“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.     

Economic Independence and Union Formation in Sweden

Although sociologists, demographers, and economists are generally agreed that economic independence enhances the likelihood that men will marry, there is disagreement concerning its effect on women. The view that economic independence weakens women's incentive to marry has probably been the most influential, although it has been subjected to few rigorous empirical tests with individual-level data. In the present paper we examine the predictors of forming a first cohabiting union, of progressing from this union to marriage, and of marrying without previously cohabiting by applying hazard regression to event-history data from the 1992 Swedish Family Survey, supplemented by earnings data extracted from the national taxation register. We test a battery of measures that reflect people's past, current, and potential attachment to the labour market. We find that the correlates of union formation for women are largely indistinguishable from the correlates of union formation for men, and that far from being less likely than other women to cohabit or to marry, women with a greater degree of economic self-sufficiency are more likely to do so.     

Reply to Allen et al.

Allen et al.’s results depend on their inclusion of children whose family at the time of their grade retention is unknown, plus adopted and foster children whose selection process into families is unknown. Children whose family has been through upheavals or transitions are less likely to make good progress in school than children from stable families. Children raised by stable same-sex couples do remarkably well in school.     

Demographic transition in sub-Saharan Africa: How big will the economic dividend be?

In mid-demographic-transition, many Asian countries enjoyed a large demographic ‘dividend’: extra economic growth owing to falling dependant/workforce ratios, or slower natural increase, or both. We estimate the dividend, 1985–2025, in sub-Saharan Africa and its populous countries. Dependency and natural increase peaked around 1985, 20 years after Asia. The UN projects an acceleration of the subsequent slow falls but disregards slowish declines in young-age mortality and thus, we argue, overestimates future fertility decline. Even if one accepts their projection, arithmetical and econometric evidence suggests an annual, if not total, dividend well below Asia's. The dividend arises more from falling dependency than reduced natural increase, and could be increased by accelerating the fertility decline (e.g., by reducing young-age mortality) or by employing a larger workforce productively. Any dividend from transition apart, low saving in much of Africa (unlike Asia) means that, given likely natural increase, current consumption per person is unsustainable because it depletes capital per person.     

Shattered Spaces. Encountering Jewish Ruins in Postwar Germany and Poland

David P. Henige, The Chronology of Oral Tradition: Quest for a Chimera (1974), x+265 (Clarendon Press, Oxford, no price).

Georges Dupeux, French Society 1789‐1870 (1976), ix+294 (Methuen, £7.50, paperback £3.90).

Jürgen Schlumbohm, Freiheit ‐ Die Anfänge der bürgerlichen Emanzipationsbewegung in Deutschland im Spiegel ihres Leitwortes (ca. 1760‐ca. 1800) (1975), 299 (Schwann, Dusseldorf, 38 DM). (Freedom ‐ The beginnings of the movement for the emancipation of the bourgeoisie in Germany in the changing light of its watchword.)

Jens Engberg, Dansk Guldalder, eller opr?ret i tugt‐ rasp‐ og forbedringshuset (1973), 190 (Rhodos, Copenhagen, D.kr. 52). (Danish Golden Age: disturbances in the penitentiary and houses of correction.)

Richard D. Altick, Victorian People and Ideas (1974), xii+338 (Dent, £4.50).

P. N. Backstrom, Christian Socialism and Cooperation in Victorian England (1974), vii+238 (Croom Helm, £5.95).

W. Hamish Fraser, Trade Unions and Society: The Struggle for Acceptance, 1850–1880 (1974), 292 (George Allen &; Unwin, £5.95).

Nancy J. Weiss, The National Urban League, 1910–1940 (1974), xiv+402 (Oxford University Press, New York, £7.25).

Arthur Marwick, War and Social Change in the Twentieth Century (1974), x+258 (Macmillan, £5.00, paperback £2.50).     

Giving Voice to Research Participants: Should IRBs Hear From Research Participant Representatives?

The current decision-making model for the review of human research contains inadequate mechanisms to ensure that the interests and perspectives of research participants are considered by Institutional Review Boards, whose decisions may profoundly affect the safety and well-being of participants. As a result, this model is far from being optimized to realize Institutional Review Boards' principal mandate and undermines the credibility of the research review process. This article proposes a procedural mechanism that would ameliorate these systemic deficiencies by allowing “research participant representatives” to give voice to participants during the research review process.     

Playing,Sitting Out,and Observing the Game: An Investigation of Faculty Members’ Perspectives on Political Behavior in Ethical Decision Making

Ethical dilemmas are inherently ambiguous, complex, and ill-defined. Additionally, these dilemmas involve multiple stakeholders. These characteristics may induce political behavior as a resolution tactic. Thus, the goal of the present effort was to investigate perspectives on politics among researchers in an ethical decision-making context. A qualitative analysis of interviews with university faculty members revealed that faculty members’ perspectives on political behavior in an ethical decision-making context fall into a number of categories, including positive, negative, and realistic views of political activity. The implications of these varying perspectives on ethical decision making are discussed.     

A Comparison of Address-Based Sampling (ABS) Versus Random-Digit Dialing (RDD) for General Population Surveys

Valid and reliable public health data are becoming more difficultto obtain through random-digit dial (RDD) telephone surveys.As a result, researchers are evaluating different survey designs(i.e., sampling frame and survey mode combinations) as complementsor alternatives to RDD. Traditionally, mail surveys of the generalpublic have been limited due to a lack of a complete samplingframe of households. Recent advances in electronic record keeping,however, have allowed researchers to develop a sample from aframe of addresses (e.g., the U.S. Postal Service Delivery SequenceFile, which appears to provide coverage which rivals or possiblyexceeds that obtained through RDD sampling methods). To testthe use of this frame for surveying adults aged 18 years andolder across a wide geographic area, a pilot study was conductedas part of the 2005 Behavioral Risk Factor Surveillance System(BRFSS). The pilot compared use of a traditional, RDD telephonesurvey methodology to an approach using a mail version of thequestionnaire completed by a random sample of households drawnfrom an address-based frame. The findings indicate that themail survey approach can achieve higher response rates in low-response-ratestates (<40%) than RDD (particularly when two mailings aresent). Additionally, the address frame with mail survey designprovides access to cell phone only households and offers costsavings over the telephone approach. The resulting sample, however,significantly overrepresents non-Hispanic whites and peoplewith higher levels of education.