We Are the Roots: The Culture of Home Health Aides

This article focuses on the contributions of its workers\u27 culture to the success of Cooperative Home Care Associates (CHCA). It examines what the home healthaides bring to the culture of the company, how their contribution develops through their experience with the company, and how their heritage contributes to their CHCA work and to the company as an organization. This is one segment of a larger study that will deal with the background and history of CHCA, the vision of the founders and its implementation, the role of organizational policy, and the contribution of management philosophy to its accomplishment

Hugs and behaviour points: alternative education and the regulation of 'excluded' youth

In England, alternative education (AE) is offered to young people formally excluded from school, close to formal exclusion or who have been informally pushed to the educational edges of their local school. Their behaviour is seen as needing to change. In this paper, we examine the behavioural regimes at work in 11 AE programmes. Contrary to previous studies and the extensive ‘best practice’ literature, we found a return to highly behaviourist routines, with talking therapeutic approaches largely operating within this Skinnerian frame. We also saw young people offered a curriculum largely devoid of languages, humanities and social sciences. What was crucial to AE providers, we argue, was that they could demonstrate 'progress' in both learning and behaviour to inspectors and systems. Mobilising insights from Foucault, we note the congruence between the external regimes of reward and punishment used in AE and the kinds of insecure work and carceral futures that might be on offer to this group of young people

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

My music is my flag: Puerto Rican musicians and their New York communities, 1917-1940

Puerto Rican music in New York is given center stage in Ruth Glasser's original and lucid study. Exploring the relationship between the social history and forms of cultural expression of Puerto Ricans, she focuses on the years between the two world wars. Her material integrates the experiences of the mostly working-class Puerto Rican musicians who struggled to make a living during this period with those of their compatriots and the other ethnic groups with whom they shared the cultural landscape.Through recorded songs and live performances, Puerto Rican musicians were important representatives for the national consciousness of their compatriots on both sides of the ocean. Yet they also played with African-American and white jazz bands, Filipino or Italian-American orchestras, and with other Latinos. Glasser provides an understanding of the way musical subcultures could exist side by side or even as a part of the mainstream, and she demonstrates the complexities of cultural nationalism and cultural authenticity within the very practical realm of commercial music.Illuminating a neglected epoch of Puerto Rican life in America, Glasser shows how ethnic groups settling in the United States had choices that extended beyond either maintenance of their homeland traditions or assimilation into the dominant culture. Her knowledge of musical styles and performance enriches her analysis, and a discography offers a helpful addition to the text

The Farm in the City in the Recent Past: Thoughts on a More Inclusive Urban Historiography

The scholarly and journalistic literature usually treats urban agriculture as a new phenomenon, but it is a neglected dimension of urban history. Some U.S. cities, at least in the Northeast, had food-raising and processing practices not just in colonial times but right up until the relatively recent past. Three areas of history are explored that have mostly omitted discussion of city food production but nonetheless provide important frameworks to explore such production: urban development, agricultural, and immigrant history. Woven throughout this piece is evidence from a study of Waterbury, Connecticut. Local food production did not die when the Industrial Revolution came to Waterbury. Farms and other food-producing, processing, and marketing operations remained and even adapted to the city\u27s growing needs and resources. The city government both supported and undermined agriculture in ways that add to an understanding of urban history and are lessons for current urban agriculture policy