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.     

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)     

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.     

Researching in the Victorian censuses: a note on a computerized,annotated bibliography of publications based substantially on the census enumerators' books

The authors describe a project, begun in 1981, to locate, list, and annotate all the published work based substantially on the census enumerators' books for nineteenth-century censuses for England and Wales. The results are currently available in a computerized file, enabling a variety of searches by topic, geographical area, and type of population. Information is provided on using the data and the computerized bibliography. The authors note that, subsequently, data for censuses of Scotland and Ireland have been added.     

Temporary workers in Canada: a multifaceted program

"This article highlights important developments in the character of temporary worker flows to Canada between 1973 and 1985 through the use of unpublished data and new measures for analyzing this data. The number of employment authorizations are converted to person years to indicate the overall labor market impact of temporary worker flows and this measure is employed in an analysis of unpublished data from Employment and Immigration Canada. The analysis reveals that a significant and growing proportion of employment authorizations are exempted from governmental procedures which link the admission of temporary workers to the Canadian labor market." Reasons for these exemptions and policy implications are discussed     

Establishing evaluation indicators on the population knowledge,attitudes, practices and skills (KAPS) of secondary school teachers and students in the Philippines

This study was conducted to establish evaluation indicators to be used as a basis in evaluating the integration of the population education program (POPED) of the Ministry of Education, Culture, and Sports within the Philippine 2ndary school curriculum. Questionnaires were used to determine existing knowledge, attitude, practice and skills (KAPS) of 3,136 high school students and 490 teachers, and data was analyzed for significant relationships between KAPS concerning POPED and demographic characteristics, exposure to population information sources, type of school attended, and exposure to POPED. KAPS and teaching method determine KAPS of the student. Data indicate that 81% of teachers had integrated POPED into the curriculum; only 19% of these had attended training on POPED. 93% utilized a lecture-discussion method in teaching POPED. Knowledge tests given to students and teachers were the same, covering demography, family size, age at marriage, responsible parenthood, use-effectiveness of methods, and population and development. Teachers performed better than students in questions on knowledge; on attitude statements teachers showed a slightly more favorable attitude towards POPED issues, most favorable to responsible parenthood, and least favorable to age at marriage. Mean preferred age at marriage (25) and mean desired number of children (3) was the same for teachers and students; teachers desired wider child spacing than students (3.3 years vs. 2.7 years). 84% of teachers used or wanted to use a family planning method, 76% of students felt they would use a method after marriage. Factors useful in predicting KAPS of teachers and students on POPED are: region of residence, age, sex, educational level, marital status, grade average, type of school, and exposure to various sources of POPED information.