Over the Hills and Through the Hollers: How One Program is Assisting Residents of Appalachian with Opioid Use Recovery

Introduction: The consequences of increasing opioid misuse in the U.S. over the last two decades have been severe, contributing to hundreds of thousands of lives lost and heavy tolls on individuals, families, and society. The Appalachian Region has been hit particularly hard, with its predominantly rural landscape seeing disproportionate increases in opioid misuse and overdoses. These cases have been difficult to address due to poor treatment access and capacity constraints in many areas of Appalachia. Purpose: The current study focuses on evaluating The Kentucky Access to Recovery Program (KATR), which provides services to individuals recovering from opioid addiction residing in several counties in Eastern Kentucky. Its purpose is to understand the impact of KATR on service recipients’ access to recovery services and supports. Methods: Semi-structured interviews were conducted with 12 service recipients, three service providers, and four vendors of support services related to housing, transportation, medical/dental care, employment, and childcare. Qualitative data were analyzed using thematic analysis. Results: Themes related to individual-level impacts were identified and discussed, including behavioral changes related to recovery, physical and mental health improvements, relationship repair, regaining custody of children, provision of needed supports, and ability to gain employment and improve finances. Study findings showed that KATR had meaningful impacts on the lives of service recipients by helping meet needs and reducing barriers to their ongoing recovery. Implications: Through its use of vouchers for support services and basic-needs provision, KATR demonstrates a potentially effective strategy for increasing access to health-related social services for persons in recovery in predominantly rural areas

Pathways to Retention: Job Satisfaction, Burnout, & Organizational Commitment Among Social Workers

Purpose: Job satisfaction, burnout, and organizational commitment remain concerns for human service organizations. Few studies have utilized a large sample of social workers to investigate these factors while also considering practice setting. In the present study, work-related burnout, satisfaction with workload, and satisfaction with organizational environment are examined as factors contributing to organizational commitment while comparing the measurement and predictive strength of these factors based on practice setting. Method: Confirmatory factor analyses and structural equation modeling were used to estimate and compare factors related to organizational commitment with a sample of 1,786 social workers practicing in the United States. Results: Satisfaction with organizational environment showed a strong positive relationship with organizational commitment. Work-related burnout was confirmed to have a negative relationship with organizational commitment. No measurement or structural model differences existed between social workers from different types of practice settings. Discussion: Findings suggest that increasing satisfaction with organizational environment is a better target for retaining employees than reducing workloads. Results emphasize the need for human service organizations to foster work environments which provide a climate of wellness, support, and recognition of employees\u27 contributions at work

Use of the Copenhagen Burnout Inventory with Social Workers: A Confirmatory Factor Analysis

Burnout among social workers continues to be a relevant issue as it can lead to major problems: personal health issues, service deterioration, and turnover. This study examined the use of the Copenhagen Burnout Inventory with U.S. social workers (N = 1774) in direct-service and non-direct-service roles. The CBI is a no-cost alternative to the commonly employed Maslach Burnout Inventory. Results revealed that the CBI is a suitable tool to measure burnout among social workers regardless of position. Screening, identifying sources, and action planning to reduce burnout are critical steps for organizations to ensure a quality atmosphere for employees and clients

Work Experiences of Rural Social Workers in the United States

Rural social workers face unique challenges and opportunities as they seek to address the needs of rural Americans. Using social media, rural social workers in the U.S. were recruited to describe their characteristics and explore factors related to their job satisfaction, burnout, and organizational commitment. Analyses included univariate descriptive statistics, bivariate correlations, and multiple regression. The sample (N = 192) represented 146 counties in 36 states. Participants tended to be White, female, MSW-degreed direct-service providers. Participants were moderately satisfied with their organizational environments and workloads. Age, being Black, and working in settings other than child welfare were most strongly related to satisfaction with workload. Personal burnout scores were highest followed by work-related and client-related burnout. Age and not working in child welfare were most strongly related to lower burnout scores. Being Black and having more tenure in one’s current job were associated with less client-related burnout. Participants indicated moderate levels of commitment to their organizations, with higher salaries and more tenure being the most strongly associated factors. Future research is necessary to examine more closely the work experiences of rural social workers who are younger, identify as racial or ethnic minorities, and employed in child welfare settings

Adjustments to Social Work Practice during the COVID-19 Adjustments to Social Work Practice during the COVID-19 Pandemic in North Carolina: Effects on Burnout and Commitment Pandemic in North Carolina: Effects on Burnout and Commitment

Since the onset of the COVID-19 pandemic, the demand for social workers in the U.S. and abroad has increased. There is demand for more social workers in North Carolina due to ongoing and increasing mental health, substance use disorder, and child welfare needs. COVID-19 has taken a toll on the personal and professional lives of social workers, and research is needed to understand the pandemic’s effects on burnout and commitment among social workers. The present study sought to understand how the COVID-19 pandemic affected the personal and professional lives of social workers practicing in North Carolina and to determine how the COVID-19 pandemic impacted social worker burnout and organizational and occupational commitment. An online survey was distributed to social workers practicing in North Carolina between February and June of 2022. Social work students recruited 120 eligible participants. Data were analyzed using descriptive statistics, correlations, and multiple regressions. Adjustments to COVID-19 were predictive of work-related burnout and affective commitment when controlling for other factors. Years of practice experience, racial identity, caregiver status, satisfaction with organizational environment, educational attainment, and urbanicity of practice location were also salient predictors across the regression models. North Carolina social workers experienced major adjustments to their personal and professional lives due to the COVID-19 pandemic, which led to negative consequences including increased work-related burnout and less organizational commitment. Additional research – particularly qualitative investigations – is needed to better understand the lived experiences of social workers during the COVID-19 pandemic

Rural Social Work: Recruitment, Job Satisfaction, Burnout, and Turnover

Rural agencies have unique challenges related to recruitment and retention of social workers. A systematic literature review was conducted to examine job satisfaction, burnout and turnover among rural social workers. Based on 28 included articles, results indicate: (a) rural social workers tend to be from rural areas or have completed training in rural settings; (b) poor job satisfaction predicts turnover among rural social workers; (c) rural vs. urban differences for satisfaction, burnout, intention to leave, and turnover are mixed; and (d) greater work-life balance and supervisory support increase retention among rural social workers. This study provides recommendations for informing education, policy and future research in social work practice in rural locations in the United States

Creating, Connecting, and Communicating: A look at social support for postpartum women

The prevalence of postpartum depression underscores the critical need for support systems for new mothers. Virtual support groups, such as the Fourth Trimester Support Group described in this paper, represent a promising avenue for addressing these challenges and providing much-needed support. This article describes the formation, activities, and evaluation of an online support group that leverages technology to foster a sense of community for new mothers. Further, the details within the case study provide a basic model for starting a similar support group

Sulfate was a trace constituent of Archean seawater

In the low-oxygen Archean world (>2400 million years ago), seawater sulfate concentrations were much lower than today, yet open questions frustrate the translation of modern measurements of sulfur isotope fractionations into estimates of Archean seawater sulfate concentrations. In the water column of Lake Matano, Indonesia, a low-sulfate analog for the Archean ocean, we find large (>20 per mil) sulfur isotope fractionations between sulfate and sulfide, but the underlying sediment sulfides preserve a muted range of δ^(34)S values. Using models informed by sulfur cycling in Lake Matano, we infer Archean seawater sulfate concentrations of less than 2.5 micromolar. At these low concentrations, marine sulfate residence times were likely 10^3 to 10^4 years, and sulfate scarcity would have shaped early global biogeochemical cycles, possibly restricting biological productivity in Archean oceans

Metabolic improvements following Roux-en-Y surgery assessed by solid meal test in subjects with short duration type 2 diabetes

BACKGROUND: Glucose homeostasis improves within days following Roux-en-Y gastric bypass (RYGB) surgery. The dynamic metabolic response to caloric intake following RYGB has been assessed using liquid mixed meal tolerance tests (MMTT). Few studies have evaluated the glycemic and hormonal response to a solid mixed meal in subjects with diabetes prior to, and within the first month following RYGB. METHODS: Seventeen women with type 2 diabetes of less than 5 years duration participated. Fasting measures of glucose homeostasis, lipids and gut hormones were obtained pre- and post-surgery. MMTT utilizing a solid 4 oz chocolate pudding performed pre-, 2 and 4 weeks post-surgery. Metabolic response to 4 and 2 oz MMTT assessed in five diabetic subjects not undergoing surgery. RESULTS: Significant reductions in fasting glucose and insulin at 3 days, and in fasting betatrophin, triglycerides and total cholesterol at 2 weeks post-surgery. Hepatic insulin clearance was greater at 3 days post-surgery. Subjects exhibited less hunger and greater feelings of fullness and satisfaction during the MMTT while consuming 52.9 ± 6.5% and 51.0 ± 6.5% of the meal at 2 and 4 weeks post-surgery respectively. At 2 weeks post-surgery, glucose and insulin response to MMTT were improved, with greater GLP-1 and PYY secretion. Improved response to solid MMTT not replicated by consumption of smaller pudding volume in diabetic non-surgical subjects. CONCLUSIONS: With a test meal of size and composition representative of the routine diet of post-RYGB subjects, improved glycemic and gut hormone responses occur which cannot be replicated by reducing the size of the MMTT in diabetic subjects not undergoing surgery

Acute mental health presentations before and during the COVID-19 pandemic

Background: A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum. // Aims: We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic. // Method: We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020. // Results: There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown. // Conclusions: UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves