Through a Trauma-Informed and Culturally Sensitive Lens: A Qualitative Study of Effective Engagement with Native American Communities

The focus of this project was on county and tribal professionals’ views on effective social work engagement with tribal communities in a large rural county located in central California. The importance of this topic is recognized by existing literature, as well as by the findings of this study, which indicate that Native Americans are an understudied group that have unique cultural, historical and service based needs. Additionally, the NASW Code of Ethics (2017) endorses social work practice, research, policies and programs that are attentive to different cultures and that challenge social injustices. The findings of this research project support these ethical considerations and shows that engagement with Native American communities necessitates a sensitive, thoughtful, patient and transparent approach based on the generational traumas, oppressions and stigmas that this group has experienced. This study utilized a qualitative and trauma-informed approach through personal interviews and two final group member check-in meetings to develop a shared understanding of the research focus, as well as to attempt to develop an action plan by the participants moving forward to address the problem. The major categories that developed included 1) Historical and Cultural Factors, 2) Needs of the Community, 3) Engagement Skills, 4) Barriers to Engagement and 5) Family and Community Systems. The data that was gathered through this research can help inform social work practice on both the micro and macro levels by leading to more effective engagement with Native Americans through the identification of factors that obstruct and facilitate service engagement in direct practice, as well as through well-structured remedial services, and key agency policies and procedures. While potential action plans were identified by participants to address the research focus, no formal action plans were developed by the group at the time of this report. Nonetheless, the research itself was important because it led to in-depth dialogue, built professional relationships within the community and increased knowledge of the topic

Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis

Cognitive Behavioural Therapy (CBT) is a widely used psychotherapeutic intervention for suicide prevention despite its efficacy for suicide prevention in adults remaining ambiguous. Reluctance or inability to access face-to-face help suggests that e-health delivery may be a valuable resource for suicidal people. The aim of this study was to systematically review and conduct meta-analysis on research assessing the efficacy of CBT delivered via face-to-face and e-health for suicidal ideation and behaviour. A comprehensive literature search of MEDLINE, PsycINFO, Scopus, PubMed and The Cochrane Central Register of Controlled Trials was conducted. From 764 identified articles, 26 met the inclusion criteria for investigating CBT for suicidal ideation and behaviours in adult populations. Data were extracted on study characteristics and meta-analysis was performed where possible. There was a statistically significant, small to medium effect for face-to-face delivered CBT in reducing suicidal ideation and behaviour although there was significant heterogeneity between the included studies. CBT delivered via e-health was not found to be efficacious for reducing suicidal ideation and behaviour in adults though the number of studies reviewed was small

The role of interest and empathy in the formation of persons

Persons are a result of acts, particularly actions with others, i.e., personal relations. In this paper, I will show, through the notions of interest and empathy, that persons are formed as a result of activity in a sensuous and social world. It will be shown that the capacity to put one's self in the place of the other, and to act and interact in a community with others, allow the individual to evolve into a full-formed, self-conscious, sensuous, and social person

Sophomore Recital:Carmen Hawkins, Flute Stefanie Lindsay, Flute Katie Vasel, Flute

Center for the Performing Arts Saturday Afternoon March 25, 2006 5:00p.m

An evaluation of antipseudomonal dosing on the incidence of treatment failure

Introduction: Significant mortality is associated with delays in appropriate antibiotic therapy in Pseudomonas aeruginosa infections. The impact of empiric dosing on clinical outcomes has been largely unreported. Methods: This retrospective cohort compared treatment failure in patients receiving guideline-concordant or guideline-discordant empiric therapy with cefepime, meropenem, or piperacillin/tazobactam. Patients with culture-positive P. aeruginosa between 1 July 2013 and 31 July 2019 were eligible for inclusion. Patients with cystic fibrosis, polymicrobial infection, and urinary or pulmonary colonization were excluded. The composite primary outcome was treatment failure, defined as (1) therapy modification due to resistance/perceived treatment failure, (2) increased/unchanged qSOFA, or (3) persistent fever 48 h after initiating appropriate therapy. Secondary outcomes included rate of infectious diseases consultation, all-cause inpatient mortality, mechanical ventilation requirement, and infection-related intensive care unit and hospital lengths of stay. Results: In total, 198 patients were included: 90 guideline-concordant and 108 guideline-discordant. Baseline characteristics were balanced. Treatment failure was more common in the guideline-discordant than the guideline-concordant group (62% versus 48%; p = 0.04). This remained significant when adjusting for supratherapeutic dosing (p = 0.02). Infectious diseases consultation was higher in the guideline-discordant group (46% versus 29%, p = 0.01), while intensive care unit length of stay was longer in the guideline-concordant group (4.5 versus 3 days, p = 0.03). Additional secondary outcomes were similar. Conclusion: Treatment failure was significantly higher in patients receiving guideline-discordant empiric antipseudomonal dosing. Guideline-directed dosing, disease states, and patient-specific factors should be assessed when considering empiric antipseudomonal dosing

Implementing social prescribing in primary care in areas of high socioeconomic deprivation:process evaluation of the ‘Deep End’ community links worker programme

Background: Social prescribing involving primary care-based ‘link workers’ is a key UK health policy which aims to reduce health inequalities. However, the process of implementation of the link worker approach has received little attention despite this being central to desired impact and outcomes. Aim: Our objective was to explore the implementation process of such an approach in practice. Design and Setting: Qualitative process evaluation of the ‘Deep End’ Links Worker Programme (LWP) over a two-year period, in seven general practices in deprived areas of Glasgow. Methods: We used thematic analysis to identify the extent of LWP integration in each practice and key factors associated with implementation. Analysis was informed by Normalisation Process Theory. Results: Only three of the seven practices fully integrated the LWP into routine practice within two years, based on NPT constructs of coherence, cognitive participation, and collective action. Compared to ‘Partially Integrated Practices’, ‘Fully Integrated Practices’ had better shared understanding of the programme among staff, higher staff engagement with LWP, and were implementing all aspects of LWP at patient, practice and community levels of intervention. Successful implementation was associated with GP buy-in, collaborative leadership, good team dynamics, link worker support, and the absence of competing innovations. Conclusions: Even in a well-resourced government funded programme, the majority of practices involved had not fully integrated the LWP within the first two years. Implementing social prescribing and link workers within primary care at scale is unlikely to be a ‘quick fix’ for mitigating health inequalities in deprived areas