Expectations of elderly people on the nurse-client relationship and interaction in home care : "When I see the nurse's smiling face it feels likes sunshine on a rainy and gloomy day"

The purpose of the thesis was to explore expectations of elderly people on the nurse-client relationship and interaction in home care. The aim is to improve the quality of care to better meet the needs of the clients. A qualitative approach was adopted. Semi-structured theme interviews were used for data collection. The interviews were conducted during spring 2006. Six elderly clients of a private home care company in Southern Finland acted as informants. Content analysis was used as the method of data analysis. The findings suggest that clients expect nurses to provide professional care with loving-kindness. Trust and mutual, active interaction were expected from the nurse-client relationship. Clients considered it important that the nurse recognizes each client's individual needs. The nurse was expected to perform duties efficiently, but in a calm and unrushed manner. A mechanic performance of tasks was considered negative. Humanity was viewed as a crucial element in the nurse-client relationship. Clients expressed their need to be seen as human beings. Seeing beyond the illness was considered important. A smiling nurse was described to be able to alleviate pain and anxiety. Clients hoped to have a close relationship with the nurse. The development of a close relationship was considered to be more likely if the nurse is familiar and genuine. Clients wish the nurses to have a more attending presence. Clients suggested that the work areas of the nurses could be limited so that they would have more time to transfer from one place to another. Clients felt that they would benefit from this as well. The nurses were expected to be more considerate. Clients wished for more information regarding changes that affect their care. They wished to be informed about changes in schedules and plans. Clients hoped for continuity from the nurse-client relationship. Considering the expectations of clients promotes client satisfaction. Home care providers have an opportunity to reflect their own care behaviour on the findings. To better meet the needs of the clients, nurses could apply the concept of loving-kindness in their work, and strive for a more attending presence.

Notary Pocketbook

The responsibilities of an Iowa Notary Public are critical to the legal, business, financial and real estate communities and should be taken seri- ously. This pocketbook is designed to assist Iowa notary publics as they perform their duties.

On the role of retaliation in trade agreements

This paper analyzes the role of retaliation in trade agreements. It shows that, in the presenceof private information, retaliation can always be used to increase the welfare derived from suchagreements by the participating governments. In particular, it is shown that retaliation is anecessary feature of any efficient equilibrium.We argue that retaliation would not be necessary if governments could resort to internationaltransfers or export subsidies to compensate for terms-of-trade externalities. Within the currentworld trading system, though, in which transfers are seldom observed whereas export subsidiesare prohibited, the use of the remaining trade instruments in a retaliatory fashion might beoptimal. The model is used to interpret the retaliatory use of antidumping observed in the lastdecades, and the proliferation of these measures relative to other trade remedies.

Product market deregulation and labor market outcomes

We consider the dynamic relationship between product market entry regulationand equilibrium unemployment. The main theoretical contribution is combininga Mortensen-Pissarides model with monopolistic competition in the goods marketand individual wage bargaining. Product market competition affects unemploymentvia two channels: the output expansion effect and a countervailing effect dueto a hiring externality. Competition is then linked to barriers to entry. Acalibrated model compares a high-regulation European regime to a low-regulationAnglo-American one. Our quantitative analysis suggests that under individualbargaining, no more than half a percentage point of European unemployment ratescan be attributed to entry regulation.

Relying on the agent in charge of production for project evaluation

I study the optimal project choice when the principal relies on the agent in charge of production for project evaluation. The principal has to choose between a safe project generating a fixed revenue and a risky project generating an uncertain revenue. The agent has private information about the production cost under each project but also about the signal regarding the profitability of the risky project. If the signal favoring the adoption of the risky project is goods news to the agent, integrating production and project evaluation tasks does not generate any loss compared to the benchmark in which the principal herself receives the signal. By contrast, if it is bad news, task integration creates an endogenous reservation utility which is type-dependent and thereby generates countervailing incentives, which can make a bias toward either project optimal. Our results can offer an explanation for why good firms can go bad and a rationale for the separation of day-to-day operating decisions from long-term strategic decisions stressed by Williamson.

Office of the State Long-Term Care Ombudsman Annual Report 2004, January 2005.

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. Iowa’s State Long-Term Care Ombudsman’s Office has gone through many changes this past year ranging from staff changes to increase in jurisdiction area. Jeanne Yordi is now the State Long-Term Care Ombudsman, joining this promotion, will be three additional Long-Term Care Ombudsmen to the unit. With additional staff this office hopes to create more public awareness; however, cases and complaints are top priority as this office may begin to fulfill the mandates of the Older Americans Act.

Office of the State Long-Term Care Ombudsman Annual Report 2007, January 2008.

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. With the addition of 2 ombudsmen, regional offices were closed and 7 local programs were established in 2007. Local long-term care ombudsmen are becoming more aware of issues that need to be addressed, yet as evidenced by the tables included in this report, the increase in work load has been phenomenal, and is reaching the point of being unmanageable with the current staff.

Office of the State Long-Term Care Ombudsman Annual Report 2006, January 2007

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. With an increasing number of complaints for federal fiscal year 2006 this office continues to struggle with fulfilling all of the mandates of the Older Americans Act. Complaint investigations and working with residents and families remain the priority.

Office of the State Long-Term Care Ombudsman Annual Report 2005, January 2006.

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. Cases and complaints remain to be this office’s top priority. Facility closures take a tremendous amount of time, and with 1 Long-Term Care Ombudsman per 10,500 beds this office struggles to meet all of the mandates of the Older Americans Act.

'The Advocate' Resident Advocate Newsletter, Janary 2007, Vol. 8.

This tool of communication between the 2,500 members of the Resident Advocate Committee (RAC) Program and the State Long-Term Care Ombudsman is used to keep all volunteers informed of their roles and responsibilites as they carry out the duties of a resident advocate. The Advocate is provided to Resident Advocates on a quarterly basis.

'The Advocate' Resident Advocate Newsletter, April 2007, Vol. 9

This tool of communication between the 2,500 members of the Resident Advocate Committee (RAC) Program and the State Long-Term Care Ombudsman is used to keep all volunteers informed of their roles and responsibilities as they carry out the duties of a resident advocate. The Advocate is provided to Resident Advocates on a quarterly basis.

'The Advocate' Resident Advocate Newsletter, July 2007, Vol. 10

This tool of communication between the 2,500 members of the Resident Advocate Committee (RAC) Program and the State Long-Term Care Ombudsman is used to keep all volunteers informed of their roles and responsibilities as they carry out the duties of a resident advocate. The Advocate is provided to Resident Advocates on a quarterly basis.

'The Advocate' Resident Advocate Newsletter, October 2007, Vol. 11

This tool of communication between the 2,500 members of the Resident Advocate Committee (RAC) Program and the State Long-Term Care Ombudsman is used to keep all volunteers informed of their roles and responsibilities as they carry out the duties of a resident advocate. The Advocate is provided to Resident Advocates on a quarterly basis.

'The Advocate' Resident Advocate Newsletter, Janary 2008, Vol. 12

This tool of communication between the 2,500 members of the Resident Advocate Committee (RAC) Program and the State Long-Term Care Ombudsman is used to keep all volunteers informed of their roles and responsibilities as they carry out the duties of a resident advocate. The Advocate is provided to Resident Advocates Committee members and long-term care facilities on a quarterly basis.

Driver scheduling problem modelling

The Drivers Scheduling Problem (DSP) consists of selecting a set of duties for vehicle drivers, for example buses, trains, plane or boat drivers or pilots, for the transportation of passengers or goods. This is a complex problem because it involves several constraints related to labour and company rules and can also present different evaluation criteria and objectives. Being able to develop an adequate model for this problem that can represent the real problem as close as possible is an important research area.The main objective of this research work is to present new mathematical models to the DSP problem that represent all the complexity of the drivers scheduling problem, and also demonstrate that the solutions of these models can be easily implemented in real situations. This issue has been recognized by several authors and as important problem in Public Transportation. The most well-known and general formulation for the DSP is a Set Partition/Set Covering Model (SPP/SCP). However, to a large extend these models simplify some of the specific business aspects and issues of real problems. This makes it difficult to use these models as automatic planning systems because the schedules obtained must be modified manually to be implemented in real situations. Based on extensive passenger transportation experience in bus companies in Portugal, we propose new alternative models to formulate the DSP problem. These models are also based on Set Partitioning/Covering Models; however, they take into account the bus operator issues and the perspective opinions and environment of the user.We follow the steps of the Operations Research Methodology which consist of: Identify the Problem; Understand the System; Formulate a Mathematical Model; Verify the Model; Select the Best Alternative; Present the Results of theAnalysis and Implement and Evaluate. All the processes are done with close participation and involvement of the final users from different transportation companies. The planner s opinion and main criticisms are used to improve the proposed model in a continuous enrichment process. The final objective is to have a model that can be incorporated into an information system to be used as an automatic tool to produce driver schedules. Therefore, the criteria for evaluating the models is the capacity to generate real and useful schedules that can be implemented without many manual adjustments or modifications. We have considered the following as measures of the quality of the model: simplicity, solution quality and applicability. We tested the alternative models with a set of real data obtained from several different transportation companies and analyzed the optimal schedules obtained with respect to the applicability of the solution to the real situation. To do this, the schedules were analyzed by the planners to determine their quality and applicability. The main result of this work is the proposition of new mathematical models for the DSP that better represent the realities of the passenger transportation operators and lead to better schedules that can be implemented directly in real situations.