Katherine W.O. Kramer

Most Nursing Home Social Service Directors Lack Training in Working With Lesbian, Gay, and Bisexual Residents

The purpose of this descriptive study is to report findings from a nationally representative mail-in survey of nursing home social service directors (n = 1,071) who were asked if they had received at least one hour of training in six different areas of cultural competency in the past five years. Of the six areas, the lowest percentage of directors reported having training in homophobia. Three-fourths of the sample had not received even one hour of homophobia training over the past five years. Directors who were more recently educated were more likely to report having received homophobia training, as were directors with a college degree, and those who worked in nursing homes located in the West and South regions of the United States. Directors with the most experience were less likely to report having received training. Findings call for immediate development and dissemination of heterosexism and homophobia training of social service staff, policy changes within the nursing home, and policy advocacy priorities for social workers.

Characteristics of Nursing Home Social Services Directors: How Common is a Degree in Social Work?

PURPOSE To report the percentage of nursing homes whose social services director has a degree in social work, to report the characteristics of social service directors, and to describe the characteristics of nursing homes most likely to employ a degreed social worker. These questions are important because social workers are core members of the interdisciplinary team in nursing homes and have responsibilities for the psychosocial well-being of residents. DESIGN AND METHODS Cross-sectional nationally representative survey of 1071 social service directors employed in US nursing homes certified to receive Medicare and/or Medicaid. RESULTS Most nursing homes do employ at least one (and typically only one) social service staff person. Most are employed full-time and half have a degree in social work. About 20% do not have a college degree. The vast majority of social service directors are white and are women. Close to 40% are licensed social workers. Full-time salaries varies enormously from less than

Factors associated with mutans streptococci among young WIC-enrolled children

15,000 to over

Postpartum Nutrient Intakes and Beverage Patterns of American Indian Women

60,000 per year. Most do not belong to an organization that helps them keep apprised of developments in nursing home social services. Using logistic regression and controlling for the effects of other independent variables, for-profit nursing homes with fewer than 121 beds, in sparsely populated counties in the West are the least likely to hire a degreed social worker as social service director. IMPLICATIONS The wide range in educational preparedness and salary indicates 2 roles: a social work role and a social services role. The different roles have implications for initial role preparation and continuing education. Clear communication about the role expectations associated with social services and social work would benefit residents, family, staff, and physicians, who would then be better prepared to draw on their skills in helping to meet the psychosocial needs of residents.

Dental caries in a cohort of very young American Indian children.

OBJECTIVES The objective of this study is to assess relationships between the presence or absence of mutans streptococci (MS) and other covariates in children aged 12-49 months. METHODS Data were analyzed using baseline information from 411 children enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC) who participated in a psychoeducational study in Iowa. Children were assessed for MS using a semiquantitative method (RODAC plates). Dental examinations using d(1) d(2) .(3) criteria and presence of visible plaque on incisors and molars were completed. Mothers completed a series of detailed questionnaires regarding their childs oral health, their socioeconomic status, their childs dietary/oral hygiene habits, and beverage consumption, among other behaviors. Bivariate relationships with the presence of MS were assessed and followed by multivariable modeling using logistic regression (alpha = 0.05). RESULTS MS was present in 144 children (35 percent). Bivariate relationships with MS presence were identified for multiple covariates that included demographic characteristics, type of beverage consumption, dental caries, and plaque measures. Multivariate logistic regression modeling suggested that MS presence in children was positively associated with nonwhite race of the child, number of teeth present, presence of cavitated lesions, proportion of teeth with plaque, and lower levels of maternal education. CONCLUSIONS The presence of MS was associated with greater caries and plaque scores and with low maternal education and nonwhite racial background.

An effective psychoeducational intervention for early childhood caries prevention: part II.

Objectives: American Indian (AI) children are at risk for chronic diseases associated with marginal early nutrition environments. We describe nutrient intakes and beverage patterns of AI women during the early postnatal period to identify nutritional adequacy and beverage habits. Methods: 24 hour recalls and beverage frequency questionnaires were administered to AI mothers (n = 239) from a Northern Plains Tribal community 1 month postpartum. 24 hour recalls were analyzed using Nutritionist PRO(R) software, and intakes were compared to Estimated Average Requirements (EAR). Results: The percentage of AI women reporting nutrient intakes below the EAR was 97% for vitamin D, 96% for vitamin E, 69% for vitamin A, 55% for vitamin C, 73% for calcium and 79% for magnesium. Median (25th, 75th percentile) beverage intakes reported by beverage consumers were 8.0(4.0, 16.0) oz milk, 8.0(3.4, 16.0) oz 100% juice, 8.0(4.0, 16.0) oz juice drinks, 18.6(7.4, 28.0) oz regular pop, 9.1(4.6, 18.3)oz sports drinks, 12.0(5.1, 22.0)oz sugared flavored water and 48.0(24.0, 96.0) oz water. Conclusions: The low nutrient and high sugared beverage intakes increased risk of chronic malnutrition. The nutritional environment predisposes AI children to chronic diseases including obesity and dental caries through early metabolic programming and later modeling behaviors.