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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.

Occupational psychologists Katie Banham & Christine Hamilton report on the initial evaluation of the DCP leadership development programme.

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.

ALLES UNTER KONTROLLE? Seit Jahrzehnten ist das Thema lumbale Instabilitat ein Dilemma der Manuellen Therapie. Endlose Debatten uber Befund- und Behandlungsmasnahmen erreichten teilweise mythische Dimensionen. Wie setzt man ein evidenzbasiertes Stabilisationstrainings in der Praxis um?

In recent years, the economic development world has come to recognize the pivotal role entrepreneurship plays in increasing a region's economic prosperity. Entrepreneurial approaches to economic development such as “economic gardening,” first introduced in the City of Littleton, Colorado, focus on the important role that timely, reliable, and actionable business information plays in the success of small and growing local businesses. This approach to economic development provides public and university libraries with a unique opportunity to play an important role in their communities by supporting the business information needs of local entrepreneurs. This article addresses some of the successes and challenges that have arisen in the implementation of a pilot economic gardening project involving several libraries and business service entities in two communities in rural Michigan.

The accelerated growth of the creative economy poses two problems for policy analysts.The first is the disconnect that exists between the use of conventional economic accounting tools used to capture skills and innovations in quantitative ways, and the qualitative essence of the creativity itself. The second problem is the tendency to examine and portray the creative economy in theoretical terms rather than through empirical studies, which creates an artificial basis for policy design. In this article, ‘relational mapping’ is outlined as an alternative empirical model and as a possible solution to both sets of problems. Relational mapping portrays the creative economy as a system of relations between workers and networks, which represent the principal creative spaces through which creative enterprise takes hold. In categorizing the creative economy in this way, it is possible to uncover new patterns and regularities in creative practices, which open up new avenues of enquiry. As an example, a relational map of arts-based organizations and networks operating in the West Midlands, United Kingdom is examined here, which magnifies the importance of underground scenes in creative economic activities, and from which it is possible to conceive of an upperground, middleground and underground of creative spaces taking hold and driving creativity in different ways.

In the following article, Christine Hamilton and Adrienne Scullion review the system of theatre provision and production that exists in the rural areas of Scotland, most especially in the Highlands and Islands, assessing the policy framework that exists in the nation as a whole and in the Highlands and Islands in particular. They highlight the role and responsibilities of volunteers within the distribution of professional theatre in Scotland, challenge the response of locally based theatre-makers and nationally responsible agencies to represent rural Scotland, and raise issues fundamental to the provision of culture nationally. In doing so, they question what we expect theatre policy to deliver in rural areas, and what we expect rural agents to contribute to theatre provision and policy. Finally, they suggest that, in the system of rural arts in Scotland, there are wider lessons for the development of arts in and the arts of other sparsely populated and fragile communities. Christine Hamilton is the director and Adrienne Scullion the academic director of the Centre for Cultural Policy Research at the University of Glasgow, where Adrienne teaches in the Department of Theatre, Film, and Television Studies.

Motivated by thinking that culture can be promoted as a driver of economic development, there has been widespread policy consensus about the importance of developing culture and the creative economy as wider attempts to promote growth in cities and regions. While the impact of creative industries differs from area to area as do the conditions and resources for this, several towns and cities have been quick to recognise and exhort the benefits of creative sectors and creative workers and to invest heavily in their creative offer: investing in creative industries as a subset of the cultural economy; showcasing their cultural assets, and implementing strategies to attract creative professionals and retain graduates.

Die unzureichende muskulare Stabilisierung der Wirbelsaule wird haufig als andauende Ursache von noziozeptiven Reizen im muskuloskelettalen System [41] betrachtet. Insbesondere die fur segmentale Instabilitaten typischen unkontrollierten Bewegungen in der Neutralzone (▸ Kap. 1.5.1) konnen durch Uberbelastung oder wiederholte Mikrotraumata zur Sensibilisierung der umliegenden osseoligamentaren und neuralen Gewebe sowie zur Entstehung von Funktionsstorungen der Gelenke und Muskulatur beitragen [40]. Eine ausreichende Stabilitat bietet daher einen wichtigen Schutz fur diese Strukturen und Funktionen. Der Befund der segmentalen Stabilitat ist eine wichtige Komponente der Untersuchung des muskuloskelettalen Systems. Ziel der Therapie ist die Wiederherstellung der Stabilitat, um die Anfalligkeit fur Schmerzen zu reduzieren und die Belastbarkeit zu verbessern.

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.

Der Erfolg einer physiotherapeutischen Behandlung hangt davon ab, wie geschickt und genau der Therapeut dem Patienten dazu verhelfen kann, sich wieder adaquat, sicher, wirksam und effizient zu bewegen. Viele Ubungen und Techniken der Funktionellen Bewegungslehre versuchen daher, sich in gleichem Mas auf die nebeneinander bestehenden Notwendigkeiten einer effizienten Mobilitat und einer adaquaten Stabilitat zu beziehen. Die muskulare Funktion ist in gewisser Weise gegensatzlich, insofern als neuromuskulare Aktivitat Bewegung sowohl in Gang setzt als auch einschrankt. Aber es ist die Beschrankung von Bewegungen, die Stabilitat und Schutz der Gelenke im wesentlichen bestimmt (Hogan 1990; Dynamische Stabilisierung). Andererseits verursacht mangelnde Beschrankung von Bewegungen Instabilitat, was allgemein als eine Ursache fur chronische Schmerzen gilt (Panjabi 1992 a). Dies ist besonders offensichtlich im Bereich der Lendenwirbelsaule, wo hohe Stabilitatsanforderungen bestehen (White u. Panjabi 1990) und wo es haufig zu Schmerzen kommt (Andersson 1981; Troup et al. 1981). Wirksame Methoden fur Test und Behandlung einer Instabilitat der Wirbelsaule sind daher fur Pravention und Behandlung wiederkehrender Schmerzen im Lumbaibereich („low back pain“, LBP) von besonderem Interesse.

A variety of foreign agents, including environmental chemicals, food additives, natural food constituents, and pharmaceuticals, enter the body every day. Many of these compounds must undergo metabolism by specific enzymes within the body to facilitate their clearance. The most important of the enzyme systems, which is found in the liver, includes the cytochrome P-450 dependent mixed function oxidase, as well as several conjugation enzymes, including sulfotransferase, glucuronyl transferase, and glutathione-S-transferase. The balance of the reactions determines the rate of metabolism and clearance of the agents, as well as the degree of intracellular damage or toxicity. Specific dietary factors, such as proteins, carbohydrates, vitamins, and minerals, affect the efficiency of these reactions.

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.

Estimates based on data obtained in this study show that an individual can obtain up to 25% of the RDA for folacin by consuming five cups of tea per day. Tea intake should be considered when the folacin status of individuals or populations is evaluated.

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.