Psychotropic medication use in Swiss nursing homes

Psychotropic medication is commonly used in nursing homes, to treat behavioural and psychological symptoms of dementia (BPSD) for example. Treatment with antipsychotics may improve BPSD in some residents but can be associated with serious side effects, such as higher mortality, faster disease progression and cerebrovascular events. In the current study, psychotropic medication use was analysed in a representative sample of nursing home residents in the German-speaking part of Switzerland, at entry and during follow-up.

Wom(b)anism: Reading Relationships Between the Community and the Womb in Sankofa, The Women of Brewster Place, and Corregidora

This project attempts to contribute to the various discourses within the black womanist tradition. In 1983, Alice Walker published her landmark collection of essays entitled In Search of Our Mother Gardens: Womanist Prose. At the outset of the volume, Walker defines the core concept of womanism. After a poetic four-part definition of the term womanist, Walker concludes by stating, 'womanist is to feminist as purple to lavender' (Phillips 19). Although this analogy is critically engaged, the scholarly discourse that emerged in response to Walker's proposition shapes the intellectual inner workings of this project. Certain established concepts (such as ancestral mediation or the laying on of hands) work in conjunction with my own concepts of 'wom(b)anism' and 'the communal womb' to frame the interpretive discussions throughout these pages. Wom(b)anism and the communal womb both emerge from the black feminist and womanist traditions, especially via the role of ancestral mediation but also within the contested discourses on womanism itself. I apply the two concepts (wom(b)anism and the communal womb) to my readings of Haile Gerima's Sankofa, Gloria Naylor's The Women of Brewster Place, and Gayl Jones' Corregidora. The relationship between the community and women's wombs across each of these texts construct a narrative that features ancestral mediation (or intervention), various acts of violence committed against women's bodies, and the complicated circumstances through which women heal themselves andtheir communities.

Nursing Homes as a Setting for Psychological Practice: Public Policy Perspectives.

Recent federal legislation has provided renewed interest in improving the quality of nursing home care. The lack of both funding and personnel are significant barriers that may keep psychology's disciplinary expertise from being fully used in nursing homes. Nursing homes may be forced to undertake mandated activities (e.g., preadmission screening, nurses aides' training, and evaluation) without psychologists' expertise, relying either on medical practitioners with little knowledge of mental health interventions or on minimally qualified, entry-level mental health workers. Advocates for improved nursing home care must see the links among basic disciplinary skills, interdisciplinary collaboration, and improved care for mentally impaired elderly individuals.

The Provision and Use of Mental Health Services in Nursing Homes: Results from the National Medical Expenditure Survey

Data from the Institutional Population Component of the National Medical Expenditure Survey were used to provide national estimates of annual mental health service provision and use in nursing homes. In addition, the relationship between service provision and setting characteristics such as ownership, size, Medicaid certification, and chain status was examined. Although more than three quarters of residents with a mental disorder resided at a nursing home that provided counseling services, fewer than one fifth actually received any mental health services within the year.

Risk Factors for Physical Restraint Use in Nursing Homes: The Impact of the Nursing Home Reform Act

This study examined the impact of the Nursing Home Reform Act of 1987 on resident-and-facility-level risk factors for physical restraint use in nursing homes. Data on the 1990 and 1993 cohorts were obtained from 268 facilities in 10 states, and data on a 1996 cohort were obtained from the Medical Expenditure Panel Survey, which sampled more than 800 nursing homes nationwide. Multivariate logistic regression models were generated for each cohort to identify the impact of resident- and facility-level risk factors for restraint use. The results indicate that the use of physical restraints continues to decline. Thirty-six percent of the 1990 cohort, 26 percent of the 1993 cohort, and 17 percent of the 1996 cohort were physically restrained. Although there was a reduced rate of restraint use from 1990 to 1996, similar resident-level factors but different facility-level factors were associated with restraint use at different points in time.

Evaluating the Effectiveness of a Commercial Portable Air Purifier in Homes with Wood Burning Stoves: A Preliminary Study

Wood burning for residential heating is prevalent in the Rocky Mountain regions of the United States. Studies have shown that wood stoves can be a significant source of PM2.5 within homes. In this study, the effectiveness of an electrostatic filter portable air purifier was evaluated (1) in a home where a wood stove was the sole heat source and (2) in a home where a wood stove was used as a supplemental heat source. Particle count concentrations in six particle sizes and particle mass concentrations in two particle sizes weremeasured for ten 12-hour purifier on and ten purifier off trials in each home. Particle count concentrations were reduced by 61–85 percent. Similar reductions were observed in particle mass concentrations. These findings, although limited to one season, suggest that a portable air purifier may effectively reduce indoor particulate matter concentrations associated with wood combustion during home heating.

The Presence of Asbestos-Contaminated Vermiculite Attic Insulation and/or Other Asbestos Containing Materials in Homes and the Potential for Living Space Contamination

Asbestos-contaminated vermiculite attic insulation (VAI) produced from a mine near Libby, Montana, may be present in millions of homes along with other commercial asbestos-containing materials (ACM). The primary goal of the research described here was to develop and test procedures that would allow for the safe and effective weatherization of low-income homes with asbestos. The presence of asbestos insulation was confirmed by bulk sampling of the suspect asbestos material. The homes were then tested for the presence of asbestos fibers in the living spaces. All 40 homes containing VAI revealed the presence of amphibole asbestos in bulk samples. Asbestos (primarily chrysotile) was confirmed in bulk samples of ACM collected from 18 homes. Amphibole asbestos was detected in the living space of 12 (26%) homes, while chrysotile asbestos was detected in the living space of 45 (98%) homes. These results suggest that asbestos sources in homes can contribute to living space contamination

Detroit: Conquering Challenges

A Montana Public Radio Commentary by Evan Barrett.

Position, professional expertise and functions of an educator of child care homes in Lithuania

Speaking about professionals, working with children at child care homes in Lithuania, first of all we encounter a problem of terminology. This problem rises, because in various countries and languages we call these professionals differently. In Lithuania we call them ”aukletojai”. We also use the word ”aukletojas” when speaking about both professionals, working directly with children at kindergartens, and parents, as all parents are educators of their children. We suppose, that the word ”aukletojas” corresponds to the German “erzieher”, and “aukleti” to “erziehen”. Every “aukletojas” in Lithuania clearly realizes, that he is a pedagogue, because in this country every professional, involved in educational work with children – an ”aukletojas”, a teacher, a social pedagogue and a special pedagogue – is called a pedagogue. In this context it is essential to conceive that in Lithuania an ”educator” and a ”social pedagogue” are different pedagogical professions and that none of the ”aukletojas” identify himself as a social pedagogue.