Person- and Task-Centered Mealtime Care: Impact on Positive, Neutral, and Challenging Behaviors in People With Dementia

Mealtime is an important daily activity to ensure intake. Person-centered and task-centered care may influence individual positive, neutral, and challenging mealtime behaviors. Yet, little work has fully examined their relationships. This study aimed to examine the association between person-centered and task-centered care approaches and individuals’ positive, neutral, and challenging mealtime behaviors. This secondary analysis of 110 videotaped mealtime observations involved 29 staff and 25 residents with dementia (42 unique staff-resident dyads) in 9 nursing homes. Videos were coded using the refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme. Logistic regression models were fit to four dependent variables representing resident mealtime behaviors: 1) positive/neutral behaviors (nonverbal), 2) positive utterances (verbal), 3) functional impairments (nonverbal), and 4) resistive behaviors (verbal and nonverbal). Independent variables were staff person-centered care modifications (nonverbal), person-centered utterances (verbal), and task-centered behaviors (verbal and nonverbal). Covariates included resident age, gender, eating function, and video duration. Resident positive utterances were associated with staff person-centered care utterances (OR =1.38, 95% CI = 1.09,1.76). Resident functional impairments were associated with staff person-centered care modifications (OR=1.33, 95% CI=1.02, 1.74) and fewer staff person-centered utterances (OR=0.81, 95% CI=0.66, 1.00). Resident resistive behaviors were associated with more staff person-centered utterances (OR=1.65, 95% CI=1.18, 2.31). Findings provided preliminary information supporting the role of staff person-centered care on resident positive and challenging mealtime behaviors. Findings inform use of verbal and nonverbal person-centered care strategies to improve positive communication and reduce challenging behaviors during mealtime in people with dementia.

Grammar and Hands: Manual Turn-Taking and Its Relationships to Verbal Turn-Taking in the Transfer of Objects

When customers bring a material item to a shop for repair, they must make the item and its troubles inspectable to the staff at the shop. This typically requires physical manipulation of the object by the customer. For their part, the staff person may then need to take the item into their own hands to further inspect it. A physical transfer of the object from customer to staff person may thus need to be accomplished. A practical problem that can arise in such transfers is this: who has the rights and responsibilities to touch and hold the object at any given time? In our data from a shoe repair shop, this practical problem is one of turn-taking of the participants’ hands, and the participants exhibit a clear normative orientation to “one person touches at a time”, with gaps and overlaps being common but brief. The parallels to verbal turn-taking are explored, as are the different affordances of each semiotic resource. The data are in American English.

Improving Student Skills and Career Readiness Through Targeted and Embedded Instruction

Background Psychology students can and sometimes do develop skills and career readiness in their courses, but these outcomes are rarely made explicit. Objective This research jointly examines how two potential factors may improve student skills and career readiness: explicit instruction on skill development in an advanced laboratory course, coupled with an embedded staff person from the institution’s career center. Method Changes in self-reports of skills and career readiness from pretest to posttest were examined for the course designed to improve these outcomes, as well as in a comparison group of similarly qualified students. Results Students in the course targeting skill development and career readiness improved on these outcomes over time. The comparison group did not improve. Conclusion These findings show promise for the impact of direct skill instruction and embedded staff on student career–related outcomes. Teaching Implications Instructors would serve their students well by pointing out the skills they are developing, when they are developing them, and their usefulness. Other implications for embedding staff, including feasibility, are discussed.

Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

ObjectiveTo describe the work environment and COVID-19 mitigation measures for homeless shelter workers and to assess occupational risk factors for COVID-19 infectionMethodsBetween June 9 and August 10, 2020, we conducted a self-administered, web-based survey among homeless shelter workers in Washington, Massachusetts, Utah, Maryland, and Georgia, in shelters where at least 1 staff person had tested positive for SARS-CoV-2. We calculated frequencies for demographics, work environment, personal protective equipment use, and SARS-CoV-2 testing history. We used generalized linear models with a binary outcome (COVID-19 positivity) and a log link, clustered by shelter network, to produce unadjusted prevalence ratios (PR) for demographics, work environment, and mitigation measures.ResultsOf the 106 respondents, 43.4% reported frequent close contact with clients and 85.8% reported wearing a mask most or all of the time; 75% reported being worried about being infected with SARS-CoV-2 at work; 15% reported testing positive for SARS-CoV-2. Of those who reported testing positive for SARS-CoV-2, 80% (12/15) believed they were infected at work. Frequent close contact with clients was significantly associated with testing positive for SARS-CoV-2 (PR 3.97, 95% CI 1.06, 14.93).ConclusionsHomeless shelter workers may be at higher risk of being infected with SARS-CoV-2 during the course of their work.

Idea Lab:

The Idea Lab within JLOE is a space to center the voices of library practitioners, with a focus on emerging practices and experimental approaches. This inaugural Idea Lab is dedicated to the creative and inspiring ways that libraries are connecting with their communities - either virtually or socially-distantly - while prioritizing health and safety for customers and for library workers. The worldwide shut down of physical library locations brought public attention to what the library community has long known–that public libraries are a last refuge for the most vulnerable members of our communities. Many libraries quickly and successfully pivoted to digital services and virtual programming, all the while understanding that these services don’t meet the needs of some of our most regular customers. People who rely on public libraries for a human connection with a staff person or another customer, internet access, a cool space on a hot day, or something as simple as a water fountain. So how have libraries responded to this urgent need to recreate our outreach and engagement strategies when our buildings are off limits and human connections are necessarily distanced by six feet or mediated through a screen? At the District of Columbia Public Library, we’re building on a foundation of strong partnerships to stay connected, deliver programs, and provide updates about library services. This looks like conducting virtual outreach through partners like the Boys & Girls Club of Greater Washington and their Clubhouse in Your House initiative and other community organizations. We’re also developing downloadable kits that partners can use to lead their own programming while taking advantage of library resources. We’re putting together programming packages and book giveaways that we can deliver to a central location - like DC Housing Authority or a summer meals distribution site - for a partner to distribute to their constituents. We know that there are critical gaps that we aren’t able to safely support right now. But I’ve never been more proud of the ingenuity and compassion of my team, my library, and of libraries around the world.

Research Roundup: Reaching Out to Parents

Most parents will agree that parenting, while rewarding, is also a very difficult job. When we provide for families in our library spaces, we really need to “be there” for parents so they feel welcome bringing their children to the library. Smiling at everyone, adults and children, when they enter the children’s room, can go a long way towards making them feel comfortable.Also, parents are very sensitive to what they perceive as surveillance and judgment from other parents as well as library staff. A withering look or brisk admonishment from a staff person is all it takes for a frazzled parent to decide they are not welcome and they likely won’t be back. We need to ensure that we give parents consistently welcoming messages and encouragement, especially when we are addressing specific issues or problems with them. This column’s links are meant to help all children’s library staff members to develop in our roles as supportive resource people in all parents’ lives as they raise their children.

The Heavy Lifting of Diversity: A Need for Scholar Administrators

Technological innovation and new economic terrain of the twenty-first century has called for higher education to re-examine how interdisciplinary ethnic studies and minority serving programs are positioned in the twenty-first century. This essay considers the utility of spaces like Black Studies departments and programs like the Mellon Mays Undergraduate Fellowship within the structure of Liberal Arts education today from the vantage a recent graduate. In the wake increasing hostility towards minority students and unfavorable media coverage of incidents on campus, colleges and universities must consider how rolling back minority focused academic and programmatic offerings alongside dramatic increases in contingent faculty and administrative staff hiring has left cultural voids. As Liberal Arts educators grapple with narrowing budget constraints and changing campus climates, the call for higher education employees who understand why disciplinary and programmatic offerings are tied to campus climate and how to use such resources grows louder. Scholar Administrators, in their ability to straddle the historically divisive line between faculty and staff, can help usher in a type of diversity that allows each student, faculty, and staff person to bear witness to the humanity in others, which ultimately is the heavy lifting of diversity.

Personnel Issues

Many of the potential problems with outsourcing can be avoided by carefully deciding which IT services can appropriately be contracted out and which cannot. Other problems, however, can only be avoided by an effective implementation of that decision and one such is the potential staff problem when transferring IT management and operation to an external body. Staff, however, often find the growth potential, greater variety, and greater business focus of some outsourcing jobs very appealing, and working for an outsourcing vendor is actually popular with some staff once the transition has been made. To an IT staff person, the vendor organization can offer wide and interesting career paths and almost a return to the traditionally sized IT section with all its scope for specialism. This variety of career path is unlikely to be offered by the slimmed-down IT provision internal to most organizations. The vendor’s core business is IT and hence resources flow into new developments and advances in a way that can give interesting and rewarding career opportunities. Instead of IT staff being treated as a necessary overhead, they become the organization’s critical asset. Not all outsourcing jobs are equally appealing, however, and some roles can be very unpopular (Robson, 1997).

Visual Cues for Person-centered Communication

Nursing home communication is frequently limited and task-focused and fails to affirm resident personhood. We tested the feasibility and effects of automated digital displays of resident photographs to remind staff ( N = 11) of resident ( n = 6) personhood. Historical photographs were displayed in digital photo frames mounted in each resident’s room. To evaluate the intervention’s effects, staff–resident conversations were audio-recorded prior to displaying the frames and repeated 2 weeks and 3 months later. Conversations were transcribed and statements were topic coded (task-focused vs. interpersonal). Staff person-centered talk increased from 11% to 32% ( z = 2.37, p = .02) after the intervention and task-talk decreased from 64% to 40%. Resident interpersonal topics increased from 20% to 37%. Staff statements increased from 29 at baseline, to 37 postintervention, and 41 at 3-month follow-up and resident engagement and reminiscence also increased. Effects were reduced after 3 months. Automated photo displays are an easily implemented, low-cost intervention to promote person-centered communication.