Education of staff and students in health care settings: integrating practice and research.

A cooperative program between the University of Iowa Hospitals and Clinics (UIHC) Department of Social Service (DSS) and the University of Iowa School of Social Work (UISSW) integrates faculty and students with clinicians for both practice and/or research internships. This program has endeavored to enhance practice and research social work through the development of (1) multiple student training programs offering both practice and research placement opportunities, (2) a jointly appointed faculty position between the UISSW and the UIHC DSS designed to improve researchers' access to and involvement with practice and practitioners' involvement in practice research, and (3) specialized student training programs including research projects in practice specialties. This project has helped clinicians conduct research, provided students with practical research experience within a clinical setting, and has increased the likelihood that both staff and students will participate in research.

Cannabis effect on spasticity in spinal cord injury.

A study was done to examine the perceived effects of cannabis on spasticity of spinal cord injured persons. Data compiled from 43 questionnaires of spinal cord injured persons suggested the following: 1) spinal cord injured persons reported decreased spasticity with marijuana use; 2) present use of marijuana correlated positively with past use; and 3) the person's reference or peer group contributed significantly to current use. The study suggests the need to examine the relationship between measurable and reported changes in spasticity.

Pain management: long-term follow-up of an inpatient program.

To determine maintenance of lifestyle changes following completion of an inpatient behavioral pain management program, 40 patients were followed up by questionnaire 6 months to 3 years after program completion, with the majority contacted at least 18 months postdischarge. Thirty-two patients completed some portion of the questionnaire. Responders were similar to nonresponders in age, sex, chronicity of pain on admission, and time since discharge. Responses to specific items indicated that patients had increased activity level and employment and had decreased use of pain-related medications. A global measure of success was based on 3 criteria: (1) reported nonuse of narcotic analgesics, muscle relaxants and tranquilizers; (2) status as employed, in training, or running a household or continuation of 50% to 100% of exercises and reported increased recreational activities; and (3) no reported increase in pain. Of the patients providing adequate data for application of these criteria, 37% met all 3 standards at follow-up. Such a multivariate criterion is recommended for assessment of multidisciplinary pain programs. More frequently practices behaviors (ie, nonuse of medications, exercises) appeared better maintained. Thus, increased behavioral practice, particularly in vocational and recreational activities, is recommended.

Results of a token economy.

A token economy for chronic psychiatric patients (average hospital stay of ten years) is reported. One hundred seventy-four patients were treated. Follow-up data were obtained on 173 patients who had been discharged from the hospital for an average of three years at the time of follow-up. One hundred twenty-five patients completed the program, which featured a graduated method for shaping behavior (functional levels). Ninety-one of the 125 patients who completed the program and were living in the community were employed. The program was most effective with patients who had been in the hospital for less than ten years and had an IQ above 80.