An examination of aftercare services for the chronically mentally ill in two communities

Within the last few decades there has been a shift from traditional institutional approaches in mental health to community based service delivery systems. Researchers examining the community-based model have focused on improving the quality of community care. Specifically, use of aftercare services has been found to improve the quality of community care (Byers, Cohen, & Harshbarger, 1978; Gittelman 1974; Krauss & Slavinsky 1982; Weinman et al. 1978). Coordination of services has also been shown to improve the quality of community care by increasing the effectiveness of aftercare (Broskowsky, marks, & Burmen 1982; Clark 1976; Krauss & Slavinsky 1982). At the level of the chronically mentally ill, quality of community life is affected by the quality of care. Researchers have shown that psychiatric patients or clients experience poor quality of life in the community (General Accounting Office, 1978; Krauss & Slavinsky, 1982; Lamb, 1982). The present research was designed to examine [1] service providers’ perceptions of aftercare service coordination in their community, [2] service receivers’ (i.e. the chronically mentally ill’s) perceptions of their quality of life in the community, and [3] factors hypothesized to affect co-ordination of services for the chronically mentally ill in the community. Organizational research has demonstrated that co-ordination is affected by relationships [1] within the agency, and, [2] between community agencies (Evan, 1967; Etztoni, 1961; marks & Broskowski, 1982). These factors hypothesized to affect co-ordination are referred to as intraorganizational perceptions and interorganizational perceptions respectively. Two communities were studied. One community operated from a community care model where chronic mental patients/clients were treated entirely in the community or on a hospital out-patient basis. The second community operated from an institutional care model using in-hospital, out-patient and community treatment. A comparison was made between the two communities using data provided by service providers. Two scales were constructed for this research. The scale for service providers examined perceptions of co-ordination of services for the chronically mentally ill, interorganizational perceptions, and intraorganizational perceptions. The self-administered instrument was constructed in the form of a multiple-choice and 5-point Likert format scale. The scale for service receivers examined Quality of Life in the community by measuring [1] life adjustment, based on factors outlined by Krauss & Slavinsky (1982) which were: a need to be taken care of, a need for social interaction, a need for relief from psychiatric symptoms, a need for basic life necessities, and a need for hope, and, [2] life satisfaction using an adapted version of the Bradburn Satisfaction Scale (Bradburn, 1969). The self-administered service receiver instrument was constructed in the form of a multiple choice and 5-point Likert format scale. It was found that co-ordination of services was moderate in the institutional care model and low in the community care model. There was a significant difference between the two communities in the perceived level of co-ordination of services. Interorganizational perceptions affected co-ordination of services at the local level. Chronically mentally ill persons experience a poor quality of life in the community: Life adjustment was affected by the level of care, relief from psychiatric symptoms, and hope of recovery provided by service providers. This paper concludes with a discussion of the limitations in the research. It is shown that there is no reason to believe that the results were spurious. Recommendations based on the research are provided, and directions for further research are suggested

Random Breath Tests (RBT): a call for national thresholds in RBT to driver ratios

RBTs are a significant component of drink-driving management programs in Australia and have been for almost 30 years. In 1976 Victoria (Vic) launched Australia’s first RBT program. Other jurisdictions introduced RBTs (partially or fully) soon after.\ua0Three key elements comprise an effective RBT program:1.\ua0\ua0\ua0\ua0 Supportive legislation that identifies strong enforcement of the program with strict and definite penalties,2.\ua0\ua0\ua0\ua0 Strong and ongoing public education to raise awareness of the program,3.\ua0\ua0\ua0\ua0 Public perception that alcohol-related breath testing is truly random and ubiquitous; that vehicles are stopped randomly without a preliminary suspicion of alcohol use.This report examines RBT practice in two state

Ethical issues in publishing in predatory journals

This is a correction for Biochemia Medica 2017;27(2):279-84. DOI: https://doi.org/10.11613/ BM.2017.030

Identification of Swine Salmonella serotypes Using Pulsed-field Gel Electrophoresis of Conserved Xba1 Fragments

Swine Salmonella isolates (n=674) from various locations throughout the United States and Canada were analyzed via pulsed-field gel electrophoresis (PFGE) with Xba1. PFGE subtypes were analyzed by cluster analysis and compared to conventional serotyping results. The analysis showed a correlation of serotype to PFGE subtype. In addition, conserved fragments were identified within the restriction patterns that were unique to each serotype. PFGE using Xba1 restriction provides a screening method for identifying swine Salmonella serotypes

Poor Reporting of Scientific Leadership Information in Clinical Trial Registers

BACKGROUND: In September 2004, the International Committee of Medical Journal Editors (ICMJE) issued a Statement requiring that all clinical trials be registered at inception in a public register in order to be considered for publication. The World Health Organization (WHO) and ICMJE have identified 20 items that should be provided before a trial is considered registered, including contact information. Identifying those scientifically responsible for trial conduct increases accountability. The objective is to examine the proportion of registered clinical trials providing valid scientific leadership information. METHODOLOGY/PRINCIPAL FINDINGS: We reviewed clinical trial entries listing Canadian investigators in the two largest international and public trial registers, the International Standard Randomized Controlled Trial Number (ISRCTN) register, and ClinicalTrials.gov. The main outcome measures were the proportion of clinical trials reporting valid contact information for the trials' Principal Investigator (PI)/Co-ordinating Investigator/Study Chair/Site PI, and trial e-mail contact address, stratified by funding source, recruiting status, and register. A total of 1388 entries (142 from ISRCTN and 1246 from ClinicalTrials.gov) comprised our sample. We found non-compliance with mandatory registration requirements regarding scientific leadership and trial contact information. Non-industry and partial industry funded trials were significantly more likely to identify the individual responsible for scientific leadership (OR = 259, 95% CI: 95-701) and to provide a contact e-mail address (OR = 9.6, 95% CI: 6.6-14) than were solely industry funded trials. CONCLUSIONS/SIGNIFICANCE: Despite the requirements set by WHO and ICMJE, data on scientific leadership and contact e-mail addresses are frequently omitted from clinical trials registered in the two leading public clinical trial registers. To promote accountability and transparency in clinical trials research, public clinical trials registers should ensure adequate monitoring of trial registration to ensure completion of mandatory contact information fields identifying scientific leadership

Investigator experiences with financial conflicts of interest in clinical trials

<p>Abstract</p> <p>Background</p> <p>Financial conflicts of interest (fCOI) can introduce actions that bias clinical trial results and reduce their objectivity. We obtained information from investigators about adherence to practices that minimize the introduction of such bias in their clinical trials experience.</p> <p>Methods</p> <p>Email survey of clinical trial investigators from Canadian sites to learn about adherence to practices that help maintain research independence across all stages of trial preparation, conduct, and dissemination. The main outcome was the proportion of investigators that reported full adherence to preferred trial practices for all of their trials conducted from 2001-2006, stratified by funding source.</p> <p>Results</p> <p>844 investigators responded (76%) and 732 (66%) provided useful information. Full adherence to preferred clinical trial practices was highest for institutional review of signed contracts and budgets (82% and 75% of investigators respectively). Lower rates of full adherence were reported for the other two practices in the trial preparation stage (avoidance of confidentiality clauses, 12%; trial registration after 2005, 39%). Lower rates of full adherence were reported for 7 practices in the trial conduct (35% to 43%) and dissemination (53% to 64%) stages, particularly in industry funded trials. 269 investigators personally experienced (n = 85) or witnessed (n = 236) a fCOI; over 70% of these situations related to industry trials.</p> <p>Conclusion</p> <p>Full adherence to practices designed to promote the objectivity of research varied across trial stages and was low overall, particularly for industry funded trials.</p