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.     

Assessing social work and nursing students’ intentions to work with dying patients

This study assessed social work and nursing students’ intentions to provide end-of-life care, based on the Theory of Planned Behavior. A total of 181 social work and nursing students completed a questionnaire examining intentions to provide end-of-life care, attitudes, subjective norms, perceived control, death anxiety, subjective knowledge, and sociodemographic characteristics. Students manifested a moderate level of intentions to provide end-of-life care, with nursing students indicating higher levels of intentions than social work students. Multiple regression analyses revealed that attitudes, subjective norms, and previous experience were the main predictors of intentions to provide end-of-life care. Recommendations for academic programs are discussed.     

Tracing disorder across theories of autism,empathy, and mental health care

Abstract

Categories of mental disorders are generally understood through a biomedical paradigm of clinical research, diagnosis, and intervention. Here, diagnoses operate as professional tools, facilitating care organization and information exchange across diverse social contexts. In this article, I focus on how the diagnosis of autism-spectrum disorder operates in this manner. Autism conceived as a biomedical disorder is then contrasted with proposals by the neurodiversity movement, who understand core qualities of autism as alternative expressions of otherwise normal processes of brain development. Finally, I supplement these conversations with insights from Gerald Edelman’s theory of neural plasticity and Felix Guattari’s paradigm of ethico-aesthetic care. Understood together, these allow mental disorders and community care generally to be reconceived in terms of networks of expressive, embodied, and dynamically embedded rhythms that transcend individual persons. This serves, additionally, to illustrate a concept of empathy that traverses neurological, psychological, and sociocultural domains.     

‘We are actually,after all,just children’: caring societies and South African infantilisation of adults with intellectual disability

This article comments on infantilisation by attending to South African adult intellectual disability (ID) care through an intersubjective ethics of care lens, and shows how such an ethic can shine light on shifting our responses towards ID. Care performance data were gathered from three sources within two South African specialist ID care sites – from 10 adult residents, 16 nurses as spatiotemporal carers, and three wards as ethnographic sites. Deeply embedded and interwoven throughout various care practices is the disabling of adults with intellectual impairment when literally referred to as ‘children’. These adult-unmaking processes constitute practices that fall short of Tronto and Kittay’s caring societies ethic. Care exchanges generate relational and intersubjective spaces in which people are understood as never meeting full criteria for personhood. Infantilising care dynamics require urgent attention if we wish to change ways in which ID is viewed and responded to in South Africa.     

锦州市区民营口腔医疗机构调查

目的：了解新医改背景下锦州市民营口腔医疗机构的资源状况。方法：通过调查问卷、现场采访等方式,以民营口腔医疗机构的负责人和口腔医生为调查对象,对锦州市区民营口腔医疗机构进行走访。结果：锦州市没有民营口腔医院,84个民营诊所拥有213台椅位,从业口腔专科医生186人。结论：个体诊所分布广泛,口腔业务量较大,占有一定市场份额;口腔诊所规模较小,医生素质偏低,专业化程度不高;民营口腔市场潜力较大,民营口腔机构也将成为口腔专业毕业生的一个重要就业渠道。     

西南边疆多民族地区社会事业的发展

社会事业是为确保社会转型、维护社会稳定、促进社会和谐和人的全面发展所提供的各种公益性支持与服务活动的总和,也是保障社会可持续发展,实现社会公正,维持社会运行和发展的重要活动。在社会转型期,通过加大和改善对西南边疆多民族地区社会事业的投入和建设,提高西南边疆多民族地区公民文化素质,加强公民法制意识,改善公民精神风貌,完善社会安全体系,使西南边疆少数民族文化教育事业有了长足发展,农村医疗卫生事业有了新突破,社会保障事业有了新进展。这在很大程度上促进了西南边疆社会和睦,逐步实现社会公平正义,为社会主义和谐社会的建设提供了基础。     

Daring to care: the role of culturally relevant care in mentoring Black and Latino male high school students

This study seeks to challenge the uni-dimensional way care in school is written about by highlighting an often overlooked aspect of care – the kind that students do for each other. Data is drawn from focus groups conducted with the youth participants and founder of Umoja Network for Young Men (UMOJA), an all-male, school-based mentoring program for over-aged and under-credited (OA/UC) high school students. The authors draw on theories of culturally relevant pedagogy, care, and critical pedagogy to present the findings and propose a form of culturally relevant care (CRC) that entails warm demanding and building mutual trust. This study highlights the humanizing experiences of the Black and Latino male transfer students and their mentor. This focus on the experiences of young Black and Latino male participants seeks to shift the discourse from one focused on deficits to one that recognizes their agency and capacities for social and academic success.     

上海城市生活不能自理老人生活照料状况及意愿研究

本文以1999年《上海市生活不能自理老人家庭照料和社会支持调查》的数据为依据,分析了上海市生活不能自理老人的家庭基本情况及其生活服务需求,为解决生活不能自理老人照料问题提供参考.     

Unequal Partners? Local Government Reorganization and the Voluntary Sector

British local government has recently undergone its most far-reaching reorganization for twenty-five years. The impact of this reorganization was considerable within local authorities but it also substantially affected other organizations with which they worked at a local level. This paper explores the perspectives of voluntary sector organizations involved in social care: a set of actors which, prior to reorganization, had been encouraged by central and local government, through notions of partnership and through community care legislation, to undertake more direct roles in service delivery, consultation and strategic planning. During the consultative period prior to reorganization, many voluntary organizations reported that they had been marginal to the process. Reflecting on the process of reorganization itself, many voluntary organization respondents commented that it had been disruptive and provoked considerable anxiety. Post-reorganization, voluntary organizations felt that rebuilding of relationships was necessary and that the promise of partnership had meant little in practice at a time of potential crisis for local.