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Innovative approaches to the provision of psychiatric care must justify their ability to improve the quality of life within the resource constraints imposed on psychiatry.
To examine the average costs per patient of the experimental and control group services.
An individual patient costing methodology that identified, measured and valued all public and private resources.
The experimental group was more likely to remain in contact with services over a 12-month period, had fewer acute readmissions and spent less time in acute in-patient units. There were significantly different levels and patterns of resource consumption between the groups and between the two separate catchment areas.
The cost analysis should be assessed in the context of the previous outcome analysis. It is likely, but not inevitable, that such units will increase the overall costs of care provision; this largely depends on the effectiveness with which such units are integrated into existing care provision.
Bilingual children face a variety of challenges that their monolingual peers do not. For instance, switching between languages requires the phonological translation of proper names, a skill that requires mapping the phonemic units of one language onto the phonemic units of the other. Proficiency of phonological awareness has been linked to reading success, but little information is available about phonological awareness across multiple phonologies. Furthermore, the relationship between this kind of phonological awareness and reading has never been addressed. The current study investigated phonological translation using a task designed to measure children's ability to map one phonological system onto another. A total of 425 kindergarten and second grade monolingual and bilingual students were evaluated. The results suggest that monolinguals generally performed poorly. Bilinguals translated real names more accurately than fictitious names, in both directions. Correlations between phonological translation and measures of reading ability were moderate, but reliable. Phonological translation is proposed as a tool with which to evaluate phonological awareness through the perspective of children who live with two languages and two attendant phonemic systems.
To demonstrate the costs and benefits of vaccinating varicella-susceptible healthcare workers at a university hospital with live, attenuated varicella-zoster virus vaccine.
Retrospective review of employee medical records and data on the cost of special paid absence for susceptible healthcare workers after exposure to varicella or herpes zoster.
A 988-bed tertiary-care university hospital.
In 1994, 224 hospital employees (3.4%) were susceptible to the varicella-zoster virus. There were 40 exposures to varicella and herpes zoster in that year, involving 29 of the susceptible employees. Nine (31%) of the exposed susceptibles became varicella immune by indirect fluorescent antibody testing subsequent to exposure. Seventeen (59%) have had multiple varicella exposures and special paid absences while employed by the hospital. In 1994, wages paid to healthcare workers while furloughed for the communicable period following varicella exposure totaled $38,463.93. An additional $24,748.74 was paid to replacement workers during that same time. Varicella vaccine to immunize all 224 susceptibles in 1994 would have cost $17,920. Absences due to varicella and herpes zoster exposure also result in disruptions to patient care.
Varicella vaccination for varicella-susceptible healthcare workers at a university hospital would result in financial savings and improved patient care. We recommend that other institutions consider the costs and benefits of adopting a varicella immunization program for their susceptible employees.
The study of bilingualism has often focused on two contradictory
possibilities: that the learning of two languages may produce deficits
performance in each language by comparison with performance of
monolingual individuals, or on the contrary, that the learning of two
languages may produce linguistic or cognitive advantages with regard to
the monolingual learning experience. The work reported here addressed
the possibility that the very early bilingual experience of infancy may
affect the unfolding of vocal precursors to speech. The results of
longitudinal research with 73 infants aged 0;4 to 1;6 in monolingual and
bilingual environments provided no support for either a bilingual deficit
hypothesis nor for its opposite, a bilingual advantage hypothesis. Infants
reared in bilingual and monolingual environments manifested similar
ages of onset for canonical babbling (production of well-formed
syllables), an event known to be fundamentally related to speech
development. Further, quantitative measures of vocal performance
(proportion of usage of well-formed syllables and vowel-like sounds)
showed additional similarities between monolingual and bilingual
infants. The similarities applied to infants of middle and low socio-economic
status and to infants that were born at term or prematurely.
The results suggest that vocal development in the first year of life is
robust with respect to conditions of rearing. The biological foundations
of speech appear to be such as to resist modifications in the natural
schedule of vocal development.
There is a recognised requirement for solid-phase, non-linear absorbing devices. We present data for a range of non-linear absorbing dyes in polymer hosts. We identify polycarbonate as a useful host material. We recognise that progress will be required to increase the laser-induced damage threshold of the dyed polymers if practical devices are to be realised.
Jon Sobrino has suggested that those who stand in the intellectual tradition of the Enlightenment tend to interpret suffering and disaster as ‘crises of meaning’, by which we seek to explain and accommodate alienating experiences within preconceived models of reality. Our question is how evil may be understood. But that search for meaning is a luxury denied those who can barely hold to existence itself. Theirs is a ‘crisis of reality’; and their question is less how to understand evil than how to withstand it, to overcome suffering or at least survive it. ‘The interpretative models become relevant [only] to the extent that they arise out of the experienced reality and aim at eliminating the wretched state of the real world’.