Pilot study results: the psychiatric RN case manager.

1. It is important to examine client and staff satisfaction with the RN case management (RNCM) model to enhance the quality of care in psychiatric settings. 2. Ninety-two percent of clients surveyed ranked the RNCM care as "excellent" or "above average." Clients valued most the humanistic role of the RNCM and repeatedly commented on the importance of the nurse being caring, genuine, and supportive. 3. RNCMs expressed high satisfaction with their role, which they described as collaborative with the psychiatrist, yet also professional and independent. Psychiatrists expressed a high degree of confidence that clients were receiving excellent care by competent nurse professionals.     

International Conference on Population Aging. Keynote address

This is the keynote address of H.E.Dr. Vincent Tabone, President of Malta, at the International Conference on Aging, which was held in San Diego in September 1992. He states that the conference celebrates the tenth anniversary of the Vienna International Plan of Action, and provides an opportunity to evaluate progress and plan future direction. Dr. Tabone, as Minister of Foreign Affairs, first introduced the question of aging at the UN General Assembly over twenty years ago; the United Nations Secretariat established its first program in the field of aging in 1970. At the World Assembly on Aging in 1982, all members adopted the International Plan of Action, which defined guidelines for policies and programs in support of the aging populations. As a direct result of this, and in support of the needs of developing countries, the UN signed an agreement with the government of Malta that established the International Institute on Aging as an autonomous body under the auspices of the UN; it is the major expression of the Vienna Plan of Action. Concern for aging populations has developed enough maturity and momentum to oversee its own progress. Although current events may relegate the social and economic implications of the aged to the sphere of rhetoric, they demand thinking in terms of generations and transcend all political boundaries. This conference will evaluate progress toward deflecting a situation where the elderly constitute an increasing proportion of the population, without adequate and appropriate provision for their livelihood, and could have direct bearing on encouraging and ensuring the continuity of the family's vital and traditional role in preserving the dignity, status, and well-being of its aging members. A nation which begrudges its dues to the elderly, the successful products of society and triumphs of life, denies its past. This conference is a reaffirmation of commitment to the United Nations Principles for Older Persons, an omen of the review of the Global Targets on Aging for the year 2001 by the General Assembly at its forty-seventh session in October, and a stepping stone in the path toward integrating the elderly more fully into the mainstream of society. The year 1992 is a year for solidarity between the generations.     

HIV testing of health care workers

Until recently, nothing much beyond education and the dispensing of condoms was being done to control the spread of AIDS. We have not yet taken sufficient measures to prevent the spread of this disease. Instead, we insist on protecting the privacy of the HIV-positive individual. However, we ignore the right to privacy by mandating testing for syphilis, which is not nearly as serious a disease as AIDS. Now, mandatory testing of health care workers is being proposed more frequently.     

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.     

Environmental issues: the challenge for the chief executive

Businesses are under pressure to adopt environmental policies and incorporate them into their strategic business planning as a matter of routine. These pressures are coming from at least five sources--stricter legislation, consumer demand, competitive advantage, staff concerns and community pressure. The challenge is enormous but there is growing evidence that sound environmental management provides pay-off in bottom line results. Business organizations have a vital role to play and its good for them. There are opportunities for new business as well as threats to those organizations which continue to ignore the trends.     

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."     

Conference on international manpower flows and foreign investment in the Asian region

This is a report from a conference held in Tokyo, Japan, in 1991 on the economic aspects of labor mobility in Asia. The authors briefly describe selected papers given at the conference and outline conference topics. A list of participants is included. (SUMMARY IN FRE AND SPA)     

Socio-demographic interests of the population during the transition to a market economy

These are the results of a 1971 survey on reproductive behavior in the former Soviet Union. The survey covered 3,152 women aged 16 or over living in rural or urban areas. Questions were included on ideal, desired, and expected number of children. The results indicate that low fertility expectations characterize the majority of the population and that current political and economic problems are likely to push expected fertility even lower. Significant differences between rural and urban populations and among regions are identified.     

Complete censuses and samples

"Complete decennial censuses are needed for small areas and other domains. Sample surveys yield diverse and timely data. Censuses can also be combined with samples, and sometimes with data from registers, for diverse estimates that are detailed over both space and time, and hence are timely for small domains. Methods of 'postcensal estimates' for small domains are described. We note uses of censuses for improving samples and of samples for improving censuses, and propose a method for cumulating data from 'rolling' (or rotating) periodic (weekly, monthly or quarterly) samples specifically designed to cover the population in detail over designed spans (annual and quinquennial)."     

Utilizing a game for both needs assessment and learning in adolescent sexuality education

A fact-gathering, experimental game proved to be an effective instrument in the needs assessment phase of an adolescent sexuality educational program aimed at low-income females. The game ("Family Few"), which covered the topics of menstruation and reproduction, was played by 35 Black, Hispanic, and white females aged 13-16 years recruited from medical and psychiatric clinics in Miami, Florida. The goals of the game were to elicit terminology used by participants, identify and correct misconceptions and misinformation, and determine if learning could occur. Although 57% of participants reported prior exposure to formal sex education, misinformation about the need for activity curtailment during menstruation and the importance of early pregnancy detection was widespread. Group members believed they needed to restrict activities involving physical exercise, sexual relations, water, and cold during menses and were not likely to seek medical or family consultation regarding a missed period until the end of the 1st trimester of pregnancy. Also evident was a need for accurate information on the side effects, risk factors, benefits, and effectiveness of contraceptive methods. The group responses enabled the sex educators to prepare a culturally responsive, developmentally oriented curriculum for further work with disadvantaged female adolescents. The group process was ranked highly on the Likert Scale by these teenagers as an enjoyable, useful means of information dissemination and problem solving.