Does Home- and Community-Based Care Affect Nursing Home Use?

A study was conducted to assess change in numbers, expenditures, and case mix of nursing home residents as Medicaid investment in home- and community-based services (HCBS) 1915(c) waivers increased in seven states. The seven states provided Medicaid expenditure and utilization data from 2001 to 2005, including waiver and state plan utilization. The Minimum Data Set was used for nursing home residents. For three states, community assessment data were also used. In six states, the number of nursing home clients decreased as the numbers of HCBS clients grew. However, in most states, the number of additional waiver clients often greatly exceeded reductions in nursing home residents. Nursing home payments decreased moderately, but this decrease was offset by increases in HCBS waiver and state plan expenditures, leading to a net increase in long-term support services (LTSS) expenditures from 2001 to 2005. Increases in waiver expenditures outpaced increases in waiver clients, indicating expansion of services on top of expansion in clients. States that showed substantial increases in HCBS showed only modest increases in nursing home case mix. The case mix for nursing home residents was more acute than that for HCBS users. The expectation that greater HCBS use would siphon off less severe LTSS users and hence lead to a higher case mix in nursing homes was partially met. The more acute case mix in nursing homes suggests that HCBS serves some individuals who were previously cared for in nursing homes but many who were not. Efforts to promote substitution of HCBS for institutional care will require more proactive strategies such as diversion.     

How Does Borderline Personality Disorder Affect Parental Care?

This article seeks to find arguments based on research for the possibility of dealing with borderline personality disorders (BPDs). This is illustrated by the frequency with which children are removed from parents who have been given the diagnosis of BPD. The author favors the view that there are degrees of BPD. As a result, it is felt that psychological treatment can do much to reverse the symptoms of BPD, in many cases, if not all. Following the delineating of the research, the author presents strategies and procedures that seek to counteract the symptoms of BPD and when possible the eventual reinstatement of children with the parent.     

Change in Parenting Behaviors from Infancy to Early Childhood: Does Change in Family Income Matter?

The current study intended to answer two main questions: First, do parenting behaviors change as family income changes? Second, if changes in family income are associated with changes in parenting behaviors, is this association different for families of various poverty statuses and ethnicities? Secondary data analyses were conducted using data from Phases I and II of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. The authors found family income increase to predict decreased maternal detachment and negative regard but bears no relation to maternal sensitivity or stimulation of development. Changes in family income also predicted changes in parenting behaviors especially strongly for poor, Hispanic and White families. Implications for parenting research and public policy are discussed.     

“Would You Do That in Your Home?” Making Nursing Homes Home-like in Culture Change Implementation

Qualitative interviews with nursing home administrators reveal innovative and cost-conscious ways to physically modify facilities that help institute culture change practices. Telephone interviews were conducted following a national survey of nursing home nursing directors and administrators. In this cross-sectional snapshot of administrator experiences, motivations for making facilities more home-like and less institutional and creative responses to challenges are described. State and corporate support and regulator encouragement are noted that help their reform efforts. Administrators note that small steps to create a more home-like environment can result in a positive impact that minimizes disruption to existing care processes. They describe how they respond to challenges, such as the physical plant and high costs, and note how comparative shopping, cost-conscious physical improvements, and continuous involvement of staff and residents contribute to successful efforts. Their examples illustrate novel ways to humanize long-term care facilities that other nursing homes can emulate.     

Signs of Change? At‐Home and Breadwinner Parents' Housework and Child‐Care Time

The authors analyze American Time Use Survey data to examine patterns in domestic work among at‐home and breadwinner parents to gauge how time availability, relative earnings, and gender shape time use in couples with extreme differences in earnings and work hours. They find that involvement in female‐typed housework is an important driver of overall housework time. It is counternormative housework behavior by at‐home fathers that shapes conclusions about how time availability, relative resources, and gender influence parents' housework. Although time availability appears to shape child care in comparable ways across parents, mothers are more engaged in child care than similarly situated fathers. Overall, comparisons point to the importance of distinguishing among gender‐normative housework tasks and accounting for differences in engagement on work and nonwork days. The results provide a basis for assessing the social significance of growing numbers of parents in work–family roles that are not gender normative.     

Work and Family: How Does the (Gender) Balance Change as Children Grow?

This article investigates how work–family balance and the gender division of labour differ according to whether children are in early childhood, middle childhood or the early teen years. It uses measures of both behaviour and attitudes, drawing on two nationally representative Australian data sets, the Bureau of Statistics Time Use Survey and the Household Income and Labour Dynamics in Australia. Women have more responsibility for care than men, but with older children there is greater gender equity in the division of labour, a less pressing domestic burden and less maternal time stress. This occurs because women recalibrate their commitments to work and home, not because domestic labour is redistributed between mothers and fathers. Further, it does not hold if women replace unpaid with paid labour; mothers who work full time have high total workloads and high stress levels regardless of the age of children. Fathers are more satisfied with their work–family balance the more they participate in childcare and the more they feel supported by their workplace to access family‐friendly work policies.     

Does Charging Nonprofit Volunteers Affect Their Satisfaction?

Nonprofits that offer volunteer experiences in foreign countries have long charged fees to their volunteers, but recently some other nonprofit organizations have begun to charge as well. Volunteer attitudes toward such fees have not previously been studied. Product marketing research has suggested that fees can sometimes improve participants’ evaluation of their experience, but public service motivation research seems to suggest that fees will diminish participants’ satisfaction. This study examines the attitudes toward fees of 4,400 volunteers who paid $310 to participate in a week‐long project that built and repaired housing in Appalachia. Although a third of volunteers believed that the fee enhanced their appreciation of the program, an equal proportion disagreed. An even larger percentage of the volunteers believed the fee discouraged some volunteers. Concerns with fees were more common among youth volunteers than adult volunteers and among those who volunteered for altruistic rather than for career reasons. Most volunteers, even those critical of fees, were positive about their volunteer experience, but those who were least positive about the fees were also somewhat less positive about their experience. These results suggest that decisions about volunteer fees must balance the benefits of additional funds for enhanced client services against the likelihood of discouraging some potential volunteers, especially younger or more altruistic volunteers.     

Does Listening to Mozart Affect Listening Ability?

Considerable research has been conducted testing Rauscher, Shaw, and Ky's (1993) Rauscher, F. H., Shaw, G. L and Ky, K. N. 1993. Music and spatial task performance. Nature, 365: 611[Crossref], [PubMed], [Web of Science ®] , [Google Scholar] Mozart Effect (ME). This study attempts to replicate, in part, research that tested the ME on listening comprehension abilities. Also included in this study is an examination of control group issues in current day research. We hypothesized that students who listen to Mozart would demonstrate greater listening comprehension than students involved in one of four control groups. Students were exposed to one of five treatments and then completed a listening comprehension test about a videotaped lecture they viewed. Ultimately, results uncovered a ME when comparing the Mozart A (alpha) group with the alternative treatment control groups (Mozart B [beta] music and Rock and Roll music), but no ME when comparing the Mozart A group and the non-music control groups (sitting in silence or working on a crossword puzzle). Discussion focused on the ME and listening comprehension as well as on the nature of control groups in experimental research.     

Migrant Care Workers or Migrants Working in Long-Term Care? A Review of Australian Experience

Discussion of the role of migrant care workers in long-term care (LTC) that has gained increasing attention in the United States and other developed countries in recent years is of particular relevance to Australia, where 24% of the total population is overseas-born, two-thirds of them coming from countries where English is not the primary language. Issues of interest arise regarding meeting LTC workforce demands in general and responding to the particular cultural and linguistic needs of postwar immigrants who are now reaching old age in increasing numbers. This review begins with an account of the overseas-born components of the aged care workforce and then examines this representation with reference to the four factors identified as shaping international flows of care workers in the comparative study carried out for the AARP Public Policy Institute in 2005: migration policies, LTC financing arrangements, worker recruitment and training, and credentialing. The ways in which these factors play out in Australia mean that while overseas-born workers are overrepresented in the LTC workforce, migrant care workers are not identifiable as a marginalized group experiencing disadvantage in employment conditions, nor do they offer a solution to workforce shortages. The Australian experience is different from those of other countries in many respects, but it does show that the experience of migrant care workers is not unique to LTC and points to the need to extend the search for solutions to workforce shortages and improving conditions of all care workers well beyond LTC systems to wider policy settings.     

How Does Divorce Affect Iranian Women's Sexual Well-Being?

Sexuality and divorce are two interwoven subjects with complex effects on women's sexual well-being in Iranian culture. Results of this exploratory study using focus group discussions and individual interviews revealed how the sexual well-being of women was influenced by the divorce experience through common patterns and recurring themes. A total of 26 women participated voluntarily in the study. They were approached through a selected social support group in a center in West Tehran in 2011, and all had been divorced for less than 10 years. For the majority, sexuality-related matters became complicated and jeopardized their overall well-being in postdivorce life. This finding, along with the fact that the majority were seeking financial and emotional support, implies that counseling women and providing economic support for postdivorce life might improve women's sexual well-being.     

Do Foster Parents and Care Workers Recognize the Needs of Youth in Family Foster Care with a History of Sexual Abuse?

Children in family foster care have the right to participate in decisions regarding their life, however, adults often advocate on behalf of children. This Q methodological study explored whether shared perspectives among foster parents and care workers resemble shared perspectives of youth regarding the psychosocial needs experienced by youth with a history of sexual abuse. Participants sorted a set of statement cards according to what they thought was most important for youth. By-person factor analyses examined how the Q sorts of foster parents and care workers related to those of youth. The results showed that foster parents mostly recognized the group of youth who value an instrumental relationship with their carers, while care workers mostly recognized the group of youth who value support of both foster and birth parents with regard to their preparation for independent living. The two youth groups characterized by ambivalence and autonomy were barely recognized. Results are discussed in light of the expected roles of foster parents and care workers, and youth’s contact with birth parents. Lastly, this study highlights the importance of youth participation, because youth offer unique and varying perspectives about their needs.     

How Does Premarital Cohabitation Affect Trajectories of Marital Quality?

We investigate the link between premarital cohabitation and trajectories of subsequent marital quality using random effects growth curve models and repeated measures of marital quality from married women in the NLSY‐79 (N = 3,598). We find that premarital cohabitors experience lower quality marital relationships on average, but this is driven by cohabitors with nonmarital births. Premarital cohabitors without nonmarital births report the same marital quality as women who did not cohabit before marriage. Nonmarital childbearing is more strongly associated with lower subsequent marital quality for White women than for Black or Hispanic women. Marital quality declines at similar rates for all couples regardless of cohabitation or nonmarital childbearing status. These findings are robust to numerous alternative model specifications.     

Does Returning to Work After Childbirth Affect Breastfeeding Practices?

This study examines the effect of the timing and intensity of returning to work after childbirth on the probability of initiating breastfeeding and the number of weeks of breastfeeding. Data come from the National Longitudinal Survey of Youth (NLSY79). Baseline probit models and family-level fixed effects models indicate that returning to work within 3 months is associated with a reduction in the probability that the mother will initiate breastfeeding by 16–18%. Among those mothers who initiate breastfeeding, returning to work within 3 months is associated with a reduction in the length of breastfeeding of 4–5 weeks. We find less consistent evidence that working at least 35 h per week (among mothers who return to work within 3 months) detracts from breastfeeding. Future research is needed on understanding how employers can design policies and workplaces that support breastfeeding.     

Developmental Change in Action Perception: Is Motor Experience the Cause?

Human actions are complex stimuli containing several perceptual dimensions an observer could attend to. Research indicates that attention to the perceptual dimensions of action undergoes a process of perceptual narrowing between 4 and 10 months, during which infants’ attention to configural and temporal information in action decreases over time, while attention to hand information is maintained. This research explored whether infants’ active experience with grasping is related to perceptual narrowing in action. Across two studies, we tested 6‐month‐old infants’ attention to changes in these action dimensions and also assessed their grasping ability. Infants who were more proficient at grasping showed a pattern more consistent with perceptual narrowing (decreasing attention to configural and temporal information) relative to those less proficient at grasping, especially for attention to configural information. In addition, attention to hand information appears to undergo U‐shaped development between 4 and 10 months, as 6‐month‐olds did not recover attention to the hand change. These findings add to a growing body of research showing that infants’ motor experience broadly influences their perception of others’ action and may follow a complex developmental pathway that diverges from perceptual narrowing over the first year.     

Does Mate Scarcity Affect Marital Choice and Family Formation? The Evidence for New and Classic Formulations of Sex Ratio Theory

Guttentag and Secord pioneered research on the social consequences of imbalances in the numbers of men and women—the sex ratio. Since then, sociologists, psychologists, anthropologists, and even biologists have investigated its effects on marriage and reproduction. I review the three prevailing theories to explain why sex ratio should affect marriage and reproduction, along with the evidence that it does. I also review the growing evidence that sex ratio imbalances are associated with mate choice. Sex ratio reveals contradictory relationships with mate preferences and actual partner choice, however, raising a conundrum for future research. Overall, there is strong experimental and correlational support for the patterns of marriage and reproduction associated with sex ratio. What emerges is the necessity for future research to distinguish among the perspectives to explain why.     

Do Disabled Elderly Medicare Beneficiaries with Major Depression Make Less Use of a Consumer-Directed Home Care Voucher Benefit?

Older adults with major depression may underutilize consumer-directed long-term care. Systematic underutilization would create disparities in outcomes, undermining program effectiveness. The Medicare Primary and Consumer-Directed Care Demonstration included a consumer-directed indemnity benefit that paid for goods and services not financed by traditional Medicare. Overall and for most categories of goods and services there was little difference in use and expenditures between those with and without major depression. However, among those using the benefit to hire in-home workers, arguably the most important consumer-directed purchase, average spending for workers was about 30% lower for depressed persons. While our findings are generally reassuring for public policy, future research is needed to verify that major depression is associated with less spending on in-home workers.