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?     

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.     

Adolescent parenthood,economic issues,and social policies

Adolescent parenthood has highly publicized adverse social and economic consequences, but these same social and economic disadvantages can be viewed as root causes of adolescent pregnancy. Recent research and revisionist debates about these issues are reviewed and summarized. Diverse implications for social policy are considered. Prevention approaches are emphasized that build on both postponing adolescent sexual intercourse and helping sexually active teens avoid pregnancy.Appreciation is expressed to Christine Bachrach and Kristin Moore for their comments on a previous version of this paper.Dr. Miller's current research interests are the family antecedents of adolescent sexual behavior and the design and evaluation of prevention programs for adolescent problem behaviors. He received his Ph.D. in family sociology from the University of Minnesota in 1975.     

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.     

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)     

Migration research and immigration policy

The author briefly reviews the impact of migration research on U.S. immigration policy over the period 1964-1992. Consideration is given to legal and illegal migrants and refugees.