Charles Auerbach

Neuroanatomic Localization of Magnetic Resonance Imaging Signal Hyperintensities in Geriatric Depression

BACKGROUND AND PURPOSE Increased frequency and severity of signal hyperintensities have been regularly reported in elderly depressed patients compared with normal subjects, however, greater neuroanatomic localization of lesions has been limited. METHODS T2-weighted MRI scans in elderly depressed patients (n = 35) and normal comparison subjects (n = 31) were assessed for signal hyperintensities in lateralized discrete brain regions. RESULTS Logistic regression revealed that left frontal deep white matter (P<.005) and left putaminal (P<.04) hyperintensities significantly predicted depressive group assignment. CONCLUSIONS Findings suggest that greater neuroanatomic localization of hyperintensities than heretofore appreciated may relate to late-life depression.

Nursing Homes as Reservoirs of MRSA: Myth or Reality?

OBJECTIVE To determine the prevalence and risk factors associated with methicillin-resistant Staphylococcus aureus (MRSA) colonization among residents of a long-term care facility (LTCF) and to investigate the association of prior antibiotics use and MRSA colonization. DESIGN Cross-sectional analysis. SETTING A large, 320-bed suburban long-term care facility in New York. PARTICIPANTS A representative sample of 160 nursing home residents. MEASUREMENTS We obtained nasal swabs to screen for MRSA colonization and reviewed the medical charts for clinical and demographic data. RESULTS A total of 160 residents participated. MRSA colonization was identified in 44 residents (27.5 %). Only 5 variables were statistically significantly associated with MRSA colonization, namely race, renal insufficiency, increased use of antibiotics, prior MRSA infection during the previous year, and prior hospitalization within 3 years. Sharing a room with a MRSA carrier did not increase the risk for colonization. CONCLUSION This study found a large reservoir of MRSA within this LTCF population. Nursing home residents with renal insufficiency, prior MRSA infection, prior hospitalization, and higher use of antibiotics were found to be at risk for MRSA colonization . These findings demonstrate that LTCFs need to be proactive in implementing appropriate antibiotics restriction practices and should give high priority to the development of more effective infection control policies.

MSW Student Satisfaction With Using Single-System-Design Computer Software to Evaluate Social Work Practice:

Objective: A computer program for social work practice research was created and then tested. This program was designed specifically for computer tasks of data entry, data analysis, and graphic presentations of single-system-design research in social work practice. Method: An evaluation of this program was conducted with 136 students at one masters of social work (MSW) program in the spring of 1996. Results: More than 95% of the students surveyed found the program added a valuable component to research, and 81.9% reported the program helpful in evaluating practice. Conclusions: Computer software programs that are research design specific may encourage more social workers to do practice evaluation studies, but further development and testing of these types of specialized programs is called for.

Do geriatricians practice what they preach?: geriatricians' personal establishment of advance directives.

Previous research has been conducted regarding preferences of physicians for life-sustaining treatments for themselves, but there is a dearth of data on personal use of advance directives (ADs) by geriatricians specifically. Using a phone survey, we contacted all graduates of the geriatric fellowship program to assess their personal use of advance directives and their personal preferences for life-sustaining treatment. Of the 124 living graduates of the Parker Jewish Institute for Health Care and Rehabilitation, 70 agreed to participate. One third of respondents had established ADs for themselves, with higher rates in women than men (p = .054). Older geriatricians were significantly more likely to have advance directives (exact trend test yields, p < .0001). In general, respondents did not inform their health care providers about their desires for end-of-life care. This study revealed that the majority of fellowship-trained geriatricians did not formally establish advance directives for themselves. Further research is needed to determine whether physicians who establish advance directives for themselves are more likely to encourage their patients to do so.

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

Childrens 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.

Validation of the T-SAT-R-2: A Reaction to Training Scale for Use in Child Welfare and Human Service Trainings

ABSTRACT This article reports on the validation of the Training Seminar Assessment Tool-Revised-Second Edition (T-SAT-R-2) instrument designed to measure participants’ satisfaction with training seminars and workshops. It was developed from an earlier version, the Training Seminar Assessment Tool-Revised (T-SAT-R), which was distributed following child welfare and social service staff development training sessions. Using confirmatory factor analysis with a sample of 656 trainees, the 25-item T-SAT-R was reduced to 13 items and is now named the T-SAT-R-2. The final model consists of 3 domains: transfer of knowledge, communication, and substance/access. The T-SAT-R-2 is in a user-friendly format and can be scored on each domain or combined to give a total score. The benefits of using the T-SAT-R-2 include that it is only 1 page, the wording is straightforward, and presenters can add additional items based on their specific presentation. Research is presented that shows the connection between satisfaction surveys and behavior change from trainings to be speculative; however, child welfare studies have indicated a link between satisfaction with training and job satisfaction and, possibly, turnover. Additional research on the effects of satisfaction with trainings for child welfare workers is warranted. For the full T-SAT-R-2 instrument, please contact the corresponding author at the listed address.