Our findings confirm the benefits of newborn screening for CAH and the importance of a second screening test, and suggest that programs for newborn CAH screening must consider complex issues in diagnosis and treatment. These results also confirm that CAH is a continuum of disorders, rather than a disorder with discrete subtypes. In addition, the difficulties in differentiating CAH subtypes in newborns, and thus deciding appropriate treatment, and the high incidence of NC CAH suggest that standard diagnostic criteria and treatment regimens for CAH may need modification. Where screening exists, physicians will encounter more cases of CAH than in the past.
Due to the increase of linguistically and culturally diverse young children in our society, accurate screening for communication disorders is becoming increasingly difficult. The Davis Observation Checklist for Texas (DOCT) is an observational teacher checklist used to screen preschool children for communication disorders in Head Start programs in Texas. The goals of this study were to assess the sensitivity and specificity of the DOCT and to evaluate the concurrent validity of the DOCT with a multicultural population. Fifty-nine English-speaking children (20 Mexican American, 19 African American, 20 Anglo) were evaluated using an assessment battery that included the McCarthy Scales of Children's Abilities (1970), the Goldman-Fristoe Test of Articulation-Revised (1986), and an informal checklist to assess voice and fluency. Concurrent validity was evaluated by obtaining the percent agreement between the outcome of the assessment battery (administered by speech pathologists and graduate clinicians) and the DOCT (administered by Head Start teachers). Results of this study show the DOCT demonstrates adequate sensitivity (80%) and specificity (98%) values and agrees well with the criterion measure in identifying children with communication disorders in the 3 populations studied.
This article describes and analyzes the development of a collaborative research model by one university faculty of social work and 10 health care settings. Established working relationships for educating students were the foundation of a research partnership formed to study questions of mutual interest. This article discusses the developmental stage of the research consortium, including needs assessment, workshop, identification of a common theme and research topic, preliminary funding, and literature review. This stage resulted in the decision to develop and test an instrument to screen for high social risk that would be capable of identifying the need for social work involvement with families to provide effective and efficient management of patients. The Delphi methodology was chosen in the first phase of the research design, and reasons for the choice of this methodology, the results from the two Delphi rounds, and a preliminary screening instrument are presented. Finally, issues in collaboration, such as institutional factors, dynamics of the working group, and leadership roles, are analyzed to identify facilitating features and problematic issues in such partnerships.
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