Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices. 相似文献
Du fait de l'allongement de l'espérance de vie, de très nombreuses personnes vivent désormais un grand âge, c'est-à-dire une longue période de l'existence au cours de laquelle ils se confrontent à leur finitude. Ce nouveau temps de l'existence questionne la conception traditionnelle d'un cycle de vie ternaire, et la définition de la fin de la vie. Autour de cette dernière étape du parcours de vie, se révèlent les ambiguïtés de la culture des problèmes de la vieillesse et se noue une controverse concernant la désinstitutionalisation et la déstandardisation des parcours de vie. A partir des données issues de travaux empiriques cet article analyse les formes originales d'action publique qui s'esquissent à l’échelle des territoires et renouvellent les cadres normatifs institutionnels de gestion de la grande vieillesse. Il met au jour la dialectique qui s'engage entre une forme de production centrifuge et institutionnalisée des politiques publiques, initiée par l'Etat et un processus centripète dans lequel la diversité et la dispersion des acteurs participent de dynamiques coopératives vs concurrentielles.
Les éléments empiriques mobilisés dans cet article sont issus d'une recherche menée dans le cadre des conventions d’études conclues pour les années 2010 (projet n4) et 2011 (projet n 4) entre l'IRES au service des organisations représentatives des travailleurs et la CGT. 相似文献
The Jewish underground movement in the Soviet Union in the second half of the 1960s produced literature that became a part of the counterculture of Soviet dissent. For the first time in decades, Russian Jews identified, to a significant degree, as people of the galut (Jewish Diaspora). The battle for the return to Israel and the new Jewish renaissance in the intellectual sphere of the unofficial led to the emergence of new topographical concepts, which were inspired primarily by the Jewish cultural tradition. In fact, the exodus texts written in the 1960s–1980s represented a new, late Soviet shaping of Zionist prose. They relate to the symbol of the Promised Land as a fundamental projection of aspirations. Late Soviet Zionist texts share the traditional Jewish vision of Israel as an imagined topos of the original homeland that is both retrospective (with reference to the biblical promise of the land and the seizure of Canaan) and prospective (return and redemption). The Exodus story contained in Sefer Shemot becomes a leading poetic, philosophical and at times religiously charged metaphor of liberation and reunification. The re-strengthened collective memory of tradition required biblical symbols to be imbued with new semiotic power.
This paper will show that the historical dimension of the events dealt with in the literature often has strong mystical and mythological traits and displays messianic-apocalyptic hopes of salvation. However, alternative literary space and time models represented in the aliyah literature hereby betray their rootedness in the teleology of the communist regime. The powerful Israel utopia reflects both the eschatological time of the Soviet empire and its phantasms of paradise on earth. Late Soviet Zionism and totalitarian discourse are shown to be two space-time utopias. 相似文献
Approaches to the concept of culture and teaching cultural competence in a foreign language classroom have been changing over the last decades. The paper summarises, compares, contrasts and evaluates four major approaches to teaching cultural competence in foreign language teaching, that is, knowledge-based approach, contrastive approach, Communicative Language Teaching and intercultural communicative competence approach. 相似文献
The period following the social mobilizations of 2011 has seen a renewed focus on the place of communication in collective action, linked to the increasing importance of digital communications. Framed in terms of personalized ‘connective action’ or the social morphology of networks, these analyses have criticized previously dominant models of ‘collective identity’, arguing that collective action needs to be understood as ‘digital networking’. These influential approaches have been significantly constructed as a response to models of communication and action evident in the rise of Independent Media Centres in the period following 1999. After considering the rise of the ‘digital networking’ paradigm linked to analyses of Indymedia, this article considers the emergence of the internet-based collaboration known as Anonymous, focusing on its origins on the 4chan manga site and its 2008 campaign against Scientology, and also considers the ‘I am the 99%’ microblog that emerged as part of the Occupy movement. The emergence of Anonymous highlights dimensions of digital culture such as the ephemeral, the importance of memes, an ethic of lulz, the mask and the grotesque. These forms of communication are discussed in the light of dominant attempts to shape digital space in terms of radical transparency, the knowable and the calculable. It is argued that these contrasting approaches may amount to opposing social models of an emerging information society, and that the analysis of contemporary conflicts and mobilizations needs to be alert to novel forms of communicative practice at work in digital cultures today. 相似文献