High-Performance Classrooms for Women? Applying a Relational Frame to Management/Organizational Behavior Courses.

ERIC Educational Resources Information Center

Buttner, E. Holly

2002-01-01

Attributes of relational theory, based on women's development, include preventive connecting, mutual empowering, achieving, and team building. These attributes are compatible with the practices of high performance work organizations. Relational practices should be integrated into management and organizational behavior courses. (Contains 53…

Understanding medical practice team roles.

PubMed

Hills, Laura

2015-01-01

Do you believe that the roles your employees play on your medical practice team are identical to their job titles or job descriptions? Do you believe that team roles are determined by personality type? This article suggests that a more effective way to build and manage your medical practice team is to define team roles through employee behaviors. It provides 10 rules of behavioral team roles that can help practice managers to select and build high-performing teams, build more productive team relationships, improve the employee recruitment process, build greater team trust and understanding; and increase their own effectiveness. This article describes in detail Belbin's highly regarded and widely used team role theory and summarizes four additional behavioral team role theories and systems. It offers lessons learned when applying team role theory to practice. Finally, this article offers an easy-to-implement method for assessing current team roles. It provides a simple four-question checklist that will help practice managers balance an imbalanced medical practice team.

Trajectories of Family Management Practices and Early Adolescent Behavioral Outcomes

ERIC Educational Resources Information Center

Wang, Ming-Te; Dishion, Thomas J.; Stormshak, Elizabeth A.; Willett, John B.

2011-01-01

Stage-environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth…

A Critique of Externally Oriented Behavior Management Approaches as Applied to Exceptional Black Children.

ERIC Educational Resources Information Center

Patton, James M.

The paper looks at philosophical, heuristic, and practical reasons why behavior management approaches have failed to positively impact on the lives of exceptional Black children. Critiqued are behavior modification techniques, contingency management strategies, suspensions, expulsions, and positive and negative reinforcement. Noted among the…

Instructional and behavior management practices implemented by elementary general education teachers.

PubMed

Reddy, Linda A; Fabiano, Gregory A; Dudek, Christopher M; Hsu, Louis

2013-12-01

This investigation examined 317 general education kindergarten through fifth-grade teachers' use of instructional and behavioral management strategies as measured by the Classroom Strategy Scale (CSS)-Observer Form, a multidimensional tool for assessing classroom practices. The CSS generates frequency of strategy use and discrepancy scores reflecting the difference between recommended and actual frequencies of strategy use. Hierarchical linear models (HLMs) suggested that teachers' grade-level assignment was related to their frequency of using instructional and behavioral management strategies: Lower grade teachers utilized more clear 1 to 2 step commands, praise statements, and behavioral corrective feedback strategies than upper grade teachers, whereas upper grade teachers utilized more academic monitoring and feedback strategies, content/concept summaries, student focused learning and engagement, and student thinking strategies than lower grade teachers. Except for the use of praise statements, teachers' usage of instructional and behavioral management strategies was not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. HLMs suggested that teachers' grade level was related to their discrepancy scores of some instructional and behavioral management strategies: Upper grade teachers had higher discrepancy scores in academic performance feedback, behavioral feedback, and praise than lower grade teachers. Teachers' discrepancy scores of instructional and behavioral management strategies were not found to be related to years of teaching experience or to the interaction of years of teaching experience and grade-level assignment. Implications of results for school psychology practice are outlined. © 2013.

Beyond ADHD: How Well Are We Doing?

PubMed Central

Stein, Ruth EK; Storfer-Isser, Amy; Kerker, Bonnie D.; Garner, Andrew; Szilagyi, Moira; Hoagwood, Kimberly E.; O’Connor, Karen G.; Horwitz, Sarah McCue

2017-01-01

Background and Objectives There has been increasing emphasis on the role of the pediatrician with respect to behavioral, learning and mental health (MH) issues, and developmental behavioral rotations are now required in pediatric residency programs. We sought to examine whether this newer emphasis on MH is reflected in pediatricians’ reports of their current practices. Methods Data from two Periodic Surveys (PS) conducted in 2004 and 2013 by the American Academy of Pediatrics (AAP) were examined to see whether there were differences in self-reported behaviors of usually inquiring/screening, treating/managing/co-managing, or referring patients for ADHD, anxiety, depression, behavioral problems or learning problems. We examined patterns for all practicing members and for those who practiced general pediatrics exclusively. Results There were few changes over the decade in the percentage who inquired or screened among all clinicians; among those exclusively practicing general pediatrics, the percentage who inquired or screened increased about 10% for ADHD and depression. ADHD remained the only condition for which the majority of respondents treated/managed/co-managed (57%). While there was some increase in the percentages who treated other conditions, the other conditions were usually treated by < 30% of respondents. A similar pattern of results was observed in analyses adjusted for physician, practice, and patient characteristics. Conclusions Despite the changing nature of pediatric practice and increased efforts to emphasize the importance of behavior, learning and MH, the pediatric community appears to be making little progress toward providing for the long-term behavioral, learning and MH needs of children and adolescents in its care. PMID:26514649

Strengthening the Focus on Business Results: The Need for Systems Approaches in Organizational Behavior Management

ERIC Educational Resources Information Center

Hyten, Cloyd

2009-01-01

Current Organizational Behavior Management (OBM) research and practice may be characterized as either behavior focused or results focused. These two approaches stem from different origins and have different characteristics. The behavior-focused approach stems from applied behavior analysis (ABA) methods and emphasizes direct observation of and…

CWLA Best Practice Guidelines: Behavior Management.

ERIC Educational Resources Information Center

Child Welfare League of America, Inc., Washington, DC.

In the context of a national discussion regarding behavior management in child and youth care settings, and in an effort to address the need to care safely and appropriately for children and youth, the Child Welfare League of America (CWLA) formed the National Task Force on Behavior Management. The task force includes representatives of advocacy…

A Middle-Range Explanatory Theory of Self-Management Behavior for Collaborative Research and Practice.

PubMed

Blok, Amanda C

2017-04-01

To report an analysis of the concept of self-management behaviors. Self-management behaviors are typically associated with disease management, with frequent use by nurse researchers related to chronic illness management and by international health organizations for development of disease management interventions. A concept analysis was conducted within the context of Orem's self-care framework. Walker and Avant's eight-step concept analysis approach guided the analysis. Academic databases were searched for relevant literature including CIHAHL, Cochrane Databases of Systematic Reviews and Register of Controlled Trials, MEDLINE, PsycARTICLES and PsycINFO, and SocINDEX. Literature using the term "self-management behavior" and published between April 2001 and March 2015 was analyzed for attributes, antecedents, and consequences. A total of 189 journal articles were reviewed. Self-management behaviors are defined as proactive actions related to lifestyle, a problem, planning, collaborating, and mental support, as well as reactive actions related to a circumstantial change, to achieve a goal influenced by the antecedents of physical, psychological, socioeconomic, and cultural characteristics, as well as collaborative and received support. The theoretical definition and middle-range explanatory theory of self-management behaviors will guide future collaborative research and clinical practice for disease management. © 2016 Wiley Periodicals, Inc.

Trauma Focused CBT for Children with Co-Occurring Trauma and Behavior Problems

ERIC Educational Resources Information Center

Cohen, Judith A.; Berliner, Lucy; Mannarino, Anthony

2010-01-01

Objective: Childhood trauma impacts multiple domains of functioning including behavior. Traumatized children commonly have behavioral problems that therapists must effectively evaluate and manage in the context of providing trauma-focused treatment. This manuscript describes practical strategies for managing behavior problems in the context of…

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.

PubMed

Montesano, Vicki L; Sivec, Harry J; Munetz, Mark R; Pelton, Jeremy R; Turkington, Douglas

2014-03-01

The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

Behavioral self-management strategies for practice and exercise should be included in neurologic rehabilitation trials and care

PubMed Central

Dobkin, Bruce H.

2018-01-01

Purpose Rehabilitation trials and post-acute care to lessen impairments and disability after stroke, spinal cord injury, and traumatic brain injury almost never include training to promote long-term self-management of skills practice, strengthening and fitness. Without behavioral training to develop self-efficacy, clinical trials and home-based therapy may fail to show robust results. Findings Behavioral theories about self-management and self-efficacy for physical activity have been successfully incorporated into interventions for chronic diseases, but rarely for neurologic rehabilitation. The elements of behavioral training include education about the effects of practice and exercise that are relevant to the person, goal setting, identification of possible barriers, problem solving, feedback about performance, tailored instruction, decision making, and ongoing personal or social support. Mobile health and tele-rehabilitation technologies offer new ways to remotely enable such training by monitoring activity from wearable wireless sensors and instrumented exercise devices to allow real-world feedback, goal setting, and instruction. Summary Motivation, sense of responsibility and confidence to practice and exercise in the home can be trained to increase adherence to skills practice and exercise both during and after formal rehabilitation. To optimize motor learning and improve long-term outcomes, self-management training should be an explicit component of rehabilitation care and clinical trials. PMID:27608301

Use of Coaching and Behavior Support Planning for Students with Disruptive Behavior within a Universal Classroom Management Program

ERIC Educational Resources Information Center

Reinke, Wendy M.; Stormont, Melissa; Herman, Keith C.; Wang, Ze; Newcomer, Lori; King, Kathleen

2014-01-01

Even with the use of effective universal classroom management practices, some students will need additional behavioral supports. However, to translate implementation of new strategies into the classroom, professional development programs need to be adaptive to the complexities teachers face in providing instruction and managing classroom behaviors…

Are person-related and socio-structural factors associated with nurses' self-management support behavior? A correlational study.

PubMed

Duprez, Veerle; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann

2018-02-01

To explore nurses' self-perceived behavior of supporting patients' self-management, and its association with person-related and socio-structural factors. Correlational study in a sample of nurses from nine general hospitals, three community healthcare organizations, and six private community practices. Nurses with >50% of their patients living with a chronic condition were eligible to participate. Data were collected at two time-points. Self-management support behavior was measured by the SEPSS-36 instrument. The person-related and socio-structural associated factors were derived from behavioral theories and measured by validated questionnaires. Nurses (N=477) scored overall low on self-management support behavior. Nurses lacked mainly competencies in collaborative goalsetting, shared decision making and organizing follow-up. Factors predicting nurses' behavior in supporting patients' self-management were self-efficacy, priority, perceived supervisor support and training in self-management support. This model explained 51.7% of the variance in nurses' behavior. To date, nurses do not optimally fulfil their role in supporting patients' self-management. Self-management support is practiced from a narrow medical point of view and primarily consists of informing patients, which is the lowest level of patient participation. It is essential to better prepare and support nurses - and by extend all healthcare professionals - for the challenges of supporting patients' self-management. Copyright © 2017 Elsevier B.V. All rights reserved.

Alcohol Outlet Workers and Managers: Focus Groups on Responsible Service Practices.

ERIC Educational Resources Information Center

Gehan, John P.; Toomey, Traci L.; Jones-Webb, Rhonda; Rothstein, Catherine; Wagenaar, Alexander C.

1999-01-01

Reports on focus group discussions with managers, bartenders, waitstaff, and security staff of retail alcohol establishments. Purpose of the focus groups was to identify beliefs, attitudes, behaviors, and practices among management and staff to guide development of training programs. Results indicate that, compared to management, staff had…

Special Education Teacher Preparation in Classroom Management: Implications for Students with Emotional and Behavioral Disorders

ERIC Educational Resources Information Center

Oliver, Regina M.; Reschly, Daniel J.

2010-01-01

Special education teachers' skills with classroom organization and behavior management affect the emergence and persistence of behavior problems as well as the success of inclusive practice for students with emotional and behavioral disorders (EBD). Adequate special education teacher preparation and strong classroom organization and behavior…

The Keys to Managing Instruction and Behavior: Considering High Probability Practices

ERIC Educational Resources Information Center

Cooper, Justin T.; Scott, Terrance M.

2017-01-01

Academics and behavior are inextricably linked, and as such, management of behavior should be considered not as an addition to the teacher's repertoire of skills but as an integral foundational component of effective instruction. Paradoxically, teachers report that students with challenging behavior are both their greatest challenge and that…

The Relationship between Teachers' Implementation of Classroom Management Practices and Student Behavior in Elementary School

ERIC Educational Resources Information Center

Gage, Nicholas A.; Scott, Terrance; Hirn, Regina; MacSuga-Gage, Ashley S.

2018-01-01

Teachers' classroom management practices have a direct impact on their students' probability of success. Evidence-based classroom management practices include (a) active instruction and supervision of students (i.e., teaching), (b) opportunities for students to respond, and (c) feedback to students. In this study, we examined the degree to which…

Assessment of healthy behaviors for metabolic syndrome among Korean adults: a modified information-motivation-behavioral skills with psychological distress.

PubMed

Lee, Guna; Yang, Sook Ja; Chee, Yeon Kyung

2016-06-18

Since the worldwide incidence of metabolic syndrome (Mets) has rapidly increased, healthy behaviors such as weight control, engaging in physical activity, and healthy diet have been crucial in the management of Mets. The purpose of this study was to examine healthy behaviors practice and factors that affect the practice in relation to Mets on the basis of a modified Information-Motivation-Behavioral skills model (IMB) with psychological distress, which is a well-known factor affecting healthy behaviors among individuals with Mets. Study participants were 267 community dwelling adults (M age: 54.0 ± 8.1 years) with Mets who were attending public health centers located in Seoul, South Korea. A structured questionnaire was administered in the areas of information, motivation, behavioral skills, and practice of Mets healthy behaviors and levels of psychological distress from May 2014 to September 2014. Structural equation modeling was used to test the modified IMB model. The modified IMB model had a good fit with the data, indicating that motivation and behavioral skills directly influenced the practice of Mets healthy behaviors, whereas information and psychological distress directly influenced motivation and influenced the practice of healthy behaviors through behavioral skills. These components of the modified IMB model explained 29.8 % of the variance in healthy behaviors for Mets. Findings suggested that strengthening motivation and behavioral skills for healthy behaviors can directly enhance healthy behavior practice. Providing information about Mets related healthy behaviors and strategies for psychological distress management can be used as the first line evidence based intervention to systemically enhance motivation and behavioral skills among individuals with Mets.

Use of Online Self-Management Diaries in Asthma and COPD: A Qualitative Study of Subjects' and Professionals' Perceptions and Behaviors.

PubMed

van Kruijssen, Valerie; van Staa, AnneLoes; Dwarswaard, Jolanda; In 't Veen, Johannes Ccm; Mennema, Bianka; Adams, Samantha A

2015-08-01

Online self-management diaries are used to support patients' self-management skills and facilitate associated behavioral changes. Although web-based diaries are well-known as a potential self-management tool, reasons that patients use (or do not use) self-management diaries, as well as perceptions and behaviors related to diary use, remain largely unknown. Semistructured interviews (n = 30) were conducted with health-care professionals and subjects to understand perceptions and behaviors related to self-management diary use for asthma and COPD in 2 hospitals in Rotterdam, The Netherlands. Subjects in this study used self-management diaries to improve their knowledge of the disease, cope more consciously with their disease, feel in control, and discuss outcomes from the self-management diaries with their health-care professionals. Two subjects reported that they used the self-management diary to cope more effectively with their disease and recognized an exacerbation and acted by adjusting their medications. Both health-care professionals and subjects experienced practical barriers in integrating self-management diaries into their regular practices. Subjects' reasons for nonuse were related to the intervention, the disease, and subject-provider contact. Health-care professionals should help patients use self-management diaries by collaboratively developing an individual treatment plan and by showing patients how to use the diaries to recognize and act on an exacerbation. Together with the suggestions made for improving the self-management diaries, this will aid in the integration of self-management diaries into regular health-care practice and enhance patients' self-management of their disease. Copyright © 2015 by Daedalus Enterprises.

Changing personnel behavior to promote quality care practices in an intensive care unit

PubMed Central

Cooper, Dominic; Farmery, Keith; Johnson, Martin; Harper, Christine; Clarke, Fiona L; Holton, Phillip; Wilson, Susan; Rayson, Paul; Bence, Hugh

2005-01-01

The delivery of safe high quality patient care is a major issue in clinical settings. However, the implementation of evidence-based practice and educational interventions are not always effective at improving performance. A staff-led behavioral management process was implemented in a large single-site acute (secondary and tertiary) hospital in the North of England for 26 weeks. A quasi-experimental, repeated-measures, within-groups design was used. Measurement focused on quality care behaviors (ie, documentation, charting, hand washing). The results demonstrate the efficacy of a staff-led behavioral management approach for improving quality-care practices. Significant behavioral change (F [6, 19] = 5.37, p < 0.01) was observed. Correspondingly, statistically significant (t-test [t] = 3.49, df = 25, p < 0.01) reductions in methicillin-resistant Staphylococcus aureus (MRSA) were obtained. Discussion focuses on implementation issues. PMID:18360574

Professionalism in Residency Training

PubMed Central

Gronowski, Ann M.; McGill, Mitchell R.

2016-01-01

Professionalism is one of the most important competencies for physicians but is also the most difficult to teach, assess, and manage. To better understand professionalism in pathology, we surveyed practicing pathologists and pathology residents and fellows in training. We identified 12 key desirable attributes of professionalism. In addition, 8 case scenarios highlighting unprofessional behavior were presented, and results between pathologists in practice and in training were compared. No significant differences between attending pathologists and residents were identified in how these cases should be managed. Our study demonstrated remarkable concordance between practicing pathologists and residents as to what constitutes professionalism and how to manage unprofessional behavior. Our case-based approach can be a useful technique to teach professionalism to both pathologists in practice and in training. PMID:28725778

Training Behavioral Healthcare Professionals: Higher Learning in the Era of Managed Care. Jossey-Bass Managed Behavioral Healthcare Library.

ERIC Educational Resources Information Center

Schuster, James M., Ed.; Lovell, Mark R., Ed.; Trachta, Anthony M., Ed.

How can clinicians receive the necessary training and information to take on the challenges and opportunities of working in the real world of today's managed healthcare? Focusing on working within the realities of managed care, this volume provides resources and ideas for integrating training on the practicalities of managed care into mental…

Classroom Management Strategies and Behavioral Interventions to Support Academic Achievement

ERIC Educational Resources Information Center

Gilpatrick, Robin Sue Holzworth

2010-01-01

This mixed method project study identified the need for effective classroom management strategies to dissuade student noncompliant behavior and to ensure academic success for all students. Enhancing classroom management practices is vital to improved student achievement and teacher self-efficacy. Within a constructivist framework, it is critical…

[Discussion on logistics management of medical consumables].

PubMed

Deng, Sutong; Wang, Miao; Jiang, Xiali

2011-09-01

Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.

The Relationship between EFL Teachers' Beliefs and Actual Practices of Classroom Management

ERIC Educational Resources Information Center

Aliakbari, Mohammad; Heidarzad, Mohsen

2015-01-01

This study aimed at analyzing Iranian EFL teachers' beliefs toward classroom management and the relationship between teachers' beliefs and their actual practices of classroom management in regard with individual variables such as gender, education degree, and teaching experience. The data were collected using a behavior and instructional…

Communicating forest management science and practices through visualized and animated media approaches to community presentations: An exploration and assessment

Treesearch

Donald E. Zimmerman; Carol Akerelrea; Jane Kapler Smith; Garrett J. O' Keefe

2006-01-01

Natural-resource managers have used a variety of computer-mediated presentation methods to communicate management practices to diverse publics. We explored the effects of visualizing and animating predictions from mathematical models in computerized presentations explaining forest succession (forest growth and change through time), fire behavior, and management options...

Classroom Behaviour: A Practical Guide to Effective Teaching, Behaviour Management and Colleague Support.

ERIC Educational Resources Information Center

Rogers, William A.

This book explores the relationship between effective teaching, behavior management, discipline, and colleague support. After an introduction, "I Never Thought I'd Become a Teacher," eight chapters include: (1) "The Dynamics of Classroom Behavior" (how student and teacher behavior affect each other, and control for the purpose…

Diabetes Treatment as "Homework": Consequences for Household Knowledge and Health Practices in Rural Uganda

ERIC Educational Resources Information Center

Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.; Meyrowitsch, Dan W.; Whyte, Susan R.

2016-01-01

Background: Health professionals assign diabetes patients "homework" in that they give them instructions on how to manage diabetes, recognizing that most diabetes care takes place in the home setting. We studied how homework is practiced and whether knowledge and behavioral practices related to diabetes self-management diffuse from…

Predictors of Adolescents’ Health- promoting Behaviors Guided by Primary Socialization Theory

PubMed Central

Rew, Lynn; Arheart, Kristopher L.; Thompson, Sanna; Johnson, Karen

2013-01-01

Purpose The purpose of this study was to determine the influence of parents and peers on adolescents’ health-promoting behaviors, framed by Primary Socialization Theory. Design and Method Longitudinal data collected annually from 1,081 rural youth (mean age = 17 ±.7; 43.5% males; 44% Hispanic) and once from their parents were analyzed using generalized linear models. Results Parental monitoring and adolescent’s religious commitment significantly predicted all health-promoting behaviors (nutrition, physical activity, safety, health practices awareness, stress management). Other statistically significant predictors were parent’s responsiveness and health-promoting behaviors. Peer influence predicted safety and stress management. Practice Implications Nurses may facilitate adolescents’ development of health-promoting behaviors through family-focused interventions. PMID:24094123

Perceived risk and risk-taking behavior during the festival firework.

PubMed

Saadat, Soheil; Naseripour, Masoud; Karbakhsh, Mojgan; Rahimi-Movaghar, Vafa

2010-01-01

To investigate the relationship between perceived risk and risk-taking behaviors during the Iranian Last Wednesday Eve Fireworks (ILWEF). A random sample of 2475 Tehranian households were asked on perceived risk of injury, risk-taking behaviors, experience of injuries, and their perception of ability to manage the harmful events during the ILWEF. Lower perceived injury risk and higher perceived ability of managing an injured household member were associated with participation in fireworks practice and incidence of injury. These findings can be of practical importance to increase safety during festivals by improving risk perception in the community.

The Behavioral Health Role in Nursing Facility Social Work.

PubMed

Myers, Dennis R; Rogers, Robin K; LeCrone, Harold H; Kelley, Katherine

2017-09-01

Types of compromised resident behaviors licensed nursing facility social workers encounter, the behavioral health role they enact, and effective practices they apply have not been the subject of systematic investigation. Analyses of 20 in-depth interviews with Bachelor of Social Work (BSW)/Master of Social Work (MSW) social workers averaging 8.8 years of experience identified frequently occurring resident behaviors: physical and verbal aggression/disruption, passive disruption, socially and sexually inappropriateness. Six functions of the behavioral health role were care management, educating, investigating, preventing, mediating, and advocating. Skills most frequently applied were attention/affirmation/active listening, assessment, behavior management, building relationship, teamwork, and redirection. Narratives revealed role rewards as well as knowledge deficits, organizational barriers, personal maltreatment, and frustrations. Respondents offered perspectives and prescriptions for behavioral health practice in this setting. The findings expand understanding of the behavioral health role and provide an empirical basis for more research in this area. Recommendations, including educational competencies, are offered.

Enhancing the quality of supportive supervisory behavior in long-term care facilities.

PubMed

McGillis Hall, Linda; McGilton, Katherine S; Krejci, Janet; Pringle, Dorothy; Johnston, Erin; Fairley, Laura; Brown, Maryanne

2005-04-01

The practices of managers and registered nurses (RNs) in long-term care facilities are frequently ineffective in assisting the licensed practical nurses (LPNs) and healthcare aides (HCAs) whom they supervise. Little research exists that examines the area of supportive relationships between nursing staff and supervisors in these settings. The purpose of this study was to gather data that could improve management practices in long-term care residential facilities and enhance the quality of the supervisory relationships between supervisors (nurse managers and RNs) and care providers (HCAs and LPNs) in these settings. The study also identified factors that influence the supervisors' ability to establish supportive relationships with care providers. The challenges and barriers to nurse managers and leaders related to enacting supportive behaviors are discussed as well as their implications for long-term care settings.

Correlates of Body Mass Index, Weight Goals, and Weight-Management Practices among Adolescents

ERIC Educational Resources Information Center

Paxton, Raheem J.; Valois, Robert F.; Drane, J. Wanzer

2004-01-01

The study examined associations among physical activity, cigarette smoking, body mass index, perceptions of body weight, weight-management goals, and weight-management behaviors of public high school adolescents. The CDC Youth Risk Behavior Survey provided a cross-sectional sample (n = 3,089) of public high school students in South Carolina.…

Measuring Practicing and Prospective Elementary Teachers' Efficacy for Classroom Management: A Preliminary Development and Validation Study

ERIC Educational Resources Information Center

Putman, S. Michael

2013-01-01

Research has shown efficacy exerts a powerful influence on behavior. Classroom management represents one vehicle for demonstrations of these behaviors, yet few instruments focus solely on the measurement of this domain-specific form of efficacy. This research explored the relationship between teacher self-efficacy and classroom management through…

Development and Construct Validity of the Classroom Strategies Scale-Observer Form

ERIC Educational Resources Information Center

Reddy, Linda A.; Fabiano, Gregory; Dudek, Christopher M.; Hsu, Louis

2013-01-01

Research on progress monitoring has almost exclusively focused on student behavior and not on teacher practices. This article presents the development and validation of a new teacher observational assessment (Classroom Strategies Scale) of classroom instructional and behavioral management practices. The theoretical underpinnings and empirical…

Network Framing of Pest Management Knowledge and Practice

ERIC Educational Resources Information Center

Moore, Keith M.

2008-01-01

Conventional technology transfer is based on the assumption that autonomous individuals independently make behavioral decisions. In contrast, Actor-Network Theory (ANT) suggests that people and technologies are interconnected in ways that reinforce and reproduce some types of knowledge and consequent behavioral practices, but not others. Research…

Guided by Theory, Informed by Practice: Training and Support for the Good Behavior Game, a Classroom-based Behavior Management Strategy

PubMed Central

Poduska, Jeanne M.; Kurki, Anja

2015-01-01

Moving evidence-based practices for classroom behavior management into real-world settings is a high priority for education and public health. This paper describes the development and use of a model of training and support for the Good Behavior Game (GBG), one of the few preventive interventions shown to have positive outcomes for elementary school children lasting through to young adulthood, ages 19–21, including reductions in the use of drugs and alcohol, school-based mental health services, and suicide ideation and attempts. We first describe the conceptual framework guiding the development of the model of training and support. Data on implementation of the model, from an ongoing trial of GBG being conducted in partnership with the Houston Independent School District, are then presented. We end with a discussion of the lessons learned and the implications for the next stage of research and practice. PMID:26236144

Power Parenting for Children with ADD/ADHD: A Practical Parent's Guide for Managing Difficult Behaviors.

ERIC Educational Resources Information Center

Flick, Grad L.

The first step in dealing with an attention deficit disorder (ADD/ADHD) child's difficult behavior is to understand its origins. This book presents behavior management techniques to help parents care for their ADD child while ensuring that the child continues to develop positive, healthy self-esteem. The guide shows how to: (1) ensure an accurate…

Integrated Theory of Health Behavior Change

PubMed Central

RYAN, POLLY

2009-01-01

An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care. PMID:19395894

Preventing Challenging Behaviors in Preschool: Effective Strategies for Classroom Teachers

ERIC Educational Resources Information Center

Coleman, Janelle C.; Crosby, Megan G.; Irwin, Heather K.; Dennis, Lindsay R.; Simpson, Cynthia G.; Rose, Chad A.

2013-01-01

This article provides practical strategies and techniques that early childhood educators can implement in their classrooms to effectively manage challenging behaviors. The specific strategies addressed fall under the following categories: (a) classroom management, (b) reinforcement, and (c) communication. Suggestions are made for how parents can…

Does Length of Developmental Behavioral Pediatrics Training Matter?

PubMed

Stein, Ruth E K; Storfer-Isser, Amy; Kerker, Bonnie D; Garner, Andrew; Szilagyi, Moira; Hoagwood, Kimberly E; O'Connor, Karen G; Green, Cori M; Horwitz, Sarah McCue

Since 1997 pediatric residencies have been required to provide a 4-week block rotation in developmental and behavioral pediatrics (DBP), but it is not known whether this has altered the care and management of children by practicing pediatricians. The objective of this study was to compare the self-reported practice patterns of pediatricians who were trained with 4 or more weeks of DBP with the practice patterns of those who were trained for <4 weeks. We used self-reported practices from the American Academy of Pediatrics Periodic Survey 85. Pediatricians were asked whether they never, sometimes, or usually inquired about and screened for, and whether they treated/managed/comanaged attention deficit hyperactivity disorder, depression, anxiety, behavior problems and learning problems. They were also asked about a series of barriers to care. Analyses were weighted to account for low response rates. Those with more DBP training were significantly more likely to treat/manage/co-manage depression, anxiety, behavior problems and learning problems, but were still doing so less than one third of the time. There were no differences in the care of patients with attention deficit hyperactivity disorder or in screening or inquiring about mental health conditions. Those with more training were more likely to perceive somewhat fewer barriers and to report more specific familiarity with some Diagnostic and Statistical Manual of Mental Disorders criteria and some treatment modalities. Longer length of training is associated with more treatment, but significant deficits in self-reported practice remain, leaving much room for additional improvement in the training of clinicians in DBP. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Using Dust Assessment Technology to Leverage Mine Site Manager-Worker Communication and Health Behavior: A Longitudinal Case Study

PubMed Central

Haas, Emily J.; Cecala, Andrew B.; Hoebbel, Cassandra L.

2016-01-01

Research continues to investigate barriers to managing occupational health and safety behaviors among the workforce. Recent literature argues that (1) there is a lack of consistent, multilevel communication and application of health and safety practices, and (2) social scientific methods are absent when determining how to manage injury prevention in the workplace. In response, the current study developed and tested a multilevel intervention case study at two industrial mineral mines to help managers and workers communicate about and reduce respirable silica dust exposures at their mine sites. A dust assessment technology, the Helmet-CAM, was used to identify and encourage communication about potential problem areas and tasks on site that contributed to elevated exposures. The intervention involved pre- and post-assessment field visits, four weeks apart that included multiple forms of data collection from workers and managers. Results revealed that mine management can utilize dust assessment technology as a risk communication tool to prompt and communicate about healthier behaviors with their workforce. Additionally, when workers were debriefed with the Helmet-CAM data through the device software, the dust exposure data can help improve the knowledge and awareness of workers, empowering them to change subtle behaviors that could reduce future elevated exposures to respirable silica dust. This case study demonstrates that incorporating social scientific methods into the application of health and safety management strategies, such as behavioral modification and technology integration, can leverage managers’ communication practices with workers, subsequently improving health and safety behaviors. PMID:26807445

Robust manipulations of pest insect behavior using repellents and practical application for integrated pest management

USDA-ARS?s Scientific Manuscript database

In agricultural settings, examples of effective control strategies using repellent chemicals in integrated pest management (IPM) are relatively scarce compared to those using attractants. This may be partly due to a poor understanding of how repellents affect insect behavior once they are deployed. ...

Measuring farmer conservation behaviors: Challenges and best practices

Treesearch

Kristin Floress; Adam Reimer; Aaron Thompson; Mark Burbach; Cody Knutson; Linda Prokopy; Marc Ribaudo; Jessica Ulrich-Schad

2018-01-01

This article presents a guide for understanding the purposes and appropriate uses of different measures of conservation behavior. While applicable across natural resource management contexts, we primarily draw upon agricultural conservation research to illustrate our points. Farmers are often of interest to researchers, program managers, extension professionals, and...

Learning Organization Practices. [Concurrent Symposium Session at AHRD Annual Conference, 1998.

ERIC Educational Resources Information Center

1998

This document contains three papers from a symposium on learning organization practices. "The Beliefs of Managers as Facilitators of Learning in Learning Organizations" (Andrea D. Ellinger) reports selected findings from a qualitative study that examined the perceptions of managers regarding their beliefs, behaviors, triggers, and…

Practical Approaches for Identifying and Managing Abused and Neglected Children.

ERIC Educational Resources Information Center

Radford, Nola T.

1998-01-01

Discusses the exceptional challenges that abused and neglected children may pose for early-intervention providers, particularly speech-language pathologists. It focuses on practical strategies regarding reporting child abuse, effectively assessing the children who have been abused, and managing the bizarre behavior they may exhibit. (Author/CR)

Preschool Teachers' Beliefs, Knowledge, and Practices Related to Classroom Management

ERIC Educational Resources Information Center

Drang, Debra Michal

2011-01-01

This study examined preschool teachers' beliefs, knowledge, and practices related to classroom management. The rationale for researching this topic is based on the role of teachers in the special education referral process, the poor success rate for inclusion for children with disabilities who demonstrate problematic classroom behaviors, and the…

Employee bad behavior: selected thoughts and strategies.

PubMed

Reinholz, Becky; Cash, Jimmie K; Kupperschmidt, Betty

2009-01-01

In summary, bad behavior is prevalent in many acute care settings. Kupperschmidt (2006) once asked if it would take a mandate from a regulatory agency to get nurses to address horizontal hostility. Perhaps the answer to that question is "Yes" and we now have that mandate. Nursing Managers and Executives are challenged to demonstrate competence in effective behavior management. Role modeling integrity by adherence to standards and governing policies motivates employees to follow such examples. Inspiring environments that allow professionals to share talents and skills in a "safe" culture of practice promotes healthy work environments and defines successful behavior management.

Food suppliers' perceptions and practical implementation of food safety regulations in Taiwan.

PubMed

Ko, Wen-Hwa

2015-12-01

The relationships between the perceptions and practical implementation of food safety regulations by food suppliers in Taiwan were evaluated. A questionnaire survey was used to identify individuals who were full-time employees of the food supply industry with at least 3 months of experience. Dimensions of perceptions of food safety regulations were classified using the constructs of attitude of employees and corporate concern attitude for food safety regulation. The behavior dimension was classified into employee behavior and corporate practice. Food suppliers with training in food safety were significantly better than those without training with respect to the constructs of perception dimension of employee attitude, and the constructs of employee behavior and corporate practice associated with the behavior dimension. Older employees were superior in perception and practice. Employee attitude, employee behavior, and corporate practice were significantly correlated with each other. Satisfaction with governmental management was not significantly related to corporate practice. The corporate implementation of food safety regulations by suppliers was affected by employees' attitudes and behaviors. Furthermore, employees' attitudes and behaviors explain 35.3% of corporate practice. Employee behavior mediates employees' attitudes and corporate practices. The results of this study may serve as a reference for governmental supervision and provide training guidelines for workers in the food supply industry. Copyright © 2015. Published by Elsevier B.V.

Challenges of managing child behavior in the 21st century dental setting.

PubMed

Sheller, Barbara

2004-01-01

This paper discussed factors influencing behavior management of the child dental patient. Pediatric dentists are affected by changes in: (1) society; (2) marketing and media; (3) communications and technology; and (4) parenting practices. Behavior of pediatric patients reflects fewer boundaries, less discipline and self-control, and lowered behavioral expectations by parents and contemporary culture. The insurance industry, regulatory bodies, legal system, dental staff, and pediatric dentist education are other influences on behavior management. Responses of the American Academy of Pediatric Dentistry (AAPD), which could support the pediatric dentist in the changing environment, include: (1) research; (2) continuing education for staff and dentists; (3) development of Internet accessible materials for the public; (4) legislative activity; (5) partnering with pediatric medicine to develop new behavior management strategies; (6) establishment of an AAPD Council on Child Behavior; and (7) ongoing critical reassessment of behavior issues by the AAPD.

Managing the Cycle of Meltdowns for Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Colvin, Geoff; Sheehan, Martin R.

2012-01-01

This book outlines practical steps for preventing and responding to the various phases of meltdown behavior in students with Autism Spectrum Disorder. Based on Geoff Colvin's best-selling book, "Managing the Cycle of Acting Out Behavior in the Classroom," this practitioner-friendly guide provides special and general education teachers of autistic…

Perceptions of Using Number Patterns to Manage Behaviors in Students with Autism

ERIC Educational Resources Information Center

Thomas, Miriam

2012-01-01

Studies have documented that an escalation in the phenomenon of aggression in autistic students reduces the potential for successful social inclusion. This qualitative case study examined the perceptions of certified professionals in education regarding implementing number patterns as a best practice to manage aggressive behaviors of students with…

Managing Race and Race-ing Management: Teachers' Stories of Race and Classroom Conflict

ERIC Educational Resources Information Center

Deckman, Sherry L.

2017-01-01

Background/Context: Research exploring suspension and expulsion practices suggests that teachers may play a key role in perpetuating racial disproportionality in school discipline by interpreting student behavior through racialized and racist lenses and by viewing the behavior of students of color as an affront to their authority, resulting in…

Complementary Roles of Care and Behavioral Control in Classroom Management: The Self-Determination Theory Perspective

ERIC Educational Resources Information Center

Nie, Youyan; Lau, Shun

2009-01-01

This study examined how classroom management practices--care and behavioral control--were differentially associated with students' engagement, misbehavior, and satisfaction with school, using a large representative sample of 3196 Grade 9 students from 117 classes in Singapore. Results of hierarchical linear modeling showed differential relations.…

Quality assessment of practice nurse communication with type 2 diabetes patients.

PubMed

Mulder, Bob C; van Belzen, Milou; Lokhorst, Anne Marike; van Woerkum, Cees M J

2015-02-01

Nurse self-management support for type 2 diabetes patients may benefit from applying theory-based behavior change counseling. The 5As model was used to assess if, and how, nurses applied the five key elements of self-management support in standard care. Seven practice nurses audio-recorded consultations with 66 patients. An existing instrument for assessing counseling quality was used to determine if the 5As were applied. Applied As were compared with quality criteria, to provide an in-depth assessment. In almost every consultation, nurses assessed health behaviors, and arranged a follow-up meeting. However, nurses advised behavior change in less than half of the consultations, while setting goals and assisting patients to overcome barriers were used even less. Comparing applied As with quality criteria revealed several issues that could be improved. Nurses consistently discussed health behaviors with patients, but important elements of self-management support were not applied. Self-management support may benefit from training nurses in performing assessments that form the base for specific advice, setting goals, and addressing barriers to behavior change. Nurses also have to learn how to combine being medical expert and behavioral counselor. Clarifying both roles to patients may facilitate communication and establishing a collaborative relationship. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Reducing Behavior Problems Among Students with Autism Spectrum Disorder: Coaching Teachers in a Mixed-Reality Setting.

PubMed

Pas, Elise T; Johnson, Stacy R; Larson, Kristine E; Brandenburg, Linda; Church, Robin; Bradshaw, Catherine P

2016-12-01

Most approaches aiming to reduce behavior problems among youth with Autism Spectrum Disorder (ASD) focus on individual students; however, school personnel also need professional development to better support students. This study targeted teachers' skill development to promote positive outcomes for students with ASD. The sample included 19 teachers in two non-public special education settings serving students with moderate to severe ASD. Participating teachers received professional development and coaching in classroom management, with guided practice in a mixed-reality simulator. Repeated-measures ANOVAs examining externally-conducted classroom observations revealed statistically significant improvements in teacher management and student behavior over time. Findings suggest that coaching and guided practice in a mixed-reality simulator is perceived as acceptable and may reduce behavior problems among students with ASD.

Enhancing Self-Efficacy for Optimized Patient Outcomes through the Theory of Symptom Self-Management

PubMed Central

Hoffman, Amy J.

2012-01-01

Background In today’s world, greater patient empowerment is imperative since 90 million Americans live with one or more chronic conditions such as cancer. Evidence reveals that healthy behaviors such as effective symptom self-management can prevent or reduce much of the suffering from cancer. Oncology nurses play a pivotal role in developing a symptom self-management plan that is critical to optimizing a patient’s symptom self-management behaviors. Objective This article uses exemplars to describe how oncology nurses can apply a tested middle-range theory, the Theory of Symptom Self-Management, to clinical practice by incorporating interventions to increase a patient’s perceived self-efficacy to optimize patient outcomes. Methods The Theory of Symptom Self-Management provides a means to understand the dynamic aspects of symptom self-management and provides a tested framework for the development of efficacy enhancing interventions for use by oncology nurses in clinical practice. Results Exemplars based on the Theory of Symptom Self-Management that depict how oncology nursing can use perceived self-efficacy enhancing symptom self-management interventions to improve the functional status and quality of life of their patients. Conclusion Guided by a theoretical approach, oncology nurses can have a significant positive impact on the lives of their patients by reducing the symptom burden associated with cancer and its treatment. Implications for Practice Oncology nurses can partner with their patients to design tailored approaches to symptom self-management. These tailored approaches provide the ability to implement patient specific behaviors that recognize, prevent, relieve, or decrease the timing, intensity, distress, concurrence, and unpleasant quality of symptoms. PMID:22495550

Effects of PMTO in Foster Families with Children with Behavior Problems: A Randomized Controlled Trial.

PubMed

Maaskant, Anne M; van Rooij, Floor B; Overbeek, Geertjan J; Oort, Frans J; Arntz, Maureen; Hermanns, Jo M A

2017-01-01

The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4-12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children's behavior problems are challenging for foster parents and increase the risk of placement breakdown. There is little evidence for the effectiveness of established interventions to improve child and parent functioning in foster families. The goal of Parent Management Training Oregon, a relatively long and intensive (6-9 months, with weekly sessions) parent management training, is to reduce children's problem behavior through improvement of parenting practices. We specifically investigated whether Parent Management Training Oregon is effective to reduce foster parenting stress. A significant effect of Parent Management Training Oregon, compared to Care as Usual was expected on reduced parenting stress improved parenting practices, and on reduced child behavior problems. Multi-informant (foster mothers, foster fathers, and teachers) data were used from 86 foster families (46 Parent Management Training Oregon, 40 Care as Usual) using a pre-posttest design. Multilevel analyses based on the intention to treat principle (retention rate 73 %) showed that Parent Management Training Oregon, compared to Care as Usual, reduced general levels of parenting stress as well as child related stress and parent-related stress (small to medium effect sizes). The clinical significance of this effect was, however, limited. Compared to a decrease in the Care as Usual group, Parent Management Training Oregon helped foster mothers to maintain parental warmth (small effect size). There were no other effects of Parent Management Training Oregon on self-reported parenting behaviors. Child behavior problems were reduced in both conditions, indicating no additive effects of Parent Management Training Oregon to Care as Usual on child functioning. The potential implication of reduced foster parenting stress for placement stability is discussed.

Practicing participative management in the clinical laboratory. Foster a productive and satisfying staff.

PubMed

Boissoneau, R; McPherson, J

1991-01-01

Employee participation and involvement are at the leading edge of management thinking today. Not only behaviorally oriented managers, but managers of all styles include personnel in decision-making. The purpose of this article is to communicate to clinical laboratory managers some recent developments in people management. Several suggestions for team building and the desired outcome of worker participation are included. Although employee participation has been a major issue in management for 10 years, many business schools still emphasize only the traditional quantitative subjects of accounting, finance, statistics, and systems engineering. Obviously, these subjects are important, but modern managers must learn qualitative or behavioral material as well. Students are affected by the lack of a notable behavioral emphasis. Unfortunately, some students think that learning in the behavioral domain is unimportant. Too often, these students encounter problems later in their careers with employees and can only wish for greater knowledge.

Reflecting on Hospitality Management Education through a Practice Lens

ERIC Educational Resources Information Center

Stierand, Marc; Zizka, Laura

2015-01-01

Purpose: The purpose of this paper is to reflect on hospitality management education from a "practice epistemology" and discuss how a connecting of savoir (theoretical knowledge or "knowing"), savoir-faire (knowing how to do tasks, i.e. task-related skills) and savoir-être (knowing how to be, i.e. behavior) can develop into…

Academic Practices to Gain and Maintain Student-Teacher Connectedness and Classroom Behavioral Management, Related to Educator Demographics

ERIC Educational Resources Information Center

Kendall, Leslie Threadgill

2015-01-01

Connectedness and classroom management has been defined as the ability to relate to students and keep order and maintain successful relationships with individuals. This qualitative study utilized surveys, questionnaires, interviews, and observations to examine the best practices implemented by educators to develop and maintain connections with…

Teacher Behavioral Practices: Relations to Student Risk Behaviors, Learning Barriers, and School Climate

ERIC Educational Resources Information Center

Martinez, Andrew; Mcmahon, Susan D.; Coker, Crystal; Keys, Christopher B.

2016-01-01

Student behavioral problems pose a myriad of challenges for schools. In this study, we examine the relations among teacher and school-level constructs (i.e., teacher collaboration, supervision/discipline, instructional management), and student-related outcomes (i.e., high-risk behaviors, barriers to learning, student social-behavioral climate).…

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

PubMed Central

Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

2014-01-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol.

PubMed

Hogue, Aaron; Bobek, Molly; Tau, Gregory Z; Levin, Frances R

2014-10-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.

Domestic food practices: A study of food management behaviors and the role of food preparation planning in reducing waste.

PubMed

Romani, Simona; Grappi, Silvia; Bagozzi, Richard P; Barone, Ada Maria

2018-02-01

Recent research has started to show the key role of daily food provision practices in affecting household food waste. Building on and extending these previous contributions, the objective of this paper is to investigate how individuals' everyday practices regarding food (e.g., shopping, cooking, eating, etc.) lead to food waste, and how policy makers and the food industry can implement effective strategies to influence such practices and ultimately help consumers reduce food waste. The research performs three Studies; a critical incident qualitative study (Study 1; N = 514) and a quantitative, survey-based study (Study 2; N = 456) to identify and examine relevant food management behaviors associated with domestic waste. Lastly, findings from a field experiment (Study 3; N = 210) suggest that a specific educational intervention, directed at increasing consumers' perceived skills related to food preparation planning behaviors, reduces domestic food waste. Implications of the research for policy makers and the food industry are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ending disruptive behavior: staff nurse recommendations to nurse educators.

PubMed

Lux, Kathleen M; Hutcheson, Jane B; Peden, Ann R

2014-01-01

The purpose of this qualitative descriptive study was to identify educational strategies that can prepare new graduates to manage disruptive behavior (DB) in the workplace. DB is any inappropriate behavior, confrontation, or conflict - ranging from verbal abuse to sexual harassment - that harms or intimidates others to the extent that quality of care or patient safety could be compromised. Individual interviews were conducted with nine staff nurses currently in practice in acute care settings in the United States. Staff nurses recommended educational strategies that focused on communication skills for professional practice. These included learning how to communicate with hostile individuals, and giving and receiving constructive criticism. Descriptions that participants provided about their work culture were an unexpected finding that has relevance for nurse educators as they prepare students for transition to practice Nurses described lack of management support and intervention for DB situations, personality clashes with coworkers, and devaluation of nursing work as affecting professional practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Integrating a family-focused approach into child obesity prevention: Rationale and design for the My Parenting SOS study randomized control trial

PubMed Central

2011-01-01

Background More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. Methods This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. Discussion Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. Trial Registration ClinicalTrials.gov: NCT00998348 PMID:21639940

Development and construct validity of the Classroom Strategies Scale-Observer Form.

PubMed

Reddy, Linda A; Fabiano, Gregory; Dudek, Christopher M; Hsu, Louis

2013-12-01

Research on progress monitoring has almost exclusively focused on student behavior and not on teacher practices. This article presents the development and validation of a new teacher observational assessment (Classroom Strategies Scale) of classroom instructional and behavioral management practices. The theoretical underpinnings and empirical basis for the instructional and behavioral management scales are presented. The Classroom Strategies Scale (CSS) evidenced overall good reliability estimates including internal consistency, interrater reliability, test-retest reliability, and freedom from item bias on important teacher demographics (age, educational degree, years of teaching experience). Confirmatory factor analyses (CFAs) of CSS data from 317 classrooms were carried out to assess the level of empirical support for (a) a 4 first-order factor theory concerning teachers' instructional practices, and (b) a 4 first-order factor theory concerning teachers' behavior management practice. Several fit indices indicated acceptable fit of the (a) and (b) CFA models to the data, as well as acceptable fit of less parsimonious alternative CFA models that included 1 or 2 second-order factors. Information-theory-based indices generally suggested that the (a) and (b) CFA models fit better than some more parsimonious alternative CFA models that included constraints on relations of first-order factors. Overall, CFA first-order and higher order factor results support the CSS-Observer Total, Composite, and subscales. Suggestions for future measurement development efforts are outlined. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Integrating a family-focused approach into child obesity prevention: rationale and design for the My Parenting SOS study randomized control trial.

PubMed

Ward, Dianne S; Vaughn, Amber E; Bangdiwala, Kant I; Campbell, Marci; Jones, Deborah J; Panter, Abigail T; Stevens, June

2011-06-05

More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. ClinicalTrials.gov: NCT00998348.

Physical aggressive resident behavior during hygienic care.

PubMed

Farrell Miller, M

1997-05-01

Management of aggressive behavior has been identified as a concern for nursing staff who provide institutional care for cognitively impaired elderly. The Omnibus Reconciliation Act (OBRA '87) mandates a trial reduction in the use of chemical and physical restraints, and the development of nursing interventions for the management of behavioral disorders of institutionalized cognitively impaired elderly. Most skilled nursing facilities, however, are limited in their ability to provide environmental and behavioral programs to manage aggressive patient behavior. For the purposes of this study, physically aggressive behavior was identified as threatened or actual aggressive patient contact which has taken place between a patient and a member of the nursing staff. This study explored the nursing staff's responses to patient physical aggression and the effects that physical aggression had on them and on nursing practice from the perspective of the nursing staff. Nursing staff employed on one Dementia Special Care Unit (DSCU) were invited to participate. Interviews with nursing staff were analyzed using qualitative descriptive methods described by Miles and Huberman (1994). Nursing staff reported that they were subjected to aggressive patient behaviors ranging from verbal threats to actual physical violence. Nursing staff reported that showering a resident was the activity of daily living most likely to provoke patient to staff physical aggression. The findings revealed geropsychiatric nursing practices for the management of physically aggressive residents, and offered recommendations for improving the safety of nursing staff and residents on a secured DSCU.

Insurers' policies on coverage for behavior management services and the impact of the Affordable Care Act.

PubMed

Edelstein, Burton L

2014-01-01

The impact of the Affordable Care Act (ACA) on dental insurance coverage for behavior management services depends upon the child's source of insurance (Medicaid, CHIP, private commercial) and the policies that govern each such source. This contribution describes historical and projected sources of pediatric dental coverage, catalogues the seven behavior codes used by dentists, compares how often they are billed by pediatric and general dentists, assesses payment policies and practices for behavioral services across coverage sources, and describes how ACA coverage policies may impact each source. Differences between Congressional intent to ensure comprehensive oral health services with meaningful consumer protections for all legal-resident children and regulatory action by the Departments of Treasury and Health and Human Services are explored to explain how regulations fail to meet Congressional intent as of 2014. The ACA may additionally impact pediatric dentistry practice, including dentists' behavior management services, by expanding pediatric dental training and safety net delivery sites and by stimulating the evolution of novel payment and delivery systems designed to move provider incentives away from procedure-based payments and toward health outcome-based payments.

Social Role Theory and Social Role Valorization for Care Management Practice.

PubMed

Blakely, Thomas J; Dziadosz, Gregory M

2015-01-01

This article proposes that social role theory (SRT) and social role valorization (SRV) be established as organizing theories for care managers. SRT is a recognized sociological theory that has a distinctive place in care management practice. SRV is an adjunct for SRT that focuses on people who are devalued by being in a negative social position and supports behavior change and movement to a valued social position.

The self-reported clinical practice behaviors of Australian optometrists as related to smoking, diet and nutritional supplementation.

PubMed

Downie, Laura Elizabeth; Keller, Peter Richard

2015-01-01

The primary aim of this study was to examine the self-reported, routine clinical practice behaviors of Australian optometrists with respect to advice regarding smoking, diet and nutritional supplementation. The study also sought to assess the potential influence of practitioner age, gender, practice location (major city versus regional), therapeutic-endorsement status and personal nutritional supplementation habits upon management practices in these areas. A survey was electronically distributed to Australian optometrists (n = 4,242). Respondents anonymously provided information about their personal demographics and lifestyle behaviors (i.e., age, gender, practice location, therapeutic-endorsement status, smoking status, nutritional supplement intake) and routine patient management practices with respect to advice across three domains: smoking, diet and nutritional supplementation. Multivariate logistic regression analyses were performed to assess for potential effects of the listed factors on practitioner behavior. A total of 283 completed surveys were received (completed survey response rate: 6.7%). Fewer than half of respondents indicated routinely asking their patients about smoking status. Younger practitioners were significantly (p < 0.05) less likely to enquire about patients' smoking behaviors, but this did not extend to counseling for smoking cessation. Almost two-thirds of respondents indicated routinely counseling patients about diet. About half of practitioners specified routinely asking their patients about nutritional supplement intake; this form of questioning was significantly more likely if the respondent was female (p < 0.05). Practitioners who recommended nutritional supplements most commonly did so for age-related macular degeneration (91.2%) and dry eye disease (63.9%). The primary source of evidence used to guide practitioners' nutrition-related patient management was reported to be peer-reviewed publications. These findings demonstrate that there are no clear predictors of practitioner behavior across the three domains. Overall, this study suggests that there is scope for Australian optometrists to improve their routine engagement by questioning patients, as well as providing evidence-based clinical advice, about smoking status, diet and nutritional supplement behaviors, being key modifiable lifestyle risk factors with long-term implications for eye health.

The Self-Reported Clinical Practice Behaviors of Australian Optometrists as Related to Smoking, Diet and Nutritional Supplementation

PubMed Central

Downie, Laura Elizabeth; Keller, Peter Richard

2015-01-01

Objective The primary aim of this study was to examine the self-reported, routine clinical practice behaviors of Australian optometrists with respect to advice regarding smoking, diet and nutritional supplementation. The study also sought to assess the potential influence of practitioner age, gender, practice location (major city versus regional), therapeutic-endorsement status and personal nutritional supplementation habits upon management practices in these areas. Methods A survey was electronically distributed to Australian optometrists (n = 4,242). Respondents anonymously provided information about their personal demographics and lifestyle behaviors (i.e., age, gender, practice location, therapeutic-endorsement status, smoking status, nutritional supplement intake) and routine patient management practices with respect to advice across three domains: smoking, diet and nutritional supplementation. Multivariate logistic regression analyses were performed to assess for potential effects of the listed factors on practitioner behavior. Results A total of 283 completed surveys were received (completed survey response rate: 6.7%). Fewer than half of respondents indicated routinely asking their patients about smoking status. Younger practitioners were significantly (p < 0.05) less likely to enquire about patients’ smoking behaviors, but this did not extend to counseling for smoking cessation. Almost two-thirds of respondents indicated routinely counseling patients about diet. About half of practitioners specified routinely asking their patients about nutritional supplement intake; this form of questioning was significantly more likely if the respondent was female (p < 0.05). Practitioners who recommended nutritional supplements most commonly did so for age-related macular degeneration (91.2%) and dry eye disease (63.9%). The primary source of evidence used to guide practitioners’ nutrition-related patient management was reported to be peer-reviewed publications. Conclusions These findings demonstrate that there are no clear predictors of practitioner behavior across the three domains. Overall, this study suggests that there is scope for Australian optometrists to improve their routine engagement by questioning patients, as well as providing evidence-based clinical advice, about smoking status, diet and nutritional supplement behaviors, being key modifiable lifestyle risk factors with long-term implications for eye health. PMID:25886641

A Preliminary Investigation of Using School-Based Coaches to Support Intervention Fidelity of a Classwide Behavior Management Program

ERIC Educational Resources Information Center

Gilmour, Allison F.; Wehby, Joseph H.; McGuire, Terrell M.

2017-01-01

Many schools are beginning to implement universal behavior management interventions as part of multitiered systems of support. Past research suggests that teachers need support to implement new practices with fidelity. Coaching is one method for supporting implementation, but little is understood about how coaching takes place when relying on…

Associations among unit leadership and unit climates for implementation in acute care: a cross-sectional study.

PubMed

Shuman, Clayton J; Liu, Xuefeng; Aebersold, Michelle L; Tschannen, Dana; Banaszak-Holl, Jane; Titler, Marita G

2018-04-25

Nurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units. A multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05. Two hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit (p < .05) were significant but level of nursing education was not. Nurse managers are significantly related to unit climates for EBP implementation primarily through their leadership behaviors. Future implementation studies should consider the leadership of nurse managers in creating climates supportive of EBP implementation.

Managing the star performer.

PubMed

Hills, Laura

2013-01-01

Our culture seems to be endlessly fascinated with its stars in entertainment, athletics, politics, and business, and holds fast to the idea that extraordinary talent accounts for an individual's extraordinary performance. At first glance, managing a star performer in your medical practice may seem like it would be an easy task. However, there's much more to managing a star performer than many practice managers realize. The concern is how to keep the star performer happy and functioning at a high level without detriment to the rest of the medical practice team. This article offers tips for practice managers who manage star performers. It explores ways to keep the star performer motivated, while at the same time helping the star performer to meld into the existing medical practice team. This article suggests strategies for redefining the star performer's role, for holding the star performer accountable for his or her behavior, and for coaching the star performer. Finally, this article offers practical tips for keeping the star performer during trying times, for identifying and cultivating new star performers, and for managing medical practice prima donnas.

A Study of the Relationship between Middle School and High School Teachers Instructional and Behavior Management Practices and Demographic Variables

ERIC Educational Resources Information Center

Santiago, Deborah Albright

2012-01-01

Although teachers implement differentiated instructional techniques to provide students with enriching hands-on activities related to real life experiences, the implementation of instructional techniques has required teachers to rethink and revise their approaches to classroom management (CM). While a gap in research exists on current practices in…

Treating youths with selective mutism with an alternating design of exposure-based practice and contingency management.

PubMed

Vecchio, Jennifer; Kearney, Christopher A

2009-12-01

Selective mutism is a severe childhood disorder involving failure to speak in public situations in which speaking is expected. The present study examined 9 youths with selective mutism treated with child-focused, exposure-based practices and parent-focused contingency management via an alternating treatments design. Broadband measures of functioning were employed, but particular focus was made on behavioral assessment of words spoken audibly and daily in public situations. Treatment ranged from 8 to 32 sessions and resulted in positive end-state functioning for 8 of 9 participants. Broader analyses indicated greater effectiveness for exposure-based practice than contingency management. The results support recent case reports of behavioral treatment for this population but in more rigorous fashion. Clinical and research challenges are discussed, including caveats about length and intensity of treatment for this population and need to develop standardized daily measures.

[The institutional promotion of good practices in the operational management of health and safety: the experience of Italy Crown Aerosols on the monitoring of behavior].

PubMed

de Merich, D; Pellicci, M; Serignoli, R

2010-01-01

Within the intelligence support and training to small and medium-sized enterprises (SMEs) and promoting a culture of health and safety at work, ISPESL is engaged on two fundamental pillars of activity: Consolidation of the national surveillance system of injuries through the promotion of methods and tools for the reconstruction of the dynamics incidental identification of causal determinants, with the aim of improving the capabilities of risk assessment of systems to prevent corporate. The promotion of good working practices, as Focal Point of the European Health and Safety at Work in Bilbao, the goal is to support prevention activities by providing business application examples of measures for improvement (technical, organizational, procedural) made in the proposing firms and validated by a technical appraisal conducted by ISPESL. Among the methodologies and tools that can be made available to companies in the operational management of health and safety in work activities, the approach to analyze and evaluate the behavior implemented by all persons within the company (managers, employees, workers) is a the most innovative preventive strategies that can be implemented to correct any improper practices behavioral wrongly tolerated in everyday work practice. The experience of Crown Aerosol Italy, the program "STOP TO ACCIDENTS, 2009 Best Practices award in the competition on the theme" Risk Assessment ", aims to demonstrate how the application of a method for monitoring behavior at work, shared in its planning with all those business, has not only reached but would assist the organization has developed at an individual level greater awareness and sense of responsibility also to their colleagues, by promoting good working practices.

Lost in translation? Moving contingency management and cognitive behavioral therapy into clinical practice.

PubMed

Carroll, Kathleen M

2014-10-01

In the treatment of addictions, the gap between the availability of evidence-based therapies and their limited implementation in practice has not yet been bridged. Two empirically validated behavioral therapies, contingency management (CM) and cognitive behavioral therapy (CBT), exemplify this challenge. Both have a relatively strong level of empirical support but each has weak and uneven adoption in clinical practice. This review highlights examples of how barriers to their implementation in practice have been addressed systematically, using the Stage Model of Behavioral Therapies Development as an organizing framework. For CM, barriers such as cost and ideology have been addressed through the development of lower-cost and other adaptations to make it more community friendly. For CBT, barriers such as relative complexity, lack of trained providers, and need for supervision have been addressed via conversion to standardized computer-assisted versions that can serve as clinician extenders. Although these and other modifications have rendered both interventions more disseminable, diffusion of innovation remains a complex, often unpredictable process. The existing specialty addiction-treatment system may require significant reforms to fully implement CBT and CM, particularly greater focus on definable treatment goals and performance-based outcomes. © 2014 New York Academy of Sciences.

Ideas and Inspirations: Good News about Diabetes Prevention and Management in Indian Country

MedlinePlus

... Combined Councils Patient Education Primary Care Provider Risk Management Veteran Resources Community Health Behavioral Health Environmental Health ... Tools Diabetes Education Lesson Plan Outlines Integrating Case Management Into Your Practice [PDF – 290 KB] Integrating DSMES ...

Taking Care of You: Body, Mind, Spirit--A Unique Stress Management Program That Improves Lifestyle Behaviors

ERIC Educational Resources Information Center

Vetter-Smith, Molly; Massey, Vera; Rellergert, Linda; Wissmann, Mary

2014-01-01

Taking Care of You: Body, Mind, Spirit is a multi-session group program developed by University of Missouri Extension that provides a unique and practical approach to helping adults better managing their stress and bounce back from life's challenges while improving lifestyle behaviors. The program combines mindfulness and a variety of other…

Behavior Management Instructional Practices and Content of College/University Physical Education Teacher Education (PETE) Programs

ERIC Educational Resources Information Center

Lavay, Barry; Henderson, Hester; French, Ron; Guthrie, Sharon

2012-01-01

Background: Since 1969, the annual United States Educational Gallup Poll has reported the ability to manage behavior and motivate students as a major challenge for teachers and the primary reason why novice teachers leave the profession prematurely. Indeed, over one-third of all new teachers resign within three years due to this perceived…

[Conflict as a reality and a cultural challenge in the practice of nurses' management].

PubMed

Prochnow, Adelina Giacomelli; Leite, Joséte Luzia; Erdmann, Alacoque Lorenzini; Trevizan, Maria Auxiliadora

2007-12-01

The practice of nurses' management is permeated by conflicts that can be interpreted through culture references. The objective of this study is to denote cultural specificities, analyzed according to Geertz's Cultural Interpretative Theory, that are expressed as conflicts in the scope of nurses' management at a University Hospital. The results denoted the incorporation of ideological elements and mechanisms of control and power, whose origin can be seen in the way in which the work is organized. The application of policies based on the profession's very values was observed. Practices highlight a cultural construction that elucidates some understandings regarding cognitive, social and behavioral processes, because they organize the interpretations and the answers to the events of nurses' practices in management. The results of this study point out the importance of organizational culture in the practice of Nursing management in the face of labor uncertainties in the complexity of a hospital environment.

The Research on the Impact of Management Level's Charismatic Leadership Style on Miners' Unsafe Behavior.

PubMed

Li, Hongxia; Di, Hongxi; Tian, Shuicheng; Li, Jian

2015-01-01

The aim of this study is research the impact of management level's charismatic leadership style on miners' unsafe behavior by using the questionnaires on charismatic leadership style, safety attitude and the miners' unsafe behavior measurement to investigate 200 employees in Shen Dong Company. The research results suggest that management level's charismatic leadership style have very important influence on miners' unsafe behavior and the influence is affected by the safety attitude which is the intermediary function. In the end, this study propose advice on how to improve the coal mine enterprise managers charismatic leadership style in the coal mine enterprise's safety management work, including attach great importance to a variety of incentive methods, set up safety moral models, practice of inductive leadership concept, create a good atmosphere of safety, etc for reference for coal mining enterprises.

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness.

PubMed

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-04-11

Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers' leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention's potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers' behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations. © 2016 by Kerman University of Medical Sciences

Newcomer adjustment: Examining the role of managers' perception of newcomer proactive behavior during organizational socialization.

PubMed

Ellis, Allison M; Nifadkar, Sushil S; Bauer, Talya N; Erdogan, Berrin

2017-06-01

Separate streams of organizational socialization research have recognized the importance of (a) newcomer proactivity and (b) manager support in facilitating newcomer adjustment. However, extant research has largely focused on the newcomers' experience, leaving the perspectives of managers during socialization relatively unexplored-a theoretical gap that has implications both for newcomer adjustment and manager-newcomer interactions that may serve as a basis for future relationship development. Drawing from the "interlocked" employee behavior argument of Weick (1979), we propose that managers' perception of newcomers' proactive behaviors are associated with concordant manager behaviors, which, in turn, support newcomer adjustment. Further, we investigate a cognitive mechanism-managers' evaluation of newcomers' commitment to adjust-which we expect underlies the proposed relationship between newcomers' proactive behaviors and managers' supportive behaviors. Using a time-lagged, 4-phase data collection of a sample of new software engineers in India and their managers, we were able to test our hypothesized model as well as rule out alternative explanations via multilevel structural equation modeling. Results broadly supported our model even after controlling for manager-newcomer social exchange relationship, proactive personalities of both newcomers and managers, and potential effects of coworker information providing. The implications of our findings for theory and practice are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Asthma management simulation for children: translating theory, methods, and strategies to effect behavior change.

PubMed

Shegog, Ross; Bartholomew, L Kay; Gold, Robert S; Pierrel, Elaine; Parcel, Guy S; Sockrider, Marianna M; Czyzewski, Danita I; Fernandez, Maria E; Berlin, Nina J; Abramson, Stuart

2006-01-01

Translating behavioral theories, models, and strategies to guide the development and structure of computer-based health applications is well recognized, although a continued challenge for program developers. A stepped approach to translate behavioral theory in the design of simulations to teach chronic disease management to children is described. This includes the translation steps to: 1) define target behaviors and their determinants, 2) identify theoretical methods to optimize behavioral change, and 3) choose educational strategies to effectively apply these methods and combine these into a cohesive computer-based simulation for health education. Asthma is used to exemplify a chronic health management problem and a computer-based asthma management simulation (Watch, Discover, Think and Act) that has been evaluated and shown to effect asthma self-management in children is used to exemplify the application of theory to practice. Impact and outcome evaluation studies have indicated the effectiveness of these steps in providing increased rigor and accountability, suggesting their utility for educators and developers seeking to apply simulations to enhance self-management behaviors in patients.

Applied behavior analysis: New directions from the laboratory

PubMed Central

Epling, W. Frank; Pierce, W. David

1983-01-01

Applied behavior analysis began when laboratory based principles were extended to humans inorder to change socially significant behavior. Recent laboratory findings may have applied relevance; however, the majority of basic researchers have not clearly communicated the practical implications of their work. The present paper samples some of the new findings and attempts to demonstrate their applied importance. Schedule-induced behavior which occurs as a by-product of contingencies of reinforcement is discussed. Possible difficulties in treatment and management of induced behaviors are considered. Next, the correlation-based law of effect and the implications of relative reinforcement are explored in terms of applied examples. Relative rate of reinforcement is then extended to the literature dealing with concurrent operants. Concurrent operant models may describe human behavior of applied importance, and several techniques for modification of problem behavior are suggested. As a final concern, the paper discusses several new paradigms. While the practical importance of these models is not clear at the moment, it may be that new practical advantages will soon arise. Thus, it is argued that basic research continues to be of theoretical and practical importance to applied behavior analysis. PMID:22478574

Improving Child Management Practices of Parents and Teachers. Maxi I Practicum. Final Report.

ERIC Educational Resources Information Center

Adreani, Arnold J.; McCaffrey, Robert

The practicum design reported in this document was based on one basic assumption, that the adult perceptions of children influence adult behavior toward children which in turn influences the child's behavior. Therefore, behavior changes by children could best be effected by changing the adult perception of, and behavior toward, the child.…

Helping Female Juveniles Improve their On-Task Behavior and Academic Performance Using a Self-Management Procedure in a Correctional Facility

ERIC Educational Resources Information Center

Caldwell, Stacy; Joseph, Laurice M.

2012-01-01

The purpose of this study was to teach female juvenile offenders with disabilities a self-management procedure to help improve on-task behavior and academic performance during independent practice of math calculation facts. Students were taught to set goals and were provided with incentives for goal attainment. A reversal single-case design…

Developing Leadership in Managers to Facilitate the Implementation of National Guideline Recommendations: A Process Evaluation of Feasibility and Usefulness

PubMed Central

Tistad, Malin; Palmcrantz, Susanne; Wallin, Lars; Ehrenberg, Anna; Olsson, Christina B.; Tomson, Göran; Holmqvist, Lotta Widén; Gifford, Wendy; Eldh, Ann Catrine

2016-01-01

Background: Previous research supports the claim that managers are vital players in the implementation of clinical practice guidelines (CPGs), yet little is known about interventions aiming to develop managers’ leadership in facilitating implementation. In this pilot study, process evaluation was employed to study the feasibility and usefulness of a leadership intervention by exploring the intervention’s potential to support managers in the implementation of national guideline recommendations for stroke care in outpatient rehabilitation. Methods: Eleven senior and frontline managers from five outpatient stroke rehabilitation centers participated in a four-month leadership intervention that included workshops, seminars, and teleconferences. The focus was on developing knowledge and skills to enhance the implementation of CPG recommendations, with a particular focus on leadership behaviors. Each dyad of managers was assigned to develop a leadership plan with specific goals and leadership behaviors for implementing three rehabilitation recommendations. Feasibility and usefulness were explored through observations and interviews with the managers and staff members prior to the intervention, and then one month and one year after the intervention. Results: Managers considered the intervention beneficial, particularly the participation of both senior and frontline managers and the focus on leadership knowledge and skills for implementing CPG recommendations. All the managers developed a leadership plan, but only two units identified goals specific to implementing the three stroke rehabilitation recommendations. Of these, only one identified leadership behaviors that support implementation. Conclusion: Managers found that the intervention was delivered in a feasible way and appreciated the focus on leadership to facilitate implementation. However, the intervention appeared to have limited impact on managers’ behaviors or clinical practice at the units. Future interventions directed towards managers should have a stronger focus on developing leadership skills and behaviors to tailor implementation plans and support implementation of CPG recommendations. PMID:27694661

School psychologists: strategic allies in the contemporary practice of primary care pediatrics.

PubMed

Wodrich, D L; Landau, S

1999-10-01

Immense changes in the developmental/behavioral aspects of primary care pediatrics have resulted from revisions in special education laws, introduction of managed care, widened dissemination of information about disabilities to parents, and the changing character of American society. Challenges associated with contemporary pediatric practice can be diminished by routine collaboration with school psychologists. An alliance with school-based psychologists permits pediatricians access to children in their natural environments and potential collaboration for preventing illness and emotional/behavior problems. Further, school psychologists can provide a partner for assessing and treating both common and low-incident disorders without the constraints imposed by managed care.

Developmentally Appropriate Discipline Practices of Elementary School Principals

ERIC Educational Resources Information Center

Burnett, Donna Silva

2010-01-01

Research has indicated that developmentally appropriate practices (DAP) should be applied to manage behavioral problems in school age children. However, little evidence exists on the extent to which elementary school principals apply these practices appropriately in student discipline. The purpose of this phenomenological study was to explore how…

The Research on the Impact of Management Level’s Charismatic Leadership Style on Miners' Unsafe Behavior

PubMed Central

Li, Hongxia; Di, Hongxi; Tian, Shuicheng; Li, Jian

2015-01-01

The aim of this study is research the impact of management level’s charismatic leadership style on miners' unsafe behavior by using the questionnaires on charismatic leadership style, safety attitude and the miners' unsafe behavior measurement to investigate 200 employees in Shen Dong Company. The research results suggest that management level’s charismatic leadership style have very important influence on miners' unsafe behavior and the influence is affected by the safety attitude which is the intermediary function. In the end, this study propose advice on how to improve the coal mine enterprise managers charismatic leadership style in the coal mine enterprise's safety management work, including attach great importance to a variety of incentive methods, set up safety moral models, practice of inductive leadership concept, create a good atmosphere of safety, etc for reference for coal mining enterprises. PMID:26628936

Adapting livestock behaviour to achieve management goals

USDA-ARS?s Scientific Manuscript database

Using livestock to efficiently achieve management goals requires melding animal behavior with mechanical and electronic equipment. Practices such as autonomously obtaining individual animal liveweight when combined with individual animal electronic identification can produce numerous cost saving ad...

The Brief Classroom Interaction Observation-Revised: An Observation System to Inform and Increase Teacher Use of Universal Classroom Management Practices

ERIC Educational Resources Information Center

Reinke, Wendy M.; Stormont, Melissa; Herman, Keith C.; Wachsmuth, Sean; Newcomer, Lori

2015-01-01

Schools are increasingly using multi-tiered prevention models to address the academic and behavior needs of students. The foundation of these models is the implementation of universal, or Tier 1, practices designed to support the academic and behavioral needs of the vast majority of students. To support teachers in the use of effective Tier 1…

Corporate sustainability: the environmental design and human resource management interface in healthcare settings.

PubMed

Sadatsafavi, Hessam; Walewski, John

2013-01-01

Purpose of the Paper: The purpose of this study is to provide healthcare organizations with a new perspective for developing strategies to enrich their human resource capabilities and improve their performance outcomes. The focus of this study is on leveraging the synergy between organizational management strategies and environmental design interventions. This paper proposes a framework for linking the built environment with the human resource management system of healthcare organizations. The framework focuses on the impact of the built environment regarding job attitudes and behaviors of healthcare workers. Research from the disciplines of strategic human resource management, resource-based view of firms, evidence-based design, and green building are utilized to develop the framework. The positive influence of human resource practices on job attitudes and behaviors of employees is one mechanism to improve organizational performance outcomes. Organizational psychologists suggest that human resource practices are effective because they convey that the organization values employee contributions and cares about their well-being. Attention to employee socio-emotional needs can be reciprocated with higher levels of motivation and commitment toward the organization. In line with these findings, healthcare environmental studies imply that physical settings and features can have a positive influence on job attitudes and the behavior of caregivers by providing for their physical and socio-emotional needs. Adding the physical environment as a complementary resource to the array of human resource practices creates synergy in improving caregivers' job attitudes and behaviors and enhances the human capital of healthcare firms. Staff, evidence-based design, interdisciplinary, modeling, perceived organizational supportPreferred Citation: Sadatsafavi, H., & Walewski, J. (2013). Corporate sustainability: The environmental design and human resource management interface in healthcare settings. Health Environments Research & Design Journal 6(2), pp 98-118.

Mental health, substance abuse, and health behavior services in patient-centered medical homes.

PubMed

Kessler, Rodger; Miller, Benjamin F; Kelly, Mark; Graham, Debbie; Kennedy, Amanda; Littenberg, Benjamin; MacLean, Charles D; van Eeghen, Constance; Scholle, Sarah Hudson; Tirodkar, Manasi; Morton, Suzanne; Pace, Wilson D

2014-01-01

The purpose of this study was to understand mental health, substance use, and health behavior activities within primary care practices recognized by the National Committee for Quality Assurance as patient-centered medical homes (PCMHs). We identified 447 practices with all levels of National Committee for Quality Assurance PCMH recognition as of March 1, 2010. We selected the largest practice from multisite groups, and 238 practices were contacted. We received 123 responses, for a 52% response rate. A 40-item web-based survey was collected. Of PCMH practices, 42% have a behavioral health clinician on site; social workers were the most frequent category of provider delivering behavioral services. There are also were care managers-distinct from behavioral health clinician-at 62% of practices. Surveyed practices were less likely to have procedures for referrals, communication, and patient scheduling for responding to mental health and substance use services than for other medical subspecialties (50% compared with 73% for cardiology and 69% for endocrinology). More than half of practices (62%) reported using electronic, standardized depression screening and monitoring; practices were less likely to screen for substance use than mental health. Among the practices, 54% used evidence-based health behavior protocols for mental health and substance use conditions. Practices reported that lack of reimbursement, time, and sufficient knowledge were obstacles. Practices serving a higher proportion of low-income patients performed more mental health organizational and clinical activities. In PCMHs, practice organization and response to behavioral issues seem to be less well developed than other types of medical care. These results support further efforts to develop whole-person care in the PCMH, with greater emphasis on access to and coordination of mental health, substance abuse, and health behavior services. Focusing primary care practices on this aspect of whole-person care will benefit from program sponsors' support and rewarding better integration with behavioral health. © Copyright 2014 by the American Board of Family Medicine.

Model, Framework, and Platform of Health Persuasive Social Network

ERIC Educational Resources Information Center

Al Ayubi, Soleh Udin

2013-01-01

Persuasive technology (PT) has the potential to support individuals to perform self-management and social support as a part of health behavior change. This has led a few researchers in the intersection of the areas of health behavior change and software engineering to apply behavior change and persuasion theories to software development practices,…

Training Mental Health Professionals to Assess and Manage Suicidal Behavior: Can Provider Confidence and Practice Behaviors Be Altered?

ERIC Educational Resources Information Center

Oordt, Mark S.; Jobes, David A.; Fonseca, Vincent P.; Schmidt, Steven M.

2009-01-01

Remarkably little systematic research has studied the effects of clinical suicidology training on changing practitioner attitudes and behaviors. In the current study we investigated whether training in an empirically-based assessment and treatment approach to suicidal patients administered through a continuing education workshop could meaningfully…

Improving Instructional Leadership Behaviors of School Principals by Means of Implementing Time Management Training Sessions

ERIC Educational Resources Information Center

Su, Yu

2013-01-01

The No Child Left Behind Act of 2001 increases school accountability and requires educators to improve student academic outcomes using evidence-based practice. One factor that contributes to desirable school outcomes is principals' instructional leadership behaviors. Principals who allocate more time to instructional leadership behaviors are more…

The Prediction Level of Teachers' Organizational Citizenship Behaviors on the Successful Practice of Shared Leadership

ERIC Educational Resources Information Center

Bostanci, Aynur B.

2013-01-01

Problem Statement: Defined as the actions that personnel voluntarily take beyond their formal job description, organizational citizenship behavior is regarded as a premise for shared leadership, a management style that is frequently used in organizations today. The relevant literature suggests that organizational citizenship behavior can provide…

Using Course Assessments to Train Teachers in Functional Behavior Assessment and Behavioral Intervention Plan Techniques

ERIC Educational Resources Information Center

Fallon, Moira A.; Zhang, Jie; Kim, Eun-Joo

2011-01-01

As the need to train more teachers to work in inclusive classrooms increases, college instructors should identify and implement course assessments measuring their effectiveness in training practices. Skills in managing the challenging behaviors of students with disabilities, such as autism and emotional disturbances are important for teachers…

Management in the Ministry of Health: what are the vital signs?

PubMed

Benjamin, S; Ahmed, A A; al-Darazi, F

1997-01-01

Effective and efficient management of health services is becoming more and more important in all countries and in all organizations whether profit or non-profit. Management practices and attitudes which may have been accepted in previous years are no longer appropriate. A study was conducted in the Ministry of Health, State of Bahrain to determine the current status of management skills and attitudes. Participants were asked to identify the best and the worst practices of managers. Eight key areas of concern were identified: participative vs. non-participative style, communication, motivation, delegation, human relations skills, style of supervision, goal-oriented behavior, and use of supervisory power. In each of these management-related skill areas, examples of best and worst practices are provided in order to aid the manager/leader in self-assessing his/her abilities as a first step toward improving management.

Five Approaches to Avoid When Managing the Middle School Classroom

ERIC Educational Resources Information Center

Englehart, Joshua M.

2013-01-01

Too often, teachers encountering difficulties with classroom management focus only on the students rather than critically examining the influence of their own approaches on student behavior. Given the particular challenges that middle school students present, certain practices and expectations exacerbate management issues, and a lack of awareness…

Lessons from Literature: Blending Academic Perspective with Management Practices

ERIC Educational Resources Information Center

Kapur, Surbhi; Mohanty, Pooja

2014-01-01

The present paper studies the role literature can play in management in general and in leadership, organizational behavior and communication in particular. Literature normally gets a skeptical reception in management studies. The paper discusses the relevance of literature for a better understanding of human behaviour and a judicious discernment…

Best practices: applying management analysis of excellence to immunization.

PubMed

Wishner, Amy; Aronson, Jerold; Kohrt, Alan; Norton, Gary

2005-01-01

The authors applied business management tools to analyze and promote excellence and to evaluate differences between average and above-average immunization peformers in private practices. The authors conducted a pilot study of 10 private practices in Pennsylvania using tools common in management to assess practices' organizational climate and managerial style. Authoritative and coaching styles of physician leaders were common to both groups. Managerial styles that emphasized higher levels of clarity and responsibility managerial styles were evident in the large practices; and rewards and flexibility styles were higher in the small above-average practices. The findings of this pilot study match results seen in high performers in other industries. It concludes that the authoritative style appears to have the most impact on performance. It has interesting implications for training/behavior change to improve immunization rates, along with traditional medical interventions.

The "wins" of change: evaluating the impact of predicted changes on case management practice.

PubMed

Stanton, Marietta P; Barnett Lammon, Carol Ann

2008-01-01

A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

Caring for 'Very Important Patients'--Ethical Dilemmas and Suggestions for Practical Management.

PubMed

Alfandre, David; Clever, Sarah; Farber, Neil J; Hughes, Mark T; Redstone, Paul; Lehmann, Lisa Soleymani

2016-02-01

The care of Very Important Patients (VIPs) is different from other patients because they may receive greater access, attention, and resources from health care staff. Although the term VIP is used regularly in the medical literature and is implicitly understood, in practice it constitutes a wide and heterogeneous group of patients that have a strong effect on health care providers. We define a VIP as a very influential patient whose individual attributes and characteristics (eg, social status, occupation, position), coupled with their behavior, have the potential to significantly influence a clinician's judgment or behavior. Physicians, celebrities, the politically powerful, and philanthropists, may all become VIPs in the appropriate context. The quality of care may be inferior because health care professionals may deviate from standard practices when caring for them. Understanding the common features among what may otherwise be very different groups of patients can help health care providers manage ethical concerns when they arise. We use a series of vignettes to demonstrate how VIPs behavior and status can influence a clinician's judgment or actions. Appreciating the ethical principles in these varied circumstances provides health care professionals with the tools to manage ethical conflicts that arise in the care of VIPs. We conclude each vignette with guidance for how health care providers and administrators can manage the ethical concern. Published by Elsevier Inc.

An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

PubMed

Dwinnells, Ronald; Misik, Lauren

2017-10-01

Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

Developing a Behavioral Model for Mobile Phone-Based Diabetes Interventions

PubMed Central

Nundy, Shantanu; Dick, Jonathan J.; Solomon, Marla C.; Peek, Monica E.

2013-01-01

Objectives Behavioral models for mobile phone-based diabetes interventions are lacking. This study explores the potential mechanisms by which a text message-based diabetes program affected self-management among African-Americans. Methods We conducted in-depth, individual interviews among 18 African-American patients with type 2 diabetes who completed a 4-week text message-based diabetes program. Each interview was audio- taped, transcribed verbatim, and imported into Atlas.ti software. Coding was done iteratively. Emergent themes were mapped onto existing behavioral constructs and then used to develop a novel behavioral model for mobile phone-based diabetes self-management programs. Results The effects of the text message-based program went beyond automated reminders. The constant, daily communications reduced denial of diabetes and reinforced the importance of self-management (Rosenstock Health Belief Model). Responding positively to questions about self-management increased mastery experience (Bandura Self-Efficacy). Most surprisingly, participants perceived the automated program as a “friend” and “support group” that monitored and supported their self-management behaviors (Barrera Social Support). Conclusions A mobile phone-based diabetes program affected self-management through multiple behavioral constructs including health beliefs, self-efficacy, and social support. Practice implications: Disease management programs that utilize mobile technologies should be designed to leverage existing models of behavior change and can address barriers to self-management associated with health disparities. PMID:23063349

The use of behavior modification techniques to successfully manage the child dental patient.

PubMed

Barenie, J T; Ripa, L W

1977-02-01

Techniques of desensitization, modeling, and contingency management that can be used in the dental office for reducing anxiety and encouraging appropriate behavior in children are discussed. The "tell, show and do" approach is one desensitization technique easily applied in the private practice. Language should be at the child's level of understanding. An older sibling will frequently serve as an excellent model for a fearful child. Social reinforcers-a handshake, a smile, or praise-should be dispensed throughout dental treatment. Rewards should only follow desired behavior.

Advancing the practice of systems engineering at JPL

NASA Technical Reports Server (NTRS)

Jansma, Patti A.; Jones, Ross M.

2006-01-01

In FY 2004, JPL launched an initiative to improve the way it practices systems engineering. The Lab's senior management formed the Systems Engineering Advancement (SEA) Project in order to "significantly advance the practice and organizational capabilities of systems engineering at JPL on flight projects and ground support tasks." The scope of the SEA Project includes the systems engineering work performed in all three dimensions of a program, project, or task: 1. the full life-cycle, i.e., concept through end of operations 2. the full depth, i.e., Program, Project, System, Subsystem, Element (SE Levels 1 to 5) 3. the full technical scope, e.g., the flight, ground and launch systems, avionics, power, propulsion, telecommunications, thermal, etc. The initial focus of their efforts defined the following basic systems engineering functions at JPL: systems architecture, requirements management, interface definition, technical resource management, system design and analysis, system verification and validation, risk management, technical peer reviews, design process management and systems engineering task management, They also developed a list of highly valued personal behaviors of systems engineers, and are working to inculcate those behaviors into members of their systems engineering community. The SEA Project is developing products, services, and training to support managers and practitioners throughout the entire system lifecycle. As these are developed, each one needs to be systematically deployed. Hence, the SEA Project developed a deployment process that includes four aspects: infrastructure and operations, communication and outreach, education and training, and consulting support. In addition, the SEA Project has taken a proactive approach to organizational change management and customer relationship management - both concepts and approaches not usually invoked in an engineering environment. This paper'3 describes JPL's approach to advancing the practice of systems engineering at the Lab. It describes the general approach used and how they addressed the three key aspects of change: people, process and technology. It highlights a list of highly valued personal behaviors of systems engineers, discusses the various products, services and training that were developed, describes the deployment approach used, and concludes with several lessons learned.

Body-Mind-Spirit Practice for Healthy Aging

ERIC Educational Resources Information Center

Lee, Eun-Kyoung Othelia; Yoon, Hyunsook; Lee, Jungui; Yoon, Jiyoung; Chang, Eunjin

2012-01-01

This community-based, health promotion intervention for seniors provided a comprehensive review of the effect of body-mind-spirit (BMS) interventions on health behaviors. The 12-week curriculum offered sessions on exercise, nutrition, sexuality, leisure, stress management, cognitive behavioral therapy, forgiveness, and happiness. Gerontological…

Pain Assessment and Management in Nursing Education Using Computer-based Simulations.

PubMed

Romero-Hall, Enilda

2015-08-01

It is very important for nurses to have a clear understanding of the patient's pain experience and of management strategies. However, a review of the nursing literature shows that one of the main barriers to proper pain management practice is lack of knowledge. Nursing schools are in a unique position to address the gap in pain management knowledge by facilitating the acquisition and use of knowledge by the next generation of nurses. The purpose of this article is to discuss the role of computer-based simulations as a reliable educational technology strategy that can enhance the learning experience of nursing students acquiring pain management knowledge and practice. Computer-based simulations provide a significant number of learning affordances that can help change nursing students' attitudes and behaviors toward and practice of pain assessment and management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Integrated Primary Care Readiness and Behaviors Scale: Development and validation in behavioral health professionals.

PubMed

Blaney, Cerissa L; Redding, Colleen A; Paiva, Andrea L; Rossi, Joseph S; Prochaska, James O; Blissmer, Bryan; Burditt, Caitlin T; Nash, Justin M; Bayley, Keri Dotson

2018-03-01

Although integrated primary care (IPC) is growing, several barriers remain. Better understanding of behavioral health professionals' (BHPs') readiness for and engagement in IPC behaviors could improve IPC research and training. This study developed measures of IPC behaviors and stage of change. The sample included 319 licensed, practicing BHPs with a range of interests and experience with IPC. Sequential measurement development procedures, with split-half cross-validation were conducted. Exploratory principal components analyses (N = 152) and confirmatory factor analyses (N = 167) yielded a 12-item scale with 2 factors: consultation/practice management (CPM) and intervention/knowledge (IK). A higher-order Integrated Primary Care Behavior Scale (IPCBS) model showed good fit to the data, and excellent internal consistencies. The multivariate analysis of variance (MANOVA) on the IPCBS demonstrated significant large-sized differences across stage and behavior groups. The IPCBS demonstrated good psychometric properties and external validation, advancing research, education, and training for IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Primary care and behavioral health practice size: the challenge for health care reform.

PubMed

Bauer, Mark S; Leader, Deane; Un, Hyong; Lai, Zongshan; Kilbourne, Amy M

2012-10-01

We investigated the size profile of US primary care and behavioral health physician practices since size may impact the ability to institute care management processes (CMPs) that can enhance care quality. We utilized 2009 claims data from a nationwide commercial insurer to estimate practice size by linking providers by tax identification number. We determined the proportion of primary care physicians, psychiatrists, and behavioral health providers practicing in venues of >20 providers per practice (the lower bound for current CMP practice surveys). Among primary care physicians (n=350,350), only 2.1% of practices consisted of >20 providers. Among behavioral health practitioners (n=146,992) and psychiatrists (n=44,449), 1.3% and 1.0% of practices, respectively, had >20 providers. Sensitivity analysis excluding single-physician practices as "secondary" confirmed findings, with primary care and psychiatrist practices of >20 providers comprising, respectively, only 19.4% and 8.8% of practices (difference: P<0.0001). In secondary analyses, bipolar disorder was used as a tracer condition to estimate practice census for a high-complexity, high-cost behavioral health condition; only 1.3-18 patients per practice had claims for this condition. The tax identification number method for estimating practice size has strengths and limitations that complement those of survey methods. The proportion of practices below the lower bound of prior CMP studies is substantial, and care models and policies will need to address the needs of such practices and their patients. Achieving a critical mass of patients for disorder-specific CMPs will require coordination across multiple small practices.

Effects of changing U.S. parenting styles on dental practice: perceptions of diplomates of the American Board of Pediatric Dentistry presented to the College of Diplomates of the American Board of Pediatric Dentistry 16th Annual Session, Atlanta, Ga, Saturday, May 26, 2001.

PubMed

Casamassimo, Paul S; Wilson, Stephen; Gross, Lucia

2002-01-01

This study surveyed board-certified pediatric dentists on their opinions about changes in U.S. parenting styles and the effects on the practice of pediatric dentistry. A questionnaire was developed, piloted, and mailed to 1,129 members of the College of Diplomates of the American Board of Pediatric Dentistry during the summer of 2000. A total of 577 respondents (51%) returned questionnaires, equally distributed across AAPD districts, with male:female ratio of 4:1 and 90% married. A majority perceived parenting styles had changed during their practice lifetime (88% "absolutely or probably changed"), with older practitioners significantly more likely to say so. Ninety-two percent felt changes were "probably or definitely bad" and 85% felt that these changes had resulted in "somewhat or much worse" patient behavior. Practitioners report performing less assertive behavior management techniques than in the past due to these changes. Diplomates report that parenting changes have occurred and they believe these are negative (bad) and have adversely influenced behavior and caused changes in pediatric dentists' behavior management.

A literature and best practices scan : ITS data management and archiving

DOT National Transportation Integrated Search

2002-05-01

To manage and operate the transportation system to exceed customer expectations, data is needed on the structure, status, use, and behavior of the entire transportation system. This info structure serves the needs of the people and organizations that...

Consideration of Culture and Context in School-Wide Positive Behavior Support: A Review of Current Literature

ERIC Educational Resources Information Center

Fallon, Lindsay M.; O'Keeffe, Breda V.; Sugai, George

2012-01-01

A review of the literature related to culture and student behavior reveals a number of interesting observations that are not surprising. First, culture is a difficult construct to define and has been defined variably over the years. Second, schools are becoming increasingly diverse, and evidence-based behavior management practices have been…

Maintain workplace civility by sharing the vow of personal responsibility.

PubMed

Chism, Marlene

2012-01-01

Office gossip, power struggles, employee burnout, and short fuses are becoming more the rule than the exception in running a medical practice. The difficult conversation avoided today can turn into the lawsuit 15 years later. Managers often find it hard to confront high performers and authority figures in the workplace. In order to deal with disruptive behavior and incivility before it ruins the medical practice, practice managers should institute the four steps outlined in this article plus the Vow of Personal Responsibility to improve clarity, teamwork, and personal performance.

The Role of Parents' Critical Thinking About Media in Shaping Expectancies, Efficacy and Nutrition Behaviors for Families.

PubMed

Austin, Erica Weintraub; Pinkleton, Bruce E; Radanielina-Hita, Marie Louise; Ran, Weina

2015-01-01

A convenience survey completed online by 137 4-H parents in Washington state explored their orientation toward critical thinking regarding media sources and content and its implications for family dietary behaviors. Parents' critical thinking toward media sources predicted their information efficacy about content. Critical thinking toward media content predicted information efficacy about sources, expectancies for parental mediation, and expectancies for family receptiveness to lower-fat dietary changes. Expectancies for receptiveness to dietary changes and expectancies for parental mediation predicted efficacy for implementing healthy dietary practices; this strongly predicted healthy dietary practices. Media-related critical thinking, therefore, indirectly but consistently affected self-reported family dietary behaviors through its effects on efficacy for managing media and expectancies for the family's receptiveness to healthy dietary changes. The results suggest parents' media literacy skills affect their family's dietary behavior. Health campaigns that help parents interpret and manage the media environment may benefit all family members.

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

PubMed

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Turn It Off: An Action Research Study of Top Management Influence on Energy Conservation in the Workplace

PubMed Central

Russell, Sally V.; Evans, Alice; Fielding, Kelly S.; Hill, Christopher

2016-01-01

This paper reports the results of an intervention study that aimed to encourage workplace energy conservation behavior by office-based employees. Taking a co-production approach we worked with the participating organization to design and implement an intervention that used the influence of top management commitment and prompts to encourage workplace energy reduction. Whilst past research has shown top management is related to workplace pro-environmental behavior, this study extends this work by examining a field-based intervention over a longitudinal period. The efficacy of the intervention was measured using observational and self-reported data over a period of 6 months. Results showed that there were significant changes in objective and self-reported energy conservation behavior, perceived top management commitment, organizational culture, norms, and knowledge regarding energy conservation behavior over the course of the study. The findings also demonstrated that the intervention was most successful for those behaviors where employees have individual responsibility. Implications for future research and practice are discussed. PMID:27047417

Turn It Off: An Action Research Study of Top Management Influence on Energy Conservation in the Workplace.

PubMed

Russell, Sally V; Evans, Alice; Fielding, Kelly S; Hill, Christopher

2016-01-01

This paper reports the results of an intervention study that aimed to encourage workplace energy conservation behavior by office-based employees. Taking a co-production approach we worked with the participating organization to design and implement an intervention that used the influence of top management commitment and prompts to encourage workplace energy reduction. Whilst past research has shown top management is related to workplace pro-environmental behavior, this study extends this work by examining a field-based intervention over a longitudinal period. The efficacy of the intervention was measured using observational and self-reported data over a period of 6 months. Results showed that there were significant changes in objective and self-reported energy conservation behavior, perceived top management commitment, organizational culture, norms, and knowledge regarding energy conservation behavior over the course of the study. The findings also demonstrated that the intervention was most successful for those behaviors where employees have individual responsibility. Implications for future research and practice are discussed.

Preparing Physicians for Practice in Managed Care Environments.

ERIC Educational Resources Information Center

Lurie, Nicole

1996-01-01

Discussion of managed health care looks at its evolution and characteristics, implications for medical education, and the competencies needed by physicians in this new environment, including epidemiological thinking, understanding of human and organizational behavior, familiarity with information technology, quality control skills, knowledge of…

Effective Classroom-Management & Positive Teaching

ERIC Educational Resources Information Center

Sieberer-Nagler, Katharina

2016-01-01

This article offers practical information for primary teachers to become more knowledgable, skilled and effective in their work. Aspects of positive teaching and learning are explored. Innovative methods for transforming common classroom management struggles into opportunities for positive change and for changing negative behaviors into positive…

Management Practices of Cats Owned by Faculty, Staff, and Students at Two Midwest Veterinary Schools

PubMed Central

Stella, Judith L.

2016-01-01

Understanding cat owners' housing, care, and management practices is important for promoting cat welfare. A survey study was conducted on the housing and management practices used for cats by students, faculty, and staff of The Ohio State University and Purdue University veterinary colleges. Subjects were 138 cat-owner dyads. Most cats (74%) were housed strictly indoors in keeping with common US veterinary recommendations. However, many did not implement best practices outlined for behavior and other welfare needs of indoor cats. The percentage of respondents placing resources where cats could be disrupted while using them was 31%, 53%, and 30% for resting areas, food/water dishes, and litter boxes, respectively. Many cats were not provided a litter box in a private area (35%), in multiple areas of the house (51%), or that was regularly washed (73%). Horizontal scratching opportunities were not provided to 38% of cats; 32% were not provided toys that mimic prey and 91% of cats were fed a diet consisting of >75% dry food. These findings suggest a need for more concerted efforts to educate owners about meeting their cats' welfare needs so as to attenuate risks and improve cat physical and behavioral welfare outcomes. PMID:28090571

Eating Disorders: A Problem in Athletics?

ERIC Educational Resources Information Center

Burckes-Miller, Mardie E.; Black, David R.

1988-01-01

A review of research regarding athletes' eating habits suggests that they may practice eating disorder habits and poor weight management behaviors as well as have poor attitudes and knowledge regarding nutrition, indicating their immediate need for appropriate education about the possible detrimental effects of such practices. (CB)

Soft skill appraisal for dentistry: a tool for positive practice management.

PubMed

Jawale, Bhushan Arun; Bendgude, Vikas; Husain, Nadeem; Thosar, Nilima; Tandon, Piyush

2011-11-01

Soft skills adoption is a learning experience for every practitioner and every academician. Author has expressed his opinion for success through educational and real values of soft skill. Soft skills behavior of individual and institution help in achieving desirable goals in general and specialty practices. Author also focused on some realistic soft skill methods for improvisation of practices for all doctor. These skills indulge positive energy in human relationship for working in symbiosis and explore infinite capabilities at institutional and doctoral level. Here, some optimistic suggestions are given for improving dental practices and academic fulfillments. These soft skills help to organize, plan and manage, and track changes during the course of the growing dental practices. However, understanding of the soft skills in practice management, its simplicity and complexity and also, its contributing factors, helps practitioners to understand the dynamic, social and complex contexts of practices. It is really helpful to all practitioners to grow their practices using soft skills.

Making time for learning-oriented leadership in multidisciplinary hospital management groups.

PubMed

Singer, Sara J; Hayes, Jennifer E; Gray, Garry C; Kiang, Mathew V

2015-01-01

Although the clinical requirements of health care delivery imply the need for interdisciplinary management teams to work together to promote frontline learning, such interdisciplinary, learning-oriented leadership is atypical. We designed this study to identify behaviors enabling groups of diverse managers to perform as learning-oriented leadership teams on behalf of quality and safety. We randomly selected 12 of 24 intact groups of hospital managers from one hospital to participate in a Safety Leadership Team Training program. We collected primary data from March 2008 to February 2010 including pre- and post-staff surveys, multiple interviews, observations, and archival data from management groups. We examined the level and trend in frontline perceptions of managers' learning-oriented leadership following the intervention and ability of management groups to achieve objectives on targeted improvement projects. Among the 12 intervention groups, we identified higher- and lower-performing intervention groups and behaviors that enabled higher performers to work together more successfully. Management groups that achieved more of their performance goals and whose staff perceived more and greater improvement in their learning-oriented leadership after participation in Safety Leadership Team Training invested in structures that created learning capacity and conscientiously practiced prescribed learning-oriented management and problem-solving behaviors. They made the time to do these things because they envisioned the benefits of learning, valued the opportunity to learn, and maintained an environment of mutual respect and psychological safety within their group. Learning in management groups requires vision of what learning can accomplish; will to explore, practice, and build learning capacity; and mutual respect that sustains a learning environment.

Youth with Behavioral Health Disorders Aging Out of Foster Care: a Systematic Review and Implications for Policy, Research, and Practice.

PubMed

Kang-Yi, Christina D; Adams, Danielle R

2017-01-01

This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.

Associations between safety climate and safety management practices in the construction industry.

PubMed

Marín, Luz S; Lipscomb, Hester; Cifuentes, Manuel; Punnett, Laura

2017-06-01

Safety climate, a group-level measure of workers' perceptions regarding management's safety priorities, has been suggested as a key predictor of safety outcomes. However, its relationship with actual injury rates is inconsistent. We posit that safety climate may instead be a parallel outcome of workplace safety practices, rather than a determinant of workers' safety behaviors or outcomes. Using a sample of 25 commercial construction companies in Colombia, selected by injury rate stratum (high, medium, low), we examined the relationship between workers' safety climate perceptions and safety management practices (SMPs) reported by safety officers. Workers' perceptions of safety climate were independent of their own company's implementation of SMPs, as measured here, and its injury rates. However, injury rates were negatively related to the implementation of SMPs. Safety management practices may be more important than workers' perceptions of safety climate as direct predictors of injury rates. © 2017 Wiley Periodicals, Inc.

38 CFR 52.90 - Participant behavior and program practices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... use of a sedating psychotropic drug to manage or control behavior. (ii) Physical restraint is any method of physically restricting a person's freedom of movement, physical activity or normal access to... any chemical or physical restraints imposed for purposes of discipline or convenience. When a...

Oil City PREP: Putting Positive Principles into Practice

ERIC Educational Resources Information Center

Eisenman, Jessica; Barnhill, Rachelle; Riley, Ben

2013-01-01

Tamara Shepard from Southwest Behavioral Health Management (SBHM) proposed a plan to schools in Venango County, Pennsylvania. School districts would collaborate with mental health agencies to create a school-based integrated classroom model that would combine education and behavioral health interventions in one setting. When she initially…

Yoga's potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study.

PubMed

Watts, Allison W; Rydell, Sarah A; Eisenberg, Marla E; Laska, Melissa N; Neumark-Sztainer, Dianne

2018-05-02

A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults. The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga's perceived influence on eating and activity behaviors among interview participants. Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle. Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.

Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine.

PubMed

Tabash, Mohammed I; Hussein, Rim A; Mahmoud, Aleya H; El-Borgy, Mohamed D; Abu-Hamad, Bassam A

2016-04-01

In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (P<0.001). Poor knowledge and poor practice levels (scores<50%) were found to improve to satisfactory levels (scores≥75%). Therefore, educational programs could be considered as an effective tool for changing health care staff practice in pharmaceutical waste management. In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.

What roles do middle managers play in implementation of innovative practices?

PubMed Central

Engle, Ryann L.; Lopez, Emily R.; Gormley, Katelyn E.; Chan, Jeffrey A.; Charns, Martin P.; Lukas, Carol VanDeusen

2017-01-01

Background: Middle managers play key roles in hospitals as the bridge between senior leaders and frontline staff. Yet relatively little research has focused on their role in implementing new practices. Purpose: The aim of this study was to expand the understanding of middle managers’ influence in organizations by looking at their activities through the lens of two complementary conceptual frameworks. Methodology/Approach: We analyzed qualitative data from 17 Veterans Affairs Medical Centers with high and low potential to change organizational practices. We analyzed 98 interviews with staff ranging from senior leaders to frontline staff to identify themes within an a priori framework reflecting middle manager activities. Findings: Analyses yielded 14 emergent themes that allowed us to classify specific expressions of middle manager commitment to implementation of innovative practices (e.g., facilitate improvement innovation, garner staff buy-in). In comparing middle manager behaviors in high and low change potential sites, we found that most emergent themes were present in both groups. However, the activities and interactions described differed between the groups. Practice Implications: Middle managers can use the promising strategies identified by our analyses to guide and improve their effectiveness in implementing new practices. These strategies can also inform senior leaders striving to guide middle managers in those efforts. PMID:26488239

A Comparison of Preservice Teachers' Beliefs on Education and Classroom Management

ERIC Educational Resources Information Center

Tertemiz, Nese; Okut, Levent

2014-01-01

The beliefs held by preservice teachers will affect their classroom perceptions and behaviors. Therefore, understanding these beliefs is necessary to better understand preservice teachers, manage educational reforms successfully, and improving their teaching practice. From another perspective, understanding the belief structures of preservice…

Use of Gaming in Self-Management of Diabetes in Teens.

PubMed

Swartwout, Ellen; El-Zein, Ashley; Deyo, Patricia; Sweenie, Rachel; Streisand, Randi

2016-07-01

With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change.

Adolescent Nutrition: Needs and Recommendations for Practice.

ERIC Educational Resources Information Center

Massey-Stokes, Marilyn

2002-01-01

Discusses the importance of healthy dietary behaviors in youth. Lists many ways in which diet can significantly affect the health of adolescents including: nutrition and learning, chronic disease risk, overweight and obesity, unhealthy weight management practices and eating disorders, barriers to healthy eating habits, and overcoming barriers in…

Design and Evaluation of a Health-Focused Personal Informatics Application with Support for Generalized Goal Management

ERIC Educational Resources Information Center

Medynskiy, Yevgeniy

2012-01-01

The practice of health self-management offers behavioral and problem-solving strategies that can effectively promote responsibility for one's own wellbeing, improve one's health outcomes, and decrease the cost of health services. Personal informatics applications support health self-management by allowing their users to easily track…

Greening of a Campus through Waste Management Initiatives: Experience from a Higher Education Institution in Thailand

ERIC Educational Resources Information Center

Tangwanichagapong, Siwaporn; Nitivattananon, Vilas; Mohanty, Brahmanand; Visvanathan, Chettiyappan

2017-01-01

Purpose: This paper aims to describe the effects of 3R (reduce, reuse and recycle) waste management initiatives on a campus community. It ascertains the environmental attitudes and opinions of the residents and investigates their behavioral responses to waste management initiatives. Practical implications for enhancing sustainable waste management…

[The Jena Anxiety Monitoring List (JAMoL) - a tool for the evidence-based treatment of panic disorder with or without agoraphobia in primary care].

PubMed

Hiller, Thomas Stephan; Freytag, Antje; Breitbart, Jörg; Teismann, Tobias; Schöne, Elisabeth; Blank, Wolfgang; Schelle, Mercedes; Vollmar, Horst Christian; Margraf, Jürgen; Gensichen, Jochen

2018-04-01

Behavior therapy-oriented methods are recommended for treating anxiety disorders in primary care. The treatment of patients with long-term conditions can be improved by case management and structured clinical monitoring. The present paper describes the rationale, design and application of the 'Jena Anxiety Monitoring List' (JAMoL), a monitoring tool for the treatment of patients with panic disorder, with or without agoraphobia, in primary care. JAMoL's design was based on established clinical measures, the rationale of exposure-based anxiety treatment, and research on family practice-based case management. After piloting, the JAMoL was used in the clinical study 'Jena-PARADISE' (ISRCTN64669297), where non-physician practice staff monitored patients with panic disorder by telephone. Using semi-structured interviews in concomitant studies, study participants were asked about the instrument's functionality. The JAMoL assesses the severity of anxiety symptoms (6 items) as well as the patient's adherence to therapy (4 items) and fosters the case management-related information exchange (3 items). An integrated traffic light scheme facilitates the evaluation of monitoring results. Within the clinical study, non-physician practice staff carried out a total of 1,525 JAMoL-supported monitoring calls on 177 patients from 30 primary care practices (median calls per patient: 10 [interquartile range, 9-10]). Qualitative analyses revealed that most practice teams and patients rated the JAMoL as a practicable and treatment-relevant tool. The JAMoL enables primary care practice teams to continuously monitor anxiety symptoms and treatment adherence in patients with panic disorder with or without agoraphobia. Within the behavior therapy-oriented treatment program 'Jena-PARADISE', the JAMoL constitutes an important case management tool. Copyright © 2018. Published by Elsevier GmbH.

Exploring Nurse Manager Support of Evidence-Based Practice: Clinical Nurse Perceptions.

PubMed

Caramanica, Laura; Spiva, LeeAnna

2018-05-01

The study identifies what constitutes nurse manager (NM) support and other resources that enable clinical nurses (CNs) to engage in evidence-based practice (EBP). Clinical nurses report that NM support enables them to use EBP but what constitutes NM support is still unclear. Nurse managers, CNs, and EBP mentors received specialized education and use a team approach for EBP. Data were collected preintervention, mid-intervention, and postintervention from observations, interviews, journaling, and surveys. Results demonstrate how NMs can perform their role responsibilities and still engage CNs to develop a spirit of inquiry, seek answers to their clinical questions using EBP, and advance their clinical performance to improve patient outcomes. Four NM supportive behaviors emerged: cultivating a shared EBP vision, ensuring use of EBP, communicating the value of EBP, and providing resources for EBP. Through education and support, NMs describe supportive behaviors necessary for the successful conduction of EBP by CNs.

The impact of social context on self-management in women living with HIV.

PubMed

Webel, Allison R; Cuca, Yvette; Okonsky, Jennifer G; Asher, Alice K; Kaihura, Alphoncina; Salata, Robert A

2013-06-01

HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicted all domains of HIV self-management including daily health practices (F = 5.40, adjusted R(2) = 0.27, p < 0.01), HIV social support (F = 4.50, adjusted R(2) = 0.22, p < 0.01), and accepting the chronic nature of HIV (F = 5.57, adjusted R(2) = 0.27, p < 0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women's social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Impact of Social Context on Self-Management in Women Living with HIV

PubMed Central

Webel, Allison R.; Cuca, Yvette; Okonsky, Jennifer G.; Asher, Alice K.; Kaihura, Alphoncina; Salata, Robert A.

2013-01-01

HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicated all domains of HIV self-management including daily health practices (F=5.40, adjusted R2=0.27, p<0.01), HIV social support (F=4.50, adjusted R2=0.22, p<0.01), and accepting the chronic nature of HIV (F=5.57, adjusted R2=0.27, p<0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women’s social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population. PMID:23631790

Assessing the whole person: case managers take a holistic approach to physical and mental health.

PubMed

Carter, Jolynne Jo; Zawalski, Sandra; Sminkey, Patrice V; Christopherson, Bruce

2015-01-01

Given the prevalence of mental health issues, particularly depressive disorders, in the U.S. population, professional case managers should increase their sensitivity to and awareness of mental illnesses, as well as their impact on physical health. Throughout the case management process, case managers frequently observe behaviors and symptoms such as those associated with depressive disorders. Case managers need to have, at a minimum, a working knowledge of mental and behavioral health issues and be familiar with basic screening tools. This will enable them to become more attuned to symptoms and behaviors that indicate that the individual should be further assessed and diagnosed by a physician. Across the case management spectrum, including acute care, accountable care organizations, patient-centered medical homes, physician practices, clinics, occupational health clinics, workers' compensation, and other settings in which case managers work with individuals (clients who receive case management services) and their families/support systems. With more than one quarter of the U.S. population affected by a depressive disorder, professional case managers who practice holistically bring together the mental and physical aspects of health. This is particularly important in a health care system and among payer sources that continue to divide the two. Case managers elevate their practice by demonstrating a greater understanding of the interconnectedness of mental and physical health and can positively influence the transdisciplinary care team to take a person-centered approach to address all health issues, in pursuit of the individual's health goals. Professional case managers must increase their understanding of mental health, becoming more aware of "red flags" that may necessitate a further evaluation and assessment by a mental health professional. They should also hone their communication skills, particularly the use of motivational interviewing techniques, to encourage individuals to discuss their feelings, worries, fears, and anxiety, as well as any potential symptoms of depression, which may range from mild to severe. Without judgment or bias, the case manager, as the advocate, can provide the information, support, or other services needed to address mental health issues, to support and further the individual's health goals.

Social Support and Lifestyle vs. Medical Diabetes Self-Management in the Diabetes Study of Northern California (DISTANCE)

PubMed Central

Rosland, Ann-Marie; Piette, John D.; Lyles, Courtney R.; Parker, Melissa M.; Moffet, Howard H.; Adler, Nancy E.; Schillinger, Dean; Karter, Andrew J.

2014-01-01

Background In chronic illness self-care, social support may influence some health behaviors more than others. Purpose Examine the relationship between social support and seven individual chronic illness self-management behaviors including two healthy “lifestyle” behaviors (physical activity and diet) and five more highly-skilled and diabetes-specific (“medical”) behaviors (checking feet, oral medication adherence, insulin adherence, self-monitoring of blood glucose, and primary care appointment attendance). Methods Using cross-sectional administrative and survey data from 13,366 patients with type 2 diabetes, we specified Poisson regression models to estimate adjusted relative risks (ARR) of practicing each self-management behavior at higher vs lower levels of social support. Results Higher levels of emotional support and social network scores were significantly associated with lifestyle behaviors [healthful eating ARR (95%CI) 1.14 (1.08, 1.21) and 1.10 (1.05, 1.16), and physical activity 1.09 (1.01, 1.17) and 1.20 (1.12, 1.28)]. Both social support measures were also associated with checking feet [ARR 1.21 (1.12, 1.31) and 1.10 (1.02, 1.17)]. Neither measure was significantly associated with other medical behaviors. Conclusions Social support was associated with increased adherence to lifestyle self-management behaviors, but was not associated with increased medical self-management behaviors, other than foot self-examination. PMID:24794624

The Integration of Behavioral Science Theory and Clinical Experience for Second-Year Medical Students.

ERIC Educational Resources Information Center

Taylor, Kathryn M.; And Others

1983-01-01

A program is described that relates behavioral science research to cancer care, encourages frank discussion and objective analysis of oncology practice, and attempts to dispell the myth that cancer patients are not medically manageable. A wide range of teaching methods are used. (MSE)

Assessing and Managing Violence Risk in Juveniles

ERIC Educational Resources Information Center

Borum, Randy; Verhaagen, David

2006-01-01

Highly practical and accessible, this is an indispensable resource for any mental health practitioner working with adolescents at risk for violent behavior. Presented is a comprehensive framework for evaluating justice-involved youth or those whose behavior in school, therapy sessions, or other contexts raises concern about violence. Detailed case…

Mechanisms of behavior modification in clinical behavioral medicine in China.

PubMed

Yang, Zhiyin; Su, Zhonghua; Ji, Feng; Zhu, Min; Bai, Bo

2014-08-01

Behavior modification, as the core of clinical behavioral medicine, is often used in clinical settings. We seek to summarize behavior modification techniques that are commonly used in clinical practice of behavioral medicine in China and discuss possible biobehavioral mechanisms. We reviewed common behavior modification techniques in clinical settings in China, and we reviewed studies that explored possible biobehavioral mechanisms. Commonly used clinical approaches of behavior modification in China include behavior therapy, cognitive therapy, cognitive-behavioral therapy, health education, behavior management, behavioral relaxation training, stress management intervention, desensitization therapy, biofeedback therapy, and music therapy. These techniques have been applied in the clinical treatment of a variety of diseases, such as chronic diseases, psychosomatic diseases, and psychological disorders. The biobehavioral mechanisms of these techniques involve the autonomic nervous system, neuroendocrine system, neurobiochemistry, and neuroplasticity. Behavior modification techniques are commonly used in the treatment of a variety of somatic and psychological disorders in China. Multiple biobehavioral mechanisms are involved in successful behavior modification.

Lessons Learned Coaching Teachers in Behavior Management: The PBISplus Coaching Model

PubMed Central

Hershfeldt, Patricia A.; Pell, Karen; Sechrest, Richard; Pas, Elise T.; Bradshaw, Catherine P.

2013-01-01

There is growing interest in coaching as a means of promoting professional development and the use of evidence-based practices in schools. This paper describes the PBISplus coaching model used to provide technical assistance for classroom- and school-wide behavior management to elementary schools over the course of three years. This tier-two coaching model was implemented within the context of school-wide Positive Behavioral Interventions and Supports (PBIS) and tested in a 42-school randomized controlled trial. We summarize some of the lessons learned by coaches regarding their efforts to gain access to the administrators, teachers, and student support staff in order to effect change and improve student outcomes. We conclude with a discussion of ways to successfully collaborate with teachers to promote effective classroom- and school-wide behavior management. PMID:23599661

Assessment of general education teachers' Tier 1 classroom practices: contemporary science, practice, and policy.

PubMed

Reddy, Linda A; Fabiano, Gregory A; Jimerson, Shane R

2013-12-01

Progress monitoring is a type of formative assessment. Most work on progress monitoring in elementary school settings has been focused on students. However, teachers also can benefit from frequent evaluations. Research addressing teacher progress monitoring is critically important given the recent national focus on teacher evaluation and effectiveness. This special topic section of School Psychology Quarterly is the first to showcase the current research on measuring Tier 1 instructional and behavioral management practices used by prekindergarten and elementary school teachers in general education settings. The three studies included in the special section describe the development and validation efforts of several teacher observational and self-report measures of instruction and/or behavioral management. These studies provide evidence for the utility of such assessments for documenting the use of classroom practices, and these assessment results may be leveraged in innovative coaching models to promote best practice. These articles also offer insight and ideas for the next generation of teacher practice assessment for the field. Finally, the special topic is capped by a commentary synthesizing the current work and offers "big ideas" for future measurement development, policy, and professional development initiatives. PsycINFO Database Record (c) 2013 APA, all rights reserved.

The influence of time management skill on the curvilinear relationship between organizational citizenship behavior and task performance.

PubMed

Rapp, Adam A; Bachrach, Daniel G; Rapp, Tammy L

2013-07-01

In this research we integrate resource allocation and social exchange perspectives to build and test theory focusing on the moderating role of time management skill in the nonmonotonic relationship between organizational citizenship behavior (OCB) and task performance. Results from matching survey data collected from 212 employees and 41 supervisors and from task performance metrics collected several months later indicate that the curvilinear association between OCB and task performance is significantly moderated by employees' time management skill. Implications for theory and practice are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Self-management by family caregivers to manage changes in the behavior and mood of their relative with dementia: an online focus group study.

PubMed

Huis In Het Veld, Judith; Verkaik, Renate; van Meijel, Berno; Verkade, Paul-Jeroen; Werkman, Wendy; Hertogh, Cees; Francke, Anneke

2016-05-03

Self-management is important for family caregivers of people with dementia, especially when they face changes in their relative's behavior and mood, such as depression, apathy, anxiety, agitation and aggression. The aim of this study is to give insight into why these changes in behavior and mood are stressful for family caregivers, what self-management strategies family caregivers use when managing these changes and the stress they experience. A qualitative study was conducted using four online focus groups with 32 family caregivers of people with dementia living in the Netherlands. Transcripts of the focus group discussions were analyzed using principles of thematic analysis. Managing changes in the behavior and mood of their relative with dementia is stressful for family caregivers because of constantly having to switch, continuously having to keep the person with dementia occupied and distracted, the fact that others see a different side to the relative, and the fact that caregivers know what to do, but are often not able to put this into practice. Caregivers use calming down and stimulation as self-management strategies for influencing the changes in the behavior and mood of their relative. Furthermore, caregivers describe three self-management strategies that let them manage their own stress and keep up the care for their loved ones: looking for distractions, getting rest, and discussing their feelings and experiences. Behavior and mood changes of a person with dementia are stressful for family caregivers. They use several self-management strategies to positively affect the mood and behavior changes, and also to manage their own stress.

Dimensionality of Upper Elementary Mathematics Instruction: Exploring Factors across Two Observational Instruments

ERIC Educational Resources Information Center

Blazar, David; Braslow, David; Charalambous, Charalambos Y.

2015-01-01

Over the past several years, research teams have developed observational instruments to measure the quality of teachers' instructional practices. Instruments such as Framework for Teaching (FFT) and the Classroom Assessment Scoring System (CLASS) assess general teaching practices, including student-teacher interactions, behavior management, and…

Constructing Ability Groups in the Secondary School: Issues in Practice.

ERIC Educational Resources Information Center

Ireson, Judith; Clark, Helen; Hallam, Susan

2002-01-01

Examines grouping practices in 45 secondary schools in England based on information provided by curriculum managers and department heads about allocation procedures, factors affecting the size and number of student groups, movement between groups, pressures and constraints on movement, and behavioral and motivational factors. Finds wide variety of…

Restorative Practices from Candy and Punishment to Celebrations and Problem-Solving Circles

ERIC Educational Resources Information Center

Goldys, Patrice H.

2016-01-01

Norwood Elementary, a Title I science, technology, engineering, and math (STEM) school in Baltimore County, MD, recently realized that traditional behavior management programs and processes were not working with their students. Over time, school administrators discovered more successful approaches, and restorative practices became the way to…

Child Behavior Problems, Teacher Executive Functions, and Teacher Stress in Head Start Classrooms

PubMed Central

Friedman-Krauss, Allison H.; Raver, C. Cybele; Neuspiel, Juliana M.; Kinsel, John

2017-01-01

Research Findings The current article explores the relationship between teachers’ perceptions of child behavior problems and preschool teacher job stress, as well as the possibility that teachers’ executive functions moderate this relationship. Data came from 69 preschool teachers in 31 early childhood classrooms in 4 Head Start centers and were collected using Web-based surveys and Web-based direct assessment tasks. Multilevel models revealed that higher levels of teachers’ perceptions of child behavior problems were associated with higher levels of teacher job stress and that higher teacher executive function skills were related to lower job stress. However, findings did not yield evidence for teacher executive functions as a statistical moderator. Practice or Policy Many early childhood teachers do not receive sufficient training for handling children’s challenging behaviors. Child behavior problems increase a teacher’s workload and consequently may contribute to feelings of stress. However, teachers’ executive function abilities may enable them to use effective, cognitive-based behavior management and instructional strategies during interactions with students, which may reduce stress. Providing teachers with training on managing challenging behaviors and enhancing executive functions may reduce their stress and facilitate their use of effective classroom practices, which is important for children’s school readiness skills and teachers’ health. PMID:28596698

The effects of self-management in general education classrooms on the organizational skills of adolescents with ADHD.

PubMed

Gureasko-Moore, Sammi; Dupaul, George J; White, George P

2006-03-01

Self-management procedures have been used in school settings to successfully reduce problem behaviors, as well as to reinforce appropriate behavior. A multiple-baseline across participants design was applied in this study to evaluate the effects of using a self-management procedure to enhance the classroom preparation skills of secondary school students with attention-deficit/ hyperactivity disorder (ADHD). Three male students enrolled in a public secondary school were selected for this study because teacher reports suggested that these students were insufficiently prepared for class and inconsistently completed assignments. The intervention involved training in self-management procedures focusing on the improvement of classroom preparation skills. Following the intervention, the training process was systematically faded. Results were consistent across the 3 participants in enhancing classroom preparation behaviors. Implications for practice and future research are discussed.

An Algorithm-Based Approach for Behavior and Disease Management in Children.

PubMed

Meyer, Beau D; Lee, Jessica Y; Thikkurissy, S; Casamassimo, Paul S; Vann, William F

2018-03-15

Pharmacologic behavior management for dental treatment is an approach to provide invasive yet compassionate care for young children; it can facilitate the treatment of children who otherwise may not cooperate for traditional in-office care. Some recent highly publicized procedural sedation-related tragedies have drawn attention to risks associated with pharmacologic management. However, it remains widely accepted that, by adhering to proper guidelines, procedural sedation can assist in the provision of high-quality dental care while minimizing morbidity and mortality from the procedure. The purpose of this paper was to propose an algorithm for clinicians to consider when selecting a behavior and disease management strategy for early childhood caries. This algorithm will not ensure a positive outcome but can assist clinicians when counseling caregivers about risks, benefits, and alternatives. It also emphasizes and underscores best-safety practices.

Space age management for social problems

NASA Technical Reports Server (NTRS)

Levine, A. L.

1973-01-01

Attempts to apply space age management to social problems were plagued with difficulties. Recent experience in the State of Delaware and in New York City, however, indicate new possibilities. Project management as practiced in NASA was applied with promising results in programs dealing with housing and social services. Such applications are feasible, according to recent research, because project management utilizes social and behavioral approaches, as well as advanced management tools, such as PERT, to achieve results.

Weight-related concerns and diet behaviors among urban young females: A cross-sectional study

PubMed Central

Omidvar, Shabnam; Amiri, Fatemeh Nasiri; Bakouei, Fatemeh; Begum, Khyrunnisa

2016-01-01

Background: Females are more likely than males to perceive themselves as too heavy, this has been explained in terms of the equation of “female beauty with extreme thinness.” Therefore, females are in general prone to develop unhealthy behaviors for weight management. Wrong weight control behaviors have significant health consequences. Objectives: To investigate the body weight concerns, body satisfaction, and weight control behaviors among young females and their association with age and socioeconomic status (SES). Materials and Methods: A cross-sectional study conducted in urban areas from a major city in South India. About 650 healthy unmarried females aged 15–25 years formed the study population. Self-reporting questionnaires were used to obtain relevant data. The categorical data were analyzed using Chi-square, correlation, and regression analyses by SPSS version 16. Results: Most overweight and obese subjects perceived themselves as overweight. Adolescents were more likely to report themselves as overweight. The perceived weight, body satisfaction, and weight control behaviors are influenced by weight status and age of the subjects. However, SES of the participants did not exhibit effect of others’ opinion about their weight and body satisfaction as well as weight management behaviors. Conclusion: The high prevalence of weight-related concerns suggests that all females should be reached with appropriate information and interventions. Healthy weight control practices need to be explicitly promoted and unhealthy practices discouraged. Young females need special attention toward weight management. PMID:27843836

The influence of ethics on leadership.

PubMed

Kraemer, A M

1995-05-01

Value driven ethical leadership is needed today. The housekeeping field employs a diverse work force, and managers must develop and empower workers to attain organization goals. As managers, we must understand and develop our personal value structures that affect our decision making. This paper reviews Lawrence Kohlberg's study of moral behavior and how those stages are relevant to ethical management practices. It also addresses ways to overcome some obstacles in understanding and dealing with personal values that may threaten moral and ethical practices. Mature ethical principles and good communication are the foundation for and foster strong leadership for the future.

Fads, fashions, and bandwagons in health care strategy.

PubMed

Kaissi, Amer A; Begun, James W

2008-01-01

Many observers have alleged that "fads," "fashions," and "bandwagons" (imitation strategies) are prominent feature of the health care organizational strategy landscape. "Imitation behavior" may fulfill symbolic functions such as signaling innovativeness but results in the adoption of strategies that are effective for some organizations but not for many organizations that adopt them. We seek to identify and recognize the extent of fads, fashions, and bandwagons in health care strategy, understand the rationale for such imitation behavior, and draw implications for practice, education, and research. We examine theoretical arguments for imitation and evidence on imitation strategies in health care organizations, based on literature review, interviews with health care managers in two different metropolitan areas, and a case example of the purchase of medical group practices by hospitals. Fads, fashions, and bandwagons can be distinguished from strategic responses to regulatory requirements and efficient strategic choices that are the result of systematic analysis. There are substantial theoretical reasons to expect imitation behavior. Imitation strategies can derive from copying the behavior of "exemplar" organizations or from "keeping up" with competitive rivals. Anecdotal and empirical evidence points to a significant amount of imitation behavior in health care strategy. The performance effects of imitation behavior have not been investigated in past research. The widespread existence of fads and fashions is an argument for evidence-based management. Although it is essential to learn about strategies that have worked for other organizations, managers should carefully take account of the quality of evidence for the strategy and their organizations' distinctive local conditions. Managers should beware of the tendency of individuals and groups to move too readily to the solution stage of problem solving.

A Descriptive Case Study of a School-Wide Positive Behavior Support (PBS) System in Schools with Principal-Led Planning Teams and Coach-Led Planning Teams

ERIC Educational Resources Information Center

McWilliams, Ellen K.

2011-01-01

Managing disruptive behaviors in schools is a high-ranking concern in communities across the country (Rose & Gallup, 2006). Unfortunately, the practice of instituting tougher and more severe consequences for increased discipline problems has not resulted in a decrease of disruptive behavior (Lewis & Garrison-Harrell, 1999; Safran &…

Reversing the Use of Hobson's Choice: Culturally Relevant Assessment and Treatment Practices for Culturally and Linguistically Diverse Learners with Problem Behaviors

ERIC Educational Resources Information Center

Obiakor, Festus E.; Gibson, Lenwood

2015-01-01

Hobson's Choice is a psychological philosophy that prescribes a "take-it-or-leave-it" approach when addressing the problematic behaviors of students. Logically, this choice provides a traditional order in the classroom and gives teachers and service providers the sole power and authority to manage problem behaviors. For many students…

Teacher Burnout: Diagnosis, Prevention, Remediation.

ERIC Educational Resources Information Center

Kossack, Sharon W.; Woods, Sandra L.

1980-01-01

Practical suggestions for diagnosing, preventing, and remediating teacher burnout include changing the school environment, health habits, supportive behavior, time management, and general perspective on teaching and job situations. (JD)

A survival strategy for an academic psychiatry department in a managed care environment.

PubMed

Harris, E S; Neufeld, J; Hales, R E; Hilty, D

2001-12-01

The changing economics of medical practice have had a profound effect on the educational, research, and service missions of academic departments of psychiatry across the country. The authors describe the development of a managed behavioral health care organization in their parent academic health system as a survival strategy for allowing their department to function in a managed care environment. They present a series of lessons learned in this effort to adapt to a highly volatile managed behavioral health care market: know how you fit into your market as well as your institution, form cooperative alliances within and outside of your institution, provide incentives to manage risk, focus on core competencies, innovate in your areas of strength, and collect data.

Evaluating the Performance Improvement Preferences of Disability Service Managers: An Exploratory Study Using Gilbert's Behavior Engineering Model

ERIC Educational Resources Information Center

Wooderson, John R.; Cuskelly, Monica; Meyer, Kim A.

2017-01-01

Background: Front-line managers play an important role in managing the performance of staff working in services for people with intellectual disability, but little is known about the practices they prefer to use to improve staff performance and whether these align with what research has shown to be effective. Method: This study comprised two…

Managing Asthma in Elementary and Middle Schools: Adherence to Federal Laws and National Guidelines

ERIC Educational Resources Information Center

Schilling, Ethan J.; Neuharth-Pritchett, Stacey; Getch, Yvette Q.; Lease, A. Michele

2017-01-01

The current study examined teacher-reported asthma management practices in school and adherence to federal guidelines for students with asthma. 593 kindergarten-eighth grade teachers completed surveys regarding compliance with federal laws and policies, information-seeking behavior, asthma-related professional development, and asthma management…

Winter habitat selection patterns of Merriam's turkeys in the southern Black Hills, South Dakota

Treesearch

Chad P. Lehman; Mark A. Rumble; Lester D. Flake

2007-01-01

In northern areas of their expanded range, information on Merriam's turkeys (Meleagris gallopavo merriami) is lacking, specifically pertaining to wintering behavior and factors associated with winter habitat selection. Forest managers need detailed quantification of the effects of logging and other management practices on wintering habitats...

Organizational Behavior: Where Does It Fit in Today's Management Curriculum?

ERIC Educational Resources Information Center

Singh, Robert P.; Schick, Allen G.

2007-01-01

Maximizing shareholder value is the dominant goal that influences management decision making in business practice. This goal--with rapid improvements in technology, changes in capital markets, and global competition--has altered employment relations between workers and top executives. The authors' purpose in this article was to share thoughts and…

Managing Student Digital Distractions and Hyperconnectivity: Communication Strategies and Challenges for Professorial Authority

ERIC Educational Resources Information Center

Cheong, Pauline Hope; Shuter, Robert; Suwinyattichaiporn, Tara

2016-01-01

Recent debates on the use of technology in classrooms have highlighted the significance of regulating students' off-task and multitasking behaviors facilitated by digital media. This paper investigates the communication practices that constitute professorial authority to manage college students' digital distractions in classrooms. Findings from…

Comparative analysis of partnership behaviors in the National Park Service

Treesearch

Melissa S. Weddell; Brett A. Wright; Kenneth F. Backman

2008-01-01

The partnership phenomenon has received considerable attention as an alternative management strategy for public agencies. The growing use of partnerships has created a need to understand key elements of partnership success and failure, how partnerships address park and recreation management paradoxes, and guidelines for best practices (Mowen & Kerstetter, 2006)....

Management of Classroom Behaviors: Perceived Readiness of Education Interns

ERIC Educational Resources Information Center

Garland, Dennis; Garland, Krista Vince; Vasquez, Eleazar, III

2013-01-01

Education students at a large research university participated in internships during their final semesters as part of their respective programs of study as a capstone experience. Qualitative and quantitative methods were used to collect data on the perceptions of interns' readiness and knowledge of evidence-based practices to manage classroom…

Chronic care coordination by integrating care through a team-based, population-driven approach: a case study.

PubMed

van Eeghen, Constance O; Littenberg, Benjamin; Kessler, Rodger

2018-05-23

Patients with chronic conditions frequently experience behavioral comorbidities to which primary care cannot easily respond. This study observed a Vermont family medicine practice with integrated medical and behavioral health services that use a structured approach to implement a chronic care management system with Lean. The practice chose to pilot a population-based approach to improve outcomes for patients with poorly controlled Type 2 diabetes using a stepped-care model with an interprofessional team including a community health nurse. This case study observed the team's use of Lean, with which it designed and piloted a clinical algorithm composed of patient self-assessment, endorsement of behavioral goals, shared documentation of goals and plans, and follow-up. The team redesigned workflows and measured reach (patients who engaged to the end of the pilot), outcomes (HbA1c results), and process (days between HbA1c tests). The researchers evaluated practice member self-reports about the use of Lean and facilitators and barriers to move from pilot to larger scale applications. Of 20 eligible patients recruited over 3 months, 10 agreed to participate and 9 engaged fully (45%); 106 patients were controls. Relative to controls, outcomes and process measures improved but lacked significance. Practice members identified barriers that prevented implementation of all changes needed but were in agreement that the pilot produced useful outcomes. A systematized, population-based, chronic care management service is feasible in a busy primary care practice. To test at scale, practice leadership will need to allocate staffing, invest in shared documentation, and standardize workflows to streamline office practice responsibilities.

Stress and dress: investigating the relationship between social anxiety and appearance management among gay and straight men.

PubMed

Reilly, Andrew; Rudd, Nancy Ann

2007-01-01

This research project explores the relationship between social anxiety and appearance management behaviors (AMB), including both routine and non-routine, among gay and straight men and women. Prior research had found links between AMB and stress (Reilly & Rudd, 2002), stress and (perceived) discrimination (Lee, 1997; Savin-Williams, 1994), and sexual orientation and weight (Brand, Rothblum, & Solom, 1992). An argument is made that links stress with AMB using the foundation of Social Comparison Theory (Festinger, 1954) as a guide. Research questions investigated were: (1) Is there a correlation between stress and AMB; (2) Is there a significant difference between body mass indices of men and women of differing sexual orientations; (3) How do AMB differ between those with gay and straight orientations; and (4) How do AMB differ between men and women? Using a survey design, a questionnaire was posted on the Internet. Measures included the Rudd/Lennon Appearance Management Scale of Routine and Risky Behaviors and the Liebowitz Social Anxiety Scale. A total of 365 usable forms were completed. Results show that social anxiety is positively correlated with non-routine AMB, or behaviors that carry some risk. Gay and straight participants differed on the routine AMB they practiced. Men and women differed on the non-routine or risky AMB they practiced or would consider practicing. Implications are discussed and further research is suggested.

[The effect of assertiveness training on communication related factors and personnel turnover rate among hospital nurses].

PubMed

Kang, Myung Ja; Lee, Haejung

2006-08-01

The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

Behavioral interventions for insomnia: Theory and practice

PubMed Central

Sharma, Mahendra P.; Andrade, Chittaranjan

2012-01-01

Insomnia is a general clinical term that refers to a difficulty in initiating or maintaining sleep. Insomnia is widely prevalent in the general population, especially in the elderly and in those with medical and psychiatric disorders. Hypnotic drug treatments of insomnia are effective but are associated with potential disadvantages. This article presents an overview of behavioral interventions for insomnia. Behavioral interventions for insomnia include relaxation training, stimulus control therapy, sleep restriction therapy, sleep hygiene, paradoxical intention therapy, cognitive restructuring, and other approaches. These are briefly explained. Research indicates that behavioral interventions are efficacious, effective, and likely cost-effective treatments for insomnia that yield reliable, robust, and long-term benefits in adults of all ages. Detailed guidance is provided for the practical management of patients with insomnia. PMID:23372241

Effectiveness of a School- and Community-based Academic Asthma Health Education Program on Use of Effective Asthma Self-care Behaviors in Older School-age Students

PubMed Central

Kintner, Eileen K.; Cook, Gwendolyn; Marti, C. Nathan; Allen, April; Stoddard, Debbie; Harmon, Phyllis; Gomes, Melissa; Meeder, Linda; Van Egeren, Laurie A.

2014-01-01

Purpose The purpose was to evaluate the effectiveness of SHARP, an academic asthma health education and counseling program, on fostering use of effective asthma self-care behaviors. Design and Methods This was a phase III, two-group, cluster randomized, single-blinded, longitudinal design guided the study. Caregivers of 205 fourth- and fifth-grade students completed the asthma health behaviors survey at pre-intervention and 1, 12, and 24 months post-intervention. Analysis involved multilevel modeling. Results All students demonstrated improvement in episode management, risk-reduction/prevention, and health promotion behaviors; SHARP students demonstrated increased improvement in episode management and risk-reduction/prevention behaviors. Practice Implications Working with schoolteachers, nurses can improve use of effective asthma self-care behaviors. PMID:25443867

Aggregate Timber Supply: From the Forest to the Market

Treesearch

David N. Wear; Subhrendu K. Pattanayak

2003-01-01

Timber supply modeling is a means of formalizing the production behavior of heterogeneous landowners managing a wide variety of forest types and vintages within a region. The critical challenge of timber supply modeling is constructing theoretically valid and empirically practical aggregate descriptions of harvest behavior. Understanding timber supply is essential for...

Crown fuel spatial variability and predictability of fire spread

Treesearch

Russell A. Parsons; Jeremy Sauer; Rodman R. Linn

2010-01-01

Fire behavior predictions, as well as measures of uncertainty in those predictions, are essential in operational and strategic fire management decisions. While it is becoming common practice to assess uncertainty in fire behavior predictions arising from variability in weather inputs, uncertainty arising from the fire models themselves is difficult to assess. This is...

Teacher-Provided Positive Attending to Improve Student Behavior

ERIC Educational Resources Information Center

Perle, Jonathan G.

2016-01-01

A teacher serves many important roles within a classroom, including an educator and a manager of child behavior. Inattention, overactivity, and noncompliance have long been cited as some of the most common areas of reported difficulty for schools (Axelrod & Zank, 2012; Goldstein, 1995). The evidence-based practice of positive attending (i.e.,…

Knowledge, Attitude, and Practice on Menstrual Hygiene Management among School Adolescents.

PubMed

Yadav, Ram Naresh; Joshi, Shrijana; Poudel, Rajesh; Pandeya, Pawan

2018-01-01

Menstrual hygiene management remains a taboo in many communities in Nepal. Cultural beliefs about menstruation such as food taboos and untouchability have negative impact on dignity, health and education of adolescent girls. The objective of the study was to assess the current knowledge, attitude and practice of school adolescents on menstrual hygiene management in Doti District in Far-Western Nepal. This cross-sectional study was carried out from October to December 2016 at seven village development committees in Doti district, Nepal. This study was done among 276 students from grade seven and eight of 11 schools. Self-administered structured questionnaire was used to obtain information from school students. Descriptive analysis was done to analyse the knowledge, attitude and practice of school adolescents on menstrual hygiene management. 67.4% respondents had fair knowledge and 26.4% respondents had good knowledge on menstrual hygiene management. However, out of 141 female adolescent respondents, only 56 (40%) were engaged in good menstrual hygiene practices. Around half of the respondents had positive attitude towards menstrual hygiene management related issues. Although knowledge on menstrual hygiene management among school adolescents is fair, still attitude and practice need to improve. Findings indicate the need of behavior change communication campaigns along with frequent reinforcement of school health education programs.

A sociogenomic perspective on neuroscience in organizational behavior.

PubMed

Spain, Seth M; Harms, P D

2014-01-01

We critically examine the current biological models of individual organizational behavior, with particular emphasis on the roles of genetics and the brain. We demonstrate how approaches to biology in the organizational sciences assume that biological systems are simultaneously causal and essentially static; that genotypes exert constant effects. In contrast, we present a sociogenomic approach to organizational research, which could provide a meta-theoretical framework for understanding organizational behavior. Sociogenomics is an interactionist approach that derives power from its ability to explain how genes and environment operate. The key insight is that both genes and the environment operate by modifying gene expression. This leads to a conception of genetic and environmental effects that is fundamentally dynamic, rather than the static view of classical biometric approaches. We review biometric research within organizational behavior, and contrast these interpretations with a sociogenomic view. We provide a review of gene expression mechanisms that help explain the dynamism observed in individual organizational behavior, particularly factors associated with gene expression in the brain. Finally, we discuss the ethics of genomic and neuroscientific findings for practicing managers and discuss whether it is possible to practically apply these findings in management.

A sociogenomic perspective on neuroscience in organizational behavior

PubMed Central

Spain, Seth M.; Harms, P. D.

2014-01-01

We critically examine the current biological models of individual organizational behavior, with particular emphasis on the roles of genetics and the brain. We demonstrate how approaches to biology in the organizational sciences assume that biological systems are simultaneously causal and essentially static; that genotypes exert constant effects. In contrast, we present a sociogenomic approach to organizational research, which could provide a meta-theoretical framework for understanding organizational behavior. Sociogenomics is an interactionist approach that derives power from its ability to explain how genes and environment operate. The key insight is that both genes and the environment operate by modifying gene expression. This leads to a conception of genetic and environmental effects that is fundamentally dynamic, rather than the static view of classical biometric approaches. We review biometric research within organizational behavior, and contrast these interpretations with a sociogenomic view. We provide a review of gene expression mechanisms that help explain the dynamism observed in individual organizational behavior, particularly factors associated with gene expression in the brain. Finally, we discuss the ethics of genomic and neuroscientific findings for practicing managers and discuss whether it is possible to practically apply these findings in management. PMID:24616682

Modeling Off-Nominal Behavior in SysML

NASA Technical Reports Server (NTRS)

Day, John C.; Donahue, Kenneth; Ingham, Michel; Kadesch, Alex; Kennedy, Andrew K.; Post, Ethan

2012-01-01

Specification and development of fault management functionality in systems is performed in an ad hoc way - more of an art than a science. Improvements to system reliability, availability, safety and resilience will be limited without infusion of additional formality into the practice of fault management. Key to the formalization of fault management is a precise representation of off-nominal behavior. Using the upcoming Soil Moisture Active-Passive (SMAP) mission for source material, we have modeled the off-nominal behavior of the SMAP system during its initial spin-up activity, using the System Modeling Language (SysML). In the course of developing these models, we have developed generic patterns for capturing off-nominal behavior in SysML. We show how these patterns provide useful ways of reasoning about the system (e.g., checking for completeness and effectiveness) and allow the automatic generation of typical artifacts (e.g., success trees and FMECAs) used in system analyses.

The effect of a contingent monetary reward on probation referrals to a drug abuse program.

PubMed

Hunsaker, A C

1985-01-01

Faced with reductions in public funds and calls for greater accountability, substance abuse programs can possibly increase revenues through patient fees by increasing referrals from the criminal justice system. Accountability can be improved through the use of organizational behavior management techniques. This study demonstrates the utility of behavioral techniques to increase referrals and revenue in an outpatient drug abuse program. The rate of criminal justice referrals increased substantially when counselors were offered "commissions" based on patient fees. These results are discussed with respect to the practicality of behavioral techniques in the management of drug abuse programs and with regard to policy implications.

Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity

ERIC Educational Resources Information Center

Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna

2008-01-01

Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…

Stress management techniques in the prison setting.

PubMed

Kristofersson, Gisli Kort; Kaas, Merrie J

2013-01-01

The percentage of incarcerated individuals in the United States is currently close to an all time high, and more stressful places than prisons are hard to find. Because registered nurses and advance practice nurses are often the only healthcare providers readily available to prison inmates, nurses need a repertoire of effective strategies to minimize prisoners' stress-related symptoms and behaviors. The purpose of this critical literature review was to identify the state of knowledge about using stress management techniques (SMTs) in the prison setting for reducing psychological problems and/or behavioral problems in male and female adult prison populations. A comprehensive, systematic integrated literature search was performed using multiple relevant databases to identify studies using various SMTs for incarcerated adults. Although clinical practice recommendations for the use of SMTs in the prison setting cannot be made with strong certainty, nurses working in the prison setting should continue to incorporate muscle relaxation, Transcendental Meditation, and certain Eastern meditative practices in the care of their clients because of the safety and possible positive impacts and practicality these methods have in this setting.

Conditions that influence the impact of malpractice litigation risk on physicians’ behavior regarding patient safety

PubMed Central

2014-01-01

Background Practicing safe behavior regarding patients is an intrinsic part of a physician’s ethical and professional standards. Despite this, physicians practice behaviors that run counter to patient safety, including practicing defensive medicine, failing to report incidents, and hesitating to disclose incidents to patients. Physicians’ risk of malpractice litigation seems to be a relevant factor affecting these behaviors. The objective of this study was to identify conditions that influence the relationship between malpractice litigation risk and physicians’ behaviors. Methods We carried out an exploratory field study, consisting of 22 in-depth interviews with stakeholders in the malpractice litigation process: five physicians, two hospital board members, five patient safety staff members from hospitals, three representatives from governmental healthcare bodies, three healthcare law specialists, two managing directors from insurance companies, one representative from a patient organization, and one representative from a physician organization. We analyzed the comments of the participants to find conditions that influence the relationship by developing codes and themes using a grounded approach. Results We identified four factors that could affect the relationship between malpractice litigation risk and physicians’ behaviors that run counter to patient safety: complexity of care, discussing incidents with colleagues, personalized responsibility, and hospitals’ response to physicians following incidents. Conclusion In complex care settings procedures should be put in place for how incidents will be discussed, reported and disclosed. The lack of such procedures can lead to the shift and off-loading of responsibilities, and the failure to report and disclose incidents. Hospital managers and healthcare professionals should take these implications of complexity into account, to create a supportive and blame-free environment. Physicians need to know that they can rely on the hospital management after reporting an incident. To create realistic care expectations, patients and the general public also need to be better informed about the complexity and risks of providing health care. PMID:24460754

Issue Brief: Supporting Student Achievement through Sound Behavior Management Practices in Schools and Juvenile Justice Facilities--A Spotlight on Positive Behavioral Interventions and Supports (PBIS)

ERIC Educational Resources Information Center

Read, Nicholas; Lampron, Stephanie

2012-01-01

Many students across the Nation struggle with emotional and behavioral problems that may lead them to act out in ways that school administrators and teachers might not understand or be prepared to respond to effectively. In today's era of highstakes testing, zero-tolerance discipline measures, and shrinking school and district budgets, there is an…

Factors Influencing Attitude, Safety Behavior, and Knowledge regarding Household Waste Management in Guinea: A Cross-Sectional Study

PubMed Central

Mamady, Keita

2016-01-01

Waste indiscriminate disposal is recognized as an important cause of environmental pollution and is associated with health problems. Safe management and disposal of household waste are an important problem to the capital city of Guinea (Conakry). The objective of this study was to identify socioeconomic and demographic factors associated with practice, knowledge, and safety behavior of family members regarding household waste management and to produce a remedial action plan. I found that no education background, income, and female individuals were independently associated with indiscriminate waste disposal. Unplanned residential area was an additional factor associated with indiscriminate waste disposal. I also found that the community residents had poor knowledge and unsafe behavior in relation to waste management. The promotion of environmental information and public education and implementation of community action programs on disease prevention and health promotion will enhance environmental friendliness and safety of the community. PMID:27092183

Factors Influencing Attitude, Safety Behavior, and Knowledge regarding Household Waste Management in Guinea: A Cross-Sectional Study.

PubMed

Mamady, Keita

2016-01-01

Waste indiscriminate disposal is recognized as an important cause of environmental pollution and is associated with health problems. Safe management and disposal of household waste are an important problem to the capital city of Guinea (Conakry). The objective of this study was to identify socioeconomic and demographic factors associated with practice, knowledge, and safety behavior of family members regarding household waste management and to produce a remedial action plan. I found that no education background, income, and female individuals were independently associated with indiscriminate waste disposal. Unplanned residential area was an additional factor associated with indiscriminate waste disposal. I also found that the community residents had poor knowledge and unsafe behavior in relation to waste management. The promotion of environmental information and public education and implementation of community action programs on disease prevention and health promotion will enhance environmental friendliness and safety of the community.

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management.

PubMed

Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

2016-01-01

Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided.

eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

PubMed Central

Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

2016-01-01

Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided. PMID:27853384

Impact of Medical Homes on Expenditures and Utilization for Beneficiaries With Behavioral Health Conditions.

PubMed

Romaire, Melissa A; Keyes, Vincent; Parish, William J; Kim, Konny

2018-05-15

Individuals with behavioral health conditions may benefit from enhanced care management provided by a patient-centered medical home (PCMH). In late 2011 and early 2012 Medicare began participating in PCMH initiatives in eight states through the Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration. This study examined how the initiatives addressed the needs of patients with behavioral health conditions and the impacts of the demonstration on expenditures and utilization for this population. Semistructured interviews provided insight into states' approaches to improving care, and multivariate difference-in-difference regressions of Medicare and Medicaid claims data were used to model changes in utilization and expenditures, comparing Medicare and Medicaid beneficiaries with behavioral health conditions in MAPCP demonstration practices with similar beneficiaries in non-PCMH primary care practices. Utilization included inpatient admissions and emergency department visits for all causes and for behavioral health conditions and outpatient visits for behavioral health conditions. Expenditure outcomes included expenditures for all services and those with a principal diagnosis of a behavioral health condition. Practices reported screening more patients for behavioral health conditions, linking patients to community-based behavioral health resources, and hiring behavioral health specialists to provide care. Several states embarked on unique initiatives to improve access to behavioral health services. However, few significant associations were found between participation in the MAPCP demonstration and utilization and expenditures for behavioral health services. Even though PCMHs made concerted efforts to improve access to care for their patients with behavioral health conditions, few substantial changes in patterns of care were noted.

Codes of environmental management practice: Assessing their potential as a tool for change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nash, J.; Ehrenfeld, J.

1997-12-31

Codes of environmental management practice emerged as a tool of environmental policy in the late 1980s. Industry and other groups have developed codes for two purposes: to change the environmental behavior of participating firms and to increase public confidence in industry`s commitment to environmental protection. This review examines five codes of environmental management practice: Responsible Care, the International Chamber of Commerce`s Business Charter for Sustainable Development, ISO 14000, the CERES Principles, and The Natural Step. The first three codes have been drafted and promoted primarily by industry; the others have been developed by non-industry groups. These codes have spurred participatingmore » firms to introduce new practices, including the institution of environmental management systems, public environmental reporting, and community advisory panels. The extent to which codes are introducing a process of cultural change is considered in terms of four dimensions: new consciousness, norms, organization, and tools. 94 refs., 3 tabs.« less

Parenting Tips: How to Improve Toddler Behavior

MedlinePlus

... of Privacy Practices Notice of Nondiscrimination Manage Cookies Advertising Mayo Clinic is a not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does not ...

Diversity management: an imperative for healthcare organizations.

PubMed

Gathers, Daryl

2003-01-01

Historically, white males have represented the ideal manager in appearance, values, and behaviors, resulting in overt or subtle discrimination in selection, evaluation, and promotion practices in corporate America. Because women and minorities could not meet this ideal, they were often passed over for advancement. The author discusses key areas of diversity management for healthcare administrators to consider: the elements of diversity, the reasons behind diversity management, and solutions for addressing many of the issues involved.

A patient-focused framework integrating self-management and informatics.

PubMed

Knight, Elizabeth P; Shea, Kimberly

2014-03-01

This article introduces a framework to (a) guide chronic illness self-management interventions through the integration of self-management and nursing informatics, (b) focus self-management research, and (c) promote ethical, patient-empowering technology use by practicing nurses. Existing theory and research focusing on chronic illness, self-management, health-enabling technology, and nursing informatics were reviewed and examined and key concepts were identified. A care paradigm focusing on concordance, rather than compliance, served as the overall guiding principle. This framework identifies key relationships among self-management (patient behaviors), health force (patient characteristics), and patient-defined goals. The role of health-enabling technology supporting these relationships is explored in the context of nursing informatics. The Empowerment Informatics framework can guide intervention design and evaluation and support practicing nurses' ethical use of technology as part of self-management support. Nurses worldwide provide support to patients who are living with chronic illnesses. As pressures related to cost and access to care increase, technology-enabled self-management interventions will become increasingly common. This patient-focused framework can guide nursing practice using technology that prioritizes patient needs. © 2013 Sigma Theta Tau International.

Knowledge, attitudes, and practices regarding antiretroviral management, reproductive health, sexually transmitted infections, and sexual risk behavior among perinatally HIV-infected youth in Thailand.

PubMed

Lolekha, Rangsima; Boon-Yasidhi, Vitharon; Leowsrisook, Pimsiri; Naiwatanakul, Thananda; Durier, Yuitiang; Nuchanard, Wipada; Tarugsa, Jariya; Punpanich, Warunee; Pattanasin, Sarika; Chokephaibulkit, Kulkanya

2015-01-01

More than 30% of perinatally HIV-infected children in Thailand are 12 years and older. As these youth become sexually active, there is a risk that they will transmit HIV to their partners. Data on the knowledge, attitudes, and practices (KAP) of HIV-infected youth in Thailand are limited. Therefore, we assessed the KAP of perinatally HIV-infected youth and youth reporting sexual risk behaviors receiving care at two tertiary care hospitals in Bangkok, Thailand and living in an orphanage in Lopburi, Thailand. From October 2010 to July 2011, 197 HIV-infected youth completed an audio computer-assisted self-interview to assess their KAP regarding antiretroviral (ARV) management, reproductive health, sexual risk behaviors, and sexually transmitted infections (STIs). A majority of youth in this study correctly answered questions about HIV transmission and prevention and the importance of taking ARVs regularly. More than half of the youth in this study demonstrated a lack of family planning, reproductive health, and STI knowledge. Girls had more appropriate attitudes toward safe sex and risk behaviors than boys. Although only 5% of the youth reported that they had engaged in sexual intercourse, about a third reported sexual risk behaviors (e.g., having or kissing boy/girlfriend or consuming an alcoholic beverage). We found low condom use and other family planning practices, increasing the risk of HIV and/or STI transmission to sexual partners. Additional resources are needed to improve reproductive health knowledge and reduce risk behavior among HIV-infected youth in Thailand.

Survey of primary care providers' knowledge of screening for, diagnosing and managing prediabetes.

PubMed

Tseng, Eva; Greer, Raquel C; O'Rourke, Paul; Yeh, Hsin-Chieh; McGuire, Maura M; Clark, Jeanne M; Maruthur, Nisa M

2017-11-01

Prediabetes affects 86 million US adults, but primary care providers' (PCPs') knowledge, practices, attitudes and beliefs toward prediabetes are unclear. Assess PCPs' (1) knowledge of risk factors that should prompt prediabetes screening, laboratory criteria for diagnosing prediabetes and guidelines for management of prediabetes; (2) management practices around prediabetes; (3) attitudes and beliefs about prediabetes. Self-administered written survey of PCPs. One hundred forty of 155 PCPs (90%) attending an annual provider retreat for academically affiliated multispecialty practices in the mid-Atlantic region. Descriptive analyses of survey questions on knowledge, management, and attitudes and beliefs related to prediabetes. Multivariate logistic regression was used to determine the association between provider characteristics (gender, race/ethnicity, years since training, specialty and provider type) and knowledge, management, and attitudes and beliefs about prediabetes. Six percent of PCPs correctly identified all of the risk factors that should prompt prediabetes screening. Only 17% of PCPs correctly identified the laboratory parameters for diagnosing prediabetes based on both fasting glucose and hemoglobin A1c. Nearly 90% of PCPs reported close follow-up (within 6 months) of patients with prediabetes. Few PCPs (11%) selected referral to a behavioral weight loss program as the recommended initial management approach to prediabetes. PCPs agreed that patient-related factors are important barriers to lifestyle change and metformin use. Provider characteristics were generally not associated with knowledge, management, attitudes and beliefs about prediabetes in multivariate analyses. Addressing gaps in knowledge and the underutilization of behavioral weight loss programs in prediabetes are two essential areas where PCPs could take a lead in curbing the diabetes epidemic.

Behavioral Health Integration into Primary Care: a Microsimulation of Financial Implications for Practices.

PubMed

Basu, Sanjay; Landon, Bruce E; Williams, John W; Bitton, Asaf; Song, Zirui; Phillips, Russell S

2017-12-01

New payments from Medicare encourage behavioral health services to be integrated into primary care practice activities. To evaluate the financial impact for primary care practices of integrating behavioral health services. Microsimulation model. We simulated patients and providers at federally qualified health centers (FQHCs), non-FQHCs in urban and rural high-poverty areas, and practices outside of high-poverty areas surveyed by the National Association of Community Health Centers, National Ambulatory Medical Care Survey, National Health and Nutrition Examination Survey, and National Health Interview Survey. A collaborative care model (CoCM), involving telephone-based follow-up from a behaviorist care manager, or a primary care behaviorist model (PCBM), involving an in-clinic behaviorist. Net revenue change per full-time physician. When behavioral health integration services were offered only to Medicare patients, net revenue was higher under CoCM (averaging $25,026 per MD in year 1 and $28,548/year in subsequent years) than PCBM (-$7052 in year 1 and -$3706/year in subsequent years). When behavioral health integration services were offered to all patients and were reimbursed by Medicare and private payers, only practices adopting the CoCM approach consistently gained net revenues. The outcomes of the model were sensitive to rates of patient referral acceptance, presentation, and therapy completion, but the CoCM approach remained consistently financially viable whereas PCBM would not be in the long-run across practice types. New Medicare payments may offer financial viability for primary care practices to integrate behavioral health services, but this viability depends on the approach toward care integration.

Pretreatment Social Relations, Therapeutic Alliance, and Improvements in Parenting Practices in Parent Management Training

ERIC Educational Resources Information Center

Kazdin, Alan E.; Whitley, Moira K.

2006-01-01

The authors examined the parent-therapist alliance in parent management training for children (N = 218; 53 girls and 165 boys, ages 2-14) referred clinically for oppositional, aggressive, and antisocial behavior. The interrelations of pretreatment parent social relationships, the parent-therapist alliance over the course of treatment, and…

Increasing In-Service Teacher Implementation of Classroom Management Practices through Consultation, Implementation Planning, and Participant Modeling

ERIC Educational Resources Information Center

Hagermoser Sanetti, Lisa M.; Williamson, Kathleen M.; Long, Anna C. J.; Kratochwill, Thomas R.

2018-01-01

Numerous evidence-based classroom management strategies to prevent and respond to problem behavior have been identified, but research consistently indicates teachers rarely implement them with sufficient implementation fidelity. The purpose of this study was to evaluate the effectiveness of implementation planning, a strategy involving logistical…

ACT for Leadership: Using Acceptance and Commitment Training to Develop Crisis-Resilient Change Managers

ERIC Educational Resources Information Center

Moran, Daniel J.; Consulting, Pickslyde

2010-01-01

The evidence-based executive coaching movement suggests translating empirical research into practical methods to help leaders develop a repertoire of crisis resiliency and value-directed change management skills. Acceptance and Commitment Therapy (ACT) is an evidence-based modern cognitive-behavior therapy approach that has been and applied to…

A novel attract-and-kill device for strengthening the management of Asian citrus psyllid

USDA-ARS?s Scientific Manuscript database

Control strategies that exploit the behavior of Asian citrus psyllid will lead to sustainable management practices of this economically important pest. Asian citrus psyllid (ACP) is a diurnal insect that strongly responds to visual cues. We developed an attract-and-kill device (AK) mimicking a citru...

Using Second Life to Enhance Classroom Management Practice in Teacher Education

ERIC Educational Resources Information Center

Mahon, Jennifer; Bryant, Bobby; Brown, Ben; Kim, Miran

2010-01-01

The following article discusses an educational simulation created within Second Life (SL) in order to assist pre-service teachers (PSTs) in gaining more experience managing student behavior. The article discusses the development, implementation, and assessment of the simulation as well as student data on the feasibility of the approach in…

Management of Hypertension in Private Practice: A Randomized Controlled Trial in Continuing Medical Education.

ERIC Educational Resources Information Center

Gullion, David S.; And Others

1988-01-01

A randomized control trial was used to evaluate a physician education program designed to improve physician management of patients' hypertension, hypertension-related behaviors, and diastolic blood pressure. It was suggested that more intensive continuing medical education programs are needed to improve physician performance and patient outcome.…

Managing outdoor recreation conflict on the Squamish, British Columbia Trail Network

Treesearch

Ana Elia Ramón Hidalgo; Howard Harshaw

2012-01-01

Recreationists with high expectations of satisfaction from outdoor recreation activities are increasingly using trails networks near urban areas. But differences in expectations, behaviors and values of trail users may create conflicts resulting in unsatisfactory experiences. The objective of this study was to test the efficacy of management practices that may reduce...

Revolving Classroom Door: Management Strategies To Eliminate the Quick Spin.

ERIC Educational Resources Information Center

Rancifer, Jesse L.

This paper presents classroom management practices that can be used to avoid the "revolving classroom door." In the revolving classroom door, misbehaving students are sent to the principal, and eventually returned to the classroom with no gains in student behavior or opportunity for learning. The paper begins by discussing the meaning of classroom…

Activating Patients for Sustained Chronic Disease Self-Management: Thinking Beyond Clinical Outcomes.

PubMed

Dye, Cheryl J; Williams, Joel E; Evatt, Janet H

2016-04-01

This article describes the impact of an 8-week community program implemented by trained volunteers on the hypertension self-management of 185 patients who were batch randomized to intervention or wait-list control groups. Compared with control group participants, a higher proportion of treatment group participants moved from the cognitive to behavioral stages of motivational readiness for being physically active (P < .001), practicing healthy eating habits (P = .001), handling stress well (P = .001), and living an overall healthy lifestyle (P = .003). They also demonstrated a greater average increase in perceived competence for self-management, F(1.134) = 4.957, P = .028, η2 = .036, and a greater increase in mean hypertension-related knowledge, F(1.160) = 16.571, P < .0005, η(2) = .094. Enduring lifestyle changes necessary for chronic disease self-management require that psychosocial determinants of health behavior are instilled, which is typically beyond standard medical practice. We recommend peer-led, community-based programs as a complement to clinical care and support the increasing health system interest in promoting population health beyond clinical walls. © The Author(s) 2016.

Effect of Community-based Behavior Change Communication on Delivery and Newborn Health Care Practices in a Resettlement Colony of Delhi.

PubMed

Parashar, Mamta; Singh, Sv; Kishore, Jugal; Kumar, Ajay; Bhardwaj, Milan

2013-01-01

Neonatal morbidity and mortality in India continue to be high. Among other reasons, newborn care practices are major contributors for such high rates. To assess the effect of behavior change communication (BCC) package among pregnant women regarding neonatal care. Semistructured and pretested schedule was used to interview 200 multigravidas on various aspects of neonatal care. Based on the preliminary data, BCC package was designed and implemented in intervention block in the community. Follow-up was done to find out change in their behavior. Data were analyzed using Epi info and Fischer exact test and chi-square test were applied in the baseline data. A P value of less than 0.05 was considered significant. Effect of the BCC package is given in terms of relative risk. BCC package increased 1.76 times higher number of deliveries conducted by trained dais in intervention group. There was significant improvement in using sterile cord tie (P = 0.01), applied nothing to the cord (P < 0.0001) and giving bath to their baby within 6 h of birth (P = 0.02) in intervention group as compared to nonintervention group. Significant difference was found between the two groups with regard to breastfeeding practices of baby. Harmful practices were reduced in the intervention group. Significant improvement was found in intervention group as compared to nonintervention group with regard to knowledge of danger signals, physiological variants, management of breastfeeding-related problems, and awareness of skin-to-skin technique for the management of hypothermic baby. Inadequate knowledge and adverse practices regarding neonatal care among mothers in study areas were found. BCC package had favorable impact on behavior of mothers for neonatal care in intervention group.

Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform

PubMed Central

Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

2018-01-01

Background Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. Objective The aim of this study was to develop and evaluate a computerized decision support platform called “Diabetes Web-Centric Information and Support Environment” (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines–based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. Methods A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners’ readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association’s (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients’ progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient’s self-management program and associated behavior interventions are delivered through a mobile patient diary via mobile phones and tablets. DWISE has been tested for its usability, functionality, usefulness, and acceptance through a series of qualitative studies. Results For the primary care practitioner tool, most usability problems were associated with the navigation of the tool and the presentation, formatting, understandability, and suitability of the content. For the patient tool, most issues were related to the tool’s screen layout, design features, understandability of the content, clarity of the labels used, and navigation across the tool. Facilitators and barriers to DWISE use in a shared decision-making environment have also been identified. Conclusions This work has provided a unique electronic health solution to translate complex health care knowledge in terms of easy-to-use, evidence-informed, point-of-care decision aids for primary care practitioners. Patients’ feedback is now being used to make necessary modification to DWISE. PMID:29669705

Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform.

PubMed

Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

2018-04-18

Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes. The aim of this study was to develop and evaluate a computerized decision support platform called "Diabetes Web-Centric Information and Support Environment" (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines-based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies. A health care knowledge management approach is used to implement DWISE so that it features the following functionalities: (1) assessment of primary care practitioners' readiness to administer validated behavior change interventions to patients with diabetes; (2) educational support for primary care practitioners to help them offer behavior change interventions to patients; (3) access to evidence-based material, such as the Canadian Diabetes Association's (CDA) clinical practice guidelines, to primary care practitioners; (4) development of personalized patient self-management programs to help patients with diabetes achieve healthy behaviors to meet CDA targets for managing type 2 diabetes; (5) educational support for patients to help them achieve behavior change; and (6) monitoring of the patients' progress to assess their adherence to the behavior change program and motivating them to ensure compliance with their program. DWISE offers these functionalities through an interactive Web-based interface to primary care practitioners, whereas the patient's self-management program and associated behavior interventions are delivered through a mobile patient diary via mobile phones and tablets. DWISE has been tested for its usability, functionality, usefulness, and acceptance through a series of qualitative studies. For the primary care practitioner tool, most usability problems were associated with the navigation of the tool and the presentation, formatting, understandability, and suitability of the content. For the patient tool, most issues were related to the tool's screen layout, design features, understandability of the content, clarity of the labels used, and navigation across the tool. Facilitators and barriers to DWISE use in a shared decision-making environment have also been identified. This work has provided a unique electronic health solution to translate complex health care knowledge in terms of easy-to-use, evidence-informed, point-of-care decision aids for primary care practitioners. Patients' feedback is now being used to make necessary modification to DWISE. ©Samina Abidi, Michael Vallis, Helena Piccinini-Vallis, Syed Ali Imran, Syed Sibte Raza Abidi. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.

Enhanced solid waste management by understanding the effects of gender, income, marital status, and religious convictions on attitudes and practices related to street littering in Nablus - Palestinian territory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Khatib, Issam A.; Arafat, Hassan A.; Daoud, Raeda

Litter is recognized as a form of street pollution and a key issue for solid waste managers. Nablus district (West Bank, Palestinian Territory), which has an established network of urban and rural roads, suffers from a wide-spread litter problem that is associated with these roads and is growing steadily with a well-felt negative impact on public health and the environment. The purpose of this research was to study the effects of four socio-economic characteristics (gender, income, marital status, and religious convictions) of district residents on their attitudes, practices, and behavior regarding street litter generation and to suggest possible remedial actions.more » All four characteristics were found to have strong correlations, not only with littering behavior and practices, but also with potential litter prevention strategies. In particular, the impact of religious convictions of the respondents on their littering habits and attitudes was very clear and interesting to observe.« less

Enhanced solid waste management by understanding the effects of gender, income, marital status, and religious convictions on attitudes and practices related to street littering in Nablus - Palestinian territory.

PubMed

Al-Khatib, Issam A; Arafat, Hassan A; Daoud, Raeda; Shwahneh, Hadeel

2009-01-01

Litter is recognized as a form of street pollution and a key issue for solid waste managers. Nablus district (West Bank, Palestinian Territory), which has an established network of urban and rural roads, suffers from a wide-spread litter problem that is associated with these roads and is growing steadily with a well-felt negative impact on public health and the environment. The purpose of this research was to study the effects of four socio-economic characteristics (gender, income, marital status, and religious convictions) of district residents on their attitudes, practices, and behavior regarding street litter generation and to suggest possible remedial actions. All four characteristics were found to have strong correlations, not only with littering behavior and practices, but also with potential litter prevention strategies. In particular, the impact of religious convictions of the respondents on their littering habits and attitudes was very clear and interesting to observe.

Project PEGS! Practices in Effective Guidance Strategies: Interactive CD-ROM Series for Educators To Practice Positive Behavior Management Skills, October 1, 1999-December 30, 2002. Final Performance Report.

ERIC Educational Resources Information Center

Quirk, Constance A.

This final report describes the activities and outcomes of a federally funded project designed to produce and field-test two computer-based interactive CD-ROMs: "PEGS! for Preschool" and "PEGS! for Secondary School". These programs, in a game format, provide beginning general and special educators with independent practice in…

How Do Private Health Plans Manage Specialty Behavioral Health Treatment Entry and Continuing Care?

PubMed

Quinn, Amity E; Reif, Sharon; Merrick, Elizabeth L; Horgan, Constance M; Garnick, Deborah W; Stewart, Maureen T

2017-09-01

This study examined private health plans' arrangements for accessing and continuing specialty behavioral health treatment in 2010 as federal health reforms were being implemented. These management practices have historically been stricter in behavioral health care than in general medical care; however, the Mental Health Parity and Addiction Equity Act of 2010 required parity in management policies. The data source was a nationally representative survey of private health plans' behavioral health treatment management approaches in 2010. Health plan executives were asked about activities for their plan's three products with highest enrollment (weighted N=8,427, 88% response rate). Prior authorization for outpatient behavioral health care was rarely required (4.7% of products), but 75% of products required authorization for ongoing care and over 90% required prior authorization for other levels of care. The most common medical necessity criteria were self-developed and American Society of Addiction Medicine criteria. Nearly all products had formal standards to limit waiting time for routine and urgent treatment, but almost 30% lacked such standards for detoxification services. A range of wait time-monitoring approaches was used. Health plans used a variety of methods to influence behavioral health treatment entry and continuing care. Few relied on prior authorization for outpatient care, but the use of other approaches to influence, manage, or facilitate access was common. Results provide a baseline for understanding the current management environment for specialty behavioral health care. Tracking health plans' approaches over time will be important to ensure that access to behavioral health care is not prohibitively restrictive.

Is Europe putting theory into practice? A qualitative study of the level of self-management support in chronic care management approaches

PubMed Central

2013-01-01

Background Self-management support is a key component of effective chronic care management, yet in practice appears to be the least implemented and most challenging. This study explores whether and how self-management support is integrated into chronic care approaches in 13 European countries. In addition, it investigates the level of and barriers to implementation of support strategies in health care practice. Methods We conducted a review among the 13 participating countries, based on a common data template informed by the Chronic Care Model. Key informants presented a sample of representative chronic care approaches and related self-management support strategies. The cross-country review was complemented by a Dutch case study of health professionals’ views on the implementation of self-management support in practice. Results Self-management support for chronically ill patients remains relatively underdeveloped in Europe. Similarities between countries exist mostly in involved providers (nurses) and settings (primary care). Differences prevail in mode and format of support, and materials used. Support activities focus primarily on patients’ medical and behavioral management, and less on emotional management. According to Dutch providers, self-management support is not (yet) an integral part of daily practice; implementation is hampered by barriers related to, among others, funding, IT and medical culture. Conclusions Although collaborative care for chronic conditions is becoming more important in European health systems, adequate self-management support for patients with chronic disease is far from accomplished in most countries. There is a need for better understanding of how we can encourage both patients and health care providers to engage in productive interactions in daily chronic care practice, which can improve health and social outcomes. PMID:23530744

Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder.

PubMed

Evans, Steven W; Owens, Julie Sarno; Bunford, Nora

2014-01-01

The purpose of this research was to update the Pelham and Fabiano ( 2008 ) review of evidence-based practices for children and adolescents with attention-deficit/hyperactivity disorder. We completed a systematic review of the literature published between 2007 and 2013 to establish levels of evidence for psychosocial treatments for these youth. Our review included the identification of relevant articles using criteria established by the Society of Clinical Child and Adolescent Psychology (see Southam-Gerow & Prinstein, in press ) using keyword searches and a review of tables of contents. We extend the conceptualization of treatment research by differentiating training interventions from behavior management and by reviewing the growing literature on training interventions. Consistent with the results of the previous review we conclude that behavioral parent training, behavioral classroom management, and behavioral peer interventions are well-established treatments. In addition, organization training met the criteria for a well-established treatment. Combined training programs met criteria for Level 2 (Probably Efficacious), neurofeedback training met criteria for Level 3 (Possibly Efficacious), and cognitive training met criteria for Level 4 (Experimental Treatments). The distinction between behavior management and training interventions provides a method for considering meaningful differences in the methods and possible mechanisms of action for treatments for these youth. Characteristics of treatments, participants, and measures, as well as the variability in methods for classifying levels of evidence for treatments, are reviewed in relation to their potential effect on outcomes and conclusions about treatments. Implications of these findings for future science and practice are discussed.

Data warehousing: toward knowledge management.

PubMed

Shams, K; Farishta, M

2001-02-01

With rapid changes taking place in the practice and delivery of health care, decision support systems have assumed an increasingly important role. More and more health care institutions are deploying data warehouse applications as decision support tools for strategic decision making. By making the right information available at the right time to the right decision makers in the right manner, data warehouses empower employees to become knowledge workers with the ability to make the right decisions and solve problems, creating strategic leverage for the organization. Health care management must plan and implement data warehousing strategy using a best practice approach. Through the power of data warehousing, health care management can negotiate bettermanaged care contracts based on the ability to provide accurate data on case mix and resource utilization. Management can also save millions of dollars through the implementation of clinical pathways in better resource utilization and changing physician behavior to best practices based on evidence-based medicine.

Exploring the use of situation awareness in behaviors and practices of health and safety leaders.

PubMed

Willmer, D R

2017-01-01

An understanding of how health and safety management systems (HSMS) reduce worksite injuries, illnesses and fatalities may be gained in studying the behaviors of health and safety leaders. These leaders bear the accountability for identifying, understanding and managing the risks of a mining operation. More importantly, they have to transfer this knowledge of perception, recognition and response to risks in the mining environment to their workers. The leaders' efforts to build and maintain a mining operation's workforce that consistently executes safe work practices may be captured through more than just lagging indicators of health and safety performance. This exploratory study interviewed six leaders in occupations such as site-level safety supervisors, mine superintendents and/or general managers at surface and underground stone, sand and gravel and metal/nonmetal mine sites throughout the United States, with employee populations ranging from 40 to 175. In exploring leaders' perspectives on how they systematically manage health and safety, examples such as approaches to task training, handling near-miss incidents, identifying future leaders and providing workers with feedback offer insights into how leaders translate their knowledge and management of site-level risks to others.

Exploring the use of situation awareness in behaviors and practices of health and safety leaders

PubMed Central

Willmer, D.R.

2018-01-01

An understanding of how health and safety management systems (HSMS) reduce worksite injuries, illnesses and fatalities may be gained in studying the behaviors of health and safety leaders. These leaders bear the accountability for identifying, understanding and managing the risks of a mining operation. More importantly, they have to transfer this knowledge of perception, recognition and response to risks in the mining environment to their workers. The leaders’ efforts to build and maintain a mining operation’s workforce that consistently executes safe work practices may be captured through more than just lagging indicators of health and safety performance. This exploratory study interviewed six leaders in occupations such as site-level safety supervisors, mine superintendents and/or general managers at surface and underground stone, sand and gravel and metal/nonmetal mine sites throughout the United States, with employee populations ranging from 40 to 175. In exploring leaders’ perspectives on how they systematically manage health and safety, examples such as approaches to task training, handling near-miss incidents, identifying future leaders and providing workers with feedback offer insights into how leaders translate their knowledge and management of site-level risks to others. PMID:29593373

Can Videos Play a Role in Promoting Good Landscape Management Behaviors?

ERIC Educational Resources Information Center

Warner, Laura A.; Lamm, Alexa J.; Rumble, Joy N.

2018-01-01

This study tested the effect of four short videos appealing to environmental values on home irrigation users' intent to use good irrigation and fertilization practices. The videos were largely ineffective, and there was only a small effect on one of the behaviors within the fertilizer loss treatment group. Implications point to a need for…

Collaborating with Parents to Establish Behavioral Goals in Child-Centered Play Therapy

ERIC Educational Resources Information Center

Post, Phyllis B.; Ceballos, Peggy L.; Penn, Saundra L.

2012-01-01

The purpose of this article is to provide specific guidelines for child-centered play therapists to set behavioral outcome goals to effectively work with families and to meet the demands for accountability in the managed care environment. The child-centered play therapy orientation is the most widely practiced approach among play therapists who…

Recognizing and Managing Children with Fetal Alcohol Syndrome/Fetal Alcohol Effects: A Guidebook.

ERIC Educational Resources Information Center

McCreight, Brenda

A family counselor and mother of adopted children with Fetal Alcohol Syndrome/Effects (FAS/E) offers practical advice and information on dealing with FAS/E's lifelong effects on behavior and learning. The book begins by discussing the historical, medical, and social aspects of FAS/E, and details common behavioral characteristics associated with…

Goal setting in diabetes self-management: Taking the baby steps to success

PubMed Central

DeWalt, Darren A.; Davis, Terry C.; Wallace, Andrea S.; Seligman, Hilary K.; Bryant-Shilliday, Betsy; Arnold, Connie L.; Freburger, Janet; Schillinger, Dean

2014-01-01

Objective To evaluate the usefulness of a diabetes self-management guide and a brief counseling intervention in helping patients set and achieve their behavioral goals. Methods We conducted a quasi-experimental study using a one group pretest posttest design to assess the effectiveness of a goal setting intervention along with a self-management guide. English- and Spanish-speaking patients with diabetes had one in-person session and two telephone follow-up calls with a non-clinical provider over a 12–16-week period. At each call and at the end of the study, we assessed success in achieving behavioral goals and problem solving toward those goals. Satisfaction with the self-management guide was assessed at the end of the study. Results We enrolled 250 patients across three sites and 229 patients completed the study. Most patients chose to set goals in diet and exercise domains. 93% of patients achieved at least one behavioral goal during the study and 73% achieved at least two behavioral goals. Many patients exhibited problem solving behavior to achieve their goals. We found no significant differences in reported achievement of behavior goals by literacy or language. Patients were very satisfied with the guide. Conclusions A brief goal setting intervention along with a diabetes self-management guide helped patients set and achieve healthy behavioral goals. Practice implications Non-clinical providers can successfully help a diverse range of patients with diabetes set and achieve behavioral goals. PMID:19359123

Integrating an agent-based model into a large-scale hydrological model for evaluating drought management in California

NASA Astrophysics Data System (ADS)

Sheffield, J.; He, X.; Wada, Y.; Burek, P.; Kahil, M.; Wood, E. F.; Oppenheimer, M.

2017-12-01

California has endured record-breaking drought since winter 2011 and will likely experience more severe and persistent drought in the coming decades under changing climate. At the same time, human water management practices can also affect drought frequency and intensity, which underscores the importance of human behaviour in effective drought adaptation and mitigation. Currently, although a few large-scale hydrological and water resources models (e.g., PCR-GLOBWB) consider human water use and management practices (e.g., irrigation, reservoir operation, groundwater pumping), none of them includes the dynamic feedback between local human behaviors/decisions and the natural hydrological system. It is, therefore, vital to integrate social and behavioral dimensions into current hydrological modeling frameworks. This study applies the agent-based modeling (ABM) approach and couples it with a large-scale hydrological model (i.e., Community Water Model, CWatM) in order to have a balanced representation of social, environmental and economic factors and a more realistic representation of the bi-directional interactions and feedbacks in coupled human and natural systems. In this study, we focus on drought management in California and considers two types of agents, which are (groups of) farmers and state management authorities, and assumed that their corresponding objectives are to maximize the net crop profit and to maintain sufficient water supply, respectively. Farmers' behaviors are linked with local agricultural practices such as cropping patterns and deficit irrigation. More precisely, farmers' decisions are incorporated into CWatM across different time scales in terms of daily irrigation amount, seasonal/annual decisions on crop types and irrigated area as well as the long-term investment of irrigation infrastructure. This simulation-based optimization framework is further applied by performing different sets of scenarios to investigate and evaluate the effectiveness of different water management strategies and how policy interventions will facilitate drought adaptation in California.

Self-Injury in Adolescents

MedlinePlus

... their emotional tension, physical discomfort, pain and low self-esteem with self-injurious behaviors. Although some teenagers may ... way. practice positive stress management. develop better social skills. Evaluation by a mental health professional may assist ...

Representational Approach: A Conceptual Framework to Guide Patient Education Research and Practice.

PubMed

Arida, Janet A; Sherwood, Paula R; Flannery, Marie; Donovan, Heidi S

2016-11-01

Illness representations are cognitive structures that individuals rely on to understand and explain their illnesses and associated symptoms. The Representational Approach (RA) to patient education offers a theoretically based, clinically useful model that can support oncology nurses to develop a shared understanding of patients' illness representations to collaboratively develop highly personalized plans for symptom management and other important self-management behaviors. This article discusses theoretical underpinnings, practical applications, challenges, and future directions for incorporating illness representations and the RA in clinical and research endeavors.

A health promotion practicum targeting the college-age population.

PubMed

Diebold, C M; Chappell, H W; Robinson, M K

2000-01-01

Senior and sophomore baccalaureate nursing students at the University of Kentucky developed a health promotion exposition that targeted college students. This experience gave senior students the opportunity to practice leadership and management skills, such as planning, organizing, collaborating, delegating, evaluating, and time management and conflict resolution. Sophomore students developed teaching abilities, practiced assessment and communication techniques, and increased their knowledge of health-promoting behaviors. Both groups experienced team building and demonstrated accountability. Students reported a positive learning experience that met various course objectives in an innovative way.

Cultural issues and other factors that affect self-management of Type 2 Diabetes Mellitus (T2D) by Chinese immigrants in Australia.

PubMed

Eh, Kexin; McGill, Margaret; Wong, Jencia; Krass, Ines

2016-09-01

To investigate the influence of cultural and other factors on diabetes self-management behaviors among Australian Chinese immigrants with T2D. A cross-sectional survey was conducted between June and October 2015. The questionnaire comprised several validated scales examining aspects of self-management practice including medication adherence, acculturation and demographics. Participants were recruited from the community and Diabetes Center of the Royal Prince Alfred Hospital (RPAH), Sydney, Australia. Of the 139 participants, a majority were female, from mainland China, with high school level education and a mean age of 64 (SD±12) years. Participants were found to have poor self-management practices generally but moderate medication adherence. 13.7% of participants reported incorporating TCM into their diabetes treatment and 24% reported a cultural shame surrounding a diabetes diagnosis. Higher levels of acculturation predicted better medication adherence, whereas stronger beliefs in TCM predicted poorer medication adherence. Gender, education level and duration of diabetes were also predictors of diabetes self-management behaviors. This study provided insight into cultural influences on diabetes self-management and medication taking among Chinese immigrants in Australia. Health care providers should take these into account in delivering culturally sensitive care and advice to achieve better health outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The New Age of Bullying and Violence in Health Care: Part 3: Managing the Bullying Boss and Leadership.

PubMed

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to all health care sections where case management is practiced. This article is the third of a 4-part series on the topic of bullying in the health care workplace. Part 3 addresses the dimensions of the bullying boss and leadership, posing major implications for patient safety plus the mental health of staff members. The complex constructs and dynamics broached by the bullying boss and department leadership are explored. These include the underlying forces at play such as power, gender, leadership styles, plus weaves in assessment models. Strategic and proactive management of bullying by leadership is vital to workforce retention and well-being. The increasing incidence and impact of bullying across all sectors have made it a major workforce performance management challenge. Health care settings are especially tense environments, often making it difficult for individuals to distinguish between bullying behavior and high expectations for staff. Bullying impacts both direct targets and bystanders who witness the assaultive behaviors, with ethical implications as well.Case management is poised to promote a safe health care workplace for patients and practitioners alike amid these intricate circumstances. Understanding types of bullying bosses and leadership styles is integral to a case manager's success in the workplace.

Association between sleep behavior and sleep-related factors among university students in Hong Kong.

PubMed

Suen, Lorna K P; Hon, K L Ellis; Tam, Wilson W S

2008-09-01

Sleep problems among university students are common; however, the association between many sleep-related factors and sleep behaviors is still unclear. The purpose of this study is to examine different sleep behaviors and sleep-related factors influencing such behaviors in university students. A descriptive survey was conducted on 400 university students in Hong Kong. The instruments for data collection consisted of the Pittsburgh Sleep Quality Index (PSQI), a sleep hygiene practice questionnaire, demographic data, and other sleep-related factors. The results reveal that 57.5% of the 400 university students are poor sleepers. Sex, year of study, sleep hygiene practice, and perceived adequate sleep in the past month all demonstrate significant associations with poor sleepers. A high prevalence of sleep-related problems among college students is confirmed and associated factors are identified. Students should be encouraged to follow sleep hygiene practice, adequate time management for academic and social activities, and suitable stress-relieving measures.

Survey of 2014 behavioral management programs for laboratory primates in the United States.

PubMed

Baker, Kate C

2016-07-01

The behavioral management of laboratory nonhuman primates in the United States has not been thoroughly characterized since 2003. This article presents the results of a survey behavioral management programs at 27 facilities and covering a total of 59,636 primates, 27,916 housed in indoor cages and 31,720 in group enclosures. The survey included questions regarding program structure, implementation, and methodology associated with social housing, positive reinforcement training, positive human interaction, exercise enclosures, and several categories of inanimate enrichment. The vast majority of laboratory primates are housed socially (83%). Since 2003, the proportion of indoor-housed primates reported to be housed singly has fallen considerably, from 59% to 35% in the facilities surveyed. The use of social housing remains significantly constrained by: 1) research protocol requirements, highlighting the value of closely involved IACUCs for harmonizing research and behavioral management; and 2) the unavailability of compatible social partners, underscoring the necessity of objective analysis of the methods used to foster and maintain compatibility. Positive reinforcement training appears to have expanded and is now used at all facilities responding to the survey. The use of enrichment devices has also increased in the participating facilities. For most behavioral management techniques, concerns over the possibility of negative consequences to animals are expressed most frequently for social housing and destructible enrichment, while skepticism regarding efficacy is limited almost exclusively to sensory enrichment. Behavioral management program staffing has expanded over time in the facilities surveyed, due not only to increased numbers of dedicated behavioral management technicians but also to greater involvement of animal care technicians, suggesting an increase in the integration of behavioral care into animal husbandry. Broad awareness of common practice may assist facilities with program evaluation and assessment of progress in the field can generate recommendations for continuing the advancement of primate behavioral management programs. Am. J. Primatol. 78:780-796, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Survey of 2014 Behavioral Management Programs for Laboratory Primates in the United States

PubMed Central

BAKER, KATE C.

2016-01-01

The behavioral management of laboratory nonhuman primates in the United States has not been thoroughly characterized since 2003. This article presents the results of a survey behavioral management programs at 27 facilities and covering a total of 59,636 primates, 27,916 housed in indoor cages and 31,720 in group enclosures. The survey included questions regarding program structure, implementation, and methodology associated with social housing, positive reinforcement training, positive human interaction, exercise enclosures, and several categories of inanimate enrichment. The vast majority of laboratory primates are housed socially (83%). Since 2003, the proportion of indoor-housed primates reported to be housed singly has fallen considerably, from 59% to 35% in the facilities surveyed. The use of social housing remains significantly constrained by: 1) research protocol requirements, highlighting the value of closely involved IACUCs for harmonizing research and behavioral management; and 2) the unavailability of compatible social partners, underscoring the necessity of objective analysis of the methods used to foster and maintain compatibility. Positive reinforcement training appears to have expanded and is now used at all facilities responding to the survey. The use of enrichment devices has also increased in the participating facilities. For most behavioral management techniques, concerns over the possibility of negative consequences to animals are expressed most frequently for social housing and destructible enrichment, while skepticism regarding efficacy is limited almost exclusively to sensory enrichment. Behavioral management program staffing has expanded over time in the facilities surveyed, due not only to increased numbers of dedicated behavioral management technicians but also to greater involvement of animal care technicians, suggesting an increase in the integration of behavioral care into animal husbandry. Broad awareness of common practice may assist facilities with program evaluation and assessment of progress in the field can generate recommendations for continuing the advancement of primate behavioral management programs. PMID:26971575

The Special Educator's Toolkit: Everything You Need to Organize, Manage, and Monitor Your Classroom

ERIC Educational Resources Information Center

Golden, Cindy

2012-01-01

Overwhelmed special educators: Reduce your stress and support student success with this practical toolkit for whole-classroom organization. A lifesaver for special educators in any K-12 setting, this book-and-CD set will help teachers expertly manage everything, from schedules and paperwork to student supports and behavior plans. Cindy Golden, a…

Money Management in Families: A Review of the Literature with a Racial, Ethnic, and Limited Income Perspective.

ERIC Educational Resources Information Center

Bowen, Cathy Faulcon; Lago, Daniel J.; Furry, Marilyn M.

1997-01-01

Review of literature from 1965 to 1995 on the money management behavior of families with limited incomes and African-American and Hispanic-American families identified practices related to budgeting, credit, savings, socialization of children, information seeking, and banking. Little documentation on these populations was found, but some…

Learning from Charter School Management Organizations: Strategies for Student Behavior and Teacher Coaching

ERIC Educational Resources Information Center

Lake, Robin; Bowen, Melissa; Demeritt, Allison; McCullough, Moira; Haimson, Joshua; Gill, Brian

2012-01-01

The National Study of Charter Management Organization (CMO) Effectiveness is a four-year study designed to assess the impact of CMOs on student achievement and to identify effective structures and practices. An earlier report from this study documented the substantial variation in CMO student achievement impacts as well as variation in CMOs' use…

Tillage and phosphorus management effects on enzyme-labile bioactive phosphorus availability in brazilian cerrado oxisols and temperature zone typic hapludults

USDA-ARS?s Scientific Manuscript database

Tillage management practices have a direct effect on the behavior and availability of soil nutrients. Phosphorus (P) is an essential element in crop growth which can be growth-limiting or an environmental contaminant, if present in excess. Sorption and availability of various soil P forms were eva...

An Examination of Open and Technology Leadership in Managerial Practices of Education System

ERIC Educational Resources Information Center

Akcil, Umut; Aksal, Fahriye Altinay; Mukhametzyanova, Farida Sh.; Gazi, Zehra Altinay

2017-01-01

In order for a smooth and problem-free transformation to take place in a digitalizing education system, efficient management is needed. Thus, educational managers need to improve their skills and develop behaviors suitable for taking education systems into the digital age. Social networks enable leaders to become digital citizens by embracing and…

Effects of a Self-Management Educational Program for the Control of Childhood Asthma.

ERIC Educational Resources Information Center

Perez, Maria Gabriela; Feldman, Lya; Caballero, Fernan

1999-01-01

Evaluates the effects of a self-management educational program on 29 children and their parents. Program consists of six sessions of information giving and cognitive-behavioral strategies for the children, and two talks and a brochure for the parents. Results indicate a significant effect on children's asthma knowledge and practice of…

Positive Classroom Management: A Step-By-Step Guide to Successfully Running the Show without Destroying Student Dignity.

ERIC Educational Resources Information Center

DiGiulio, Robert

This publication provides practical, step-by-step guidance for teachers on becoming more effective in classroom management by using a positive and constructive, rather than negative and punitive, approach to foster prosocial student behavior. The publication is divided into an introduction and three parts. The Introduction examines why effective…

Selling Out (In) Sport Management: Practically Evaluating the State of the American (Sporting) Union

ERIC Educational Resources Information Center

Wiest, Amber; King-White, Ryan

2013-01-01

When teaching in Sport Management programs professors are often forced to respond to the actions and teachings of professionals in the field. According to the study by Kincheloe & Steinberg many of these normalized and, indeed celebrated, behaviors are actions that are part and parcel of the "recovery movement" which (re)inscribe new…

Feedback to Managers, Volume II: A Review and Comparison of Sixteen Multi-Rater Feedback Instruments.

ERIC Educational Resources Information Center

Van Velsor, Ellen; Leslie, Jean Brittain

"Feedback to Managers" is a two-volume report. Volume 2 compares 16 of the better feedback instruments available. The following are the instruments: (1) ACUMEN Group Feedback; (2) BENCHMARKS; (3) the Campbell Leadership Index; (4) COMPASS: the Managerial Practices Survey; (5) the Executive Success Profile; (6) Leader Behavior Analysis…

Balancing Riparian Management and River Recreation: Methods and Applications for Exploring Floater Behavior and Their Interaction with Large Wood

NASA Astrophysics Data System (ADS)

Biedenweg, Kelly; Akyuz, Kate; Skeele, Rebecca

2012-08-01

River managers are tasked with meeting both ecological and human needs. In the Puget Sound lowland, riparian management often includes placing or allowing the presence of large wood to stabilize riverbanks and enhance salmon habitat. Although this practice benefits humans by protecting infrastructure and natural resources, it is unclear how such practices interact with an additional human interest, recreation. Furthermore, we were unable to find studies that describe how an agency can go about researching the interaction between recreation and large wood management practices. This study tested methods for describing and estimating the number of river floaters, where they float in relationship to river projects, the risks they take while floating, and their perceptions of large wood in the river. Selecting a high-use suburban river in Washington State, we used riverside observations, interviews, and an infrared counter to gather data in the summer of 2010. Statistical analyses provided general characteristics of users, trends in engaging in risky behaviors, and estimates of use for the entire season and on the busiest day. Data mapping with GIS presented the density of use along the river and frequency of use of specific float routes. Finally, qualitative analysis of interviews clarified floaters' perspectives of large wood. To address the multiple mandates of river managers, it is important to understand recreation users, the factors that could be putting them at risk, and how the actual users perceive large wood in the river. This study demonstrates methods for scientifically gathering such information and applying it when making riparian management decisions.

AAMFT Master Series tapes: an analysis of the inclusion of feminist principles into family therapy practice.

PubMed

Haddock, S A; MacPhee, D; Zimmerman, T S

2001-10-01

Content analysis of 23 American Association for Marriage and Family Therapy Master Series tapes was used to determine how well feminist behaviors have been incorporated into "ideal" family therapy practice. Feminist behaviors were infrequent, being evident in fewer than 3% of time blocks in event sampling and 10 of 39 feminist behaviors of the Feminist Family Therapist Behavior Checklist. These eminent therapists most often dealt with empowerment of male clients and management of power differentials in the therapeutic relationship in a relatively feminist manner, but they tended to hold women responsible for family issues, endorsed traditional rather than egalitarian relationships, and overlooked how the social context affects families. Several of the therapists were blatantly sexist in their treatment of female clients, communicating disrespect of and pathologizing them. The few tapes portraying effective incorporation of feminist principles in family therapy indicate that a handful of behaviors are key to this approach.

Assessing the homogenization of urban land management with an application to US residential lawn care

PubMed Central

Polsky, Colin; Grove, J. Morgan; Knudson, Chris; Groffman, Peter M.; Bettez, Neil; Cavender-Bares, Jeannine; Hall, Sharon J.; Heffernan, James B.; Hobbie, Sarah E.; Larson, Kelli L.; Morse, Jennifer L.; Neill, Christopher; Nelson, Kristen C.; Ogden, Laura A.; O’Neil-Dunne, Jarlath; Pataki, Diane E.; Roy Chowdhury, Rinku; Steele, Meredith K.

2014-01-01

Changes in land use, land cover, and land management present some of the greatest potential global environmental challenges of the 21st century. Urbanization, one of the principal drivers of these transformations, is commonly thought to be generating land changes that are increasingly similar. An implication of this multiscale homogenization hypothesis is that the ecosystem structure and function and human behaviors associated with urbanization should be more similar in certain kinds of urbanized locations across biogeophysical gradients than across urbanization gradients in places with similar biogeophysical characteristics. This paper introduces an analytical framework for testing this hypothesis, and applies the framework to the case of residential lawn care. This set of land management behaviors are often assumed—not demonstrated—to exhibit homogeneity. Multivariate analyses are conducted on telephone survey responses from a geographically stratified random sample of homeowners (n = 9,480), equally distributed across six US metropolitan areas. Two behaviors are examined: lawn fertilizing and irrigating. Limited support for strong homogenization is found at two scales (i.e., multi- and single-city; 2 of 36 cases), but significant support is found for homogenization at only one scale (22 cases) or at neither scale (12 cases). These results suggest that US lawn care behaviors are more differentiated in practice than in theory. Thus, even if the biophysical outcomes of urbanization are homogenizing, managing the associated sustainability implications may require a multiscale, differentiated approach because the underlying social practices appear relatively varied. The analytical approach introduced here should also be productive for other facets of urban-ecological homogenization. PMID:24616515

Clinical trial management of participant recruitment, enrollment, engagement, and retention in the SMART study using a Marketing and Information Technology (MARKIT) model

PubMed Central

Gupta, Anjali; Calfas, Karen J.; Marshall, Simon J.; Robinson, Thomas N.; Rock, Cheryl L.; Huang, Jeannie S.; Epstein-Corbin, Melanie; Servetas, Christina; Donohue, Michael C.; Norman, Gregory J.; Raab, Fredric; Merchant, Gina; Fowler, James H.; Griswold, William G.; Fogg, B.J.; Patrick, Kevin

2015-01-01

Advances in information technology and near ubiquity of the Internet have spawned novel modes of communication and unprecedented insights into human behavior via the digital footprint. Health behavior randomized controlled trials (RCTs), especially technology-based, can leverage these advances to improve the overall clinical trials management process and benefit from improvements at every stage, from recruitment and enrollment to engagement and retention. In this paper, we report the results for recruitment and retention of participants in the SMART study and introduce a new model for clinical trials management that is a result of interdisciplinary team science. The MARKIT model brings together best practices from information technology, marketing, and clinical research into a single framework to maximize efforts for recruitment, enrollment, engagement, and retention of participants into a RCT. These practices may have contributed to the study’s on-time recruitment that was within budget, 86% retention at 24 months, and a minimum of 57% engagement with the intervention over the 2-year RCT. Use of technology in combination with marketing practices may enable investigators to reach a larger and more diverse community of participants to take part in technology-based clinical trials, help maximize limited resources, and lead to more cost-effective and efficient clinical trial management of study participants as modes of communication evolve among the target population of participants. PMID:25866383

Cognitive Behavioral Training and Education for Spaceflight Operations

NASA Technical Reports Server (NTRS)

Moonmaw, Ronald

2011-01-01

Cognitive behavioral-training (CBT) is an evidence-based practice commonly used to help treat insomnia, and is part of NASA's countermeasure regimen for Fatigue Management. CBT addresses the life style and habits of individuals that are maladaptive to managing stress and fatigue. This includes addressing learned behavioral responses that may cause stress and lead to an increased sense of fatigue. While the initial cause of onset of fatigue in the individual may be no longer present, the perception and engrained anticipation of fatigue persist and cause an exaggerated state of tension. CBT combined with relaxation training allows the individual to unlearn the maladaptive beliefs and behaviors and replace them with routines and techniques that allow cognitive restructuring and resultant relief from stress. CBT allows for elimination in individuals of unwanted ruminating thoughts and anticipatory anxiety by, for example, training the individuals to practice stressful situations in a relaxed state. As a result of CBT, relaxation can be accomplished in many ways, such as progressive muscle relaxation, meditation and guided imagery. CBT is not therapy, but rather the synthesis of behavioral countermeasures. CBT utilizes progressive relaxation as a means of reinforcing educational and cognitive countermeasures. These countermeasures include: masking, elimination of distracting thoughts, anxiety control, split attention, cognitive restructuring and other advanced psychological techniques.

Self-Reported Changes in Food Safety Behaviors among Foodservice Employees: Impact of a Retail Food Safety Education Program

ERIC Educational Resources Information Center

Anding, Jenna D.; Boleman, Chris; Thompson, Britta

2007-01-01

A food safety education program developed for retail food establishments was evaluated to assess the extent to which participants were practicing selected behaviors linked to reducing the risk of foodborne disease both before and after the program. Scores from the state health department's Certified Food Manager (CFM) exam also were examined.…

Reinforcement learning in supply chains.

PubMed

Valluri, Annapurna; North, Michael J; Macal, Charles M

2009-10-01

Effective management of supply chains creates value and can strategically position companies. In practice, human beings have been found to be both surprisingly successful and disappointingly inept at managing supply chains. The related fields of cognitive psychology and artificial intelligence have postulated a variety of potential mechanisms to explain this behavior. One of the leading candidates is reinforcement learning. This paper applies agent-based modeling to investigate the comparative behavioral consequences of three simple reinforcement learning algorithms in a multi-stage supply chain. For the first time, our findings show that the specific algorithm that is employed can have dramatic effects on the results obtained. Reinforcement learning is found to be valuable in multi-stage supply chains with several learning agents, as independent agents can learn to coordinate their behavior. However, learning in multi-stage supply chains using these postulated approaches from cognitive psychology and artificial intelligence take extremely long time periods to achieve stability which raises questions about their ability to explain behavior in real supply chains. The fact that it takes thousands of periods for agents to learn in this simple multi-agent setting provides new evidence that real world decision makers are unlikely to be using strict reinforcement learning in practice.

UPMC Prescription for Wellness: A Quality Improvement Case Study for Supporting Patient Engagement and Health Behavior Change.

PubMed

Maners, Rebecca J; Bakow, Eric; Parkinson, Michael D; Fischer, Gary S; Camp, Geoffrey R

Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.

Telephone Counseling to Implement Best Parenting Practices to Prevent Adolescent Problem Behaviors

PubMed Central

Pierce, John P.; James, Lisa E.; Messer, Karen; Myers, Mark G.; Williams, Rebecca E.; Trinidad, Dennis R.

2008-01-01

There is considerable suggestive evidence that parents can protect their adolescents from developing problem behaviors if they implement recommended best parenting practices. These include providing appropriate limits on adolescent free time, maintaining a close personal relationship with the adolescent, and negotiating and providing incentives for positive behavior patterns. However, retention of the study samples has limited conclusions that can be drawn from published studies. This randomized controlled trial recruited and randomized a national population sample of 1036 families to an intensive parenting intervention using telephone counseling or to a no-contact control group. At enrollment, eligible families had an eldest child between the ages of 10–13 years. The intervention included an initial training program using a self-help manual with telephone counselor support. Implementation of best parenting practices was encouraged using quarterly telephone contacts and a family management check-up questionnaire. A computer-assisted structured counseling protocol was used to aid parents who needed additional assistance to implement best practices. This, along with a centralized service, enabled implementation of quality control procedures. Assessment of problem behavior is undertaken with repeated telephone interviews of the target adolescents. The study is powered to test whether the intervention encouraging parents to maintain best parenting practices is associated with a reduction of 25% in the incidence of problem behaviors prior to age 18 years and will be tested through a maximum likelihood framework. PMID:17964223

Utilization and Economic Contribution of Psychiatric Mental Health Nurse Practitioners in Public Behavioral Health Services.

PubMed

Chapman, Susan A; Phoenix, Bethany J; Hahn, Talia E; Strod, Deborah C

2018-06-01

Expanded insurance coverage through the Affordable Care Act and parity in behavioral health coverage have increased demand for services. Yet there is a persistent shortage in the behavioral health workforce. Psychiatric Mental Health Nurse Practitioners (PMHNPs) may be part of the solution to shortages but are not yet fully utilized. The purpose of this study was to describe how PMHNPs are utilized, identify barriers to full utilization, and assess PMHNPs' economic contribution in public behavioral health systems. This study used a mixed methods approach, selecting counties for use of PMHNPs, geography, population size, rural/urban, and availability of financial data. The authors conducted 1- to 2-day site visits in 2014-2015 including semi-structured interviews with management and clinical leaders and collected PMHNP staffing and billing data. Thematic analysis of interview data was conducted and aggregate staffing and billing data were analyzed to determine net PMHNP financial contribution. The primary billed service for PMHNPs is medication management. Barriers to full utilization included system-level barriers to hiring PMHNPs, lack of role-appropriate job descriptions, confusion related to scope of practice/supervision requirements, and challenges in recruitment and retention. Fiscal analysis showed a positive net contribution from PMHNP services. PMHNPs can make a significant contribution to behavioral healthcare delivery, particularly in public mental health settings, yet greater understanding of their role and addressing barriers to practice is needed. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of Health and Human Services. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Centralized care management support for "high utilizers" in primary care practices at an academic medical center.

PubMed

Williams, Brent C; Paik, Jamie L; Haley, Laura L; Grammatico, Gina M

2014-01-01

Although evidence of effectiveness is limited, care management based outside primary care practices or hospitals is receiving increased attention. The University of Michigan (UM) Complex Care Management Program (CCMP) provides care management for uninsured and underinsured, high-utilizing patients in multiple primary care practices. To inform development of optimal care management models, we describe the CCMP model and characteristics and health care utilization patterns of its patients. Of a consecutive series of 49 patients enrolled at CCMP in 2011, the mean (SD) age was 48 (+/- 14); 23 (47%) were women; and 29 (59%) were White. Twenty-eight (57%) had two or more chronic medical conditions, 39 (80%) had one or more psychiatric condition, 28 (57%) had a substance abuse disorder, and 11 (22%) were homeless. Through phone, e-mail, and face-to-face contact with patients and primary care providers (PCPs), care managers coordinated health and social services and facilitated access to medical and mental health care. Patients had a mean (SD) number of hospitalizations and emergency room (ER) visits in 6 months prior to enrollment of2.2 (2.5) and 4.2 (4.3), respectively, with a nonstatistically significant decrease in hospitalizations, hospital days, and emergency room visits in 6 months following enrollment in CCMP. Centralized care management support for primary care practices engages high-utilizing patients with complex medical and behavioral conditions in care management that would be difficult to provide through individual practices and may decrease health care utilization by these patients.

Participatory approach to the development of a knowledge base for problem-solving in diabetes self-management.

PubMed

Cole-Lewis, Heather J; Smaldone, Arlene M; Davidson, Patricia R; Kukafka, Rita; Tobin, Jonathan N; Cassells, Andrea; Mynatt, Elizabeth D; Hripcsak, George; Mamykina, Lena

2016-01-01

To develop an expandable knowledge base of reusable knowledge related to self-management of diabetes that can be used as a foundation for patient-centric decision support tools. The structure and components of the knowledge base were created in participatory design with academic diabetes educators using knowledge acquisition methods. The knowledge base was validated using scenario-based approach with practicing diabetes educators and individuals with diabetes recruited from Community Health Centers (CHCs) serving economically disadvantaged communities and ethnic minorities in New York. The knowledge base includes eight glycemic control problems, over 150 behaviors known to contribute to these problems coupled with contextual explanations, and over 200 specific action-oriented self-management goals for correcting problematic behaviors, with corresponding motivational messages. The validation of the knowledge base suggested high level of completeness and accuracy, and identified improvements in cultural appropriateness. These were addressed in new iterations of the knowledge base. The resulting knowledge base is theoretically grounded, incorporates practical and evidence-based knowledge used by diabetes educators in practice settings, and allows for personally meaningful choices by individuals with diabetes. Participatory design approach helped researchers to capture implicit knowledge of practicing diabetes educators and make it explicit and reusable. The knowledge base proposed here is an important step towards development of new generation patient-centric decision support tools for facilitating chronic disease self-management. While this knowledge base specifically targets diabetes, its overall structure and composition can be generalized to other chronic conditions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Participatory approach to the development of a knowledge base for problem-solving in diabetes self-management

PubMed Central

Cole-Lewis, Heather J.; Smaldone, Arlene M.; Davidson, Patricia R.; Kukafka, Rita; Tobin, Jonathan N.; Cassells, Andrea; Mynatt, Elizabeth D.; Hripcsak, George; Mamykina, Lena

2015-01-01

Objective To develop an expandable knowledge base of reusable knowledge related to self-management of diabetes that can be used as a foundation for patient-centric decision support tools. Materials and methods The structure and components of the knowledge base were created in participatory design with academic diabetes educators using knowledge acquisition methods. The knowledge base was validated using scenario-based approach with practicing diabetes educators and individuals with diabetes recruited from Community Health Centers (CHCs) serving economically disadvantaged communities and ethnic minorities in New York. Results The knowledge base includes eight glycemic control problems, over 150 behaviors known to contribute to these problems coupled with contextual explanations, and over 200 specific action-oriented self-management goals for correcting problematic behaviors, with corresponding motivational messages. The validation of the knowledge base suggested high level of completeness and accuracy, and identified improvements in cultural appropriateness. These were addressed in new iterations of the knowledge base. Discussion The resulting knowledge base is theoretically grounded, incorporates practical and evidence-based knowledge used by diabetes educators in practice settings, and allows for personally meaningful choices by individuals with diabetes. Participatory design approach helped researchers to capture implicit knowledge of practicing diabetes educators and make it explicit and reusable. Conclusion The knowledge base proposed here is an important step towards development of new generation patient-centric decision support tools for facilitating chronic disease self-management. While this knowledge base specifically targets diabetes, its overall structure and composition can be generalized to other chronic conditions. PMID:26547253

Attitudes and knowledge about pain: an assessment of West Virginia family physicians.

PubMed

Ponte, Charles D; Johnson-Tribino, Jennifer

2005-01-01

This study's objective was to determine the attitudes/beliefs and knowledge of West Virginia's family physicians regarding evaluation and treatment of patients with pain. A 20-item instrument (10 attitudinal/behavioral and 10 knowledge items) was mailed to 537 members of the West Virginia Chapter of the American Academy of Family Physicians in October 2002. Five percent of the surveys were mailed to out-of-state members. No follow-up questionnaire was mailed. A total of 186 surveys (186/537, 34.6%) were returned. The typical respondent was a male ages 30-54 graduating in 1983 or later and having 15.5 years of practice experience. The majority of respondents were in a solo or group practice. There were no differences in response rates according to age, gender, years in practice, and practice setting. Chronic nonmalignant pain and assessing pain in the elderly are problematic for many physician providers. Perceived regulatory scrutiny does impact physician prescribing of opioids for patients in pain. Knowledge gaps were uncovered in the areas of fentanyl administration, the use of propoxyphene in the elderly, the management of opioid-induced constipation, laxative prescription, and the use of oxygen to manage opioid-induced respiratory depression. The majority of respondents felt that their formal medical training did not prepare them to effectively manage pain. This survey provides valuable insight into the attitudes/behaviors and knowledge about pain and its management by West Virginia family physicians. A national sample, using a revised instrument, is needed to more fully characterize and validate the findings from this statewide survey.

Principals' Perceptions of the Impact of the APPR on Instructional Practices in New York State Public School Districts

ERIC Educational Resources Information Center

Mangeri, Richard

2017-01-01

The purpose of this study was to investigate principals' perceptions of the impact of the New York State Annual Professional Performance Review on instructional practices. Dr. Philip Hallinger's Principal Instructional Management Rating Scale (PIMRS) was used to examine principal behaviors as they relate to school mission/goals, instruction and…

Medical Home Implementation Gaps for Seniors: Perceptions and Experiences of Primary Care Medical Practices.

PubMed

Hoff, Timothy; DePuccio, Matthew

2018-07-01

The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed. Physicians and staff identified PCMH implementation gaps for their seniors: (a) performing in-depth clinical assessments, (b) identifying seniors' life needs and linking them with community resources, and (c) care management and coordination, in particular self-management support for seniors. Prior experiences trying to perform these aspects of PCMH care for older adults produced collective understandings that led to inaction and avoidance by medical practices around the first two gaps, and proactive behavior that took strategic advantage of external incentives for addressing the third gap. Greater understanding of physician and staff's PCMH implementation experiences, and the learning that accumulates from these experiences, allows for a deeper understanding of how primary care practices choose to enact the medical home model for seniors on an everyday basis.

Self-management for patients with inflammatory bowel disease in a gastroenterology ward in China: a best practice implementation project.

PubMed

Chen, Ruo-Bing

2016-11-01

Globally, there is an increasing incidence of inflammatory bowel disease. It is very important for patients to be involved with self-management that can optimize personal heath behavior to control the disease. The aim of this project was to increase nursing staff knowledge of inflammatory bowel disease discharge guidance, and to improve the quality of education for discharged patients, thereby improving their self-management. A baseline audit was conducted by interviewing 30 patients in the gastroenterology ward of Huadong Hospital, Fudan University. The project utilized the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research Into Practice audit tools for promoting quality of education and self-management of patients with inflammatory bowel disease. Thirty patients were provided with written materials, which included disease education and information regarding self-management. A post-implementation audit was conducted. There was improvement of education prior to discharge and dietary consultancy in the gastroenterology ward. Self-management plans utilizing written materials only were not sufficient for ensuring sustainability of the project. Comprehensive self-management education can make a contribution to improving awareness of the importance of self-management for patients with inflammatory bowel disease.

Balancing the Ecological Function of Residential Stormwater Ponds with Homeowner Landscaping Practices.

PubMed

Monaghan, Paul; Hu, Shangchun; Hansen, Gail; Ott, Emily; Nealis, Charles; Morera, Maria

2016-11-01

Stormwater ponds are installed in urban developments to provide the ecosystem services of flood control and water treatment. In coastal areas, these ponds are connected to watersheds that can drain directly into protected estuaries, making their design, function, and maintenance critical to environmental protection. However, stormwater ponds in residential areas are increasingly managed as aesthetic amenities that add value to real estate rather than as engineered devices with special maintenance requirements. To help extend the life of neighborhood stormwater systems and improve ecosystem services, homeowners should follow best management practices for nutrient management and add shoreline plantings and non-invasive, beneficial aquatic plants to their ponds. This study used focus group and survey research to document the knowledge, behaviors, and attitudes of homeowners living near stormwater ponds in a master-planned community in Florida. The study was designed to use a social marketing research approach to promote Extension best practices. Findings indicate that many residents were aware of the functional components of stormwater systems and respondents' receptivity to best management practices was mediated by age, their attitudes about water quality and whether their home was adjacent to a pond. These findings can be used to target Extension audiences and improve adoption of stormwater pond best management practices for increased protection of water quality.

Balancing the Ecological Function of Residential Stormwater Ponds with Homeowner Landscaping Practices

NASA Astrophysics Data System (ADS)

Monaghan, Paul; Hu, Shangchun; Hansen, Gail; Ott, Emily; Nealis, Charles; Morera, Maria

2016-11-01

Stormwater ponds are installed in urban developments to provide the ecosystem services of flood control and water treatment. In coastal areas, these ponds are connected to watersheds that can drain directly into protected estuaries, making their design, function, and maintenance critical to environmental protection. However, stormwater ponds in residential areas are increasingly managed as aesthetic amenities that add value to real estate rather than as engineered devices with special maintenance requirements. To help extend the life of neighborhood stormwater systems and improve ecosystem services, homeowners should follow best management practices for nutrient management and add shoreline plantings and non-invasive, beneficial aquatic plants to their ponds. This study used focus group and survey research to document the knowledge, behaviors, and attitudes of homeowners living near stormwater ponds in a master-planned community in Florida. The study was designed to use a social marketing research approach to promote Extension best practices. Findings indicate that many residents were aware of the functional components of stormwater systems and respondents' receptivity to best management practices was mediated by age, their attitudes about water quality and whether their home was adjacent to a pond. These findings can be used to target Extension audiences and improve adoption of stormwater pond best management practices for increased protection of water quality.

Managing change: an overview.

PubMed

Lorenzi, N M; Riley, R T

2000-01-01

As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

Which interventions are used by health care professionals to enhance medication adherence in cardiovascular patients? A survey of current clinical practice.

PubMed

Berben, Lut; Bogert, Laura; Leventhal, Marcia E; Fridlund, Bengt; Jaarsma, Tiny; Norekvål, Tone M; Smith, Karen; Strömberg, Anna; Thompson, David R; De Geest, Sabina

2011-03-01

Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice. To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions. A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management. Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence. Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence. Copyright © 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Countering workplace aggression: an urban tertiary care institutional exemplar.

PubMed

Phillips, Susan

2007-01-01

The purpose of this process improvement project was to provide nursing staff with evidence-based knowledge and skills to manage patients and/or visitors with the potential for violence. Current statistics describing workplace violence in healthcare settings are alarming. Workplace violence significantly impacts nursing practice and may contribute to physical injuries, psychological trauma, decreased productivity, and low morale among nurses. This is particularly germane to those nurses who have been inadequately trained to manage aggressive patients and/or family behaviors. Following a series of disruptive episodes on the pulmonary-medical service that occurred at our facility in the winter of 2006, an employee safety team was formed to address the issue of workplace violence. Around this same time frame, a team comprising system hospital representatives was also initiated to globally address workplace violence. A Workplace Violence Education Program was devised to equip nurses with information, skills, and practical tools that will empower them when encountering clinical situations characterized by disruptive or abusive patient and/or family behaviors. The ultimate goal was to diffuse progressive, escalating aggressive behaviors in the clinical setting. FINDINGS/OUTCOMES: Evidence-based approaches formed the basis of an educational offering focusing on workplace violence prevention and management. This informational intervention was devised to empower clinical nursing staff with knowledge to enhance judgment, decision making, and implementation of behavioral strategies to reduce the likelihood of patient/family behaviors escalating to aggression. Interdisciplinary collaboration that included clinical experience, expertise, and knowledge generated from current literature reviews contributed to a successful educational program for nurses focusing on a historically neglected topic--workplace violence.

Evidence-Based Psychosocial Treatments for Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

PubMed Central

Evans, Steven W; Owens, Julie; Bunford, Miss Nora

2014-01-01

Objective The purpose of this research was to update the Pelham and Fabiano (2008) review of evidence-based practices for children and adolescents with Attention-Deficit/ Hyperactivity Disorder. Method We completed a systematic review of the literature published between 2008 and 2013 to establish levels of evidence for psychosocial treatments for these youth. The review included the identification of relevant articles using criteria established by the Society of Clinical Child and Adolescent Psychology (see Southam-Gerow & Prinstein, in press) using keyword searches and a review of tables of contents. Results We extend the conceptualization of treatment research by differentiating training interventions from behavior management and by reviewing the growing literature on training interventions. Consistent with the results of the previous review we concluded that behavioral parent training, behavioral classroom management and behavioral peer interventions were well-established treatments. In addition, organization training met the criteria for a well-established treatment. Combined training programs met criteria for Level 2 (Probably Efficacious), neurofeedback training met criteria for Level 3 (Possibly Efficacious), and cognitive training met criteria for Level 4 (Experimental Treatments). Conclusions The distinction between behavior management and training interventions provides a method for considering meaningful differences in the methods and possible mechanisms of action for treatments for these youth. Characteristics of treatments, participants, and measures, as well as the variability in methods for classifying levels of evidence for treatments, are reviewed in relation to their potential effect on outcomes and conclusions about treatments. Implications of these findings for future science and practice are discussed. PMID:24245813

Which family factors predict children’s externalizing behaviors following discharge from psychiatric inpatient treatment?

PubMed Central

Blader, Joseph C.

2010-01-01

Objective Parents’ behavior management practices, parental stress, and family environment are highly pertinent to children’s conduct problems. Preadolescents’ psychiatric hospitalization usually arises because of severe conduct problems, so the relationships of family-related variables to postdischarge functioning warrant investigation. This study examined postdischarge clinical course and select family factors to model outcomes via a) predictors measured at admission, b) predictors measured concurrently with outcome, and c) changes in predictor values from admission through follow-up. Method In a prospective follow-up of 107 child psychiatry inpatients, caregivers completed rating scales pertaining to their child’s behavior, parenting practices, parenting stress, caregiver strain, and their own psychological distress at admission and three, six, and 12 months after discharge. Results The magnitude of reductions in parenting stress between admission and follow-up bore the strongest relationship to improvements in externalizing behavior. The largest and most sustained decreases in externalizing behavior arose among youngsters whose parents reported high parenting stress at admission and low parenting stress after discharge. By contrast, children whose parents reported low parenting stress at admission and follow-up showed significantly less postdischarge improvement. Parenting stress changes were not attributable to changes in behavioral symptoms. Parenting stress eclipsed relationships between behavior management practices and child outcomes, suggesting that parenting stress might have a mediational role. Conclusions High initial parenting stress disposed to better outcomes over the year of follow-up. Consistently low stress predicted less improvement. Higher stress at admission may imply more advantageous parent–child relationships or motivation for subsequent persistence with treatment. Interventions that ameliorate high stress may warrant further study. Low parenting stress might signify disengagement, or, alternatively, that parents of some chronically impaired children become rather inured to fluctuations in behavioral problems. If confirmed, further examination of these and other accounts for a relationship between low parenting stress and suboptimal child outcome seems warranted. PMID:17076752

What are the disruptive symptoms of behavioral disorders after traumatic brain injury? A systematic review leading to recommendations for good practices.

PubMed

Stéfan, Angélique; Mathé, Jean-François

2016-02-01

Behavioral disorders are major sequelae of severe traumatic brain injury. Before considering care management of these disorders, and in the absence of a precise definition for TBI-related behavioral disorder, it is essential to refine, according to the data from the literature, incidence, prevalence, predictive factors of commonly admitted disruptive symptoms. Systematic review of the literature targeting epidemiological data related to behavioral disorders after traumatic brain injury in order to elaborate good practice recommendations according to the methodology established by the French High Authority for Health. Two hundred and ninety-nine articles were identified. The responsibility of traumatic brain injury (TBI) in the onset of behavioral disorders is unequivocal. Globally, behavioral disorders are twice more frequent after TBI than orthopedic trauma without TBI (Masson et al., 1996). These disorders are classified into disruptive primary behaviors by excess (agitation 11-70%, aggression 25-39%, irritability 29-71%, alcohol abuse 7-26% drug abuse 2-20%), disruptive primary behaviors by default (apathy 20-71%), affective disorders - anxiety - psychosis (depression 12-76%, anxiety 0.8-24,5%, posttraumatic stress 11-18%, obsessive-compulsive disorders 1.2-30%, psychosis 0.7%), suicide attempts and suicide 1%. The improvement of care management for behavioral disorders goes through a first step of defining a common terminology. Four categories of posttraumatic behavioral clinical symptoms are defined: disruptive primary behaviors by excess, by default, affective disorders-psychosis-anxiety, suicide attempts and suicide. All these symptoms yield a higher prevalence than in the general population. They impact all of life's domains and are sustainable over time. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Practice behaviors of RNs related to hazardous risks within the clinical setting.

PubMed

Gordon, G P

1999-06-01

A practice behavior survey was distributed to 250 RNs in the Metropolitan Detroit area. Seventy percent of the RNs responded to questions focused on needle-stick and splash injuries, handwashing, gloving, and other available measures that prevent injuries and infection. Respondents reported a larger than expected number of sticks (34.5%) and splashes (40.8%), but most of these instances were handled to the nurses' satisfaction. The nurses reported that while occupationally acquired hepatitis B/C, along with AIDS, are serious concerns, a large majority (75%) had not heard of the Campaign For Health Care Safety. The results of this survey have implications for research, practice, management, and public policy. This exploratory pilot survey raises numerous professional issues.

Screening women for intimate partner violence: Creating proper practice habits.

PubMed

Knox, Beth

2018-05-17

Intimate partner violence continues to be a challenge for advanced practice registered nurses to address and manage in their daily practice. This article reviews current healthcare concerns in heterosexual, bisexual, transgender, and lesbian women, and explores screening guidelines and resources for developing successful screening habits. Additionally, the article discusses how the Transtheoretical Model and Stages of Change offers insight into the behavior of women who experience intimate partner violence and provides safety strategies for these women.

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review)

PubMed Central

Miller, R G.; Jackson, C E.; Kasarskis, E J.; England, J D.; Forshew, D; Johnston, W; Kalra, S; Katz, J S.; Mitsumoto, H; Rosenfeld, J; Shoesmith, C; Strong, M J.; Woolley, S C.

2009-01-01

Objective: To systematically review evidence bearing on the management of patients with amyotrophic lateral sclerosis (ALS). Methods: The authors analyzed studies from 1998 to 2007 to update the 1999 practice parameter. Topics covered in this section include breaking the news, multidisciplinary clinics, symptom management, cognitive and behavioral impairment, communication, and palliative care for patients with ALS. Results: The authors identified 2 Class I studies, 8 Class II studies, and 30 Class III studies in ALS, but many important areas have been little studied. More high-quality, controlled studies of symptomatic therapies and palliative care are needed to guide management and assess outcomes in patients with ALS. Recommendations: Multidisciplinary clinic referral should be considered for managing patients with ALS to optimize health care delivery and prolong survival (Level B) and may be considered to enhance quality of life (Level C). For the treatment of refractory sialorrhea, botulinum toxin B should be considered (Level B) and low-dose radiation therapy to the salivary glands may be considered (Level C). For treatment of pseudobulbar affect, dextromethorphan and quinidine should be considered if approved by the US Food and Drug Administration (Level B). For patients who develop fatigue while taking riluzole, withholding the drug may be considered (Level C). Because many patients with ALS demonstrate cognitive impairment, which in some cases meets criteria for dementia, screening for cognitive and behavioral impairment should be considered in patients with ALS (Level B). Other management strategies all lack strong evidence. GLOSSARY ALS = amyotrophic lateral sclerosis; ALS-FTD = amyotrophic lateral sclerosis with a dementia meeting the Neary criteria for frontotemporal dementia; ALSbi = amyotrophic lateral sclerosis with behavioral impairment; ALSci = amyotrophic lateral sclerosis with cognitive impairment; BTxA = botulinum toxin type A; BTxB = botulinum toxin type B; DM = dextromethorphan; FDA = Food and Drug Administration; FTD = frontotemporal dementia; NIV = noninvasive ventilation; PEG = percutaneous endoscopic gastrostomy; Q = quinidine. PMID:19822873

A Fair Go for All? The Impact of Intragroup Diversity and Diversity-Management Skills on Student Experiences and Outcomes in Team-Based Class Projects

ERIC Educational Resources Information Center

Shaw, James B.

2004-01-01

A longitudinal study of 390 students in 64 Practical Organizational Behavior Education (PROBE) project teams was conducted on the effects of intragroup diversity and student diversity-management skills. The impact of gender, age, and nationality variables on student grades, cognitive processes, perceptions of team effectiveness, and satisfaction…

Peer with Intellectual Disabilities as a Mindfulness-Based Anger and Aggression Management Therapist

ERIC Educational Resources Information Center

Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Singh, Judy; Singh, Ashvind N. A.; Singh, Angela D. A.

2011-01-01

A young man with intellectual disabilities (ID) and mental illness, who had previously been taught to successfully manage his aggressive behavior by using "Meditation on the Soles of the Feet," reported that he shared his mindfulness practice with his peers with ID. When requested by his peers, and without any training as a therapist, he began to…

Effects of using visualization and animation in presentations to communities about forest succession and fire behavior potential

Treesearch

Jane Kapler Smith; Donald E. Zimmerman; Carol Akerelrea; Garrett O' Keefe

2008-01-01

Natural resource managers use a variety of computer-mediated presentation methods to communicate management practices to the public. We explored the effects of using the Stand Visualization System to visualize and animate predictions from the Forest Vegetation Simulator-Fire and Fuels Extension in presentations explaining forest succession (forest growth and change...

Value and challenges of conducting rapid response research on wildland fires

Treesearch

L. Lentile; P. Morgan; C. Hardy; A. Hudak; R. Means; R. Ottmar; P. Robichaud; E. Kennedy Sutherland; J. Szymoniak; F. Way; J. Fites-Kaufman; S. Lewis; E. Mathews; H. Shovik; K. Ryan

2007-01-01

Rapid Response Research is conducted during and immediately after wildland fires, in coordination with fire management teams, in order to collect information that can best be garnered in situ and in real-time. This information often includes fire behavior and fire effects data, which can be used to generate practical tools such as predictive fire models for managers....

Treating the Whole Person: A Counseling, Psychology and Support Model for Learners with Learning Difficulty and Disabilities

ERIC Educational Resources Information Center

Lee, Larry

2014-01-01

Concerned about traditional practice that attempted to manage the challenging behavior of learners with learning difficulty and disabilities (LLDD) in learning and social environments, I questioned the extent to which they could manage themselves. From 265 students, 15 males, median age of 19, were invited to participate in 12 weekly one-hour…

Assessing the relationship between different forms of landowner assistance and family forest owner behaviors and intentions

Treesearch

Michael A. Kilgore; Stephanie A. Snyder; Derya Eryilmaz; Marla A. Markowski-Lindsay; Brett J. Butler; David B. Kittredge; Paul F. Catanzaro; Jaketon H. Hewes; Kyle Andrejczyk

2015-01-01

In this study, we examine how family forest owners who receive various types of assistance differ from unassisted landowners with respect to their forestland management practices, attitudes and concerns, and future management, use, and ownership intentions. We do so by utilizing a national database containing information on private forest owners and the forestland they...

Money matters: a resident curriculum for financial management.

PubMed

Mizell, Jason S; Berry, Katherine S; Kimbrough, Mary Katherine; Bentley, Frederick R; Clardy, James A; Turnage, Richard H

2014-12-01

A 2005 survey reported 87% of surgery program directors believed practice management training should occur during residency. However, only 8% of program directors believed residents received adequate training in practice management [1]. In addition to the gap in practice financial management knowledge, we recognized the need for training in personal finance among residents. A literature review and needs assessment led to the development of a novel curriculum for surgery residents combining principles of practice management and personal finance. An 18-h curriculum was administered over the 2012 academic year to 28 post graduate year 1-5 surgery residents and faculty. A self-assessment survey was given at the onset and conclusion of the curriculum [2]. Pre-tests and post-tests were given to objectively evaluate each twice monthly session's content. Self-perception of learning, interest, and acquired knowledge were analyzed using the Wilcoxon signed ranks test. Initial self-assessment data revealed high interest in practice management and personal finance principles but a deficiency in knowledge of and exposure to these topics. Throughout the curriculum, interest increased. Residents believed their knowledge of these topics increased after completing the curriculum, and objective data revealed various impacts on knowledge. Although surgery residents receive less exposure to these topics than residents in other specialties, their need to know is no less. We developed, implemented, and evaluated a curriculum that bridged this gap in surgery education. After the curriculum, residents reported an increase in interest, knowledge, and responsible behavior relating to personal and practice financial management. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of different management systems on rutting behavior and behavioral repertoire of housed Maghrebi male camels (Camelus dromedarius).

PubMed

Fatnassi, Meriem; Padalino, Barbara; Monaco, Davide; Aubé, Lydiane; Khorchani, Touhami; Lacalandra, Giovanni Michele; Mohamed, Hammadi

2014-06-01

Camel management has been changing in recent years from an extensive to a semi-intensive or intensive system, particularly for breeding bulls and dairy dromedary camels. Captivity may affect animal welfare, and low libido is the major complaint for housed breeding bulls. Since welfare status could also affect reproductive performance, the aim of this study was to evaluate different management practices on behavior, particularly on sexual behavior, and to identify some behavioral needs of male dromedary camels reared for semen collection. The effects of the following management systems on their behavior were compared: (i) traditional: housing in a single stall for 24 h (H24), (ii) housing in a single stall for 23 h with 1 h free in the paddock (H23), and (iii) housing in a single stall for 22 h and 30 min with 1 h paddock time and 30 min exposure to a female camel herd (ExF). During the trial, blood cortisol concentrations were assessed and camels were filmed daily for 30 min in the mornings and during a female passage in the evenings. Videos were analyzed in order to fill out a focal sampling ethogram and to score sexual behavior. As a result, there were no differences between the H24 and H23 systems, whereas ExF had a significant positive impact on their sexual behavior score and behavioral repertoire, further reducing cortisol levels. Overall, it seems that male dromedary camel welfare status improves when their behavioral needs for social interaction and movement are satisfied.

Autism spectrum disorders: an update on oral health management.

PubMed

Gandhi, Roopa P; Klein, Ulrich

2014-06-01

Dental professionals caring for patients with a diagnosis of autism spectrum disorder (ASD) will need to provide oral health care based on a family-centered approach that involves a comprehensive understanding of parental concerns and preferences, as well as the unique medical management, behaviors, and needs of the individual patient. With the rising prevalence of autism spectrum disorders (ASD), oral health providers will find themselves increasingly likely to care for these patients in their daily practice. The purpose of this article is to provide a comprehensive update on the medical and oral health management of patients with autism spectrum disorders. The authors conducted a literature review by searching for relevant articles written in English in the PubMed database pertaining to the medical and oral health management of autism, including caries status, preventive, behavioral, trauma, and restorative considerations. A detailed family centered approach based on parental preferences and concerns, the patient's challenging behaviors, and related comorbidities can serve to improve the treatment planning and oral health management of dental patients with ASD. Published by Mosby, Inc.

Healthcare managers' leadership profiles in relation to perceptions of work stressors and stress.

PubMed

Lornudd, Caroline; Bergman, David; Sandahl, Christer; von Thiele Schwarz, Ulrica

2016-05-03

Purpose The purpose of this study is to investigate the relationship between leadership profiles and differences in managers' own levels of work stress symptoms and perceptions of work stressors causing stress. Design/methodology/approach Cross-sectional data were used. Healthcare managers ( n = 188) rated three dimensions of their leadership behavior and levels of work stressors and stress. Hierarchical cluster analysis was performed to identify leadership profiles based on leadership behaviors. Differences in stress-related outcomes between profiles were assessed using one-way analysis of variance. Findings Four distinct clusters of leadership profiles were found. They discriminated in perception of work stressors and stress: the profile distinguished by the lowest mean in all behavior dimensions, exhibited a pattern with significantly more negative ratings compared to the other profiles. Practical implications This paper proposes that leadership profile is an individual factor involved in the stress process, including work stressors and stress, which may inform targeted health promoting interventions for healthcare managers. Originality/value This is the first study to investigate the relationship between leadership profiles and work stressors and stress in healthcare managers.

Exploring leadership and team communication within the organizational environment of a dental practice.

PubMed

Chilcutt, Alexa Stough

2009-10-01

A lack of training in leadership and communication skills can place dentists at a disadvantage, leading to high degrees of staff-related stress and turnover. A dentist's leadership style directly affects an office's communication practices, and specific leadership behaviors affect the degree of team identity, interdependence and social distance (a measure of the influential power of team members). The author recruited 10 dental offices to take part in a study. Qualitative methods included in-depth interviews of one dentist, one senior staff member and one newer staff member from each office. The interview findings show that clear and definable relationships exist between leadership behaviors--hierarchical or team-oriented organizational perspectives, proactive or laissez-faire leadership styles, and autocratic or participative decision-making processes--and the team's communication practices. Decision-making processes directly affect the degree of team identification experienced by staff members, and conflict-management tactics affect team members' sense of interdependence and social distance. The findings of this study indicate that dentists should engage in participative decision-making processes that include staff members, thereby communicating their value to the practice and empowering employees. They also must become proactive in facilitating an environment that encourages collaboration and confrontation as healthy forms of conflict management. These leadership and communication behaviors are the most significant in creating a real rather than nominal team culture, which, in turn, leads to increased overall productivity, an enhanced level of services provided to patients and improved team member satisfaction.

Teachers' Reported Use of Instructional and Behavior Management Practices for Students with Behavior Problems: Relationship to Role and Level of Training in ADHD

ERIC Educational Resources Information Center

Martinussen, Rhonda; Tannock, Rosemary; Chaban, Peter

2011-01-01

The present study examined general and special education teachers' self-reported level of in-service training in attention-deficit hyperactivity disorder (ADHD), a common childhood mental health disorder, and the relationship between teachers' level of training in ADHD and their reported use of a range of recommended instructional and behavior…

The 'fixed cost effect' on practice management.

PubMed

Tipton, E F; Finley, J B

1999-01-01

To obtain a better understanding of the behavior of "non-professional" costs in a medical practice, the authors analyzed the expenses of a 19-doctor practice. The analysis revealed that 80 percent of these expenses were fixed costs. Fixed costs, as opposed to variable costs, remain static in total but vary on a per unit basis as volume changes. Organizations with high fixed cost must maximize capacity to achieve profitability. Thus, the relationship among volume, capacity, cost and profit must be understood by medical practices negotiating rates for service units.

Building a novel inpatient diabetes management mentor program: a blueprint for success.

PubMed

Modic, Mary Beth; Sauvey, Rebecca; Canfield, Christina; Kukla, Aniko; Kaser, Nancy; Modic, Joselyn; Yager, Christina

2013-01-01

The intent of this project was to create a formalized educational program for bedside nurses responsible for inpatient diabetes management. Bedside nurses are recruited to serve as diabetes management mentors. The mentors receive advanced education concerning teaching and learning principles, the AADE7™ Self-Care Behaviors, and diabetes management strategies. They teach their peers, advocate for patients, and facilitate referrals for outpatient Diabetes Self-Management Education (DSME) programs. The focus of these ongoing educational activities is to foster the development of diabetes management mentors and to create teaching tools that mentors can use with peers to address practice gaps or skill deficiencies. The diabetes management mentor is integral in enhancing the care of patients with diabetes in the hospital. The empowerment of bedside nurses as mentors for their peers and their patients is an invaluable asset that helps nurses take ownership of their practice. This role could be applied to other complex disease entities, helping nurses to develop specific management skills to improve patient outcomes and enhance patient satisfaction.

Partnering With Community-Dwelling Individuals With Diabetes for Health Behavior Change Using Action Plans: An Innovation in Health Professionals Education and Practice.

PubMed

Barry Hultquist, Teresa; Brown, Sara Goomis; Geske, Jenenne; Kaiser, Katherine Laux; Waibel-Rycek, Denise

2015-11-01

Health care practitioners support or hinder an individual's attempts to self-manage health behavior. Practitioners must understand an individual's health needs and goals to effectively partner for behavior change. Self-management support (SMS) promote efforts toward positive health behavior change. Practitioners need training to provide effective SMS, beginning with their formal education. The purpose of this educational practice project was to integrate an evidence-based intervention (SMS using action plans) into a nursing curriculum. Three sequential steps included (1) providing foundational SMS education, (2) SMS application with students' personal action plans, and (3) implementing SMS with community-dwelling individuals with diabetes. Students (n = 130) partnered with participants (n = 85), developing short- (n = 240) and long-term (n = 99) action plans during home visits. The average baseline Diabetes Empowerment Scale score measuring participant's perceived psychosocial diabetes management self-efficacy was 4.3 (1-5 scale, SD = 0.51, n = 83). Most common short-term actions related to physical activity (n = 100, 42%) and healthy eating (n = 61, 25%). Average participant confidence level was 7.7 (SD = 1.9, 0-10 scale). Short-term goal evaluation (n = 209) revealed 66% (n = 137) were met more than 50% of the time. Both participants (99%) and students (99%) expressed satisfaction with home visit and action plan experiences. This teaching-learning experience is replicable and applicable to any professional health care student. © 2015 Society for Public Health Education.

Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

PubMed

Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

2006-01-01

At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

Indicators of club management practices and biological measurements of patrons' drug and alcohol use.

PubMed

Byrnes, Hilary F; Miller, Brenda A; Johnson, Mark B; Voas, Robert B

2014-12-01

Electronic music and dance events in nightclubs attract patrons with heavy alcohol/drug use. Public health concerns are raised from risks related to these behaviors. Practices associated with increased risk in these club settings need to be identified. The relationship between club management practices and biological measures of patrons' alcohol/drug use is examined. Observational data from 25 events across six urban clubs were integrated with survey data (N = 738 patrons, 42.8% female) from patrons exiting these events, 2010-2012. Five indicators of club management practices were examined using mixed model regressions: club security, bar crowding, safety signs, serving intoxicated patrons, and isolation. Analyses revealed that serving intoxicated patrons and safety signs were related to substance use. Specifically, serving intoxicated patrons was related to heavy alcohol and drug use at exit, while safety signs were marginally related to less exit drug use. CONCLUSIONS/IMPORTANCE: Findings indicate observable measures in nightclubs provide important indicators for alcohol/drug use, suggesting practices to target. Study strengths include the use of biological measures of substance use on a relatively large scale. Limitations and future directions are discussed.

Putting Theory Into Practice: A Case Study of Diabetes-Related Behavioral Change Interventions on Chicago's South Side

PubMed Central

Peek, Monica E.; Ferguson, Molly J.; Roberson, Tonya P.; Chin, Marshall H.

2014-01-01

Diabetes self-management is central to diabetes care overall, and much of self-management entails individual behavior change, particularly around dietary patterns and physical activity. Yet individual-level behavior change remains a challenge for many persons with diabetes, particularly for racial/ethnic minorities who disproportionately face barriers to diabetes-related behavioral changes. Through the South Side Diabetes Project, officially known as “Improving Diabetes Care and Outcomes on the South Side of Chicago,” our team sought to improve health outcomes and reduce disparities among residents in the largely working-class African American communities that comprise Chicago's South Side. In this article, we describe several aspects of the South Side Diabetes Project that are directly linked to patient behavioral change, and discuss the theoretical frameworks we used to design and implement our programs. We also briefly discuss more downstream program elements (e.g., health systems change) that provide additional support for patient-level behavioral change. PMID:25359248

Putting theory into practice: a case study of diabetes-related behavioral change interventions on Chicago's South Side.

PubMed

Peek, Monica E; Ferguson, Molly J; Roberson, Tonya P; Chin, Marshall H

2014-11-01

Diabetes self-management is central to diabetes care overall, and much of self-management entails individual behavior change, particularly around dietary patterns and physical activity. Yet individual-level behavior change remains a challenge for many persons with diabetes, particularly for racial/ethnic minorities who disproportionately face barriers to diabetes-related behavioral changes. Through the South Side Diabetes Project, officially known as "Improving Diabetes Care and Outcomes on the South Side of Chicago," our team sought to improve health outcomes and reduce disparities among residents in the largely working-class African American communities that comprise Chicago's South Side. In this article, we describe several aspects of the South Side Diabetes Project that are directly linked to patient behavioral change, and discuss the theoretical frameworks we used to design and implement our programs. We also briefly discuss more downstream program elements (e.g., health systems change) that provide additional support for patient-level behavioral change. © 2014 Society for Public Health Education.

Are personal characteristics of massage therapists associated with their clinical, educational, and interpersonal behaviors?

PubMed Central

Boulanger, Karen; Campo, Shelly

2013-01-01

Background Social Cognitive Theory suggests that characteristics of health professionals, such as their beliefs in the effectiveness of their care, influence their behavior. Studying the characteristics of massage therapists may, therefore, provide insight into their clinical, educational and interpersonal behavior, which ultimately affects their client interactions. Purpose To examine the association of three personal factors (outcome expectations, expectancies, and practice experience) of the massage therapist and the practice environment with the frequency of three interventional behaviors (clinical, educational, and interpersonal) using Social Cognitive Theory as a theoretical framework. Methods A random sample of licensed massage therapists in Iowa completed a mailed questionnaire. Questions included training in massage, use of specific massage techniques and practices, 11 outcome expectations, and 17 different behaviors with their respective expectancies for contributing to favorable client outcomes. Factor analyses were conducted on the behavior and expectancy items. Regression analyses were used to examine the relationship of massage therapist characteristics to the different categories of behavior. Results The response rate was 40% (N = 151). The most common techniques employed were Swedish massage, trigger point therapy, and stretching. The most common practices recommended to clients were encouraging water intake, heat application, stretching, stress management, and exercise counseling. Expectancies was the only Social Cognitive Theory variable that significantly predicted the frequency of every category of behavior (clinical, interpersonal, education; all ps < .01). Outcome expectations predicted clinical (p = .03) and educational (p < .01), but not interpersonal behavior. No other associations reached statistical significance. Conclusions Massage therapists’ belief in massage to enact a favorable change in a client is strongly associated with their clinical, educational, and interpersonal behavior. Massage therapists were optimistic regarding the ability of massage to provide a favorable outcome, especially if the desired outcome was supported by research. PMID:24000306

Attitude and Intention Regarding Pain Management among Chinese Nursing Students: A Cross-Sectional Questionnaire Survey.

PubMed

Fang, Liang-Yu; Xu, Yin-Chuan; Lin, Dan-Ni; Jin, Jing-Feng; Yan, Min

2017-08-01

Optimal pain management is a priority in effective nursing care. Lack of sufficient pain knowledge associated with inadequate pain management has been proved. However, the intention, defined as the predictor of behavior, regarding pain management remains unknown. Therefore, the study was to determine the attitude and intention regarding pain management among Chinese nursing students and investigate the underlying determinants and their interactions in terms of intention toward pain management. The Pain Management Survey Questionnaire, comprising the key determinants of the theory of planned behavior-that is, direct attitude, belief-based intention, subjective norm, direct control, and indirect control-was used to collect data from 512 nursing students who undertook clinical rotation in an affiliated hospital of a medical college in China. Data were analyzed using descriptive statistics, independent sample t test, Pearson correlation analysis, or structural equation modeling analysis. Chinese nursing students reported negative attitudes and behavioral intentions toward pain management. Direct control, subjective norm, belief-based attitude, and indirect control independently predicted nursing students' intention to treat patients with pain. Direct control was the strongest predictor. Structural equation modeling analysis further revealed 39.84% of the variance associated with intention that could be explained by determinants of the theory of planned behavior. Additionally, educational school level and previous pain management training had great effects on pain management intention. Overall, this study identified intention as an important factor in effective pain treatment. Chinese nursing students have negative attitudes and insufficient intention to pain management. Therefore, hospitals and universities in China should manage these factors to improve nursing students' practice regarding pain management. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management.

PubMed

Turner, Kea; Samuel, Cleo A; Donovan, Heidi As; Beckjord, Ellen; Cardy, Alexandra; Dew, Mary Amanda; van Londen, G J

2017-04-01

Providers' communication skills play a key role in encouraging breast cancer survivors to report symptoms and adhere to long-term treatments such as adjuvant endocrine therapy (AET). The purpose of this study was to examine provider perspectives on patient-provider communication regarding AET symptom management and to explore whether provider perspectives vary across the multi-disciplinary team of providers involved in survivorship care. We conducted three one-hour focus groups with a multi-disciplinary group of health care providers including oncology specialists, primary care physicians, and non-physician providers experienced in caring for breast cancer survivors undergoing AET (n = 13). Themes were organized using Epstein and Street's (2007) Framework for Patient-Centered Communication in Cancer Care. The findings of this study suggest providers' communication behaviors including managing survivors' uncertainty, responding to survivors' emotions, exchanging information, and enabling self-management influences the quality of patient-provider communication about AET symptoms. Additionally, lack of systematic symptom assessment tools for AET requires providers to use discretion in determining which symptoms to discuss with survivors resulting in approaches that vary based on providers' discipline. There may be AET-specific provider communication skills and behaviors that promote effective patient-provider communication but additional research is needed to identify practices and policies that encourage these skills and behaviors among the many providers involved in survivorship care. Efforts are also needed to coordinate AET symptom assessment across providers, clarify providers' roles in symptom assessment, and determine best practices for AET symptom communication.

Practical implications of incentive systems are utilized by dental franchises.

PubMed

Yavner, S B

1989-01-01

The success of any dental practice depends, among other factors, on the critical role of staff employees. In order to encourage desired staff behaviors, incentive systems can be designed for employee dentists, assistants/hygienists and managers. A survey of dental franchises was conducted in 1987 for the purpose of examining their incentive control systems. The specific incentives employed by these dental franchises for their employees are analyzed. The implications of these incentive systems used by dental franchise organizations for all dental practices are then discussed.

Do On-site Mental Health Professionals Change Pediatricians’ Responses to Children’s Mental Health Problems?

PubMed Central

Horwitz, Sarah McCue; Storfer-Isser, Amy; Kerker, Bonnie D.; Szilagyi, Moira; Garner, Andrew S.; O’Connor, Karen G.; Hoagwood, Kimberly E.; Green, Cori M.; Foy, Jane M.; Stein, Ruth E.K.

2016-01-01

Objective The objectives were to: assess the availability of on-site mental health professionals (MHP) in primary care; examine practice/pediatrician characteristics associated with on-site MHPs; and determine whether presence of on-site MHPs is related to pediatricians’ co-managing or more frequently identifying, treat/managing or referring MH problems. Methods Analyses included AAP members who participated in an AAP Periodic Survey in 2013 and who practiced general pediatrics (N=321). Measures included socio-demographics, practice characteristics, questions on about on-site MHPs, co-management of MH problems and pediatricians’ behaviors in response to 5 prevalent MH problems. Weighted univariate, bivariate and multivariable analyses were performed. Results Thirty-five percent reported on-site MHPs. Practice characteristics (medical schools/universities/HMOs, <100 visits/week, <80% of patients privately insured), and interactions of practice location (urban) with visits and patient insurance, were associated with on-site MHPs. There was no overall association between co-location and co-management or whether pediatricians usually identified, treat/managed or referred 5 common child MH problems. Among the subset of pediatricians who reported co-managing there was an association with co-management when the on-site MHP was a child psychiatrist, SA counselor, or social worker. Conclusions On-site MHPs are more frequent in settings where low-income children are served and where pediatricians train. Pediatricians who co-manage MH problems are more likely to do so when the on-site MHP is a child psychiatrist, SA counselor, or social worker. Overall, on-site MHPs were not associated with co-management or increased likelihood of pediatricians identifying, treating/managing, or referring children with 5 common child MH problems. PMID:27064141

Feeding, eating and behavioral disturbances in Prader-Willi syndrome and non-syndromal obesity.

PubMed

Sonnengrün, Lilli; Schober, Celestina; Vogel, Mandy; Hiemisch, Andreas; Döhnert, Mirko; Hilbert, Anja; Kiess, Wieland

2016-08-01

Although most individuals with Prader-Willi syndrome (PWS) are obese, little is known about the impact of obesity-related psychosocial factors in PWS. In the present study we compared feeding, eating, and behavioral disturbances in children and adolescents with PWS, peers with non-syndromal obesity, and normal weight controls. Twelve persons with PWS, aged 7-22 years, age- and gender-matched obese and normal weight individuals were analyzed regarding parental feeding practices, eating disturbances, and behavioral problems via standardized questionnaires. Parents of individuals with PWS reported significantly more restrictive feeding and monitoring than did parents of obese or normal weight children without PWS (p<0.05). Social problems were more common in the obese and the PWS group than in the normal-weight group (p<0.05). Behavioral problems were significantly correlated with parental restrictive feeding practices. Our data show that children and adolescents with PWS are affected by psychosocial problems, and that restrictive feeding practices might be associated with more severe behavioral problems. Further studies in larger samples will be necessary to replicate these results and possibly provide new therapeutic approaches for the management of PWS.

Guidelines for the management of cognitive and behavioral problems in dementia.

PubMed

Sadowsky, Carl H; Galvin, James E

2012-01-01

Family physicians play a crucial role in the management and ongoing care of patients with Alzheimer disease (AD). This article reviews the effects of nonpharmacologic and pharmacologic interventions on the functional abilities and behavior of patients with dementia and how these can be implemented into clinical practice. Nonpharmacologic interventions are recommended as the initial strategy for managing problematic behaviors. Strategies for improving behavior include ensuring that the patient's environment is safe, calm, and predictable; removing environmental stressors; and identifying and avoiding situations that agitate or frighten the patient. Simple interventions include redirecting and refocusing the patient, increasing social interaction, establishing regular sleep habits, eliminating sources of conflict and frustration, and establishing rewards for successes. The effectiveness of long-term behavioral management is largely dependent on the caregiver; as such, it is important to assess the role and needs of the caregiver. Because currently available therapies cannot reverse the pathologic processes of AD, the primary objective of pharmacotherapy is to preserve cognitive and functional ability, minimize behavioral disturbances, and slow disease progression. Cholinesterase inhibitors represent first-line therapy for patients with mild to moderate AD, whereas a glutamate N-methyl D-aspartate antagonist is used in the treatment of moderate to severe AD. Looking forward, there are a number of therapies in development aimed at modifying the disease course; these include amyloid-lowering drugs, τ-based and neuroprotective approaches, acetylcholine agonists, and mitochondrial inhibitors.

Relations Among Student Attention Behaviors, Teacher Practices, and Beginning Word Reading Skill

PubMed Central

Sáez, Leilani; Folsom, Jessica Sidler; Al Otaiba, Stephanie; Schatschneider, Christopher

2011-01-01

The role of student attention for predicting kindergarten word reading was investigated among 432 students. Using SWAN behavior rating scores, we conducted an exploratory factor analysis, which yielded three distinct factors that reflected selective attention. In this study, we focused on the role of one of these factors, which we labeled attention-memory behaviors, for predicting reading performance. Teacher ratings of attention predicted word reading above and beyond the contribution of phonological awareness and vocabulary knowledge. In addition, the relations between four teacher practices and attention ratings for predicting reading performance were examined. Using HLM, significant interactions between student attention and teacher practices observed during literacy instruction were found. In general, as ratings of attention improved, better kindergarten word reading performance was associated with high levels of classroom behavior management. However, by mid-year, better word reading performance was not associated with high levels of teacher task- orienting. A significant three-way interaction was also found among attention, individualized instruction, and teacher task re-directions. The role of regulating kindergarten student attention to support beginning word reading skill development is discussed. PMID:22207616

Development of and feedback on a fully automated virtual reality system for online training in weight management skills.

PubMed

Thomas, J Graham; Spitalnick, Josh S; Hadley, Wendy; Bond, Dale S; Wing, Rena R

2015-01-01

Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations. © 2014 Diabetes Technology Society.

Development of and Feedback on a Fully Automated Virtual Reality System for Online Training in Weight Management Skills

PubMed Central

Spitalnick, Josh S.; Hadley, Wendy; Bond, Dale S.; Wing, Rena R.

2014-01-01

Virtual reality (VR) technology can provide a safe environment for observing, learning, and practicing use of behavioral weight management skills, which could be particularly useful in enhancing minimal contact online weight management programs. The Experience Success (ES) project developed a system for creating and deploying VR scenarios for online weight management skills training. Virtual environments populated with virtual actors allow users to experiment with implementing behavioral skills via a PC-based point and click interface. A culturally sensitive virtual coach guides the experience, including planning for real-world skill use. Thirty-seven overweight/obese women provided feedback on a test scenario focused on social eating situations. They reported that the scenario gave them greater skills, confidence, and commitment for controlling eating in social situations. PMID:25367014

Clinical trial management of participant recruitment, enrollment, engagement, and retention in the SMART study using a Marketing and Information Technology (MARKIT) model.

PubMed

Gupta, Anjali; Calfas, Karen J; Marshall, Simon J; Robinson, Thomas N; Rock, Cheryl L; Huang, Jeannie S; Epstein-Corbin, Melanie; Servetas, Christina; Donohue, Michael C; Norman, Gregory J; Raab, Fredric; Merchant, Gina; Fowler, James H; Griswold, William G; Fogg, B J; Patrick, Kevin

2015-05-01

Advances in information technology and near ubiquity of the Internet have spawned novel modes of communication and unprecedented insights into human behavior via the digital footprint. Health behavior randomized controlled trials (RCTs), especially technology-based, can leverage these advances to improve the overall clinical trials management process and benefit from improvements at every stage, from recruitment and enrollment to engagement and retention. In this paper, we report the results for recruitment and retention of participants in the SMART study and introduce a new model for clinical trials management that is a result of interdisciplinary team science. The MARKIT model brings together best practices from information technology, marketing, and clinical research into a single framework to maximize efforts for recruitment, enrollment, engagement, and retention of participants into a RCT. These practices may have contributed to the study's on-time recruitment that was within budget, 86% retention at 24 months, and a minimum of 57% engagement with the intervention over the 2-year RCT. Use of technology in combination with marketing practices may enable investigators to reach a larger and more diverse community of participants to take part in technology-based clinical trials, help maximize limited resources, and lead to more cost-effective and efficient clinical trial management of study participants as modes of communication evolve among the target population of participants. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Robust Manipulations of Pest Insect Behavior Using Repellents and Practical Application for Integrated Pest Management.

PubMed

Wallingford, Anna K; Cha, Dong H; Linn, Charles E; Wolfin, Michael S; Loeb, Gregory M

2017-10-01

In agricultural settings, examples of effective control strategies using repellent chemicals in integrated pest management (IPM) are relatively scarce compared to those using attractants. This may be partly due to a poor understanding of how repellents affect insect behavior once they are deployed. Here we attempt to identify potential hallmarks of repellent stimuli that are robust enough for practical use in the field. We explore the literature for success stories using repellents in IPM and we investigate the mechanisms of repellency for two chemical oviposition deterrents for controlling Drosophila suzukii Matsumura, a serious pest of small fruit crops. Drosophila suzukii causes injury by laying her eggs in ripening fruit and resulting larvae make fruit unmarketable. In caged choice tests, reduced oviposition was observed in red raspberry fruit treated with volatile 1-octen-3-ol and geosmin at two initial concentrations (10% and 1%) compared to untreated controls. We used video monitoring to observe fly behavior in these caged choice tests and investigate the mode of action for deterrence through the entire behavioral repertoire leading to oviposition. We observed fewer visitors and more time elapsed before flies first landed on 1-octen-3-ol-treated fruits than control fruits and concluded that this odor primarily inhibits behaviors that occur before D. suzukii comes in contact with a potential oviposition substrate (precontact). We observed some qualitative differences in precontact behavior of flies around geosmin-treated fruits; however, we concluded that this odor primarily inhibits behaviors that occur after D. suzukii comes in contact with treated fruits (postcontact). Field trials found reduced oviposition in red raspberry treated with 1-octen-3-ol and a combination of 1-octen-3-ol and geosmin, but no effect of geosmin alone. Recommendations for further study of repellents for practical use in the field are discussed. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Strategic action or self-control? Adolescent information management and delinquency.

PubMed

Grigoryeva, Maria S

2018-05-01

Recent scholarship has begun to challenge the prevailing view that children are passive recipients of parental socialization, including the common belief that parental disciplinary practices are central to explaining adolescent problem behaviors. This research shows that children exert a significant influence over parents via information management, or the degree to which children disclose information about their behavior to parents. Despite the incorporation of child information management into contemporary models of parenting, significant theoretical and empirical concerns cast doubt on its utility over classic parent-centered approaches. The current paper addresses these concerns and adjudicates between disparate definitions of adolescent information management in two ways. First, it provides a theoretically grounded definition of information management as agentic behavior. Second, it specifies a model that tests definitions of secret keeping as agentic against a non-agentic definition of secret keeping supplied by criminological theories of self-control. The model is estimated with three four-wave cross-lagged panel models, which disentangle the interrelationships between parenting, child concealment of information, and child problem behavior in a sample of high risk youth. The results offer support for a definition of concealment as strategic and self-regarding, and have implications for research on delinquency, parent-child interactions, and child agency. Copyright © 2018 Elsevier Inc. All rights reserved.

Alcohol drinking behaviors and alcohol management policies under outsourcing work conditions: A qualitative study of construction workers in Taiwan.

PubMed

Cheng, Wan-Ju; Cheng, Yawen

2016-02-01

Workplace alcohol policies are crucial for workers' health and safety. The practice of outsourcing is gaining popularity around the world and was found to be associated with poorer health in the working population. This study aimed to examine how outsourcing complicates the implementation of workplace alcohol policies and affects workers' drinking behaviors. In-depth interviews were conducted with 16 outsource workers, 3 subcontractors and 3 worksite supervisors. Information regarding workers' drinking behaviors, their knowledge, and attitudes toward workplace alcohol policy were analyzed using a qualitative thematic analysis. Factors associated with poor workplace alcohol management included smaller size and private ownership of outsourcers, subcontractors' own drinking behavior and positive attitude to alcohol, and precarious employment conditions of outsourcing workers. The multilateral relationship between outsourcers, subcontractors, and workers complicated and impaired the implementation of workplace alcohol policies. The implementation of workplace alcohol management policies was hampered in outsourcing work conditions due to poor coordination of supervisors in the subcontract chain. The enforcement of alcohol policies in the workplace should be strengthened by consolidating management responsibilities of outsourcers and subcontractors. Copyright © 2015 Elsevier B.V. All rights reserved.

Safety climate and safety behaviors in the construction industry: The importance of co-workers commitment to safety.

PubMed

Schwatka, Natalie V; Rosecrance, John C

2016-06-16

There is growing empirical evidence that as safety climate improves work site safety practice improve. Safety climate is often measured by asking workers about their perceptions of management commitment to safety. However, it is less common to include perceptions of their co-workers commitment to safety. While the involvement of management in safety is essential, working with co-workers who value and prioritize safety may be just as important. To evaluate a concept of safety climate that focuses on top management, supervisors and co-workers commitment to safety, which is relatively new and untested in the United States construction industry. Survey data was collected from a cohort of 300 unionized construction workers in the United States. The significance of direct and indirect (mediation) effects among safety climate and safety behavior factors were evaluated via structural equation modeling. Results indicated that safety climate was associated with safety behaviors on the job. More specifically, perceptions of co-workers commitment to safety was a mediator between both management commitment to safety climate factors and safety behaviors. These results support workplace health and safety interventions that build and sustain safety climate and a commitment to safety amongst work teams.

Exploring Cultural Influences of Self-Management of Diabetes in Coastal Kenya

PubMed Central

Abdulrehman, Munib Said; Woith, Wendy; Jenkins, Sheryl; Kossman, Susan; Hunter, Gina Louise

2016-01-01

In spite of increasing prevalence of diabetes among Kenyans and evidence suggesting Kenyans with diabetes maintain poor glycemic control, no one has examined the role of cultural attitudes, beliefs, and practices in their self-management of diabetes. The purpose of this ethnographic study was to describe diabetes self-management among the Swahili of coastal Kenya, and explore factors that affect diabetes self-management within the context of Swahili culture. Thirty men and women with type 2 diabetes from Lamu town, Kenya, participated in this study. Diabetes self-management was insufficiently practiced, and participants had limited understanding of diabetes. Economic factors such as poverty and the high cost of biomedical care appear to have more influence in self-management behavior than socio-cultural and educational factors do. Economic and socio-cultural influences on diabetes self-management should not be underestimated, especially in a limited resource environment like coastal Kenya, where biomedical care is not accessible or affordable to all. PMID:28462335

Treatment of Obesity in Primary Care.

PubMed

Tsai, Adam G; Remmert, Jocelyn E; Butryn, Meghan L; Wadden, Thomas A

2018-01-01

This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians (PCPs) to help their patients with weight management. Studies on lifestyle modification, commercial weight loss programs, and medical and surgical options are reviewed. Several clinical suggestions on obesity management that PCPs can take back and use immediately in office practice are offered. Copyright © 2017 Elsevier Inc. All rights reserved.

Leadership Behaviors of Management for Complex Adaptive Systems

DTIC Science & Technology

2010-04-01

arson • The Five Dysfunctions of a Team - Patrick M. Lencioni Agile Development Practices • Agile Project Management with Scrum – Ken Schwaber...and down to the individual and team level – Relationships are not defined hierarchically, but rather through interactions across References: Mike...n – Consisting of parts intricately combined © Copyright 2009 Northrop GrummanCopyright 2010 Northrop Grumman 5 Predictable or Adaptive Software/IT

Safety climate and mindful safety practices in the oil and gas industry.

PubMed

Dahl, Øyvind; Kongsvik, Trond

2018-02-01

The existence of a positive association between safety climate and the safety behavior of sharp-end workers in high-risk organizations is supported by a considerable body of research. Previous research has primarily analyzed two components of safety behavior, namely safety compliance and safety participation. The present study extends previous research by looking into the relationship between safety climate and another component of safety behavior, namely mindful safety practices. Mindful safety practices are defined as the ability to be aware of critical factors in the environment and to act appropriately when dangers arise. Regression analysis was used to examine whether mindful safety practices are, like compliance and participation, promoted by a positive safety climate, in a questionnaire-based study of 5712 sharp-end workers in the oil and gas industry. The analysis revealed that a positive safety climate promotes mindful safety practices. The regression model accounted for roughly 31% of the variance in mindful safety practices. The most important safety climate factor was safety leadership. The findings clearly demonstrate that mindful safety practices are highly context-dependent, hence, manageable and susceptible to change. In order to improve safety climate in a direction which is favorable for mindful safety practices, the results demonstrate that it is important to give the fundamental features of safety climate high priority and in particular that of safety leadership. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Optimal Pain Assessment in Pediatric Rehabilitation: Implementation of a Nursing Guideline.

PubMed

Kingsnorth, Shauna; Joachimides, Nick; Krog, Kim; Davies, Barbara; Higuchi, Kathryn Smith

2015-12-01

In Ontario, Canada, the Registered Nurses' Association promotes a Best Practice Spotlight Organization initiative to enhance evidence-based practice. Qualifying organizations are required to implement strategies, evaluate outcomes, and sustain practices aligned with nursing clinical practice guidelines. This study reports on the development and evaluation of a multifaceted implementation strategy to support adoption of a nursing clinical practice guideline on the assessment and management of acute pain in a pediatric rehabilitation and complex continuing care hospital. Multiple approaches were employed to influence behavior, attitudes, and awareness around optimal pain practice (e.g., instructional resources, electronic reminders, audits, and feedback). Four measures were introduced to assess pain in communicating and noncommunicating children as part of a campaign to treat pain as the fifth vital sign. A prospective repeated measures design examined survey and audit data to assess practice aligned with the guideline. The Knowledge and Attitudes Survey (KNAS) was adapted to ensure relevance to the local practice setting and was assessed before and after nurses' participation in three education modules. Audit data included client demographics and pain scores assessed annually over a 3-year window. A final sample of 69 nurses (78% response rate) provided pre-/post-survey data. A total of 108 pediatric surgical clients (younger than 19 years) contributed audit data across the three collection cycles. Significant improvements in nurses' knowledge, attitudes, and behaviors related to optimal pain care for children with disabilities were noted following adoption of the pain clinical practice guideline. Targeted guideline implementation strategies are central to supporting optimal pain practice. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Adolescent Nutrition and Physical Fitness. Selected Indicators. Findings for 9th-12th Grade Students from the 1993 North Carolina Youth Risk Behavior Survey.

ERIC Educational Resources Information Center

Mikow, Victoria A.

A survey of 2,439 high school students (the 1993 Youth Risk Behavior Survey) in North Carolina found that students present a mixed picture of healthy and risky physical, nutritional, and weight management practices. The survey examined perception of body weight; weight control by gender; method of weight control; consumption of fruit or fruit…

Reducing agricultural greenhouse gas emissions: role of biotechnology, organic systems, and consumer behavior

USDA-ARS?s Scientific Manuscript database

All agricultural systems have environmental and societal costs and benefits that should be objectively quantified before recommending specific management practices. Agricultural biotechnology, which takes advantage of genetically engineered organisms (GEOs), along with organic cropping systems, econ...

Mindfulness and motivational interviewing: two candidate methods for promoting self-management.

PubMed

Benzo, Roberto P

2013-08-01

There is no conclusive evidence about the way to a promote behavior change in self-management programs for patients with chronic obstructive pulmonary disease (COPD). The latter is a significant knowledge gap as there is a need to promote a sustained effect in interventions like Pulmonary Rehabilitation or Supporting Programs. Embracing patient's values seems to be a key ingredient to ignite genuine motivation for behavior change. This manuscript describes two pilot qualitative studies carried out in patients with severe COPD aimed to engage the patient inner experience and promote self-management: a trial testing motivational interviewing (MI) as one style of helping patients with severe COPD make changes in their behavior and second a trial testing a mindfulness-based intervention. The MI study consisted of a 3-month program of weekly coaching phone calls after one face-to-face visit. The following themes were outstanding: patients value the supportive communication with coach and believe the MI-based coaching created increased level of awareness and accountability. They perceived an increase in physical activity and reported "feeling better" or other benefits not directly related to exercise. The Mindfulness for Health Program was a mandatory 8-week program that consisted on 2-hour classes aimed to cultivate nonjudgmental attention in the moment (through different meditative practices and sharing) plus monthly face-to-face encounters aimed to sustain practice and sharing of life experiences for 1 year. The following themes (at 1 year) were outstanding: appreciating life by seeing hardships as opportunities, valuing the self through compassion and awareness, cultivating connectedness with others, acquiring joy, and adopting healthy behaviors. In the search for the "holy grail" for self-management programs that can promote a behavior change, mindfulness and MI seem promising for cultivating a way to live a life in which people are fully present and consciously agree with.

Culturally relevant model program to prevent and reduce agricultural injuries.

PubMed

Helitzer, D L; Hathorn, G; Benally, J; Ortega, C

2014-07-01

Limited research has explored pesticide injury prevention among American Indian farmers. In a five-year agricultural intervention, a university-community partnership, including the University of New Mexico School of Medicine, New Mexico State University, Shiprock Area Cooperative Extension Service, and Navajo Nation communities, used a culturally relevant model to introduce and maintain safe use of integrated pest management techniques. We applied the Diffusion of Innovations theory and community-based approaches to tailor health promotion strategies for our intervention. In a longitudinal study with repeated measures, we trained six "model farmers" to be crop management experts in pesticide safety, application, and control. Subsequently, these model farmers worked with 120 farm families randomized into two groups: intervention (Group 1) and delayed intervention (Group 2). Measurements included a walk-through analysis, test of knowledge and attitudes, and yield analysis. Both groups demonstrated improvements in pesticide storage behaviors after training. Test scores regarding safety practices improved significantly: from 57.3 to 72.4 for Group 1 and from 52.6 to 76.3 for Group 2. Group 1 maintained their knowledge and safety practices after the intervention. Attitudes about pesticides and communication of viewpoints changed across the study years. With pesticides and fertilizer, the number of corn ears increased by 56.3% and yield (kg m(-2)) of alfalfa increased by 41.2%. The study combined traditional farming practices with culturally relevant approaches and behavior change theory to affect knowledge, safety practices, attitudes, communication channels, and crop yield. Storage behaviors, use of pesticides and safety and application equipment, and safety practice knowledge changed significantly, as did attitudes about social networking, social support, and the compatibility and relative advantage of pesticides for farms.

Influences of health literacy, judgment skills, and empowerment on asthma self-management practices.

PubMed

Londoño, Ana Maria Moreno; Schulz, Peter J

2015-07-01

Asthma self-management has been recognized as an essential factor for the improvement of asthma outcomes and patients' quality of life (WHO, 2013). Likewise, empowerment and health literacy have been noted as important elements for the management of chronic diseases. To study the influence of health literacy and empowerment on asthma self-management. This cross-sectional study used a self-reported questionnaire assessing health literacy, judgment skills, empowerment, and asthma self-management; 236 patients were recruited from medical offices in Switzerland and Italy. Judgment skills (B=2.28, p<0.001) and empowerment (B=0.19, p<0.05) have a significant and positive influence on several asthma self-management practices such as use of medicines, timely medical consultation, and asthma triggers control whereas health literacy (B=-0.15, p<0.175) appeared to have a negative effect on self-management practices. However, this was not significant. These findings suggest that empowered patients with adequate judgment skills carry out key self-management tasks more appropriately, which in turn will potentially result in better asthma control. This study recommends that both empowerment and judgment skills should be addressed in patient education as they serve as essential motivators to engage patients in these behaviors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Beware the next big thing.

PubMed

Birkinshaw, Julian

2014-05-01

Innovative management ideas that bubble up in other companies pose a perennial quandary for leaders: Should you attempt to borrow new ideas, and if so, which ones and how? Even the most promising practices can be disastrous if they're transplanted into the wrong company, writes Julian Birkinshaw of London Business School. Broadly speaking, there are two ways to borrow from innovative companies, he argues. The first, observe and apply, is the most commonly used approach for adopting new management ideas. It can and does work well, but only under Limited sets of circumstances: when the observed practice easily stands alone or involves just a small constellation of supporting behaviors (think of GE's well-regarded succession-planning process) and when a company's management model or way of thinking is very similar to the originator's (think of two software firms that both use the Agile development approach). The second method is to extract a management practice's essential principle-its underlying logic-and ask a series of questions to determine if it is right for your firm, including: How is your company different from the originating firm? Are the goals of the practice important to your organization? Many management innovations are launched with great fanfare, only to fade in popularity. With careful analysis, you can avoid falling prey to this hype cycle. And even if it turns out that a borrowed idea isn't right for you, the analysis will help you better understand your own management models and sharpen your practices.

On becoming a coach: a pilot intervention study with managers in long-term care.

PubMed

Cummings, Greta; Mallidou, Anastasia A; Masaoud, Elmabrok; Kumbamu, Ashok; Schalm, Corinne; Spence Laschinger, Heather K; Estabrooks, Carole A

2014-01-01

Health care leaders have called for the development of communication and leadership skills to improve manager-employee relationships, employee job satisfaction, quality care, and work environments. The aim of the study reported here was to pilot how a 2-day coaching workshop ("Coaching for Impressive CARE") conducted as a leadership development strategy influenced frontline care managers' coaching practices in residential long-term care (LTC) settings. We had four objectives: (a) to identify managers' perceptions of their role as a coach of employee performance in LTC facilities, (b) to understand managers' intentions to coach employee performance, (c) to examine opportunities and factors that contributed to or challenged implementation of workshop coaching skills in daily leadership/management practice, and (d) to examine managers' reports of using coaching practices and employee responses after the workshop. We used an exploratory/descriptive design involving pre-/post-workshop surveys, e-mail reminders, and focus groups to examine participation of 21 LTC managers in a 2-day coaching workshop and their use of coaching practices in the workplace. Focus group findings provided examples of how participants used their coaching skills in practice (e.g., communicating empathy) and how staff responded. Factors contributing to and challenging implementation of these coaching skills in the workplace were identified. Attitudes and intentions to be a coach increased significantly, and some coaching skills were used more frequently after the workshop, specifically planning for performance change with employees. The coaching workshop was feasible to implement, well received by participants, influenced their willingness to become coaches, and had some noted impact on their use of coaching behaviors in the workplace. Coaching skills by managers to improve staff performance with residents in LTC facilities can be learned.

From Our Practices to Yours: Key Messages for the Journey to Integrated Behavioral Health.

PubMed

Gold, Stephanie B; Green, Larry A; Peek, C J

The historic, cultural separation of primary care and behavioral health has caused the spread of integrated care to lag behind other practice transformation efforts. The Advancing Care Together study was a 3-year evaluation of how practices implemented integrated care in their local contexts; at its culmination, practice leaders ("innovators") identified lessons learned to pass on to others. Individual feedback from innovators, key messages created by workgroups of innovators and the study team, and a synthesis of key messages from a facilitated discussion were analyzed for themes via immersion/crystallization. Five key themes were captured: (1) frame integrated care as a necessary paradigm shift to patient-centered, whole-person health care; (2) initialize: define relationships and protocols up-front, understanding they will evolve; (3) build inclusive, empowered teams to provide the foundation for integration; (4) develop a change management strategy of continuous evaluation and course-correction; and (5) use targeted data collection pertinent to integrated care to drive improvement and impart accountability. Innovators integrating primary care and behavioral health discerned key messages from their practical experience that they felt were worth sharing with others. Their messages present insight into the challenges unique to integrating care beyond other practice transformation efforts. © Copyright 2017 by the American Board of Family Medicine.

Is management still a science?

PubMed

Freedman, D H

1992-01-01

New technologies are transforming products, markets, and entire industries. Yet the more science and technology reshape the essence of business, the less useful the concept of management itself as a science seems to be. On reflection, this paradox is not so surprising. The traditional scientific approach to management promised to provide managers with the capacity to analyze, predict, and control the behavior of the complex organizations they led. But the world most managers currently inhabit often appears to be unpredictable, uncertain, and even uncontrollable. In the face of this more volatile business environment, the old-style mechanisms of "scientific management" seem positively counterproductive. And science itself appears less and less relevant to the practical concerns of managers. In this article, science journalist David Freedman argues that the problem lies less in the shortcomings of a scientific approach to management than in managers' understanding of science. What most managers think of as scientific management is based on a conception of science that few current scientists would defend. What's more, just as managers have become more preoccupied with the volatility of the business environment, scientists have also become preoccupied with the inherent volatility--the "chaos" and "complexity"--of nature. They are developing new rules for complex behavior in physical systems that have intriguing parallels to the kind of organizational behaviors companies are trying to encourage. In fact, science, long esteemed by business as a source of technological innovation, may ultimately prove of greatest value to managers as a source of something else: useful ways of looking at the world.

AAFP and ISFM Guidelines for diagnosing and solving house-soiling behavior in cats.

PubMed

Carney, Hazel C; Sadek, Tammy P; Curtis, Terry M; Halls, Vicky; Heath, Sarah; Hutchison, Pippa; Mundschenk, Kari; Westropp, Jodi L

2014-07-01

These Guidelines have been developed by the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM) as a resource for veterinary practitioners who want to better understand and manage the important clinical condition of house-soiling in their feline patients. The Guidelines offer straightforward, practical solutions that, in most cases, will help veterinarians and cat owners prevent, manage or entirely remediate feline house-soiling behavior. The Guidelines include scientifically documented information when it is available. However, because research is often lacking, some recommendations reflect the accumulated clinical experience of the authors. © ISFM and AAFP 2014.

Using an evidence-based online module to improve parents' ability to support their child with Developmental Coordination Disorder.

PubMed

Camden, Chantal; Foley, Véronique; Anaby, Dana; Shikako-Thomas, Keiko; Gauthier-Boudreault, Camille; Berbari, Jade; Missiuna, Cheryl

2016-07-01

Developmental Coordination Disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents' awareness and building capacity but few interventions incorporating these best practices are documented. To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioral changes when managing their child's health condition. A mixed-methods, before-after design guided by the Theory of Planned Behavior was employed. Data about the knowledge, skills and behaviors of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. Paired T-tests, sensitivity analyses and thematic analyses were performed on data as appropriate. One hundred-sixteen, 81 and 58 participants respectively completed the three questionnaires. For knowledge and skills, post- and follow-up scores were significantly higher than baseline scores (p < 0.01). Fifty-two (64%) participants reported an intention to change behavior post-intervention and 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents' behavioral change: sharing information, trialing strategies and changing attitudes. Factors influencing parents' ability to implement these behavioral changes included clear recommendations, time, and 'right' attitude. Perceived outcomes associated with the parental behavioral changes involved improvement in well-being for the children at school, at home, and for the family as a whole. The online module increased parents' self-reported knowledge and skills in DCD management. Future research should explore its impacts on children's long-term outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Preventative Disease Management and Grower Decision Making: A Case Study of California Wine-Grape Growers.

PubMed

Hillis, Vicken; Lubell, Mark; Kaplan, Jonathan; Baumgartner, Kendra

2017-06-01

Preventative disease management is challenging to farmers because it requires paying immediate costs in the hopes of returning uncertain future benefits. Understanding farmer decision making about prevention has the potential to reduce disease incidence and minimize the need for more costly postinfection practices. For example, the grapevine trunk-disease complex (esca, Botryosphaeria dieback, Eutypa dieback, and Phomopsis dieback) significantly affects vineyard productivity and longevity. Given the chronic nature of the infections and inability to eradicate the fungal pathogens, the preventative practices of delayed pruning, applications of pruning-wound protectants, and double pruning (also known as prepruning) are the most effective means of management. We surveyed wine-grape growers in six regions of California on their use of these three practices. In spite of acknowledging the yield impacts of trunk diseases, a substantial number of respondents either choose not to use preventative practices or incorrectly adopted them in mature vineyards, too late in the disease cycle to be effective. Growers with more negative perceptions of cost efficacy were less likely to adopt preventative practices or were more likely to time adoption incorrectly in mature vineyards. In general, preventative management may require strong intervention in the form of policy or extension to motivate behavioral change.

[Development of knowledge, attitude and practice questionnaire on prevention and control of occupational diseases].

PubMed

Gao, Yuan; Feng, Yuchao; Wang, Min; Su, Yiwei; Li, Yanhua; Wang, Zhi; Tang, Shihao

2015-04-01

To develop the knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups, and to provide a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect. The initial questionnaire which was evaluated by the experts was used to carry out a pre-survey in Guangzhou, China. The survey results were statistically analyzed by t test, identification index method, correlation analysis, and Cronbach's a coefficient method. And then the questionnaire was further modified, and the content of the questionnaire was determined finally. After modification, there were 18 items on knowledge, 16 items on attitude, and 12 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for enterprise managers"; there were 19 items on knowledge, 10 items on attitude, and 11 items on behavior in the "Knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for workers". The knowledge, attitude and practice questionnaire on the prevention and control of occupational diseases for occupational groups is developed successfully, and it is a convenient and effective tool for the survey of knowledge, attitude, and behavior on the prevention and control of occupational diseases in occupational groups and the evaluation of intervention effect.

Integrating self-management and exercise for people living with arthritis.

PubMed

Mendelson, A D; McCullough, C; Chan, A

2011-02-01

The Program for Arthritis Control through Education and Exercise, PACE-Ex™, is an arthritis self-management program incorporating principles and practice of self-management, goal setting and warm water exercise. The purpose of this program review is to examine the impact of PACE-Ex on participants' self-efficacy for condition management, self-management behaviors, goal achievement levels and self-reported disability, pain and health status. A retrospective review was conducted on participants who completed PACE-Ex from 1998 to 2006. A total of 347 participants completed 24 PACE-Ex programs [mean age 69.9 (±12.2) years, living with arthritis mean of 14.1 (±13.2) years]. Participants showed statistically significant improvements in their self-efficacy to manage their condition (Program for Rheumatic Independent Self-Management Questionnaire) (P < 0.001) and performance of self-management behaviors (Self-Management Behavior Questionnaire) (P < 0.01). Self-reported health status, disability and pain levels improved post-program (P < 0.01) despite reporting statistically significant increase in the total swollen and tender joint counts (Health Assessment Questionnaire) (P < 0.05). Sixty-eight percent of participants achieved or exceeded their long-term goal as measured by Goal Attainment Scaling. These findings remain to be proven with a more rigorous method yet they suggest that PACE-Ex is a promising intervention that supports healthy living for individuals with arthritis.

Modifying physician behavior to improve cost-efficiency in safety-net ambulatory settings.

PubMed

Borkowski, Nancy; Gumus, Gulcin; Deckard, Gloria J

2013-01-01

Change interventions in one form or another are viewed as important tools to reduce variation in medical services, reduce costs, and improve quality of care. With the current focus on efficient resource use, the successful design and implementation of change strategies are of utmost importance for health care managers. We present a case study in which macro and micro level change strategies were used to modify primary care physicians' practice patterns of prescribing diagnostic services in a safety-net's ambulatory clinics. The findings suggest that health care managers using evidence-based strategies can create a practice environment that reduces barriers and facilitates change.

Best practices: Use of an administrative review committee at New Hampshire Hospital to mitigate risk with high-profile patients.

PubMed

de Nesnera, Alexander; Folks, David G

2010-07-01

An increasing number of patients manifesting violent and aggressive behaviors are treated at New Hampshire Hospital. Over the past ten years, the volume of referrals on an involuntary emergency petition has increased 70%. New Hampshire Hospital has successfully initiated its Administrative Review Committee, which confers a risk management process to mitigate potential liability for the hospital and treating clinicians for these high-risk patients. This best practice is viewed as helpful by clinicians and by the hospital's legal counsel. Hospitals treating similar high-risk patients may also benefit from developing a similar committee and risk management process.

Personalizing knowledge delivery services: a conceptual framework

NASA Technical Reports Server (NTRS)

Majchrzak, Ann; Chelleppa, Ramnath K.; Cooper, Lynne P.; Hars, Alexander

2003-01-01

Consistent with the call of the Minnesota Symposium for new theory in knowledge management, we offer a new conceptualization of Knowledge Management Systems (KMS) as a portfolio of personalized knowledge delivery services. Borrowing from research on online consumer behavior, we describe the challenges imposed by personalized knowledge delivery services, and suggest design parameters that can help to overcome these challenges. We develop our design constructs through a set of hypotheses and discuss the research implications of our new conceptualization. Finally, we describe practical implications suggested by our conceptualization - practical suggestions that we hope to gain some experience with as part of an ongoing action research project at our partner organization.

Prerequisites in behavioral science and business: opportunities for dental education.

PubMed

Dunning, David G; Lange, Brian M; Madden, Robert D; Tacha, Koko K

2011-01-01

There is increasing pressure on recent dental school graduates to understand and successfully utilize patient management and business management strategies to run a productive dental office. Dental schools are faced with the dilemma to either add more credit hours in their already crowded curriculum or adjust predental school requirements. All fifty-nine U.S. dental schools were assessed online to determine admission requirements in the areas of behavioral science and business education. Results show that only 11.9 percent of the schools require prerequisite course work in behavioral science and no school requires prerequisite course work in business. However, 64.4 percent and 30.5 percent of schools encouraged or recommended prerequisite course work in behavioral science and business, respectively. We suggest that the dental education community involve key stakeholders to discuss the incorporation of prerequisite course work in behavioral science and business. Additional courses in these disciplines would provide dental students better backgrounds from which the dental curriculum could build a more advanced and applied perspective to better prepare students for practice.

Behavioral cardiology: current advances and future directions.

PubMed

Rozanski, Alan

2014-07-08

Growing epidemiological evidence identifies key domains relevant to behavioral cardiology, including health behaviors, emotions, mental mindsets, stress management, social connectedness, and a sense of purpose. Each of these domains exists along a continuum, ranging from positive factors that promote health, to negative factors, which are pathophysiological. To date, there has been relatively little translation of this growing knowledge base into cardiology practice. Four initiatives are proposed to meet this challenge: 1) promulgating greater awareness of the potency of psychosocial risks factors; 2) overcoming a current "artificial divide" between conventional and psychosocial risk factors; 3) developing novel cost-effective interventions using Internet and mobile health applications, group-based counseling, and development of tiered-care behavioral management; and 4) in recognition that "one size does not fit all" with respect to behavioral interventions, developing specialists who can counsel patients in multidisciplinary fashion and use evidence-based approaches for promoting patient motivation and execution of health goals. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Optimal stimulation as theoretical basis of hyperactivity.

PubMed

Zentall, Sydney

1975-07-01

Current theory and practice in the clinical and educational management of hyperactive children recommend reduction of environmental stimulation, assuming hyperactive and distractable behaviors to be due to overstimulation. This paper reviews research suggesting that hyperactive behavior may result from a homeostatic mechanism that functions to increase stimulation for a child experienceing insufficient sensory stimulation. It is suggested that the effectiveness of drug and behavior therapies, as well as evidence from the field of sensory deprivation, further support the theory of a homeostatic mechanism that attempts to optimize sensory input.

Development and demonstration of smoke plume, fire emissions, and pre- and postprescribed fire fuel models on North Carolina Coastal Plain forest ecosystems

Treesearch

Robert A. Mickler; Miriam Rorig; Christopher D. Geron; Gary L. Achtemier; Andrew D. Bailey; Candice Krull; David Brownlie

2007-01-01

Wildland fuels have been accumulating in the United States during at least the past half-century due to wildland fire management practices and policies. The additional fuels contribute to intense fire behavior, increase the costs of wildland fire control, and contribute to the degradation of local and regional air quality. The management of prescribed and wildland fire...

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2018-02-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

2017 National Standards for Diabetes Self-Management Education and Support.

PubMed

Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

2017-10-01

Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

Psychosocial treatments for schizophrenia.

PubMed

Mueser, Kim T; Deavers, Frances; Penn, David L; Cassisi, Jeffrey E

2013-01-01

The current state of the literature regarding psychosocial treatments for schizophrenia is reviewed within the frameworks of the recovery model of mental health and the expanded stress-vulnerability model. Interventions targeting specific domains of functioning, age groups, stages of illness, and human service system gaps are classified as evidence-based practices or promising practices according to the extent to which their efficacy is currently supported by meta-analyses and individual randomized controlled trials (RCTs). Evidence-based practices include assertive community treatment (ACT), cognitive behavior therapy (CBT) for psychosis, cognitive remediation, family psychoeducation, illness self-management training, social skills training, and supported employment. Promising practices include cognitive adaptive therapy, CBT for posttraumatic stress disorder, first-episode psychosis intervention, healthy lifestyle interventions, integrated treatment for co-occurring disorders, interventions targeting older individuals, peer support services, physical disease management, prodromal stage intervention, social cognition training, supported education, and supported housing. Implications and future directions are discussed.

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives

PubMed Central

Eisen, Jeffrey C.; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy

2013-01-01

Objective: To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. Method: The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). Results: While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Conclusion: Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. Trial Registration: ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912 PMID:24800110

Pilot Study of Implementation of an Internet-Based Depression Prevention Intervention (CATCH-IT) for Adolescents in 12 US Primary Care Practices: Clinical and Management/Organizational Behavioral Perspectives.

PubMed

Eisen, Jeffrey C; Marko-Holguin, Monika; Fogel, Joshua; Cardenas, Alonso; Bahn, My; Bradford, Nathan; Fagan, Blake; Wiedmann, Peggy; Van Voorhees, Benjamin W

2013-01-01

To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007. The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention). While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses. Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings. ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912.

Family management of a chronic health condition: perspectives of adolescents.

PubMed

Wollenhaupt, Josanne; Rodgers, Beth; Sawin, Kathleen J

2012-02-01

A growing number of adolescents and their families are dealing with a chronic health condition that impacts their daily life. Research using the Family Management Style Framework (FMSF) has added much to our understanding of how the family integrates chronic condition management into family life. Less clear, however, is the adolescent perspective of the FMSF components. The purpose of this secondary qualitative analysis was to explore 25 interviews of adolescents with spina bifida to uncover the adolescent's perspective of the three major FMSF components: Definition of the Situation, Management Behaviors, and Perceived Consequences. Adolescents were able to articulate their perspectives and their observations of their parents' behaviors that related to the three components and related dimensions of the framework. Data from this analysis led to proposed expansion of the FMSF definitions from an adolescent perspective. Implications for integrating the adolescent perspective into future research and clinical practice are discussed.

Patients' self-efficacy within online health communities: facilitating chronic disease self-management behaviors through peer education.

PubMed

Willis, Erin

2016-01-01

In order to combat the growing burden of chronic disease, evidence-based self-management programs have been designed to teach patients about the disease and its affect on their lives. Self-efficacy is a key component in chronic disease self-management. This research used online ethnography and discourse analysis (N = 8,231) to examine self-efficacy within the computer-mediated communication (CMC) of four online health communities used by people with arthritis. Specifically, online opinion leaders were identified for examination. Across the four communities, there was a cyclical process that involved "disease veterans" sharing their experiences and gaining credibility within the community, new(er) members suffering from disease symptoms and sharing their experiences online, and finally, asking others for help with arthritis self-management behaviors. Three themes follow: (1) sharing disease experience, (2) suffering from disease symptoms, and (3) asking for help. Practical implications for health promotion and education are discussed.

[Evaluation of a medication self-management education program for elders with hypertension living in the community].

PubMed

Lee, Jong Kyung

2013-04-01

The purpose of this study was to examine the effect of a medication self-management education program on medication awareness, communication with health care provider, medication misuse behavior, and blood pressure in elders with hypertension. The research design for this study was a non-equivalent control group quasi-experimental design. Participants were 23 elders for the control group, and 26 elders for the experimental group. The experimental group participated in the medication self-management education program which included the following, verbal education, 1:1 consultation, practice in medication self-management, and discussion over 5 sessions. Data were analyzed using the SPSS 18.0 program. There were statistically significant differences between the experimental and control group for medication awareness, medication misuse behavior, and communication with health care providers. However, no significant difference was found between the two groups for blood pressure. The results indicate that the education program is effective in improving medication awareness and communication with health care providers and in decreasing medication misuse behavior. Therefore, it is recommended that this education program be used as an effective intervention for improving medication self-management for elders with hypertension.

Use of antipsychotic medications for the management of delirium: an audit of current practice in the acute care setting.

PubMed

Tropea, J; Slee, J; Holmes, A C N; Gorelik, A; Brand, C A

2009-02-01

Despite delirium being common in older hospitalized people, little is known about its management. The aims of this study are (1) to describe the pharmacological management of delirium in an acute care setting as a baseline measure prior to the implementation of newly developed Australian guidelines; and (2) to determine what areas of delirium pharmacological management need to be targeted for future practical guideline implementation and quality improvement activities. A medical record audit was conducted using a structured audit form. All patients aged 65 years and over who were admitted to a general medical or orthopaedic unit of the Royal Melbourne Hospital between 1 March 2006 and 28 February 2007 and coded with delirium were included. Data on the use of antipsychotic medications for the management of delirium in relation to best practice recommendations were assessed. Overall 174 episodes of care were included in the analysis. Antipsychotic medications were used for the management of most patients with severe behavioral and or emotional disturbance associated with delirium. There was variation in the prescribing patterns of antipsychotic agents and the documentation of medication management plans. Less than a quarter of patients prescribed antipsychotic medication were started on a low dose and very few were reviewed on a regular basis. A wide range of practice is seen in the use of antipsychotic agents to manage older patients with severe symptoms associated with delirium. The findings highlight the need to implement evidence-based guideline recommendations with a focus on improving the consistency in the pharmacological management and documentation processes.

Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system.

PubMed

Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J

2015-12-15

Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.

Transcultural Pain Management: Theory, Practice, and Nurse-Client Partnerships.

PubMed

Rosa, William E

2018-02-01

Nursing is becoming increasingly aware of its impact as a global profession. Part of this evolution is the understanding that the Western evidence-based construct may not be reliably or universally applicable to transcultural settings and clients. In a global world, no 'one size fits all' and no singular approach to pain management is appropriate; there are, quite literally, infinite variations in cross-cultural dynamics. Nurses working in the field of pain management must be able to navigate their responsibilities within the global health context. The role of the pain management nurse in the global world is to provide individualized and culturally relevant pain management for clients, which is mindful of multifactorial contributors to the pain experience, such as the physiologic, affective, cognitive, behavioral, sociocultural, and environmental, and to view adequate pain management as an international human right. Through the skillful integration of theory, practice, and the ability to build respectful and responsible nurse-client partnerships, pain management nurses can deliver contextually relevant care that promotes safety, quality, and healing. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Impact of a primary care intervention on physician practice and patient and family behavior: keep ME Healthy---the Maine Youth Overweight Collaborative.

PubMed

Polacsek, Michele; Orr, Joan; Letourneau, Lisa; Rogers, Victoria; Holmberg, Robert; O'Rourke, Karen; Hannon, Cindy; Lombard, Kenneth A; Gortmaker, Steven L

2009-06-01

To evaluate the effect of a pediatric primary care-based intervention, on improved clinical decision support and family management of risk behaviors for childhood overweight. An experimental field trial was conducted with 12 intervention sites in urban and rural areas of Maine and nonrandomized control sites. Change was assessed by using clinical and parent measures from 9 intervention and 10 control sites before and during the Maine Youth Overweight Collaborative intervention. Longitudinal information was collected from chart audits of patients aged 5-18 years (n = 600), systematic samples of parents collected before (n = 346) and during (n = 386) the intervention in 12 sites, and systematic samples of parents in 9 intervention (n = 235) and 10 control (n = 304) sites collected during the intervention. Surveys of health care providers (n = 14 and 17) before and during the intervention were also collected. Teams worked over 18 months to implement improvements in clinical decision support, including tracking BMI percentiles, identification of overweight patients, appropriate laboratory tests, counseling of families and patients use of a behavioral screening tool, and other improvements following the chronic-care model targeting patients aged 5 to 18 and their families. Large changes occurred in clinical practice from before to during the Maine Youth Overweight Collaborative: increases in assessment of BMI (38%-94%), BMI percentile for age and gender (25%-89%), use of the 5-2-1-0 behavioral screening tool (0%-82%), and weight classification (19%-75%). Parent surveys indicated improvements in providers' behavior and rates of counseling. Intervention providers reported improvements in knowledge, attitudes, self-efficacy, and practice. The Maine Youth Overweight Collaborative intervention improved clinical decision support and family management of risk behaviors, indicating a promising primary care-based approach to address overweight risk among children and youth.

Healthy Choices for Every Body Adult Curriculum Improves Participants' Food Resource Management Skills and Food Safety Practices.

PubMed

Adedokun, Omolola A; Plonski, Paula; Jenkins-Howard, Brooke; Cotterill, Debra B; Vail, Ann

2018-06-01

To evaluate the impact of the University of Kentucky's Healthy Choices for Every Body (HCEB) adult nutrition education curriculum on participants' food resource management (FRM) skills and food safety practices. A quasi-experimental design was employed using propensity score matching to pair 8 intervention counties with 8 comparison counties. Independent-samples t tests and ANCOVA models compared gains in FRM skills and food safety practices between the intervention and comparison groups (n = 413 and 113, respectively). Propensity score matching analysis showed a statistical balance and similarities between the comparison and intervention groups. Food resource management and food safety gain scores were statistically significantly higher for the intervention group (P < .001), with large effect sizes (d = 0.9) for both variables. The group differences persisted even after controlling for race and age in the ANCOVA models. The HCEB curriculum was effective in improving the FRM skills and food safety practices of participants. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Indicators of Club Management Practices and Biological Measurements of Patrons’ Drug and Alcohol Use

PubMed Central

Byrnes, Hilary F.; Miller, Brenda A.; Johnson, Mark B.; Voas, Robert B.

2015-01-01

Background Electronic Music Dance Events in nightclubs attract patrons with heavy alcohol/drug use. Public health concerns are raised from risks related to these behaviors. Practices associated with increased risk in these club settings need to be identified. Objectives The relationship between club management practices and biological measures of patrons’ alcohol/drug use is examined. Methods Observational data from 25 events across 6 urban clubs were integrated with survey data (N=738 patrons, 42.8% female) from patrons exiting these events, 2010–2012. Five indicators of club management practices were examined using mixed model regressions: club security, bar crowding, safety signs, serving intoxicated patrons, and isolation. Results Analyses revealed that serving intoxicated patrons and safety signs were related to less substance use. Specifically, serving intoxicated patrons was related to heavy alcohol and drug use at exit, while safety signs were marginally related to less exit drug use. Conclusions/Importance Findings indicate observable measures in nightclubs provide important indicators for alcohol/drug use, suggesting practices to target. Study strengths include the use of biological measures of substance use on a relatively large scale. Limitations and future directions are discussed. PMID:24832721

Dairy Herd Health.

ERIC Educational Resources Information Center

Wolanyk, Alison M.; Bishop, Natalie

This monograph, designed to help secondary students recognize symptoms of major dairy cattle diseases, stresses the need for preventative management practices and cooperation between the dairy farmer and the veterinarian. The first of three parts, The Healthy Animal, is divided into five units: body parts, vital signs, excretions, behavior, and…

Theory X/Y in the Health Care Setting: Employee Perceptions, Attitudes, and Behaviors.

PubMed

Prottas, David J; Nummelin, Mary Rogers

Douglas McGregor's conceptualization of Theory X and Theory Y has influenced management practices for almost six decades, despite the relative paucity of empirical support. This empirical study examined the relationships between health care employees' perceptions of (1) manager Theory Y and Theory X orientations; (2) work unit psychological safety, organizational citizenship behavior, and service quality; and (3) the employing entity. The study used survey data from more than 3500 employees of a large US health care system and analyzed them using confirmatory factor and hierarchical regression analyses. Results indicate that McGregor's conceptualization is best considered as two separate constructs-Theory Y and Theory X-rather than as one-dimensional X/Y construct. This study's three dependent variables were positively related to Theory Y and negatively related to Theory X, with larger Theory Y effect sizes. Psychological safety partially mediated the relationship between Theory Y and the dependent variables Y. Practical implications are presented.

General patterns of managerial approaches to work motivation: Implications for rehabilitation professionals involved in occupational rehabilitation.

PubMed

Murphy, G C; Foreman, P

1993-03-01

Calls for rehabilitation counselors to learn more about the world of work have been recently repeated. The validity of these calls is suggested by a group of studies which indicate that the rehabilitation counseling literature has an established emphasis on matters of counseling and adjustment rather than on matters related to behavior in organizations. A survey of rehabilitation counsellors' beliefs about key topics in organizational behavior indicates that their beliefs are often discrepant with those of practicing managers and supervisors. A summary of dominant models of work motivation adopted by managerial workers is presented and some implications for occupational rehabilitation practice identified. Finally, some contemporary literature relevant to managerial approaches to employee motivation are identified and it is suggested that familiarity with this literature could assist rehabilitation practitioners move from a more narrow occupational rehabilitation role to a broader involvement in organizational life via the expansion of the disability management approach in work organizations.

A systematic review of health literacy interventions for people living with HIV

PubMed Central

Perazzo, Joseph; Reyes, Darcel; Webel, Allison

2017-01-01

Health literacy significantly impacts health-related outcomes among people living with HIV. Our aim was to systematically review current literature on health literacy interventions for people living with HIV. The authors conducted a thorough literature search following the PRISMA statement and the AMSTAR checklist as a guide, and found six studies that met inclusion/exclusion criteria. The majority of these interventions were designed to improve HIV treatment adherence as well as HIV knowledge and treatment-related skills, with one study focusing on e-Health literacy. Several of the studies demonstrated trends toward improvement in medication adherence, but most did not achieve statistical significance primarily due to methodological limitations. Significant improvements in knowledge, behavioral skills, and e-Health literacy were found following interventions (p = 0·001–0·05). Health literacy interventions have the potential to promote HIV-related knowledge, behavioral skills, and self-management practices. More research is needed to assess the efficacy of interventions to promote a variety of self-management practices. PMID:26864691

Ethical obliqations and the dental office team.

PubMed

Roucka, Toni M; Zarkowski, Pamela; Donate-Bartfield, Evelyn; Patthoff, Donald E

2013-01-01

A hypothetical case of alleged sexual misconduct in a practice with high employee turnover and stress is analyzed by three experts. This case commentary examines the ethical role expectations of an office manager who is not directly involved but becomes aware of the activities. The commentators bring the perspectives of a dental hygienist, academic administrator, and attorney; a teacher of behavioral sciences in a dental school; and a general dentist with many years of practice experience.

A Qualitative Study of Doctors of Chiropractic in a Nova Scotian Practice-based Research Network: Barriers and Facilitators to the Screening and Management of Psychosocial Factors for Patients With Low Back Pain.

PubMed

Stilwell, Peter; Hayden, Jill A; Des Rosiers, Piaf; Harman, Katherine; French, Simon D; Curran, Janet A; Hefford, Warren

2018-01-01

This study aimed to assess chiropractors' awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants' desire to fulfill patients' anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers. Copyright © 2017. Published by Elsevier Inc.

Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria

PubMed Central

Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

2017-01-01

Abstract Background: Improving employees’ perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. Methods: The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest–posttest control group design. Results: The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Conclusions: Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace. PMID:28471971

Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria.

PubMed

Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

2017-05-01

Improving employees' perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest-posttest control group design. The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace.

Familial factors responsible for persistent crying-induced asthma: a case report.

PubMed

Weinstein, A G

1987-10-01

Crying behavior of the asthmatic child may induce wheezing symptoms. This may be a clinical problem for families with asthmatic children who exhibit frequent and persistent crying behavior. This case report identifies behaviors by the child and parents that may be responsible for continual crying. Child factors include (1) "spoiled" personality, (2) poor self-image, (3) biologic sensitivity to foods, medication, and environmental allergens producing irritability. Parental factors include poor disciplinary practices secondary to (1) disrupted home life, (2) guilt, and (3) overprotective behavior. Identification of these factors may be helpful in establishing clinical management strategies to reduce crying-induced asthma.

Primary Care Interventions to Reduce Childhood Obesity in Latino Families.

PubMed

Gonzalez, Giulliana

2016-01-01

Increasing rates of obesity in Latino children call for culturally sensitive primary care interventions. Despite recent efforts to address this growing disparity, little is known about cultural variables that influence obesity management programs in Latino children. A literature search was conducted using CINHAL, Scopus, PubMed, and PsycINFO to review the state of the science regarding primary care interventions to decrease obesity in Latino children. The author analyzed the effects of several cultural practices on obesity and made recommendations based on their clinical implications for weight reduction management programs. Obesity in Latino children is a multifactorial problem influenced by family behaviors, cultural perceptions of weight and health, traditional dietary norms, and socioeconomic status. Current practice lags behind national obesity management recommendations and is further hindered by a lack of consideration of the roles of key cultural differences in Latino families. It is imperative to recognize the importance of family preferences and culture when developing weight reduction programs so as to foster long-term behavior changes. More research assessing the efficacy of culturally competent interventions is necessary to guide national efforts to address this increasing disparity. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Relations among student attention behaviors, teacher practices, and beginning word reading skill.

PubMed

Sáez, Leilani; Folsom, Jessica Sidler; Al Otaiba, Stephanie; Schatschneider, Christopher

2012-01-01

The role of student attention for predicting kindergarten word reading was investigated among 432 students. Using Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scale behavior rating scores, the authors conducted an exploratory factor analysis, which yielded three distinct factors that reflected selective attention. In this study, the authors focused on the role of one of these factors, which they labeled attention-memory, for predicting reading performance. Teacher ratings of attention-memory predicted word reading above and beyond the contribution of phonological awareness and vocabulary knowledge. In addition, the relations between four teacher practices and attention ratings for predicting reading performance were examined. Using hierarchical linear modeling, the authors found significant interactions between student attention and teacher practices observed during literacy instruction. In general, as ratings of attention improved, better kindergarten word reading performance was associated with high levels of classroom behavior management. However, better word reading performance was not associated with high levels of teacher task orienting. A significant three-way interaction was also found among attention, individualized instruction, and teacher task redirections. The role of regulating kindergarten student attention to support beginning word reading skill development is discussed.

Effects of RN Age and Experience on Transformational Leadership Practices.

PubMed

Herman, Susan; Gish, Mary; Rosenblum, Ruth; Herman, Michael

2017-06-01

This study reported the evolution of transformational leadership (TL) practices and behaviors across years of age, management experience, and professional nursing practice within a professional nursing leadership organization. Recent studies of CNO TL found valuations peak near age 60 years. This study reported on a wider range of management positions, correlating years of RN practice and management experience and age to TL metrics. This study used Kouzes and Posner's Leadership Practices Inventory-Self-Assessment (LPI-S) to survey a nursing leadership organization, the Association of California Nurse Leaders (ACNL). Anonymous responses were analyzed to identify leadership trends in age and years of professional service. On average, LPI-S metrics of leadership skills advance through years of management, RN experience, and age. The TL scores are statistically higher in most LPI-S categories for those with more than 30 years of RN or management experience. Decade-averaged LPI-S TL metrics in the ACNL survey evolve linearly throughout age before peaking in the decade from age 60 to 69 years. A similar evolution of TL metrics is seen in decades of either years of management experience or years of RN experience. Transformational leadership increased with nursing maturity particularly for LPI-S categories of "inspire a shared vision," "challenge the process," and "enable others to act." In the ACNL population studied, decade-averaged leadership metrics advanced. Leadership evolution with age in the broader RN population peaked in age bracket 60 to 69 years. The LPI-S averages declined when older than 70 years, coinciding with a shift from full-time work toward retirement and part-time employment.

Health Professionals’ Alcohol-Related Professional Practices and the Relationship between Their Personal Alcohol Attitudes and Behavior and Professional Practices: A Systematic Review

PubMed Central

Bakhshi, Savita; While, Alison E.

2013-01-01

Health professionals’ personal health behaviors have been found to be associated with their practices with patients in areas such as smoking, physical activity and weight management, but little is known in relation to alcohol use. This review has two related strands and aims to: (1) examine health professionals’ alcohol-related health promotion practices; and (2) explore the relationship between health professionals’ personal alcohol attitudes and behaviors, and their professional alcohol-related health promotion practices. A comprehensive literature search of the Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, British Nursing Index, Web of Science, Scopus and Science Direct (2007–2013) identified 26 studies that met the inclusion criteria for Strand 1, out of which six were analyzed for Strand 2. The findings indicate that health professionals use a range of methods to aid patients who are high-risk alcohol users. Positive associations were reported between health professionals’ alcohol-related health promotion activities and their personal attitudes towards alcohol (n = 2), and their personal alcohol use (n = 2). The findings have some important implications for professional education. Future research should focus on conducting well-designed studies with larger samples to enable us to draw firm conclusions and develop the evidence base. PMID:24366045

Investigation of the working behavior of part-time occupational physicians using practical recording sheets.

PubMed

Ikegami, Kazunori; Nozawa, Hiroki; Michii, Satoshi; Sugano, Ryosuke; Ando, Hajime; Hasegawa, Masayuki; Kitamura, Hiroko; Ogami, Akira

2016-12-03

We investigated the working behavior of part-time occupational physicians using practical recording sheets to clarify issues of occupational physicians' activities according to industrial groups or size of business. We collected 561 recording sheets in 96 industries from 11 part-time occupational physicians as collaborators, who volunteered to be a part of this research. We collected a variety of information from the practical recording sheets, including the industry in which each occupational physician was employed, the annual number of times of work attendance, occupational physician-conducted workplace patrol, and employee health management. We investigated their annual practices regarding work environment management, work management, health management, and general occupational health management. In addition, we analyzed the differences between the secondary and tertiary industry groups and between the group of offices employing 100 people or fewer (≤100 group) and 101 people and above (≥101 group) in each industry group. The median work attendance by all occupational physicians was four times a year; the tertiary industry group had a significantly lower rate of work attendance than the secondary industry group. The occupational physicians' participation in risk assessment, mental health measures or overwork prevention, and the formulation of the occupational health management system and the annual plan were significantly lower in the tertiary industry group than in the secondary industry group. We observed that for the annual number of times of work attendance, occupational physician-conducted workplace patrol was significantly lower in the ≤100 group than in the ≥101 group in each industry group. These findings show that occupational physicians' activities have not been conducted enough in tertiary industries and small-sized offices employing ≤100 people. It would be necessary to evaluate how to provide occupational health service or appropriate occupational physicians' activities for small-sized offices or tertiary industries. Thereafter, it would likely be beneficial to construct a system to support the activities of part-time occupational physicians as well as the activity of occupational health at workplaces.

Motivation in Work Organizations.

ERIC Educational Resources Information Center

Lawler, Edward E., III

Written with the student audience in mind, this book is about the motivational determinants of behavior in work organizations. For practicing managers, helpful information may be found in the chapters dealing with day-to-day motivational problems. Three chapters deal specifically with motivational theory, and five chapters emphasize research and…

Practical Advice for Guiding the Gifted.

ERIC Educational Resources Information Center

Cross, Tracy

1998-01-01

Among 11 ideas for guiding gifted students are to: recognize and respect the relationship between social/emotional needs and academic needs; teach pro-social skill development; teach ways to manage stress; model the behavior desired in students; embrace diversity; expose students to knowledgeable counseling; and provide opportunities for down…

Hand-to-Hand Combat and the Use of Combatives Skills: An Analysis of United States Army Post Combat Surveys from 2004-2008

DTIC Science & Technology

2014-11-19

to develop virtual environments for practicing stress management skills with military personnel prior to deployment. Cyberpsychology , Behavior , and... Social Networking , 13, 83-94. doi: 10.1089=cyber.2009.0336 Bowen, G. A. (2009). Document analysis as a qualitative research method. Qualitative... Behavioral Science and Leadership, was very helpful in providing insight and advice as the project progressed. Matt Larsen, US Army (Retired), former

Revolutionizing Child Welfare with Outcomes Management

PubMed Central

Toche-Manley, Linda L.; Dietzen, Laura; Nankin, Jesse; Beigel, Astrid

2013-01-01

Outcomes management technology holds great promise for improving the quality of services provided to youth in the child welfare system. Advantages include better detection of behavioral health and trauma-related issues, early indicators of case progress or risk of failure and program- and system-level learning. Yet organizational barriers to implementation persist. Attention is spent in this paper on addressing these barriers so the use of outcomes management technology becomes a common practice. A model for predicting resiliency is presented, along with case examples demonstrating its potential use for treatment planning and monitoring progress. PMID:23460130

Student participation and interactivity using asynchronous computer-mediated communication for resolution of an undergraduate capstone management case study.

PubMed

Miller, Paulette J

2012-01-01

Online discussion activities are designed for computer-mediated learning activities in face-to-face, hybrid, and totally online courses. The use of asynchronous computer-mediated communication (A-CMC) coupled with authentic workplace case studies provides students in the protected learning environment with opportunities to practice workplace decision making and communication. In this study, communication behaviors of transmitter and receiver were analyzed to determine participation and interactivity in communication among small-group participants in a health information management capstone management course.

Offroad vehicle riders in Big Cypress National Preserve: Results from a survey of permit holders

USGS Publications Warehouse

Farrell, T.; Kendra, A.; Roggenbuck, J.; Hall, T.; Marion, J.L.

1999-01-01

A survey of 800 offroad vehicle (ORV) owners at Big Cypress National Preserve, Florida, was conducted to obtain information on visitor characteristics and management preferences. This report characterizes survey results for riders of all-terrain vehicles, swamp buggies, standard 4-wheeled street vehicles, and airboats. Riders tended to feel satisfied with their ORV experiences and Preserve conditions. Riders were strongly opposed to management approaches that would restrict use or require certain behaviors. More favored were management actions to encourage low impact use practices

Web-based classroom data collection in ADHD: a best practices case study.

PubMed

Bhatara, Vinod; Vogt, H Bruce; Ellis, Roland; Alshari, Ghyath; Patrick, Sarah

2003-09-01

Best practices research identifies and disseminates effective clinical strategies developed and refined by clinicians for their practices. As opposed to the content of health care, medical students and residents are typically not trained in the process of its provision. This paper illustrates a best practices approach to development of a Web-based classroom data collection method to improve medication management in attention deficit hyperactivity disorder (ADHD). 1) To increase Primary Care Physician (PCP) awareness of the process of best practices research, and; 2) to highlight the use of the World Wide Web as a tool for integration of care of children with ADHD. Based on the review of a large national study in ADHD, the key ingredients for the best pharmacotherapy practices were identified. The lessons from the literature were adapted for local practice using the framework and steps for best practices outlined by Mold and Gregory. A conceptual model of managing information provided by parents/caregivers and teachers to PCPs was developed. Several steps were identified, including Web-based classroom behavioral data collection by a care manager and feedback reports to PCPs from a child psychiatrist based on the data collected. This model is currently being tested. Our preliminary experience suggests that a best practices approach has potential applications to a variety of primary care settings in South Dakota. We encourage PCPs to consider best practice strategies for their own practices. The practice-based research network (Rush Net) being developed by the Center for Rural Health Improvement of the University of South Dakota School of Medicine's Department of Family Medicine can be helpful in this regard.

Parental Self-Assessment of Behavioral Effectiveness in Young Children and Views on Corporal Punishment in an Academic Pediatric Practice.

PubMed

Irons, Lance B; Flatin, Heidi; Harrington, Maya T; Vazifedan, Turaj; Harrington, John W

2018-03-01

This article assesses parental confidence and current behavioral techniques used by mostly African American caregivers of young children in an urban Southeastern setting, including their use and attitudes toward corporal punishment (CP). Two hundred and fifty parental participants of children aged 18 months to 5 years completed a survey on factors affecting their behavioral management and views on CP. Statistical analysis included χ 2 test and logistic regression with confidence interval significance determined at P <.05. Significant associations of CP usage were found in parents who were themselves exposed to CP and parental level of frustration with child disobedience. A total of 40.2% of respondents answered that they had not received any discipline strategies from pediatricians and 47.6% were interested in receiving more behavioral strategies. Clear opportunities exist for pediatricians to provide information on evidence-based disciplinary techniques, and these discussions may be facilitated through the creation of a No Hit Zone program in the pediatric practice.

The role of comorbidities in patients' hypertension self-management.

PubMed

Fix, Gemmae M; Cohn, Ellen S; Solomon, Jeffrey L; Cortés, Dharma E; Mueller, Nora; Kressin, Nancy R; Borzecki, Ann; Katz, Lois A; Bokhour, Barbara G

2014-06-01

We sought to understand barriers to hypertension self-management in patients with hypertension and comorbidities. We conducted semi-structured, qualitative interviews with 48 patients with uncontrolled hypertension and at least one comorbidity to learn about beliefs and behaviors that might affect hypertension self-management. Using a grounded theory strategy, we analyzed interview transcripts detailing patients' hypertension self-management behaviors vis-à-vis a framework including Explanatory Models-a patient's understanding of the pathophysiology, cause, course, treatment, and severity of an illness, such as hypertension. We identified four factors that interfered with hypertension self-management. (1) Interdependence: Participants saw hypertension as interconnected to their comorbidities and subsequently had difficulty separating information about their illnesses. (2) Low priority: Compared to other conditions, participants assigned hypertension a lower priority. (3) Conflicts: Participants struggled with conflicts between hypertension self-management practices and those for comorbidities. (4) Managing multiple medications: Polypharmacy led to patients' confusion and concern about taking medications as prescribed. Participants did not experience hypertension as a discreet clinical condition; rather, they self-managed hypertension concurrently with other conditions, leading to a breakdown in hypertension self-management. We provide strategies to address each of the four barriers to better equip providers in addressing their clinically salient concerns.

Participatory adaptive management leads to environmental learning outcomes extending beyond the sphere of science.

PubMed

Fujitani, Marie; McFall, Andrew; Randler, Christoph; Arlinghaus, Robert

2017-06-01

Resolving uncertainties in managed social-ecological systems requires adaptive experimentation at whole-ecosystem levels. However, whether participatory adaptive management fosters ecological understanding among stakeholders beyond the sphere of science is unknown. We experimentally involved members of German angling clubs ( n = 181 in workshops, n = 2483 in total) engaged in self-governance of freshwater fisheries resources in a large-scale ecological experiment of active adaptive management of fish stocking, which constitutes a controversial management practice for biodiversity and ecosystem functioning when conducted inappropriately. The collaborative ecological experiments spanned several years and manipulated fish densities in 24 lakes with two species. In parallel, we experimentally compared changes in ecological knowledge and antecedents of proenvironmental behavior in stakeholders and managers who were members of a participatory adaptive management treatment group, with those receiving only a standard lecture, relative to placebo controls. Using a within-subjects pretest-posttest control design, changes in ecological knowledge, environmental beliefs, attitudes, norms, and behavioral intentions were evaluated. Participants in adaptive management retained more knowledge of ecological topics after a period of 8 months compared to those receiving a standard lecture, both relative to controls. Involvement in adaptive management was also the only treatment that altered personal norms and beliefs related to stocking. Critically, only the stakeholders who participated in adaptive management reduced their behavioral intentions to engage in fish stocking in the future. Adaptive management is essential for robust ecological knowledge, and we show that involving stakeholders in adaptive management experiments is a powerful tool to enhance ecological literacy and build environmental capacity to move toward sustainability.

Participatory adaptive management leads to environmental learning outcomes extending beyond the sphere of science

PubMed Central

Fujitani, Marie; McFall, Andrew; Randler, Christoph; Arlinghaus, Robert

2017-01-01

Resolving uncertainties in managed social-ecological systems requires adaptive experimentation at whole-ecosystem levels. However, whether participatory adaptive management fosters ecological understanding among stakeholders beyond the sphere of science is unknown. We experimentally involved members of German angling clubs (n = 181 in workshops, n = 2483 in total) engaged in self-governance of freshwater fisheries resources in a large-scale ecological experiment of active adaptive management of fish stocking, which constitutes a controversial management practice for biodiversity and ecosystem functioning when conducted inappropriately. The collaborative ecological experiments spanned several years and manipulated fish densities in 24 lakes with two species. In parallel, we experimentally compared changes in ecological knowledge and antecedents of proenvironmental behavior in stakeholders and managers who were members of a participatory adaptive management treatment group, with those receiving only a standard lecture, relative to placebo controls. Using a within-subjects pretest-posttest control design, changes in ecological knowledge, environmental beliefs, attitudes, norms, and behavioral intentions were evaluated. Participants in adaptive management retained more knowledge of ecological topics after a period of 8 months compared to those receiving a standard lecture, both relative to controls. Involvement in adaptive management was also the only treatment that altered personal norms and beliefs related to stocking. Critically, only the stakeholders who participated in adaptive management reduced their behavioral intentions to engage in fish stocking in the future. Adaptive management is essential for robust ecological knowledge, and we show that involving stakeholders in adaptive management experiments is a powerful tool to enhance ecological literacy and build environmental capacity to move toward sustainability. PMID:28630904

Development of psychiatric risk evaluation checklist and routine for nurses in a general hospital: ethnographic qualitative study.

PubMed

Camargo, Ana Luiza Lourenço Simões; Maluf Neto, Alfredo; Colman, Fátima Tahira; Citero, Vanessa de Albuquerque

2015-01-01

There is high prevalence of mental and behavioral disorders in general hospitals, thus triggering psychiatric risk situations. This study aimed to develop a psychiatric risk assessment checklist and routine for nurses, the Psychiatric Risk Evaluation Check-List (PRE-CL), as an alternative model for early identification and management of these situations in general hospitals. Ethnographic qualitative study in a tertiary-level private hospital. Three hundred general-unit nurses participated in the study. Reports were gathered through open groups conducted by a trained nurse, at shift changes for two months. The questions used were: "Would you consider it helpful to discuss daily practice situations with a psychiatrist? Which situations?" The data were qualitatively analyzed through an ethnographic approach. The nurses considered it useful to discuss daily practice situations relating to mental and behavioral disorders with a psychiatrist. Their reports were used to develop PRE-CL, within the patient overall risk assessment routine for all inpatients within 24 hours after admission and every 48 hours thereafter. Whenever one item was present, the psychosomatic medicine team was notified. They went to the unit, gathered data from the nurses, patient files and, if necessary, attending doctors, and decided on the risk management: guidance, safety measures or mental health consultation. It is possible to develop a model for detecting and intervening in psychiatric and behavioral disorders at general hospitals based on nursing team observations, through a checklist that takes these observations into account and a routine inserted into daily practice.

Occupational health management system: A study of expatriate construction professionals.

PubMed

Chan, I Y S; Leung, M Y; Liu, A M M

2016-08-01

Due to its direct impact on the safety and function of organizations, occupational health has been a concern of the construction industry for many years. The inherent complexity of occupational health management presents challenges that make a systems approach essential. From a systems perspective, health is conceptualized as an emergent property of a system in which processes operating at the individual and organizational level are inextricably connected. Based on the fundamental behavior-to-performance-to-outcome (B-P-O) theory of industrial/organizational psychology, this study presents the development of an I-CB-HP-O (Input-Coping Behaviors-Health Performance-Outcomes) health management systems model spanning individual and organizational boundaries. The model is based on a survey of Hong Kong expatriate construction professionals working in Mainland China. Such professionals tend to be under considerable stress due not only to an adverse work environment with dynamic tasks, but also the need to confront the cross-cultural issues arising from expatriation. A questionnaire was designed based on 6 focus groups involving 44 participants, and followed by a pilot study. Of the 500 questionnaires distributed in the main study, 137 valid returns were received, giving a response rate of 27.4%. The data were analyzed using statistical techniques such as factor analysis, reliability testing, Pearson correlation analysis, multiple regression modeling, and structural equation modeling. Theories of coping behaviors and health performance tend to focus on the isolated causal effects of single factors and/or posits the model at single, individual level; while industrial practices on health management tend to focus on organizational policy and training. By developing the I-CB-HP-O health management system, incorporating individual, interpersonal, and organizational perspectives, this study bridges the gap between theory and practice while providing empirical support for a systems view of health management. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Randomized Controlled Trial of the Effects of Online Pain Management Education on Primary Care Providers.

PubMed

Trudeau, Kimberlee J; Hildebrand, Cristina; Garg, Priyanka; Chiauzzi, Emil; Zacharoff, Kevin L

2017-04-01

To improve pain management practices, we developed an online interactive continuing education (CE) program for primary care providers (PCPs). This program follows the flow of clinical decision-making through simulated cases at critical pain treatment points along the pain treatment continuum. A randomized controlled trial was conducted to test the efficacy of this program. Participants were randomized to either the experimental condition or the control condition (online, text-based CE program). A total of 238 primary care providers were recruited through hospitals, professional newsletters, and pain conferences. Participants in both conditions reported significantly improved scores on knowledge (KNOW-PAIN 50), attitudes (CAOS), and pain practice behaviors (PPBS) scales over the four-month study. The experimental condition showed significantly greater change over time on the tamper-resistant formulations (TRFs) of opioids and dosing CAOS subscale compared with the control condition. Post hoc comparisons suggested that participants in the experimental condition were less likely to endorse use of opioid TRFs over time compared with the control condition. Exploratory analyses for potential moderators indicated a significant three-way interaction with time, condition, and discipline (i.e., physician vs other) for the impediments and concerns attitudes subscale and the early refill behaviors subscale. Post hoc comparisons indicated that physicians in the experimental condition exhibited the greatest change in attitudes and the nonphysicians exhibited the greatest change in reported behaviors in response to requests for early refills. Findings suggest online CE programs may positively impact PCPs' knowledge, attitudes, and pain practice behaviors but provide minimal evidence for the value of including interactivity. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Child Behavior Problems, Teacher Executive Functions, and Teacher Stress in Head Start Classrooms.

PubMed

Friedman-Krauss, Allison H; Raver, C Cybele; Neuspiel, Juliana M; Kinsel, John

2014-01-01

The current article explores the relationship between teachers' perceptions of child behavior problems and preschool teacher job stress, as well as the possibility that teachers' executive functions moderate this relationship. Data came from 69 preschool teachers in 31 early childhood classrooms in 4 Head Start centers and were collected using Web-based surveys and Web-based direct assessment tasks. Multilevel models revealed that higher levels of teachers' perceptions of child behavior problems were associated with higher levels of teacher job stress and that higher teacher executive function skills were related to lower job stress. However, findings did not yield evidence for teacher executive functions as a statistical moderator. Many early childhood teachers do not receive sufficient training for handling children's challenging behaviors. Child behavior problems increase a teacher's workload and consequently may contribute to feelings of stress. However, teachers' executive function abilities may enable them to use effective, cognitive-based behavior management and instructional strategies during interactions with students, which may reduce stress. Providing teachers with training on managing challenging behaviors and enhancing executive functions may reduce their stress and facilitate their use of effective classroom practices, which is important for children's school readiness skills and teachers' health.

Reducing domestic heating demand: Managing the impact of behavior-changing feedback devices via marketing.

PubMed

Jensen, Thorben; Chappin, Émile J L

2017-07-15

Feedback devices can be used to inform households about their energy-consumption behavior. This may persuade them to practice energy conservation. The use of feedback devices can also-via word of mouth-spread among households and thereby support the spread of the incentivized behavior, e.g. energy-efficient heating behavior. This study investigates how to manage the impact of these environmental innovations via marketing. Marketing activities can support the diffusion of devices. This study aims to identify the most effective strategies of marketing feedback devices. We did this by adapting an agent-based model to simulate the roll-out of a novel feedback technology and heating behavior within households in a virtual city. The most promising marketing strategies were simulated and their impacts were analyzed. We found it particularly effective to lend out feedback devices to consumers, followed by leveraging the social influence of well-connected individuals, and giving away the first few feedback devices for free. Making households aware of the possibility of purchasing feedback devices was found to be least effective. However, making households aware proved to be most cost-efficient. This study shows that actively managing the roll-out of feedback devices can increase their impacts on energy-conservation both effectively and cost-efficiently. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychopharmacologic interventions for repetitive behaviors in autism spectrum disorders.

PubMed

Soorya, Latha; Kiarashi, Jessica; Hollander, Eric

2008-10-01

This article provides an overview of psychopharmacological treatments for repetitive behaviors in autism spectrum disorders (ASDs) in the context of current conceptualizations of this understudied core symptom domain. The available literature on the widely used selective serotonin reuptake inhibitors (SSRIs), including fluvoxamine, fluoxetine, citalopram, escitalopram, and sertraline, are reviewed. In addition to SSRIs, research on effects of other pharmacologic interventions such as divalproex sodium, risperidone, and the neuropeptide oxytocin are presented. To date, data are mixed for interventions commonly prescribed in clinical practice and suggest several areas of investigation in advancing research on the medication management of repetitive behaviors.

Simulation experience enhances physical therapist student confidence in managing a patient in the critical care environment.

PubMed

Ohtake, Patricia J; Lazarus, Marcilene; Schillo, Rebecca; Rosen, Michael

2013-02-01

Rehabilitation of patients in critical care environments improves functional outcomes. This finding has led to increased implementation of intensive care unit (ICU) rehabilitation programs, including early mobility, and an associated increased demand for physical therapists practicing in ICUs. Unfortunately, many physical therapists report being inadequately prepared to work in this high-risk environment. Simulation provides focused, deliberate practice in safe, controlled learning environments and may be a method to initiate academic preparation of physical therapists for ICU practice. The purpose of this study was to examine the effect of participation in simulation-based management of a patient with critical illness in an ICU setting on levels of confidence and satisfaction in physical therapist students. A one-group, pretest-posttest, quasi-experimental design was used. Physical therapist students (N=43) participated in a critical care simulation experience requiring technical (assessing bed mobility and pulmonary status), behavioral (patient and interprofessional communication), and cognitive (recognizing a patient status change and initiating appropriate responses) skill performance. Student confidence and satisfaction were surveyed before and after the simulation experience. Students' confidence in their technical, behavioral, and cognitive skill performance increased from "somewhat confident" to "confident" following the critical care simulation experience. Student satisfaction was highly positive, with strong agreement the simulation experience was valuable, reinforced course content, and was a useful educational tool. Limitations of the study were the small sample from one university and a control group was not included. Incorporating a simulated, interprofessional critical care experience into a required clinical course improved physical therapist student confidence in technical, behavioral, and cognitive performance measures and was associated with high student satisfaction. Using simulation, students were introduced to the critical care environment, which may increase interest in working in this practice area.

Regulation and Mindful Resident Care in Nursing Homes

PubMed Central

Colón-Emeric, Cathleen S.; Plowman, Donde; Bailey, Donald; Corazzini, Kirsten; Utley-Smith, Queen; Ammarell, Natalie; Toles, Mark; Anderson, Ruth

2009-01-01

Regulatory oversight is intended to improve the health outcomes of nursing home residents, yet evidence suggests that regulations can inhibit mindful staff behaviors that are associated with effective care. We explored the influence of regulations on mindful staff behavior as it relates to resident health outcomes, and offer a theoretical explanation of why regulations sometimes enhance mindfulness and other times inhibit it. We analyzed data from an in-depth, multiple case study including field notes, interviews, and documents collected in 8 nursing homes. We completed a conceptual/thematic description using the concept of mindfulness to reframe the observations. Shared facility mission strongly impacted staff perceptions of the purpose and utility of regulations. In facilities with a resident-centered culture, regulations increased mindful behavior, whereas in facilities with a cost-focused culture, regulations reduced mindful care practices. When managers emphasized the punitive aspects of regulation we observed a decrease in mindful practices in all facilities. PMID:20479137

myPace: an integrative health platform for supporting weight loss and maintenance behaviors.

PubMed

Barnett, Julie; Harricharan, Michelle; Fletcher, Dave; Gilchrist, Becky; Coughlan, Jane

2015-01-01

Obesity is a major health concern caused by unhealthy eating behaviors. Digital weight loss interventions have adopted mobile technology primarily in order to support self-monitoring. However, many available apps are not designed as a part of dietetic practice; therefore, a distinct gap in the research exists relating to technology that supports the patient-practitioner relationship. This paper presents myPace, which is a complete weight loss and management system that is deployed via a smartphone and a PC. It connects dietitians and patients between face-to-face consultations and extends the relationship through patients' regular progress updates and dietitians' tailored and timely advice, for sustained behavior change. The prototype was developed from research into behavior change for weight loss, which furthermore was underpinned by theory and tenets of human support models, such as the supportive accountability framework. We report on an early-phase system design goals via a formative research process, which aimed to implement theoretical principles and match practical dietetic practice. To that end, only the clinical end user's perspective was sought through a coaching think-aloud protocol on the first iteration of the prototype and interviews with dietitians. Findings show that the system has many positive design features, but which require further development in order for the system to be fully acceptable within dietetic practice and motivate patient engagement.

Self-management support in primary care: enactments, disruptions, and conversational consequences.

PubMed

Thille, Patricia; Ward, Natalie; Russell, Grant

2014-05-01

A common refrain in chronic disease management is that patients and clinicians need to enact new roles: patients as their own caregivers; clinicians as professional supporters of patient self-management activities. These roles are central to self-management support (SMS), an approach that emphasizes a clinical partnership, and promotes patient identification and achievement of realistic and short-term behavioral goals. With SMS, behavior change is the desired end, not the means to a desired biomedical end. Shifting SMS concepts into clinical practice has proven to be difficult and inconsistent, creating potential, unknown risks or harms to patients. We completed a discourse analysis of 16 clinical dialogues between diabetic patients and clinicians, collected during a study of six Ontario Family Health Teams, to explore the questions of risks and harms relating to SMS implementation. We observed varying degrees of incomplete implementation of SMS, as well as interactions that actively negated the core principles. Contrary to SMS principles, clinicians tended to emphasize behavioral changes as means to achieve biomedical ends, though to varying degrees. We present two appointments in detail, highlighting how linking behavior change closely with biomedical measures often elicited face-saving defenses from patients. The subsequent dialogue shifted attention away from problem solving and behavior change into active negotiation of responsibility and identity. Interactions that oriented more to SMS concepts elicited fewer defensive maneuvers from patients. Our analysis helps explicate one additional mechanism by which self-management talk threatens the clinical relationship, and highlights a promising method to mitigate this threat. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Influence of Parenting Style and Child Temperament on Child-Parent-Dentist Interactions.

PubMed

Aminabadi, Naser Asl; Deljavan, Alireza Sighari; Jamali, Zahra; Azar, Fatemeh Pournaghi; Oskouei, Sina Ghertasi

2015-01-01

This study aimed to investigate the interaction between parenting style and child's temperament as modulators of anxiety and behavior in children during the dental procedure. Healthy four- to six-year-olds (n equals 288), with carious primary molars scheduled to receive amalgam fillings were selected. The Primary Caregivers Practices Report was used to assess the parenting style, and the Children's Behavior Questionnaire-Very Short Form was used to evaluate child temperament. Children were managed using common behavior management strategies. Child behavior and anxiety during the procedure were assessed using the Frankl behavior rating scale and the verbal skill scale, respectively. Spearman's correlation coefficient was used to examine the correlation among variables. Authoritative parenting style was positively related to positive child's behavior (P<.05) and negatively related to child's anxiety (P<.05). A positive relationship existed between permissive subscale and negative behaviors (P<.05) and child's anxiety (P<.05). There was a significant direct effect of authoritative parenting style on the effortful control trait (P<.05) and permissive parent style on the child negative affectivity (P<.05). Parenting style appeared to mediate child temperament and anxiety, and was related to the child's behavior. Parenting style should be considered in the selection of behavior guidance techniques.

Do it well and do it right: The impact of service climate and ethical climate on business performance and the boundary conditions.

PubMed

Jiang, Kaifeng; Hu, Jia; Hong, Ying; Liao, Hui; Liu, Songbo

2016-11-01

Prior research has demonstrated that service climate can enhance unit performance by guiding employees' service behavior to satisfy customers. Extending this literature, we identified ethical climate toward customers as another indispensable organizational climate in service contexts and examined how and when service climate operates in conjunction with ethical climate to enhance business performance of service units. Based on data collected in 2 phases over 6 months from multiple sources of 196 movie theaters, we found that service climate and ethical climate had disparate impacts on business performance, operationalized as an index of customer attendance rate and operating income per labor hour, by enhancing service behavior and reducing unethical behavior, respectively. Furthermore, we found that service behavior and unethical behavior interacted to affect business performance, in such a way that service behavior was more positively related to business performance when unethical behavior was low than when it was high. This interactive effect between service and unethical behaviors was further strengthened by high market turbulence and competitive intensity. These findings provide new insight into theoretical development of service management and offer practical implications about how to maximize business performance of service units by managing organizational climates and employee behaviors synergistically. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Shared vision and autonomous motivation vs. financial incentives driving success in corporate acquisitions

PubMed Central

Clayton, Byron C.

2015-01-01

Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives. PMID:25610406

Reducing visitor noise levels at Muir Woods National Monument using experimental management.

PubMed

Stack, David W; Peter, Newman; Manning, Robert E; Fristrup, Kurt M

2011-03-01

Noise impacts resources and visitor experience in many protected natural areas, and visitors can be the dominant source of noise. This experimental study tested the efficacy and acceptability of signs asking visitors to be quiet at Muir Woods National Monument, California. Signs declaring a "quiet zone" (at the park's Cathedral Grove) or a "quiet day" (throughout the park) were posted on a randomized schedule that included control days (no signs). Visitor surveys were conducted to measure the cognitive and behavioral responses of visitors to the signs and test the acceptability of these management practices to visitors. Visitors were highly supportive of these management practices and reported that they consciously limited the amount of noise they produced. Sound level measurements showed substantial decreases on days when signs were posted. © 2011 Acoustical Society of America

Shared vision and autonomous motivation vs. financial incentives driving success in corporate acquisitions.

PubMed

Clayton, Byron C

2014-01-01

Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives.

Concurrent Validity of the Classroom Strategies Scale-Teacher Form: A Preliminary Investigation

ERIC Educational Resources Information Center

Reddy, Linda A.; Dudek, Christopher M.; Rualo, Angelique J.; Fabiano, Gregory A.

2016-01-01

The present study investigated the concurrent validity of the Classroom Strategies Scale-Teacher Form (CSS-T), a multidimensional teacher formative assessment of instructional and behavioral management practices. The CSS-T is compared with the Classroom Assessment Scoring System (CLASS), a well-known teacher assessment of overall classroom…

Social and Emotional Learning and Teachers

ERIC Educational Resources Information Center

Schonert-Reichl, Kimberly A.

2017-01-01

Teachers are the engine that drives social and emotional learning (SEL) programs and practices in schools and classrooms, and their own social-emotional competence and wellbeing strongly influence their students. But when teachers poorly manage the social and emotional demands of teaching, students' academic achievement and behavior both suffer.…

A Performance-Based Method of Student Evaluation

ERIC Educational Resources Information Center

Nelson, G. E.; And Others

1976-01-01

The Problem Oriented Medical Record (which allows practical definition of the behavioral terms thoroughness, reliability, sound analytical sense, and efficiency as they apply to the identification and management of patient problems) provides a vehicle to use in performance based type evaluation. A test-run use of the record is reported. (JT)

Think First: Addressing Aggressive Behavior in Secondary Schools

ERIC Educational Resources Information Center

Larson, Jim

2005-01-01

This highly practical book presents a complete anger and aggression management training program for middle and high school students. The volume incorporates a newly revised version of the author's proven "Think First" manual, which includes step-by-step skills training guidelines and 20 reproducible handouts and forms. Also provided are…

Managing Microcomputer Applications: A Primer and Guide to Good Practice,

DTIC Science & Technology

1988-03-01

15 What are the Attitude Changes...39 Behavioral Characteristics of the Computer-Oriented Worker ....... 42 Implications for...widespread in the Corps. Attitudes Computer usage is often Communications problems with ADP groups in many looked on as an ’extra’ FOA’s have created a

Demonstration-Based Education Generates Behavior Change Related to Conservation Practices

ERIC Educational Resources Information Center

Smart, Alexander J.; Bauman, Peter J.; Boltz, Stan; Hemenway, Jeff

2017-01-01

Getting agricultural producers to make changes to their operations is difficult, especially related to complex systems such as the water cycle on managed agricultural lands. We surveyed participants who had watched a rainfall simulator demonstration during the summer of 2015. Results indicate that the demonstration was effective in providing…

Comparison of enterococci and cow-specific qPAR markers in streams impacted by farms under different management practices

EPA Science Inventory

Nonpoint Sources (NPS) of pollution (e.g., agriculture, wildlife, urban runoff) are major contributors of microbial contaminants to surface waters. However, little is known about the behavior and the effect of environmental determinants on molecular markers of fecal contamination...

Assessing quality of citizen scientists’ soil texture estimates to evaluate land potential

USDA-ARS?s Scientific Manuscript database

Texture influences nearly all soil processes and is often the most measured parameter in soil science. Estimating soil texture is a universal and fundamental practice applied by resource scientists to classify and understand the behavior and management of soil systems. While trained soil scientist c...

Toward an Ecological Perspective of Resident Teaching Clinic

ERIC Educational Resources Information Center

Smith, C. Scott; Francovich, Chris; Morris, Magdalena; Hill, William; Langlois-Winkle, Francine; Rupper, Randall; Roth, Craig; Wheeler, Stephanie; Vo, Anthony

2010-01-01

Teaching clinic managers struggle to convert performance data into meaningful behavioral change in their trainees, and quality improvement measures in medicine have had modest results. This may be due to several factors including clinical performance being based more on team function than individual action, models of best practice that are…

Wildland Arson as Clandestine Resource Management: A Space-Time Permutation Analysis and Classification of Informal Fire Management Regimes in Georgia, USA

NASA Astrophysics Data System (ADS)

Coughlan, Michael R.

2016-05-01

Forest managers are increasingly recognizing the value of disturbance-based land management techniques such as prescribed burning. Unauthorized, "arson" fires are common in the southeastern United States where a legacy of agrarian cultural heritage persists amidst an increasingly forest-dominated landscape. This paper reexamines unauthorized fire-setting in the state of Georgia, USA from a historical ecology perspective that aims to contribute to historically informed, disturbance-based land management. A space-time permutation analysis is employed to discriminate systematic, management-oriented unauthorized fires from more arbitrary or socially deviant fire-setting behaviors. This paper argues that statistically significant space-time clusters of unauthorized fire occurrence represent informal management regimes linked to the legacy of traditional land management practices. Recent scholarship has pointed out that traditional management has actively promoted sustainable resource use and, in some cases, enhanced biodiversity often through the use of fire. Despite broad-scale displacement of traditional management during the 20th century, informal management practices may locally circumvent more formal and regionally dominant management regimes. Space-time permutation analysis identified 29 statistically significant fire regimes for the state of Georgia. The identified regimes are classified by region and land cover type and their implications for historically informed disturbance-based resource management are discussed.

Wildland Arson as Clandestine Resource Management: A Space-Time Permutation Analysis and Classification of Informal Fire Management Regimes in Georgia, USA.

PubMed

Coughlan, Michael R

2016-05-01

Forest managers are increasingly recognizing the value of disturbance-based land management techniques such as prescribed burning. Unauthorized, "arson" fires are common in the southeastern United States where a legacy of agrarian cultural heritage persists amidst an increasingly forest-dominated landscape. This paper reexamines unauthorized fire-setting in the state of Georgia, USA from a historical ecology perspective that aims to contribute to historically informed, disturbance-based land management. A space-time permutation analysis is employed to discriminate systematic, management-oriented unauthorized fires from more arbitrary or socially deviant fire-setting behaviors. This paper argues that statistically significant space-time clusters of unauthorized fire occurrence represent informal management regimes linked to the legacy of traditional land management practices. Recent scholarship has pointed out that traditional management has actively promoted sustainable resource use and, in some cases, enhanced biodiversity often through the use of fire. Despite broad-scale displacement of traditional management during the 20th century, informal management practices may locally circumvent more formal and regionally dominant management regimes. Space-time permutation analysis identified 29 statistically significant fire regimes for the state of Georgia. The identified regimes are classified by region and land cover type and their implications for historically informed disturbance-based resource management are discussed.

Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leong, Cheng Nang; Shakespeare, Thomas Philip; North Coast Cancer Institute, Coffs Harbour

2006-12-01

Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scoresmore » were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.« less

Body dissatisfaction, bulimic symptoms, and clothing practices among college women.

PubMed

Trautmann, Julianne; Worthy, Sheri Lokken; Lokken, Kristine L

2007-09-01

Clothing use may be a behavioral avoidance strategy for individuals with body dissatisfaction and eating pathology. The authors administered the Body Image Avoidance Questionnaire (J. C. Rosen, D. Srebnik, E. Saltzberg, & S. Wendt, 1991), the Bulimia Test-Revised (M. Thelen, J. Farmer, S. Wonderlich, & M. Smith, 1991), and the Body dissatisfaction subscale of the Eating Disorder Inventory (D. M. Garner, M. P. Olmstead, & J. Polivy, 1983) to undergraduate college women from two universities (N = 540). Results indicated that women who were more dissatisfied with their bodies (beta = .396) and had greater disordered eating behaviors (beta = .378) were more likely to engage in clothing-related appearance-management behaviors (p < .001), including wearing apparel to camouflage their bodies; avoiding revealing, brightly colored, or tightly fitting clothing; and avoiding shopping for clothing. These findings suggest that the presence of certain clothing-related appearance-management behaviors may be a warning sign that an individual is at risk for developing an eating disorder or may currently have an eating disorder.

Changing Provider Behavior in the Context of Chronic Disease Management: Focus on Clinical Inertia.

PubMed

Lavoie, Kim L; Rash, Joshua A; Campbell, Tavis S

2017-01-06

Widespread acceptance of evidence-based medicine has led to the proliferation of clinical practice guidelines as the primary mode of communicating current best practices across a range of chronic diseases. Despite overwhelming evidence supporting the benefits of their use, there is a long history of poor uptake by providers. Nonadherence to clinical practice guidelines is referred to as clinical inertia and represents provider failure to initiate or intensify treatment despite a clear indication to do so. Here we review evidence for the ubiquity of clinical inertia across a variety of chronic health conditions, as well as the organizational and system, patient, and provider factors that serve to maintain it. Limitations are highlighted in the emerging literature examining interventions to reduce clinical inertia. An evidence-based framework to address these limitations is proposed that uses behavior change theory and advocates for shared decision making and enhanced guideline development and dissemination.

Making a Good Impression at Work: National Differences in Employee Impression Management Behaviors in Japan, Korea, and the United States.

PubMed

Krieg, Alexander; Ma, Li; Robinson, Patricia

2018-02-17

Impression management has important implications for success at work. This study explores differences in impression management in the East and West by examining the use of self-promotion, ingratiation, and exemplification directed towards three targets: supervisors, peers, and subordinates among 945 company employees from Japan, Korea, and the United States. Our results show that Korean employees used all three strategies most frequently, followed by United States, and then Japanese employees. Japanese and Korean employees used impression management strategies differentially across the three targets, and U.S. employees used impression management equally across targets. This elucidates how cultural trends in hierarchical relationships impact social behavior within the workplace. A follow-up mediation analysis found that relational or labor mobility fully mediated country differences in impression management, suggesting that culture is also reflected in larger social ecological trends in employee's ability and likelihood to change jobs, which also account for impression management strategy usage. Theoretical and practical implications for international business are discussed. This research may be useful in aligning strategies foreign employees might employ for using impression management when in Japan, Korea, and the United States.

Self-Care Behaviors in Heart Failure.

PubMed

Cavalcante, Agueda Maria Ruiz Zimmer; Lopes, Camila Takao; Brunori, Evelise Fadini Reis; Swanson, Elizabeth; Moorhead, Sue Ann; Bachion, Maria Márcia; de Barros, Alba Lucia Bottura Leite

2017-05-18

To identify self-care behaviors, instruments, techniques, parameters for the assessment of self-care behaviors in people with heart failure, compare these behaviors with the indicators of the Nursing Outcomes Classification outcome, Self Management: Cardiac Disease. Integrative literature review performed in Lilacs, Medline, CINAHL, and Cochrane, including publications from 2009 to 2015. One thousand six hundred ninety-one articles were retrieved from the search, of which 165 were selected for analysis. Ten self-care behaviors and several different assessment instruments, techniques, and parameters were identified. The addition and removal of some indicators are proposed, based on this review. The data provide substrate for the development of conceptual and operational definitions of the indicators, making the outcome more applicable for use in clinical practice. © 2017 NANDA International, Inc.

Achieving optimal welfare for the Nile hippopotamus (Hippopotamus amphibius) in North American zoos and aquariums.

PubMed

Tennant, Kaylin S; Segura, Valerie D; Morris, Megan C; Snyder, Kristen Denninger; Bocian, David; Maloney, Dan; Maple, Terry L

2017-07-29

Compared to other megafauna managed in zoos and aquariums, the current state of welfare for the Nile hippopotamus (Hippopotamus amphibius) is poorly understood. Complex behavior and physiological characteristics make hippos a difficult species to manage. Thus, hippos in managed care are currently at risk for a decreased state of welfare. In an effort to assess and improve conditions for this species, a survey was administered to North American institutions housing Nile hippos. This assessment utilized a multiple-choice format and consisted of questions relating to group structure, behavior, and exhibit design, allowing for the creation of cross-institutional, welfare-based analysis. Responses were gathered from 85.29% of the institutions to which the survey was distributed. Despite recommendations for maintaining groups of at least five individuals (Forthman, 1998), only 34.25% of hippos in North America were housed in groups of three or more. The survey also highlighted that 39.29% of institutions secure their hippos in holding areas overnight, despite their highly active nocturnal propensities. A better understanding of hippo behavior and environmental preferences can be used to inform wellness-oriented management practices to achieve a state of "optimal welfare". Copyright © 2017 Elsevier B.V. All rights reserved.

Exploring parental factors related to weight management in survivors of childhood central nervous system tumors.

PubMed

Santa Maria, Diane; Swartz, Maria C; Markham, Christine; Chandra, Joya; McCurdy, Sheryl; Basen-Engquist, Karen

2014-01-01

Childhood central nervous system tumor survivors (CCNSTS) are at risk for adverse health issues. Little research has been conducted to explore the role of parental factors in weight management to mitigate adverse health outcomes. We conducted 9 group interviews (n=20) with CCNSTS, their parents, and health care providers to ascertain parental factors that may influence weight management practices in CCNSTS. Three main themes were identified: parenting style, parent-child connectedness, and food and physical activity (PA) environment. Although most parents adopted an authoritative parenting style related to diet and PA practices, some adopted a permissive parenting style. Participants expressed high levels of connection that may hinder the development of peer relationships and described the food and PA environments that promote or hinder weight management through parental modeling of healthy eating and PA and access to healthy food and activities. Weight management interventions for CCNSTS may experience greater benefit from using a family-focused approach, promoting positive food and PA environments, parental modeling of healthy eating and exercise, and partnering with youth to adopt weight management behaviors.

Adaptive change in corporate control practices.

PubMed

Alexander, J A

1991-03-01

Multidivisional organizations are not concerned with what structure to adopt but with how they should exercise control within the divisional form to achieve economic efficiencies. Using an information-processing framework, I examined control arrangements between the headquarters and operating divisions of such organizations and how managers adapted control practices to accommodate increasing environmental uncertainty. Also considered were the moderating effects of contextual attributes on such adaptive behavior. Analyses of panel data from 97 multihospital systems suggested that organizations generally practice selective decentralization under conditions of increasing uncertainty but that organizational age, dispersion, and initial control arrangements significantly moderate the direction and magnitude of such changes.

The effect of physician practice organization on efficient utilization of hospital resources.

PubMed

Burns, L R; Chilingerian, J A; Wholey, D R

1994-12-01

This study examines variations in the efficient use of hospital resources across individual physicians. The study is conducted over a two-year period (1989-1990) in all short-term general hospitals with 50 or more beds in Arizona. We examine hospital discharge data for 43,625 women undergoing cesarean sections and vaginal deliveries without complications. These data include physician identifiers that permit us to link patient information with information on physicians provided by the state medical association. The study first measures the contribution of physician characteristics to the explanatory power of regression models that predict resource use. It then tests hypothesized effects on resource utilization exerted by two sets of physician level factors: physician background and physician practice organization. The latter includes effects of hospital practice volume, concentration of hospital practice, percent managed care patients in one's hospital practice, and diversity of patients treated. Efficiency (inefficiency) is measured as the degree of variation in patient charges and length of stay below (above) the average of treating all patients with the same condition in the same hospital in the same year with the same severity of illness, controlling for discharge status and the presence of complications. After controlling for patient factors, physician characteristics explain a significant amount of the variability in hospital charges and length of stay in the two maternity conditions. Results also support hypotheses that efficiency is influenced by practice organization factors such as patient volume and managed care load. Physicians with larger practices and a higher share of managed care patients appear to be more efficient. The results suggest that health care reform efforts to develop physician-hospital networks and managed competition may promote greater parsimony in physicians' practice behavior.

The effect of physician practice organization on efficient utilization of hospital resources.

PubMed Central

Burns, L R; Chilingerian, J A; Wholey, D R

1994-01-01

OBJECTIVE. This study examines variations in the efficient use of hospital resources across individual physicians. DATA SOURCES AND SETTING. The study is conducted over a two-year period (1989-1990) in all short-term general hospitals with 50 or more beds in Arizona. We examine hospital discharge data for 43,625 women undergoing cesarean sections and vaginal deliveries without complications. These data include physician identifiers that permit us to link patient information with information on physicians provided by the state medical association. STUDY DESIGN. The study first measures the contribution of physician characteristics to the explanatory power of regression models that predict resource use. It then tests hypothesized effects on resource utilization exerted by two sets of physician level factors: physician background and physician practice organization. The latter includes effects of hospital practice volume, concentration of hospital practice, percent managed care patients in one's hospital practice, and diversity of patients treated. Efficiency (inefficiency) is measured as the degree of variation in patient charges and length of stay below (above) the average of treating all patients with the same condition in the same hospital in the same year with the same severity of illness, controlling for discharge status and the presence of complications. PRINCIPAL FINDINGS. After controlling for patient factors, physician characteristics explain a significant amount of the variability in hospital charges and length of stay in the two maternity conditions. Results also support hypotheses that efficiency is influenced by practice organization factors such as patient volume and managed care load. Physicians with larger practices and a higher share of managed care patients appear to be more efficient. CONCLUSIONS. The results suggest that health care reform efforts to develop physician-hospital networks and managed competition may promote greater parsimony in physicians' practice behavior. PMID:8002351

Cognitive hypnotherapy for pain management.

PubMed

Elkins, Gary; Johnson, Aimee; Fisher, William

2012-04-01

Pain is a serious health care problem and there is growing evidence to support the use of hypnosis and cognitive-behavioral interventions for pain management. This article reviews clinical techniques and methods of cognitive hypnotherapy for pain management. Current research with emphasis given to randomized, controlled trials is presented and the efficacy of hypnotherapy for pain management is discussed. Evidence for cognitive hypnotherapy in the treatment in chronic pain, cancer, osteoarthritis, sickle cell disease, temporomandibular disorder, fibromyalgia, non-cardiac chest pain, and disability related chronic pains are identified. Implications for clinical practice and research are discussed in light of the accumulating evidence in support of the efficacy and effectiveness of cognitive hypnotherapy for pain management.

Patients' experiences of shared decision making in primary care practices in the United kingdom.

PubMed

Fullwood, Catherine; Kennedy, Anne; Rogers, Anne; Eden, Martin; Gardner, Caroline; Protheroe, Joanne; Reeves, David

2013-01-01

Shared decision making (SDM) and patient self-management support are key components of US and UK policy for chronic disease management, whereby SDM is seen as enhancing physician-patient negotiation around self-management. The WISE trial is implementing training in self-management support for primary care physicians in one UK region. This article describes preintervention levels of patient-reported SDM and explores how this varies with patient and practice characteristics. We analyzed baseline data from a cluster randomized controlled trial for 2965 patients with diabetes, chronic obstructive pulmonary disease, and irritable bowel syndrome (IBS) from 29 family practices. Patient-level measures included self-report of chronic conditions, SDM (Health Care Climate Questionnaire [HCCQ]), health status, and demographic characteristics. Area and practice characteristics included chronic disease workload and socioeconomic deprivation. The mean SDM score was 75 (out of 100), but the range was wide. The mean score was lower for IBS patients but did not vary with other disease conditions. Younger patients and those with poorer health status reported lower degrees of SDM. No associations were found with practice characteristics. The study was restricted to one socioeconomically deprived region, and hence results may not be nationally representative of the United Kingdom. Ceiling effects on SDM scores may limit the utility of the HCCQ. Lower ratings from some patient groups may reflect differences in expectations rather than differences in physician behavior. Overall levels of SDM were high, and no patient or practice characteristic represented a serious barrier to SDM. However, we cannot say to what extent SDM in this chronic population addressed self-management issues rather than clinical care. More nuanced measures of SDM are required that distinguish between different forms of care.

Partnering with diabetes educators to improve patient outcomes

PubMed Central

Burke, Sandra D; Sherr, Dawn; Lipman, Ruth D

2014-01-01

Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient’s health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes. PMID:24550679

Policy-into-practice for rheumatoid arthritis: randomized controlled trial and cohort study of e-learning targeting improved physiotherapy management.

PubMed

Fary, Robyn E; Slater, Helen; Chua, Jason; Ranelli, Sonia; Chan, Madelynn; Briggs, Andrew M

2015-07-01

To examine the effectiveness of a physiotherapy-specific, web-based e-learning platform, "RAP-el," in best-practice management of rheumatoid arthritis (RA) using a single-blind, randomized controlled trial (RCT) and prospective cohort study. Australian-registered physiotherapists were electronically randomized into intervention and control groups. The intervention group accessed RAP-eL over 4 weeks. Change in self-reported confidence in knowledge and skills was compared between groups at the end of the RCT using linear regression conditioned for baseline scores by a blinded assessor, using intent-to-treat analysis. Secondary outcomes included physiotherapists' satisfaction with RA management and responses to RA-relevant clinical statements and practice-relevant vignettes. Retention was evaluated in a cohort study 8 weeks after the RCT. Eighty physiotherapists were randomized into the intervention and 79 into the control groups. Fifty-six and 48, respectively, provided baseline data. Significant between-group differences were observed for change in confidence in knowledge (mean difference 8.51; 95% confidence interval [95% CI] 6.29, 10.73; effect size 1.62) and skills (mean difference 7.26; 95% CI 5.1, 9.4; effect size 1.54), with the intervention group performing better. Satisfaction in ability to manage RA, 4 of the 6 clinical statements, and responses to vignettes demonstrated significant improvement in the intervention group. Although 8-week scores showed declines in most outcomes, their clinical significance remains uncertain. RAP-eL can improve self-reported confidence, likely practice behaviors and satisfaction in physiotherapists' ability to manage people with RA, and improve their clinical knowledge in several areas of best-practice RA management in the short term. © 2015, American College of Rheumatology.

Longitudinal Relations Between Observed Parenting Behaviors and Dietary Quality of Meals From Ages 2 to 5

PubMed Central

Montaño, Zorash; Smith, Justin D.; Dishion, Thomas J.; Shaw, Daniel S.; Wilson, Melvin N.

2015-01-01

Objectives Parents influence a child’s diet by modeling food choices, selecting the food they will make available, and controlling the child’s intake. Few studies have examined the covariation between parent’s behavior management practices and their guidance and support for a young child’s nutritional environment in early childhood. We hypothesized that parents’ positive behavior support (PBS), characterized as skillful behavior management and proactive structuring of children’s activities, would predict dietary quality over the course of early childhood (age 2 to 5 years), a critical period for the development of a dietary lifestyle through the lifespan. Methods Participants included 731 culturally diverse, low-income families in a randomized, controlled trial of the Family Check-Up. Families participated in a yearly home visit videotaped assessment when children were 2 to 5 years. PBS and dietary quality of meals parents served to their children were assessed by coding videotapes of structured parent–child interactions, including a meal preparation task. A cross-lagged panel model was used to evaluate the longitudinal relation between PBS and the dietary quality of meals served during the meal preparation task. Results Analyses revealed that PBS repeatedly predicted meals’ dietary quality the following year: age 2–3 (β = .30), age 3–4 (β = 0.14), age 4–5 (β = 0.37). Dietary quality significantly predicted PBS 1 year later: age 3–4 (β = 0.16), age 4–5 (β = 0.14). As expected, the relative strength of the relationship from PBS to dietary quality was significantly stronger than the reverse, from dietary quality to PBS. Conclusions Positive behavior management and proactive parenting practices are an important foundation for establishing a healthy nutritional environment for young children. These findings suggest that family-centered prevention interventions for pediatric obesity may benefit from targeting PBS in service of promoting better dietary quality. PMID:25555539

Longitudinal relations between observed parenting behaviors and dietary quality of meals from ages 2 to 5.

PubMed

Montaño, Zorash; Smith, Justin D; Dishion, Thomas J; Shaw, Daniel S; Wilson, Melvin N

2015-04-01

Parents influence a child's diet by modeling food choices, selecting the food they make available, and controlling the child's intake. Few studies have examined the covariation between parent's behavior management practices and their guidance and support for a young child's nutritional environment in early childhood. We hypothesized that parents' positive behavior support (PBS), characterized as skillful behavior management and proactive structuring of children's activities, would predict dietary quality over the course of early childhood (age 2 to 5 years), a critical period for the development of a dietary lifestyle. Participants included 731 culturally diverse, low-income families in a randomized, controlled trial of the Family Check-Up. Families participated in a yearly home visit videotaped assessment PBS and dietary quality of meals parents served to their children were assessed by coding videotapes of structured parent-child interactions. A cross-lagged panel model was used to evaluate the longitudinal relation between PBS and the dietary quality of meals served during a meal preparation task. Analyses revealed that PBS repeatedly predicted meals' dietary quality the following year: age 2-3 (β = .30), age 3-4 (β = 0.14), age 4-5 (β = 0.37). Dietary quality significantly predicted PBS 1 year later: age 3-4 (β = 0.16), age 4-5 (β = 0.14). As expected, the relative strength of the relationship from PBS to dietary quality was significantly stronger than the reverse, from dietary quality to PBS. Positive behavior management and proactive parenting practices are an important foundation for establishing a healthy nutritional environment for young children. These findings suggest that family-centered prevention interventions for pediatric obesity may benefit from targeting PBS in service of promoting better dietary quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cardiac health: primary prevention of heart disease in women.

PubMed

Turk, Melanie Warziski; Tuite, Patricia K; Burke, Lora E

2009-09-01

Heart disease is the number one cause of death among women. Although 450,000 women die annually from heart disease, this fact is unknown to many women. Because heart disease is frequently preventable, increasing awareness of personal risk and preventative measures is a key element of health care for women. Nurse clinicians can evaluate, educate, and counsel women regarding their risk for this pervasive disease and promote behavior changes that will decrease that risk. Research evidence supports that lifestyle behaviors are the cornerstone of heart disease prevention. This article presents current evidence for the prevention of heart disease related to dietary intake, physical activity, weight management, smoking cessation, blood pressure control, and lipid management. Guidelines for implementing findings in clinical practice are discussed.

Parental Attributions of Control for Child Behaviour and Their Relation to Discipline Practices in Parents of Children with and Without Developmental Delays.

PubMed

Jacobs, Myrthe; Marks Woolfson, Lisa; Hunter, Simon C

2017-01-01

Children with developmental delays (DD) are at risk for developing behavior problems. Research suggests that parents' causal attributions for child behavior are related to parenting. This study investigated this association in parents of children with DD compared to parents of typically developing (TD) children. It specifically focused on attributions of child control by separating these from attributions of responsibility, blame and intent, and from attributions of parent control and responsibility. Fifty-one parents of children with DD and 69 parents of TD children completed two questionnaires. The Written Analogue Questionnaire measured causal attributions. The Parenting Scale measured dysfunctional discipline practices. Parents of children with DD viewed the child's role in problematic behavior more positively while also viewing misbehavior as more fixed than parents of TD children. Parents of TD children who viewed their child as more in control over misbehavior used less dysfunctional discipline, but this association was not found for parents of children with DD. The results advance understanding of how parents perceive behavior problems in children with DD and the important role these perceptions play in parental behavior management strategies. More importantly, these perceptions relate to discipline practices differently for parents of children with DD compared to parents of TD children, highlighting that parent interventions should be adapted to the specific needs of parents of children with DD.

Parent Management Training-Oregon Model: Adapting Intervention with Rigorous Research.

PubMed

Forgatch, Marion S; Kjøbli, John

2016-09-01

Parent Management Training-Oregon Model (PMTO(®) ) is a set of theory-based parenting programs with status as evidence-based treatments. PMTO has been rigorously tested in efficacy and effectiveness trials in different contexts, cultures, and formats. Parents, the presumed agents of change, learn core parenting practices, specifically skill encouragement, limit setting, monitoring/supervision, interpersonal problem solving, and positive involvement. The intervention effectively prevents and ameliorates children's behavior problems by replacing coercive interactions with positive parenting practices. Delivery format includes sessions with individual families in agencies or families' homes, parent groups, and web-based and telehealth communication. Mediational models have tested parenting practices as mechanisms of change for children's behavior and found support for the theory underlying PMTO programs. Moderating effects include children's age, maternal depression, and social disadvantage. The Norwegian PMTO implementation is presented as an example of how PMTO has been tailored to reach diverse populations as delivered by multiple systems of care throughout the nation. An implementation and research center in Oslo provides infrastructure and promotes collaboration between practitioners and researchers to conduct rigorous intervention research. Although evidence-based and tested within a wide array of contexts and populations, PMTO must continue to adapt to an ever-changing world. © 2016 Family Process Institute.

Sex and drug risk behavior pre- and post-emigration among Latino migrant men in post-Hurricane Katrina New Orleans.

PubMed

Mills, Jennifer; Burton, Nicole; Schmidt, Norine; Salinas, Oscar; Hembling, John; Aran, Alberto; Shedlin, Michele; Kissinger, Patricia

2013-06-01

High rates of sex and drug risk behaviors have been documented among Latino migrant men in the US. Whether these behaviors were established in the migrants' home countries or were adopted in the US has not been described and has implications for prevention strategies. Quarterly surveys were conducted to gather information on selected sex and drug risk practices of Latino migrant men who arrived in New Orleans after Hurricane Katrina seeking work. Both kappa scores and McNemar's tests were performed to determine if practice of these behaviors in home country was similar to practice post-emigration to the US. Female sex worker (FSW) patronage, same sex encounters (MSM), and crack cocaine use was more likely to occur post- rather than pre-emigration. Of those who ever engaged in these selected behaviors, most adopted the behavior in the US (i.e., 75.8% of FSW patrons, 72.7% of MSM participants, and 85.7% of crack cocaine users), with the exception of binge drinking (26.8%). Men who were living with a family member were less likely to adopt FSW patronage OR = 0.27, CI = 0.10-0.76, whereas men who earned >$465 per week were more likely to adopt crack cocaine use OR = 6.29 CI = 1.29, 30.57. Interventions that facilitate the maintenance of family cohesion and provide strategies for financial management may be useful for reducing sex and drug risk among newly arrived migrants.

Modified social learning theory re-examined: correlates of self-management behaviors of persons with Type 2 diabetes.

PubMed

Nugent, Linda E; Wallston, Kenneth A

2016-12-01

Modified social learning theory (MSLT) applied to health predicts that health behavior is a multiplicative function of health value and perceptions of control over health. The self-management behaviors of persons with Type 2 diabetes mellitus, internal diabetes locus of control (IDLC), diabetes self-efficacy (DSE), and health value (HV) were assessed with an index of diabetes self-care activities in 107 patients receiving insulin. Multiple regression analysis showed DSE as the only MSLT construct that correlated with the index of diabetes self-care behaviors (β = .21, p < .05). While the predicted three-way interaction of IDLC × DSE × HV was significant (∆R 2  = 4.5 %, p < .05) in the final step of the hierarchical model, the pattern of the findings only partially supported MSLT. Instead of finding that patients who were simultaneously high on all three predictors scored highest on the behavioral index, we found that patients who were low on all three constructs reported the least amount of diabetes self-care behavior. Implications for further modification of MSLT and its applications to clinical practice are discussed.

Chronic Disease Self-Management by People With HIV.

PubMed

McDonald, Karalyn; Slavin, Sean; Pitts, Marian K; Elliott, Julian H

2016-05-01

As HIV has transitioned into a chronic disease, reappraisal of clinical management has occurred with chronic disease self-management (CDSM) as one possibility. However, despite extensive work on CDSM across a range of diseases, little attention has focused on psychosocial contexts of the lives of people for whom programs are intended. This article reports semi-structured interviews used to explore health practices and motivations of 33 people with HIV (PWHIV) in Australia. Within participants' accounts, different forms of subjectivity and agency emerged with implications for how they understood and valued health-related behaviors. Four themes arose: health support and disclosure, social support and stigma, employment/structure, and health decisions beyond HIV. The experience of stigma and its intersection with CDSM remains relatively un-chartered. This study found stigma shapes agency and engagement with health. Decisions concerning health behaviors are often driven by perceived social and emotional benefit embedded in concerns of disclosure and stigma. © The Author(s) 2015.

Strategies for Sustained Weight Management: Perspectives From African American Patients With Type 2 Diabetes.

PubMed

Fitzpatrick, Stephanie L; Hill-Briggs, Felicia

2017-06-01

Purpose The purpose of this study was to identify effective strategies for sustained weight management used by African American patients with obesity and type 2 diabetes. Methods In this study, nominal group technique was used to identify effective strategies for weight management used by 12 African Americans with overweight/obesity and type 2 diabetes who successfully lost or maintained their weight after completing DECIDE (Decision-making Education for Choices In Diabetes Everyday), a 9-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training program. Results Participants generated a list of 101 strategies that covered 4 domains: nutrition, physical activity, cognitive-behavioral strategies, and other. Self-monitoring and relying on social support were the top 2 strategies for weight maintenance. Conclusion Future obesity studies should consider including friends/family as well as electronic tools to facilitate self-monitoring and regular practice of behavioral strategies for long-term success.

General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues.

PubMed

Kavan, Michael G; Saxena, Shailendra K; Rafiq, Naureen

2018-05-15

Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and assist parents by providing effective monitoring tools for behavior problems. Effective strategies for influencing a child's behavior include positive reinforcement to increase appropriate behavior, extinction (planned ignoring) for most low-level problematic behaviors, and time-out from reinforcement for more problematic behaviors. Written contracting provides parents the opportunity to communicate with their children about important behaviors and strengthens the commitment of each party to improve behavior. Parents should be cautioned about the use of punishment (e.g., scolding, taking away privileges or possessions) because it suppresses behavior only temporarily. Physicians should discourage physical or corporal punishment because it is related to negative parent-child relationships, increased aggressiveness, antisocial behavior, lower cognitive ability, lower self-esteem, mental health problems, and increased risk of physical abuse.

Classroom Age Composition and Vocabulary Development Among At-Risk Preschoolers

PubMed Central

Guo, Ying; Tompkins, Virginia; Justice, Laura; Petscher, Yaacov

2016-01-01

Research Findings The purpose of this exploratory study was to examine the relationship between classroom age composition and preschoolers’ vocabulary gains over an academic year and also to examine whether these relations were moderated by classroom quality. In this study (N = 130 children in 16 classrooms representing a subset of all children enrolled in these classrooms), results showed a significant cross-level interaction between classroom age composition and children’s age, suggesting positive effects of greater variance in classroom age composition for younger but not older children. The interaction between behavior management (1 dimension of classroom quality) and classroom age composition was also significant, indicating that a wider distribution of classroom age composition was positively related to children’s vocabulary gains within classrooms characterized by better behavior management. Practice or Policy Findings underscore the importance of children’s social interactions with more knowledgeable conversational partners in promoting their vocabulary development and signify the need to help teachers learn how to manage children’s behaviors so as to provide a classroom that is optimal for child learning. PMID:27660399

Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain.

PubMed

O'Sullivan, Peter B; Caneiro, J P; O'Keeffe, Mary; Smith, Anne; Dankaerts, Wim; Fersum, Kjartan; O'Sullivan, Kieran

2018-05-01

Biomedical approaches for diagnosing and managing disabling low back pain (LBP) have failed to arrest the exponential increase in health care costs, with a concurrent increase in disability and chronicity. Health messages regarding the vulnerability of the spine and a failure to target the interplay among multiple factors that contribute to pain and disability may partly explain this situation. Although many approaches and subgrouping systems for disabling LBP have been proposed in an attempt to deal with this complexity, they have been criticized for being unidimensional and reductionist and for not improving outcomes. Cognitive functional therapy was developed as a flexible integrated behavioral approach for individualizing the management of disabling LBP. This approach has evolved from an integration of foundational behavioral psychology and neuroscience within physical therapist practice. It is underpinned by a multidimensional clinical reasoning framework in order to identify the modifiable and nonmodifiable factors associated with an individual's disabling LBP. This article illustrates the application of cognitive functional therapy to provide care that can be adapted to an individual with disabling LBP.

Documentation of violence risk information in psychiatric hospital patient charts: an empirical examination.

PubMed

Elbogen, Eric B; Tomkins, Alan J; Pothuloori, Antara P; Scalora, Mario J

2003-01-01

Studies have identified risk factors that show a strong association with violent behavior in psychiatric populations. Yet, little research has been conducted on the documentation of violence risk information in actual clinical practice, despite the relevance of such documentation to risk assessment liability and to conducting effective risk management. In this study, the documentation of cues of risk for violence were examined in psychiatric settings. Patient charts (n = 283) in four psychiatric settings were reviewed for documentation of violence risk information summarized in the MacArthur Violence Risk Assessment Study. The results revealed that particular patient and institutional variables influenced documentation practices. The presence of personality disorder, for example, predicted greater documentation of cues of violence risk, regardless of clinical setting. These findings have medicolegal implications for risk assessment liability and clinical implications for optimizing risk management in psychiatric practice.

An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training.

PubMed

France, Daniel J; Leming-Lee, Susie; Jackson, Tom; Feistritzer, Nancye R; Higgins, Michael S

2008-04-01

Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings. Direct observational analyses were performed on 30 surgical teams (15 neurosurgery cases and 15 cardiac cases) to evaluate surgical team compliance with integrated safety and CRM practices after extensive CRM training. Observed surgical teams were compliant with only 60% of the CRM and perioperative safety practices emphasized in the training program. The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.

Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach.

PubMed

Hutting, Nathan; Detaille, Sarah I; Engels, Josephine A; Heerkens, Yvonne F; Staal, J Bart; Nijhuis-van der Sanden, Maria Wg

2015-01-01

To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as "self-management behavior at work" with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants. This study resulted in a theory- and practice-based self-management program, based on behavioral change theories, guideline-related evidence, and practice-based knowledge that fits the needs of employees with CANS.

Managing the professional nurse. Part I. The organizational theories.

PubMed

McClure, M L

1984-02-01

How do employment organizations outside the hospital field deal with issues such as staff productivity, motivation, burnout, and high turnover? In Part I of this two-part article, the author presents an overview of modern management theory and practice, drawn from the literature on organizational behavior. She shows how nursing administrators can use this scholarly foundation to better understand the organizing principles and problems of their departments. In Part II (to be published in March 1984), the author applies these classic and relevant theories to the specific challenges that face the manager of professional nurses.

Restoring professionalism: the physician fitness-for-duty evaluation.

PubMed

Finlayson, A J Reid; Dietrich, Mary S; Neufeld, Ron; Roback, Howard; Martin, Peter R

2013-01-01

We compare findings from 10 years of experience evaluating physicians referred for fitness-to-practice assessment to determine whether those referred for disruptive behavior are more or less likely to be declared fit for duty than those referred for mental health, substance abuse or sexual misconduct. Deidentified data from 381 physicians evaluated by the Vanderbilt Comprehensive Assessment Program (2001-2012) were analyzed and compared to general physician population data and also to previous reports of physician psychiatric diagnosis found by MEDLINE search. Compared to the physicians referred for disruptive behavior (37.5% of evaluations), each of the other groups was statistically significantly less likely to be assessed as fit for practice [substance use, %: odds ratio (OR)=0.22, 95% confidence interval (CI)=0.10-0.47, P<.001; mental health, %: OR=0.14, 95% CI=0.06-0.31, P<.001; sexual boundaries, %: OR=0.27, 95% CI=0.13-0.58, P=.001]. The number of referrals to evaluate physicians presenting with behavior alleged to be disruptive to clinical care increased following the 2008 Joint Commission guidelines that extended responsibility for professional conduct outside the profession itself to the institutions wherein physicians work. Better strategies to identify and manage disruptive physician behavior may allow those physicians to return to practice safely in the workplace. © 2013.

Team Member Training Manual.

DTIC Science & Technology

1998-07-01

by those who studied human behavior. Behaviorists such as Abraham Maslow , and Frederick Herzberg developed theories of motivation which share much of...the same kinds of things as Theory Y. Theory Y as well as the theories of Maslow and Herzberg offer ways for managers to practice "pull" concepts of...29 Maslow ’s Hierarchy of Needs

The TELEPAC Project: A Service Delivery Model for the Severely Handicapped in Rural Areas.

ERIC Educational Resources Information Center

Hofmeister, Alan M.; Atkinson, Charles M.

Described is Project TELEPAC, a telecommunications-based system which provides instructional packets to parents of severely handicapped children in rural areas of Utah. In addition to the parent involvement packets which outline teaching methods, correction procedures and behavior management practices for arithmetic, language arts, self help and…

Managerial and Organizational Career Development: An Annotated Bibliography.

ERIC Educational Resources Information Center

Maddox, E. Nick; And Others

1988-01-01

This annotated bibliography is an extension of an earlier work published in the "Career Planning and Adult Development Journal" in 1983. It represents a cross-sectional look at the expanding field of career development as it relates to organizational behavior and human resource management disciplines and practice. Citations are included of 295…

Youth Risk Assessment in Complex Agency Practice

ERIC Educational Resources Information Center

Groner, Mark R.; Solomon, Jean

2007-01-01

Advancements in the delivery of community-based services and tight utilization management of high-cost treatment options result in youths with serious behavior problems receiving intervention in lower levels of care than was true ten or fifteen years ago. This shift in where services tend to be delivered necessitates enhancement of risk assessment…

Considerations for 21st-Century Disciplinary Policy and Practice

ERIC Educational Resources Information Center

Englehart, Joshua M.

2014-01-01

While the conceiving of 21st-century schools has rightly included much discussion on curriculum and instruction, changing demands and conditions also present necessary changes in the way that student behavior is managed. A review of the literature on student discipline over the past decade reveals three particular issues that warrant attention in…

Planning Good Days for Children with ADHD: Tips for Parents.

ERIC Educational Resources Information Center

Brozovich, Richard; And Others

Practical suggestions are offered for parents of children with attention deficit hyperactivity disorder (ADHD) for managing the behavior of their children through the use of positive and negative consequences. Suggestions focus on the child getting up in the morning, getting ready for school, homework, chores, dinner time, free time, bed time,…

Development of a New Psychosocial Treatment for Adult ADHD

ERIC Educational Resources Information Center

Solanto, Mary V.; Marks, David J.; Mitchell, Katherine J.; Wasserstein, Jeanette; Kofman, Michele D.

2008-01-01

Objective: The purpose of this study was to assess the effectiveness of a new manualized group Meta-Cognitive Therapy (MCT) for adults with ADHD that extends the principles and practices of cognitive-behavioral therapy to the development of executive self-management skills. Method: Thirty adults diagnosed with ADHD completed an 8- or 12-week…

Teaching Adult Learner Characteristics and Facilitation Strategies through Simulation-Based Practice

ERIC Educational Resources Information Center

Speed, Sally A.; Bradley, Elizabeth; Garland, Krista Vince

2015-01-01

This article relates a project in which a curriculum module was developed to help graduate students more effectively manage behaviors of adults in facilitation sessions. The module was piloted in the project and later included in a graduate level course in the Creative Studies Department of SUNY Buffalo State. The curriculum identified…

Best Practices in the Navy’s Energy Programs Strategic Communication Factors Operating in the Tactical Forces

DTIC Science & Technology

2009-12-01

Management Pilot Project.” NRSW E -Notes, No. 132, January 30, 2008. http://secnavportal.donhq.navy.mil/ portal /server.pt/gateway/PTARGS_0_0_2426...CONSERVATION.........................................................................................52 E . MATERIAL AND SOCIAL INCENTIVES IMPACT BEHAVIOR...73 E . SUPPORT AN INTEGRATED COMMUNICATION PROCESS...........75 VI. METHODS

Principals' Leadership in Mexican Upper High Schools: The Paradoxes between Rules and Practices

ERIC Educational Resources Information Center

Santizo Rodall, Claudia A.; Ortega Salazar, Sylvia B.

2018-01-01

This article discusses the type of organization and leadership that underlies a competency-based management rule established in Mexico (2008) applicable to principals in public upper high schools. This rule, identified as the 449 Agreement, describes competencies and communicates expected behavior. Implementation, however, is mediated by the…

Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial.

PubMed

Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

2016-01-01

Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies.

Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial

PubMed Central

Poureslami, Iraj; Kwan, Susan; Lam, Stephen; Khan, Nadia A; FitzGerald, John Mark

2016-01-01

Background Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients. Methods Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures. Results Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05). Conclusion Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD. Clinical implication A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies. PMID:27536093

Herding: a new phenomenon affecting medical decision-making in multiple sclerosis care? Lessons learned from DIScUTIR MS.

PubMed

Saposnik, Gustavo; Maurino, Jorge; Sempere, Angel P; Ruff, Christian C; Tobler, Philippe N

2017-01-01

Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS) when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors) of herding in the management of MS. We conducted a study among neurologists with expertise in MS care throughout Spain. Participants answered questions regarding the management of 20 case scenarios commonly encountered in clinical practice and completed 3 surveys and 4 experimental paradigms based on behavioral economics. The herding experiment consisted of a case scenario of a 40-year-old woman who has been stable for 3 years on subcutaneous interferon and developed a self-limited neurological event. There were no new magnetic resonance imaging (MRI) lesions. Her neurological examination and disability scores were unchanged. She was advised by an MS neurologist to switch from interferon to fingolimod against best practice guidelines. Multivariable logistic regression analysis was conducted to evaluate factors associated with herding. Out of 161 neurologists who were invited to participate, 96 completed the study (response rate: 60%). Herding was present in 75 (78.1%), having a similar prevalence in MS experts and general neurologists (68.8% vs 82.8%; P =0.12). In multivariate analyses, the number of MS patients seen per week was positively associated with herding (odds ratio [OR] 1.08, 95% CI 1.01-1.14). Conversely, physician's age, gender, years of practice, setting of practice, or risk preferences were not associated with herding. Herding was a common phenomenon affecting nearly 8 out of 10 neurologists caring for MS patients. Herding may affect medical decisions and lead to poorer outcomes in the management of MS.

Diabetes Distress or Major Depressive Disorder? A Practical Approach to Diagnosing and Treating Psychological Comorbidities of Diabetes.

PubMed

Kreider, Kathryn Evans

2017-02-01

The presence of major depressive disorder (MDD) in people with diabetes may be up to three times more common than in the general population. People with diabetes and major depressive disorder have worse health outcomes and higher mortality rates. Diabetes distress refers to an emotional state where people experience feelings such as stress, guilt, or denial that arise from living with diabetes and the burden of self-management. Diabetes distress has also been linked to worse health outcomes. There are multiple treatment options for MDD including pharmacotherapy and cognitive behavioral approaches. Providers treating patients with diabetes must be aware of the frequent comorbidity of diabetes, diabetes distress, and depression and manage patients using a multidisciplinary team approach. This article discusses the epidemiology, pathophysiology, and bi-directional relationship of diabetes and depression and provides a practical, patient-centered approach to diagnosis and management.

Analyzing best practices in employee health management: how age, sex, and program components relate to employee engagement and health outcomes.

PubMed

Terry, Paul E; Grossmeier, Jessica; Mangen, David J; Gingerich, Stefan B

2013-04-01

Examine the influence of employee health management (EHM) best practices on registration, participation, and health behavior change in telephone-based coaching programs. Individual health assessment data, EHM program data, and health coaching participation data were analyzed for associations with coaching program enrollment, active participation, and risk reduction. Multivariate analyses occurred at the individual (n = 205,672) and company levels (n = 55). Considerable differences were found in how age and sex impacted typical EHM evaluation metrics. Cash incentives for the health assessment were associated with more risk reduction for men than for women. Providing either a noncash or a benefits-integrated incentive for completing the health assessment, or a noncash incentive for lifestyle management, strengthened the relationship between age and risk reduction. In EHM programs, one size does not fit all. These results can help employers tailor engagement strategies for their specific population.

The Effectiveness of a Web-Based Resource in Improving Post-Concussion Management in High Schools

PubMed Central

Glang, Ann E.; Koester, Michael C.; Chesnutt, James C.; Gioia, Gerard A.; McAvoy, Karen; Marshall, Sondra; Gau, Jeff M.

2014-01-01

BACKGROUND Because many sports concussions happen during school-sponsored sports events, most state concussion laws specifically hold schools accountable for coach training and effective concussion management practices. Brain 101: The Concussion Playbook is a web-based intervention that includes training in sports concussion for each member of the school community, presents guidelines on creating a concussion management team, and includes strategies for supporting students in the classroom. METHODS The group randomized controlled trial examined the efficacy of Brain 101 in managing sports concussion. Participating high schools (N=25) were randomly assigned to the Brain 101 intervention or control. Fall athletes and their parents completed online training, and Brain 101 school administrators were directed to create concussion management policy and procedures. RESULTS Student athletes and parents at Brain 101 schools significantly outperformed those at control schools on sports concussion knowledge, knowledge application, and behavioral intention to implement effective concussion management practices. Students who had concussions in Brain 101 schools received more varied academic accommodations than students in control schools. CONCLUSIONS Brain 101 can help schools create a comprehensive school-wide concussion management program. It requires minimal expenditures and offers engaging and effective education for teachers, coaches, parents, and students. PMID:25438964

A snapshot of pharmacist attitudes and behaviors surrounding the management of pediatric asthma.

PubMed

Elaro, Amanda; Shah, Smita; Armour, Carol L; Bosnic-Anticevich, Sinthia

2015-01-01

The aim of this study is to identify the current status of pediatric asthma management in the Australian community pharmacy setting from the pharmacists' perspective. This research will allow us to identify training needs of community pharmacists. Pharmacists were recruited from the Sydney metropolitan region and asked to complete a self-reported questionnaire that elucidated information on four general domains relating to pediatric asthma management within community pharmacy. All data collected were analysed descriptively. Bivariate Pearson correlations were performed to determine whether interrelationships existed between specific domains. All 77 pharmacists completed the questionnaire. Thirty-two percent had not completed any asthma related CPD in the past year and only 25% of pharmacists reported using the national asthma guidelines in practice. Just over half of the pharmacists (54%) reported that they provide device technique demonstrations for new inhaled medicines, and 35% of pharmacists reported that they check for written asthma self-management plan possession. Although 65% of pharmacists reported confidence in communication skills, most pharmacists were not confident in setting short-/long-term goals with the patient and carer for managing asthma at home. Pharmacists believed that they are just as effective as doctors in providing asthma counseling and education. Lack of time was identified as a significant barrier. We have identified a gap between guideline recommended practices and the self-reported practices of community pharmacists. Pharmacists need more appropriate continuing education programs that can translate into improved pediatric asthma self-management practices and thus improved asthma outcomes in children. This may require an alternative approach.

Sleep Differences by Race in Preschool Children: The Roles of Parenting Behaviors and Socioeconomic Status.

PubMed

Patrick, Kristina E; Millet, Genevieve; Mindell, Jodi A

2016-01-01

This study aimed to examine whether socioeconomic variables (SES) and parenting behaviors mediate differences in sleep problems between Black and White preschool-aged children. Parents of 191 preschool-aged children (53% male; 77% White) completed questionnaires regarding SES and sleep behaviors. Parenting behaviors and SES were analyzed as mediators of differences in sleep problems between Black and White children. Parent behaviors related to bedtime routine and independence mediated the relationship between race and parent-reported bedtime difficulty, parent confidence managing sleep, and sleep onset latency. SES mediated the relationship between race and sleep onset latency. Sleep differences between Black and White preschool children were primarily mediated by parent behaviors rather than socioeconomic variables. Results may reflect differences in cultural practices and provide important information for treatment and parent-directed intervention regarding improving sleep in young children.

Managing Complexity in Evidence Analysis: A Worked Example in Pediatric Weight Management.

PubMed

Parrott, James Scott; Henry, Beverly; Thompson, Kyle L; Ziegler, Jane; Handu, Deepa

2018-05-02

Nutrition interventions are often complex and multicomponent. Typical approaches to meta-analyses that focus on individual causal relationships to provide guideline recommendations are not sufficient to capture this complexity. The objective of this study is to describe the method of meta-analysis used for the Pediatric Weight Management (PWM) Guidelines update and provide a worked example that can be applied in other areas of dietetics practice. The effects of PWM interventions were examined for body mass index (BMI), body mass index z-score (BMIZ), and waist circumference at four different time periods. For intervention-level effects, intervention types were identified empirically using multiple correspondence analysis paired with cluster analysis. Pooled effects of identified types were examined using random effects meta-analysis models. Differences in effects among types were examined using meta-regression. Context-level effects are examined using qualitative comparative analysis. Three distinct types (or families) of PWM interventions were identified: medical nutrition, behavioral, and missing components. Medical nutrition and behavioral types showed statistically significant improvements in BMIZ across all time points. Results were less consistent for BMI and waist circumference, although four distinct patterns of weight status change were identified. These varied by intervention type as well as outcome measure. Meta-regression indicated statistically significant differences between the medical nutrition and behavioral types vs the missing component type for both BMIZ and BMI, although the pattern varied by time period and intervention type. Qualitative comparative analysis identified distinct configurations of context characteristics at each time point that were consistent with positive outcomes among the intervention types. Although analysis of individual causal relationships is invaluable, this approach is inadequate to capture the complexity of dietetics practice. An alternative approach that integrates intervention-level with context-level meta-analyses may provide deeper understanding in the development of practice guidelines. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Family involvement is helpful and harmful to patients’ self-care and glycemic control

PubMed Central

Mayberry, Lindsay Satterwhite; Osborn, Chandra Y.

2014-01-01

Objective We assessed the relationships between supportive and obstructive family behaviors and patients’ diabetes self-care activities and HbA1C, and potential interaction effects and differences by demographic characteristics. Methods In a cross-sectional study, 192 adults with type 2 diabetes completed the Diabetes Family Behavior Checklist-II, the Summary of Diabetes Self-Care Activities, and a glycemic control (HbA1C) test. Results Participants reported similar rates of supportive and obstructive behaviors that were positively correlated (rho=0.61, p<.001). In adjusted analyses, supportive family behaviors were associated with adherence to different self-care behaviors (β=0.20–0.50, p<.05), whereas obstructive family behaviors were associated with less adherence to self-care behaviors (β=−0.28–−0.39, p<.01) and worse HbA1C (β=0.18, p<.05). Supportive behaviors protected against the detrimental effect of obstructive behaviors on HbA1C (interaction β=−0.22, p<.001). Non-Whites reported more supportive and obstructive behaviors than Whites, but race did not affect the relationships between family behaviors and self-care or HbA1C. Conclusion Involving family members in patients’ diabetes management may compromise patients’ self-care and glycemic control unless family members are taught to avoid obstructive behaviors. Practice Implications Our findings endorse interventions that help family members develop actionable plans to support patients’ self-care and train them to communicate productively about diabetes management. PMID:25282327

Examination of environmentally friendly "green" logistics behavior of managers in the pharmaceutical sector using the Theory of Planned Behavior.

PubMed

Arslan, Miray; Şar, Sevgi

2017-12-11

Logistics activities play a prominent role in enabling manufacturers, distribution channels, and pharmacies to work in harmony. Nowadays these activities have become increasingly striking in the pharmaceutical industry and seen as a development area for this sector. Additionally, green practices are beginning to be more attracting particularly in decreasing costs and increasing image of pharmaceutical companies. The main objective of this study was modeling green logistics (GL) behavior of the managers in the pharmaceutical sector in the theory of planned behavior (TPB) frame via structural equation modeling (SEM). A measurement tool was developed according to TPB. Exploratory factor analysis was conducted to determine subfactors of GL behavior. In the second step, confirmatory factor analysis (CFA) was conducted for confirming whether there is a relationship between the observed variables and their underlying latent constructs. Finally, structural equation model was conducted to specify the relationships between latent variables. In the proposed green logistics behavior (GLB) model, the positive effect of environmental attitude towards GL, perceived behavioral control related GL, and subjective norm about GL on intention towards GL were found statistically significant. Nevertheless, the effect of attitude towards costs of GL on intention towards GL was not found statistically significant. Intention towards GL has been found to have a positive statistically significant effect on the GL behavior. Based on the results of this study, it is possible to say that TPB is an appropriate theory for modeling green logistics behavior of managers. This model can be seen as a guide to the companies in the pharmaceutical sector to participate in green logistics. Copyright © 2017 Elsevier Inc. All rights reserved.

A qualitative study of the relationship between clinician attributes, organization, and patient characteristics on implementation of a disease management program.

PubMed

Brazil, Kevin; Cloutier, Michelle M; Tennen, Howard; Bailit, Howard; Higgins, Pamela S

2008-04-01

The purpose of this study was to examine the challenges of integrating an asthma disease management (DM) program into a primary care setting from the perspective of primary care practitioners. A second goal was to examine whether barriers differed between urban-based and nonurban-based practices. Using a qualitative design, data were gathered using focus groups in primary care pediatric practices. A purposeful sample included an equal number of urban and nonurban practices. Participants represented all levels in the practice setting. Important themes that emerged from the data were coded and categorized. A total of 151 individuals, including physicians, advanced practice clinicians, registered nurses, other medical staff, and nonmedical staff participated in 16 focus groups that included 8 urban and 8 nonurban practices. Content analyses identified 4 primary factors influencing the implementation of a DM program in a primary care setting. They were related to providers, the organization, patients, and characteristics of the DM program. This study illustrates the complexity of the primary care environment and the challenge of changing practice in these settings. The results of this study identified areas in a primary care setting that influence the adoption of a DM program. These findings can assist in identifying effective strategies to change clinical behavior in primary care practices.

Analysis of behavioral risk factor surveillance system data to assess the health of Hispanic Americans with diabetes in El Paso County, Texas.

PubMed

Martinez, Nelda C; Bader, Julia

2007-01-01

The purpose of this study is to determine and describe the health of Hispanic Americans who live in El Paso County, Texas, along the US-Mexico border, particularly the multidimensional self-management practices of those with diabetes. This study also assesses Hispanic Americans with diabetes consistent with Healthy People 2010 diabetes goals and objectives. Data from the 2002 Paso del Norte Behavioral Risk Factor Surveillance System are used for analysis of behavioral health risk factors associated with diabetes among Hispanic Americans in El Paso County, Texas. One- and two-way frequency tables with logistic regression and tests for comparison of means are used for data analysis. The greatest numbers of Hispanic American residents are younger, with those diagnosed with diabetes aged 45 years and older and with lower level of education, lowest income level, and unable to work. The odds of having diabetes are 4 times greater with increasing age and 6 times greater with lower income level. The type of medical treatment is consistent with the frequency of various diabetes self-management behaviors to optimize health. Hispanic Americans are within the goal for several Healthy People 2010 targets for diabetes. Hispanic Americans along the US-Mexico border remain at risk for development of diabetes, although several self-management behavioral activities are recognized as important for prevention of diabetes to optimize quality of life.

Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults

PubMed Central

Guedes, Renata; Azola, Alba; Macrae, Phoebe; Sunday, Kirstyn; Mejia, Veerley; Vose, Alicia; Humbert, Ianessa A.

2017-01-01

Swallowing maneuvers are routinely trained in dysphagia rehabilitation with the assumption that practiced behaviors transfer to functional swallowing, however transfer is rarely examined in the deglutition literature. The goal of this study was to train the volitional laryngeal vestibule closure (vLVC) maneuver, which is a swallowing maneuver that targets prolonged laryngeal vestibule closure (LVC). In two different training experiments, 69 healthy adults underwent Long-hold (hold vLVC as long as possible) or Short-hold vLVC training (hold vLVC for 2 seconds). Before and after vLVC training, natural swallows (swallowing without a therapeutic technique) were completed. The outcome variables included laryngeal vestibule closure reaction time and the duration of laryngeal vestibule closure. Results indicate that during both Long-hold and Short-hold vLVC trainings, vLVC swallows had faster laryngeal vestibule closure reaction times and longer durations of laryngeal vestibule closure than in pre-training 5ml liquid swallows. However, only faster laryngeal vestibule closure reaction times transferred to post-training 5ml liquid swallows (20–24% faster), but not prolonged durations of laryngeal vestibule closure. Our findings suggest that swallowing maneuver training has the potential to induce transfer of what was practiced to functional swallowing behavior, although not all practiced behaviors may generalize. These findings are significant for bolstering the effectiveness of dysphagia management medical settings and should be tested in individuals with dysphagia. PMID:28322908

Examination of swallowing maneuver training and transfer of practiced behaviors to laryngeal vestibule kinematics in functional swallowing of healthy adults.

PubMed

Guedes, Renata; Azola, Alba; Macrae, Phoebe; Sunday, Kirstyn; Mejia, Veerley; Vose, Alicia; Humbert, Ianessa A

2017-05-15

Swallowing maneuvers are routinely trained in dysphagia rehabilitation with the assumption that practiced behaviors transfer to functional swallowing, however transfer is rarely examined in the deglutition literature. The goal of this study was to train the volitional laryngeal vestibule closure (vLVC) maneuver, which is a swallowing maneuver that targets prolonged laryngeal vestibule closure (LVC). In two different training experiments, 69 healthy adults underwent Long-hold (hold vLVC as long as possible) or Short-hold vLVC training (hold vLVC for 2s). Before and after vLVC training, natural swallows (swallowing without a therapeutic technique) were completed. The outcome variables included laryngeal vestibule closure reaction time and the duration of laryngeal vestibule closure. Results indicate that during both Long-hold and Short-hold vLVC trainings, vLVC swallows had faster laryngeal vestibule closure reaction times and longer durations of laryngeal vestibule closure than in pre-training 5ml liquid swallows. However, only faster laryngeal vestibule closure reaction times transferred to post-training 5ml liquid swallows (20-24% faster), but not prolonged durations of laryngeal vestibule closure. Our findings suggest that swallowing maneuver training has the potential to induce transfer of what was practiced to functional swallowing behavior, although not all practiced behaviors may generalize. These findings are significant for bolstering the effectiveness of dysphagia management in medical settings and should be tested in individuals with dysphagia. Copyright © 2017 Elsevier Inc. All rights reserved.

Using Health Information Technology to Improve Adherence to Opioid Prescribing Guidelines in Primary Care

PubMed Central

Zlateva, Ianita; Khatri, Khushbu; Ciaburri, Nicholas

2015-01-01

Objective: To evaluate the impact of a clinical dashboard for opioid analgesic management on opioid prescribing and adherence to opioid practice guidelines in primary care. Methods: A pre/postimplementation evaluation using electronic health record (EHR) data from patients receiving chronic opioid therapy (COT) between April 1, 2011 and March 31, 2013. Measures include annual proportions of COT patients who received urine drug testing, signed an opioid treatment agreement, had a documented assessment of pain-related functional status, and had at least 1 visit with a behavioral health provider. Results: Adherence to several opioid prescribing guidelines improved in the postimplementation year compared with the preimplementation year: (1) the proportions of COT patients with a signed opioid treatment agreement and urine drug testing increased from 49% to 63% and 66% to 86%, respectively. The proportion of COT patients with a documented assessment of functional status increased from 33% to 46% and those with a behavioral health visit increased from 24% to 28%. However, there was a small decline in the proportion of patients prescribed COT from 3.4% to 3.1%. Discussion: Implementation of an opioid dashboard led to increased adherence to certain opioid practice guidelines and a decline in COT. This may be attributable to more efficient team-based pain management facilitated by the dashboard and increased transparency of opioid prescription practices. Health Information Technology solutions such as clinical dashboards can increase adherence to practice guidelines. PMID:25411860

Health Information Management Leaders and the Practice of Leadership through the Lens of Bowen Theory.

PubMed

Sheridan, Patty Thierry; Watzlaf, Valerie; Fox, Leslie Ann

2016-01-01

Even though leadership is one of the most examined topics in the organizational literature, its application in the field of health information management (HIM) has not been studied extensively. This descriptive, mixed-methodology study examined HIM leadership through the lens of Bowen theory. The researchers conducted surveys of HIM directors and managers, administrators and colleagues of HIM leaders, and HIM staff using focus groups, observations of meetings, and face-to-face interviews. Results showed that HIM leaders are valued for HIM expertise in electronic health records, privacy, security, and coding; for being the center or heart of the organization; and for commonly valued leadership behaviors and skills including dependability, strategic planning, project management, listening ability, and fairness. Leadership was seen as a reciprocal process, and a team approach was preferred. Good communication, education, and training on HIM topics were also valued. However, HIM leaders believed that they spend more time on management activities than on leadership activities, although they would prefer the reverse. Future research is needed to examine how HIM leadership can be practiced more consistently in the workplace across different HIM functions.

Greening academia: Developing sustainable waste management at Higher Education Institutions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, N.; Williams, I.D., E-mail: idw@soton.ac.uk; Kemp, S.

Higher Education Institutions (HEIs) are often the size of small municipalities. Worldwide, the higher education (HE) sector has expanded phenomenally; for example, since the 1960s, the United Kingdom (UK) HE system has expanded sixfold to >2.4 million students. As a consequence, the overall production of waste at HEIs throughout the world is very large and presents significant challenges as the associated legislative, economic and environmental pressures can be difficult to control and manage. This paper critically reviews why sustainable waste management has become a key issue for the worldwide HE sector to address and describes some of the benefits, barriers,more » practical and logistical problems. As a practical illustration of some of the issues and problems, the four-phase waste management strategy developed over 15 years by one of the largest universities in Southern England - the University of Southampton (UoS) - is outlined as a case study. The UoS is committed to protecting the environment by developing practices that are safe, sustainable and environmentally friendly and has developed a practical, staged approach to manage waste in an increasingly sustainable fashion. At each stage, the approach taken to the development of infrastructure (I), service provision (S) and behavior change (B) is explained, taking into account the Political, Economic, Social, Technological, Legal and Environmental (PESTLE) factors. Signposts to lessons learned, good practice and useful resources that other institutions - both nationally and internationally - can access are provided. As a result of the strategy developed at the UoS, from 2004 to 2008 waste costs fell by around Pounds 125k and a recycling rate of 72% was achieved. The holistic approach taken - recognizing the PESTLE factors and the importance of a concerted ISB approach - provides a realistic, successful and practical example for other institutions wishing to effectively and sustainably manage their waste.« less

Greening academia: developing sustainable waste management at Higher Education Institutions.

PubMed

Zhang, N; Williams, I D; Kemp, S; Smith, N F

2011-07-01

Higher Education Institutions (HEIs) are often the size of small municipalities. Worldwide, the higher education (HE) sector has expanded phenomenally; for example, since the 1960s, the United Kingdom (UK) HE system has expanded sixfold to >2.4 million students. As a consequence, the overall production of waste at HEIs throughout the world is very large and presents significant challenges as the associated legislative, economic and environmental pressures can be difficult to control and manage. This paper critically reviews why sustainable waste management has become a key issue for the worldwide HE sector to address and describes some of the benefits, barriers, practical and logistical problems. As a practical illustration of some of the issues and problems, the four-phase waste management strategy developed over 15 years by one of the largest universities in Southern England--the University of Southampton (UoS)--is outlined as a case study. The UoS is committed to protecting the environment by developing practices that are safe, sustainable and environmentally friendly and has developed a practical, staged approach to manage waste in an increasingly sustainable fashion. At each stage, the approach taken to the development of infrastructure (I), service provision (S) and behavior change (B) is explained, taking into account the Political, Economic, Social, Technological, Legal and Environmental (PESTLE) factors. Signposts to lessons learned, good practice and useful resources that other institutions--both nationally and internationally--can access are provided. As a result of the strategy developed at the UoS, from 2004 to 2008 waste costs fell by around £125k and a recycling rate of 72% was achieved. The holistic approach taken--recognizing the PESTLE factors and the importance of a concerted ISB approach--provides a realistic, successful and practical example for other institutions wishing to effectively and sustainably manage their waste. Copyright © 2011 Elsevier Ltd. All rights reserved.

The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model.

PubMed

Williams, Leanne M; Pines, Adam; Goldstein-Piekarski, Andrea N; Rosas, Lisa G; Kullar, Monica; Sacchet, Matthew D; Gevaert, Olivier; Bailenson, Jeremy; Lavori, Philip W; Dagum, Paul; Wandell, Brian; Correa, Carlos; Greenleaf, Walter; Suppes, Trisha; Perry, L Michael; Smyth, Joshua M; Lewis, Megan A; Venditti, Elizabeth M; Snowden, Mark; Simmons, Janine M; Ma, Jun

2018-02-01

Precision medicine models for personalizing achieving sustained behavior change are largely outside of current clinical practice. Yet, changing self-regulatory behaviors is fundamental to the self-management of complex lifestyle-related chronic conditions such as depression and obesity - two top contributors to the global burden of disease and disability. To optimize treatments and address these burdens, behavior change and self-regulation must be better understood in relation to their neurobiological underpinnings. Here, we present the conceptual framework and protocol for a novel study, "Engaging self-regulation targets to understand the mechanisms of behavior change and improve mood and weight outcomes (ENGAGE)". The ENGAGE study integrates neuroscience with behavioral science to better understand the self-regulation related mechanisms of behavior change for improving mood and weight outcomes among adults with comorbid depression and obesity. We collect assays of three self-regulation targets (emotion, cognition, and self-reflection) in multiple settings: neuroimaging and behavioral lab-based measures, virtual reality, and passive smartphone sampling. By connecting human neuroscience and behavioral science in this manner within the ENGAGE study, we develop a prototype for elucidating the underlying self-regulation mechanisms of behavior change outcomes and their application in optimizing intervention strategies for multiple chronic diseases. Copyright © 2017. Published by Elsevier Ltd.

Clinical features and multidisciplinary approaches to dementia care

PubMed Central

Grand, Jacob HG; Caspar, Sienna; MacDonald, Stuart WS

2011-01-01

Dementia is a clinical syndrome of widespread progressive deterioration of cognitive abilities and normal daily functioning. These cognitive and behavioral impairments pose considerable challenges to individuals with dementia, along with their family members and caregivers. Four primary dementia classifications have been defined according to clinical and research criteria: 1) Alzheimer’s disease; 2) vascular dementias; 3) frontotemporal dementias; and 4) dementia with Lewy bodies/Parkinson’s disease dementia. The cumulative efforts of multidisciplinary healthcare teams have advanced our understanding of dementia beyond basic descriptions, towards a more complete elucidation of risk factors, clinical symptoms, and neuropathological correlates. The characterization of disease subtypes has facilitated targeted management strategies, advanced treatments, and symptomatic care for individuals affected by dementia. This review briefly summarizes the current state of knowledge and directions of dementia research and clinical practice. We provide a description of the risk factors, clinical presentation, and differential diagnosis of dementia. A summary of multidisciplinary team approaches to dementia care is outlined, including management strategies for the treatment of cognitive impairments, functional deficits, and behavioral and psychological symptoms of dementia. The needs of individuals with dementia are extensive, often requiring care beyond traditional bounds of medical practice, including pharmacologic and non-pharmacologic management interventions. Finally, advanced research on the early prodromal phase of dementia is reviewed, with a focus on change-point models, trajectories of cognitive change, and threshold models of pathological burden. Future research goals are outlined, with a call to action for social policy initiatives that promote preventive lifestyle behaviors, and healthcare programs that will support the growing number of individuals affected by dementia. PMID:21655340

Translating Research to Practice for Children With Autism Spectrum Disorder: Part I: Definition, Associated Behaviors, Prevalence, Diagnostic Process, and Interventions.

PubMed

Johnson, Norah L; Burkett, Karen; Reinhold, Judy; Bultas, Margaret W

2016-01-01

The number of children with autism spectrum disorder (ASD) is rising, along with the potential for challenging behaviors during health care encounters. We present an overview of the emerging science related to ASD diagnosis and interventions for children with ASD. Emerging science on ASD reveals common associated challenging behaviors, increasing prevalence, emphasis on early diagnosis at 18 to 24 months of age, changes in the diagnostic process with criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, and interventions with medication, education, and behavior management. Family and health care provider preparation strategies facilitate care of children with ASD and their families. Early diagnosis at 18 to 24 months of age and evidence-based interventions contribute to best outcomes for children and families. Health care providers must be aware of the state of the science for diagnosis and best practices to provide family-centered care for this growing population. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Behavioral health support and online peer communities: international experiences

PubMed Central

Harding, Claire

2016-01-01

Online peer support communities play an important part in many people’s experience of healthcare. They can be particularly significant in behavioral health/mental health due to the difficulties that people may experience in accessing face to face care for these conditions. There is considerable diversity of practice in service management, target group, and moderation practices of online peer support communities. People using the communities also appear to have diverse aims and experiences. This heterogeneity contributes to a relative lack of data about the value and effectiveness of online peer support in behavioral health, although there is significant research into some aspects of these communities. The digital behavioral health service Big White Wall was launched in the UK in 2007, and in the US in 2015, and is focused on delivering moderated peer support. There are considerable differences in health systems between the two countries, and this has been reflected in different experiences of implementation. The value of online peer support could be maximized if systemic challenges to implementation and adoption were addressed more effectively. PMID:28293613

Foodservice employees benefit from interventions targeting barriers to food safety.

PubMed

York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

2009-09-01

The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

Treatment Practices and Outcomes of Meibomian Gland Dysfunction at a Tertiary Center in Southern India.

PubMed

Lee, Ling; Garrett, Qian; Flanagan, Judith L; Vaddavalli, Pravin K; Papas, Eric B

2016-12-19

To describe the current treatment practices for meibomian gland dysfunction (MGD) at a tertiary eye center, together with the subjective outcomes and compliance behaviors of patients. This retrospective cohort study reviewed medical records for MGD severity grading, treatment prescribed, and follow-up schedule. In addition, participants were surveyed to gauge subjective outcomes and treatment adherence. Eight hundred ten patients were diagnosed with "MGD" or "meibomitis" and had a total of 14 different treatment combinations prescribed. In 3.0% of cases, there was no treatment specified. As MGD severity increased, it became more likely that management would be applied and this was also associated with significantly longer treatment durations (P=0.02) and shorter follow-up periods (P<0.001). Posttreatment subjective outcomes and treatment adherence surveys had a response rate of 36.7% and 24.1% respectively. Overall, 53.5% reported sustained improvement, 40.7% no improvement, and 5.7% experienced temporary relief. Although no treatment regimen seemed to be more efficacious than others, patients showed greater adherence when using topical reagents compared with lid hygiene measures (P≤0.002). Clinicians, in this large tertiary eye center, use a wide range of treatment regimens to manage MGD. This suggests the need for development of standard management protocols. Whether alone, or in combination, no MGD treatment significantly improved subjective symptoms, a result that may be influenced by compliance behaviors. Use of topical reagents (eye drops or ointment) seemed to be associated with the best compliance. Future focus on more effective MGD treatments is needed to improve practical outcomes.

Social media and nutrition education: the food hero experience.

PubMed

Tobey, Lauren N; Manore, Melinda M

2014-01-01

Social media can be a quick, low-cost, direct way for nutrition educators to broaden the scope of their targeted programs. The authors' viewpoint is that for social media to be effective, strategies for its use should follow "best practices" guidelines. This viewpoint suggests social media best practices based on experience gained from the Food Hero social marketing campaign. Understanding of how nutrition educators can take advantage of social media as a new mechanism for reaching their target audience is needed, including best practices for implementation, management, and evaluation. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Serum cholesterol: attitudes and behavior of family practice residents.

PubMed

Kelly, R B; Velez-Holvino, O; Alemagno, S A

1991-09-01

Given the current health promotion efforts regarding coronary artery disease, more information is needed about residents' attitudes and behaviors that relate to identification and management of patients with elevated serum cholesterol levels. Family practice residents from eight US programs (N = 128) were surveyed in 1989 to assess their attitudes and reported practice patterns. Resident survey data were compared, when feasible, to published data from 1986 and 1990 surveys of practicing physicians performed by the National Heart, Lung, and Blood Institute. The use of faculty "key contacts" resulted in a 90% response rate (N = 115). Both residents and practicing physicians attributed a high degree of importance to cholesterol as a risk factor. Residents reported more frequent routine screening of middle-aged men than the routine screening rate of practicing physicians in 1986 (P less than .01). Residents reported less frequent screening of younger and older adults than of middle-aged men (P less than .001). Residents' threshold for the use of cholesterol-lowering medication was lower than that of practicing physicians surveyed in 1986, but higher than that of physicians surveyed in 1990. Compared with practicing physicians, residents did not believe they were as well prepared to counsel patients about dietary change or as successful when they tried to help patients make changes; residents reported a significantly higher rate of referral to dietitians (P less than .01). Residents may need more education regarding screening guidelines for children and young adults. A health promotion skills gap may exist that explains reported discrepancies between self-report and actual behavior and indicates that residency educators may need to pay more attention to fostering dietary assessment and counseling skills in their residents.

Effective Management of Pain and Anxiety for the Pediatric Patient in the Emergency Department.

PubMed

Young, Virginia B

2017-06-01

Inadequate treatment of pain for children in the emergency department is a persistent problem. Health care professionals are bound by ethical principles to provide adequate pain management; in children, this may be challenging owing to cognitive and developmental differences, lack of knowledge regarding best practices, and other barriers. Studies have concluded that immediate assessment, treatment, and reassessment of pain after an intervention are essential. Self-report and behavioral scales are available. Appropriate management includes pharmacologic and nonpharmacologic interventions. Specific diagnoses (eg, abdominal pain or traumatic injuries) have been well-studied and guidance is available to maximize efforts in managing the associated pain. Copyright © 2017 Elsevier Inc. All rights reserved.

Towards adaptive and integrated management paradigms to meet the challenges of water governance.

PubMed

Halbe, J; Pahl-Wostl, C; Sendzimir, J; Adamowski, J

2013-01-01

Integrated Water Resource Management (IWRM) aims at finding practical and sustainable solutions to water resource issues. Research and practice have shown that innovative methods and tools are not sufficient to implement IWRM - the concept needs to also be integrated in prevailing management paradigms and institutions. Water governance science addresses this human dimension by focusing on the analysis of regulatory processes that influence the behavior of actors in water management systems. This paper proposes a new methodology for the integrated analysis of water resources management and governance systems in order to elicit and analyze case-specific management paradigms. It builds on the Management and Transition Framework (MTF) that allows for the examination of structures and processes underlying water management and governance. The new methodology presented in this paper combines participatory modeling and analysis of the governance system by using the MTF to investigate case-specific management paradigms. The linking of participatory modeling and research on complex management and governance systems allows for the transfer of knowledge between scientific, policy, engineering and local communities. In this way, the proposed methodology facilitates assessment and implementation of transformation processes towards IWRM that require also the adoption of adaptive management principles. A case study on flood management in the Tisza River Basin in Hungary is provided to illustrate the application of the proposed methodology.

Minority and Immigrant Youth Exposure to Community Violence: The Differential Effects of Family Management and Peers.

PubMed

Antunes, Maria João Lobo; Ahlin, Eileen M

2018-02-01

Experiences with neighborhood violence can produce negative consequences in youth, including stress, anxiety, and deviant behavior. Studies report that immigrant and minority youth are more likely to be exposed to violence but less likely to perpetrate it. Similarly, research shows parenting practices are differentially adopted by Blacks, Whites, and Hispanics. Although family management strategies can often act as a barrier to the detrimental effects of exposure to community violence (ETV-C), there is a paucity of investigation on how Hispanic subgroups (e.g., Puerto Rican, Mexican) and immigrant families employ such practices in protecting their children against victimization and violence in the community. Applying an ecological framework, we use data from the Project on Human Development in Chicago Neighborhoods to examine the role of parenting and peer relationships on youth ETV-C, across race/ethnicity and immigrant generational status. Our sample is drawn from Cohorts 9, 12, and 15, and is over 40% Hispanic-Latino. We investigate the differences in within and outside the home family management strategies in terms of both race/ethnicity and immigrant generational status. Our work also seeks to determine the effects of race/ethnicity and immigrant status on youth ETV-C, while examining the influence of family management and peer relations. Results indicate that the adoption of family management practices is not homogeneous across Hispanic subgroups or immigrant generational status, and parenting practices seem to mediate the relationship between these characteristics and exposure to violence. Variations in parenting practices underscore the need to disentangle the cultural plurality of racial/ethnic grouping and how immigrant generational status influences parenting choices that protect children from exposure to violence in the community.

Examining the Echolalia Literature: Where Do Speech-Language Pathologists Stand?

PubMed

Stiegler, Lillian N

2015-11-01

Echolalia is a common element in the communication of individuals with autism spectrum disorders. Recent contributions to the literature reflect significant disagreement regarding how echolalia should be defined, understood, and managed. The purpose of this review article is to give speech-language pathologists and others a comprehensive view of the available perspectives on echolalia. Published literature from the disciplines of behavioral intervention, linguistics, and speech-language intervention is discussed. Special areas of focus include operational definitions, rationales associated with various approaches, specific procedures used to treat or study echolalic behavior, and reported conclusions. Dissimilarities in the definition and understanding of echolalia have led to vastly different approaches to management. Evidence-based practice protocols are available to guide speech-language interventionists in their work with individuals with autism spectrum disorders.

Health of Gullah families in South Carolina with Type 2 diabetes: Diabetes self-management analysis from Project SuGar

PubMed Central

Johnson-Spruill, Ida; Pamela, Hammond; Davis, Bertha; McGee, Zina; Louden, Dr. Delroy

2009-01-01

Purpose The purpose of this study was to describe diabetes self-management practices and service utilization among Gullah families in South Carolina. Methods Data were obtained from 1,276 persons with type 2 diabetes through interviews using the Family Health History Questionnaire. This was a primary analysis of a project conducted in conjunction with a parent study (Project SuGar) which focused on the molecular aspects of diabetes. Descriptive statistics were used for data analysis. Results Diabetes self-management behaviors were not consistent with recommendations from the American Diabetes Association. Over half (55.6%) reported exercising, but only 27.7% reported self-glucose monitoring. Service utilization was poor, less than half, (41.1%) reported referral to a diabetic class/diet, 32.8% reported making yearly visits to the ophthalmologist; 22.3% reported visiting the dentist, and only 12.8% reported visiting the podiatrist. Conclusions Although some self-management behaviors were identified, Gullah family members remain at risk for preventable diabetes complications. Education must reflect behaviors and beliefs valued by Gullah individuals. Culturally appropriate educational programs may increase use of health care services aimed at decreasing preventable complications of type 2diabetes in the Gullah population. PMID:19244567

Health perceptions and behaviors of school-age boys and girls.

PubMed

Graham, M V; Uphold, C R

1992-01-01

This study described and compared the health perceptions and behaviors of 83 school-age boys and girls. An age-appropriate interview schedule was designed to collect data related to demographic characteristics, health perceptions, safety, life-style practices, nutrition, dental health, and care of minor injuries. Findings indicated that most boys and girls viewed themselves as healthy and managed their own care fairly well in the areas of seat belt use, exercise, and dental health. Nutrition was identified as an area of concern, with 10% of the children skipping breakfast, and over half eating snacks with empty calories. Generally, children were found to be knowledgeable in the management of simple injuries and how to respond in the event of an emergency. Boys and girls were similar in all areas of health perceptions and behaviors except for dental health, with boys reporting more regular visits to the dentist than did girls. Further research is needed to learn more about the process by which school-age children acquire positive health behaviors to assist nurses to design and implement intervention programs that appropriately address the needs of this age group.