Predictors of preintake attrition in a rural community mental health center.

[Correction Notice: An erratum for this article was reported in Vol 6(2) of Psychological Services (see record 2009-06563-006). The article contains data that were obtained from archival records of the same community mental health center (serving adults, adolescents, and children), and that reflect information from initial consumer contacts made with the center during the same period of time, as that reported in “Clinical Intake of Child and Adolescent Consumers in a Rural Community Mental Health Center: Does Wait-time Predict Attendance?” by Marne L. Sherman, David D. Barnum, Adam Buhman-Wiggs, and Erik Nyberg (Community Mental Health Journal, 2009, Vol. 45, No. 1, pp. 78–84). Information is provided in this clarification about the data used in both articles.] Preintake attrition presents a challenge in outpatient mental health settings, in part due to the waste of limited clinical resources when potential consumers do not attend appointments. While understanding the phenomenon of mental health consumer attrition has received clinical and empirical attention for more than 40 years, the data remain somewhat mixed as to the key predictors of preintake attrition. Additionally, little attention has been directed at understanding missed intake appointments in community mental health centers within rural settings. This study examines predictors of attended appointments for intake in a rural community mental health center, with particular attention to the effect of intake delay or wait-time between call for appointment and scheduled appointment. Wait-time is identified as a significant predictor of appointment attendance in logistic regression analysis, even after controlling for consumer variables, such as referral source and payor source. The impact of wait-time on the likelihood of attending the intake appointment was not moderated by the case urgency. Considerations for applying these results to the organization of clinical service delivery in a rural community mental health center are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims

Road traffic accidents often cause serious physical and psychological sequelae. Specialists of various medical faculties are involved in the treatment of accident victims. Little is known about the factors which might predict psychiatric disorders, e.g. Posttraumatic Stress Disorder (PTSD) after accidents and how psychological problems influence physical treatment. In a prospective study 179 unselected, consecutively admitted road traffic accident victims were assessed a few days after the accident for psychiatric diagnoses, severity of injury and psychopathology. All were inpatients and had to be treated for bone fractures. At 6-months follow-up assessment 152 (85%) of the patients were interviewed again. Of the patients, 18.4% fulfilled the criteria for Posttraumatic Stress Disorder (DSM-III-R) within 6 months after the accident. Patients who developed PTSD were injured more severely and showed more symptoms of anxiety, depression and PTSD a few days after the accident than patients with no psychiatric diagnosis. Patients with PTSD stayed significantly longer in the hospital than the other patients. Multiple regression analysis revealed that the length of hospitalization was due mainly to a diversity of factors such as severity of injury, severity of accident, premorbid personality and psychopathology. Posttraumatic stress disorder is common after road traffic accidents. Patients with PTSD at follow-up can be identified by findings from early assessment. Untreated psychological sequelae such as PTSD cause longer hospitalization and therefore more costs than in non-PTSD patients.     

Simultaneous Shifted Continued Fraction Expansions in Quadratic Time

In the theory of stream ciphers, important measures to assess the randomness of a given bit sequence are the linear and the jump complexity, both obtained from the continued fraction expansion (c.f.e.) of the generating function of the sequence. This paper describes a way to compute all continued fraction expansions (and thereby the linear complexity profiles, l.c.p.'s) of the shifted sequences , , , simultaneously in at most bit operations on bit space. If is not fixed beforehand, but varies during the computation, we have to start from . In this case we obtain the result in bit operations on space or as well in bit operations on linear space. In comparison, the well-known Berlekamp--Massey algorithm, when applied iteratively, needs O steps. A recent algorithm of Stephens and Lunnon works in O integer operations, but only gives the l.c.p., not the complete c.f.e. Received: April 29, 1996; revised version: November 3, 1997     

Rasterised Water Demands: Methodology for Their Assessment and Possible Applications

In this paper a methodology for the calculation of grid cell spatially distributed water demands—for the stakeholders domestic, municipal, industrial and agricultural (without rainfed or irrigated crop production) water use—is presented. As case study the Kitzbühel region in the Austrian Alps, encompassing 20 municipalities, was chosen. Austria is one of few countries within the European Union that provides data of the population and housing census of 2001 in a raster format, with resolutions 125, 250, 500, 1,000 and 2,500 m. From these available data, population and employment raster data were used for the analysis. Based upon the latter and a calibrated related rate of water use (litre per unit per time interval), rasterised yearly and winter water demands were calculated. These rasters represent the alpine character of the study area and are independent of political borders. They can be used in hydraulics related studies, a wide range of water resources management studies and for landscape and urban planning studies. The limiting factor and scale for all applicable studies is the resolution and availability of accurate population and water use data. This fine-resolution water demand dataset can only be generated with the high resolution census data and (reasonably) accurate water use data via survey and expert input. Therefore the scale of studies where the proposed methodology is applicable is limited to a local and regional scale, up to national borders where the detailed population and housing census of 2001 is available as raster data.     

Selection of Strategies for Winter Maintenance of Roads Based on Climatic Parameters

The aims of the presentation are to discuss the efficiency of the different methods for friction control of winter roads on the safety and accessibility due to climatic conditions, to show that the climate should be an important factor in selecting the strategies for winter maintenance and to establish climatic parameters that may be helpful in making those decisions. The analyses are based on Swedish data assembled by VTI on road accidents involving fatalities and severe injuries, road surface conditions and climate. The accident and the road condition recordings are compared to self-defined climatic parameters, which describe the severity, stability and instability of the winter climate in the regions investigated. The parameters are assumed to describe whether salting or sanding is favorable/unfavorable for friction control. The results of the analyses show that the effect of salting is substantial for improving accessibility. Generally the number of winter accidents resulting in fatalities and severe injuries is lower on the salted road network compared to the unsalted road network in the southern and central parts of Sweden. However, in the northern region, with very cold winters, the number of winter accidents is highest on the salted road network. The data also indicates that the highest accident numbers are found when the proportion of vehicle mileage on snow and ice in the winters varies within 30–40%. The paper recommends that salting should be avoided in areas and in periods when the frequency of road surface temperatures below ?8°C exceeds 20%. In such climates the warm-wetted sand method is probably more favorable for friction control. Warm-wetted sand is also favorable on roads with traffic less than average annual daily traffic 2,000 and in periods with stable winter conditions.