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Background Non-adherence to psychotropic medications is common in schizophrenia and bipolar disorders (BDs) leading to adverse outcomes. We examined patterns of antipsychotic use in schizophrenia and BD and their impact on subsequent acute care utilization. Methods We used electronic health record (EHR) data of 577 individuals with schizophrenia, 795 with BD, and 618 using antipsychotics without a diagnosis of either illness at two large health systems. We structured three antipsychotics exposure variables: the proportion of days covered (PDC) to measure adherence; medication switch as a new antipsychotic prescription that was different than the initial antipsychotic; and medication stoppage as the lack of an antipsychotic order or fill data in the EHR after the date when the previous supply would have been depleted. Outcome measures included the frequency of inpatient and emergency department (ED) visits up to 12 months after treatment initiation. Results Approximately half of the study population were adherent to their antipsychotic medication (a PDC ≥ 0.80): 53.6% of those with schizophrenia, 52.4% of those with BD, and 50.3% of those without either diagnosis. Among schizophrenia patients, 22.5% switched medications and 15.1% stopped therapy. Switching and stopping occurred in 15.8% and 15.1% of BD patients and 7.4% and 20.1% of those without either diagnosis, respectively. Across the three cohorts, non-adherence, switching, and stopping therapy were all associated with increased acute care utilization, even after adjusting for baseline demographics, health insurance, past acute care utilization, and comorbidity. Conclusion Non-continuous antipsychotic use is common and associated with high acute care utilization.

Antipsychotic medications carry an established lifetime risk of metabolic syndrome. This retrospective chart review evaluated feasibility of a metabolic monitoring clinical decision support tool (CDST) for weight, lipid, blood glucose, and blood pressure management of 163 clients in an early psychosis outpatient clinic over 2 years. Each parameter had at least 98 (60.1%) clients with a recorded value, the most being documented for weight with 112 (68.7%) clients. CDST adherence ranged from at least 54.3–100% for non-pharmacologic interventions (e.g. clinic counseling, referral to health program or primary care) and at least 33.3–100% for pharmacologic interventions (e.g. metformin). Though no baseline cardiometabolic abnormalities were identified, dyslipidemia and obesity were later found in 37 (22.7%) and 35 (21.5%) clients, respectively. Only 14 (8.6%) clients were prescribed medications for cardiometabolic abnormalities by psychiatrists in the clinic. Increasing focus on physical health is needed to better this population’s long-term prognosis.

Background Communication and collaboration between healthcare, community, and government organizations is key for community violence prevention. This qualitative study aimed to assess Innovation Forum (IF) participant solutions’ alignment with recommended strategies, to identify innovative solutions, and to identify the most common participant priorities. Methods IF were held via teleconference in August 2022 in Indianapolis, Indiana with participants from healthcare organizations, the community, and local government. Forum solutions were documented, coded, and categorized to eight recommended violence prevention strategies from the Centers for Disease Control and Prevention (CDC) and the National Institute for Criminal Justice Reform (NICJR). Uncategorized solutions were considered innovative. Solutions were analyzed by descriptive thematic analysis to identify participant priorities. Results Seventy-seven participants and 11 facilitators participated in 10 IF. Participants generated 162 solutions. Twenty-two solutions were unable to be categorized according to the CDC and NICJR strategies. The most common participant priorities were: 1. Improve collaboration between existing community organizations and dissemination of resources (42, 21.9%), 2. Improve the community’s physical and social environment (27, 14.1%), 3. Increase public awareness and media campaigns (26, 13.5%), 4. Promote a nurturing environment and supports for children and youth (26, 13.5%), and 5. Increase employment, vocational skills, and trade programs (19, 9.9%). Conclusions Innovation forums identified innovative solutions and participant priorities for violence prevention with representatives from healthcare, the community, and government organizations. Most solutions and priorities aligned with national recommendations, reinforcing their relevance at the community level.

Persons with serious mental illness (SMI) often rely on family for significant assistance and support, but the contributions made by persons with SMI to their families have been overlooked. This study assessed the extent to which persons with SMI contribute help or support to their families and identified significant predictors of contribution using an analysis of 1 year of clinicians’ electronic health record (EHR) notes. EHR notes with reference to families of 226 Veterans with SMI were extracted and classified as suggesting help being given to and/or received from families. Forty-one percent of the sample contributed to family in a variety of ways. More frequent contact with family and being female were significant predictors of contribution. This study underlines the potential for reciprocal relationships within families of individuals with SMI. Clinicians can help clients and families maximize the support they provide to one another and possibly improve outcomes.

For years, researchers and educators alike have studied differences in educational performance as they relate to gender. And while many subject areas have been debated, \"the existence, degree, and origin of a gender gap in mathematics are highly debated\" (Guiso, Monte, Sapienza & Zingales, 2008). What has not been more widely researched is if specialized academic programs help to narrow the gender gap in what is often perceived as one of the most gender stereotyped subject – mathematics. The specific question explored in this study is whether or not having students involved in the International Baccalaureate (IB) math program further close the gender gap in mathematics. The purpose of this quantitative study was to evaluate if a specialized academic program – the IB program –helps to narrow the gender gap in mathematics over time. This study is a quantitative comparative analysis of female and male test scores for student in grades 11 and 12 participating in IB Math Studies SL at Selected High School. Test scores of all students who took the exam in years 2002 through 2010 at Selected High School were collected for analysis. Additionally, the Grade Point Average (GPA) for the academic school year that corresponds with the year of test examination was also collected. GPA was only collected for years 2005 through 2010 because in the first three years of the program a two-year math class was in effect and there was a lack of complete archival data. The results of this study mirror existing research on both the gender gap in mathematics and the academic performance of males versus females. Kenney-Benson, Pomerantz, Ryan & Patrick (2006) identified that female students consistently outperform males students in terms of grades, yet male students consistently score higher on math achievement tests. This is further supported by the research of Yee & Eccles (1988) that found that females attribute success to effort, whereas males attribute success to skill. This could be one possible explanation for this study's results. The way in which male and female student approach their academics might be more influential than the academic rigor, curriculum or teaching methods.