Difficult-to-engage patients: a specific target for time-limited assertive outreach in a Swiss setting.

OBJECTIVE: Assertive community treatment (ACT) failed to develop in Europe, and its efficacy is debated. In Lausanne, Switzerland, ACT focuses on difficult-to-engage patients and aims to facilitate linkage with outpatient care through time-limited interventions. This study aimed to evaluate the applicability and efficiency of time-limited ACT. METHODS: We retrospectively assessed social, clinical, and functional outcomes and motivation for treatment in 75 consecutively seen subjects treated between 2000 and 2002. RESULTS: With 70% of the interventions lasting less than 6 months, we observed significant improvement in most clinical and social problems, in collaboration, in motivation for treatment, and in social network support, despite high baseline levels of clinical and social problems. The number of hospitalizations decreased significantly. CONCLUSIONS: Time-limited ACT is a useful treatment for difficult-to-engage patients with severe clinical and social problems, and it facilitates linkage to care. This narrower target for ACT may facilitate its implementation in Europe.

Exploring the use of mobile communications in a retirement home in Toronto: Preliminary results

This paper describes preliminary results of a qualitative case study on mobile communication conducted in an elders¿ retirement home in Toronto (Ontario, Canada) in May 2012. This is part of an international research project on the relationship between mobile communications and older people.Secondary data at a Canadian level contextualizes the case study. We focus ondemographic characteristics and on adoption and use of information and communication technologies (ICTs) broken by age.Participants in the study (21 individuals) are between 75 and 98 years of age, thereforewe can consider that the gathered evidence refers to the ¿old¿ older. Mobile phoneusers in the sample describe very specific uses of the mobile phone, while non-usersreport not facing external pressures for adopting that technology. The main channel formediated communication is the landline; in consequences mobile phones ¿when used¿ constitute an extra layer of communication. Finally, when members of the personal network of the individuals live abroad they are more prone to use Internet and Skype. We are also able to find ex-users of both mobile telephony and computers/internet who stopped using these technologies because they did not find any use for them.