Background and Objectives Civil money penalties (CMP) are fines collected by CMS and then redistributed to states for the sole purpose of improving resident care and quality of life through reinvestment in quality improvement projects. This study examined state variation in civil money penalty enforcement actions for quality of life (QOL) and quality of care (QOC) deficiencies in nursing homes. Research Design and Methods 2015–2016 cross-sectional CASPER nursing home survey data obtained from the CMS QCOR database were used to explore the pattern of enforcement actions for QOL and QOC deficiencies across states. Fixed effects regression models examined relationships between state-level characteristics, quality deficiencies, and enforcement actions imposed by states. Results State enforcement actions resulting in a CMP were more likely for QOC deficiencies (M = 0.143, SD = 0.097) than for QOL deficiencies (M = 0.070, SD = 0.056) and states exhibited variability in imposing enforcement actions. The presence of severe QOC deficiencies resulting in actual resident harm contributed to CMP enforcement actions for both QOL and QOC deficiencies. States with primarily for-profit status providers had more enforcement actions. Discussion and Implications The variability noted in state enforcement for quality deficiencies actions parallels inconsistencies in state regulatory oversight of nursing homes.
Background and Objectives Suicide has become a major public health concern worldwide and in the United States. Rates of suicide increase during the life course and are highest among middle- to old-age adults. Help-seeking represents a crucial coping mechanism that can mitigate suicide risk. Yet, less is known about suicide risk help-seeking, especially among these age groups. To address this knowledge gap, a systematic review of existing literature was performed to obtain a refined understanding of help-seeking for suicide risk among middle- to old-age adults. Research Design and Methods Using PRISMA guidelines, electronic databases, and key journals with suicide and/or gerontology focuses were searched to identify peer-reviewed publications in English between 2010-2020. A total of 4,732 unduplicated publications were screened for relevance based on titles and abstracts and of which, 52 were reviewed in full text. Results 24 articles met inclusion criteria and were included in qualitative synthesis. These articles discussed a range of topics, including prevalence of service utilization, service use prior to suicide death, and correlates of help-seeking. In general, prevalence of service utilization was low and varied by suicidal history (e.g., higher prevalence among individuals with a history of suicide attempt than those with suicide ideation only). Key facilitators (e.g., current or history of suicidal thoughts, plan, or attempt) and barriers (e.g., stigma) for service use and help-seeking were also identified. Discussion and Implications Findings highlight the need for future studies and tailored services to improve age-appropriate and culturally responsive suicide prevention and intervention strategies for middle- to old-age adults.
Objectives: Recent preclinical studies suggested potential anticancer effects of antidepressant (AD) use in multiple cancers, but the effect on lung cancer in human studies remains unclear. This meta-analysis examined the effect of AD use on lung cancer incidence and mortality. Methods: Web of Science, Medline, CINAHL, and PsycINFO databases were searched to identify eligible studies published by June 2022. We conducted a meta-analysis using a random effects model to estimate pooled risk ratio (RR) and 95% confidence interval (CI) for comparing those with AD use and non-use. Heterogeneity was examined using Cochran’s Q test and inconsistency I2 statistics. The methodological quality of selected studies was assessed using the Newcastle-Ottawa Scale for observational studies. Results: The meta-analysis, including 11 publications involving 1913172 participants, showed that AD use significantly increased lung cancer risk by 11% (RR= 1.11; 95% CI= 1.01, 1.22; I2= 74.3%; n= 6); however, all-cause mortality was not affected by AD use (RR= 1.05; 95% CI= 0.68, 1.58; I2= 90.1%; n= 4) while lung cancer-specific mortality could be reduced by 32% from onse study. Subgroup analysis showed that serotonin and norepinephrine reuptake inhibitors (SNRIs) were associated with an increased lung cancer risk (RR= 1.38; 95% CI= 1.07, 1.78), but selective serotonin reuptake inhibitors (RR= 1.05; 95% CI=0.91, 1.21) and tricyclic antidepressants (RR= 1.09; 95% CI=0.95, 1.26) were not. In addition, variations in the definition of AD use could be the source of heterogeneity of observed effects. The quality of selected studies was good (n= 5) to fair (n= 6). Conclusions: Evidence suggests that AD use was associated with an elevated risk of lung cancer but not with all-cause mortality. More research is needed to precisely estimate the effect of AD use on lung cancer-specific mortality. (Funding: University of Central Florida Center for Behavioral Health Research and Training; Registration: PROSPERO; registration number: CRD42022350719) Citation Format: Eunkyung Lee, David Li, Yongho Park, Alice Rodriguez-Fuguet, Xiaochuan Wang, Wen Cai Zhang. Antidepressant use and lung cancer risk and mortality: A meta-analysis of observational studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6464.
Drawing on data from the National Latino and Asian American Study, this article examines the influence of family relational factors, independently and jointly with immigration generation status, on past-year mental health service utilization among Asian Americans ( N = 1,599). Findings revealed the important role of family relation in influencing the likelihood and type of Asian Americans’ mental health service use. Lower level of family cohesion and higher level of family conflict were associated with increased likelihood of service use. Results from multiple logistic regressions further indicated that generation status interacts with family relation in affecting service use. Specifically, effect of family cohesion on general health service use was modified by generation status among third- or later-generation Asian Americans. Practice implications and future research directions are discussed to better understand and address the mental health needs of this population.
Social workers have been at the forefront of research and advocacy to improve nursing home care for several decades. However, United States (U.S.) regulations have not kept pace with professional standards, as nursing home social services workers are still not required to have a degree in social work and many are assigned caseloads that are untenable for providing quality psychosocial and behavioral health care. The National Academies of Sciences, Engineering, and Medicine (NASEM)'s recently published interdisciplinary consensus report,The National Imperative to Improve Nursing Home Quality: Honoring our Commitment to Residents, Families, and Staff (NASEM, 2022) makes recommendations for changing these regulations, reflecting years of social work scholarship and policy advocacy. In this commentary, we highlight the NASEM report recommendations for social work and chart a course for continuing scholarship and policy advocacy to improve resident outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.