Readmission to an acute psychiatric unit within 28 days of discharge : identifying those at risk

Objective. To examine factors that could help identify those most at risk of readmission to an acute psychiatric in-patient unit within 28 days of a discharge.

Method. A detailed file audit was conducted comparing 54 consecutive patients who had been readmitted within 28 days of discharge with 61 patients, chosen at random, who had not been readmitted during the same period.

Results. Readmission within 28-days of discharge was associated with having been admitted in the previous year (P = 0.004), receiving the Disability Support Pension (P = 0.015), not having a discharge plan sent to the patient’s GP on discharge from the index admission (P = 0.05), receiving follow-up by the mental health team within 7 days of discharge (P = 0.007) and being unemployed (P = 0.015).

Conclusions. Targeting those with previous admissions for focussed discharge planning may help organisations reduce the numbers of unnecessary early readmissions.

What is known about the topic? Readmission within 28-days of discharge is being increasingly used by service funders and organisations as an indicator of the effectiveness of community care and of the organisation’s ability to provide continuous care across programs. Previous studies, mainly conducted in the US in the mid-90s, often reach contradictory conclusions and their relevance to the Australian setting is limited.

What does this paper add? This paper uses data from an Australia mental health service. It identifies patient and service characteristics associated with rapid re-admission and provides a baseline to evaluate strategies to reduce the readmission rate.

What are the implications for practitioners? This paper highlights the importance of careful discharge planning and communication with general practitioners particularly in relation to patients who have had previous admissions.

Holy days after migration

In Zavoj, a mountainous village in the Republic of Macedonia, the Day of the Holy Mother is the most significant day in the village's ritual calendar. Over the last two decades the festival has been transformed due to emigration, but importantly, many Zavoj emigrants return to the village for the festival. Added to this are several other celebrations related to holy days that take place in the village. The focus of this paper will be the Mala Sveta Bogorodica (minor Holy Mother) festivity, and the sacred sites on the Old Zavoj Road. A very active church committee draws together the emigrants and produces a new type of village community and new types of social practices. Parallel to this, is the dramatic transformation of the architecture of the village. From data of recent field work, this paper will explore the emigrant gathering in Zavoj, and why the village becomes a place for the celebration of holy days after migration.

Performance score variation between days at Australian national and Olympic women's artistic gymnastics competition

We determined the inter-day variability in elite-standard women's artistic gymnastics competition scores. National (50 gymnasts for up to three days) and Olympic (24 gymnasts for up to five days) competition scores published in the public domain (‘Giant poster pull-out’, 2010; Gymnastics Australia, 2008) were evaluated using three statistical measures. Analyses of the inter-day differences in the mean scores as a percentage (MDiff%), coefficient of variation percentages for the mean score across both days (CV%), and Pearson correlation coefficients for the inter-day score (r) were interpreted using thresholds from trivial to large. National-class gymnasts' two-day performance variation was trivial for vault, small for floor and beam, and moderate for bars. When senior gymnasts competed for a third day the performance variation increased to moderate for vault. Across five days of Olympic competition there were trivial (e.g. CV%: vault = 0.8) to small (e.g. CV%: bars = 2.0) variations in performances between days on all apparatus. Olympians' performance score consistency is superior to senior, national-class competitors. The performance score consistency required for gymnasts who aspire to participate at the Olympics as a top-24 competitor is better than 3%.

"Lose 30lbs in 30 days" : assigning responsibility for deceptive advertising of weight-loss products

Purpose – The aim of this paper is to outline key social marketing issues apparent in deceptive weight-loss advertising, from the perspective of government policy-makers, manufacturers, the media, and consumers. The purpose is to examine the complexity of one aspect of the obesity battle and provide a framework for coordinated and integrated social marketing initiatives from a multiple stakeholder perspective.

Design/methodology/approach – The results of deceptive weight-loss advertising are framed using the harm chain model, and the paper offers recommended solutions based on a framework of marketing, education and policy changes across the network of stakeholders.

Findings – This paper concludes that a resolution to the harm created by deceptive weight-loss advertising can be achieved by the creation of a more holistic, system-wide solution to this important health and policy issue. This networked approach must involve all aspects of harm in a multi-stakeholder solution, including both upstream and downstream integration. Specific recommendations are made for policy-makers, manufacturers, the media, and consumers to achieve this goal.

Social implications – From a marketing perspective, analyzing the issue of deceptive weight-loss advertising using the harm chain allows for the creation of a more holistic, system-wide solution involving stakeholders in all aspects of harm for this important health and policy issue.

Originality/value – This research examines the problem of obesity and weight-loss advertising from the unique perspective of the harm chain framework. The authors make unified recommendations for various stakeholders including industry, media, government and consumers, in order to direct integrated social marketing and consumer-oriented strategies within this industry.