Interactional perspectives on the mistreatment of older and vulnerable people in long‐term care settings

This article draws on a study aimed at developing theoretical and methodological understanding of the abuse and neglect (mistreatment) of older people in long‐term care settings such as care homes and hospitals. It presents an interactionist account of mistreatment of older people in such establishments. Starting with an outline of definitional issues surrounding the topic, the allied concept of dignity is also briefly explored, and one important model described; we present dignity as the converse of mistreatment. The article argues for the potential of a positioning theory analysis of mistreatment. Positioning theory proposes that interactions are based on taking of ‘positions’, clusters of rights and duties to act in certain ways and impose particular meanings, which enable or prohibit access to certain storylines. It is argued that ‘malignant’ positioning can contribute to the creation of a climate that allows mistreatment to take place, or fails to prohibit its development. Mistreatment of people with dementia is used as an illustration, and it is argued that this is potentially generated by negative feedback loops of behaviour patterns, interpretations and malignant positioning by staff or family carers and subsequent response to these interpretations by the person with dementia. Positioning theory also allows for an explanation of the importance and impact of organizational cultures and social factors such as ageism. Individual staff members take positions, use meanings and develop storylines imbued with such factors. This understanding therefore overcomes some of the potential confusions created by concepts such as organizational or institutional abuse, removing the need to ascribe intentions and personal responsibility to such constructs. The article concludes with some suggestions for further research to develop an understanding of the kinds of cultures that allow mistreatment and consequently to inform the development of protective measures.     

Time Spent Eating and Its Implications for Americans’ Energy Balance

The upward trend in Americans’ weight has precipitated research aimed at identifying its underlying causes. In this paper we examine trends in Americans’ time spent eating in an attempt to gain a better understanding of Americans’ changing eating habits and their predictors. Data used in the analyses come from four national time use surveys conducted between 1975 and 2007. We find that Americans’ total eating time has risen over the past 30 years largely because of increases in secondary eating time. Multivariate analyses reveal that shifts over time in wage rates, food prices, household income, and racial/ethnic composition may be contributing to Americans’ changing eating patterns.     

Monitoring the Impact of Land Reform on Quality of Life: A South African Case Study

This paper outlines the approach that isutilized by the Monitoring and Evaluationdirectorate of the Department of Land Affairs (DLA) in South Africa in assessing the qualityof life for the land Reform beneficiaries. Thepaper begins with an overview of the three LandReform programs in South Africa. The paper thenmoves on to outline the original design formonitoring and evaluating the quality of lifefor land reform beneficiaries. It then proceedsto detail the current Monitoring and Evaluationdesign being utilized, highlighting itsstrengths and weaknesses. The last sectiondiscusses some of the findings of the qualityof life study undertaken in 1999.     

Short-term Migration and the Acquisition of a World Language

LA MIGRATION DE COURTED URÉE ET L'ACQUISITION D'UNE LANGUE D'ENVERGURE MONDIALE
L'anglais s'impose toujours plus comme langue de communication mondiale. Pourtant, on connaît mal les mécanismes par lesquels il s'impose de plus en plus comme seconde langue dans des populations en grande partie monolingues, et on en mesure mal également les conséquences immédiates. Dans cette étude, nous nous intéressons plus particulièrement à un cas particulier: l'acquisition de l'anglais seconde langue par les Coréens. Nous examinons brièvement la place qu'occupe la langue anglaise en Corée et le poids des mesures d'incitation déployées dans ce pays pour l'acquisition de l'anglais. Sur la base d'analyses empiriques, nous tirons la conclusion que les Coréens appliquent à l'acquisition d'une langue d'envergure mondiale une stratégie transnationale: la migration de courte durée dans des pays où la langue anglaise domine. Pour conclure, nous examinons encore quelques-unes des implications potentielles de ces mouvements et des nombreuses voies ouvertes à la recherche.     

Estimation across multiple models with application to Bayesian computing and software development

Statistical models are sometimes incorporated into computer software for making predictions about future observations. When the computer model consists of a single statistical model this corresponds to estimation of a function of the model parameters. This paper is concerned with the case that the computer model implements multiple, individually-estimated statistical sub-models. This case frequently arises, for example, in models for medical decision making that derive parameter information from multiple clinical studies. We develop a method for calculating the posterior mean of a function of the parameter vectors of multiple statistical models that is easy to implement in computer software, has high asymptotic accuracy, and has a computational cost linear in the total number of model parameters. The formula is then used to derive a general result about posterior estimation across multiple models. The utility of the results is illustrated by application to clinical software that estimates the risk of fatal coronary disease in people with diabetes.     

Employers' Perceptions and Practice in the Employability of Disabled People: a survey of companies in south east UK

This article reports a foundation survey of the extent of employment of disabled people in three sectors of industry--transportation, IT and financial services--in two UK counties, identifies which specific disabilities and limitations on personal skills are seen by employers as the greatest impediments to employment, proposes a new model for analysis by using a modification of established recording models and provides a springboard for further work. The survey reported here was based on structured interviews with personnel officers conducted by telephone. No separate question was devoted to invitation of free comment, but the interview delivery of the questionnaire normally led to a general discussion of the issues raised, and some typical quotes and comments from respondents are included in the Results.     

Implementing Consumer Choice in Long‐term Care: The Impact of Individual Budgets on Social Care Providers in England

In common with many advanced welfare states, England has increasingly relied on consumerist principles to deliver both greater quality and improved efficiency in the long‐term care system. The Individual Budget (IB) pilots marked the next step in this process, through a new system of funding whereby greater control of resources is given to service users, in lieu of direct in‐kind care provision. IBs have the potential to transform the market for care services as well as the relationships between key stakeholders within it. Purchasing will increasingly be shaped by the demands of IB holders, with providers expected to deliver a wider range of personalized services. What will this mean for providers, and what can they do to prepare for these changes? These questions are relevant not just in England but in many other countries adopting similar mechanisms for devolving control over the design, delivery and funding of care to the end‐user. The article explores the early impact of IBs on providers' services, on their workforces, and on the administrative implications for providers of managing IBs. The study finds that providers were positive about the opportunities for better‐quality services that IBs can bring about. However, participants highlighted a number of obstacles to their effectiveness, and reported a range of potentially adverse administrative and workforce consequences which have the potential to jeopardize the consumerist policy objectives of increased choice and efficiency.     

Youth and parent perceptions of aftercare supports at discharge from residential care

While much is known about youth struggles after reintegration into the home and community settings following stays in out‐of‐home care, little is known about appropriate supports for aftercare, or parent (see Note ¹ ) and youth perceptions during this critical transition period. This study seeks to begin to address these questions through surveys evaluating youth (n = 48) and parent (n = 48) perceptions of (i) transition planning, family preparedness and aftercare; (ii) youth preparedness for the transition period across major life domains (e.g. education, health care, relationships); and (iii) the importance of specific aftercare supports and services. Results indicate differences between youth and parents on perceptions of need for continued supports, likelihood of participation in aftercare programs; and youth preparedness for success in relationships, family and independent living domains. In contrast, similarities were found on youth and parent ratings regarding the importance of specific services and supports, with both groups indicating supports in education as most important and supports in mental health as least. Study limitations, future research and implications are provided.