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The Mount Sinai Hospital in New York City was in the epicenter of the COVID-19 pandemic and had to transform from a tertiary to crisis care hospital and increase its bed capacity by 50 percent to care for COVID-19 patients. The size, scope, complexity and uncertainty of this crisis was unparalleled. This article describes the comprehensive response of the Department of Social Work Services, one of the largest hospital social work departments in the country. The response was informed by four Departmental principles, as well as crisis intervention strategies. This article describes organizational structures, practice models, policies, and protocols developed to respond quickly and effectively, given infection prevention mandates, to patient, population and workforce needs. Finally, it includes how social workers addressed COVID-19 related physical and psychosocial needs and applied and modified interprofessional communication and collaboration. Lessons learned and clinical and administrative changes that will assist in navigating "new normal" operations are discussed.

In the era of Medicaid Redesign and the Affordable Care Act, the emergency department (ED) presents major opportunities for social workers to assume a leading role in the delivery of care. Through GEDI WISE-Geriatric Emergency Department Innovations in care through Workforce, Informatics and Structural Enhancements,-a unique multidisciplinary partnership made possible by an award from the Center for Medicare and Medicaid Innovation, social workers in The Mount Sinai ED have successfully contributed to improvements in health outcomes and transitions for older adults receiving emergency care. This article will describe the pivotal and highly valued role of the ED social worker in contributing to the multidisciplinary accomplishments of GEDI WISE objectives in this new model of care.

This study investigated the effects of "motor-control training" (MCT) using the model of deficits in the activation of transversus abdominis (TrA) in people with recurrent back pain. The purpose of this investigation was to establish whether MCT - implemented within a new group intervention (experimental group) - is able to produce results similar to those of a conventional intervention applied individually (control group) to people suffering from back pain. Using the form of an experimental pre-post-test design, the study consisted of an experimental group (N = 18, mean age M = 45.2; SD = 18.4; 9 ♂, 9 ♀) and a comparison group (N = 13; age = 56.6; SD = 18.5; 6 ♂, 7 ♀). The training covered a period of six weeks, with two training sessions per week. The amount of training was the same in both groups. Aside from the same extent of training, the participants in the experimental group completed training content in the group interventions identical to that completed by the comparison group in the individual treatments. To clarify: The difference between the two groups was that the participants in the individual-therapy control group received individual feedback on their exercise performance and correction notes from the instructor. This degree of individual attention was not given within the group therapy. The selective activation of the M. transversus abdominis (TrA) was the main focus of the intervention, with the intent of improving its stabilising corset function, especially within the lumbar region, via increased tension of the thoracolumbar fascia. To record the progress of both groups, the anterolateral abdominal muscle recruitment of the M. transversus abdominis (TrA) was measured as a main influencing factor for anterolateral stabilisation of the spine. For measurements of muscle recruitment, rehabilitative ultrasound imaging (M-Turbo™ SonoSite(®) Erlangen in B-Mode) according to Whittaker (2007) was used. Furthermore, the relationship between pain relief and the development of muscle recruitment was evaluated. Finally, the possible pain relief and the improvement of daily routine disruptions were assessed via the visual analogous scale (VAS) and the Oswestry Disability Questionnaire (ODI) (Mannion et al., 2006a,b). Both forms of intervention produced significant improvements in abdominal muscle control and pain (p < 0.003; p < 0.007). However, according to Cohen (1988), the effect sizes could be classified as a low to medium effect advantage on the part of the individual treatment (d < 0.5). Nevertheless, there were no statistically significant differences between individual and group interventions for the measured parameters, indicating that the group interventions can be considered more efficient because more patients were helped at the same time with similar effort. This result provides new and valuable insights for doctors, sports medicine specialists and physiotherapists, as well as for the sponsors of prescribed treatments, and it confirms the usefulness of integrating the new form of intervention into existing multimodal back therapy training concepts.

Tongue movements for speech in three adults with Down syndrome and one normal speaking control were investigatedusing electropalatography (EPG) and diadochokinetic rate (DDK)techniques. The subjects with Down syndrome all showedsubstantially larger areas of tongue-palate contact comparedwith the control subject for alveolar sounds /t, d, n, l/, anddifferences in fricative articulation. Undershoot (incompleteclosure) was a feature of velar articulations /k, g/ in the subjectswith Down syndrome. Longer closure duration, longer consonanttransition times within clusters and consistently slower DDKrates were also noted. Asymmetry and variabilitywere evident in two of the subjects with Down Syndrome.The results support the hypothesis that people with Downsyndrome have difficulties with coordinating the rapid tonguemovements necessary for clear speech with impaired tonguemotility and motor programming as well as phonological delay.Implications for treatment are discussed.

Medications can affect, and be affected by, nutrition. The interactions between drugs and various components in the diet are in part responsible for the erratic drug responses observed in patients. Because of the diversity of food consumption patterns among individuals and the widespread use of drugs, an array of varied and complicated side effects can occur. When vitamins, minerals, or other food components alter drug utilization or when drugs induce nutritional deficiencies, the effect poses a risk to the patient. Drugs can also affect many nutrition-related factors, such as appetite, taste acuity, and gastrointestinal function. Dietary habits or metabolic changes should be examined carefully and evaluated in any patient who unexpectedly gains or loses weight while taking drugs. Medicated patients need to be aware of good nutrition practices and to understand the importance of dietary modifications associated with certain diseases. A nutritious diet not only makes an important contribution to the health of those individuals but also reduces the risk of nutrition disorders or altered drug efficacy. Nutrition counseling should be considered for medicated patients to help them make rational decisions about their food choices.

The age of the population continues to increase. At the turn of the century, 4% (about 3.1 million people) were 65 years of age or older. Today the percentage has increased to 12%, or 27.4 million people, and the prediction for the 21st century may increase to 17 to 20%. It should be noted that the number of individuals 85 years of age and older, as well as those over the age of 100, is increasing rapidly. The nutritional problems of the elderly are related to physiological decline, to low economic status and limited food consumption, and to a multitude of disease processes and the therapeutic regimens prescribed to cure or treat those illnesses. Examined as a group, the elderly at first appear to be less uniform in their health status than younger members of the population. However, only 10% of the elderly population contributes to the disproportionate (30%) expenditure of health care services. A majority of the elderly are normal, healthy individuals. Yet, with each decade of life the percentage of the elderly population needing additional care increases. The national nutritional surveys (National Food Consumption Survey and the National Health and Nutrition Examination Surveys, I and II) used entirely different methodologies, but reported very similar findings. The mean intake of this population was actually quite good, revealing low intakes of calcium and iron in the elderly female population. However, the standard deviation of the intake data strongly suggests a major portion of the population is at nutritional risk. For more than 30% of the population, nutrient intakes below two thirds of the recommended dietary allowances (RDA) occurred for calories, calcium, and vitamin A, while for more than 20% of the population, iron and vitamin C were at risk. Although the data evaluating the effects of age on the nutritional requirements of the elderly are limited, careful interpretation of the existing assessment and intervention efforts can provide some basic guidelines. Generalities about calorie intake must be avoided, and emphasis must be placed on calorie needs. Enhanced activity should be encouraged. Protein intake for the majority of elderly exceeds the RDA, but with increased age a greater amount of high quality protein is needed to maintain nitrogen balance. The group at greatest risk is the poor elderly who may not be able to afford enough high quality protein. Increased consumption of complex carbohydrates serves several functions including decreased caloric density and enhanced nutrient intake. Decreasing total dietary fat decreases caloric intake and indirectly decreases dietary cholesterol.(ABSTRACT TRUNCATED AT 400 WORDS)

Female guinea pigs were fed diets varied in ascorbic acid and iron concentration for 21 days. Tissue concentrations of ascorbic acid, iron (total, ferritin and hemosiderin) and copper were determined in blood, liver and spleen. High dietary ascorbic acid (10 times control) increased tissue ascorbic acid levels and produced a decrease in liver ferritin and hemosiderin, without altering liver or plasma total iron. Conversely, splenic total iron increased with no changes in ferritin and hemosiderin iron. The increased ascorbic acid did lower copper levels in blood and liver, 39% and 52%, respectively. In guinea pigs maintained on an ascorbic acid-free diet for 21 days, a decrease in hepatic ferritin and total iron was observed, as well as an increase in splenic hemosiderin and total iron. No change in plasma iron was observed nor were any of the copper pools altered. Intake of high dietary iron (10 times control) increased hepatic iron stores and produced a reciprocal decrease in hepatic copper. Even though splenic iron increased, no significant change in copper resulted. The significance of these nutrient interactions is discussed.

Ascorbic acid deprivation for 21 days in female guinea pigs was associated with an increase in splenic hemosiderin and total iron, but no change in splenic ferritin iron. Decreases in hepatic ferritin, hemosiderin, and total iron were also produced. Upon refeeding ascorbic acid for only 3 days, elevated splenic total iron returned to control levels while the diminished hepatic iron stores remained low.