Examining the Nursing Home Physical Environment Through Policy-Driven Culture Change

A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.     

主体文化在培养正确的文化态度中的作用研究

随着全球化进程的迅速发展,跨文化交际更加频繁,然而在多种文化的交流和碰撞之中,文化的多样性正受到威胁。作为英语学习者,培养正确的文化态度变得至关重要。本文提出在英语教学过程中,要在保护主体文化的基础上,学习目的语文化。只有兼顾两者才能有效地进行跨文化交流,才能培养正确的文化态度,从而培养批判思维能力,吸取目的语文化的精髓并将主体文化不断完善,发扬光大。同时本文还介绍了具体进行文化教授的方法供学习者和教师参考。     

‘There it will be better … ’: Southern Sudanese in Khartoum imagining a new ‘home’ away from ‘home’

At the time of the research, Khartoum was a multi-ethnic and multinational metropolis of 8 million people. A considerable part of the population consists of Southern Sudanese migrants and displaced persons that came during the 20 years plus of civil war in South Sudan to the capital. These people were categorised after the Comprehensive Peace Agreement (CPA), as displaced people regardless as to whether they come to the capital as labour migrants, students or because of the war to the capital. The notion of displacement assumes that they are people who are ‘out of place’: thereby assuming a former situation of being in place, a place that can be called ‘home’. After the CPA from 2005, this frequently only imagined home became a real place for the IDP’s to which they are supposed to go back. Yet, many migrants and displaced people are reluctant to move to Southern Sudan. Their decision about going to the South or staying in Khartoum depends not only on the opportunities and perspectives in their respective ‘home’ areas but also on the perceptions of belonging and identity. The imaginations and aspirations about the future life in South Sudan, which I analyse in this article, reflect this ambivalent positioning.     

Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.     

Working together in a deficit logic: home–school partnerships with Somali diaspora parents

Drawing on discursive psychology this article examines the understandings teachers and principals in Danish Public Schools have regarding Somali diaspora parenting practices. Furthermore, the article investigates what these understandings mean in interaction with children in the classrooms and with parents in home–school communication. It is argued that in a society with increased focus on parental responsibility the teachers and principals draw on a deficit logic when dealing with Somali diaspora parents and children which consequently leads to teachers either transmitting their expertise by educating parents or compensating for perceived deficiencies in parental practices. Both these strategies result in significant marginalizing consequences where ‘difference’ is understood as ‘wrong’ or ‘inadequate’.     

The complexities of cultural support planning for Indigenous children in and leaving out‐of‐home care: the views of service providers in Victoria,Australia

Indigenous children and young people are over‐represented at all stages of the Australian child protection system. Policy and legislative initiatives exist in the state of Victoria, Australia aiming to support the connection between Indigenous children and young people in state care and their culture and community. This exploratory research involved focus group consultations with seven child and family welfare agencies to investigate the impacts, barriers, benefits and limitations of cultural support planning for Indigenous young people in, and leaving care in, Victoria. Findings indicated that cultural planning was of value when it could be completed. However, various shortcomings of current systems were identified including limited resourcing of Aboriginal Community Controlled Organisations to generate plans and provide direct and secondary consultation services to implement plans, difficulty gathering information for plans and some Indigenous young people expressing disinterest in connecting to their culture and community. Complexities in the relationships between the Indigenous and non‐Indigenous agencies that aimed to support Indigenous young people in care were also acknowledged. Participants identified a number of strategies to improve outcomes, such as facilitating better relationships between agencies, promoting opportunities for ongoing cultural training for staff in mainstream agencies and improving the resourcing of Aboriginal Community Controlled Organisations to deliver planning and to support cultural connections.     

Exploring Home Sharing for Elders

Research suggests that third party-arranged home sharing (“TPAHS”) enables elders to remain at home in advanced age by connecting elder home owners with suitable live-in “matches.” TPAHS potentially saves elders, their families, and Medicaid budgets millions of a dollars per year in avoided and postponed nursing home costs. In interviews with elder TPAHS participants of one TPAHS program, we found that similarity in values, ability to utilize the TPAHS organization's guidance, and, when relevant, familiarity with their matches' mental health challenges, correlated with said participants' satisfaction with their matches while a lack of these qualities correlated with match dissatisfaction. With these findings in mind, we suggest strategies TPAHS organizations can use to best serve the elderly TPAHS participants who may benefit from intensified match support but may not seek it.