Purpose: This article provides a review of current trends in social work licensure and regulation in the United States. Methods: Topics include practice regulation, the purpose of licensure, the gap ...between social work education and regulation, and practice mobility. Results: Recommendations for advancing licensure and regulation practices for the future are also provided. Conclusion: Includes narrowing the gap between Council on Social Work Education standards and Association of Social Work Boards exam content, improving licensure preparation in educational settings, resolving macro practice concerns about social work licensure, developing consistency across license titles, providing transparency in exam pass rate demographics, achieving practice mobility, and advancing empirical research on testing and practice competence.
Tidal influences on the saline interface of a shallow unconfined aquifer have been investigated by using both dc resistivity traversing and cross-borehole resistivity tomography (CRT). Variations in ...bulk resistivity structure obtained through resistivity traversing provide a clear general picture of the structure of the saline interface and its mixing zone. On all three resistivity traverses there are also indications that a small degree of mixing of saline and fresh water is occurring ahead of the main saline boundary. For one of the traverses much more detail of variations in resistivity structure is provided by CRT utilising three 10
m long electrode strings installed at 10
m separation. CRT images of the saline mixing zone do not reveal any significant difference between low and high tide for tidal ranges of about 2
m, but for a tidal range of approximately twice this clearly show effects due to both increased wave run-up and tidal head. Correlation of the bulk resistivity with fluid resistivity values measured in parallel bores suggests that although there is no apparent widening of the mixing zone during the tidal cycle significant variations in salinity do occur which can be envisaged in terms of the horizontal movement of near vertical salinity contours.
Attempts have been made to use various forms of cellular vectors to deliver therapeutic genes to diseased tissues like malignant tumours. However, this approach has proved problematic due to the poor ...uptake of these vectors by the target tissue. We have devised a novel way of using magnetic nanoparticles (MNPs) to enhance the uptake of such 'therapeutically armed' cells by tumours. Monocytes naturally migrate from the bloodstream into tumours, so attempts have been made to use them to deliver therapeutic genes to these sites. However, transfected monocytes injected systemically fail to infiltrate tumours in large numbers. Using a new in vitro assay for assessing monocyte extravasation, we show that the ability of transfected human monocytes to migrate across a human endothelial cell layer into a 3D tumour spheroid is markedly increased when cells are pre-loaded with MNPs and a magnetic force is applied close to the spheroid. Furthermore, systemic administration of such 'magnetic' monocytes to mice bearing solid tumours led to a marked increase in their extravasation into the tumour in the presence of an external magnet. This new magnetic targeting approach could be used to increase the targeting, and thus the efficacy, of many cell-based gene therapies in vivo.
Objective:
Critically ill patients are at high risk of developing pressure ulcers (PU), with the sacrum and heels being highly susceptible to pressure injuries. The objective of our study was to ...evaluate the clinical effectiveness of a new multi-layer, self-adhesive soft silicone foam heel dressing to prevent PU development in trauma and critically ill patients in the intensive care unit (ICU).
Method:
A cohort of critically ill patients were enrolled at the Royal Melbourne Hospital. Each patient had the multi-layer soft silicone foam dressing applied to each heel on admission to the emergency department. The dressings were retained with a tubular bandage for the duration of the patients’ stay in the ICU. The skin under the dressings was examined daily and the dressings were replaced every three days. The comparator for our cohort study was the control group from the recently completed Border Trial.
Results:
Of the 191 patients in the initial cohort, excluding deaths, loss to follow-up and transfers to another ward, 150 patients were included in the final analysis. There was no difference in key demographic or physiological variables between the cohorts, apart from a longer ICU length of stay for our current cohort. No PUs developed in any of our intervention cohort patients compared with 14 patients in the control cohort (n=152; p<0.001) who developed a total of 19 heel PUs.
Conclusion:
We conclude, based on our results, that the multi-layer soft silicone foam dressing under investigation was clinically effective in reducing ICU-acquired heel PUs. The findings also support previous research on the clinical effectiveness of multi-layer soft silicone foam dressings for PU prevention in the ICU.
Impacts of the COVID-19 pandemic upon social work programs have been profound and institutions have struggled to identify appropriate policies and interventions to address students' educational, ...health, and safety needs. This manuscript reports the results of a survey administered to BSW and MSW students at three different timepoints during the pandemic: March 2020 (N = 157), November 2020 (N = 87), and March 2021 (N = 45). The survey explored students' experiences of online learning, pandemic-related stressors, mental health symptoms, and the department and institution's responses to the pandemic. Although initial comfort with online classroom learning was low, comfort levels increased significantly as the pandemic continued. Students in the MSW online program were the most comfortable with online learning and BSW students the least. Students reported high levels of pandemic-related stressors and behavioral health symptoms throughout the pandemic and approximately half the sample reported concerns about program continuance. Although students felt supported by the social work program, they felt institutional policies to address COVID-19 were inadequate. Useful interventions identified included access to mental health, financial supports, flexibility and support from faculty, clear and consistent communication, and a decrease in field hours during the pandemic.
This article provides an evidence-based discussion of an ongoing effort within the operations of hunger relief organizations to address diversity, equity, and inclusion (DEI) by sourcing and ...distributing more culturally relevant food. Through nearly 100 interviews with food bank personnel in diverse roles (from partner agency relations to executives) representing various regions of the United States, we explore the challenges faced by different functional units within the organization. These interviews indicate a shift to more inclusive language, more personalized metrics, and more inclusive operations. We critically analyze the related literature and identify opportunities for infusing DEI practices in the study of hunger relief supply chains.
The Rho GTPase activating protein 26 (
ARHGAP26
) gene has been reported to be associated with neuropsychiatric diseases and neurodegenerative diseases including Parkinson’s disease. We examined ...whether the
ARHGAP26
gene is associated with Alzheimer’s disease (AD) and/or cardiovascular disease (CVD). Multivariable logistic regression model was used to examine the associations of 154 single nucleotide polymorphisms (SNPs) within the
ARHGAP26
gene with AD and CVD using the Alzheimer’s Disease Neuroimaging Initiative 1 (ADNI-1) cohort. Fourteen SNPs were associated with AD (top SNP rs3776362 with
p
= 3.43 × 10
−3
), while 37 SNPs revealed associations with CVD (top SNP rs415235 with
p
= 2.06 × 10
−4
). Interestingly, 13 SNPs were associated with both AD and CVD. SNP rs3776362 was associated with CVD, Functional Activities Questionnaire (FAQ), and Clinical Dementia Rating Sum of Boxes (CDR-SB). A replication study using a Caribbean Hispanics sample showed that 17 SNPs revealed associations with AD, and 12 SNPs were associated with CVD. The third sample using a family-based study design showed that 9 SNPs were associated with AD, and 3 SNPs were associated with CVD. SNP rs6836509 within the
ARHGAP10
gene (an important paralogon of
ARHGAP26
) was associated with AD and cerebrospinal fluid total tau (t-tau) level in the ADNI sample. Several SNPs were functionally important using the RegulomeDB, while a number of SNPs were associated with significant expression quantitative trait loci (eQTLs) using Genotype-Tissue Expression (GTEx) databases. In conclusion, genetic variants within
ARHGAP26
were associated with AD and CVD. These findings add important new insights into the potentially shared pathogenesis of AD and CVD.
Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome are rare, but potentially fatal complications of antipsychotic‐associated hyperglycaemia. The mechanisms for this remain unclear, but ...are probably multifactorial. The suggested reasons include drug‐induced weight gain and adiposity, development of the metabolic syndrome, antagonism of serotonin (5‐hydroxytryptamine) receptors, drug‐induced leptin resistance, dyslipidaemia mediated pancreatic β‐cell damage and hepatocyte transcription factor dysregulation. Patients with schizophrenia are known to be at a higher genetic risk of developing diabetes mellitus and cardiovascular disease. This review emphasizes a rare case of hyperosmolar hyperglycaemic syndrome in a young man with schizophrenia and discusses proposed mechanisms for the development of antipsychotic‐associated diabetes mellitus.
Older lesbian, gay, bisexual, and transgender (LGBT) persons face many challenges in aging, including coping with life-long discrimination and encountering family and others who are not supportive of ...their identities and relationships. Members of this population who reside in small towns and rural areas face even more challenges in older adulthood. This article presents a case study of an older woman who is questioning her sexual orientation and discusses her experiences in the context of aging in a rural community. The article also addresses the historical context in which older LGBT people came of age as well as health issues that impact them. In addition, recommendations are offered for improving provider services with LGBT individuals.
BackgroundThe number and quality of well-designed scientific studies in the orthopaedic literature are limited. The purpose of this review was to determine the methodological qualities of published ...meta-analyses on orthopaedic-surgery-related topics.MethodsA systematic review of meta-analyses was conducted. A search of the Medline database provided lists of meta-analyses in orthopaedics published from 1969 to 1999. Extensive manual searches of major orthopaedic journals, bibliographies of major orthopaedic texts, and personal files identified additional studies. Of 601 studies identified, forty met the criteria for eligibility. Two investigators each assessed the quality of the studies under blinded conditions, and they abstracted relevant data.ResultsMore than 50% of the meta-analyses included in this review were published after 1994. We found that 88% had methodological flaws that could limit their validity. The main deficiency was a lack of information on the methods used to retrieve and assess the validity of the primary studies. Regression analysis revealed that meta-analyses authored in affiliation with an epidemiology department and those published in nonsurgical journals were associated with higher scores for quality. Meta-analyses with lower scores for quality tended to report positive findings. The meta-analyses that focused upon fracture treatment and degenerative disease (hip, knee, or spine) had significantly lower mean quality scores than did meta-analyses that examined thrombosis prevention and diagnostic tests (p < 0.05).ConclusionsThe majority of meta-analyses on orthopaedic-surgery-related topics have methodological limitations. Limitation of bias and improvement in the validity of the meta-analyses can be achieved by adherence to strict scientific methodology. However, the ultimate quality of a meta-analysis depends on the quality of the primary studies on which it is based. A meta-analysis is most persuasive when data from high-quality randomized trials are pooled.
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