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Evans JPO, Elarnaut F, Downes D, Lee WK, Arnold EL, Rogers K. Sparse interleaved sampling for high resolution focal construct geometry X-ray tomography. Opt Express 2023; 31:15301-15315. [PMID: 37157634 DOI: 10.1364/oe.484008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We demonstrate interleaved sampling by multiplexing conical subshells within the tomosynthesis and raster scanning a phantom through a 150 kV shell X-ray beam. Each view comprises pixels sampled on a regular 1 mm grid, which is then upscaled by padding with null pixels before tomosynthesis. We show that upscaled views comprising 1% sample pixels and 99% null pixels increase the contrast transfer function (CTF) computed from constructed optical sections from approximately 0.6 line pairs/mm to 3 line pairs/mm. The driver of our method is to complement work concerning the application of conical shell beams to the measurement of diffracted photons for materials identification. Our approach is relevant to time-critical, and dose-sensitive analytical scanning applications in security screening, process control and medical imaging.
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Chaudhry N, Muhammad H, Seidl C, Downes D, Young DA, Hao Y, Zhu L, Vincent TL. Highly efficient CRISPR-Cas9-mediated editing identifies novel mechanosensitive microRNA-140 targets in primary human articular chondrocytes. Osteoarthritis Cartilage 2022; 30:596-604. [PMID: 35074547 PMCID: PMC8987936 DOI: 10.1016/j.joca.2022.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE MicroRNA 140 (miR-140) is a chondrocyte-specific endogenous gene regulator implicated in osteoarthritis (OA). As mechanical injury is a primary aetiological factor in OA, we investigated miR-140-dependent mechanosensitive gene regulation using a novel CRISPR-Cas9 methodology in primary human chondrocytes. METHOD Primary (passage 1/2) human OA chondrocytes were isolated from arthroplasty samples (six donors) and transfected with ribonuclear protein complexes or plasmids using single guide RNAs (sgRNAs) targeting miR-140, in combination with Cas9 endonuclease. Combinations of sgRNAs and single/double transfections were tested. Gene editing was measured by T7 endonuclease 1 (T7E1) assay. miRNA levels were confirmed by qPCR in chondrocytes and in wild type murine femoral head cartilage after acute injury. Predicted close match off-targets were examined. Mechanosensitive miR-140 target validation was assessed in 42 injury-associated genes using TaqMan Microfluidic cards in targeted and donor-matched control chondrocytes. Identified targets were examined in RNAseq data from costal chondrocytes from miR-140-/- mice. RESULTS High efficiency gene editing of miR-140 (90-98%) was obtained when two sgRNAs were combined with double RNP-mediated CRISPR-Cas9 transfection. miR-140 levels fell rapidly after femoral cartilage injury. Of the top eight miR-140 gene targets identified (P < 0.01), we validated three previously identified ones (septin 2, bone morphogenetic protein 2 and fibroblast growth factor 2). Novel targets included Agrin, a newly recognised pro-regenerative cartilage agent, and proteins associated with retinoic acid signalling and the primary cilium. CONCLUSION We describe a highly efficient CRISPR-Cas9-mediated strategy for gene editing in primary human chondrocytes and identify several novel mechanosensitive miR-140 targets of disease relevance.
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Affiliation(s)
- N Chaudhry
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, OX3 7FY, United Kingdom
| | - H Muhammad
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, OX3 7FY, United Kingdom
| | - C Seidl
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, OX3 7FY, United Kingdom
| | - D Downes
- MRC Molecular Haematology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, OX3 9DS, United Kingdom
| | - D A Young
- Skeletal Research Group, Biosciences Institute, Newcastle University, Central Parkway, Newcastle Upon Tyne, NE1 3BZ, United Kingdom
| | - Y Hao
- Skeletal Research Group, Biosciences Institute, Newcastle University, Central Parkway, Newcastle Upon Tyne, NE1 3BZ, United Kingdom
| | - L Zhu
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, OX3 7FY, United Kingdom
| | - T L Vincent
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, OX3 7FY, United Kingdom.
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Bern-Klug M, Smith KM, Roberts AR, Kusmaul N, Gammonley D, Hector P, Simons K, Galambos C, Bonifas RP, Herman C, Downes D, Munn JC, Rudderham G, Cordes EA, Connolly R. About a Third of Nursing Home Social Services Directors Have Earned a Social Work Degree and License. J Gerontol Soc Work 2021; 64:699-720. [PMID: 33656405 DOI: 10.1080/01634372.2021.1891594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/13/2021] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
Nursing home (NH) residents have high psychosocial needs related to illness, disability, and changing life circumstances. The staff member with the most expertise in addressing psychosocial needs is the social worker. However, federal regulations indicate that only NHs with 120+ beds need hire a social services staff member and that a "qualified social worker" need not have a social work degree. Therefore, two-thirds of NHs are not required to employ a social services staff member and none are required to hire a degreed social worker. This is in stark contrast to NASW professional standards. Reporting findings from this nationally representative sample of 924 social services directors, we describe the NH social services workforce and document that most NHs do hire social services staff, although 42% of social services directors are not social work educated. 37% of NHs have a degreed and licensed social worker at the helm of social services. The odds of hiring a degreed and licensed social workers are higher for larger NHs, especially if not-for-profit and not part of a chain. NH residents deserve psychosocial care planned by staff with such expertise. Quality of psychosocial care impacts quality of life.
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Affiliation(s)
| | - Kevin M Smith
- Department of Psychological & Quantitative Foundations, The University of Iowa, Iowa City, USA
| | - Amy Restorick Roberts
- Department of Family Science & Social Work, College of Education, Health & Society, Miami University, Oxford, Ohio, USA
| | - Nancy Kusmaul
- Department of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Denise Gammonley
- College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida, Orlando, Florida, USA
| | - Paige Hector
- Paige Ahead Healthcare Education & Consulting, LLC, Tucson, Arizona, USA
| | - Kelsey Simons
- Department of Psychiatry, VISN 2 Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, University of Rochester Medical Center, Rochester, New York, USA
| | - Colleen Galambos
- Helen Bader Endowed Chair in Applied Gerontology and Professor, Helen Bader School of Social Welfare, University of Wisconsin Milwaukee, Milwaukee, Wisconsin, USA
| | - Robin P Bonifas
- Department of Social Work, John A. Hartford Faculty Scholar in Geriatric Social Work, College of Health and Human Services, Indiana State University, Terre Haute, USA
| | - Chris Herman
- Senior Practice Associate-Aging and IRB Chair, National Association of Social Workers (NASW), Washington, USA
| | - Deirdre Downes
- Social Work and Supportive Care Programs , Isabella Geriatric Center, MJHS, New York, USA
| | - Jean C Munn
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Giang Rudderham
- Data Science Consultant, Iowa Social Science Research Center, University of Iowa, Iowa City, Iowa, USA
| | | | - Robert Connolly
- Retired CMS Health Insurance Analyst, Marriottsville, MD, USA
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Shevchuk A, Evans JPO, Dicken AJ, Elarnaut F, Downes D, Godber SX, Rogers KD. Combined X-ray diffraction and absorption tomography using a conical shell beam. Opt Express 2019; 27:21092-21101. [PMID: 31510192 DOI: 10.1364/oe.27.021092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/29/2019] [Indexed: 06/10/2023]
Abstract
We combine diffraction and absorption tomography by raster scanning samples through a hollow cone of pseudo monochromatic X-rays with a mean energy of 58.4 keV. A single image intensifier takes 90x90 (x,y) snapshots during the scan. We demonstrate a proof-of-principle of our technique using a heterogeneous three-dimensional (x,y,z) phantom (90x90x170 mm3) comprised of different material phases, i.e., copper and sodium chlorate. Each snapshot enables the simultaneous measurement of absorption contrast and diffracted flux. The axial resolution was ~1 mm along the (x,y) orthogonal scan directions and ~7 mm along the z-axis. The tomosynthesis of diffracted flux measurements enable the calculation of d-spacing values with ~0.1 Å full width at half maximum (FWHM) at ~2 Å. Thus the identified materials may be color-coded in the absorption optical sections. Characterization of specific material phases is of particular interest in security screening for the identification of narcotics and a wide range of homemade explosives concealed within complex "everyday objects." Other potential application areas include process control and biological imaging.
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Dicken AJ, Evans JPO, Rogers KD, Prokopiou D, Godber SX, Elarnaut F, Shevchuk A, Downes D, Wilson M. Confocal energy-dispersive X-ray diffraction tomography employing a conical shell beam. Opt Express 2019; 27:19834-19841. [PMID: 31503738 DOI: 10.1364/oe.27.019834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/18/2019] [Indexed: 06/10/2023]
Abstract
We introduce a new high-energy X-ray diffraction tomography technique for volumetric materials characterization. In this method, a conical shell beam is raster scanned through the samples. A central aperture optically couples the diffracted flux from the samples onto a pixelated energy-resolving detector. Snapshot measurements taken during the scan enable the construction of depth-resolved dark-field section images. The calculation of d-spacing values enables the mapping of material phase in a volumetric image. We demonstrate our technique using five ~15 mm thick, axially separated samples placed within a polymer tray of the type used routinely in airport security stations. Our method has broad analytical utility due to scalability in both scan size and X-ray energy. Additional application areas include medical diagnostics, materials science, and process control.
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Glajchen M, Berkman C, Otis-Green S, Stein GL, Sedgwick T, Bern-Klug M, Christ G, Csikai E, Downes D, Gerbino S, Head B, Parker-Oliver D, Waldrop D, Portenoy RK. Defining Core Competencies for Generalist-Level Palliative Social Work. J Pain Symptom Manage 2018; 56:886-892. [PMID: 30201485 DOI: 10.1016/j.jpainsymman.2018.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/03/2018] [Indexed: 11/21/2022]
Abstract
CONTEXT Care provided to seriously ill patients by frontline social workers is a component of generalist-level palliative care. The core competencies for high-quality generalist-level palliative social work are necessary to promote training curricula and best practices but have not yet been defined in the U.S. OBJECTIVE The objective of this study was to develop consensus-derived core competencies for generalist-level palliative social work. METHODS Fifty-five proposed social work competencies were categorized by the eight domains of palliative care identified by the National Consensus Project for Quality Palliative Care. The competencies were rated by 41 regionally dispersed, Master's level social workers selected through purposive and snowball sampling using a Delphi method. Each was rated as essential for generalist-level palliative social work, acceptable with modifications, or rejected based on the judgment that it was not essential for generalist-level palliative social work or was outside the scope of practice. Consensus was defined as >70% agreement to accept or reject a competency. Three review rounds were needed to achieve consensus on all competencies. RESULTS Two competencies were added to the original list. Of the 57 proposed competencies, 41 were accepted (19 after modification) and 16 were rejected. Competencies in the social, spiritual, cultural, and ethical/legal aspects of care domains were relatively more likely to be accepted compared with those in structure and processes of care, physical care, psychological care, and care of patient at the end of life. CONCLUSION The 41 consensus-derived competencies for generalist-level palliative social work may inform the development of training curricula and standards for high-quality care.
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Affiliation(s)
- Myra Glajchen
- MJHS Institute for Innovation in Palliative Care, New York, New York.
| | - Cathy Berkman
- Fordham University Graduate School of Social Service, New York, New York
| | | | - Gary L Stein
- Wurzweiler School of Social Work at Yeshiva University, New York, New York
| | - Tom Sedgwick
- New York University Langone Medical Center, New York, New York
| | | | - Grace Christ
- Columbia University School of Social Work, New York, New York
| | - Ellen Csikai
- University of Alabama School of Social Work, Tuscaloosa, Alabama
| | | | - Susan Gerbino
- New York University Silver School of Social Work, New York, New York
| | - Barbara Head
- University of Louisville School of Medicine and Kent School of Social Work, Louisville, Kentucky
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Reinhardt JP, Downes D, Cimarolli V, Bomba P. END-OF-LIFE CONVERSATIONS AND HOSPICE PLACEMENT: ASSOCIATION WITH LESS AGGRESSIVE CARE DESIRED IN THE NURSING HOME. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J P Reinhardt
- The New Jewish Home, New York, New York, United States
| | - D Downes
- MSW Isabella Geriatric Center, New York, New York, USA
| | - V Cimarolli
- PhD Research Institute on Aging, The New Jewish Home, New York, New York, USA
| | - P Bomba
- MD Excellus BlueCross BlueShield & MedAmerica Insurance Company, Rochester, New York,USA
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Reinhardt JP, Downes D, Cimarolli V, Bomba P. End-of-Life Conversations and Hospice Placement: Association with Less Aggressive Care Desired in the Nursing Home. J Soc Work End Life Palliat Care 2017; 13:61-81. [PMID: 28271977 DOI: 10.1080/15524256.2017.1282919] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Education about end-of-life care and treatment options, communication between family and health care providers, and having advance directives and medical orders in place are important for older adults with chronic, progressive decline and end-stage disease who spend their last days in the nursing home. This study used retrospective data (6 months before death) of long-stay nursing home decedents (N = 300) taken from electronic health records to capture the end-of-life experience. Findings showed for almost all decedents, Do Not Resuscitate and Do Not Intubate orders were in place, and just over one-half had Do Not Hospitalize and No Artificial Feeding orders in place. A small proportion had No Artificial Hydration or No Antibiotic orders in place. Overall, there was congruence between documented medical orders and treatment received. Findings showed that use of hospice and discussions about particular life-sustaining treatments each had significant associations with having less aggressive medical orders in place. These results can inform best practice development to promote high quality, person-directed, end-of-life care for nursing home residents.
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Affiliation(s)
- Joann P Reinhardt
- a Research Institute on Aging , The New Jewish Home , New York , New York , USA
| | | | - Verena Cimarolli
- a Research Institute on Aging , The New Jewish Home , New York , New York , USA
| | - Patricia Bomba
- c Excellus BlueCross BlueShield & MedAmerica Insurance Company , Rochester , New York , USA
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Evans JPO, Godber SX, Elarnaut F, Downes D, Dicken AJ, Rogers KD. X-ray absorption tomography employing a conical shell beam. Opt Express 2016; 24:29048-29059. [PMID: 27958570 DOI: 10.1364/oe.24.029048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We demonstrate depth-resolved absorption imaging by scanning an object through a conical shell of X-rays. We measure ring shaped projections and apply tomosynthesis to extract optical sections at different axial focal plane positions. Three-dimensional objects have been imaged to validate our theoretical treatment. The novel principle of our method is scalable with respect to both scan size and X-ray energy. A driver for this work is to complement previously reported methods concerning the measurement of diffracted X-rays for structural analysis. The prospect of employing conical shell beams to combine both absorption and diffraction modalities would provide enhanced analytical utility and has many potential applications in security screening, process control and diagnostic imaging.
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Bern-Klug M, Connolly R, Downes D, Galambos C, Kusmaul N, Kane R, Hector P, Beaulieu E. Responding to the 2015 CMS Proposed Rule Changes for LTC Facilities: A Call to Redouble Efforts to Prepare Students and Practitioners for Nursing Homes. J Gerontol Soc Work 2016; 59:98-127. [PMID: 26913558 DOI: 10.1080/01634372.2016.1157116] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In July of 2015, the Federal Register published for public comment proposed rule changes for nursing homes certified to receive Medicare and/or Medicaid. If the final rules are similar to the proposed rules, they will represent the largest change in federal rules governing nursing homes since the Nursing Home Reform Act which was part of OBRA 1987. The proposed changes have the potential to enhance the quality of care and quality of life of nursing home residents. Many of the proposed changes would directly affect the practice of social work and would likely expand the role for nursing home social workers. This article discusses the role that members of the National Nursing Home Social Work Network (NNHSW Network) played in developing and submitting a response to CMS. The article provides the context for the publication of the proposed rules, describes the process used by the NNHSW Network to develop and build support for comments on these rules, and also includes the actual comments submitted to CMS. Social work education programs and continuing education programs throughout the country will continue to have an important role to play in helping to prepare social work students and practitioners for a career in long-term care.
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Affiliation(s)
- Mercedes Bern-Klug
- a School of Social Work and Iowa Geriatric Education Center , University of Iowa , Iowa City , Iowa , USA
| | | | | | - Colleen Galambos
- d School of Social Work , University of Missouri , Columbia , Missouri , USA
| | - Nancy Kusmaul
- e School of Social Work , University of Maryland Baltimore County , Baltimore , Maryland , USA
| | - Rosalie Kane
- f School of Public Health and Long Term Care Resource Center , University of Minnesota , Minneapolis , Minnesota , USA
| | - Paige Hector
- g Paige Ahead Healthcare Education & Consulting, LLC , Tucson , Arizona , USA
| | - Elise Beaulieu
- h Nursing Home Social Work Consultant , Boston , Massachusetts , USA
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Reinhardt JP, Boerner K, Downes D. The Positive Association of End-of-Life Treatment Discussions and Care Satisfaction in the Nursing Home. J Soc Work End Life Palliat Care 2015; 11:307-322. [PMID: 26654063 DOI: 10.1080/15524256.2015.1107805] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
With the progression of dementia, the need for families and health care providers to have discussions about end-of-life (EOL) treatments arises. EOL treatment decisions often involve whether or not medical interventions intended to prolong life-such as resuscitation, artificial nutrition and hydration, and use of antibiotics-are desired. It is unclear if family satisfaction with care in the nursing home may be associated with involvement in EOL treatment discussions. The frequency of discussions that family members reported having with health care team members regarding multiple life-sustaining treatments and symptom management for their relatives with advanced dementia were examined over a 6-month period along with the association of these particular discussions with care satisfaction over time. Results showed that greater frequency of discussion of EOL treatment wishes was positively associated with higher care satisfaction scores among family members of nursing home residents with dementia. When considered together, greater frequency of discussion of artificial hydration was uniquely associated with greater care satisfaction and increased care satisfaction over time. Social workers must ensure that EOL treatment discussions with older adults in the nursing home and their family members take place and that preferences are communicated among the various interdisciplinary health team members.
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Affiliation(s)
| | - Kathrin Boerner
- b Department of Gerontology , John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston , Boston , Massachusetts , USA
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Simons K, Connolly RP, Bonifas R, Allen PD, Bailey K, Downes D, Galambos C. Psychosocial assessment of nursing home residents via MDS 3.0: recommendations for social service training, staffing, and roles in interdisciplinary care. J Am Med Dir Assoc 2012; 13:190.e9-190.e15. [PMID: 21856244 DOI: 10.1016/j.jamda.2011.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 07/07/2011] [Accepted: 07/07/2011] [Indexed: 11/29/2022]
Abstract
The Minimum Data Set 3.0 has introduced a higher set of expectations for assessment of residents' psychosocial needs, including new interviewing requirements, new measures of depression and resident choice, and new discharge screening procedures. Social service staff are primary providers of psychosocial assessment and care in nursing homes; yet, research demonstrates that many do not possess the minimum qualifications, as specified in federal regulations, to effectively provide these services given the clinical complexity of this client population. Likewise, social service caseloads generally exceed manageable levels. This article addresses the need for enhanced training and support of social service and interdisciplinary staff in long term care facilities in light of the new Minimum Data Set 3.0 assessment procedures as well as new survey and certification guidelines emphasizing quality of life. A set of recommendations will be made with regard to training, appropriate role functions within the context of interdisciplinary care, and needs for more realistic staffing ratios.
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Affiliation(s)
- Kelsey Simons
- Baycrest, Kunin Lunenfeld Applied and Evaluative Research Unit, University of Toronto, Factor Inwentash Faculty of Social Work, Toronto, Canada.
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Connolly RP, Downes D, Reuter J. A look at MDS 3.0 psychosocial changes. Provider 2012; 38:39-42. [PMID: 22530338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Connolly R, Downes D, Fogler S, Reuter J. MDS 3.0: more training needed. Social workers concerned about interview requirements. Provider 2010; 36:85-89. [PMID: 21038823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Robert Connolly
- Centers for Medicare & Medicaid Services, Ellicott City, MD, USA
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Downes D. Management skills linked to the profitability of large practices. J Clin Orthod 1992; 26:280-3. [PMID: 1430177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Wilt TJ, Lofgren RP, Nichol KL, Schorer AE, Crespin L, Downes D, Eckfeldt J. Fish oil supplementation does not lower plasma cholesterol in men with hypercholesterolemia. Results of a randomized, placebo-controlled crossover study. Ann Intern Med 1989; 111:900-5. [PMID: 2683921 DOI: 10.7326/0003-4819-111-11-900] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
STUDY OBJECTIVE To determine the effects of fish oil supplementation on plasma cholesterol in middle-aged men with isolated hypercholesterolemia. DESIGN Randomized double-blind placebo-controlled (safflower oil) two-period crossover trial with 12-week treatment periods. SETTING Outpatient general medicine clinic at a university-affiliated Veterans Affairs hospital. PATIENTS Thirty-eight men with plasma cholesterol between 5.68 and 7.76 mmol/L (220 to 300 mg/dL), triglyceride levels less than 3.39 mmol/L (300 mg/dL), and free of coexisting diseases. INTERVENTIONS Fish oil and placebo (safflower oil) supplementation. After basal measurements and a 4-week lead-in period, twenty 1-g capsules of either fish oil or placebo oil were provided for 12 weeks (period 1). After a 4-week washout phase participants then received the other oil for an additional 12 weeks (period 2). MEASUREMENTS AND MAIN RESULTS Blood was drawn at the beginning and end of each study period and analyzed for levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, apolipoprotein A1, and apolipoprotein B. Low-density lipoprotein (LDL) cholesterol was calculated using the Friedewald equation. Total and LDL cholesterol increased from the before treatment values by 4.8% and 9.1%, respectively, after ingestion of fish oil. Compared with placebo, LDL cholesterol was significantly higher (4.5 compared with 4.1 mmol/L, P = 0.01) and triglycerides lower (1.3 compared with 1.8 mmol/L, P = 0.01) after fish oil. Total and HDL cholesterol and apolipoprotein A1 and B levels did not differ. CONCLUSIONS Fish oil supplements do not lower plasma cholesterol levels in middle-aged men with hypercholesterolemia without elevated triglycerides. They should not be recommended as a method to lower plasma cholesterol in these patients.
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Affiliation(s)
- T J Wilt
- Minneapolis Veterans Affairs Medical Center, Minneapolis
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Affiliation(s)
- D Downes
- Mullard Radio Astronomy Observatory, Cavendish Laboratory, Cambridge
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