The meaning of family-like care among operators of small board and care homes

Thirty-six operators of small board and care homes were interviewed to explore how they conceptualize the care that they provide to frail, elderly persons. The meanings these operators attach to the care they provide reveal, through stories of “why” and “how” they provide care, both shared meanings and dimensions of difference in how they view their work. A range of motivations (the “why” of care), from altruism to economics, combine with varied styles of service delivery (the “how” of care), from full domestic integration to separate domains, to create a typology of meanings in this form of residential care. Implications of these dimensions for quality of care and social policy are derived from this typology.     

The impact of legislator and constituency ideology on voting on the assault weapons ban

Using variables that represent a legislator's entire legal constituency, previous research by social scientists has concluded that views of the legislator's constituency have little effect on how legislators vote. This question is reexamined by defining constituency as those voters most likely to vote for the legislator (i.e., members of the legislator's own political party and independents). Furthermore, instead of measuring constituency by either a demographic or vote-based measure, a survey measure of the ideological identification of voters (i.e., the voter's self-identification as liberal, moderate, or conservative) is introduced. It is found that the ideology of a senator's electoral constituency was an important factor on the recent U.S. Senate vote to ban 19 semi-automatic assault weapons. The findings have important implications for how social scientists conceptualize and measure constituency.     

The impact of legislator and constituency ideology on voting on the assault weapons ban

Using variables that represent a legislator's entire legal constituency, previous research by social scientists has concluded that views of the legislator's constituency have little effect on how legislators vote. This question is reexamined by defining constituency as those voters most likely to vote for the legislator (i.e., members of the legislator's own political party and independents). Furthermore, instead of measuring constituency by either a demographic or vote-based measure, a survey measure of the ideological identification of voters (i.e., the voter's self-identification as liberal, moderate, or conservative) is introduced. It is found that the ideology of a senator's electoral constituency was an important factor on the recent U.S. Senate vote to ban 19 semi-automatic assault weapons. The findings have important implications for how social scientists conceptualize and measure constituency.     

Language ideology in an endogamous society: The case of Daghestan

Studies of multilingual systems found in Indigenous small-scale communities often assume that exogamous marriages are the norm in such societies and contribute to their linguistic diversity. This paper is an account of the language ideology of endogamous societies in rural highland Daghestan (Northeast Caucasus). By studying language policing and language choice in infrequent mixed marriages, the paper uncovers the beliefs that support endogamy and reveals issues of linguistic identity and attitudes toward the usage of the matrilect within the family and the village. Interviews show that in-married women do not bring new languages to the villages, because they quickly acquire the local language new to them and use it with all their in-laws and their children. A strong association between villages and languages together with the ideology supporting linguistic homogeneity within the village contributes to the maintenance of the regional linguistic diversity.     

The ideology of social problems: gambling, a case study

Un problème social représente la géneralisation d'une déviation sérieuse par rapport au comportement normatif et comprend des aspects tant objectifs que subjectifs; c'est-à-dire, d'une part, des actes de transgression objectivement vérifiables et, d'autre part, la consience répandue quant à la nature et aux conséquences indésirables de ces comportements. Selon ces critères, le jeu d'argent est généralement considéré - par l'opinion professionnelle non moins que par la non-professionnelle - comme un problème social sésrieux. Un examen de la situation du jeu d'argent mene a la conclusion qu'il n'est pas un problème social et qu'une telle désignation ne répond pas à une analyse critique mais plutôt à un certain ensemble de croyances - une idéologie La conception publique du jeu est analogue à celle que l'on se fait d'autres phénomènes sociaux qui sont de la meme façon dévalues au plan moral. Les aspects problématiques de plusieurs tels phenomenes, surtout dans la ‘societé de masse,’ sont examinés brièvement dans le texte. Dans tous les cas, les données empiriques indiquent clairement que de telles activités constituent une adaptation sociale rationnelle de la part de groupes qui sont généralement des objets de stigmatisation. A social problem is understood to imply a generalized serious departure from normatively sanctioned behaviour, comprising objective as well as subjective aspects; the former manifest by means of objectively verifiable acts of transgression, and the latter consisting of a widespread awareness of the undesirable nature and consequences of the relevant conduct. On these criteria, gambling is by general assent - professional no less than lay - considered to qualify as a serious social problem. Examining the rightful status of gambling as a social problem, this paper concludes such designation does not stand up to critical analysis but derives from a particular set of beliefs - an ideology. The public concept of gambling is analogous to the view taken of other social phenomena, similarly morally devalued. The problematic aspects of several such phenomena, especially of ‘mass society,’ are briefly examined in the present paper. In all instances, empirical evidence clearly suggests such activities constitute socially adaptive rational behaviour for such social groups as generally find themselves the principal targets for stigmatization.     

Health care segregation and race disparities in infectious disease: the case of nursing homes and seasonal influenza vaccinations

Examining nursing home segregation and race disparities in influenza vaccinations, this study demonstrates that segregation may increase both susceptibility and exposure to seasonal flu for black Americans. Evidence based on the 2004 U.S. National Nursing Home Survey shows that individuals in nursing homes with high percentages of black residents have less personal immunity to flu because they are less likely to have been vaccinated against the disease; they may also be more likely to be exposed to flu because more of their coresidents are also unvaccinated. This implies that segregation may generate dual disease hazards for contagious conditions. Segregation appears to limit black Americans' access to personal preventive measures against infection, while spatially concentrating those people who are most likely to become contagious.     

Impact of regulation and financing on small board-and-care homes in Maryland

States use forms of regulation in small board-and-care homes to control quality; however, quality varies in spite of these efforts. This study of 94 small facilities compared quality of care measures in homes regulated by a state-administered program with those in nonregulated homes. It also compared homes on those variables using average payment for services as the independent variable. Results indicate that higher payments for services had a greater impact on quality than did participation in a regulatory program. Adequate funding may be key to maintaining reasonable quality in these homes.     

Membership participation and ideology in large voluntary organisations: The case of the National Trust

Commonly, voluntary organisations are formally accountable to their memberships, but the rights of members to influence organisational policies are often minimal. Members may be recruited by organisations to provide funding, legitimacy and voluntary help; members may join in order to obtain material benefits, to express support for organisations' goals and, in some cases, to influence policy. The disjunction between these two sets of expectations can lead to disputes in large voluntary bodies, especially those whose members hold a wide range of ideological positions. This creates problems for those running the organisations, who both have to account to a variety of other groups and also maintain their public legitimacy. Illustrations of some of these issues are drawn from environmental organisations, particularly the National Trust. An earlier version of this article was given at the first international conference of the International Society for Third Sector Research at Pecs, Hungary, in July 1994. I am very grateful to Michael Fogarty, Peter Jackson and Jean Warburton for detailed comments on earlier drafts.     

The impact of regulation on pharmaceutical research expenditures: a dynamic approach

This paper estimates the impact of federal regulation of drug quality on research spending by the pharmaceutical industry. The theoretical approach recognizes that the effects of these regulations on research spending depend upon the reactions of R&D decision makers and the information available during project selection. The information available to R&D decision makers in the 1960s suggests that it would have been difficult for them to forecast accurately regulatory effects on research profitability. As better information developed in the late 1960s and early 1970s, however, regulation had a significant effect on research spending. These differences in response are tested econometrically and prove to be empirically significant. The estimates of current regulatory effects on pharmaceutical R&D spending are quite large.     

The impact of expert evidence on care proceedings

There has been an increased demand for expert child psychiatric opinion in child care cases where social services have instigated care proceedings under the Children Act 1989. However, there has been little evaluation of this work in terms of whether such a referral changes the care plan of the referring social work agency or the outcome for the child. This article examines the contribution to care proceedings of assessment reports completed by a child and adolescent forensic psychiatry team in respect of 37 consecutive child care cases. All of the assessments were presented to court and the information was collated once the proceedings were completed. Our findings indicated that the court followed the recommendations of the child psychiatric report entirely in 73% of cases. In addition, in 86% of cases the social service departments reported that they had gained confirmation of their professional opinion. In only 10% of cases did they change their care plan in response to the child psychiatric assessment. In conclusion, the results suggest that in most cases social service departments are using child psychiatry expert evidence merely to validate and/or lend support to their original care plans. Copyright © 1999 John Wiley & Sons, Ltd.     

Politics and ideology in migration policy formulation: the case of Kuwait

In 1716, 3 prominent families of the original Kuwaitis agreed that 1 family would control finance and commerce, another seafaring activities, and the 3rd the government. This continued allegiance has been instrumental in shaping migration policy in Kuwait. Migration to Kuwait began in the 1930s-1940s to meet labor needs of the oil industry and the social infrastructure. This began a steady increase, with several setbacks in the early 1970s, of the migrant population. Between (1959-1964), Kuwait had to determine how it would exist and operate as an independent state. The new state established migration policy based on a need for national identity and on weighing the interests of 4 political groups: the ruling family; the wealthy merchants; the Arab Nationalist Movement; and Kuwaiti Nationalists. 3 migration laws emerged which satisfied the 4 groups and in some form continued into the 1980s. These laws basically allowed the continuation of free immigration of labor with the government controlling entry, movement, rights, and employment of the migrants while stressing neutrality and reciprocity with other states, especially Arab states. 1 law greatly limited the number of citizenships to nonKuwaitis and guaranteed economic control and major share of profits to Kuwaitis. Between 1965-1984, many changes to migration policy occurred for political, demographic, and economic reasons. 1 such change was an amendment restricting naturalization to Muslims, thereby not allowing naturalization of the growing Asian migration population, to preserve their cultural authenticity. By 1984, following 1 rebalance of the distribution of Kuwaitis and nonKuwaitis, economic declines, and security threats, migration policy shifted back to population balance. Kuwaiti history shows, however, that experimenting with migration policy and population balance cannot establish internal political and social cohesion. This is a revised version of a paper originally presented at the 1987 Annual Meeting of the Population Association of America (see Population Index, Vol. 53, No. 3, Fall 1987, p. 409).     

Old-age homes and services: old and new approaches to aged care

Although generational co-residence continues to be the dominant form of housing and care for Indian elders and only 1% live in old-age homes, the numbers and types of these homes are growing. This article describes a recent study of 48 old-age homes in different parts of India, approximately 12%-15% of all homes. They included the more traditional free homes for the aged poor who have no family to care for them and the more recent for-pay homes for the middle-class. A small number of day-care centers, also a new phenomenon, were investigated. Two- to three-hour structured interviews were conducted with managers, supervisors, and trustees, augmented by a checklist of environmental and neighborhood features. Most homes house small numbers of residents, have common spaces for dining, TV and prayer, have access to medical care and transportation, provide meals and some assistance with activities of daily living, and are open to all castes. All are run by non-governmental organizations (NGOs), only one-third with any government assistance. Free homes tend to be bigger and older, serve nonaged clients, have less privacy and emphasize occupational therapy and income-generating activities, and are more like board-and-care homes. For-pay homes have more privacy and western-style amenities, focus on local community outreach and provide fewer meals. The gradual increase of all old-age homes has given rise to debates about their appropriate roles in Indian society and about their quality. Government grants to NGOs for homes and day-care centers (often considered more appropriate support for elders) are limited. With the National Policy on Older Persons looking to NGOs and village councils to be the primary sources of non-familial aged care, several ways to build their capacity are suggested.     

Unlicensed care homes in the United States: a clandestine sector of long-term care

Residential care facilities operating without a state license are known to house vulnerable adults. Such unlicensed care homes (UCHs) commonly operate illegally, making them difficult to investigate. We conducted an exploratory, multimethod qualitative study of UCHs, including 17 subject matter expert interviews and site visits to three states, including a total of 30 stakeholder interviews, to understand UCH operations, services provided, and residents served. Findings indicate that various vulnerable groups reside in UCHs; some UCHs offer unsafe living environments; and some residents are reportedly abused, neglected, and financially exploited. Regulations, policies, and practices that might influence UCH prevalence are discussed.     

Quality care for ill children: AIDS-specialized foster family homes

Children with AIDS and related complexes present a new and serious challenge to the child welfare field's foster care system. At this stage of the world's knowledge of AIDS and treatment capacity for its victims, the children are stigmatized as plague bearers, their viability is unknown, and few, if any, will ever have a home to return to. This article describes a special foster care demonstration in behalf of AIDS infants.