The relationships between work stressors and organizational performance in long-term care for elderly residents

This study investigates the relationships between work stressors and organizational performance in terms of the quality of care provided by the long-term care facilities. Work stressors are first examined in relation to the unit's structural factors, resident characteristics, and to the unit specialization. The study is completed by an investigation into the associations of work stressors such as job demands or time pressure, role ambiguity, resident-related stress, and procedural injustice to organizational performance. Also the moderating effect of job control in the job demands organizational performance relationship is examined. The study was carried out in the National Research and Development Centre for Welfare and Health (STAKES). Survey data were drawn from 1194 nursing employees in 107 residential-home and health-center inpatient units in 1999 and from 977 employees in 91 units in 2002. Information on the unit resident characteristics and the quality of care was provided by the Resident Assessment Instrument (RAI). The results showed that large unit size or lower staffing levels were not consistently related to work stressors, whereas the impairments in residents' physical functioning in particular initiated stressful working conditions for employees. However, unit specialization into dementia and psychiatric residents was found to buffer the effects that the resident characteristics had on employee appraisals of work stressors, in that a high proportion of behavioral problems was related to less time pressure and role conflicts for employees in specialized units. Unit specialization was also related to improved team climates and the organizational commitment of employees. Work stressors associated with problems in care quality. Time pressure explained most of the differences between units in how the employees perceived the quality of physical and psychosocial care they provide for the residents. A high level of job demands in the unit was also found to be related to some increases in all clinical quality problems. High job control buffered the effects of job demands on the quality of care in terms of the use of restraints on elderly residents. Physical restraint and especially antipsychotic drug use were less prevalent in units that combined both high job demands and high control for employees. In contrast, in high strain units where heavy job demands coincided with a lack of control for employees, quality was poor in terms of the frequent use of physical restraints. In addition, procedural injustice was related to the frequent use of antianxiety of hypnotic drugs for elderly residents. The results suggest that both job control and procedural justice may have improved employees' abilities to cope when caring for the elderly residents, resulting in better organizational performance.

Management of persistent pain in the older people

Persistent pain is a commonly experienced symptom. It affects 25% of community-dwelling older adults and up to 80% of nursing home residents, and can have a major impact on quality of life and functional capacity. Unfortunately pain in older patients is often undertreated and misunderstood. Assessment of pain type and severity is important. Most older people, even with moderately impaired cognition, are able to self-report pain. Validated assessment tools using non-verbal pain cues are available for people with more advanced cognitive impairment. Management of pain in older people can be challenging. Physiological changes may impact on pain perception and the pharmacodynamics and pharmacokinetics of medications. Older people are often more sensitive to the adverse effects of analgesic medications and are at risk of drug–drug interactions due to the presence of co-morbidities and polypharmacy. In general, analgesic medications should be commenced at low doses, titrated based on effect and tolerability, and regularly reviewed. Contemporary pain management often utilises multiple analgesics in lower doses to optimise efficacy and avoid dose-related toxicity. A bio-psycho-social approach to the management of persistent pain, utilising a multidisciplinary team and including non-drug strategies, may produce the best results. The goal of pain management is not always to eliminate pain, since this may not be attainable, but rather to enhance function and improve quality of life. This article discusses persistent non-cancer pain in older people, its assessment and management, and the risks and benefits of pharmacological treatment in this population.

Multi-UAV Task Allocation using Team Theory

A multiple UAV search and attack mission in a battlefield involves allocating UAVs to different target tasks efficiently. This task allocation becomes difficult when there is no communication among the UAVs and the UAVs sensors have limited range to detect the targets and neighbouring UAVs, and assess target status. In this paper, we propose a team theoretic approach to efficiently allocate UAVs to the targets with the constraint that UAVs do not communicate among themselves and have limited sensor range. We study the performance of team theoretic approach for task allocation on a battle field scenario. The performance obtained through team theory is compared with two other methods, namely, limited sensor range but with communication among all the UAVs, and greedy strategy with limited sensor range and no communication. It is found that the team theoretic strategy performs the best even though it assumes limited sensor range and no communication.

PICES-GLOBEC International Program on Climate Change and Carrying Capacity: Summary of the 1998 MODEL, MONITOR and REX Workshops, and Task Team Reports.

This volume summarizes the results of three workshops organized by the PICES-GLOBEC Climate Change and Carrying Capacity Program that were held just prior to the PICES Seventh Annual Meeting in Fairbanks, Alaska, in October 1998. These workshops represent the efforts of the REX, MODEL, and MONITOR Task Teams to integrate the results of national GLOBEC and GLOBEC-like programs to arrive at a better understanding of the ways in which climate change affects North Pacific ecosystems. (PDF contains 91 pages)

Workshop on Conceptual/Theoretical Studies and Model Development including the MODEL Task Team Report; BASS Team Report; REX Task Team Reports

A workshop was convened by the MODEL Task Team and held June 23-28, 1996, in Nemuro, Japan, to develop the modeling requirements of the PICES Climate Change and Carrying Capacity (CCCC) Program. It was attended by over 40 scientists from all member nations of PICES. The principal objectives of the workshop were to • review the roles and limitations of modeling for the CCCC program; • propose the level of modeling required; and • provide a plan for how to promote these modeling activities. Secondary activities at the workshop included organisational meetings of the Regional comparisons (REX) and Basin-scale experiment (BASS) Task Teams, and a symposium by Japan-GLOBEC on “Development and application of new technologies for measurement and modeling in marine ecosystems.” This report serves as a record of the proceedings of this workshop. (PDF contains 89 pages)

Fry production: nursing spawn

(4 p.)

Fast fingerling production: nursing spawn in ponds

(4 pp.)

Fingerling production: nursing fry in ponds

(4 p.)