Evidence Of Cultural Change Research Articles

Culture Change in Skilled Nursing: An Exploratory Comparison of a Traditional Home to a New Model

The culture change movement has pushed for reform for more than two decades to align policy, the long-term care industry, and resident preferences with regard to care. Evidence from research indicates that culture change has the potential to improve quality in nursing homes. There is no one-size-fits-all way to implement culture change; however, there are key elements and associated concepts and models. A common thread is that they run counter to the medical model, typically found in nursing homes, where care is provided in a hospital-like setting according to the schedules and routines of physicians and staff with little resident input. This qualitative study looks for evidence of culture change in a traditional model of care compared to a newer culture change model, by describing the differences in practices associated with the medical model, person-centered care, and person-directed care between the two settings. Our results indicate that there is evidence of person-directed care in one model of culture change—the Green House home—but not in the traditional nursing home. Future studies should examine other culture change models to compare the differences in the utilization of person-directed care. This information will help to clarify the definitions and concepts of culture change, along with developing best practices for future culture change models.

Creating a Culture of Continuous Improvement in Outpatient Laboratories: Effects on Wait Times, Employee Engagement, and Efficiency.

Transforming health care remains a challenge as many continuous improvement (CI) initiatives fail or are not sustained. Although the literature suggests the importance of culture, few studies provide evidence of cultural change creating sustained CI. This improvement initiative focused on creating cultural change through goal alignment, visual management, and empowering frontline employees. Data included 113 133 encounters. Cochran-Armitage tests and X-bar charting compared wait times during the CI initiative. Odds of waiting <15 minutes increased in both phase 2 (odds ratio = 3.57, 95% confidence interval = [3.43-3.71]) and phase 3 (odds ratio = 5.39, 95% confidence interval = [5.07, 5.74]). At 3 years follow-up, 95% of wait times were <15 minutes. Productivity increased from 519 to 644 patients/full-time equivalent/month; 33/42 Press Ganey employee engagement components significantly improved. This study demonstrates the efficacy of a culture of CI approach to sustain wait time improvement in outpatient laboratory services, and should be considered for application in other areas of health care quality.

THE ARCHAEOLOGY OF HOME:QIAOXIANGAND NONSTATE ACTORS IN THE ARCHAEOLOGY OF THE CHINESE DIASPORA

The archaeology of the nineteenth-century Chinese diaspora is a well-developed archaeological subfield, but research on Chinese migrants’ homelands is lacking. Survey of a qiaoxiang (home village) in China's Pearl River Delta provides the first archaeological evidence from a home village of Chinese migrants. Transnational comparative analysis with collections recovered from Chinese diaspora settlements reveals stark differences in the use of China-produced goods between qiaoxiang and Chinese settlements abroad. Qiaoxiang residents primarily used locally produced ceramics, while residents of Chinese diaspora settlements consumed ceramics produced in Gaobei and Jingdezhen, major pottery centers located in northeast Guangdong Province and Jiangxi Province, hundreds of kilometers to the north. Additionally, qiaoxiang residents were engaged in global networks of consumption, using British refined earthenwares and other products produced in Europe and the United States. These findings challenge the common assumption made in diaspora research that artifacts produced in migrants’ homelands are evidence of tradition, while those produced in migrants’ adopted countries are evidence of culture change. Instead, the results of qiaoxiang archaeology indicate the significance of nonstate actors, especially import-export companies, in shaping the material worlds of both homeland and diaspora communities. (Spanish abstract available as Supplemental Text 1.)

OER — the Southampton experience

The Southampton experience of OER has been successful in repurposing over 50 CAT points of climate change resources. There is evidence of culture change amongst those staff who have contributed resources when clearing third party material, and successful negotiations with publishers have depended upon establishing contacts and networking in order to side-step a standardized web process. The level of resource required to repurpose materials means it is unrealistic to expect a widespread take up in UK educational institutions unless, at a national level, the community can negotiate agreements with the major scientific publishers. The requirement of authors to relinquish their copyright when publishing journals has significantly impeded open access in this project. Local repositories offer a more user friendly interface than JorumOpen.

Some Recent Controversies in the Study of Later Greek Rhetoric

����� �� THE GREEKS OF THE ROMAN EMPIRE produced no equal to Cicero or Quintilian: among their extensive writings there is no profound philosophical examination of political rhetoric and no comprehensive account of rhetorical education based on a lifetime of teaching. But the numerous later Greek rhetorical treatises, dry reading as they may seem, sometimes even poorly written, have considerable significance for the intellectual history of the early centuries of the Christian era. They are a major source for our understanding of education, its materials, goals, and values, as experienced by most important thinkers of the times, pagan and Christian; the training they describe directly influenced the form and style of composition of much of the writing that has survived; they are evidence for cultural change and for the perception of Greek language and literature of the classical period more than five hundred years later; and they provide linguists and philologists with useful concepts and terminology to describe the workings of texts, pagan and Christian, ancient and modern. From 1931, when Hugo Rabe published the last of his editions of later Greek rhetorical texts, to 1974, when Josef Martin published Antike Rhetorik: Technik und Methode (1974), making extensive use of later Greek rhetorical treatises, study of later Greek rhetoric was at a low point. There was of course continued interest in On the Sublime, traditionally attributed to Longinus and surely the finest Greek work on rhetoric of the imperial period. Other important exceptions include Guilelmo Ballaira’s edition of Tiberius’ handbook of Demosthenic figures and Dieter Hagedorn’s monograph, Zur Ideenlehre des Hermogenes (1964). Since the 1970s, with the expansion of research opportunities and younger scholars’ search for opportunities in original work, there has been a modest renaissance that has produced new insight and new controversy. In some ways we now know more about the authors and their works; in some ways we are now uncertain about what we thought we

Sacred Figures in Navajo Blankets: A Re-Evaluation of Timeframe and Its Implications for Cultural Change

ABSTRACTRecent research has uncovered a Navajo poncho bearing the image of a Navajo Holy Person figure. Dating to the 1860s, it predates all previously known examples by two decades. This discovery refines the dating sequence of Navajo textile history, provides direct evidence of cultural change, and suggests broader cultural interaction in the Southwest in the mid-nineteenth century.