Study protocol of a randomized controlled trial evaluating home treatment with peer support for acute mental health crises (HoPe).

BACKGROUND: Home treatment (HT) is a treatment modality for patients with severe mental illness (SMI) in acute mental crises. It is frequently considered equivalent to psychiatric inpatient treatment in terms of treatment outcome. Peer Support (PS) means that people with lived experience of a mental illness are trained to support others on their way towards recovery. While PS is growing in international importance and despite a growing number of studies supporting its benefits, it is still not comprehensively implemented into routine care. The HoPe (Home Treatment with Peer Support) study investigates a combination of both - HT and PS - to provide further evidence for a recovery-oriented treatment of psychiatric patients. METHODS: In our randomized controlled trial (RCT), HT with PS is compared with HT without PS within a network of eight psychiatric clinical centers from the North, South and East of Germany. We investigate the effects of a combination of both approaches with respect to the prevention of relapse/recurrence defined as first hospitalization after randomization (primary outcome), disease severity, general functioning, self-efficacy, psychosocial health, stigma resistance, recovery support, and service satisfaction (secondary outcomes). A sample of 286 patients will be assessed at baseline after admission to HT care (data point t0) and randomized into the intervention (HT + PS) and control arm (HT). Follow-Up assessments will be conducted 2, 6 and 12 months after admission (resulting in three further data points, t1 to t3) and will be analyzed via intention-to-treat approach. DISCUSSION: This study may determine the positive effects of PS added to HT, prove additional evidence for the efficacy of PS and thereby facilitate its further implementation into psychiatric settings. The aim is to improve quality of mental health care and patients' recovery as well as to reduce the risk of relapses and hospitalizations for patients with SMI. TRIAL REGISTRATION: The trial is registered with ClinicalTrials.gov: NCT04336527 , April 7, 2020.

Technical assessment of mechanical and electronic traps to facilitate future improvements in trap efficacy and humaneness.

BACKGROUND: Snap traps and electronic traps are the main devices for nonchemical management of rodent pests. Traps should be efficient and should not cause unnecessary suffering of animals. Harmonized, systematic test methods are required to make sure that mechanical forces or electrical parameters are optimal to achieve swift unconsciousness and death. This study aimed to describe technical trap properties that can be used to facilitate future improvements in trap efficacy and humaneness. METHODS: We constructed a device to assess spring energy, triggering force, impulse and clamping force, and developed an arrangement to assess effective voltage, current, effective current and effective energy taking effect on rodent bodies in electronic traps - all without the use of animals. Descriptive data of trap characteristics were collated. RESULTS: All factors showed variability among snap trap models and trigger types, and there was considerable overlap between mouse and rat traps. For most trap models, there was no difference among new snap traps and traps that had been trigged 20 times. Effective current and effective energy decreased with lower voltage input, but the traps indicated weak battery by LED lights, and one model switched off automatically when voltage was insufficient. CONCLUSION: With the device and the electronic arrangement, the majority of snap trap models and electronic traps available on the market can be assessed in a standardized and repeatable way. Matching the data generated in this study with data on time for trapped target animals to reach irreversible unconsciousness, and experiences from pest control practitioners, should allow relating properties of traps to efficacy and animal welfare issues. This can support further development and optimization of traps for nonchemical rodent pest control. © 2024 Julius Kuehn-Institut and The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

[Home Treatment "Bremen ambulant vor Ort (BravO)"]. / Die aufsuchende Behandlung "Bremen ambulant vor Ort (BravO)".

OBJECTIVE: The existing legal framework to foster home treatment for severe mental illness imposes challenges for implementation. 'Bremen ambulant vor Ort (BravO)' provides home treatment on basis of the "Bundespflegesatzverordnung". METHODS: The concept and framework of BravO will be outlined, routine data on the BravO treatment from October 1st, 2019 to September 30th, 2021 were analysed. RESULTS: Financial and staff resources of 20 in-patient treatment places were equivalently transferred into BravO. 298 patients generating 392 cases received treatment. Median treatment span was 36 days, with 21 days (median) of service delivery. 74.7 % were diagnosed either in ICD-10 groups F2 or F3. CONCLUSION: BravO was successfully implemented into routine care. BravO allows flexible home treatment for people with severe mental illness apart from existing treatment framework.