The Nursing Home Compare Report Card: Consumers' Use and Understanding

The Nursing Home Compare report card provides information on the World Wide Web about quality measures for almost every nursing home in the United States. In this research, we first examined whether consumers were using Nursing Home Compare. Second, we examined whether consumers could accurately interpret the quality information given in Nursing Home Compare. Data were collected from 4754 family members of nursing home residents. A comprehension index was used to examine whether the information contained in Nursing Home Compare for each quality measure was understood by family members. We found that 31% of these consumers used the Internet in choosing a nursing home, and 12% recalled using Nursing Home Compare. We also found that, in general, the comprehension index scores were high, indicating good understanding. Simply having the Nursing Home Compare report card available does not mean that it will be used, nor does it mean that it can influence consumers in any meaningful way. The findings show that consumers understand Nursing Home Compare information, and approximately 12% currently access the Web site.     

WHAT IS THE MULTITUDE?

Nicholas Brown and Imre Szeman continue their conversation with Michael Hardt and Antonio Negri. (See ‘The Global Coliseum: On Empire’ in Cultural Studies, 16.2, (March 2002), p. 177–192). In this new interview they press the authors of Empire and Multitude on questions that have arisen both out of their own involvement with the theoretical issues generated by Empire and from new areas opened up by Multitude. Why is the multitude not a class? How can the unity of a political project be maintained in the multiplicity of the multitude? Is democracy still a project for the future? Can a political subject constitute itself outside the structure of sovereignty? In other words, what is the multitude?     

Hope as a coping resource among parents at risk for child maltreatment

This study investigated hope as a protective factor buffering the relationships between parenting stress and well-being among a sample of parents identified at moderate to high risk for child maltreatment. Two hundred parents were recruited from a nonprofit organization providing secondary and tertiary child maltreatment prevention programs. Results of the analyses showed that parental stress was negatively associated with subjective and emotional well-being. Hope was positively correlated with well-being and negatively associated with parenting stress. Hierarchical regression analyses showed that hope had a significant incremental relationship to well-being and that the negative effects of parenting stress fell below statistical significance. These findings provide preliminary support for hope as a coping resource social workers can target when working with parents in the prevention of child maltreatment.     

Children as Witnesses: Understanding Their Capacities,Needs, and Experiences

Historically the law regarded children as inherently unreliable and made it difficult for them to testify. Since 1975 awareness of child abuse has increased and research has established that children can be reliable witnesses. Governments began to recognize the needs and capacities of children and enacted legal reforms to facilitate prosecutions for child abuse. This paper reports on a survey of victim witness workers and other justice system professionals which reveals some of the continuedfailings of that system in dealing with children. Althoughrelatively rare, there are cases of false allegations of abuse, usually a result of investigations by poorly trained professionals. Further legal reforms and better human supports are required to ensure that the needs of children are met and their capacities as witnesses are fully appreciated.     

Sorcery,Theft and Affinity: The Estrangement of Intimacy in Eastern Java

Research has called attention to the importance placed on incorporating the ‘Other’— turning outsiders into insiders—particularly in local and rural contexts of Southeast Asia. This can be seen in a variety of cultural phenomena such as origin myths, marriage patterns and even home design. Rather than focusing on the way strangers are included, in this article I analyse the converse phenomenon: estrangement among family, neighbours and friends. In Tegalgaring in far east Java, house design and a relaxed trespass etiquette welcome passers-by; nevertheless, while front doors are left open, bedrooms and cupboards remain locked. When something is presumed stolen, it is either said to be ‘missing’ or attributed to ‘outsiders’. Suspicion, however, falls on those who are nearest. Sorcery is thought, in theory, to work over long distances. Yet in ‘actual’ cases, the ‘victim’ is often the alleged sorcerer's neighbour, family member or friend. I contextualise these phenomena in terms of other research from the region and argue that, while the inclusion of the ‘Other’ is crucial, the in-group estrangement is also significant.     

Indigenous Australian population projections: problems and prospects

According to estimates from the 2006 Census, Aboriginal and Torres Strait Islander (Indigenous) Australians made up 2.5 % of the total Australian population. However, the focus of research and policy debate on Indigenous Australians far exceeds their population size for reasons of history, socio-economics, geography and demography. This has led to a need for accurate population projections of the population. In this paper, we outline a number of issues related to Indigenous population projections. These include the nature of self-identification; the impact of particular policy changes; significant differences in demographic parameters; and high rates of exogamy, especially in urban areas. We also document the relative accuracy of past and current population projections. In the final section of the paper we outline a research agenda that has the potential to lead to new and better Indigenous population projections.     

“Fear Runs Deep:” The Anticipated Needs of LGBT Older Adults in Long-Term Care

Objectives: Older lesbian, gay, bisexual, and transgender (LGBT) adults are a vulnerable yet resilient population who face unique stressors as they foresee health decline. This paper presents the results of a study about community-dwelling LGBT older adults’ anticipated needs and fears related to nursing homes and assisted living. Methods: This qualitative study collected data through seven focus groups. The sample (N = 50) consisted of LGBT-identified adults age 55 and over. We used an inductive, thematic analysis approach to data analysis. Results: Participants seek an inclusive environment where they will be safe and feel connected to a community. They fear dependence on healthcare providers, dementia, mistreatment, and isolation. Importantly, these fears can lead to identity concealment and psychological distress, including suicide ideation. Discussion: This study adds to the existing literature about the worries of older LGBT adults as they anticipate long-term care. The results suggest that older LGBT adults seek LGBT-inclusive residential care settings that encompass two distinct yet related aspects of LGBT-affirmative care: the procedural (e.g. culturally competent skills and knowledge of practitioners) and the implicit (e.g. the values and mission of the organization). This paper identifies implications for practice, policy, and training.     

Comparison of household-survey estimates with projections of mortality and orphan numbers in sub-Saharan Africa in the era of HIV/AIDS

The United Nations publishes estimates of HIV prevalence, AIDS mortality, and orphan numbers for all countries of the world. It is important to assess the validity of these model-based estimates since they underpin much policy concerned with care and prevention. Household surveys that ask questions about the survival of children's parents (orphanhood) offer an independent source of data with which these estimates can be compared. Survey estimates of maternal and paternal orphans are significantly lower than model estimates for 40 surveys in 36 countries of sub-Saharan Africa (p < 0.001, p = 0.002). This is probably because adult mortality from causes other than AIDS is lower than assumed in the models, although under-reporting of orphanhood in surveys may also play a role. Reducing adult mortality from causes other than AIDS brings the model estimates into close agreement with the surveys. This suggests that the fraction of orphans attributable to AIDS is greater than estimated previously.