The Social Work Role in Reducing 30-Day Readmissions: The Effectiveness of the Bridge Model of Transitional Care

The hospital experience is taxing and confusing for patients and their families, particularly those with limited economic and social resources. This complexity often leads to disengagement, poor adherence to the plan of care, and high readmission rates. Novel approaches to addressing the complexities of transitional care are emerging as possible solutions. The Bridge Model is a person-centered, social work-led, interdisciplinary transitional care intervention that helps older adults safely transition from the hospital back to their homes and communities. The Bridge Model combines 3 key components—care coordination, case management, and patient engagement—which provide a seamless transition during this stressful time and improve the overall quality of transitional care for older adults, including reducing hospital readmissions. The post Affordable Care Act (ACA) and managed care environment’s emphasis on value and quality support further development and expansion of transitional care strategies, such as the Bridge Model, which offer promising avenues to fulfil the triple aim by improving the quality of individual patient care while also impacting population health and controlling per capita costs.     

Making predictions from complex longitudinal data, with application to planning monitoring intervals in a national screening programme

When biological or physiological variables change over time, we are often interested in making predictions either of future measurements or of the time taken to reach some threshold value. On the basis of longitudinal data for multiple individuals, we develop Bayesian hierarchical models for making these predictions together with their associated uncertainty. Particular aspects addressed, which include some novel components, are handling curvature in individuals' trends over time, making predictions for both underlying and measured levels, making predictions from a single baseline measurement, making predictions from a series of measurements, allowing flexibility in the error and random-effects distributions, and including covariates. In the context of data on the expansion of abdominal aortic aneurysms over time, where reaching a certain threshold leads to referral for surgery, we discuss the practical application of these models to the planning of monitoring intervals in a national screening programme. Prediction of the time to reach a threshold was too imprecise to be practically useful, and we focus instead on limiting the probability of exceeding the threshold after given time intervals. Although more complex models can be shown to fit the data better, we find that relatively simple models seem to be adequate for planning monitoring intervals.     

Situational leadership theory: A test of three versions

Three versions of the leadership dynamics derived from Hersey and Blanchard's Situational Leadership Theory were identified: (1) the original, 1972, statement of the theory; (2) the revised, 2007, theory; and (3) an alternative statement of the theory's essential principle of differential follower response to “autonomy afforded by the leader” in conjunction with “follower developmental level” (as indexed by employee job experience). Survey data collected from 357 banking employees and 80 supervisors, sampled from 10 Norwegian financial institutions, were analyzed for predicted interactions. Results indicated that the 2007 revised theory was a poorer predictor of subordinate performance and attitudes than the original version. The third, alternative, version (which predicted an autonomy × job experience interaction) offered promise for further exploration of the theory's essential principle that employee outcomes are associated with prescribed leader behaviors in combination with follower developmental level, although this version also did not add substantially to accounting for criterion variance.     

The Infirmary as a Short-Term Psychiatric Facility

Abstract

The purpose of this study was to describe the role of the Oregon State University Infirmary (inpatient unit) in the provision of crisis intervention services for students with emotional problems. The focus was on the working assumptions of the infirmary program, the patient population which utilized the infirmary, the dimensions of treatment, and treatment outcomes.

Data were collected for a three year span on all patients who had contact with the infirmary for problems of an emotional nature. Records were reviewed for demographic variables, presenting symptomatology, diagnosis, treatment, disposition, and outcomes. Comparisons were made between these patients and those who received outpatient services through the Oregon State University Mental Health Clinic.

Demographic data indicated that patients who were treated in the infirmary differed only slightly from either the general student population of the university or from students receiving outpatient services. Presenting symptoms reflected a wide range of emotional problems. The severity of psychopathology was demonstrated by the finding that one-quarter of the patients manifested symptoms of acute psychosis, suicidal preoccupation, acute drug reaction, or toxic alcohol reaction. Consistent with the working assumptions of the program, the focus of treatment was short-term, intensive, and symptom directed. Treatment outcomes as determined by followup data were generally positive.

It was concluded that the infirmary provided an important treatment option which extended rather than duplicated outpatient services. The need for such an option was clearly demonstrated. The study was supportive of the concept that a university infirmary has the potential for utilization as a multipurpose facility.     

Positive Changes in Perceptions and Selections of Healthful Foods by College Students After a Short-Term Point-of-Selection Intervention at a Dining Hall

Abstract

Objective: Determine the effects of a short-term, multi-faceted, point-of-selection intervention on college students’ perceptions and selection of 10 targeted healthful foods in a university dining hall and changes in their self-reported overall eating behaviors. Participants: 104 college students, (age 18–23) completed pre-I and post-I surveys. Methods: Pre-survey collected at dining hall in April 2007, followed by 3-week intervention then post-survey collected via email. Healthy choice indicators, large signs, table tents, flyers and colorful photographs with “benefit-based messages” promoted targeted foods. Response rate to both surveys was 38%. Results: Significantly more participants reported that healthful choices were clearly identified in the dining hall after the intervention. Over 20% of participants reported becoming more aware of healthful food choices in the dining hall after the intervention. Significant increases in self-reported intake were reported for cottage cheese and low-fat salad dressing, with a trend toward increased consumption of fresh fruit. Seven of the 14 assessed eating behaviors had significant changes in the desired direction. Increased awareness of healthful foods was the top reason for self-reported changes in overall eating behaviors. Conclusion: Short-term, multi-faceted, point-of-selection marketing of healthful foods in university dining halls may be beneficial for improving college students’ perceptions and selections of targeted healthful foods in the dining hall and may improve overall eating behaviors of college students.     

University Presidents’ Perceptions and Practice Regarding the Carrying of Concealed Handguns on College Campuses

Abstract

Objective: To assess the perceptions and practices of a national sample of college and university presidents regarding their support for concealed handguns being carried on college campuses. Participants: The sample for this study consisted of a national random sample of 900 college or university presidents. Methods: In the spring of 2013, a 3-wave mailing procedure was used to ensure an adequate response rate to a valid and reliable questionnaire. Results: The response rate was 46%, more than what was needed based on the power analysis. The vast majority (95%) of respondents were not supportive of carrying concealed handguns on campuses. They perceived there to be more disadvantages than advantages to handguns on campus. However, college administrators were not focused enough on the primary prevention of campus firearm trauma. Conclusions: The findings of this study suggest a number of activities that could be implemented to enhance safety on college and university campuses.     

Radical Social Work in These Contemporary Times

This article explores the educational journey of one man from leaving school in the mid-1970s, at the age of 14, through a period of chaotic drug use, and on to developing his career helping other chaotic drug users back into a “normal” life. Although focused on someone with drug dependency as part of his history, the article exposes issues that potentially underlie the experiences of many learners within working-class communities. In particular, it examines the role of formal and informal education, considers education's ability to liberate or domesticate (Freire, 1972), and examines approaches to learning that support recovery and transformation.     

The Booker Prize: A Bourdieusian Perspective

Abstract

Excellence is everywhere. At the heart of the performance‐centred, technocratic language of business, sport and the university, the ubiquity of excellence is accompanied by a transparency of effects that mean nothing but nevertheless manage to transform practices within and between all cultural and corporate institutions. Tracing the notion of excellence associated, in the nineteenth century, with culture and humanity, this paper addresses the implications of its usage in recent decades for ideas concerning the contemporary role and status of the university in order to theorise the upheavals in social and economic thinking that underlie recent cultural transformations.     

Family-based approach to the child welfare system: an integration of Bowen family theory concepts

The purpose of this article is to apply Bowen family systems theory to work with families involved in the child welfare system. An overview of family systems theory is provided, and then specific tenets of Bowen family systems theory are presented. The authors highlight incidents within the child welfare setting that can be conceptualized through Bowen family therapy terms and concepts. A case study is used to highlight how this theory could be applied in practice. Furthermore, recommendations for child welfare practice and policy implications are discussed, utilizing the lens of a Bowenian family systems approach.     

Creating the park cool island in an inner-city neighborhood: heat mitigation strategy for Phoenix, AZ

We conducted microclimate simulations in ENVI-Met 3.1 to evaluate the impact of vegetation in lowering temperatures during an extreme heat event in an urban core neighborhood park in Phoenix, Arizona. We predicted air and surface temperatures under two different vegetation regimes: existing conditions representative of Phoenix urban core neighborhoods, and a proposed scenario informed by principles of landscape design and architecture and Urban Heat Island mitigation strategies. We found significant potential air and surface temperature reductions between representative and proposed vegetation scenarios: 1) a Park Cool Island effect that extended to non-vegetated surfaces; 2) a net cooling of air underneath or around canopied vegetation ranging from 0.9 °C to 1.9 °C during the warmest time of the day; and 3) potential reductions in surface temperatures from 0.8 °C to 8.4 °C in areas underneath or around vegetation.