Specific heat functions for the orthorhombic Nd3+ in scheelite type of crystals.

Nd3+ doped scheelite type of crystals have attracted extensive interests because of their applications in solid state lasers, as well as upconversion luminescence and magneto-optical and magnetic properties. Usually, these properties are closely related to the local structures and properties of the Nd3+ impurities in the hosts. Since information about electronic states and local structures of the impurity Nd3+ in the scheelite crystals would be helpful to the understanding of the properties of these materials, theoretical investigations on the specific heat functions and the local structures for these Nd3+ centers are of significance.

Theoretical investigations of the specific heat functions for the orthorhombic Nd+3 centers in some crystals.

Garnets doped with Nd+3 have attracted extensive interests because of their applications in solid-state lasers, as well as upconversion luminescence and magneto-optical and magnetic properties. Usually, these properties are closely related to the local structures and properties of the Nd+3 impurities in the hosts. Since information about electronic states and local structures of the impurity Nd+3 in the garnets would be helpful to the understanding of the properties of these materials, theoretical investigations on the specific heat functions and the local structures for these Nd+3 centers are of significance.

Triplet-triplet energy transfer from naphthalene to biacetyl in the vapor phase.

In principle the optical energy absorbed by a complex molecule raises that molecule to one of its excited states, and afterwards this excitation energy decays through the different relaxation channels. Initially, electronically excited naphthalene emits photons in the phosphorescence band of naphthalene and these emitted photons are absorbed by the acceptor molecule biacetyl, then excited biacetyl phosphoresces. In this investigation, sensitized phosphorescence decay times in different conditions were measured for naphthalene-biacetyl system in the vapor phase. The ultraviolet-visible spectrum of biacetyl vapor at room temperature conditions was broad and structureless.

Psychosocial aspects of breast cancer.

This article provides an overview of the psychosocial aspects of breast cancer. Common psychologic reactions during detection, diagnosis, and treatment include anxiety, denial, anger, and depression. Suggestions for primary care provider interventions such as providing education and support, are discussed. Many treatments for the disease seriously challenge a woman's self-image and sexuality. Family issues are equally important including relationships with children and spouses or partners. Social support can be a powerful force which facilitates successful coping with these challenges. The advent of genetic testing poses a whole set of psychologic and social issues which primary care providers will need to be aware of in the future. Primary care providers have an important role in determining the psychological outcome of breast cancer. By being aware of the common psychologic and social problems, they can be prepared to contribute to a successful outcome.

Evaluating social work discharge planning services for elderly people: access, complexity, and outcome.

The discharge planning role of hospital social workers has become increasingly important in services to elderly people. This article examines three issues: (1) the extent to which elderly people most in need receive social work services, (2) the extent to which the discharge planning performed is a professional task, and (3) the effectiveness of discharge planning for those who return to their homes after hospitalization. The study focused on 1,100 elderly patients from five Baltimore hospitals. Data were gathered from their social workers, from the patients themselves (by phone after discharge), and from medical records. Results show that only a minority of elderly patients who return to the community after hospitalization receive social work services while in the hospital but that those who do are likely to have posthospital needs. In most cases, the discharge planning uses professional skills, but 28 percent of cases are fairly routine. Finally, social work services were effective in reducing the level of unmet needs in the areas of nursing, medication, and physical therapy.

Burnout in hospital social workers who work with AIDS patients.

Fears of a future shortage of experienced social workers in the acquired immune deficiency syndrome (AIDS) field because of burnout prompted this study of 128 hospital social workers who work with AIDS patients. Results show that hospital AIDS social workers had slightly higher rates of emotional exhaustion and depersonalization on the Maslach Burnout Inventory but also felt a substantially higher level of personal accomplishment. Age, autonomy, and belonging to a support group explained 19 percent of the variance in burnout. Hospital administrators are urged to examine their administrative policies concerning these factors and to explore ways to preserve and enhance the most satisfying aspects of the work. Further research is encouraged to explore the relationship between young age and burnout and to better understand the factors that make AIDS work satisfying.

Impact of hospital discharge planning on meeting patient needs after returning home.

This study examines the contribution of hospital discharge planning in meeting the needs of patients for care after their return home. A random sample of 919 admissions (age 60 and over) to five hospitals was studied to obtain information on characteristics of discharge planning during the patients' hospital stay. Specifically, information was obtained on the involvement of a designated professional for managing and coordinating the discharge plan, and the extent to which the planning was interdisciplinary. Patient interviews conducted two weeks after discharge provided information on needs for care related to: (1) treatment, (2) activity limitations, and (3) other self-sufficiency limitations. Patients were asked about their need for care in these three areas and about whether or not these needs were being met. Overall, 97 percent reported one or more needs for care and 33 percent reported that at least one of these needs was not being met. Findings show that the involvement of a discharge planning case manager is related to a significant reduction in unmet treatment needs, but not to reductions in activity limitation, other self-sufficiency needs, or overall needs. No significant effects of interdisciplinary planning were identified. These findings suggest that treatment-related benefits result when a case manager has specific responsibility for the discharge planning of elderly patients returning home after hospitalization. These results provide insights into what is being achieved through current discharge planning practices. The meeting of specific patient needs through enhanced discharge planning may save future costs by reducing the rates of complications and hospital readmissions in an era of prospective payment, thus potentially offsetting the increased costs involved in planning and coordinating postdischarge care for older adults.

The Medicaid personal care services program: implications for social work practice.

Results of a survey of Medicaid personal care programs in 15 states and the District of Columbia in 1987 show that these programs suffer from many problems. Low wages and slow payment make recruitment and retention of qualified workers difficult. Other problems include lack of coordination among agencies, lack of adequate standards for training or supervision of workers, unequal access to programs, and inequities among states. Implications for social workers are discussed.

Long term care needs and personal care services under Medicaid: a survey of administrators.

Home and community based care services constitute a public initiative in the development of a long term care service network. One such home based initiative is the personal care service program of Medicaid. The authors conducted a national survey of administrators of this program. They received a response from 16 administrators of such programs in 1987-1988. The responses raise significant issues regarding training, access to and equity of services, quality of services, administrative oversight and the coordination of home-based care in a network of available services. Based on administrator responses, the authors draw several conclusions.

Post-hospital support program for the frail elderly and their caregivers: a quasi-experimental evaluation.

This paper evaluates the Post-Hospital Support Program for the frail elderly and their caregivers using a quasi-experimental design. The program goals were to reduce stress in the caregivers, improve functioning and reduce mortality in patients, and reduce health service utilization in patients. Subjects were patients at the Johns Hopkins Hospital in Baltimore, Maryland, age 65 or over, who were returning home to the care of a non-paid caregiver and who had extensive post-hospital care needs which were expected to continue for at least one year. The 93 comparison group patient/caregiver pairs were discharged between May 15, 1983 and May 14, 1984. The 98 treatment group pairs were discharged between May 15, 1984 and May 14, 1985. Interviews were conducted with patients and caregivers at 1, 3, 6, 9, and 12 months after discharge. Results showed a slight reduction in caregiver stress and a substantial reduction in hospital days used by the treatment group. When confounding and history effects are taken into consideration, an average difference of 6.5 days per patients remains. The data also suggest that the treatment program may have postponed some deaths and nursing home placements. The results suggest that support services for the frail elderly and their caregivers can be cost efficient by reducing hospital length-of-stay. Savings were estimated at $4,585 per patient per year in this study. However, further work is needed to design programs which more effectively reduce caregiver stress.

Foster home care for the frail elderly as an alternative to nursing home care: an experimental evaluation.

This paper describes a program (Community Care Program) in which some elderly hospital patients who were candidates for nursing home placement were placed in foster homes. Caregivers were carefully trained and supervised. A total of 112 elderly inpatients were randomly assigned to placement in a nursing home or a foster care home. Patients and caregivers were interviewed at 3, 6, 9, and 12 months after placement. Community Care Program patients were more likely to maintain or improve ADL (activities of daily living) and mental status scores. They also had better nursing outcomes and were more likely to get out of the house than were nursing home patients. Nursing home patients had higher life satisfaction, and participated in more social and recreational activities. The Community Care Program was 17 per cent less costly than nursing home care. The results suggest that foster care may be a viable alternative for a segment of the nursing home population.

The practice-research partnership: is it compatible with teaching?

This commentary discusses possible conflicts that can develop among the needs of students, those of a school of social work's faculty, and those of health care agencies involved in a joint practice-research model. It also discusses the needs for schools of social work and the profession as a whole to develop funded research for social work in health care.