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.

A Jewel in Our Midst: a photo essay of the Connecticut River

Its unique tidal marshes, ecology, geology, scenic areas, and fascinating history make the Connecticut River a treasure to residents and visitors alike. It is one of the 1,713 “Wetlands of International Importance” designated throughout the world by the International Ramsar Convention. This photo essay also describes the education efforts underway by Connecticut Sea Grant and its partners to assist educators with resource materials.

Improving Automaticity with Basic Addition Facts: Do Taped Problems Work Faster Than Cover, Copy, Compare?

This small pilot study compared the effectiveness of two interventions to improve automaticity with basic addition facts: Taped Problems (TP) and Cover, Copy, Compare (CCC), in students aged 6-10. Automaticity was measured using Mathematics Curriculum-Based Measurement (M-CBM) at pretest, after 10 days, and after 20 days of intervention. Our hypothesis was that the TP group will gain higher levels of automaticity more quickly than the CCC and control groups. However, when gain scores were compared, no significant differences were found between groups. Limitations to the study include low treatment integrity and a short duration of intervention.

In honor of the ninetieth birthday of Charles Frederick Johnson, professor of English in Trinity college, 1883-1906; papers, essays, and stories by his former students,

CONTENTS. (cont.) --The Christianity of the fourth Gospel, by the Rev. C. B. Hedrick.--Correctness, by the Rev. M. B. Stewart.--An optimistic realist, Ernst Zahn, by B. Q. Morgan.--The hermit story, as used by Voltaire and Mark Twain, by F. A. G. Cowper.--Thumbnail classics. Jack Harker at Yalevard, by P. Curtiss.--The man who heard everything, by W. Trumbull.--"Whiskey, bullets, and..."--The novelist takes to real estate, by R. Wright.

A fiscal profile of the Illinois Public Community College System, Fiscal years 1966-1994.

"January 1994."

A study of fall 1980 Illinois community college freshmen earning baccalaureate degrees from Illinois public universities (1980-1988).

Cover title.

Bibliography of research studies on file at the Illinois Community College Board.

Cover title.

Community college coaction /

"March 1987."

Fall 1986 first-time community college student transfer study /

Cover title.

Illinois Community College Board.

Mode of access: Internet.

Illinois community college bulletin.

"A publication of the Illinois Community College Board."

Illinois junior-community college development, 1946-1980 /

Bibliography: p. 312-316.

Minority student participation : Illinois Public Community College System : fiscal years 1983 through 1986.

"September 1986."

New educational horizons : a study of community college possibilities in the southwest Chicago suburban area /

"May 1961."

Operating budget recommendations for the Illinois public community college system.

Description based on: FY 1978; title from cover.