Medication management, antidepressant drugs, and the elderly: an overview.

1. Several factors may affect an elderly client's use of medications: polypharmacy, potentially leading to interactions; over-the-counter drugs taken without a physician's knowledge; noncompliance or poor compliance with medication regimens; and ageist beliefs. 2. Psychiatric nurses must be aware that the signs and symptoms they observe may be the result of normal physical or biological aging, psychosocial changes, disease-related changes, medication side effects, or a drug interaction. 3. Nurses must ask two questions when psychotropic drugs are used with elderly clients: What will be the onset, duration, magnitude, and characteristic action of a specific drug in an individual; and What are the characteristics of an "ideal" medication?     

Effective boards: how executive directors define and develop them

There is growing recognition in the nonprofit field that the executive director has a key role in determining whether the board of directors will function effectively. To aid executives in this vital role, two recent studies defined a "good board" from the point of view of two samples of executive directors of community agencies, then sought factors related to board performance as measured by this definition. In interviews, executives whose boards scored higher than their peers on this performance measurement related how they work with their boards in such areas as recruitment of new members, financial management, fundraising, and leadership development.     

Eliminating smoking from the workplace

Employers are more readily realizing that a nonsmoking policy in the workplace is a more effective way to run their businesses. They are recognizing costs such as productivity losses, increased health and life insurance costs, employer liability for diseases jointly linked to smoking and occupational exposures, absenteeism, passive smoking-induced health care costs among nonsmokers, workers' compensation, and fire losses. Concomitantly, employees are supporting policies that limit smoking to achieve a clean air environment. Former Surgeon General Koop's goal of "a smokefree society by the year 2000" is being recognized by more and more segments of society.     

Clinical program renovation management

The day-to-day management of medical practice is so heavily influenced by tactical imperatives that few physicians have the time to think strategically. Traditionally, the difference between tactics and strategy is not a major concern of most physician executives. The realm of tactics is the short run, when managers must make do with the fixed resources at hand. Strategy addresses the long run, when all resources and markets are variable. A tactical focus is understandable, maybe even acceptable, in industries where nothing challenges traditional approaches to production of an established product or service. However, medical care in the 1990s is changing so fast that a physician executive must devote an incredible amount of time and effort just to stay confused about what is going on.     

Immigrant fertility: an examination of social characteristics and assimilation

"This study compares the fertility patterns of foreign-born and native-born women in Canada and examines whether [the] same set of social characteristics accounts for differential fertility among both the groups. The study also assesses the importance of social characteristics and assimilation on immigrant fertility behavior. Two generations of currently married/cohabiting women with spouse present are analyzed using multiple regressions. The results reveal similar effects on fertility of social characteristics for foreign-born and native-born, while in the case of younger generations the effects are stronger."     

Spontaneously settled refugees in Northwestern Province,Zambia

The UN High Commissioner for Refugees (UNHCR) commissioned researchers from the University of Zambia to conduct a socioeconomic survey and census of "spontaneously settled" Zairean and Angolan refugees in the Northwestern Province of Zambia in 1982. The sample consisted of 188 Angolans, 201 Zaireans, and 2 South Africans. The difficulties experienced by refugees in Northwestern Province in achieving integration were related to a combination of factors including the lack of a clear national policy on refugees and refugee status, a national concern for maintaining security, the popular belief that aliens are responsible for an increasing crime rate, the desire by immigration officials for stricter laws to control alien infiltration, conflict between traditional and modern leaders, and Zambia's deteriorating economic situation. In spite of the problems described, the integration of refugees into existing communities is a desirable goal and should be encouraged. One should not assume that self-settling refugees are able to live with ethnic kin, receive assistance and hospitality, and thus are better off than those in camps. The Zambian case provides ample evidence that integration is not easy even with kin support, shared ethnicity, language, and historical connections. Moreover, given the fact that Zambia will continue to receive refugees it is vital that there is a well defined refugee policy and an administrative mechanism for implementing that policy at all levels. This will be particularly important in Zambia as it will undoubtedly continue to receive large influxes of refugees, from countries such as Namibia, Uganda, Angola, Mozambique, and South Africa.     

Asian immigrants in Canada: some findings from 1981 census

Immigrant characteristics in Canada are analyzed using data from the 1981 census. "The purpose of this paper is to focus on Asian immigrants and to compare them with immigrants born in the United Kingdom, and also to compare them with Canadian-born persons with respect to age, sex, marital status composition, educational attainment, labour force participation, class of worker, occupation and income." (summary in FRE, SPA)     

Basic humanitarian principles applicable to non-nationals

This article examines the general status in international law of certain fundamental human rights to determine the minimum "no derogation" standards, and then surveys a number of formal agreements between stages governing migration matters, while examining some of the standard-setting work undertaken by the International Labor Organization (ILO) and other institutions. Article 13 of the Universal Declaration of Human Rights, proclaims the right of everyone to leave any country, including his or her own. The anti-discrimination provision is widely drawn and includes national or social origin, birth, or other status. Non-discrimination is frequently the core issue in migration matters; it offers the basis for a principles approach to questions involving non-nationals and their methodological analysis, as well as a standard for the progressive elaboration of institutions and practices. As a general rule, ILO conventions give particular importance to the principle of choice of methods by states for the implementation of standards, as well as to the principle of progressive implementation. Non-discrimination implies equality of opportunity in the work field, inremuneration, job opportunity, trade union rights and benefits, social security, taxation, medical treatment, and accommodation; basic legal guarantees are also matters of concern to migrant workers, including termination of employment, non-renewal of work permits, and expulsion. The generality of human rights is due not because the individual is or is not a member of a partucular group, and claims to such rights are not determinable according to membership, but according to the character of the right in question. The individualized aspect of fundamental human rights requires a case-by-case consideration of claims, and the recognition that to all persons now certain special duties are owed.