Confronting the prospect of dying: Reports of terminally ill patients
To identify dominant themes characterizing patients’ perspectives on death during their last months of life, an ethnographic technique of interviewing and an inductive qualitative approach to analysis were employed.
Changing patterns of inpatient care for children and adolescents at the Menninger Clinic, 1988-1994
The authors describe trends in inpatient psychiatric length of stay (LOS) and admissions for the population of children and adolescents (N = 784) at the Menninger Clinic from 1988 to 1994. During this period, median LOS declined dramatically from 7 months to 3 weeks, whereas admissions increased 4-fold. The diagnostic case mix changed substantially, with a crossover in modal principal diagnosis from personality disorder to affective disorder. Use of medications became almost universal. Diagnosis and medication use became less important determinants of LOS over time. The practical implications of these patterns include higher patient turnover, fewer inpatient clinical contact hours, and heightened importance of continuity with outpatient care. Research should center on the impact of declining LOS on clinical and functional outcomes for children and adolescents.
A very large protein with diverse functional motifs is deficient in rjs (runty, jerky, sterile) mice
Three radiation-induced alleles of the mouse p locus, p(6H), p(25H), and p(bs), cause defects in growth, coordination, fertility, and maternal behavior in addition to p gene-related hypopigmentation.
An inpatient measure of adolescent and child psychosocial services and treatment
Now more than ever there exists an urgent need to develop and test conceptually grounded, theoretically differentiated measures of mental health services because of the rapid adoption of managed mental health care throughout the United States. This article presents the results of testing a new research instrument, the Inpatient Measure of Adolescent and Child Services and Treatment (I-MACST). The instrument assesses eight psychosocial mental health service strategies for psychiatrically hospitalized children and adolescents and provides an understanding of the therapeutic and case management service orientations of inpatient facilities. Data collected from three hospitals, one of them at two time points, demonstrate reliability for the eight scales. In addition, results show that the I-MACST differentiates between services in child and adolescent inpatient units and that it detects differences in services that reflect changes in the organization of one hospital. The I-MACST characterizes the treatment practices of on entire facility with little demand on staff time.
Factors Associated with Inpatient and Outpatient Treatment for Children and Adolescents with Serious Mental Illness
This study describes the distribution of children and adolescents in psychiatric inpatient and outpatient facilities and identifies factors associated with the selection of individuals into inpatient versus outpatient care. Sample Data: The data are from a 1986 nationally representative sample surveyed by the National Institute of Mental Health. Results indicate that the vast majority of children and adolescents with psychiatric problems receive outpatient treatment rather than inpatient care. Factors that predict psychiatric hospitalization rather than outpatient care are (1) public or private insurance coverage versus no insurance; (2) previous hospitalization; (3) psychiatric diagnosis of affective or psychotic disorders versus conduct disorders, adjustment disorders, drug and alcohol abuse, and other disorders; and (4) age, with adolescents more likely to be hospitalized than children. Further research is needed to explore the role of insurance in mental health sorting processes. Moreover, systematic, controlled research is needed to determine how different financing strategies affect mental health outcomes for children and adolescents.
Child and adolescent outcomes of inpatient psychiatric services: A research agenda
Psychiatric inpatient hospitalization is viewed generally as an expensive, most-restrictive treatment setting which should be replaced by communitybased alternatives for children and adolescents. But little is known about the outcomes of psychiatric hospitalization, and evidence that the alternatives are more effective is inconclusive. We describe the distribution of services provided to children and adolescents in psychiatric inpatient, outpatient and partial care facilities from 1986 national estimates. We find that over the course of a year, 682,756 children and adolescents receive treatment in inpatient (16.4%), outpatient (80.8%), or partial care (2.6%) facilities in a year. We then review the research literature and find that the existing research on outcomes of hospitalization is methodologically inadequate, severely limiting the causal inferences that can be made. However, trends in the evidence suggest that treatment and aftercare are important predictors of better psychiatric outcomes, controlling for organicity, symptoms, and diagnosis. Finally, we recommend testing treatment and aftercare services explicitly; using systematic, controlled research designs with comparison groups; and developing more refined descriptions of services in order to replicate effective interventions, and to generate and test theory about causes and effects of services and outcomes.
Is Social Network a Protective Factor for Cognitive Impairment in US Chinese Older Adults? Findings from the PINE Study
Background: Social network has been identified as a protective factor for cognitive impairment. However, the relationship between social network and global and subdomains of cognitive function remains unclear. Objective: This study aims to provide an analytic framework to examine quantity, composition, and quality of social network and investigate the association between social network, global cognition, and cognitive domains among US Chinese older adults.
Integrative clinical, genomics and metabolomics data analysis for mainstream precision medicine to investigate COVID-19
The time has never been more critical for drug discovery data and innovative solutions development based on artificial intelligence …