Rate and predictors of service disengagement in an epidemiological first-episode psychosis cohort

To assess the prevalence and predictors of service disengagement in a treated epidemiological cohort of first-episode psychosis (FEP) patients.

Quality of Service for Multicasting in Content Addressable Networks

Multicasting is an efficient mechanism for one to many data dissemination. Unfortunately, IP Multicasting is not widely available to end-users today, but Application Layer Multicast (ALM), such as Content Addressable Network, helps to overcome this limitation. Our OM-QoS framework offers Quality of Service support for ALMs. We evaluated OM-QoS applied to CAN and show that we can guarantee that all multicast paths support certain QoS requirements.

Transition and Justice: Negotiating the Terms of New Beginnings in Africa

Transition and Justice examines a series of cases from across the African continent where peaceful ‘new beginnings’ were declared after periods of violence and where transitional justice institutions helped define justice and the new socio-political order. Offers a new perspective on transition and justice in Africa transcending the institutional limits of transitional justice Covers a wide range of situations, and presents a broad range of sites where past injustices are addressed Examines cases where peaceful ‘new beginnings’ have been declared after periods of violence Addresses fundamental questions about transitions and justice in societies characterized by a high degree of external involvement and internal fragmentation

Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia spectrum and bipolar I disorders: the 24-month follow-up ACCESS II study

OBJECTIVE The ACCESS treatment model offers assertive community treatment embedded in an integrated care program to patients with psychoses. Compared to standard care and within a controlled study, it proved to be more effective in terms of service disengagement and illness outcomes in patients with schizophrenia spectrum disorders over 12 months. ACCESS was implemented into clinical routine and its effectiveness assessed over 24 months in severe schizophrenia spectrum disorders and bipolar I disorder with psychotic features (DSM-IV) in a cohort study. METHOD All 115 patients treated in ACCESS (from May 2007 to October 2009) were included in the ACCESS II study. The primary outcome was rate of service disengagement. Secondary outcomes were change of psychopathology, severity of illness, psychosocial functioning, quality of life, satisfaction with care, medication nonadherence, length of hospital stay, and rates of involuntary hospitalization. RESULTS Only 4 patients (3.4%) disengaged with the service. Another 11 (9.6%) left because they moved outside the catchment area. Patients received a mean of 1.6 outpatient contacts per week. Involuntary admissions decreased from 34.8% in the 2 previous years to 7.8% during ACCESS (P < .001). Mixed models repeated-measures analyses revealed significant improvements among all patients in psychopathology (effect size d = 0.64, P < .001), illness severity (d = 0.84, P = .03), functioning level (d = 0.65, P < .001), quality of life (d = 0.50, P < .001), and client satisfaction (d = 0.11, P < .001). At 24 months, 78.3% were fully adherent to medication, compared to 25.2% at baseline (P = .002). CONCLUSIONS ACCESS was successfully implemented in clinical routine and maintained excellent rates of service engagement and other outcomes in patients with schizophrenia spectrum disorders or bipolar I disorder with psychotic features over 24 months. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01888627.