[Inpatient Equivalent Home Treatment (IEHT) compared to inpatient psychiatric treatment: 12-month follow-up results of a retrospectively matched cohort study using propensity score]. / Stationsäquivalente Behandlung (StäB) im Vergleich mit vollstationärer Behandlung: 12-Monats-Follow-up Ergebnisse einer mittels Propensity-Score gematchten retrospektiven Kohortenstudie.

AIM OF THE STUDY: Comparison of psychiatric services use in the 12-month follow-up period between Inpatient Equivalent Home Treatment (IEHT) and inpatient psychiatric treatment. METHODS: In a retrospective 12-month follow-up study, 223 patients from the Inpatient Equivalent Home Treatment (IEHT) intervention group (IG) were compared to a matched inpatient control group (CG) on their utilization of psychiatric services. RESULTS: The inpatient readmission rate in the IG was significantly 11% lower than in the CG. The number of treatment days in the IG was significantly lower than in the CG. In the IG, psychiatric services at the outpatient clinic were used significantly more often for the first time than in the CG. CONCLUSION: The present study suggests that IEHT is superior to inpatient treatment in terms of the risk of inpatient readmission and the duration of inpatient treatment days. An outpatient services use effect following IEHT is observed.

A nature-based solution selection framework: Criteria and processes for addressing hydro-meteorological hazards at open-air laboratories across Europe.

Nature-based solutions (NbS) can be beneficial to help human communities build resilience to climate change by managing and mitigating related hydro-meteorological hazards (HMHs). Substantial research has been carried out in the past on the detection and assessment of HMHs and their derived risks. Yet, knowledge on the performance and functioning of NbS to address these hazards is severely lacking. The latter is exacerbated by the lack of practical and viable approaches that would help identify and select NbS for specific problems. The EU-funded OPERANDUM project established seven Open-Air Laboratories (OALs) across Europe to co-develop, test, and generate an evidence base from innovative NbS deployed to address HMHs such as flooding, droughts, landslides, erosion, and eutrophication. Herein, we detail the original approaches that each OAL followed in the process of identifying and selecting NbS for specific hazards with the aim of proposing a novel, generic framework for selecting NbS. We found that the process of selecting NBS was overall complex and context-specific in all the OALs, and it comprised 26 steps distributed across three stages: (i) Problem recognition, (ii) NbS identification, and (iii) NbS selection. We also identified over 20 selection criteria which, in most cases, were shared across OALs and were chiefly related to sustainability aspects. All the identified NbS were related to the regulation of the water cycle, and they were mostly chosen according to three main factors: (i) hazard type, (ii) hazard scale, and (iii) OAL size. We noticed that OALs exposed to landslides and erosion selected NbS capable to manage water budgets within the soil compartment at the local or landscape scale, while OALs exposed to floods, droughts, and eutrophication selected approaches to managing water transport and storage at the catchment scale. We successfully portrayed a synthesis of the stages and steps followed in the OALs' NbS selection process in a framework. The framework, which reflects the experiences of the stakeholders involved, is inclusive and integrated, and it can serve as a basis to inform NbS selection processes whilst facilitating the organisation of diverse stakeholders working towards finding solutions to natural hazards. We animate the future development of the proposed framework by integrating financial viability steps. We also encourage studies looking into the implementation of the proposed framework through quantitative approaches integrating multi-criteria analyses.

Terrestrial laser scanning for 3D mapping of an alpine ice cave.

Perennial ice deposits in caves are an underexplored component of the cryosphere preserving a largely untapped archive of long-term changes in landscape and climate whose existence is threatened by climate change. This study demonstrates how terrestrial laser scanning (TLS) can be used to fully and accurately (registration accuracy < 1 cm standard deviation of point differences) assess the geometry of an ice-bearing cave in the Eastern Alps (Tyrol, Austria). Three TLS campaigns and 255 scan positions were used to acquire point clouds with a high sampling density (2 cm average point spacing) in order to minimise shading effects and to assure a precise and highly resolved 3D documentation of the cave. A semi-automated registration and point cloud-processing approach adapted to the site-specific demands ensured a complete and error-minimised assessment of the cave's geometry serving as a solid basis for future quantifications of snow and ice content dynamics. Dominant cave surface structures were investigated by performing a multiscale principal component analysis (PCA) to identify a detailed and computationally efficient basis for future airflow modelling tasks.

[Comparison of Inpatient Equivalent Home Treatment (IEHT) with Standard Inpatient Treatment: A Matched Cohort Study]. / Stationsäquivalente Behandlung (StäB) im Vergleich mit vollstationärer Behandlung: 12-Monats-Follow-up einer gematchten Kohortenstudie.

OBJECTIVE: Effectiveness of Inpatient Equivalent Home Treatment (IEHT) was examined in comparison to standard psychiatric inpatient treatment. IEHT is similar to the internationally known Home Treatment or Crisis Resolution Teams. It provides acute psychiatric treatment at the user's home, similar to inpatient hospital treatment in terms of content, flexibility, and complexity. METHODS: This retrospective matched control study used routine data of 86 patients (IEHT, n = 43, standard inpatient treatment n = 43). Readmission rates and cumulative hospital days were compared within a 12-month-follow-up time period. RESULTS: The readmission rate was lower and cumulative treatment days were longer after IETH. However, both group differences were not statistically significant. CONCLUSION: The present study indicates that IEHT is not inferior to standard inpatient treatment in terms of the risk of readmission.

Nature-based solutions efficiency evaluation against natural hazards: Modelling methods, advantages and limitations.

Nature-based solutions (NBS) for hydro-meteorological risks (HMRs) reduction and management are becoming increasingly popular, but challenges such as the lack of well-recognised standard methodologies to evaluate their performance and upscale their implementation remain. We systematically evaluate the current state-of-the art on the models and tools that are utilised for the optimum allocation, design and efficiency evaluation of NBS for five HMRs (flooding, droughts, heatwaves, landslides, and storm surges and coastal erosion). We found that methods to assess the complex issue of NBS efficiency and cost-benefits analysis are still in the development stage and they have only been implemented through the methodologies developed for other purposes such as fluid dynamics models in micro and catchment scale contexts. Of the reviewed numerical models and tools MIKE-SHE, SWMM (for floods), ParFlow-TREES, ACRU, SIMGRO (for droughts), WRF, ENVI-met (for heatwaves), FUNWAVE-TVD, BROOK90 (for landslides), TELEMAC and ADCIRC (for storm surges) are more flexible to evaluate the performance and effectiveness of specific NBS such as wetlands, ponds, trees, parks, grass, green roof/walls, tree roots, vegetations, coral reefs, mangroves, sea grasses, oyster reefs, sea salt marshes, sandy beaches and dunes. We conclude that the models and tools that are capable of assessing the multiple benefits, particularly the performance and cost-effectiveness of NBS for HMR reduction and management are not readily available. Thus, our synthesis of modelling methods can facilitate their selection that can maximise opportunities and refute the current political hesitation of NBS deployment compared with grey solutions for HMR management but also for the provision of a wide range of social and economic co-benefits. However, there is still a need for bespoke modelling tools that can holistically assess the various components of NBS from an HMR reduction and management perspective. Such tools can facilitate impact assessment modelling under different NBS scenarios to build a solid evidence base for upscaling and replicating the implementation of NBS.

[Clinical Effectiveness of "FlexiTeam" (Home Treatment and Intensive Outpatient Treatment) - Comparison of a Model Project According to §â€Š64b in Berlin with Inpatient Treatment-as-Usual]. / Klinische Wirksamkeit von "FlexiTeam" (Home Treatment und intensivierte ambulante Behandlung) ­ Vergleich einer Behandlung in einem Modellprojekt nach §â€Š64b in Berlin mit der stationären Behandlung.

OBJECTIVE: To investigate the clinical effectiveness of "Home Treatment" (HT) together with intensive outpatient treatment (IAB) in comparison to the usual psychiatric inpatient treatment. METHODS: In a retrospective controlled pre-post-study 83 patients receiving HT plus IAB were matched with 83 patients receiving inpatient treatment as usual. Routine data were compared with regard to length of stay and hospital readmission rate in a follow-up period of 6 and 12 months respectively. RESULTS: There was no significant reduction of the length of stay of the first hospital admission. However, there was a significant, notable reduction with regard to length of stay and hospital readmission rate in the intervention group in a follow-up period of 6 and 12 months respectively. CONCLUSION: HT plus intensive outpatient treatment is an effective complement to the usual psychiatric inpatient treatment. It can reduce the risk of hospital readmission and the length of stay for eligible patients.