◽  
Gram Negative ◽  
Content Type ◽  
E Coli ◽  
Patient Groups ◽  
Gram Negative Organisms

The clinical significance of endotoxin detection in blood has been evaluated for a broad range of patient groups in over 40 studies published over 4 decades. The influences of Gram-negative (GN) bacteremia species type and patient inclusion criteria on endotoxemia detection rates in published studies remain unclear. Studies were identified after a literature search and manual reviews of article bibliographies, together with a direct approach to authors of potentially eligible studies for data clarifications. The concordance between GN bacteremia and endotoxemia expressed as the summary diagnostic odds ratios (DORs) was derived for three GN bacteremia categories across eligible studies by using a hierarchical summary receiver operating characteristic (HSROC) method. Forty-two studies met broad inclusion criteria, with between 2 and 173 GN bacteremias in each study. Among all 42 studies, the DORs (95% confidence interval) were 3.2 (1.7 to 6.0) and 5.8 (2.4 to 13.7) in association with GN bacteremias withEscherichia coliand those withPseudomonas aeruginosa, respectively. Among 12 studies of patients with sepsis, the proportion of endotoxemia positivity (95% confidence interval) among patients withP. aeruginosabacteremia (69% [57 to 79%];P= 0.004) or withProteusbacteremia (76% [51 to 91%];P= 0.04) was significantly higher than that among patients without GN bacteremia (49% [33 to 64%]), but this was not so for patients bacteremic withE. coli(57% [40 to 73%];P= 0.55). Among studies of the sepsis patient group, the concordance of endotoxemia with GN bacteremia was surprisingly weak, especially forE. coliGN bacteremia.

scholarly journals Mental health service use, depression, panic disorder and life events among Swedish young adults in 2000 and 2010: a repeated cross-sectional population study in Stockholm County, Sweden

2017 ◽  
Vol 27 (5) ◽  
pp. 510-518 ◽  
Author(s):  
A. Lundin ◽  
Y. Forsell ◽  
C. Dalman
Keyword(s):  
Young Adults ◽  
Panic Disorder ◽  
Life Events ◽  
Service Use ◽  
Psychiatric Service ◽  
Psychiatric Services ◽  
Mental Health Service Use ◽  
Stockholm County ◽  
Cross Sectional ◽  
Psychiatric Service Use

Aims.The use of specialised psychiatric services for depression and anxiety has increased steadily among young people in Sweden during recent years. It is not known to what extent this service use is due to an increase in psychiatric morbidity, or whether other adversities explain these trends. The aim of this study is to examine if there is increased use of psychiatric services among young adults in Sweden between 2000 and 2010, and if so, to what extent this increase is associated with differences in depression, anxiety and negative life events.Methods.This is a repeated cross-sectional study of 20–30-year old men and women in Stockholm County in 2000 and 2010 (n = 2590 and n = 1120). Log-binomial regression analyses were conducted to compare the prevalence of service use, depression and panic disorder between the two cohorts. Self-reported life events were entered individually and as a summary index, and entered as potential mediators. Different effects of life events on service use were examined through interaction analysis. We report prevalence proportion ratios (PPR) with 95% confidence intervals.Results.Specialised psychiatric service use, but also depression and panic disorder was more common in the younger cohort (current service use 2.4 and 5.0%). The younger cohort did not report more life events overall or among those with depression or anxiety. Neither depression, panic disorder nor life events could explain the increased use of psychiatric services in the younger cohort (Fully adjusted model PPR = 1.70, 1.20–2.40 95% CI). There was no significant interaction between cohort and life events in predicting psychiatric service use.Conclusion.This study provides initial support for an increase in service use among young adults compared with 10 years earlier. The increased service use cannot be explained with increasing worse life situations.

Longitudinal evaluation of efficiency in a petrochemical company

2017 ◽  
Vol 24 (7) ◽  
pp. 1786-1813 ◽  
Author(s):  
Charles Von Gilsa ◽  
Daniel Pacheco Lacerda ◽  
Luis Felipe Riehs Camargo ◽  
Iberê Guarani Souza ◽  
Ricardo Augusto Cassel
Keyword(s):  
Learning Process ◽  
Statistical Significance ◽  
Malmquist Index ◽  
Internal Reference ◽  
Content Type ◽  
Internal Resources ◽  
Investment Projects ◽  
Actual Change ◽  
Petrochemical Company ◽  
Efficiency And Productivity

Purpose The purpose of this paper is to longitudinally assess the technical efficiency and productivity, considering investment projects and technological change, in a second-generation petrochemical company. Design/methodology/approach The study uses data envelopment analysis (DEA) together with the Malmquist index to measure efficiency during the analysis periods. The working method consists of four main phases, namely development of the conceptual model, construction of the mathematical model, application of model to the case, and analysis of the results. The study utilizes a quantitative approach with descriptive goals seeking to evaluate the impacts of technical changes on the operational efficiency and productivity of the production process. Findings The use of DEA associated with the Malmquist index proved to be viable for analyzing a single company and identifying efficiency improvements, as well as the impacts of the learning process and the implementation of improvement projects. However, the results of the improvement projects and learning process were not representative and had no statistical significance on the actual change in efficiency of the company during the periods analyzed. For the case in question, the learning process and continuous improvement were not observed during all study periods. Practical implications The proposition that the improvement projects and investments implemented increased the efficiency of the company was rejected. Hence, with this work, it was possible to determine that the company unnecessarily invested resources in projects to increase efficiency. Furthermore, the company could have explored more internal resources before making significant investments in increased efficiency. Originality/value As for the value of this research in the theoretical and academic scope, this paper advances knowledge on the application of DEA because it proposes to establish an internal reference benchmarking for comparison. The literature contains few studies that analyze organizations using continuous processes, such as petrochemical processes, in longitudinal studies as a function of time, especially with the use of DEA.

Mixed emotions and credence service use: insights from at-risk gamblers

2021 ◽  
Vol 35 (6) ◽  
pp. 740-754
Author(s):  
Svetlana De Vos ◽  
Roberta Crouch ◽  
Pascale Quester ◽  
Jasmina Ilicic
Keyword(s):  
At Risk ◽  
Service Use ◽  
Positive Impact ◽  
Individual Characteristics ◽  
Service Research ◽  
Content Type ◽  
Tolerance Of Ambiguity ◽  
Phase Study ◽  
Vulnerable Consumers ◽  
Credence Services

Purpose This paper aims to explore the power of appeals based on fear mixed with challenge co-designed with vulnerable consumers in motivating the use of credence services. Design/methodology/approach A qualitative phase (Study 1), comprising focus groups of self-identified at-risk gamblers, revealed a series of conceptual themes for advertising stimuli that were then tested empirically (Study 2) on the likelihood to use credence services in a gambling context. Individual characteristics such as tolerance of ambiguity were also tested for their potential moderating influence. Findings In comparison to appeals based on single emotions, fear mixed with the challenge has a significantly stronger impact on intentions to use credence services in at-risk gamblers. Findings confirm the indirect positive impact of fear mixed with the challenge via sequential mediators of involvement with advertising and attitude towards credence service advertising. The moderating role of tolerance of ambiguity on credence service use intentions was confirmed. Originality/value The potential of a fear mixed with challenge appeal to motivate vulnerable consumers to seek credence services has not been investigated to date. The findings contribute to both the transformative service research and advertising literature streams by providing valuable insights into promotional campaigns aimed at vulnerable consumers such as at-risk gamblers.

Adapted dialectical behaviour therapy skills group service evaluation

2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Robert John Searle ◽  
Ianiv Borseti
Keyword(s):  
Intellectual Disability ◽  
Psychological Intervention ◽  
Training Group ◽  
Skills Training ◽  
Well Being ◽  
Service Evaluation ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Friedman Analysis

Purpose The purpose of this paper is to determine the effectiveness of an adapted dialectical behaviour therapy (DBT) treatment programme for individuals with an intellectual disability, via completion of a service evaluation. Design/methodology/approach Outcome measurements were competed at pre-, post- and 12 months follow-up, and the effectiveness of the intervention was assessed using a Friedman analysis. Findings Findings demonstrated that the treatment group showed significant differences in their “psychological distress” scores, but no significant differences were found in their “psychological well-being”, “anxiety” or “quality of life” (WHO-QOL) scores over time. Originality/value Overall, the current study adds to the small but growing literature that supports using the skills training group part of DBT as a stand-alone psychological intervention when working with people with an intellectual disability.

scholarly journals Commentary on “promoting positive communication environments: a service evaluation”: the communication partnership as a focus for change

2018 ◽  
Vol 23 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Karen Bunning
Keyword(s):  
Learning Disabilities ◽  
Research Design ◽  
Service Evaluation ◽  
Realist Evaluation ◽  
Content Type ◽  
Positive Communication ◽  
Communication Environments ◽  
Adults With Learning Disabilities ◽  
Instructional Training

Purpose The purpose of this paper is to debate the complexities of intervening with adults with learning disabilities and support staff in the natural environment and challenges of evaluating change. Design/methodology/approach A critical review of the relevance and amenability of communication partnerships for interventions that promote communication growth in context was carried out. Particular consideration was given to the mechanism for change and implications for research design. Findings The communication partnership is a reasonable focus for interventions aiming to promote the communication of adults with learning disabilities. Combining instructional training with in situ coaching appears to provide the most effective approach. Bringing about change within the dynamic context of communication is challenging and may benefit from an open, investigative design. Originality/value This paper synthesises the available evidence on intervening in the communication environment and debates the potential of realist evaluation as a context-focused research design.

“StatLit: tactical interventions for strategic transformation”

2017 ◽  
Vol 34 (9) ◽  
pp. 10-14
Author(s):  
Seth Porter ◽  
Ameet Doshi
Keyword(s):  
Information Literacy ◽  
Literacy Instruction ◽  
Design Methodology ◽  
Statistical Significance ◽  
Statistical Reasoning ◽  
Statistical Literacy ◽  
Content Type ◽  
Research Libraries ◽  
Biennial Conference ◽  
Strategic Transformation

Purpose This paper was inspired by an Association of College and Research Libraries Biennial Conference 2017 roundtable that aimed to transform existing notions about statistical literacy in information literacy instruction. Design/methodology/approach In Baltimore, the authors facilitated an in-person discussion and synchronous virtual dialogue via Twitter and Periscope about teaching basic statistical concepts (such as mean vs median) and the real implications of “statistical significance”. Findings A recording of the roundtable is available here: http://bit.ly/StatLit. Originality/value The goal of the StatLit roundtable was to inspire transformational thinking for teaching basic statistical reasoning to students within a library context.

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