Historically, African Americans have resisted participation in clinical trials and other research projects because of distrust of the mostly white research establishment. Although there are legitimate reasons for refusing to join clinical trials, most notably the abuses of the Tuskegee Syphilis Study, African Americans may be passing up opportunities to obtain needed medications years before they reach the market. This article analyzes 29 empirical articles from medical and mental health journals for their findings on recruiting and maintaining African Americans in clinical trials. Reasons for declining and accepting opportunities to participate are organized into themes that represent the salient findings of these reports. Suggestions for social work interventions and changes in research designs are intended to make the research process more welcoming to African Americans. Interventions are linked to the themes and incorporate social work ethics and values. The premise of this study is that African Americans should be offered realistic opportunities supported by sufficient resources to increase participation.

There are large individual differences in the degree of association between the accuracy of memories and subjective confidence in those memories. Are these differences stable within the same test, and between alternate forms of a test? In Experiment 1, college students were tested on 3 recognition memory tasks, then retested 2 weeks later on alternate forms of the same tasks. The relationship between confidence judgments and recognition performance displayed low split-half stability and low alternate-forms stability.Asecond experiment with elderly adults replicated these findings. In a third experiment, college students recalled answers to general knowledge questions and rated confidence in the correctness of each answer. Individual differences in the association between confidence and recall performance were not stable across the odd-and even-numbered items on the test. These data indicate the need for the development of procedures that will produce stable estimates of individuals' metacognitive accuracy.The present research investigated the association between the accuracy ofmemories and a person's confidence in those memories, a topic that has long been of interest in psychology (see, e.g., Seward, 1928;Strong, 1912Strong, , 1913Trow, 1923). The association between confidence judgments and memory performance has been important in several areas ofresearch, and currently is one aspect ofmetacognition being studied along with others such as feelingof-knowing judgments, judgments oflearning, and calibration of comprehension. Also, in the eyewitness memory field, the usefulness of eyewitness confidence as a predictor ofrecall and recognition accuracy has been the subject ofmuch research (e.g., Brigham, 1990;Deffenbacher, 1980;Leippe, 1980;Luus & Wells, 1994;Perfect, Watson, & Wagstaff, 1993;Wells & Murray, 1984).Individuals can vary greatly in metacognitive accuracy, that is, how accurately their metacognitive judgments predict performance on a criterion task. For example, Deffenbacher, Leu, and Brown (1981) reported that individual subjects' point-biserial correlations between confidence judgments and performance on a face recognition task ranged from -.05 to .60. In the research presented in this article, Goodman-Kruskal gamma correlations between confidence and memory performance covered almost the entire possible range, from -1 to +1.The magnitude ofthese individual differences is not confined to studies in which Portions of these data were presented at the annual meeting of the American Psychological Association, Boston, August 1990. We thank R. Crowder, R. Fisher, A. Glenberg, C. MacLeod, T.Nelson, and R. Proctor for their helpful reviews of earlier versions of this article. We also thank 1. Allen, R. Bonner, and D. DeMare for assisting with data collection. Correspondence should be addressed to W. B. Thompson, Department of Psychology, Niagara University, Niagara Falls, NY 14109-2208 (e-mail: wbt@niagara.edu). subjects make postrecall and postrecognition confidence judgments; correlations between feeling-of...

The value of hospital social work is supported by one hospital's tracking system that monitored social work discharge services and compared outcome with non-social work discharges. The sample consisted of a total of 64,722 patients admitted to the "med-surg" hospital unit over a two and one-half year time period from 2002 to 2004. Of the total patients in the sample, 15.7% (n = 10,156) had social work involvement. Sixty percent of the social worker patients were age 70 or over compared with the mean age of the sample of 56.2 years. The mean length of stay for social work served patients was 11.4 days (sd = 13.9) compared to 4.3 days (sd = 6.3) non-social work patients, a difference that was significant (t =-68.3; p = .000). The authors attribute the longer lengths of stay to social workers' receiving older and more difficult-to-place patients. An evidence-based case is made for the cost-containment value of social workers in hospitals and for the creation of a tracking infrastructure to aid in monitoring the daily achievements of medical/surgical social workers.

Two studies were conducted to investigate the use of imagery by subjects of different ages. Experiment 1 was designed to test the effectiveness of "peg-word" system as a memory aid for the elderly. Variables believed to be important in the effectiveness of mnemonic devices were manipulated. The results showed that the mnemonic and imagery instructions were of benefit to the young subjects but not to the older subjects. Age was also found to interact with the concreteness variable, item concreteness having a smaller effect on the oldest subjects. These results suggest that the older subjects were not using imagery mediation effectively. Under the conditions of the second experiment, however, item concreteness had a similar effect across age groups. Tye of instruction was also manipulated in Experiment 2 and only the middle age group improved with imagery instructions. The older age group was not benefited by such instruction.

The value of the presence of social work in emergency rooms is supported by directly examining the hospitalization rates of patients seen by social workers. It utilizes a 3-year-long data set of social work self-reports on medical emergency room outcomes at a large, teaching hospital in the New York Metropolitan area with a sample size of 3370. The study findings suggest that social workers in this acute care hospital's emergency room often are referred the most complex cases. The data on this site indicate that the majority of social work dispositions were to home (54%) or a nursing facility (8.4%). Only 16% of the patients seen by social work were admitted to the hospital. These findings support the cost-effective nature of social work in the emergency room setting and the importance of finding alternatives to hospital admissions. The results of a logistic regression suggest that the criteria used by social workers to assess patients are based on sound psychosocial factors. Patients who were assessed as having "Environmental" (p = .00) or "Relationship" problems (p = .00) were much less likely to be admitted. Conversely, patients with "Care/ADL" problems (p = .00) and behavior problems (p = .00) had a heightened chance of being admitted. Being African American has less effect but was still relevant.