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Problem Severity (problem + severity)
Selected AbstractsThe Effect of Problem Severity, Managerial and Organizational Capacity, and Agency Structure on Intergovernmental Collaboration: Evidence from Local Emergency ManagementPUBLIC ADMINISTRATION REVIEW, Issue 2 2010Michael McGuire Like most public managers nowadays, local emergency managers operate within complex, uncertain environments. Rapid changes in the scope and severity of the issues increase the extent of intergovernmental collaboration necessary to address such challenges. Using a large data set of county emergency management agency directors, variations in intergovernmental collaboration reflect influences from problem severity, managerial capacity, and structural factors. The results demonstrate that public managers who perceive problems as severe, possess specific managerial skills, lead high-capacity organizations, and operate in less complex agency structures collaborate more often and more effectively across governmental boundaries. [source] Long-Term Posttreatment Functioning Among Those Treated for Alcohol Use DisordersALCOHOLISM, Issue 2 2006Patrick R. Clifford This article summarizes the proceedings of a symposium that was organized and chaired by Patrick R. Clifford and presented at the 2005 Research Society on Alcoholism meeting in Santa Barbara, California. The aims of the presentation were to focus on the prediction and explanation of longer-term functioning following alcohol use disorders (AUD) treatment. Along these lines, Stephen A. Maisto, PhD, presented data (i.e., Project MATCH outpatient sample) on the relationship between drinking behavior in the first year following AUD outpatient treatment initiation and functioning at 3-year follow-up. Robert L. Stout, PhD, using data from the Extended Case Monitoring Study, analyzed long-term drinking patterns using shorter-term information. James R. McKay, PhD, examined the relationship between treatment services received and problem severities across a 2-year follow-up period. J. Scott Tonigan, PhD, served as the panel discussant. [source] Acceptability of Emergency Department-based Screening and Brief Intervention for Alcohol ProblemsACADEMIC EMERGENCY MEDICINE, Issue 12 2000Daniel W. Hungerford DrPH Abstract. Objectives: To adapt screening and brief intervention for alcohol problems (SBI) to a high-volume emergency department (ED) setting and evaluate its acceptability to patients. Methods: Patients at a large public-hospital ED were screened with the Alcohol Use Disorders Identification Test (AUDIT). Screen-positive drinkers (AUDIT score , 6) were provided brief, on-site counseling and referral as needed. Three months later, project staff blinded to baseline measures reassessed alcohol intake, alcohol-related harm, alcohol dependence symptoms, and readiness to change. Results: Of 1,034 patients approached, 78.3% (810) consented to participate (95% CI = 75.5% to 81.2%), and 21.2% (172) screened positive (95% CI = 18.4% to 24.0%). Of 88 patients with complete intervention data, 94.3% (83) accepted an intervention (95% CI = 89.5% to 99.2%), with acceptance rates ranging from 93% to 100% across four alcohol-problem-severity levels (p = 0.7). A majority (59.0%) set goals to decrease or stop drinking (95% CI = 48.4% to 69.6%). The group recontacted (n= 23) experienced statistically significant decreases in alcohol intake, alcohol-related harm, and dependence symptoms, with measures decreasing for 68%, 52%, and 61% of the patients. Readiness to change also showed statistically significant improvement, with scores increasing for 43% of the patients. Moreover, two-thirds of the patients (15/23) reported at follow-up that SBI was a helpful part of their ED visit. Conclusions: High rates of consent and acceptance of counseling for alcohol problems by patients across a wide range of problem severity indicate that this protocol was acceptable to at-risk patients in a public-hospital ED. Improvements in alcohol-related outcome measures at follow-up were strong enough to warrant controlled studies of intervention efficacy. [source] Guided self-help supported by paraprofessional mental health workers: an uncontrolled before,after cohort studyHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2009Paul Farrand Senior Lecturer in Health Psychology Abstract There has been considerable development of guided self-help clinics within primary care. This uncontrolled before,after cohort study examines efficiency and effectiveness of these clinics when supported by paraprofessional mental health workers having little mental health training and experience. Data were collected by seven Graduate Mental Health Workers (GMHW) located in South-west England. Alongside an analysis of clinic attendance and dropout, efficiency was measured with respect to the number and length of sessions to support patients with the effectiveness of the interventions examined with respect to problem severity. Over a 15-month period, 1162 patients were referred to the GMHW clinics with 658 adopting guided self-help. Patients using guided self-help received an average input per patient, excluding assessment, of four sessions of 40 minutes. Dropout rate was comparable to other primary-care-based mental health clinics supported by experienced mental health professionals with 458 patients completing all support sessions. However, only 233 patients went on to attend the 3 months of follow-up session. Effectiveness of guided self-help clinics supported by paraprofessional mental health workers was comparable to that supported by an experienced mental health nurse. Improvements in problem severity were statistically significant, with 55% and 58% (final support session) and 63% and 62% (3 months of follow-up) of patients experiencing clinically significant and reliable change for anxiety and depression, respectively. However, concerns exist over the efficiency of the GMHW clinic especially with respect to the use of longer support sessions and high dropout rate at the 3 months of follow-up session. The paper concludes by highlighting the effectiveness of guided self-help when supported by paraprofessional mental health workers, but questions the utility of the two-plus-one model of service delivery proposing a collaborative care approach as an alternative. [source] Effectiveness of an integrated, trauma-informed approach to treating women with co-occurring disorders and histories of trauma: The Los Angeles site experienceJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 7 2007Margaret Gatz Effectiveness of an integrated trauma-informed approach to treating women with co-occurring disorders and histories of trauma was evaluated. Baseline and 12-month assessments were completed by 136 intervention- and 177 comparison-group women. The intervention group received Seeking Safety, a trauma-specific group treatment focusing on safety and coping skills, in the context of integrated substance abuse and mental health services. The comparison group received similar services but not trauma-specific group treatment. Intervention women showed significantly better treatment retention over three months and greater improvement on posttraumatic stress symptoms and coping skills. On most outcomes, those who completed treatment improved more than those who discontinued. Improvements on symptoms of distress and drug problem severity were partially mediated by gains in coping skills. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 863,878, 2007. [source] The Effect of Problem Severity, Managerial and Organizational Capacity, and Agency Structure on Intergovernmental Collaboration: Evidence from Local Emergency ManagementPUBLIC ADMINISTRATION REVIEW, Issue 2 2010Michael McGuire Like most public managers nowadays, local emergency managers operate within complex, uncertain environments. Rapid changes in the scope and severity of the issues increase the extent of intergovernmental collaboration necessary to address such challenges. Using a large data set of county emergency management agency directors, variations in intergovernmental collaboration reflect influences from problem severity, managerial capacity, and structural factors. The results demonstrate that public managers who perceive problems as severe, possess specific managerial skills, lead high-capacity organizations, and operate in less complex agency structures collaborate more often and more effectively across governmental boundaries. [source] Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods studyAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2009Tricia Nagel Abstract Objective:,To develop and evaluate a culturally adapted brief intervention for Indigenous people with chronic mental illness. Design:,A mixed methods design in which an exploratory phase of qualitative research was followed by a nested randomised controlled trial. Setting:,Psycho-education resources and a brief intervention, motivational care planning (MCP), were developed and tested in collaboration with aboriginal mental health workers in three remote communities in northern Australia. Participants:,A total of 49 patients with mental illness and 37 carers were recruited to a randomised controlled trial that compared MCP (n = 24) with a clinical control condition (treatment as usual, n = 25). Intervention:,The early treatment group received MCP at baseline and the late treatment group received delayed treatment at six months. Main outcome measures:,The primary outcome was mental health problem severity as measured by the health of the nation outcome scales. Secondary measures of well-being (Kessler 10), life skills, self-management and substance dependence were chosen. Outcome assessments were performed at baseline, six-month, 12-month and 18-month follow up. Results:,Random effects regression analyses showed significant advantage for the treatment condition in terms of well-being with changes in health of the nation outcome scales (P < 0.001) and Kessler 10 (P = 0.001), which were sustained over time. There was also significant advantage for treatment for alcohol dependence (P = 0.05), with response also evident in cannabis dependence (P = 0.064) and with changes in substance dependence sustained over time. Conclusions:,These results suggest that MCP is an effective treatment for Indigenous people with mental illness and provide insight into the experience of mental illness in remote communities. [source] Service Problems and Recovery Stratégies: An ExperimentCANADIAN JOURNAL OF ADMINISTRATIVE SCIENCES, Issue 1 2000Terrence J. Levesque This experiment examines the effectiveness of recovery stratégies after a service failure on customer loyalty and complaint intentions. Respondents encountered different core failures in ternis of problem severity (denial or delay) and criticality levels (high or low). The results suggest the effectiveness of service recovery strategies,assistance (fixing the problem) and/or compensation (defraying the costs incurred),varied depending on the txpe of service, problem severity, and criticality levels. The implication is that recovery strategies need to be matched to the specific incident. Service firms should focus on avoiding or reducing core failures. Getting it right the first time is the best strategy. Résumé La présente recherche examine au moyen d'une expérience l'efficacité de différentes stratégies de récupération sur la fidélité et les intentions de porter plainte de la clientèle à la suite d'une défaillance de service. Les participants ont été confrontés à différentes défaillances de service en termes de gravité (interruption du service ou délai) et de niveau critique (élevé ou faible). Les résultats indiquent que l'efficacité des stratégies de récupération,aide technique (résolution du problème) et/ou compensation financière (défraiement des coǔts encourus),varie en fonction du genre de service, de la gravité du problème et des niveaux critiques. Les résultats de l'étude laissent supposer que les stratégies de récupération doivent ,tre associées à un incident spécifique. Les entreprises de services doivent mettre l'accent sur l'évitement ou la réduction des défaillances. La meilleure stratégie consiste encore à donner le service correctement. [source] | |||||||||||||