Urinary and fecal incontinence are independently associated with falls risk among older women and men with complex needs: A national population study.

Aims: To determine the relationships between urinary incontinence (UI), fecal incontinence (FI), and falls risk among community-dwelling older women and men with complex needs, after controlling for confounders.

Methods: All community care recipients in New Zealand undergo standardized needs assessments, using the Home Care International Residential Assessment Instrument (interRAI-HC), which elicits information over multiple domains, including UI and FI frequency and falls. Consenting women and men aged greater than or equal to 65 years with at least one interRAI-HC assessment undertaken between 1 July 2012 and 1 June 2018 were investigated using multilevel mixed effects ordinal regression models, stratified by sex.

The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction.

Introduction: In the development of terminology of the lower urinary tract, due to its increasing complexity, the terminology for male lower urinary tract and pelvic floor symptoms and dysfunction needs to be updated using a male-specific approach and via a clinically-based consensus report.

Methods: This report combines the input of members of the Standardisation Committee of the International Continence Society (ICS) in a Working Group with recognized experts in the field, assisted by many external referees. Appropriate core clinical categories and a subclassification were developed to give a numeric coding to each definition.

Special considerations in the urological management of the older spinal cord injury patient.

Purpose: This paper reports the key findings of Committee 8 of the Joint SIU-ICUD Consultation on Urologic Management of the Spinal Cord Injured Patient and address issues pertaining to the older person with a SCI and the time-related changes relevant to their urological, gastrointestinal and functional management.

Methods: A literature review using the Pubmed and Ovid search engines was performed examining pertinent literature regarding SCI in the older patient.

Results: There is a rising incidence of both traumatic and non-traumatic spinal cord injury (SCI) in older people and improvements in healthcare and nutrition mean patients with SCI are living longer.

Symptoms of bowel dysfunction and their management after spinal cord injury in a New Zealand centre.

Aim: To document the symptoms of bowel dysfunction, and how the bowels are managed, in a cohort of patients following a spinal cord injury. To relate these to the level of the spinal injury and to examine the relationship between bowel symptoms and bladder dysfunction.

Method: Participants were identified from the discharge data from the Burwood Spinal Unit, one of two national Spinal Units in New Zealand, in two two-year sets from 1-3 years post-injury and from 20-21 years post-injury.

Diversity, distribution and conservation of the terrestrial reptiles of Oman (Sauropsida, Squamata).

In the present work, we use an exceptional database including 5,359 records of 101 species of Oman's terrestrial reptiles together with spatial tools to infer the spatial patterns of species richness and endemicity, to infer the habitat preference of each species and to better define conservation priorities, with especial focus on the effectiveness of the protected areas in preserving this unique arid fauna. Our results indicate that the sampling effort is not only remarkable from a taxonomic point of view, with multiple observations for most species, but also for the spatial coverage achieved. The observations are distributed almost continuously across the two-dimensional climatic space of Oman defined by the mean annual temperature and the total annual precipitation and across the Principal Component Analysis (PCA) of the multivariate climatic space and are well represented within 17 out of the 20 climatic clusters grouping 10% of the explained climatic variance defined by PC1 and PC2.

Falls and hip fractures associated with urinary incontinence among older men and women with complex needs: A national population study.

Aims: To determine if urinary incontinence (UI) was an independent risk factor for falls and hip fractures in community-dwelling older men and women with complex needs, after controlling for confounders.

Methods: Since 2012, all community care recipients in New Zealand have undergone standardized needs assessments using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC elicits information over multiple domains, including UI frequency and falls.

Urinary incontinence, but not fecal incontinence, is a risk factor for admission to aged residential care of older persons in New Zealand.

Aims: To determine if urinary incontinence (UI) and fecal incontinence (FI) were independent risk factors for aged resident care (ARC) admissions for older people, after controlling for confounders and applying apposite statistical methods.

Methods: Since 2012, all community care recipients in New Zealand have undergone a standardized needs assessment using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC instrument elicits information on 236 questions over 20 domains, including UI and FI frequency within the last 3 days.

Workforce and Leader Development: Learning From the Baldrige Winners in Health Care.

It is ironic that perhaps the only constant in health care organizations today is change. To compete successfully in health care and position an organization for high performance amid continuous change, it is very important for managers to have knowledge of the best learning and development practices of high-performing organizations in their industry. The rapid increases in the rate of technological change and geometric increases in knowledge make it virtually imperative that human resources are developed effectively.

Conservative treatment for incontinence in women in rest home care in Christchurch: Outcomes and cost.

Aims: To assess if conservative therapy can reduce urinary leakage and pad usage and improve quality of life in elderly incontinent women living in a rest home setting; and if so at what additional cost.

Methods: Sixty-eight elderly women with urinary incontinence, and preserved cognitive ability, living in 26 rest homes were identified. Clinical evaluation, included bladder diary, pad weigh tests, pad usage, and quality of life and activities questionnaires (FIM: Functional Impairment Measure; EQ-5D: Euroquol 5 dimension score; ICIQ-SF: International Consultation on Incontinence-Short Form).

Performance management excellence among the Malcolm Baldrige National Quality Award Winners in Health Care.

When carefully constructed, performance management systems can help health care organizations direct their efforts toward strategic goals, high performance, and continuous improvement needed to ensure high-quality patient care and cost control. The effective management of performance is an integral component in hospital and health care systems that are recognized for excellence by the Malcolm Baldrige National Quality Award in Health Care. Using the framework in the 2011-2012 Health Care Criteria for Performance Excellence, this article identifies the best practices in performance management demonstrated by 15 Baldrige recipients.

Improving organizational climate for excellence in patient care.

Managers in health care organizations today are expected to achieve higher-quality patient care at a lower cost. Developing and maintaining a positive organizational climate can help improve motivation and foster higher employee performance. In turn, this will help the organization deliver better patient care at a lower cost.

Conquering the Sahara and Arabian deserts: systematics and biogeography of Stenodactylus geckos (Reptilia: Gekkonidae).

Background: The evolutionary history of the biota of North Africa and Arabia is inextricably tied to the complex geological and climatic evolution that gave rise to the prevalent deserts of these areas. Reptiles constitute an exemplary group in the study of the arid environments with numerous well-adapted members, while recent studies using reptiles as models have unveiled interesting biogeographical and diversification patterns. In this study, we include 207 specimens belonging to all 12 recognized species of the genus Stenodactylus.

Managing human resources for successful strategy execution.

Managers face difficult challenges when they implement organizational strategies to achieve important goals. Execution of strategy has become more dependent upon the effective management of human resources. This article suggests how people can be managed more effectively to facilitate the execution of strategies and improve organizational performance.

Sacral neuromodulation with implanted devices for urinary storage and voiding dysfunction in adults.

Background: The neural control of storage and voiding of urine is complex and dysfunction can be difficult to treat. One treatment for people with refractory symptoms is continuous electrical nerve stimulation of the sacral nerve roots using implanted electrodes and an implanted pulse generator.

Objectives: To determine the effects of implantable electrical stimulation devices in the treatment of urine storage and voiding problems.

Managing immature, irresponsible, or irritating employees.

Most managers can remember employees who were immature, irresponsible, or very irritating. They also recall how difficult it was to direct these individuals. This article discusses attitudinal problems and counterproductive behavior that can lead to lower quality performance.

Inappropriate selection of first-line managers can be hazardous to the health of organizations.

Inappropriate selection decisions that occur when individuals are hired or promoted into first-line managerial positions without full consideration of their qualifications can create major problems for health care organizations. This article examines the perceptions that employees may have regarding new managers who are ineffective and the problems resulting from inappropriate selection decisions and offers suggestions for avoiding these problems.

A successful nurse-led model in the elective orthopaedic admissions process.

Aim: To document a nurse-led admissions process for same day orthopaedic surgery, on relatively fit patients under 70 years of age.

Methods: Patients undergoing minor surgery, under 70 years of age, and with a body mass index (BMI) of <35, were selected from the total of patients being admitted for elective orthopaedic surgery under the Accident Compensation Commission (ACC) contract. The nurse-led project relied primarily on an admission questionnaire, on physician consultation notes, and on previous clinical records.

Chronic suprapubic catheterization in the management of patients with spinal cord injuries: analysis of upper and lower urinary tract complications.

Objective: To assess whether chronic suprapubic catheterization (SPC) in patients with spinal cord injury (SCI) is associated with a higher incidence of significant urinary tract complications than in patients whose urinary tracts are managed by other methods.

Patients And Methods: Our experience suggested that the incidence of complications in patients with SCI and SPC was acceptable and relatively low. Between 1988 and 2001, 1018 patients were admitted to our unit after SCI; 149 were managed by SPC and we retrospectively reviewed them, with a mean follow-up of 6 years.

The department manager and effective human resource planning: an overview.

Department managers in health care organizations play a pivotal role in ensuring the success of human resource (HR) planning. This article describes HR planning and its importance to the organization and department managers. Organizational support necessary for effective HR planning is also covered.

Improving safety management in health care organizations.

This article explores reducing workplace accidents and resulting injuries through the introduction of better safety management programs in health care organizations. It examines the benefits of such programs and discusses causes of accidents. It presents components considered necessary for inclusion in an effective accident prevention program.

Propiverine compared to oxybutynin in neurogenic detrusor overactivity--results of a randomized, double-blind, multicenter clinical study.

Objectives: To compare the efficacy and tolerability of propiverine and oxybutynin in patients with neurogenic detrusor overactivity.

Methods: Patients were eligible, if at least 18 years of age and suffering from neurogenic detrusor overactivity. Eligibility also required a maximum cystometric capacity less than 300 ml.

Managing human resources to improve employee retention.

Managers face increased challenges as the demand for health care services increases while the supply of employees with the requisite skills continues to lag. Employee retention will become more important in the effort to service health care needs. Appropriate human resource management strategies and policies implemented effectively can significantly assist managers in dealing with the employee retention challenges ahead.

Improving productivity through more effective time management.

Effective time management has become increasingly important for managers as they seek to accomplish objectives in today's organizations, which have been restructured for efficiency while employing fewer people. Managers can improve their ability to manage time effectively by examining their attitudes toward time, analyzing time-wasting behaviors, and developing better time management skills. Managers can improve their performance and promotion potential with more effective time utilization.

Personality conflicts and objectivity in appraising performance.

A daunting challenge for any health care manager is to be involved in a personality conflict with an employee and then maintain objectivity in appraising that employee's performance. This article explores the relationship between personality conflicts and performance appraisal. Types of perceptual problems, such as recent behavior bias and horn effect, are discussed.

Managing effectively in the downsized organization.

Many health care institutions have downsized in recent years for a variety of reasons including cost savings and the need to be proactive in restructuring the organization for more effective performance. In a downsized organization, top management must develop new strategies to enable line managers at all levels to operate effectively. New policies for human resource strategic planning, selective hiring, employee empowerment, training and development, reduction of status distinctions, sharing of appropriate information with employees, and paying for performance must be implemented.