***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objectives To improve engagement with care and prevent psychiatric readmission , a transitional case management intervention has been established to link with primary and secondary care . The intervention begins during hospitalization and ends 1 month after discharge . The goal of this study was to assess the effectiveness of this short intervention in terms of the level of engagement with outpatient care and the rate of readmissions during 1 year after discharge . Methods Individuals hospitalized with common mental disorders were r and omly assigned to be discharged to routine follow-up by private psychiatrists or general practitioners with ( n = 51 ) or without ( n = 51 ) the addition of a transitional case management intervention .  Main outcome measures were number of contacts with outpatient care and rate of readmission during 12 months after discharge . Results Transitional case management patients reported more contacts with care service in the period between 1 and 3 months after discharge ( p = 0.004 ) . Later after discharge ( 3–12 months ) , no significant differences of number of contacts remained . The transitional case management intervention had no statistically significant beneficial impact on the rate of readmission ( hazard ratio = 0.585 , p = 0.114 ) . Conclusion The focus on follow-up after discharge during hospitalization leads to an increased short-term rate of engagement with ambulatory care despite no differences between the two groups after 3 months of follow-up . This short transitional intervention did , however , not significantly reduce the rate of readmissions during the first year following discharge . Trial registration number : Clinical Trials.gov Identifier NCT02258737 This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer BACKGROUND There is a need for interventions that effectively reduce compulsory admission to psychiatry . We conducted a r and omised controlled trial to investigate whether an innovative intervention programme prevents compulsory re-admission in people with serious mental illness . METHODS The programme addresses primarily patients ' self-management skills . It consists of individualised psychoeducation focusing on behaviours prior to and during illness-related crises , crisis cards and , after discharge from the psychiatric hospital , a 24-month preventive monitoring . A total of 238 in patients with compulsory admission(s ) in the past were r and omised to the intervention group or to treatment as usual ( TAU ) . RESULTS Fewer participants who completed the 24-month programme were compulsorily readmitted to psychiatry ( 28 % ) , compared with those receiving TAU ( 43 % ) . Likewise , the number of compulsory readmissions per patient was significantly lower ( 0.6 v. 1.0 ) and involuntary episodes were shorter ( 15 v. 31 days ) , compared with TAU . A negative binomial regression model showed a significant intervention effect ( RR 0.6 ; 95 % confidence interval 0.3 - 0.9 ) ; further factors linked to the risk of compulsory readmission were the number of compulsory admissions in the patient 's history ( RR 2.8 ) , the diagnosis of a personality disorder ( RR 2.8 ) , or a psychotic disorder ( RR 1.9 ) . Dropouts ( 37 % intervention group ; 22 % TAU ) were characterised by a high number of compulsory admissions prior to the trial , younger age and foreign nationality . CONCLUSIONS This study suggests that this intervention is a feasible and valuable option to prevent compulsory re-hospitalisation in a high-risk group of people with severe mental health problems , social disabilities , and a history of hospitalisations Discharge from psychiatric inpatient care is frequently described as chaotic , stressful , and emotionally charged . Following discharge , service users are vulnerable to becoming overwhelmed by the challenges involved in readapting to their home environments , which could result in serious problems and lead to readmission . The short transitional intervention in psychiatry ( STeP ) is a bridging intervention that includes pre- and post-discharge sections . It aims to prepare patients for specific situations in the period immediately following discharge from a psychiatric hospital . We conducted a quasi-experimental pilot study to determine the feasibility of the intervention , and gain insight into the effects of the STeP. Two inpatient wards at a Swiss psychiatric hospital participated in the study , and represented the intervention and control arms . Patient recruitment and baseline assessment were performed 2 weeks prior to discharge . Follow-up data were collected 1 week subsequent to discharge . Question naires measured coping , admission and health-care usage , self-efficacy , working alliance , experience of transition , and the number of difficulties experienced following discharge .  Fourteen and 15 patients completed the follow-up assessment in the control and intervention groups , respectively . The STeP did not affect primary or secondary outcomes ; however , it was shown to be feasible , and patients ' feedback highlighted the importance of post-discharge contact sessions . Further research is required to improve underst and ing of the discharge experience , identify relevant patient outcomes , and assess the effectiveness of the intervention in an adequately-powered r and omized , controlled trial Background : Only 42 % of initial appointments following psychiatric hospitalization are kept nationally . Missed appointments increase the likelihood of rehospitalization and increase costs of outpatient care . Objective : This study explored the feasibility , outcomes , and cost of a  transition intervention  on attendance at the first postdischarge appointment . Design : A pilot study using a one-group prospect i ve design interviewed 15 patients hospitalized with psychosis to address potential barriers to attendance at the first postdischarge appointment . Patients also identified an agenda for this appointment and received a reminder letter . Results : Twelve ( 92 % ) of 13 patients attended the postdischarge appointment compared with the previous rate of 44 % . Two additional patients were unable to attend because they had been rehospitalized before the scheduled time of the first appointment . Discussion : Contact with a clinician who can bridge the gap between discharge and the first postdischarge appointment is feasible and may be helpful in increasing attendance rates This pilot r and omized control trial was motivated by the discovery that many individuals with mental health problems are re-hospitalized within a year , with many being unable to fully adjust to community living . A solution was proposed in the form of an intervention called transitional discharge . The transitional discharge model included : ( 1 ) peer support , which is assistance from former patients who provide friendship , underst and ing and encouragement ; and ( 2 ) overlap of inpatient and community staff in which the inpatient staff continue to work with the discharged patient until a working relationship is established with a community care provider . The overall aim of this study was to test the discharge model design ed to assist patients discharged from acute admission wards to adjust to community living . This aim was tested through a number of related hypotheses , which suggest that , 5 months following discharge from an acute admission ward of a psychiatric hospital , individuals participating in a transitional discharge model : ( 1 ) report fewer symptoms ; ( 2 ) report better levels of functioning ; ( 3 ) have better quality of life ; ( 4 ) are less likely to have been re-admitted to hospital . The study used a r and omized experimental design with two conditions : experimental and usual treatment . In general , both the control and the experimental group demonstrated significant improvements in symptom severity and functional ability after 5 months . Usual treatment subjects in the control group were more than twice as likely to be re-admitted to hospital . This study needs to be replicated in Scotl and with a larger sample and with a modified variation of the intervention called the Transitional Care Intervention OBJECTIVES This study tested the accuracy of models for predicting  rehospitalization  in a managed behavioral health organization and tested the effectiveness of different care management strategies for enhancing outpatient treatment follow-up . METHODS In a controlled study , patients with an inpatient mental health or substance use admission received one of three types of care management , distinguished by the level of care managers ' involvement in discharge planning and postdischarge outreach : usual ( N=31 ) , enhanced ( N=94 ) , and intensive ( N=74 ) . The groups were compared with each other and with a cohort admitted in the year before the study that received usual care management ( N=192 ) to determine whether differences existed in time to outpatient follow-up , amount of postdischarge care , and rehospitalization at 30 , 60 , and 180 days . RESULTS No differences between groups were found . The majority of patients ( 69 percent ) received outpatient care within 30 days of discharge . Prediction models using logistic regression suggested that the number of clinical and sociodemographic risk factors identified by care managers was related to the rate of rehospitalization at 60 and 180 days . Patients authorized to receive intermediate care ( partial hospitalization or residential care ) and those who failed to attend intermediate care if it was authorized were more likely than other patients to be rehospitalized at 30 , 60 , and 180 days . CONCLUSIONS Outpatient follow-up after psychiatric hospitalization did not improve with increasingly intensive discharge planning and outreach . Improvement in prediction of risk of rehospitalization may increase opportunities to provide intensive interventions for difficult-to-engage patients The objective of this study was to determine the cost and effectiveness of a transitional discharge model ( TDM ) of care with clients who have a chronic mental illness . The model was tested in a r and omized clinical trial using a cluster design . This model consisted of : ( 1 ) Peer support for 1 year and ( 2 ) Ongoing support from hospital staff until a therapeutic relationship was established with the community care provider .  Participants ( n = 390 ) were interviewed at discharge , 1 month post-discharge , 6 months post-discharge and 1 year post-discharge . Data collected included demographics , quality of life , health care utilization , levels of functioning and the degree of intervention received . The intervention group post-discharge costs and quality of life were not significantly improved compared with the control group . Although not predicted a priori , intervention subjects were discharged an average of 116 days earlier per person . Based on the hospital per diem rate this would be equivalent to 12 M dollars CDN hospital costs . Both under-implementation among implementation wards and contamination in control wards were found . This study demonstrates some of the multiple challenges in health system research OBJECTIVES This study assessed the effectiveness of a brief three-month critical time intervention ( B-CTI ) model in improving continuity of psychiatric outpatient care for individuals with serious mental illness who are discharged from inpatient psychiatric treatment facilities . METHODS A total of 135 consenting veterans who were diagnosed as having serious mental illness and were discharged from an acute inpatient unit were r and omly assigned to receive either B-CTI or usual care . The three-month B-CTI intervention begins before discharge . A B-CTI clinician meets with the patient , assesses needs , and maintains a high level of patient contact after discharge . Participants completed interviews at baseline and three months later . Chart review s provided data on service utilization in the six months postdischarge . RESULTS Compared with the control group , the B-CTI group had significantly fewer days between their hospital discharge and their first outpatient service .  B-CTI participants were more likely to have had an outpatient visit and to have had more total mental health and substance abuse visits within 30 and 180 days of discharge . They had greater continuity of care as evidence d by a greater number of two-month blocks with two or more outpatient visits over 180 days . Participants in the B-CTI group reported receiving more help in making and keeping medical and mental health appointments , making family contact and community connections , and receiving information on prescribed medications . CONCLUSIONS This study provides evidence that a B-CTI targeted at the point of inpatient discharge can be helpful in promoting postdischarge continuity of care for persons with serious mental illness . The limited association of improved continuity of care with patient outcomes in this brief intervention dem and s further study AIMS AND OBJECTIVES To investigate the effectiveness of discharge planning on the knowledge , clinical symptoms and frequency of hospitalisation of persons with schizophrenia . BACKGROUND Discharge planning is associated with decreases in the duration of hospitalisation , readmission to hospitals and decreases in medical costs . Yet , there is little known about the effectiveness of discharge planning among persons with schizophrenia in Iran . DESIGN Longitudinal clinical trial . METHODS In this longitudinal clinical trial , 46 persons with schizophrenia admitted to psychiatric hospitals were selected and classified into either intervention or control groups . For the intervention group , the discharge planning was design ed using the nursing process model . The intervention was implemented across six sessions in the hospital and six sessions in patient 's home ( up to three months after discharge ) . Friedman test , independent t-tests , chi-squared test , Mann-Whitney U-test and Mc-Nemar 's test were used to analyse demographic characteristics , knowledge scores , clinical symptoms and the frequency of hospitalisation . RESULTS The intervention group demonstrated improved clinical symptoms between the time of discharge and three months after discharge and had higher knowledge levels compared with the control group . In addition , the frequency of patients ' hospitalisation preintervention and three months postintervention was statistically significantly lower in the intervention group , while no such differences were 
    Output:
    
Conclusions : We observed that transitional interventions with bridging components were no more effective in reducing readmission than treatment as usual ; however , these results are based on limited evidence .
Nevertheless , transitional interventions with bridging components are preferred by service users and could be an alternative to strategies regularly employed