The Calculating for an Adequate Systems Tool (CAST): A Low-Cost and Effective Tool to Improve a Community’s Substance Use Disorder Care Preparedness

Objective In the context of an ongoing opioid crisis, the authors used The Calculating for an Adequate Systems Tool (CAST) to help quantify the rural community preparedness to care of people with substance use disorders (SUDs.) Methods CAST was developed by Green and associates in 2017. CAST uses demographics, social, and community indicators to produce a global risk score for hospitalization due to SUDs and highlights which SUD care system resource areas in the studied community are lacking or redundant. There are no human subjects involved; the majority of the required data for CAST is freely available on official national databases, making the tool accessible and low-cost. When specific data was not available through online resources, the study authors worked with key community leaders and the CAST authors to develop proxies to adapt the tool to match the data available for the subject. The study, done in 2019, used CAST on the rural community of Towner County, ND, which had been reportedly successful in terms of the opioid epidemic. Results Surprisingly, the calculated hospitalization risk level was medium. Among the studied factors, however, several in the referral and recovery category were below calculated need, and most in all categories were meeting or exceeding need. Conclusions A limitation of this study is proxy development due to lack of specific data- a widespread problem in rural health. CAST and most of its required data are available online, making it an effective tool to help optimize resource allocation in the care of people with SUD

Improvement Least-Distance Measure Model with Coplanar DMU on Strong Hyperplanes

Technique of Data Envelopment Analysis (DEA) involves methods conducted for desirable objective management of Decision Making Unit (DMU) that is same increasing of efficiency level. Data envelopment analysis furthermore determines the efficiency level, provides situation, removes inefficiency with evaluated benchmarking information. In this paper the use of the improvement Least-Distance measure with relation previous model by coplanar DMU, is proposed for computational dissipation at assess distance on these interior combinations, for determination the shortest projection from a considered unit to the strongly efficient production frontier. Therefore locate nearest path to improvement efficiency the evaluated DMU

Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care

BACKGROUND: Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. METHODS: The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. RESULTS: The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. CONCLUSION: Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients

The Policy We Can Get: Seniority, Authority, and Gender Legislation in Israel and Argentina

Most explanations for women politicians’ legislative agendas and their choice to represent women rely on assumptions about their individual policy preferences. Even research exploring policy variation among women assumes that it is best explained by ideological differences on the left-right political spectrum. Through a comparative case study of Israel and Argentina I show that the pursuit of gender legislation is more a function of constraints and strategic choices than policy preferences. Argentina and Israel are representative of the two main types of country cases used in the gender and politics literature – Argentina has institutionalized women’s presence in the legislature, and Israel has not. This crucial difference supports the generalizability of my findings. Drawing on field work in Israel combined with cross national statistical analyses, I argue that as women gain access to powerful positions within the legislature we will observe changes in their legislative agenda. I assume that in order to advance or succeed in politics, women will endeavor to mimic men’s behavior. However, in the Argentinian and Israeli cases the picture that emerges is quite different. I find that policy variation among women generally, and the choice to advocate for gender-related legislation specifically, is driven by the degree of institutional marginalization women experience. While women may want to behave like their male colleagues as they gain seniority and enter positions of authority in the legislature, they face particular instrumental constraints. As a result, though we may expect women to expand their legislative agenda and effectively cease to advocate for niche issues like women’s issues, instead I find that they are unable to do so. Marginalization within the legislature both in Israel and Argentina causes women to maintain a certain degree of commitment to women’s issues. While in the Israeli case, the extreme marginalization of women in the legislature results in women exclusively working on gender-related policy, in Argentina, due to the normalization of women’s presence in the legislature, I observe women legislators broadening their policy scope beyond women’s issues. This work is a significant contribution to the representation literature as it provides a clear and intuitive explanation for policy outcomes for historically marginalized communities. The larger implication of this work is that the normalization of increased descriptive representation for historically marginalized communities decreases the likelihood for large-scale social change