Under Construction: Linkages between Youth and Adult Systems after Expanding Transition Services

Summary: This report summarizes changes between 2003 and 2007 in relationships among organizations that offer services to individuals in transition to adulthood, ages 14‐25, who have serious mental health conditions in Clark County, Washington. In 2002 Clark County received a Partnerships for Youth Transition grant from the Center for Mental Health Services (CMHS), Division of Service and Systems Improvement, Child, Adolescent and Family Branch. The purpose of these grants was to plan, design, and implement programs to support the transition to adulthood for youth with serious mental health conditions up to age 25 and their families. Services for these youths span child and adult mental health service systems, and many different systems (e.g., vocational rehabilitation, substance abuse, education). Understanding how this vast array of services and systems interacted and changed over the course of the grant helps to identify whether such grants can positively impact the kinds of interactions that facilitate the process of transition for young people maturing into adulthood. While each locale has its own particular set of services, policies, and organizing forces, it is hoped that the findings in this county provide insight into systems in other sites. The primary audience for this report includes policy makers, state and regional administrators, program designers, and others interested in improving the network of services and supports for transition age youth (TAY) from mental health and other systems that TAY are involved with during their transition to adulthood. Others who may be interested in these findings include youth, family members, youth allies, and service providers

A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation

The Clubhouse Model has been in existence for over sixty-five years; however, a review that synthesizes the literature on the model is needed. The current study makes use of the existing research to conduct a systematic review of articles providing a comprehensive understanding of what is known about the Clubhouse Model, to identify the best evidence available, as well as areas that would benefit from further study. Findings are summarized and evidence is classified by outcome domains. Fifty-two articles met the selection criteria of Randomized Clinical Trials (RCT\u27s), quasi-experimental studies, or observational studies for domains of employment (N = 29); quality of life/satisfaction (N = 10); reductions in psychiatric hospitalization(s) (N = 10); social relationships (N = 10); education (N = 3); and health promotion activities (N = 2). RCT results support the efficacy of the Clubhouse Model in promoting employment, reducing hospitalization(s), and improving quality of life. Quasi-experimental and observational studies offer support in education and social domains. The findings from this review indicate that Clubhouses are a promising practice but additional studies using rigorous methods that report the strength of the outcomes are needed to evaluate Clubhouse programs with fidelity to the Clubhouse Model

Where are Bridges Needed: Relationships Between Youth and Adult Services Before Strengthening the Transition System

Summary: This report summarizes the nature of the relationships between organizations and agencies in Clark County, WA, that could form a system of services to support youth and young adults with serious mental health conditions during the ages of the transition from adolescence to adulthood (ages 14‐25)

Visualization of Dissolution‐Precipitation Processes in Lithium–Sulfur Batteries

In this work, light is shed on the dissolution and precipitation processes S8 and Li2S, and their role in the utilization of active material in Li-S batteries. Combining operando X-ray Tomographic Microscopy and optical image analysis, in real-time; sulfur conversion/dissolution in the cathode, the diffusion of polysulfides in the bulk electrolyte, and the redeposition of the product of the electrochemical reaction, Li2S, on the cathode are followed. Using a custom-designed capillary cell, positioning the entire cathode volume within the field of view, the conversion of elemental sulfur to soluble polysulfides during discharge is quantitatively followed. The results show the full utilization of elemental sulfur in the cathode in the initial stage of discharge, with all solid sulfur converted to soluble polysulfide species. Optical image analysis shows a rapid diffusion of polysulfides as they migrate from the cathode to the bulk electrolyte at the start of discharge and back to the cathode in the later stages of discharge, with the formation and precipitation of Li2S. The results point to the redeposition of Li2S on all available surfaces in the cathode forming a continuous insulating layer, leaving polysulfide species remaining in the electrolyte, and this is the process limiting the cell\u27s specific capacity

A Resident-Based Reimbursement System for Intermediate Care Facilities for the Mentally Retarded

In this article, the authors present a resident-based reimbursement system for intermediate care facilities for the mentally retarded (ICFs-MR), which represent a large and growing proportion of the Medicaid budget. The statistical relationship between resident disability level and the expected cost of caring for the individual is estimated, allowing for the prediction of expected resource use across the population of ICF-MR residents. The system incorporates an indirect cost rate, a base direct care rate (constant across all providers), and an individual-specific direct care rate, based on the expected cost of care

Counting hard-to-count populations: the network scale-up method for public health

Estimating sizes of hidden or hard-to-reach populations is an important problem in public health. For example, estimates of the sizes of populations at highest risk for HIV and AIDS are needed for designing, evaluating and allocating funding for treatment and prevention programmes. A promising approach to size estimation, relatively new to public health, is the network scale-up method (NSUM), involving two steps: estimating the personal network size of the members of a random sample of a total population and, with this information, estimating the number of members of a hidden subpopulation of the total population. We describe the method, including two approaches to estimating personal network sizes (summation and known population). We discuss the strengths and weaknesses of each approach and provide examples of international applications of the NSUM in public health. We conclude with recommendations for future research and evaluation

Sequential deep learning image enhancement models improve diagnostic confidence, lesion detectability, and image reconstruction time in PET

Background: Investigate the potential benefits of sequential deployment of two deep learning (DL) algorithms namely DL-Enhancement (DLE) and DL-based time-of-flight (ToF) (DLT). DLE aims to enhance the rapidly reconstructed ordered-subset-expectation-maximisation algorithm (OSEM) images towards block-sequential-regularised-expectation-maximisation (BSREM) images, whereas DLT aims to improve the quality of BSREM images reconstructed without ToF. As the algorithms differ in their purpose, sequential application may allow benefits from each to be combined. 20 FDG PET-CT scans were performed on a Discovery 710 (D710) and 20 on Discovery MI (DMI; both GE HealthCare). PET data was reconstructed using five combinations of algorithms:1. ToF-BSREM, 2. ToF-OSEM + DLE, 3. OSEM + DLE + DLT, 4. ToF-OSEM + DLE + DLT, 5. ToF-BSREM + DLT. To assess image noise, 30 mm-diameter spherical VOIs were drawn in both lung and liver to measure standard deviation of voxels within the volume. In a blind clinical reading, two experienced readers rated the images on a five-point Likert scale based on lesion detectability, diagnostic confidence, and image quality. Results: Applying DLE + DLT reduced noise whilst improving lesion detectability, diagnostic confidence, and image reconstruction time. ToF-OSEM + DLE + DLT reconstructions demonstrated an increase in lesion SUVmax of 28 ± 14% (average ± standard deviation) and 11 ± 5% for data acquired on the D710 and DMI, respectively. The same reconstruction scored highest in clinical readings for both lesion detectability and diagnostic confidence for D710. Conclusions: The combination of DLE and DLT increased diagnostic confidence and lesion detectability compared to ToF-BSREM images. As DLE + DLT used input OSEM images, and because DL inferencing was fast, there was a significant decrease in overall reconstruction time. This could have applications to total body PET