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The Facebook Oversight Board’s ruling temporarily upholding the social media giant’s ban on former President Donald J. Trump, which they instructed the company to reassess within six months, noted that the parameters for an indefinite suspension are not defined in Facebook's policies. The non-decision in this high-profile case illustrates the difficulties stemming from the lack of clear frameworks for regulating social media. For starters, says web science pioneer James Hendler, social media companies need a better definition of the misinformation they seek curb. Absent a set of societally agreed upon rules, like those that define slander and libel, companies currently create and enforce their own policies — and the results have been mixed at best. “If Trump wants to sue to get his Facebook or Twitter account back, there’s no obvious legal framework. There’s nothing to say of the platform, ‘If it does X, Y, or Z, then it is violating the law,’” said Hendler, director of the Institute for Data Exploration and Applications at Rensselaer Polytechnic Institute. “If there were, Trump would have to prove in court that it doesn’t do X, Y, or Z, or Twitter would have to prove that it does, and we would have a way to adjudicate it.” As exemplified in disputes over the 2020 presidential election results, political polarization is inflamed by a proliferation of online misinformation. A co-author of the seminal 2006 Science article that established the concept of web science, Hendler said that “as society wrestles with the social, ethical, and legal questions surrounding misinformation and social media regulation, it needs technologist to help inform this debate.” “People are claiming artificial intelligence will handle this, but computers and AI are very bad at ‘I’ll know it when I see it,’” said Hendler, who’s most recent book is titled Social Machines: The Coming Collision of Artificial Intelligence, Social Networking, and Humanity. “What we need is a framework that makes it much clearer: What are we looking for? What happens when we find it? And who’s responsible?” The legal restrictions on social media companies are largely dictated by a single sentence in the Communications Decency Act of 1996, known as Section 230, which establishes that internet providers and services will not be treated as traditional publishers, and thus are not legally responsible for much of the content they link to. According to Hendler, this clause no longer adequately addresses the scale and scope of power these companies currently wield. “Social media companies provide a podium with an international reach of hundreds of millions of people. Just because social media companies are legally considered content providers rather than publishers, it doesn’t mean they’re not responsible for anything on their site,” Hendler said. “What counts as damaging misinformation? With individuals and publishers, we answer that question all the time with libel and slander laws. But what we don’t have is a corresponding set of principles to adjudicate harm through social media.” Hendler has extensive experience in policy and advisory positions that consider aspects of artificial intelligence, cybersecurity and internet and web technologies as they impact issues such as regulation of social media, and powerful technologies including facial recognition and artificial intelligence. Hendler is available to speak to diverse aspects of policies related to social media, information technologies, and AI.
With “Herd Immunity” Unlikely, Antivirals To Play Key Role in COVID-19 Management
According to The New York Times, the prospects for reaching “herd immunity” in the fight against COVID-19 are increasingly dim. Subsequently, the virus “will most likely become a manageable threat that will continue to circulate in the United States for years to come.” Therefore, long-term management of the SARS-CoV-2 virus, which causes COVID-19, will be increasingly important. As with influenza, and mosquito-borne viruses, like Zika, developing better antivirals for such perennial threats will have to be a part of the plan. Rensselaer Polytechnic Institute researchers Jonathan Dordick, a chemical engineer, and Robert Linhardt, a biochemist are developing one promising antiviral approach that uses a decoy to trap the virus before it can infect a cell. This decoy strategy has shown promise in combating a number of viruses, including SARS-CoV-2, dengue, Zika, and influenza A. Dordick and Linhardt, who is internationally recognized for his creation of synthetic heparin, focus on viruses that use glycoproteins to latch onto human cells, a trait common to many viruses, including coronaviruses. They study how viruses gain entry into human cells at the molecular level and identify safe, effective compounds to offer as a decoy. In their most recent test of this viral decoy strategy on mammalian cells, Dordick and Linhardt demonstrated that a compound derived from edible seaweeds substantially outperforms remdesivir, the current standard antiviral used to combat COVID-19. Heparin, a common blood thinner, and a heparin variant stripped of its anticoagulant properties, performed on par with remdesivir in inhibiting SARS-CoV-2 infection in mammalian cells. Both compounds bind tightly to the spike protein on the surface of SARS-CoV-2, the same strategy the team employed in their previous viral work. Dordick and Linhardt are available to speak on the viral decoy strategy and the need for more effective antivirals in future pandemic control.
Kelley School expert who studies causes and effects of recalls available to discuss Peloton
Peloton Interactive Inc. on May 5 announced that it is recalling its treadmills in a statement from CEO John Foley who also apologized for the company’s initial refusal to comply with federal safety regulators’ prior request for this action. George Ball, assistant professor of operations and decision technologies and Weimer Faculty Fellow at the Indiana University Kelley School of Business, studies the causes and effects of product recalls. Below are comments from Ball. He can be reached at gpball@indiana.edu. “Recall decisions like this are very difficult for managers to make, especially the ones that are high profile and associated with consumer injury. Managers have to balance the firm financial health with consumer safety. Thus, this is a rich area of research. The research that my colleagues and I undertake in this field deal both with the regulator and the firm. My comments will attempt to address both perspectives. “I will start with the regulator. I am currently involved in a research project with two colleagues that is specifically critiquing the Consumer Product Safety Commission for situations very similar to this Peloton recall. There are three main regulators in the US that oversee product quality and in particular recalls: the FDA, NHTSA and the CPSC. “Of those, CPSC is the least proactive and in my view, least successful in properly managing product recalls and their timeliness. This is because there are two main ways in which a firm can push firms to recall; they can force them to, or they can work with the firm management to help encourage them, or nudge them, to recall. The FDA is very good at influencing firms while NHTSA is quite good at mandating recalls. CPSC does neither well. “In particular, the FDA frequently chooses to use their relationships with senior quality executives at firms to nudge them to recall when FDA feels it may be necessary and the firm has not yet acted upon the quality problem. Conversely, NHTSA mandates approximately 20 to 30 percent of auto recalls, such that they choose to force instead of nudge. However, in both cases, while neither industry (medical products and autos) are perfect when it comes to recall timeliness, and both have suffered unfortunate well-known examples of firms dragging their feet in the recall decision, both have a well-developed approach. “CPSC mandates practically no recalls and they do not, from my research, have strong relationships with firm executives that can help them nudge firms to make the quick recall decision. Thus, this Peloton example is one of many in which consumer product firms may take too long to recall. “From the firm perspective. There are several potential red flags that may indicate the firm took too long. The longer a consumer product industry CEO has been in their role, the slower they are to make recall decisions. This is because the longer a CEO is in the role, the less open they are to taking responsibility for such high-profile mistakes. Interestingly, a new CEO, such as one who has been in their role for two to three years, is much more likely to recall a faulty product. “The CEO of Peloton definitely falls into the category of a fairly long-tenured CEO who has his reputation tied closely to the firm’s success. Secondly, the more stock a CEO owns in their firm, the slower they are to make the recall decision, because they are trying to protect their financial welfare. The CEO of Peloton appears to have a significant fortune at stake in Peloton stock, which would be consistent with our research. The more stock a CEO owns, the slower the firm take to recall defective products.”
Starter vape packs to be handed out in hospitals
A new trial from the University of East Anglia will see smokers attending hospital emergency departments given e-cigarette starter packs to help them quit. The initiative comes as a Cochrane Review - the international gold standard for high quality, trusted health information – about vaping is updated today. The review, led by the University of Oxford and involving the UEA team, shows how nicotine electronic cigarettes could increase the number of people who stop smoking compared to nicotine replacement therapy – such as chewing gum and patches – and compared to electronic cigarettes that do not contain nicotine. The new trial will offer stop smoking advice and an e-cigarette ‘starter pack’ to patients attending hospital emergency departments for any reason, to try to encourage and support them to quit smoking – even for those who might not have considered it before. The new trial is funded by the National Institute for Health Research (NIHR) and will be run by the Norwich Clinical Trials Unit at UEA. Prof Caitlin Notley, from UEA’s Norwich Medical School, said; “Many people who smoke want to quit, but find it difficult to succeed in the long term. “Electronic cigarettes mimic the experience of cigarette smoking because they are hand-held and generate a smoke-like vapour when used. They can be an attractive option for helping people switch from smoking, even if they have tried and failed in the past. “We know that they are much less harmful than smoking tobacco, and that they have been shown to help smokers quit. Trial co-lead Dr Ian Pope, also from UEA’s Norwich Medical School and an emergency physician, said: “Emergency Departments in England see over 24 million people each year of whom around a quarter are current smokers. “Attending the Emergency Department offers a valuable opportunity for people to be supported to quit smoking, which will improve their chances of recovery from whatever has brought them to hospital, and also prevent future illness.” The study will run over 30 months across five hospitals in England and Scotland – at the Norfolk and Norwich University Hospital, the Royal London Hospital and Homerton University Hospital in London, Leicester Royal Infirmary and the Royal Infirmary of Edinburgh. Smokers who agree to take part will be randomly assigned to receive either smoking advice during their emergency department wait, an e-cigarette starter pack and referral to local stop smoking services, or just written information about locally available stop smoking services. Both groups of patients will be asked if they are still smoking one, three and six months after they attended hospital. The research team hope to eventually recruit around 1,000 smokers to the trial. Prof Notley said: “We’ll be looking at the number of people who successfully quit smoking across both groups, to see which intervention works best. We’ll also work out how much it would cost to roll the scheme out nationally,” she added. ‘Electronic cigarettes for smoking cessation (Review)’ is published by the Cochrane Library on April 29, 2021.
Thousands of men to trial prostate cancer home testing kit
Thousands of men worldwide are to receive a home test kit for prostate cancer – thanks to pioneering research from the University of East Anglia and the Norfolk and Norwich University Hospital (NNUH). The research team are trialling a new home-testing ‘Prostate Screening Box’ to collect men’s urine samples at-home. The urine samples will be used to analyse the health of the prostate in 2,000 men in the UK, Europe and Canada. This simple urine test is intended to diagnose aggressive prostate cancer and in a pilot study predicted which patients required treatment up to five years earlier than standard clinical methods. Lead researcher Dr Jeremy Clark from the University of East Anglia 'unboxes' the new home testing kit live on Sky News. The Prostate Screening Box has been developed in collaboration with REAL Digital International Limited to create a kit that fits through a standard letterbox. It means that men can provide a urine sample in the comfort of their own home, instead of going into a clinic or having to undergo an uncomfortable rectal examination. The research team hope that it could revolutionise diagnosis of the disease. Lead researcher Dr Jeremy Clark, from UEA’s Norwich Medical School, said: “Prostate cancer is the most common cancer in men in the UK. However it usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime. It is not a simple matter to predict which tumours will become aggressive, making it hard to decide on treatment for many men. “The most commonly used tests for prostate cancer include blood tests, a physical examination known as a digital rectal examination (DRE), an MRI scan or a biopsy. “We have developed the PUR (Prostate Urine Risk) test, which looks at gene expression in urine samples and provides vital information about whether a cancer is aggressive or ‘low risk’. “The Prostate Screening Box part sounds like quite a small innovation, but it means that in future the monitoring of cancer in men could be so much less stressful for them and reduce the number of expensive trips to the hospital. “The prostate lies just below the bladder. It constantly produces secretions which naturally flow into the urethra - the tube through which urine passes from the bladder. The prostatic secretions carry cells and molecules from all over the prostate which are flushed out of the body on urination. We collect these and examine them. It’s a way of sampling the whole prostate in one go. “As the prostate is constantly secreting, the levels of biomarkers in the urethra will build up with time. Collecting from the first wee of the day means that overnight secretions can be collected which makes the analysis more sensitive.” The team have previously trialled the kit with a small group of participants, but in the next phase of the research study are rolling it out to thousands. Men taking part in the trial will receive a home urine-sampling kit and will be asked to provide two urine samples – one to be taken first thing in the morning and the second an hour later. The samples will then be sent back to the lab for analysis. Dr Clark said: “Feedback from early participants showed that the at-home collection was much preferred over sample collection in a hospital. “We hope that using our Prostate Screening Box could in future revolutionise how those on ‘active surveillance’ are monitored for disease progression, with men only having to visit the clinic after a positive urine result. “This is in contrast to the current situation where men are recalled to the clinic every six to 12 months for a range of tests including DRE, PSA tests, painful and expensive biopsies and MRI. We are working to develop the test to help patients in three years’ time. “A negative test could enable men to only be retested every two to three years, relieving stress to the patient and reducing hospital workload,” he added. Robert Mills, Consultant Clinical Director in Urology at NNUH, said: “This simple, non-invasive urine test has the potential to significantly change how we diagnose and manage early prostate cancer for the benefit of patients and health care systems. It may enable us to avoid unnecessary diagnosis of low risk disease as well as managing patients more appropriately with surveillance for those with low risk of progression and early curative treatment for those at high risk of progression.” Paul Villanti, executive director of programs at Movember, said: “The PUR test has great potential to transform the way prostate cancer is managed. Not only can it accurately predict when a man’s disease will become aggressive and require treatment, but it has the added advantage of allowing men to complete it at home. “We are proud to have supported the development of the PUR test from its early stages as part of our Global Action Plan on Biomarkers, through to this trial involving thousands of men across the world. “Through our Global Action Plan on active surveillance, we have been able to identify hundreds of men from the UK, Germany, Italy and Canada who are suitable to take part in this trial. “We hope it will speed up the trial’s progress and get this test included as part of clinical care for men as quickly as possible.” The research has been funded by a Movember and Prostate Cancer UK Innovation award, the Masonic Charitable Foundation, the Bob Champion Cancer Trust, the King family, the Andy Ripley Memorial Fund, the Hargrave Foundation, Norfolk Freemasons and the Tesco Centenary Grant.
Expert available to discuss Facebook Oversight Board's decision on Trump's account
Reporters: Girish Mallapragada, a social media marketing expert at the Indiana University Kelley School of Business, is available Wednesday (May 5) to discuss the Facebook Oversight Board's decision to uphold Facebook's ban on former President Donald Trump. In advance of the announcement, Mallapragada, an associate professor of marketing and Weimer Faculty Fellow, said he questioned whether the board’s decision will have much of an impact on Trump’s outreach to his followers. He noted that Trump’s rise in popularity primarly came through his use of another social media platform, Twitter, and not as much through Facebook. “He was more adept at short form communication than long contextual messages. Twitter is ideal for the former, Facebook for the latter,” Mallapragada said. “Twitter is closest online to a live large audience, where he thrives.” “If Facebook allows him to comeback, it might make people unhappy and others happy, but I don’t think it would be impactful to make a big difference.” George Vlahakis, associate director of communications and media relations at Kelley, can help arrange for interviews with Mallapragada, and can be reached at vlahakis@iu.edu.
A Message from Dean Sarah Gehlert on the Derek Chauvin Verdict
When I heard the verdict read at the trial of Derek Chauvin, I was relieved that a change had been made in how excessive violence by police officers has been viewed and treated in courts. This gave me some hope that a door had finally been opened to create change. A single verdict does not even begin to erase all the lives lost over decades of police violence based on prejudice and discrimination. It does however signal that change is happening, or is at least possible, if we are vigilant. It can be a step taken toward ending systemic discrimination by race in how our judicial system considers the actions of police. The wisdom of George Floyd’s seven-year-old daughter, who stated that her dad “changed the world,” has been validated. We also recognize the wisdom and courage of Darnella Frazier, the Minnesota teenager who filmed the event, knowing that what she was witnessing was wrong. When the verdict came in, I was with a group of community activists from three California counties around Los Angeles. While group members expressed some elation for an episode of justice realized, some cautioned that this victory does not mean that all is well. Racism, and the discrimination that it engenders, continues to run rampant through our judicial system. Within the last week we have added the names of Daunte Wright and Adam Toledo to our protests and vigils. We hope this verdict is a turning point, but we will need to work to assure it. It is worth reading a publication from 2018 to understand the role that social work needs to play in ensuring effective and lasting change to our judicial system. In their paper entitled “The Futile Fourth Amendment,” Professor Osagie Obasogie and Postdoctoral Researcher Zachary Newman examine the Supreme Court case that established the standard for court adjudication of excessive force by police, and how this has perpetuated excessive use of force in many communities of color. Protesting alone will not create the change we want to see. It will require change in policy and practices to establish equal protection for all under the law. This is a moment for us as social workers to seize. We must not wait to act until there is another incident of police brutality or an unfair trial. We should use this moment to move forward with renewed conviction in our beliefs, using our training in policy, community organizing, management and planning, and clinical practice. We should always be the voices demanding equality under the law, saying that an end to systemic racism is possible. The world is ready for change and social work should be leading it, with those whom we serve. We should be the champions of social justice for the well-being of individuals, families and communities through innovative teaching of evidence-informed and practice-based skills, and pioneering transformative research. If not us, then who? Sarah Gehlert Dean
Social Work is Advancing Addiction Science Research
Tens of thousands of Americans die from drug use and addiction every year, with overdoses killing over 63,000 people in America in 2016, according to the National Institute on Drug Abuse. Add in deaths linked to alcohol overuse and tobacco, and the number climbs above half a million Americans. The collective work of several researchers at the USC Suzanne Dworak-Peck School of Social Work, in collaboration with other USC faculty and outside organizations, is advancing knowledge of substance use disorders. Social work has become a hub where researchers and practitioners drive understanding and improve treatment for this disease that impacts millions of families each year. “Either as a cause or consequence, addiction relates to every problem we deal with in social work,” said John Clapp, professor and associate dean for research and faculty development at the USC Suzanne Dworak-Peck School of Social Work. Addiction’s complexity The social work field is uniquely poised to help effect change because of its holistic approach to individual well-being and the public good. According to Clapp, substance use disorder problems are inherently ecological, impacting and being impacted by individuals, families, peers, neighborhoods, communities and public policy in complex and dynamic ways. Untangling those causes and effects and interdependencies is one part of the solution. The other part is understanding that simple solutions may stay out of reach. “We will not find a one-size-fits-all answer,” said Clapp. Looking at addiction as a genetic, psychological or sociological issue only shows one piece of the overall cause. A comprehensive approach is essential, he said, especially when statistics from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) show alcohol use disorders alone as the third leading cause of preventable death in the world. A hub for addiction science The need for a transdisciplinary response to this worldwide crisis was behind the 2018 creation of the USC Institute on Addiction Science (IAS), a joint venture between social work and the Keck School of Medicine of USC, with membership from 10 different schools, colleges and hospitals. Its vision is to strengthen the discipline of addiction science and improve the lives of those touched by the disease. Clapp is co-director of the institute and one of its founding architects. IAS is quickly becoming the foremost place for a broad effort focused on addiction that brings together researchers from the fields of public health, social work, law, public policy, mathematicians, computer engineers and others in recognition of the promise of new approaches to longstanding problems. The USC Suzanne Dworak-Peck School of Social Work has eight faculty making substantial contributions to the prevention of addiction-related disorders as members of the IAS: Professor Avalardo Valdez, associate professors Julie Cederbaum and Alice Cepeda, and assistant professors Jordan Davis, Shannon Dunn, Jungeun Olivia Lee, Danielle Madden, and Hans Oh. “Social work brings one of the broadest perspectives on the underpinnings and solutions to the addiction crisis,” said Adam Leventhal, director of IAS and professor of preventive medicine and psychology at Keck. “By approaching addiction as a health condition and a social justice issue, social work brings to the table the opportunity for high-impact, multi-modal intervention and social policy approaches, which are needed to address the addiction epidemic.” A holistic approach Social work faculty are raising the bar in addiction science research, developing new and novel approaches to improving outcomes for those affected by addiction. In a study recently published in Addiction, a multidisciplinary team lead by Davis and Clapp found gender differences in the risk factors for relapse following treatment for opioid use disorder. The study was the first in this field to use machine learning techniques to process large data sets and identify risk factors for relapse, said Davis, who also serves as associate director of the USC Center for Artificial Intelligence in Society (CAIS). The findings may result in more personalized treatment for opioid use disorder with lasting results. This dovetails with additional research Davis is conducting with computer science engineers at CAIS to collect and input neighborhood and census data into their models in an effort to better understand how these macro variables affect relapse. “We are finding that data points such as crime statistics, population density and concentrated poverty tend to be some of the most important predictors of relapse, over and above individual-level predictors such as impulsivity, motivation or gender,” Davis said. These findings echo Clapp’s description of addiction as ecological and point to the need for holistic solutions. “These machine learning techniques are helping us gain an apparent picture of what the most important factors are surrounding someone’s recovery,” Davis said. “Environment matters greatly.” Davis is also collaborating closely with Eric Pedersen, associate professor at Keck School of Medicine at USC, on several research efforts examining substance use among veterans. Most recently, they have assembled a survey group of approximately 1,200 veterans whom they survey quarterly about their well-being. A recently conducted survey of the group found that veterans with PTSD prior to the COVID-19 pandemic were now managing their symptoms with more frequent alcohol and cannabis use. Another joint research endeavor between the two is examining the use of mindfulness smart phone apps to help reduce substance use in Operation Enduring Freedom/Operation Iraqi Freedom veterans with PTSD and alcohol use disorder. Where well-being and inequalities intersect Jungeun Olivia Lee also seeks to decode the network of relationships between socioeconomic status, adverse childhood experiences and drug use. Her experience as a social work practitioner working directly with clients drives her motivation to demonstrate to policymakers what she sees as a linkage between unemployment, economic stress and substance use disorders. She is lead author on a paper published in Nicotine & Tobacco Research that found unemployment may advance nicotine addiction among young adults, rather than the idea that nicotine addiction may lead to unemployment. Lee’s research interests lie at the intersection of substance use and co-occurring mental health, social inequalities (such as poverty and low socioeconomic status), and adverse childhood experiences. She is interested in combining these three areas of inquiry to explore their influence on addictive behavior that can persist over generations of at-risk families, such as adolescent mothers and their children. Her memories of working directly with clients struggling with the impact of addiction remain clear in her mind. When Lee hears policymakers and others suggest that individual willpower will solve substance use disorder problems, she has a straightforward response: “People are not born with addiction.” In her view, many factors contribute to the triggered distress, including socioeconomic status and adverse childhood experiences. Lee is exploring an idea with other IAS researchers to investigate the relationship between financial strain and employment uncertainty and addiction. “Individual circumstances, such as losing a job, certainly influence substance use, but policy-level decisions, such as the generosity of unemployment insurance, can mitigate the impact,” she said. Transdisciplinary collaboration with social scientists, psychologists and medical researchers at IAS and across the USC campus enriches and amplifies her work. “We are breaking down discipline-specific silos and bringing new and valuable perspectives to this work,” she said. “The synergy is both useful and inspiring.” Looking ahead Researchers also hope to spark interest in the field among the next generation. A new minor for undergraduate students in addiction science was introduced at USC in Fall 2020. The minor is an interdisciplinary collaboration of the Keck School of Medicine, the USC Suzanne Dworak-Peck School of Social Work, the USC School of Pharmacy and the USC Dornsife College of Letters, Arts, and Sciences. It is designed to provide students with a transdisciplinary approach to understanding and treatment of the broad spectrum of addiction-related problems. The goal of addiction science research and education is to improve the long-term effect of addiction treatment and save lives. As society’s understanding of the cause of addiction grows, researchers like those in the school of social work and the IAS strive to bridge the gap between science, practice and policy to positively impact outcomes for those affected by addiction.
New CBS Sitcom "United States of Al" Taps Experience of Social Work Student and Veteran
On April 1, 2021, CBS premiered United States of Al - a new comedy from producer Chuck Lorre (Two and a Half Men, Big Bang Theory) about a Marine combat veteran struggling to readjust to civilian life and the interpreter who served with his unit in Afghanistan and has just arrived to start a new life in America. The show explores the relationship between these two men and how they help each other adjust to their new lives. So, what does a CBS sitcom have to do with the USC Suzanne Dworak-Peck School of Social Work? Enter Master of Social Work (MSW) student Josh Emerson, who landed in the right place at the right time through his field internship at No One Left Behind. No One Left Behind (NOLB) is an all-volunteer, national nonprofit organization that supports recipients of the Special Immigrant Visa (SIVs), and those pursuing an SIV. The founders of No One Left Behind believe the U.S. has a moral obligation to protect these interpreters, and their families, who served side-by-side with American soldiers. Emerson, a veteran of the U.S. Army who deployed to Iraq and Afghanistan, is very familiar with Iraqi and Afghan interpreters. “I went on missions with these interpreters, got to know them, built relationships with them,” he said. “I was so very happy to be able to work with them in this capacity. In addition to providing resources for SIV ambassadors living in the United States, NOLB advocates on behalf of the SIV population to the executive and legislative branches of government provides subject matter expertise to the media, and partners with U.S. businesses to provide opportunities for what they call “this next generation of Americans.” Alea Nadeem, MSW ’15, is a board member of NOLB and reached out to USC with a field internship opportunity for social workers to do macro-level clinical work in a nonprofit setting. Nadeem became Emerson’s field instructor. “What Josh has brought to No One Left Behind has never been brought to the board before,” Nadeem said. “They now see the value in social work.” Bringing the issue to a larger audience Chase Millsap, a consultant and writer on United States of Al, is a former board member of No One Left Behind. “I am still very supportive, impressed and proud of all the work the NOLB team does on a daily basis,” he said. A veteran of the U.S. Marine Corps and U.S. Army Special Forces, he holds a master’s degree from USC Sol Price School of Public Policy. "USC helped me to learn the tools about how to connect entertainment and policy,” Millsap said. “United States of Al is a perfect example of those two worlds coming together in a powerful (and funny) way.” Millsap’s idea was to bring the issues around SIVs into America's living rooms, in a way that would make them relatable. Emerson’s experience as a veteran, his clinical and project management skills obtained through his social work studies and his stellar ability to work one-on-one with SIV recipients and applicants allowed him to inform the show’s stories with a wide breadth of knowledge. Emerson joined James Miervaldis, chairman of the NOLB board, in helping the writers and actors on the show understand the SIV issues, the ways in which NOLB provides assistance and advocacy, and sharing funny stories of cultural differences between Afghans and Americans. Emerson and Miervaldis have also been able to include some of NOLB’s SIV ambassadors in the process, those with an SIV who have already established themselves in the U.S. and are contracted by NOLB to help others assimilate. “They’re talking to the exact people they're portraying,” Emerson said. Nadeem sees Emerson’s contribution to the show as another platform through which to educate. “There are a lot of different tentacles to social work, and it may not seem like the most obvious place in TV and film, but it is,” she said. The show itself touches on everything social workers value ― service, challenging social injustice, dignity and worth of a person, the importance of human relationships and integrity. “This just makes so much sense that a social worker would be involved in this show because that's what we're always trying to communicate to a larger audience,” Nadeem said. “Through this show, you can make a greater impact for these folks to sort of assimilate them to be American citizens, and then also have the whole world appreciate their culture and appreciate what they've done for our nation to keep U.S. service members safe.” A valued member of the team Emerson, a father of five who resides in New Hampshire, knew he wanted to work with veterans after leaving military service. He felt that an MSW was the most versatile degree for this and chose the USC Suzanne Dworak-Peck School of Social Work because of its military social work track. “I think to be a good social worker you need to have experience in life,” Emerson said. “To have seen some things, or been through some things, to understand the population you're dealing with and what they're going through.” When Emerson began his internship at NOLB in 2020, Miervaldis immediately began working with him to focus on SIVs who recently had come to the United States. The first case Miervaldis assigned to Emerson was an SIV family with two young children who needed emergency surgery at a specialty hospital in Washington D.C. “This SIV packed up his family, his pregnant wife and the two kids, used up all his money to take them by bus from Texas to D.C. in the middle of a pandemic and ended up in a bad part of town,” Miervaldis said. As the SIV’s assigned caseworker, Emerson established a relationship and trust with the SIV, helped him obtain safe housing and a job interview, and coordinated details for the children’s surgery with the hospital. “He’s gone and done everything,” Miervaldis said. “We are very proud of Josh’s initiative and empathy for a family in such need. No One Left Behind is the safety net for our allies.” Last year, NOLB helped over 600 families with visas and resettlement. “Josh has exceeded all our expectations and done so while communicating with clients who speak in broken English, Dari and Pashtu, struggling during a pandemic,” Miervaldis said. “His professionalism and empathy are great credits to USC. We would not be where we are today without him. That is not hyperbole.” Miervaldis hopes NOLB will have more social work interns from USC to continue Emerson’s work. For him, Emerson’s project management skills have been the greatest asset, creating a new process for how NOLB provides help for SIV families. “We told Josh, you're a pathfinder, you're a pioneer,” Miervaldis said. “We need to figure out very quickly what works, what doesn't work, and he took it and said, ‘okay, point me in the right direction.’ He’s very much valued as a member of the team.” From advocacy to TV No One Left Behind gets about 20 messages every day from Iraqi or Afghan interpreters who served with U.S. forces in their countries, and who now receive daily death threats from the Taliban. “They're not allowed to live in their homes or their neighborhoods anymore because they helped the U.S.,” Emerson said. “Now the U.S. is withdrawing from all these countries, and the Taliban and terrorist activities in general are picking up, and these people are getting pressured and killed. NOLB has over 300 cases of SIVs who have been killed waiting for their visas.” Emerson hopes that the added exposure from United States of Al will bring awareness particularly to service members about what these interpreters are experiencing and how they can help. One of the requirements for an SIV is a letter of recommendation from the U.S. service member with whom they served, and those have been the most difficult items for SIV applicants to secure. “I have been able to provide some input to what should be addressed in the show,” Emerson said. “It's interesting to see how advocacy on an issue can turn into something this large scale.” See more news from USC Suzanne Dworak-Peck here.
COVID-19 Pandemic Increasing Substance Use Among Veterans with PTSD
Nine months into the pandemic, everyone has been affected by COVID-19 in some way. However, one group that needs special attention and support is U.S. veterans who were already struggling with symptoms of posttraumatic stress disorder (PTSD). A recently conducted survey by Jordan Davis, assistant professor at the USC Suzanne Dworak-Peck School of Social Work, and Eric Pedersen, associate professor at Keck School of Medicine of USC, found evidence that veterans with PTSD prior to the pandemic were now managing their symptoms with more frequent alcohol and cannabis use. “The pandemic has not been easy on folks, especially for those that have PTSD or an alcohol use disorder (AUD),” said Davis, who also is associate director of the USC Center for Artificial Intelligence in Society (CAIS). “Some of the stories I’ve heard [from study participants] have been heart-wrenching.” An extraordinary resource of veterans not affiliated with VA services Davis and Pedersen lead several efforts examining substance use among veterans. They have assembled a survey group of about 1,200 military veterans, a percentage of whom struggle with PTSD symptoms but have not yet sought professional help via the Department of Veterans Affairs (VA) to improve their wellbeing. “We’ve decided to focus on the population of veterans who, for one reason or another, say they don’t need mental health care,” Davis said. Attitudes about care, transportation barriers or perceived stigma from others may deter them from seeking care for PTSD symptoms, and some self-medicate with alcohol, cannabis, cigarettes, or more rarely, methamphetamine or cocaine. Davis cited larger studies 1,2 that found only about half of the veterans who need some sort of mental health care receive it. Many studies of veterans recruit subjects from the VA who are likely already receiving care. The unique sample group that Davis and Pedersen have created may offer fresh insights into how to motivate these veterans outside the VA system to seek care and how best to deliver it. Tracking pandemic effects on mental health It all began with a one-time survey of young adult veterans to measure drinking habits and willingness to seek help. Pedersen and others had developed a brief intervention that had yielded some success reducing drinking in the short-term, but he knew that sustaining those reductions would be difficult unless the veterans agreed to more formal care. The one-off survey, conducted in February 2020, would set a baseline that could be used to inform the brief intervention content. Then COVID-19 cases began multiplying. Affected cities and states began to impose restrictions on public gatherings and more. Pedersen and Davis soon obtained additional funding from the Keck School of Medicine of USC COVID-19 Funding Program and the National Institute of Alcohol and Abuse to follow up with their sample group and see how these veterans were coping with the unprecedented health crisis. “The result is that we can follow up with these veterans from a pre-COVID-19 time period for the next several years, tracking their depression, anxiety and PTSD symptoms and substance use,” Pedersen said. The researchers aim to understand how the veterans are sleeping, what their stress levels are like, and how things have changed as the pandemic wears on. They hope to gain new insights about what motivates some to seek care and how that can be replicated. So far, the results point to some unfortunate, but not unexpected, news. “We’re finding that those veterans who were struggling with PTSD prior to the pandemic are actually doing worse in terms of their substance use behaviors, drinking and cannabis use, as well as their stressful reactions to the pandemic,” Pedersen said. Pedersen and Davis will continue to follow up with these veterans through at least February 2022, surveying them every three months to see how they are progressing. In addition to the survey, they also conduct in-depth qualitative interviews with a subset of the group to enrich their understanding of what their lives are like now and how things have changed for them. The interviews last about an hour, sometimes more. “We talk about the positive and negative things that have happened and what their expectations are for the future,” Davis said. The details are confidential, of course, but it is clear that the pandemic has upended people’s lives and livelihoods across the United States. The toll on those who were already experiencing mental health issues and addiction has been heavy, but Davis and Pedersen are hopeful that their insights and findings will lead to better treatment and outreach in the future. Reducing barriers to care One bright spot over the past nine months has been the quick embrace of telehealth. The VA was already leading the way to telehealth as a way to improve access to its services, and following the stay-at-home orders of the pandemic, telehealth has grown in acceptance and use. Now, online counseling sessions, Alcoholics Anonymous meetings, and medical visits are commonplace. Pedersen and Davis don’t see that changing even when face-to-face gatherings become the norm once again. It has been a promising start to the research, and Pedersen and Davis are even more excited about what the future may hold. They plan on submitting for more grants to continue to track the mental health and substance use of this group of hundreds of veterans with the goal of understanding what factors lead individuals to seek care. Down the road, they hope to use this longitudinal data to help identify profiles of people more or less likely to seek care. “Then we can tailor interventions to increase their willingness to seek care for a problem like a substance use disorder or PTSD,” Davis said. Recognizing patterns in substance use and when to seek care is very important in helping that part of the veteran population that is trying to deal with symptoms of depression, anxiety, PTSD, or substance abuse on their own. “We know that things are bad now and we can expect that there will be lingering effects for years to come,” said Pedersen. “What we hope is that these findings and our future work will help the VA and others create more effective programs and outreach to address the unique needs of veterans.” 1 Veterans Health Administration Office of Patient Care Services, Analysis of VA Health Care Utilization Among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn Veterans. Washington, DC: U.S. Department of Veterans Affairs, 2017. www.publichealth.va.gov/epidemiology/reports/oefoifond/health-care-utilization/. 2 Tanielian, Terri and Lisa H. Jaycox, eds., Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Santa Monica, CA: RAND Corporation, 2008. www.rand.org/pubs/monographs/MG720.html.