Publication Type: Conference Paper/Unpublished Manuscript
Abstract: The shift of high-tech medical care from hospital to home has been one of the most pronounced trends in health care over past two decades. In 1970, hospital care expenditures exceeded those for home care by a 279:1 ratio; by 1991, this margin had been reduced to 29:1, and declined to 12:1 in 2004. The majority of this cost shift has come as a result of technological advancements that have allowed patients, family members, and friends to perform medical interventions in the home that were formerly only possible in hospital. Pressures on hospitals to release patients earlier and to move certain treatments out of expensive clinical settings and expanded insurance coverage for home care coverage have furthered this trend. However, this expanded coverage pays primarily for medicines and supplies, not for home health aides or visiting nurses. Therefore, families are largely on their own in operating the machinery and administering care. The offloading of high-tech care from hospitals to families is especially paradoxical in that it represents a reversal in the long-term trend of moving medical care out of the home and into public institutions: for the first time, a form of care that has been thoroughly professionalized and bureaucratized is being transferred from formal institutions back into families, where in many cases, there is no one home to do the work. This study explores how families and patients cope with critical care offloading.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: American parents of children adopted from China frequently consume Chinese cultural objects for display in their homes. While they defend this consumption and display as an effort to validate their children�s ethno-cultural origins, parents also reveal that it signifies and solidifies their own identifications with Chinese culture. As part of a larger research project examining China adoptive parents� evolving �Chinese� identities, this paper asks: Which parents exhibit their family�s �Chineseness� in this way, and why? Through semi-structured in-depth interviews with ninety-one Americans in the China adoption process, I focus on the emergent and personal meanings that parents give to Chinese cultural objects; demonstrating how these meanings both structure parents� consumption and yield a display differential. In doing so, I reveal that White European-parents and mothers are most likely to engage in this consumption and display; thereby, amending the three types of ethno-cultural identity consumption represented in the literature. Specifically, I expose the central role of race in ethno-cultural identity consumption; specify that the collective category of reference for ethno-cultural identity consumption is not always an ethnic category; and illustrate the ways in which global ethno-cultural identity consumption both appeals to and satisfies distinctly local constructs.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: Early indications are that the Medicare home health prospective payment system (PPS) has controlled Medicare home health expenditures. However, studies indicate many unresolved questions about whether PPS improves patient quality of care and is cost-effective. The question persists as to whether PPS has intensified the Medicare home health benefit�s historic focus on acute medical care, ignoring the needs of persons with chronic diseases. The paper reviews effective home-based palliative care interventions and presents the views of seven home health care nurses regarding the impact of Medicare requirements on their management of Alzheimer�s disease patients. The nurses identify Alzheimer�s disease symptom management and psychosocial needs as phantoms, omnipresent below the surface but not attended to by home care clinicians. Nurse coping strategies are discussed. The paper asserts the policy failure to address the cost and quality of life issues of home health Alzheimer�s patients is analogous to the end-of-life care situation Medicare confronted in the 1970s prior to the demonstration program which preceded the Hospice Medicare Benefit. The article asserts that a similar demonstration is appropriate to determine how PPS might better facilitate management of home health Alzheimer Disease patient quality of life and costs.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: Louisiana’s Road Home Program, designed to assist individuals affected by Hurricanes Katrina and Rita to get back into their homes as soon as possible, grants eligible homeowners up to $150,000 in compensation for their losses. The Road Home Program’s website offers information for individuals seeking to utilize its services as it helps build a “safer, smarter, stronger Louisiana”. The field of public administration historically has given much attention to accountability, ethics, and transparency. Because of the documented prevalence of corruption at all levels of government, this paper assumes that any social services program should be subject to increased academic scrutiny. Therefore, a transparency model was developed to specifically assess the level of transparency in government services websites. This model will be applied to the Road Home Program’s website to determine the quality, level, and availability of public information. Further, the analysis will be used to make a strong theoretical case for increased transparency of government services and to empirically study the administrative and information architecture of government websites to ensure that necessary public information is available and accessible.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: Academic studies on bars and bar behavior have focused mainly on the interactions and social worlds of the customers with peripheral attention to the roles of bartenders and their duties and interactions with customers. This paper will explore the woman bartender�s multiple roles and examine how she maintains the social order of the bar, creates an enjoyable environment, and establishes relationships with her customers through boundary construction. Through an ethnographic analysis on an urban bar I will show how the bartender shifts roles and negotiates boundaries between herself and her customers in order to maintain her authority and the social order within the bar and protect herself from emotional, psychological, and physical harm. I will show the necessity of such construction and the consequences of not doing so. Furthermore, by looking at female bartenders I will shed light on women in the service industry in positions of authority.