Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change

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.     

Donor Requirements and Pockets of Effectiveness in Senegal's Bureaucracy

Donors increasingly value the work of statistics, project assessment and related offices in developing countries, but can they ensure these offices are able to do their work? This article assesses donors’ efforts to do so in Senegal's ministries of finance, health and agriculture in the mid‐2000s. It contends that donors' impact is greatest if they generate political incentives for governments to create ‘pockets of effectiveness’ in these areas. The health and agriculture case studies indicate that direct donor involvement, particularly if incompatible with domestic political forces, produces disappointing results, while the finance case studies suggest donors can induce political support for the work of specific offices if donor incentives coincide with domestic political imperatives.     

Leadership,Passion and Performance: A Study of Job Creation Projects during the Recession

In the aftermath of the economic recession that began in 2008, governmental bodies have been assisting private sector companies to create jobs. To increase financial performance under greater economic uncertainty and liquidity constraints, this study proposes that a leader's type of passion could explain why some project leaders who receive government funding succeed in creating jobs whereas others do not. Harmonious passion, a voluntary but not overpowering urge to engage in an activity, leads to higher job creation, especially under greater environmental complexity. Obsessive passion, an uncontrollable urge to engage in an activity, also leads to higher job creation, particularly under increasing environmental dynamism. Using survey data from 105 European Union projects and archival data on job creation from the EU funding agency, we find support for the proposed framework. The findings provide a basis for acknowledging the relevance of a leader's passion for environmental adaptation.     

Diesel Engine Exhaust and Lung Cancer Mortality: Time‐Related Factors in Exposure and Risk

To develop a quantitative exposure‐response relationship between concentrations and durations of inhaled diesel engine exhaust (DEE) and increases in lung cancer risks, we examined the role of temporal factors in modifying the estimated effects of exposure to DEE on lung cancer mortality and characterized risk by mine type in the Diesel Exhaust in Miners Study (DEMS) cohort, which followed 12,315 workers through December 1997. We analyzed the data using parametric functions based on concepts of multistage carcinogenesis to directly estimate the hazard functions associated with estimated exposure to a surrogate marker of DEE, respirable elemental carbon (REC). The REC‐associated risk of lung cancer mortality in DEMS is driven by increased risk in only one of four mine types (limestone), with statistically significant heterogeneity by mine type and no significant exposure‐response relationship after removal of the limestone mine workers. Temporal factors, such as duration of exposure, play an important role in determining the risk of lung cancer mortality following exposure to REC, and the relative risk declines after exposure to REC stops. There is evidence of effect modification of risk by attained age. The modifying impact of temporal factors and effect modification by age should be addressed in any quantitative risk assessment (QRA) of DEE. Until there is a better understanding of why the risk appears to be confined to a single mine type, data from DEMS cannot reliably be used for QRA.     

Gender and Casual Sexual Activity From Adolescence to Emerging Adulthood: Social and Life Course Correlates

The prevalence of casual sexual activity among teens and emerging adults has led to much public attention. Yet limited research has investigated whether the number of casual sexual partners per year changes as heterosexual men and women transition from adolescence into emerging adulthood. We considered the influence of social context and life course factors on the number of casual sex partners. We examined four waves of interviews from the Toledo Adolescent Relationships Study (TARS) and used negative binomial growth curve models to investigate patterns of change in the number of casual sex partners (N = 1,196) ages 15 to 22. Men and women both reported increases in the number of casual sex partners over time and did not differ from each other in the rate of change over time. In all, 40% of respondents reported a recent casual sex partner at age 22. Number of prior dating relationships, education status, substance use, and perceptions of peer sexual behavior significantly influenced the number of casual sex partners. Emerging adults who did not complete high school, compared to those enrolled in four-year degree programs, reported significantly more partners. The findings contribute to research on intimate relationships and provide insights for programs targeting emerging adults.     

Male Role Endorsement Explains Negative Attitudes Toward Lesbians and Gay Men Among Students in Mexico More Than in Germany

Anti-gay attitudes vary across cultures because the larger social context plays a role in attitude formation. Psychological correlates of these attitudes have been investigated in the United States and Europe. Endorsement of traditional gender roles has emerged from that research as a central correlate, next to religiosity and personal contact with lesbians/gay men. In a cross-sectional study, we tested whether these correlates are relevant in Mexico, characterized as an androcentric culture in which both gender-role traditionalism and religiosity are high, using a college-age student sample (N = 63). Because we relied on self-reports, the motivation to appear nonprejudiced was also assessed. We found typical gender differences in attitudes toward gay men. In bivariate tests, anti-gay attitudes were related to male role endorsement, contact with lesbians/gay men, and religiosity. In a multivariate analysis, variance in attitudes was explained by male role endorsement; personal contact or religiosity did not explain additional variance. In a German comparison sample (N = 112), male role endorsement played a smaller role. Variance in anti-gay attitudes in the German sample was also related to personal contact, religiosity, and the motivation to appear nonprejudiced. We discuss the centrality of (male) gender-role endorsement in cultures with high gender-role traditionalism.