Persistent issues and elusive answers in social welfare policy, planning and administration.
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To study the relationship of task strain and physical fitness to fatigue among nurses employed at social welfare facilities, we investigated the degree of habitual end-of-work fatigue among 99 nurses (ages 20-49 years) in its relationship to both the degree of strain in various tasks and various indices of physical fitness. Results were as follows: (1) Fatigue complaint rates were nearly the same (35-38%) regardless of age. (2) Mean arm power and maximal oxygen uptake (VO2max) were significantly lower in a high degree of fatigue group than a low degree of fatigue group. (3) Four of 21 tasks elicited strain complaint rates greater than 50%: "nursing of seriously ill patients", "nursing of medical device-assisted patients", "bathing care", and "excretory/diaper changing care". (4) Significant positive correlations were noted between the degree of fatigue and the degree of strain complaint with regard to "nursing of medical device-assisted patients", "bathing care", and "excretory/diaper changing care". (5) Strain complaint rates were significantly higher in a low arm power group than a high arm power group with regard to "nursing of seriously ill patients", "nursing of medical device-assisted patients", and "excretory/diaper changing care". (6) Strain complaint rates were significantly higher in a low VO2max group than a high VO2max group with regard to "nursing of medical device-assisted patients", "bathing care", and "excretory/diaper changing care". These results suggest the need for measures to alleviate task strain and to increase arm strength and overall stamina so that nursing work does not result in excessive fatigue.
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We could reasonably expect society to give at least the same weight to the marginal utility of the poor as to the rich, and to the marginal utility of the ill as compared to the healthy. Whilst Hansen et al. [Journal of Health Economics (2004)], may be said to link CEA and CBA within a welfarist framework, the assumptions they require are inconsistent with these types of ethical preferences. Thus, the degree to which they employ a reasonable social welfare function is doubtful. This paper argues that any link between CEA and CBA will occur not within a welfarist framework but instead within a non-welfarist one in which it is unlikely that CBA results could be easily transformed into cost-effectiveness ratios.
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177 cases of parapartum mental illness and 173 matched obstetric controls were studied retrospectively from the perspective of the social welfare services (SWS). Data covering five years before the index partus until five to seven years thereafter, were studied. Parapartum mentally ill women were known to the SWS to a much greater extent (75%) than their matched controls (33%). They also presented more severe environmental problems than their matched controls. Within the index sample the largest number of adverse factors known to the SWS was found in the addicts and NTI (neuroses and temporary insufficiencies) groups. The dysfunction in the families appeared to be constant throughout the observation period. A large proportion of the index children (32%) had been placed in foster care or adopted. When the index women had applied to the SWS during the first postpartum year the social workers were informed of the fact that she had contacted a psychiatric department in 8 out of 10 cases. However, only in half of these cases had regular collaboration taken place. Collaboration was far more frequent when the mother suffered from severe mental illness than when she was suffering from a less severe mental disturbance.
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