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This article will discuss the establishment of a "partnership" of two State of Wisconsin regions (northern and western); thirty-four county human service agencies; the University of Wisconsin Department of Social Work; and the Continuing Education unit on the same campus: the Community-Based Services Training Partnership for Adults (CBSTP). The partnership's purpose is to develop a carefully researched and designed curriculum training module that is outcome-based, practice-oriented, and designed to improve the quality of services to vulnerable adults living in northern and western rural Wisconsin. The article explores efforts at current program identification and problem solving, the establishment of an advisory board representing the state and county members, methodology, and funding initiatives. The final product of this initiative will be a manual that will include all aspects of the training curriculum.

Purpose: This study was designed to identify which of 3 treatments for aspiration on thin liquids--chin-down posture, nectar-thickened liquids, or honey-thickened liquids--results in the most successful immediate elimination of aspiration [...]

The ability to assess accurately risk factors for maltreatment while in family foster care is essential for developing prevention and intervention strategies. Yet information about children involved in maltreatment episodes while in foster care is severely limited. This correlational study reports on characteristics, health, and functioning parameters of all 78 children with substantiated maltreatment reports between 1984-1988 in an urban foster care program as compared to a random sample of 229 nonmaltreated children in foster care in the same time period. Almost 50% of the substantiated maltreatment was sexual abuse with the remainder physical abuse and neglect. Problems in health, development, and functioning were reported in the social services record for a large number of all children, but children sexually abused while in care were significantly more likely to have a nonkinship placement, and to have mental health and development problems identified. Physical abuse and neglect while in foster care were not associated with child health and functioning characteristics. The implications of these results are discussed within the context of the data source used. Key Words - Physical abuse, Foster care, Sexual abuse, Neglect.

Types and frequency of child abuse and neglect reports in family foster care in Baltimore, Maryland as compared to reports among nonfoster families are reported. Data on maltreatment incidents in foster homes were abstracted from Child Protective Services investigation records for the years 1984-1988. Comparisons were made to community reports. Results indicated that foster families had over a three-fold increased frequency of maltreatment reports as compared to nonfoster families. Report frequency was highest for physical abuse with a seven-fold risk of report as compared to nonfoster families. Overall, 20% of foster care reports were substantiated as compared to 35% of nonfoster reports, although the risk of having a substantiated report was significantly higher in foster care. The distribution of report types in foster care differed from those in the community with physical abuse the most frequent allegation in foster care, as compared to neglect as the most frequent allegation in the community. Explanations for these findings including differences in criteria for report and substantiation are advanced.

Background Liquid aspiration during swallowing has been linked to pneumonia, the most common cause of infectious death in the elderly. This paper examines the key issues in the design and implementation of the first multisite, randomized behavioral trial in dysphagia in an aging population. The study evaluated two commonly used treatments with respect to short-term and long-term management of liquid aspiration and subsequent pneumonia in dysphagic geriatric participants with dementia and/or Parkinson's disease. Methods Discussed are lessons learned during the conduct of this trial and include (1) ethical and methodological design issues, (2) pragmatic implementation of procedures and forms, (3) importance of multiple communication and monitoring strategies, (4) response to funding issues, and (5) changes in staff and facilities. Results In order to complete this trial the researchers were required to provide more support than anticipated in tasks such as completion of regulatory requirements by sites, supplementing site staff to identify potential study participants using a 'circuit rider' approach, continued recruitment of new sites and staff throughout the course of the trial, adapting forms and procedures and managing within economic constraints in a changing trial environment. Limitations Many of the challenges faced by the researchers were not anticipated when the study began. Successful strategies are described for these unanticipated difficulties, based on retrospective evaluation. Conclusions Successful conduct of clinical trials in long-term care environments that are heavily impacted by changes extraneous to the trial design and with staff typically new to clinical trials is possible but success depends on logistical flexibility. [ABSTRACT FROM AUTHOR]

We have been investigating the squirrel monkey (Saimiri sciureus) as a suitable animal model for testing the effects of noise on hearing. Our previous research has shown a similarity between human and squirrel monkey temporary threshold shift (TTS) growth with time in the noise. The goal of this study was to measure the frequency spread of TTS to five different industrial noises for both humans and squirrel monkeys and to compare the results. Fifteen human subjects and six squirrel monkeys were exposed to each of the five noises for 8 h, and TTS was measured at ten different frequencies ranging from 250 Hz to 8 kHz. In the experiments with humans, five frequencies were tested twice (counterbalanced) after each 8-h session. In the squirrel monkey experiments, a complete 8-h exposure was required for each frequency tested, since only one frequency could be measured each time the monkeys were removed from the noise. The results indicate that in predicting human TTS from the squirrel monkey TTS for these exposures, TTS would be overestimated at 750 Hz and 1 kHz and underestimated at 5.6 kHz, whereas the TTS at other frequencies would correspond closely. [Work supported by NIOSH.] [ABSTRACT FROM AUTHOR]

Background: Secondary use of Electronic Health Records (EHRs) has mostly focused on health conditions (diseases and drugs). Function is an important health indicator in addition to morbidity and mortality. Nevertheless, function has been overlooked in accessing patients' health status. The World Health Organization (WHO)'s International Classification of Functioning, Disability and Health (ICF) is considered the international standard for describing and coding function and health states. We pioneer the first comprehensive analysis and identification of functioning concepts in the Mobility domain of the ICF.Results: Using physical therapy notes at the National Institutes of Health's Clinical Center, we induced a hierarchical order of mobility-related entities including 5 entities types, 3 relations, 8 attributes, and 33 attribute values. Two domain experts manually curated a gold standard corpus of 14,281 nested entity mentions from 400 clinical notes. Inter-annotator agreement (IAA) of exact matching averaged 92.3 % F1-score on mention text spans, and 96.6 % Cohen's kappa on attributes assignments. A high-performance Ensemble machine learning model for named entity recognition (NER) was trained and evaluated using the gold standard corpus. Average F1-score on exact entity matching of our Ensemble method (84.90 %) outperformed popular NER methods: Conditional Random Field (80.4 %), Recurrent Neural Network (81.82 %), and Bidirectional Encoder Representations from Transformers (82.33 %).Conclusions: The results of this study show that mobility functioning information can be reliably captured from clinical notes once adequate resources are provided for sequence labeling methods. We expect that functioning concepts in other domains of the ICF can be identified in similar fashion. [ABSTRACT FROM AUTHOR]