Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers

Objective: In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. Method: A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. Results: The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Conclusion: Routine monitoring of caseload, especially by a workplace supervisor, may be effective in reducing work-related stress and enhancing case manager personal efficacy. Keywords: case management, caseload, stress

Biological management of the invasive Vachellia nilotica ssp. indica (Benth.) Kyal. & Boatwr. (Fabales: Mimosoideae) in tropical Australia: stress-inducing potential of Anomalococcus indicus Ramakrishna (Insecta: Hemiptera: Coccoidea: Lecanodiaspididae), an agent of promise

Vachellia nilotica ssp. indica (hereafter, V. n. indica) is an important tree weed in Australia. Its dense populations induce undesirable changes in the vast areas of northern Australia. Because chemical and mechanical management options appear unviable for various reasons, biological management of this tree is considered a better option. Among the many trialled arthropods in Australian context, Anomalococcus indicus, a lecanodiaspid native to India, has been identified as a potent-candidate, since in India, its native terrain, it is the most widespread and occurs throughout the year. Severe infestations of A. indicus cause defoliation, wilting and death of branches, and occasionally the tree. Populations of A. indicus have been brought into Australia and are being tested for its host specificity under quarantine conditions. This article reports the physiological damage and stress it inflicts in the shoots of V. n. indica. Younger-nymphal instars of A. indicus feed on cortical-parenchyma cells of young stems, whereas the older instars and adults feed from the phloem of old stems. Two conspicuous responses of V. n. indica arising in response to the feeding action of A. indicus are changes in the cell-wall dynamics and irregular cell divisions. The feeding action of A. indicus elicits a sequence of reactions in the stem tissues of V. n. indica such as differentiation of thick-walled elements in the outer cortical parenchyma, differential thickening of cells with supernumerary layers of either suberin or lignin, proliferations of parenchyma and phloem, wall thickening and obliteration of inner lumen of phloem cells, and the sieve plates plugged with callosic deposits. The responses are the culminations of interaction between the virulence factor (one or more of the salivary proteins?) from A. indicus and the resistance factor in V. n. indica. We have analysed structural changes in the context of their functions, by comparing the feeding action of A. indicus with that of other hemipteroids. From the level of stress it induces, this study confirms that A. indicus has the potential to be an effective biological management of V. n. indica in Australia. © 2014 © 2014 Taylor & Francis and Aboricultural Association.

Contemporary social variations in household water use, management strategies and awareness under conditions of 'water stress': the case of Greater Amman Jordan

One of the distinctive characteristics of the water supply system of Greater Amman, the capital of Jordan, is that it has been based on a regime of rationing since 1987, with households receiving water once a week for various durations. This reflects the fact that while Amman's recent growth has been phenomenal, Jordan is one of the ten most water-scarce nations on earth. Amman is highly polarised socio-economically, and by means of household surveys conducted in both high- and low-income divisions of the city, the aim has been to provide detailed empirical evidence concerning the storage and use if water, the strategies used by households to manage water and overall satisfactions with water supply issues, looking specifically at issues of social equity. The analysis demonstrates the social costs of water rationing and consequent household management to be high, as well as emphasising that issues of water quality are of central importance to all consumers.

Iron homeostasis and management of oxidative stress response in bacteria

Iron is both an essential nutrient for the growth of microorganisms, as well as a dangerous metal due to its capacity to generate reactive oxygen species (ROS) via the Fenton reaction. For these reasons, bacteria must tightly control the uptake and storage of iron in a manner that restricts the build-up of ROS. Therefore, it is not surprising to find that the control of iron homeostasis and responses to oxidative stress are coordinated. The mechanisms concerned with these processes, and the interactions involved, are the subject of this review.

The role of management consultation, support, and coping on nurses` health during the stress of restructuring

This study examined the impact of hospital restructuring moves on a sample of Australian nurses' health. The role of organizational support, assessed via levels of consultation with staff, social support, and nurses coping were examined as further contributors or mediators of the relationship between the impact of restructuring and nurses' health. Data from 201 hospital nurses indicated that the factors in the model explained 41% of the variance in nurses' health. “Top-down” communication style by management contributed negatively to nurses' health and increased their perceptions of the impact of restructuring. Support from peers, supervisors, and family together with seeing the demands of impact of restructuring as a challenge, contributed positively to nurses' health and reduced the level of avoidance strategies used. The implications of these findings are discussed.

Bullfrog hemogram under management stress

Stress is one of the major obstacles in frog culture and can be caused by factors such as inappropriate farming systems; inadequate management among other situations. The objective of the present study was to assess the hemogram, erythrogram and leukogram of bullfrogs (L. catesbeianus) when exposed to stress caused by different types of management: density and handling (manipulation), developed in the laboratory and repeated in the field for the appropriate comparisons in a experimental period of 30 days. The density experiment was conducted with four treatments: 70 animals m(-2) (D70); 100 animals m(-2) (D100), Control; 150 animals m(-2) (D150) and 200 animals m(-2) (D200), with 10, 14, 21 and 28 animals/box in the laboratory, respectively. Each treatment was performed with three simultaneous replicates. The handling experiment was conducted with three treatments: Treatment Without Handling (WH); Treatment with Partial Handling (PH) every 15 days and Treatment with Total Handling (TH) every 15 days. Each treatment was performed with four simultaneous replications. The methodology of the blood analysis followed international recommendations. In the present study we could observe that the animals of the field experiment did not reflect the same stress response observed in the laboratory in both experiment, which demonstrated the plasticity of these animals.

An adjustable sling in the management of recurrent urodynamic stress incontinence after previous failed midurethral tape

The aim of this prospective study was to evaluate the feasibility and outcome of an adjustable sling system AMI in patients with recurrent urinary stress incontinence after failed suburethral sling insertion.

Monitoring Programmes, Multiple Stress Analysis and Decision Support for River Basin Management

The identification of plausible causes for water body status deterioration will be much easier if it can build on available, reliable, extensive and comprehensive biogeochemical monitoring data (preferably aggregated in a database). A plausible identification of such causes is a prerequisite for well-informed decisions on which mitigation or remediation measures to take. In this chapter, first a rationale for an extended monitoring programme is provided; it is then compared to the one required by the Water Framework Directive (WFD). This proposal includes a list of relevant parameters that are needed for an integrated, a priori status assessment. Secondly, a few sophisticated statistical tools are described that subsequently allow for the estiation of the magnitude of impairment as well as the likely relative importance of different stressors in a multiple stressed environment. The advantages and restrictions of these rather complicated analytical methods are discussed. Finally, the use of Decision Support Systems (DSS) is advocated with regard to the specific WFD implementation requirements.

Management are aliens! Rumors and stress during organizational change

Rumors collected from a large public hospital undergoing change were content analyzed, and a typology comprising the following five broad types of change-related rumors was developed: rumors about changes to job and working conditions, nature of organizational change, poor change management, consequences of the change for organizational performance, and gossip-rumors. Rumors were also classified as positive or negative on the basis of their content. As predicted, negative rumors were more prevalent than positive rumors. Finally, employees reporting negative rumors also reported more change-related stress as compared to those who reported positive rumors and those who did not report any rumors. The authors propose that rumors be treated as verbal symbols and expressions of employee concerns during organizational change.