Factors Related to Not Following Up with Recommended Testing in the Diagnosis of Newborn Hearing Loss.

Children's hearing is a public health concern, and universal newborn hearing screenings are the first step in detecting and treating congenital hearing loss. Despite the high rate of participation in such programs, loss to follow-up (LTF) with additional recommended diagnosis and treatment has been a persistent problem. The current research seeks to expand the knowledge base at the point of diagnosis, where there is a large drop-off in parents following through with recommended care. This research was organized around the following question: What biopsychosocial factors are associated with LTF between screenings and diagnostic evaluations? A prospective quantitative longitudinal study tracked 203 families whose newborns were referred for additional testing at discharge from the hospital after birth. Binary logistic regression was used to determine what constellation of factors best predicted LTF. Psychosocial factors related to being lost to follow-up at diagnosis included race and ethnicity and access to health care professionals, with African American babies being most at risk for LTF; however, the impact of race and ethnicity declined when parents believed they had more health care professionals with whom to consult.

Oldsters and Ngrams: age stereotypes across time.

Google Books Ngram Viewer searches over five million books published between 1800 and 2000 and plots trends in word usage. With this tool, the frequencies of literary references to younger and older adults were assessed across time. Young and old women were shown to be underrepresented in the literature for the past 200 years. In addition, the usage of different terms and adjectives to describe older adults were tracked and found to change across time. The literature of the early 1900s, e.g., revealed a shift from more positive to less positive terms, which may reflect a change in attitude toward older adults.

Open-ended and Open-door Treatment Groups for Young People with Mental Illness.

The concept of open-ended groups is expanded to include an open-door model (OEOD) wherein members with severe mental illnesses, including schizophrenia disorders and bi-polar, can join, leave, and re-enter groups as their life circumstances dictate their availability and willingness for treatment. This model is grounded on the work of Schopler and Galinsky's (1984/2006) and Galinsky and Schopler's (1989) theses on the value and processes of open-ended groups and includes perspectives on mutual aid and group development. Groupwork with the OEOD format is illustrated with examples taken from a group of 79 participants diagnosed with first-episode schizophrenia/schizoaffective disorders, 40 of who had co-occurring substance abuse. Of the 79 participants in the OEOD group program, 70 (89%) remained in treatment for the maximum of 3 years. The over-all value of group treatment for this population is reviewed along with the small number of available publications on open-ended and open-door-type groups.

The value of the presence of social work in emergency departments.

The value of the presence of social work in emergency rooms is supported by directly examining the hospitalization rates of patients seen by social workers. It utilizes a 3-year-long data set of social work self-reports on medical emergency room outcomes at a large, teaching hospital in the New York Metropolitan area with a sample size of 3370. The study findings suggest that social workers in this acute care hospital's emergency room often are referred the most complex cases. The data on this site indicate that the majority of social work dispositions were to home (54%) or a nursing facility (8.4%). Only 16% of the patients seen by social work were admitted to the hospital. These findings support the cost-effective nature of social work in the emergency room setting and the importance of finding alternatives to hospital admissions. The results of a logistic regression suggest that the criteria used by social workers to assess patients are based on sound psychosocial factors. Patients who were assessed as having "Environmental" (p = .00) or "Relationship" problems (p = .00) were much less likely to be admitted. Conversely, patients with "Care/ADL" problems (p = .00) and behavior problems (p = .00) had a heightened chance of being admitted. Being African American has less effect but was still relevant.

How older Hispanic immigrants in New York City cope with current traumatic stressors: practice implications.

Older minority immigrant groups in the United States may be at increased risk for traumatic stress in an age of terrorism and of civil and political unrest. This exploratory study investigated how older Hispanic immigrants in New York City coped in response to current traumatic stressors, and whether they differed from a comparison group of older US-born non-Hispanics. We administered the Impact of Events Scale-Revised (IES-R) and the Brief COPE instruments to 24 older Hispanic immigrants and 15 older non-Hispanics, born in the United States, at 2 senior centers. Hispanic immigrants showed greater symptomatic response to current stressors as measured by significantly higher scores on the hyperarousal and avoidance subscales of the IES-R. Both groups used passive coping strategies. Older Hispanic immigrants may be at increased risk for negative psychological consequences caused by a current stressor. Practitioners should encourage older Hispanic immigrants to use active coping strategies to deal with those stressors.

From hospital to nursing facility: factors influencing decisions.

This study addresses the factors influencing decisions to send medicine-surgical (med-surg) patients home or to nursing facilities (NFs). The sample (n = 7,852) was taken from a large, urban, teaching, med-surg unit where discharges were documented and data collected over a two-and-a-half-year period. Using logistical regression, the factors found to most influence the decision were age (z = 26.99, p = .000; odds = 1.06); patients diagnosed with "musculoskeletal system" problems (z = 11.07, p = .000; odds = 5.36); and needing skilled professional care (z = -15.03, p = .000; odds = .21) or nonprofessional personal care (z = 6.62,p = .000; odds = 2.32). Having less effect, but important information for discharge planners, was being an African American (z = 3.82, p = .000; odds = .76) or Latino (z = -3.96, p = .000; odds = .54). A review of the literature found limited knowledge of the factors that influence hospital patients, family members, and professionals, including social workers, to make the decision to recommend home care or NF care.

The role of intact family childhood on women's earnings capacity: implications for evidence-based practices.

This article examines the complexities of working with an evidence-based model to design intervention strategies benefiting individuals and families. It addresses the question, to what extent should the evidence of economic advantage for female children raised in two-parent families influence social work support for practices and policies that encourage marriage? The article reviews current research findings indicating benefits of two-parent families on children's well-being and contemporary policy prescriptions promoting marriage. It presents findings of the authors' study which considers the effects of being raised in an intact family on the economic future of young women. The evidence presented in the literature and found in our own study suggests that promotion of marriage may be a sound intervention strategy for parents interested in the economic advantages for their children later in life. For others, it may be the wrong choice based on women's personal circumstances. The association between early family structure and future well-being is further complicated by large gaps in the data on cultural and family diversity. Suggestions for social work practice are based on the synthesis of the evidence-based model and the values of the profession.

Evidence that supports the value of social work in hospitals.

The value of hospital social work is supported by one hospital's tracking system that monitored social work discharge services and compared outcome with non-social work discharges. The sample consisted of a total of 64,722 patients admitted to the "med-surg" hospital unit over a two and one-half year time period from 2002 to 2004. Of the total patients in the sample, 15.7% (n = 10,156) had social work involvement. Sixty percent of the social worker patients were age 70 or over compared with the mean age of the sample of 56.2 years. The mean length of stay for social work served patients was 11.4 days (sd = 13.9) compared to 4.3 days (sd = 6.3) non-social work patients, a difference that was significant (t =-68.3; p = .000). The authors attribute the longer lengths of stay to social workers' receiving older and more difficult-to-place patients. An evidence-based case is made for the cost-containment value of social workers in hospitals and for the creation of a tracking infrastructure to aid in monitoring the daily achievements of medical/surgical social workers.

Offering African Americans opportunities to participate in clinical trials research: how social workers can help.

Historically, African Americans have resisted participation in clinical trials and other research projects because of distrust of the mostly white research establishment. Although there are legitimate reasons for refusing to join clinical trials, most notably the abuses of the Tuskegee Syphilis Study, African Americans may be passing up opportunities to obtain needed medications years before they reach the market. This article analyzes 29 empirical articles from medical and mental health journals for their findings on recruiting and maintaining African Americans in clinical trials. Reasons for declining and accepting opportunities to participate are organized into themes that represent the salient findings of these reports. Suggestions for social work interventions and changes in research designs are intended to make the research process more welcoming to African Americans. Interventions are linked to the themes and incorporate social work ethics and values. The premise of this study is that African Americans should be offered realistic opportunities supported by sufficient resources to increase participation.

Cognitive enhancement therapy: a therapeutic treatment strategy for first-episode schizophrenia patients.

Cognitive enhancement therapy (CET) for first-episode schizophrenia combines supportive therapy with social skills and cognitive remediation training. It includes exercises aimed at ameliorating cognitive and negative symptoms in a purposefully motivational format. In this treatment model, the clinician takes an active role as coach, teacher, and therapist in order to engage patients in skills-enhancing work matched to levels of illness and abilities. The therapeutic alliance allows for a safe environment to utilize principles of errorless learning and positive reinforcement. Although this strategy is best implemented in groups, it can be adapted to the individual mode of treatment. Skills-building exercises are described in sufficient detail to be useful to clinicians working with patients in the first years of schizophrenia.

Prozac and crime: who is the victim?

Prozac has been cited in more medication defense criminal cases in the United States than has any other psychotropic drug. In the majority of these cases, defendants are arguing that they are the victims of the drug. Defendants assert that they are victimized by their own involuntary intoxication or that of witnesses and crime victims who have been adversely influenced by Prozac. This article reviews 12 criminal cases in the United States in which Prozac victimization is a salient theme, and it calls for mental health professional organizations to intervene in a growing legal conundrum.