Determining a patient's comfort in inquiring about healthcare providers' hand-washing behavior.

PubMed

Clare, Camille A; Afzal, Omara; Knapp, Kenneth; Viola, Deborah

2013-06-01

To determine whether a patient's level of assertiveness and other factors influences her comfort level in asking her provider to wash his or her hands. In this pilot study, we developed a survey to gather cross-sectional information on a variety of factors that might explain patient willingness to ask her health-care provider to wash his or her hands. Three primary predictor variables are analyzed: (1) patient assertiveness; (2) patient familiarity with her healthcare provider; and (3) whether the patient has observed hand-washing behavior. Fifty patients participated from the Obstetrics and Gynecology Department of Metropolitan Hospital Center. Less assertive patients are much less likely than assertive patients to ask physicians to wash hands (25% versus 68%; Fisher's exact test P = 0.0427). Among the 3 assertiveness questions included in the survey, the ability to ask physicians questions during visits is most strongly indicative of willingness to ask about hand washing. Familiarity with the names of regular health-care providers has a statistically significant impact on willingness to ask about hand washing. Evidence suggests that observing hand washing behavior affects willingness to ask, but differences are not statistically significant. Results by socioeconomic status such as age, education, income, and race/ethnicity are inconclusive. A patient's level of assertiveness alone is not sufficient to determine her willingness to inquire about the hand-washing behavior of her provider. A high percentage of patients did not see their provider engaging in adequate hand washing behavior. If patients feel comfortable with their provider to inquire about their care and request hand-washing behavior, health outcomes are affected by reducing the rates of health care-associated infections.

Agoraphobics' interpersonal problems. Their role in the effects of exposure in vivo therapy.

PubMed

Emmelkamp, P M

1980-11-01

The effects of self-controlled exposure in vivo therapy were compared between assertive and unassertive agoraphobics and between agoraphobics with high and low marital satisfaction. Assessments were made at the pretest, at the posttest after four therapy sessions, and at the follow-up one month later. Assessments were carried out by the therapist, by an independent observer, and by the patient. No significant differences were found between the groups with high and low marital satisfaction. The only significant difference between the groups with high and low assertiveness was shown at the posstest by the phobic anxiety scale; compared with high assertive patients, low assertive patients improved more.

Involuntary admission may support treatment outcome and motivation in patients receiving assertive community treatment.

PubMed

Kortrijk, Hans Erik; Staring, A B P; van Baars, A W B; Mulder, C L

2010-02-01

Patients with severe mental illness who are treated in assertive community treatment (ACT) teams are sometimes involuntarily admitted when they are dangerous to themselves or others, and are not motivated for treatment. However, the consequences of involuntary admission in terms of psychosocial outcome and treatment motivation are largely unknown. We hypothesized that involuntary admission would improve psychosocial outcome and not adversely affect their treatment motivation. In the context of routine 6-monthly outcome monitoring in the period January 2003-March 2008, we used the Health of the Nation Outcome Scales (HoNOS) and a motivation-for-treatment scale to assess 260 severely mentally ill patients at risk for involuntary admission. Mixed models with repeated measures were used for data analyses. During the observation period, 77 patients (30%) were involuntarily admitted. Relative to patients who were not involuntarily admitted, these patients improved significantly in HoNOS total scores (F = 17,815, df = 1, p < 0.001) and in motivation for treatment (F = 28.139, df = 1, p < 0.001). Patients who were not involuntarily admitted had better HoNOS and motivation scores at baseline, but did not improve. Involuntary admission in the context of ACT was associated with improvements in psychosocial outcome and motivation for treatment. There are no indications that involuntary admission leads to deterioration in psychosocial outcome or worsening of motivation for treatment.

The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review.

PubMed

Omura, Mieko; Maguire, Jane; Levett-Jones, Tracy; Stone, Teresa Elizabeth

2017-11-01

Communication errors have a negative impact on patient safety. It is therefore essential that healthcare professionals have the skills and confidence to speak up assertively when patient safety is at risk. Although the facilitators to and barriers of assertive communication have been the subject of previous reviews, evidence regarding the effectiveness of interventions designed to enhance assertive communication is lacking. Thus, this paper reports the findings from a systematic review of the effectiveness of assertiveness communication training programs for healthcare professionals and students. The objective of this review is to identify, appraise and synthesise the best available quantitative evidence in relation to the effectiveness of assertiveness communication training programs for healthcare professionals and students on levels of assertiveness, communication competence and impact on clinicians' behaviours and patient safety. The databases included: CINAHL, Cochrane library, EMBASE, Informit health collection, MEDLINE, ProQuest nursing and allied health, PsycINFO, Scopus and Web of Science. The search for unpublished studies included: MedNar, ProQuest Dissertations & Theses A&I. Studies published in English from 2001 until 2016 inclusive were considered. The review included original quantitative research that evaluated (a) any type of independent assertiveness communication training program; and (b) programs with assertiveness training included as a core component of team skills or communication training for healthcare professionals and students, regardless of healthcare setting and level of qualification of participants. Studies selected based on eligibility criteria were assessed for methodological quality and the data were extracted by two independent researchers using the Joanna Briggs Institute critical appraisal and data extraction tools. Eleven papers were critically appraised using the Joanna Briggs Institute critical appraisal checklists. Eight papers from the USA, Australia, Ireland, and Taiwan were included in the review. Interventions to improve assertive communication were reported to be effective to some degree with all targeted groups except experienced anaesthesiologists. Face-to-face and multimethod programs, support from leaders, teamwork skills training and communication techniques adapted from the aviation industry were identified as appropriate approaches for optimising the effectiveness of assertiveness communication training programs. Behavioural change as the result of assertiveness interventions was evaluated by observer-based rating scales during simulation, whilst self-perceived knowledge and attitudes were evaluated using validated scales. Future research should consider evaluation of sustained effect on behaviour change and patient safety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Are Hypertensives Less Assertive? A Controlled Evaluation.

ERIC Educational Resources Information Center

Keane, Terence M.; And Others

1982-01-01

Assessed the performance of hypertensive patients in increasingly demanding interpersonal interactions. Twelve extended role-played scenes were employed. Results indicated that the hypertensive patients responded less assertively than the nonpatient comparison group. However, the performance of the normotensive patient group was similar to that of…

A Tool to Teach Communication Skills to Pharmacy Students

PubMed Central

2008-01-01

Objective To develop a tool to teach pharmacy students assertive communication skills to use when talking with physicians over the telephone. Design As an assignment for their Communication Skills and Counseling course, students were asked to write a script involving a patient care issue or problem covering 3 different communication styles that could be used when contacting a prescriber by telephone: passive, aggressive, and assertive. Students worked in groups to write and act out the scripts for the class. Assessment Eight scripts were developed by students and rated by peers and faculty members. The script that received the highest ratings was used in the development of a multimedia educational CD. Conclusion The development of hypothetical scripts describing a drug therapy problem and illustrating the types of interactions between physicians and pharmacists while discussing the problem allowed pharmacy students to explore different communication techniques and improve their communication skills. PMID:18698394

Staff's perceptions of voluntary assertiveness skills training.

PubMed

McVanel, Sarah; Morris, Beth

2010-01-01

Clinicians' ability to be assertive when unsure or concerned about procedures, treatment modalities, or patients' symptoms is key in reducing risk and preventing sentinel events. In this article, the authors provide a framework for generic, voluntary assertiveness communication skills workshops that any educator can implement.

Influence of social competence of physicians on patient compliance with osteoporosis medications--a study on Polish postmenopausal women.

PubMed

Bryl, Nadia; Horst-Sikorska, Wanda; Ignaszak-Szczepaniak, Magdalena; Marcinkowska, Michalina; Michalak, Michał; Sewerynek, Ewa

2012-07-01

The aim of the study was to examine the impact of social competence of physicians on the effectiveness of patient compliance and persistence with therapy. The study included physicians and their patients, previously diagnosed with osteoporosis, and eligible to receive pharmacological treatment. The physicians were evaluated with the social competence questionnaire involving three dimensions: social exposure, intimacy and assertiveness, as well as in the combined scale. All patients in the study group were prescribed the same medication: alendronate once a week. Compliance and persistence of the patients were juxtaposed with social interaction skills of physicians during 7 scheduled appointments at 2-month intervals. Doctor's effectiveness in situations demanding close interpersonal contact was higher in the group with good compliance--group A (p < 0.001), as well as in the situations of social exposure, (p < 0.001). On the other hand, their assertiveness was higher in the group with poor compliance--group B (p < 0.001). Co-morbid conditions (group A: 76%, group B: 74%), as well as earlier fractures (40.43% vs. 36.78%) were comparable in both groups. Disease acceptance and suggested methods of treatment were more often accepted by patients from group A than group B (56% vs. 33%, respectively). (1) Disease acceptance is essential for effective treatment. (2) Social skills of physicians influence patient adherence to therapy recommendations. (3) Close interpersonal contact between physicians and their patients eliminates the feeling of fear and

Effects of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients.

PubMed

Silverman, Michael J

2011-01-01

The purpose of this study was to implement and measure the effectiveness of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients. Participants (N=133) were randomly assigned by group to one of three conditions: (a) Assertiveness Music Therapy, (b) No Music Assertiveness, or (c) Music No Assertiveness. Participants in both assertiveness conditions role played a number of different commonly occurring scenarios at an inpatient psychiatric facility and in the community. There were no significant between-group differences in posttest quality of life, locus of control, or other subscales. However, participants in both assertiveness conditions tended to have slightly higher internal locus of control and overall quality of life scores than participants in the music no assertiveness condition. Additionally, the assertiveness music therapy condition had higher attendance rates than the other conditions. A higher percentage of participants from both the assertiveness music therapy and music no assertiveness conditions indicated they thought their session was the most helpful/therapeutic group therapy session in which they had participated; this was not the case for the assertiveness no music condition. Future research is warranted to measure the effects of protocols that can help psychiatric patients generalize skills learned in treatment.

Personality correlates of obese eating behaviour: Swedish universities Scales of Personality and the Three Factor Eating Questionnaire.

PubMed

Elfhag, K

2005-12-01

To study the relationship between personality characteristics and eating behaviour in obese patients. The participants were 45 patients with a mean body mass index (BMI) of 39 kg/m2. Eating behaviour was measured with the Three Factor Eating Questionnaire (TFEQ) also taking the subscales Flexible Control and Rigid Control into account, and Personality was assessed with the Swedish universities Scales of Personality (SSP). In linear regression analyses the personality characteristic greater Lack of Assertiveness could explain 17% of Disinhibited eating and 13% of Hunger scores, whereas less Lack of Assertiveness could explain 12% of Flexible Control. BMI was negatively related to one of the personality characteristics, Adventure Seeking. A lacking ability to be socially self-assertive and confident characterized obese patients with more problematic eating behaviours that imply a risk for over consumption of food. A greater self-assertiveness was found in patients with a relatively more efficient eating strategy such as flexible control over eating.

Assertive community treatment for elderly people with severe mental illness

PubMed Central

2010-01-01

Background Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. Methods We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. Discussion This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. Trial Registration The Netherlands National Trial Register NTR1620 PMID:20958958

Assertive community treatment for elderly people with severe mental illness.

PubMed

Stobbe, Jolanda; Mulder, Niels C L; Roosenschoon, Bert-Jan; Depla, Marja; Kroon, Hans

2010-10-19

Adults aged 65 and older with severe mental illnesses are a growing segment of the Dutch population. Some of them have a range of serious problems and are also difficult to engage. While assertive community treatment is a common model for treating difficult to engage severe mental illnesses patients, no special form of it is available for the elderly. A special assertive community treatment team for the elderly is developed in Rotterdam, the Netherlands and tested for its effectiveness. We will use a randomized controlled trial design to compare the effects of assertive community treatment for the elderly with those of care as usual. Primary outcome measures will be the number of dropouts, the number of patients engaged in care and patient's psychiatric symptoms, somatic symptoms, and social functioning. Secondary outcome measures are the number of unmet needs, the subjective quality of life and patients' satisfaction. Other secondary outcomes include the number of crisis contacts, rates of voluntary and involuntary admission, and length of stay. Inclusion criteria are aged 65 plus, the presence of a mental disorder, a lack of motivation for treatment and at least four suspected problems with functioning (addiction, somatic problems, daily living activities, housing etc.). If patients meet the inclusion criteria, they will be randomly allocated to either assertive community treatment for the elderly or care as usual. Trained assessors will use mainly observational instruments at the following time points: at baseline, after 9 and 18 months. This study will help establish whether assertive community treatment for the elderly produces better results than care as usual in elderly people with severe mental illnesses who are difficult to engage. When assertive community treatment for the elderly proves valuable in these respects, it can be tested and implemented more widely, and mechanisms for its effects investigated. The Netherlands National Trial Register NTR1620.

New cure or same old story? International (Africa).

PubMed

1996-03-25

In Kenya, Professor Arthur Obel claimed that he has discovered a wonder drug, Pearl Omega, which can reverse HIV-positive status in some patients. In response to criticism, Obel modified his claim to assert that his drug alleviates the suffering of AIDS patients and prolongs their lives. Obel refused to provide proof that 7 of 32 HIV-positive patients who received Pearl Omega had become seronegative. While the Kenyan government supports local initiatives in the world-wide search for a cure for AIDS, it insists that all drugs being used to treat the disease undergo rigorous testing. With 5% of the Kenyan population believed to be HIV positive, medical authorities expect that the Pearl Omega debate is far from over.

Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark: 4-year register-based follow-up.

PubMed

Hastrup, Lene Halling; Aagaard, Jørgen

2015-02-01

Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. The study was based on a quasi-experimental design with a control group from the neighbouring region. Costs and retention in mental health services were analysed by using register data 1 year before and 4 years after inclusion in the study. Data on the use of supportive housing were available for the year before baseline and the subsequent 2 years only. Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P < 0.17). Days in supportive housing were lower for the ACT group before baseline and remained so (dropping to zero) for the subsequent 2 years. Over 4 years, the mean total costs per patient in the group receiving ACT were DDK 493,442 (SE = 34,292). Excluding costs of supportive housing, the mean total costs per patient of the control group were DDK 537,218 (SE = 59,371), P < 0.53. If these costs are included, however, the mean total costs for the ACT group are unchanged, whereas costs for the control group rise to DDK 671,500 (SE = 73,671), P < 0.03. While ACT appears to have resulted in a significant reduction in costs for psychiatric hospitalizations, baseline differences in use of supportive housing make the effects of ACT on overall costs more ambiguous. At worst, however, overall costs did not increase. Given the generally acknowledged clinical benefits of ACT over standard outpatient care, the results support further dissemination of ACT in Denmark.

Relationship satisfaction in women: a longitudinal case-control study about the role of breast cancer, personal assertiveness, and partners' relationship-focused coping.

PubMed

Hinnen, Chris; Hagedoorn, Mariët; Ranchor, Adelita V; Sanderman, Robbert

2008-11-01

The aim of this study was to investigate whether a breast cancer diagnosis, personal assertiveness (i.e. frequency of assertive behaviour and tension associated with this behaviour), and partners' relationship-focused coping (i.e. active engagement and protective buffering) were sources of variation in patients' relationship satisfaction, cross-sectionally and over time. This longitudinal case-control study assessed the two dimensions of personal assertiveness and relationship satisfaction in both women with cancer (N=72) and comparison controls (N=62). In addition, patients completed a measure assessing their partners' active engagement and protective buffering. Cases (i.e. women with breast cancer) were not found to report more relationship problems than controls. Women with breast cancer who tended not to express their concerns and feelings and who experienced much tension when they did, reported relatively low marital satisfaction. Moreover, partners' protective buffering was associated with less relationship satisfaction in especially more assertive (i.e. high frequency of assertive behaviour and low tension) women with cancer, while active engagement was associated with more relationship satisfaction, regardless of the women's personal assertiveness. The results of the present study indicate that a breast cancer diagnosis by itself may not be a risk factor for relationship problems. However, in the context of an illness such as cancer, personal assertiveness, and a partner's relationship-focused coping strategies do seem to play a role in maintaining a satisfactory relationship with one's partner.

Development and evaluation of a modified brief assertiveness training for nurses in the workplace: a single-group feasibility study.

PubMed

Nakamura, Yohei; Yoshinaga, Naoki; Tanoue, Hiroki; Kato, Sayaka; Nakamura, Sayoko; Aoishi, Keiko; Shiraishi, Yuko

2017-01-01

Effective communication has a great impact on nurses' job satisfaction, team relationships, as well as patient care/safety. Previous studies have highlighted the various beneficial effects of enhancing communication through assertiveness training programs for nurses. However, most programs take a long time to implement; thus, briefer programs are urgently required for universal on-the-job-training in the workplace. The purpose of this feasibility study was to develop and evaluate a modified brief assertiveness training program (with cognitive techniques) for nurses in the workplace. This study was carried out as a single-group, open trial (pre-post comparison without a control group). Registered nurses and assistant nurses, working at two private psychiatric hospitals in Miyazaki Prefecture in Japan, were recruited. After enrolling in the study, participants received a program of two 90-min sessions with a 1-month interval between sessions. The primary outcome was the Rathus Assertiveness Schedule (RAS), with secondary measurements using the Brief Version of the Fear of Negative Evaluation Scale (BFNE) and the Brief Job Stress Questionnaire (BJSQ). Assessments were conducted at baseline and after a 1-month interval (pre- and post-intervention). A total of 22 participants enrolled in the study and completed the program. The mean total score on the primary outcome (RAS) significantly improved from -12.9 (SD = 17.2) to -8.6 (SD = 18.6) ( p  = 0.01). The within-group effect size at the post-intervention was Cohen's d = 0.24; this corresponds to the small effect of the program. Regarding secondary outcomes, there were no statistically significant effects on the BFNE or any of the BJSQ subscales (job-stressors, psychological distress, physical distress, worksite support, and satisfaction). This single-group feasibility study demonstrated that our modified brief assertiveness training for nurses seems feasible and may achieve a favorable outcome in improving their assertiveness. Further controlled trials with longer follow-up periods are required in order to address the limitations of this study.

Effects of Assertiveness Training and Expressive Writing on Acculturative Stress in International Students: A Randomized Trial

PubMed Central

Tavakoli, Shedeh; Lumley, Mark A.; Hijazi, Alaa M.; Slavin-Spenny, Olga M.; Parris, George P.

2010-01-01

International university students often experience acculturative stress, and culturally appropriate techniques to manage stress are needed. This randomized trial tested the effects of group assertiveness training, private expressive writing, their combination, and a wait-list control on the acculturative stress, affect, and health of 118 international students at an urban, American university. Interventions were conducted at the start of a semester, and assessments were conducted at baseline and the end of the semester. Group assertiveness training was rated positively by students and led to lower negative affect, whereas expressive writing was less well received and led to higher homesickness and fear, but also higher positive affect. The combined intervention had no effects, perhaps because the two components negated each other. It is concluded that group assertiveness training improves emotional adjustment of international students, but expressive writing has mixed effects and needs further development and study. PMID:20357910

[Between anxiety and depression. The status of assertiveness disorders and social phobias].

PubMed

Granger, B; Azais, F; Albercque, C; Debray, Q

1995-05-01

The authors try to answer the question of the nosological status of social phobias and assertiveness difficulties, which are usually included in the large group of anxious troubles. The correlation between Rathus Rating Scale, Hamilton Depression Rating Scale (HDRS) and sub-scores of HDRS were studied in two populations; the first one was constituted by anxious and/or depressed patients, the second, extracted from the first one, by anxious patients only. The results show that lack of assertiveness has probably both affective and anxious components. These results are important from a nosological and therapeutic point of view.

The Relationship Between Cultural Sensitivity and Assertiveness in Nursing Students from Turkey.

PubMed

Kılıç, Serap Parlar; Sevinç, Sibel

2018-07-01

As foreigners live in and visit Turkey for various reasons, it is essential to provide culturally appropriate health care. This study was conducted to determine the relationship between cultural sensitivity and assertiveness in university nursing students. This descriptive, cross-sectional study was conducted at two universities in the cities of Kilis and Elazığ, Turkey. The study sample consisted of 444 nursing students. Data collection tools included a questionnaire about participant sociodemographic characteristics, Chen and Starosta's Intercultural Sensitivity Scale, and the Rathus Assertiveness Scale. The mean age of participants was 21.09 years. Most students (71.6%) were female and 34.7% of the students stayed at the hostel. Of the students, 44.4%, 27.5%, and 28.2% attended were the second-, third-, and fourth-year students, respectively. Participants were asked about problems related to caring for patients who speak different languages. The mean score for the Intercultural Sensitivity Scale was 89.42 ± 13.55 and the total score for all students for the Assertiveness Scale was 112.64 ± 15.61. We identified a positive relationship between total scores for the Intercultural Sensitivity Scale and the Assertiveness Scale ( p < .001). There was relationship between cultural sensitivity and gender and want to work overseas; assertiveness and year of nursing education and want to work overseas. Nursing students at both schools had a moderate level of cultural sensitivity and assertiveness. It has been determined that as assertiveness level of the students increased, intercultural sensitivity of them also increased. Consequently, it is concluded that training as assertive and self-confident individuals during the nursing education of students has a contribution to making patient-specific and culture-sensitive care.

An exploratory study of sexual assertiveness and characteristics of African American women in negotiating condom use at an HBCU.

PubMed

Jenkins, Chalice C; Kennedy, Bernice Roberts

2013-01-01

The transmission of HIV/AIDS among African American women through heterosexual sex is an epidemic. Critical themes extracted from the HIV/AIDS sexual assertiveness literature revealed that: (a) sexual assertiveness is related to HIV risk, (b) sexual assertiveness is related to communication, and (c) women with low sexual assertiveness are at risk for HIV. This descriptive study sought to answer the following research question: What do young adult college attending African American women self-report about asking information about their partner's sexual history? The multifaceted model of HIV risk is the theoretical framework which guided this descriptive study. A basic tenet of the multifaceted model of HIV risk is that there is no single predictor of women's HIV risk behavior. Results revealed that 104 young adult college attending African American women who volunteered to attend a one day HIV prevention training overall scored high on a Sexual Assertive Scale on subscales of Information Communication, Refusal, and Pregnancy/STD Prevention Subscale, and scored in the medium range on the Initiation Subscales. The Information Communication and Pregnancy/ STD Prevention Subscale received the highest scores. More research is needed targeting diverse African American females with different socioeconomic status, various locations, and educated to determine their sexual assertiveness with partners which are essential in developing specific programs for diverse groups of African American females.

Exploring Japanese nurses' perceptions of the relevance and use of assertive communication in healthcare: A qualitative study informed by the Theory of Planned Behaviour.

PubMed

Omura, Mieko; Stone, Teresa E; Maguire, Jane; Levett-Jones, Tracy

2018-08-01

The hierarchical nature of healthcare environments presents a key risk factor for effective interprofessional communication. Power differentials evident in traditional healthcare cultures can make it difficult for healthcare professionals to raise concerns and be assertive when they have concerns about patient safety. This issue is of particular concern in Japan where inherent cultural and social norms discourage assertive communication. The aim of this study was to (a) explore nurses' perceptions of the relevance and use of assertive communication in Japanese healthcare environments; and (b) identify the factors that facilitate or impede assertive communication by Japanese nurses. A belief elicitation qualitative study informed by the Theory of Planned Behaviour was conducted and reported according to the COnsolidated criteria for REporting Qualitative research. Twenty-three practicing Japanese registered nurses were recruited by snowball sampling from October 2016 to January 2017. Individual face-to-face semi-structured interviews were conducted and transcribed in Japanese and then translated into English. Two researchers independently conducted a directed content analysis informed by the Theory of Planned Behaviour. Participants' responses were labelled in order of frequency for behavioural beliefs about the consequences of assertive communication, sources of social pressure, and factors that facilitate or impede assertive communication in Japanese healthcare environments. Although person-centred care and patient advocacy were core values for many of the participants, strict hierarchies, age-based seniority, and concerns about offending a colleague or causing team disharmony impeded their use of assertive communication. Novice nurses were particularly reluctant to speak up because of their perception of having limited knowledge and experience. This study identified Japanese nurses' behavioural, normative, and control beliefs in relation to assertive communication. The findings will be used to inform the development of a culturally appropriate assertiveness communication training program for Japanese nurses and nursing students. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Prototype Two-Level Multicomputer Study

DTIC Science & Technology

1999-01-01

Wakeup : When this input is asserted, the wakeJnt bit in the special register ISR (Interrupt Status Register) is set. 43 MYRINET SAN INTERFACE Pin...including the double-word pointed to by RMC, the headJnt bit of ISR is set (page 10). RMW Receive-Message Header Wakeup : This is the same physical register...Register) are both equal to 1. WAKE synch. I Wakeup : When this input is asserted, the wakeJnt bit in the special register ISR (Interrupt Status

Internal Medicine Residents' Perceived Ability to Direct Patient Care: Impact of Gender and Experience

PubMed Central

Bartels, Christie; Goetz, Sarah; Ward, Earlise

2008-01-01

Abstract Background Physicians are expected to effect patient care by giving orders to members of a healthcare team. Because women are socialized to be less directive than men, the assertive behavior required of new physicians may be experienced differently by male and female residents. We sought to explore the effects of gender and year of training on residents' experiences and perceived ability to direct patient care. Methods This was a mixed-methods, cross-sectional, descriptive study employing a quantitative written survey and qualitative interviews among internal medicine residents at an academic health center. Measurements included questionnaires and interviews about stress, assertiveness, and personal factors that influence their effectiveness in directing patient care. Analyses examined differences by gender and year of training. Results One hundred residents were invited to participate; 65 returned questionnaires, and 16 of these residents were interviewed. Compared with male residents, female residents selected less assertive behaviors for clinical scenarios (p = 0.047) and were more likely to perceive gender as inhibiting their ability to influence patient care (p < 0.01). Stress associated with being assertive varied more with experience than gender. Interviews corroborated these findings and supported the complexity of gender norms for behavior for female residents in a directive leadership position. Conclusions When compared with male peers, female residents reported more gender issues in residency and chose less assertive behaviors in clinical scenarios. Experience mitigated some gender differences. Our findings suggest that discussion of the existing research on prescriptive gender norms for behavior and leadership may be warranted in resident orientation. PMID:19049356

How repeated 15-minute assertiveness training sessions reduce wrist cutting in patients with borderline personality disorder.

PubMed

Hayakawa, Masaya

2009-01-01

The aim of this work was to examine a possible treatment for patients with borderline personality disorder who have wrist-cutting syndrome, a condition characterized by repeated, superficial wrist cutting in a non-suicidal fashion. Within the current healthcare system in Japan, the average amount of time a doctor can spend with a psychiatric outpatient is about 8 to 15 minutes. We, therefore, examined whether repeated 15-minute psychotherapy sessions to improve patient assertiveness would be effective for reducing wrist cutting and possibly other forms of self-mutilation. We treated 13 patients diagnosed with borderline personality disorder and wrist-cutting syndrome with assertiveness training during 15-minute, biweekly therapy sessions over a course of one to four years. At the conclusion of psychotherapeutic treatment, 69% of outpatients showed a statistically significant reduction in wrist-cutting behavior.

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men

PubMed Central

Semple, Shirley J.; Strathdee, Steffanie A.; Zians, Jim; McQuaid, John R.; Patterson, Thomas L.

2011-01-01

Drug assertiveness skills have been demonstrated effective in reducing substance use behaviors among patients with alcohol- or heroin-use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men (MSM) enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation-seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. PMID:21550758

Sexual Assertiveness Mediates the Associations Between Partner Facilitative Responses and Sexual Outcomes in Women With Provoked Vestibulodynia.

PubMed

McNicoll, Gabrielle; Corsini-Munt, Serena; O Rosen, Natalie; McDuff, Pierre; Bergeron, Sophie

2017-10-03

Provoked vestibulodynia (PVD) is a recurrent idiopathic vulvo-vaginal pain associated with negative sexual and psychological consequences. Facilitative partner responses to pain are currently receiving empirical attention because they are positively associated with women's sexual outcomes. However, the mechanisms through which facilitative responses to pain are associated with these outcomes have not been examined. One potential mechanism is sexual assertiveness, which has been found to be associated with better sexual function and satisfaction in women with PVD. The present study examined whether women's sexual assertiveness mediated the association between women's perception of facilitative partner responses and women's sexual function and satisfaction. Women (N = 140) with PVD symptomatology completed self-reported questionnaires evaluating their perception of their partners' facilitative responses, and their own sexual assertiveness, sexual function, and sexual satisfaction. Dependent measures were sexual function measured by the Female Sexual Function Index and sexual satisfaction assessed by the Global Measure of Sexual Satisfaction Scale. Results indicated that women's higher sexual assertiveness mediated the association between their greater perceived facilitative partner responses and their improved sexual function and satisfaction. Findings suggest a potential mechanism through which partner responses may be associated with women's sexual outcomes.

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men.

PubMed

Semple, Shirley J; Strathdee, Steffanie A; Zians, Jim; McQuaid, John R; Patterson, Thomas L

2011-10-01

Drug assertiveness skills have been demonstrated to be effective in reducing substance use behaviors among patients with alcohol or heroin use disorders. This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. Copyright © 2011 Elsevier Inc. All rights reserved.

Music Videos: The Look of the Sound

ERIC Educational Resources Information Center

Aufderheide, Pat

1986-01-01

Asserts that music videos, rooted in mass marketing culture, are reshaping the language of advertising, affecting the flow of information. Raises question about the society that creates and receives music videos. (MS)

Schizophrenia treatment: content versus delivery.

PubMed

van Os, J

2009-01-01

To review the evidence supporting the importance of ensuring that patients with psychiatric disorders receive an optimal and appropriate level of non-pharmacological treatment, and how Assertive Community Treatment (ACT) may be able to contribute to this aim. Analysis of data from selected individual published studies on ACT, in addition to reviews from the Cochrane Library, and other study groups. Treatment management using ACT appears to offer benefits in terms of reduction in hospitalisation, although there is some debate as to whether this is the most representative outcome measure. Preliminary indications using remission as an outcome measure have also shown promising results in favour of ACT. While further investigation and validation are necessary, current data indicate that ACT may be an appropriate strategy to facilitate the delivery of treatment to patients with psychotic disorders.

Interpersonal problems across restrictive and binge-purge samples: data from a community-based eating disorders clinic.

PubMed

Raykos, Bronwyn C; McEvoy, Peter M; Carter, Olivia; Fursland, Anthea; Nathan, Paula

2014-08-01

Contemporary models of eating disorders suggest that interpersonal problems contribute to the maintenance of eating disorders. This study examined whether baseline interpersonal problems differed across eating disorder diagnoses and across eating disorder subtypes ("restrictors" vs. "binge-purge" patients) in a large clinical sample. Patients with a primary eating disorder diagnosis (N=406) completed measures of interpersonal problems, eating disorder symptoms, and mood prior to treatment at a specialist eating disorder clinic. Across the sample, more severe eating disorder psychopathology was associated with significantly greater difficulty socializing. Anorexia Nervosa (AN)/restrictor patients reported significantly greater difficulty socializing than Bulimia Nervosa (BN)/binge-purge patients. AN patients reported significantly greater difficulty on a measure of competitiveness/assertiveness compared to BN and Eating Disorder Not Otherwise Specified patients. All findings were significant after controlling for comorbid depression and anxiety symptoms. Interpersonal problems appear to be unique risk factors for eating disorders. Specific interpersonal mechanisms include difficulties socializing and being assertive, which were most pronounced in AN patients. These findings provide potential avenues for enhancing interventions, such as adjunctive assertiveness training for AN. Copyright © 2014 Elsevier Ltd. All rights reserved.

78 FR 21850 - Federal Motor Vehicle Safety Standards; Matters Incorporated by Reference

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-12

... Alliance of Automobile Manufacturers. The petitioner asserts that the amendments to one FMVSS are not based... The agency received a petition for reconsideration from the Alliance of Automobile Manufacturers...

Cultural factors influencing Japanese nurses' assertive communication. Part 1: Collectivism.

PubMed

Omura, Mieko; Stone, Teresa E; Levett-Jones, Tracy

2018-02-06

Culture influences the way health-care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally-appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally. © 2018 John Wiley & Sons Australia, Ltd.

Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness.

PubMed

Rutten, Elisabeth A P; Bachrach, Nathan; van Balkom, Anton J L M; Braeken, Johan; Ouwens, Machteld A; Bekker, Marrie H J

2016-12-01

Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness. © 2015 The British Psychological Society.

Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China.

PubMed

Lee, S; Crockett, M S

1994-01-01

The purpose of the study was to examine the effectiveness of assertiveness training in improving self-perceived levels of stress and assertiveness among nurses in Taiwan, Republic of China. The two-group experimental design was conducted in a 2,000-bed veteran general hospital. A sample of 60 volunteer Chinese-speaking nurses participated in the study. Subjects were randomly assigned to one of two treatments: assertiveness training (AT) or alternate treatment control (ATC), which served as a control and contained updated knowledge of new computer technology for in patient settings. Subjects in each group participated in six 2-hour workshops in the same two-week period. All subjects were pre-, post-, and follow-up posttested for stress and assertiveness with the Perceived Stress Scale (PSS) and Rathus Assertiveness Schedule (RAS), respectively. Results revealed the following: (1) subjects in both groups of pretest were clearly subassertive and under considerable stress; (2) by the end of training, the AT group scored significantly higher on the rating of assertiveness than those in the ATC group, and had successfully maintained their improvement by the 4-week follow-up; and (3) by the end of training, the AT group reported significantly lower levels of stress than the ATC group as indicated on the PSS, and successfully maintained their improvements at the 4-week follow-up. Overall, the results indicate clear support for the effectiveness of assertiveness training for treating subassertive behaviors and stress in a population of professional nurses in Taiwan.

Theoretical background of retrieving Green's function by cross-correlation: one-dimensional case

NASA Astrophysics Data System (ADS)

Nakahara, Hisashi

2006-06-01

Recently, an assertion has been verified experimentally and theoretically that Green's function between two receivers can be reproduced by cross-correlating the records at the receivers. In this paper, we have theoretically proved the assertion for 1-D media with the free surface by using the Thomson-Haskell matrix method. Strictly speaking, one side of the cross-correlation between records at two receivers is the convolution between Green's function and the autocorrelation function of the source wavelet. This study extends the geometry considered by Claerbout to two receivers vertically apart, and is a special case of the proof by Wapenaar et al. which dealt with 3-D arbitrary inhomogeneous media. However, a simple geometry in 1-D problems enables us to make the proof without any approximations and to better understand the physical background with more ease. That is the main advantage of this study. Though a 1-D geometry seems far from reality, it may be sufficient if an appropriate combination of receivers and earthquakes is selected. In fact, such a geometry is often seen in seismological observations by a vertical array of seismographs in the shallow subsurface. Therefore, we refer to a possibility that the proof in this paper is applied to the estimation of site amplification factors by using records of a vertical seismographic array.

Proactive infection control measures to prevent nosocomial transmission of vancomycin-resistant enterococci in Hong Kong.

PubMed

Cheng, Vincent Chi-Chung; Tai, Josepha Wai-Ming; Chen, Jonathan Hon-Kwan; So, Simon Yung-Chun; Ng, Wing-Chun; Hung, Ivan Fan-Ngan; Leung, Sally Sau-Man; Wong, Sally Cheuk-Ying; Chan, Tuen-Ching; Chan, Felix Hon-Wai; Ho, Pak-Leung; Yuen, Kwok-Yung

2014-10-01

The study describes a proactive infection control approach to prevent nosocomial transmission of vancomycin-resistant enterococci (VRE) and tests if this approach is effective for controlling multiple-drug resistant organisms in a nonendemic setting. In response to the increasing prevalence of VRE in Hong Kong since 2011, we adopted a multifaceted assertive approach in our health care network. This included active surveillance culture, extensive contact tracing, directly observed hand hygiene in conscious patients before they received meals and medications, stringent hand hygiene and environmental cleanliness, and an immediate feedback antimicrobial stewardship program. We report the occurrence of VRE outbreaks in our hospital after institution of these measures and compared with the concurrent occurrence in other public hospitals in Hong Kong. Between July 1, 2011 and November 13, 2013, VRE was identified in 0.32% (50/15,851) of admission episodes by active surveillance culture. The risk of VRE carriage was three times higher in patients with a history of hospitalization outside our hospital networks in the past 3 months (0.56% vs. 0.17%; p = 0.001) compared with those who were not. Extensive contact tracing involving 3277 patient episodes was performed in the investigation for the 25 VRE index patients upon whom implementation of contact precautions was delayed (more than 48 hours of hospitalization). One episode of VRE outbreak was identified in our hospital network, compared with the 77 VRE outbreaks reported in the other hospital networks (controls) without these proactive infection control measures. Our multifaceted assertive proactive infection control approach can minimize the nosocomial transmission and outbreak of VRE in a nonendemic area. Copyright © 2014. Published by Elsevier B.V.

Method and apparatus for high speed data acquisition and processing

DOEpatents

Ferron, J.R.

1997-02-11

A method and apparatus are disclosed for high speed digital data acquisition. The apparatus includes one or more multiplexers for receiving multiple channels of digital data at a low data rate and asserting a multiplexed data stream at a high data rate, and one or more FIFO memories for receiving data from the multiplexers and asserting the data to a real time processor. Preferably, the invention includes two multiplexers, two FIFO memories, and a 64-bit bus connecting the FIFO memories with the processor. Each multiplexer receives four channels of 14-bit digital data at a rate of up to 5 MHz per channel, and outputs a data stream to one of the FIFO memories at a rate of 20 MHz. The FIFO memories assert output data in parallel to the 64-bit bus, thus transferring 14-bit data values to the processor at a combined rate of 40 MHz. The real time processor is preferably a floating-point processor which processes 32-bit floating-point words. A set of mask bits is prestored in each 32-bit storage location of the processor memory into which a 14-bit data value is to be written. After data transfer from the FIFO memories, mask bits are concatenated with each stored 14-bit data value to define a valid 32-bit floating-point word. Preferably, a user can select any of several modes for starting and stopping direct memory transfers of data from the FIFO memories to memory within the real time processor, by setting the content of a control and status register. 15 figs.

Method and apparatus for high speed data acquisition and processing

DOEpatents

Ferron, John R.

1997-01-01

A method and apparatus for high speed digital data acquisition. The apparatus includes one or more multiplexers for receiving multiple channels of digital data at a low data rate and asserting a multiplexed data stream at a high data rate, and one or more FIFO memories for receiving data from the multiplexers and asserting the data to a real time processor. Preferably, the invention includes two multiplexers, two FIFO memories, and a 64-bit bus connecting the FIFO memories with the processor. Each multiplexer receives four channels of 14-bit digital data at a rate of up to 5 MHz per channel, and outputs a data stream to one of the FIFO memories at a rate of 20 MHz. The FIFO memories assert output data in parallel to the 64-bit bus, thus transferring 14-bit data values to the processor at a combined rate of 40 MHz. The real time processor is preferably a floating-point processor which processes 32-bit floating-point words. A set of mask bits is prestored in each 32-bit storage location of the processor memory into which a 14-bit data value is to be written. After data transfer from the FIFO memories, mask bits are concatenated with each stored 14-bit data value to define a valid 32-bit floating-point word. Preferably, a user can select any of several modes for starting and stopping direct memory transfers of data from the FIFO memories to memory within the real time processor, by setting the content of a control and status register.

A Test of Three Basic Assumptions of Situational Leadership® II Model and Their Implications for HRD Practitioners

ERIC Educational Resources Information Center

Zigarmi, Drea; Roberts, Taylor Peyton

2017-01-01

Purpose: This study aims to test the following three assertions underlying the Situational Leadership® II (SLII) Model: all four leadership styles are received by followers; all four leadership styles are needed by followers; and if there is a fit between the leadership style a follower receives and needs, that follower will demonstrate favorable…

Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team. Preliminary results.

PubMed

Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Murphy, Suzanne; Zaman, Rashid

2007-06-01

Forty patients who had been treated for three years in an ad-hoc, assertive treatment team for patients who had suffered a first psychotic episode were compared to forty patients who had been followed up after a first psychotic episode in a community mental health team. All patients had suffered a first or early psychotic episode. The main differences between the two teams was that the ad-hoc team was assertive in its approach, offered more structured psycho-education, relapse prevention and psycho-social interventions, and had a policy of using atypical anti-psychotics at the lowest effective dose. There were many differences in outcome measures at the end of three years between the two groups. The EI patients are more likely to be taking medication at the end of three years. They are more compliant with medication. They are more likely to be prescribed atypical medication. The EI patients are more likely to have returned to work or education. The EI patients are more likely to remain living with their families. They are less likely to suffer depression to the extent of requiring anti-depressants. They appear to commit less suicide attempts. The patients in the EI service also appear to be less likely to suffer relapse and re-hospitalisation, and are less likely to have involuntary admission to hospital. They have systematic relapse prevention plans based on early warning signs. They and their families receive more psycho-education. These indications suggest that the EI patients are at the end of three years better able to manage their illness/vulnerability on their own than the CMHT patients. More patients in the EI group stopped using illicit drugs than in the CMHT group. All the above changes were statistically significant except for the number of patients who stopped using illicit drugs. In this case it is believed that the sample size was too small to demonstrate significance. These results suggest that an ad-hoc early intervention team is more effective than standard community mental health team in treating psychotic illness.

L Band Service Compatibility : Part II: Optimum GPS Receiver ABI Compatibility

DOT National Transportation Integrated Search

2015-03-12

Workshop Objectives. This is the Second of Two Parts on Compatibility. Last time, OOBE. Today examine mitigation of Adjacent Band Interference, ABI. Apply Relevant TWG and NPEF (2011) data to engage compatibility analysis. Assert Principle: Dr. Brad ...

A value proposition for early physical therapist management of neck pain: a retrospective cohort analysis.

PubMed

Horn, Maggie E; Brennan, Gerard P; George, Steven Z; Harman, Jeffrey S; Bishop, Mark D

2016-07-12

Neck pain is one of the most common reasons for entry into the healthcare system. Recent increases in healthcare utilization and medical costs have not correlated with improvements in health. Therefore there is a need to identify management strategies for neck pain that are effective for the patient, cost efficient for the payer and provided at the optimal time during an episode of neck pain. One thousand five hundred thirty-one patients who underwent physical therapist management with a primary complaint of non-specific neck pain from January 1, 2008 to December 31, 2012 were identified from the Rehabilitation Outcomes Management System (ROMS) database at Intermountain Healthcare. Patients reporting duration of symptoms less than 4 weeks were designated as undergoing "early" management and patients with duration of symptoms greater than 4 weeks were designated as receiving "delayed" management. These groups were compared using binary logistic regression to examine odds of achieving Minimal Clinically Important Difference (MCID) on the Neck Disability Index (NDI) and Numerical Pain Rating Scale (NPRS). Separate generalized linear modeling examined the effect of timing of physical therapist management on the metrics of value and efficiency. Patients who received early physical therapist management had increased odds of achieving MCID on the NDI (aOR = 2.01, 95 % CI 1.57, 2.56) and MCID on the NPRS (aOR = 1.82, 95 % CI 1.42, 2.38), when compared to patients receiving delayed management. Patients who received early management demonstrated the greatest value in decreasing disability with a 2.27 percentage point change in NDI score per 100 dollars, best value in decreasing pain with a 0.38 point change on the NPRS per 100 dollars. Finally, patients receiving early management were managed more efficiently with a 3.44 percentage point change in NDI score per visit and 0.57 point change in NPRS score per visit. These findings suggest that healthcare systems that provide pathways for patients to receive early physical therapist management of neck pain may realize improved patient outcomes, greater value and higher efficiency in decreasing disability and pain compared to delayed management. Further research is needed to confirm this assertion.

Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team - final results.

PubMed

Agius, Mark; Shah, Samir; Ramkisson, Roshelle; Murphy, Suzanne; Zaman, Rashid

2007-09-01

Sixty-two patients who had been treated for three years in an ad-hoc, assertive treatment team for patients who had suffered a first psychotic episode were compared to sixty-two patients who had been followed up after a first psychotic episode in a community mental health team. All patients had suffered a first or early psychotic episode. The main differences between the two teams was that the ad-hoc team was assertive in its approach, offered more structured psycho-education, relapse prevention and psycho-social interventions, and had a policy of using atypical anti-psychotics at the lowest effective dose. There were many differences in outcome measures at the end of three years between the two groups. The EI patients are more likely to be taking medication at the end of three years. They are more compliant with medication. They are more likely to be prescribed Atypical Medication. The EI patients are more likely to have returned to Work or Education. The EI patients are more likely to remain living with their families. They are less likely to suffer depression to the extent of requiring anti-depressants. They appear to commit less suicide attempts. The patients in the EI service also appear to be less likely to suffer relapse and re-hospitalisation, and are less likely to have involuntary admission to hospital. They have systematic relapse prevention plans based on Early Warning Signs. They and their families receive more psycho-education. These indications suggest that the EI patients are at the end of three years better able to manage their illness/vulnerability on their own than the CMHT patients. More patients in the EI group stopped using illicit drugs than in the CMHT group. All the above changes were statistically significant except for the total improvement in employment status and education status, which however approached significance. These results suggest that an ad-hoc Early Intervention Team is more effective than standard Community Mental Health Team in treating psychotic illness.

Influences of Scholarship Aid on the Social Exchange Cycle: A Qualitative Exploration of Scholarship Recipients and Direct Reciprocity

ERIC Educational Resources Information Center

Forrest, Jeannie

2010-01-01

Social exchange theory asserts that individuals who receive a gift will be pressed by an internal sense of obligation to give back in turn (Mauss, 2002). While there is a great deal of literature devoted to giving, there is little literature about the receiving end of the exchange cycle. Deeply impacted by the effects of direct reciprocity are…

Marx in Narnia.

ERIC Educational Resources Information Center

Wade, Barrie; Sheppard, John

1989-01-01

Argues that teachers must understand the different values found in children's literature. Examines four aspects of values present in C. S. Lewis's "Chronicles of Narnia." Asserts that teachers must take responsibility for how such texts are received by young readers in the current multicultural, sexually equal society. (MM)

Communication and teamwork in patient care: how much can we learn from aviation?

PubMed

Lyndon, Audrey

2006-01-01

To identify evidence on the role of assertiveness and teamwork and the application of aviation industry techniques to improve patient safety for inpatient obstetric care. Studies limited to research with humans in English language retrieved from CINAHL, PubMed, Social Science Abstracts, and Social Sciences Citation Index, and references from reviewed articles. A total of 13 studies were reviewed, including 5 studies of teamwork, communication, and safety attitudes in aviation; 2 studies comparing these factors in aviation and health care; and 6 studies of assertive behavior and decision making by nurses. Studies lacking methodological rigor or focusing on medication errors and deviant behavior were excluded. Pilot attitudes regarding interpersonal interaction on the flight deck predicted effective performance and were amenable to behavior-based training to improve team performance. Nursing knowledge was inconsistently accessed in decision making. Findings regarding nurse assertiveness were mixed. Adaptation of training concepts and safety methods from other fields will have limited impact on perinatal safety without an examination of the contextual experiences of nurses and other health care providers in working to prevent patient harm.

Canine-assisted therapy for children with ADHD: preliminary findings from the positive assertive cooperative kids study.

PubMed

Schuck, Sabrina E B; Emmerson, Natasha A; Fine, Aubrey H; Lakes, Kimberley D

2015-02-01

The objective of this study was to provide preliminary findings from an ongoing randomized clinical trial using a canine-assisted intervention (CAI) for 24 children with ADHD. Project Positive Assertive Cooperative Kids (P.A.C.K.) was designed to study a 12-week cognitive-behavioral intervention delivered with or without CAI. Children were randomly assigned to group therapy with or without CAI. Parents of children in both groups simultaneously participated in weekly parent group therapy sessions. Across both treatment groups, parents reported improvements in children's social skills, prosocial behaviors, and problematic behaviors. In both groups, the severity of ADHD symptoms declined during the course of treatment; however, children who received the CAI model exhibited greater reductions in the severity of ADHD symptoms than did children who received cognitive-behavioral therapy without CAI. Results suggest that CAI offers a novel therapeutic strategy that may enhance cognitive-behavioral interventions for children with ADHD. © 2013 SAGE Publications.

Identification of Psychological Dysfunctions and Eating Disorders in Obese Women Seeking Weight Loss: Cross-Sectional Study

PubMed Central

Panchaud Cornut, Maude; Szymanski, Jennifer; Marques-Vidal, Pedro; Giusti, Vittorio

2014-01-01

Objective. The aim of this study is to analyse associations between eating behaviour and psychological dysfunctions in treatment-seeking obese patients and identify parameters for the development of diagnostic tools with regard to eating and psychological disorders. Design and Methods. Cross-sectional data were analysed from 138 obese women. Bulimic Investigatory Test of Edinburgh and Eating Disorder Inventory-2 assessed eating behaviours. Beck Depression Inventory II, Spielberger State-Trait Anxiety Inventory, form Y, Rathus Assertiveness Schedule, and Marks and Mathews Fear Questionnaire assessed psychological profile. Results. 61% of patients showed moderate or major depressive symptoms and 77% showed symptoms of anxiety. Half of the participants presented with a low degree of assertiveness. No correlation was found between psychological profile and age or anthropometric measurements. The prevalence and severity of depression, anxiety, and assertiveness increased with the degree of eating disorders. The feeling of ineffectiveness explained a large degree of score variance. It explained 30 to 50% of the variability of assertiveness, phobias, anxiety, and depression. Conclusion. Psychological dysfunctions had a high prevalence and their severity is correlated with degree of eating disorders. The feeling of ineffectiveness constitutes the major predictor of the psychological profile and could open new ways to develop screening tools. PMID:24737999

The experience of patients participating in a small randomised control trial that explored two different interventions to reduce anxiety prior to an MRI scan.

PubMed

Tugwell-Allsup, J; Pritchard, A W

2018-05-01

This paper reports qualitative findings from within a larger randomised control trial where a video clip or telephone conversation with a radiographer was compared to routine appointment letter and information sheet to help alleviate anxiety prior to their MRI scan. Questionnaires consisting of three free-text response questions were administered to all of the 74 patients recruited to the MRI anxiety clinical trial. The questionnaire was designed to establish patients' experiences of the intervention they had received. These questionnaires were administered post-scan. Two participants from each trial arm were also interviewed. A thematic approach was utilised for identifying recurrent categories emerging from the qualitative data which are supported by direct quotations. Participants in the interventional groups commented positively about the provision of pre-MRI scan information they received and this was contrastable with the relatively indifferent responses observed among those who received the standard information letter. Many important themes were identified including the patients needs for clear and simplified information, the experience of anticipation when waiting for the scan, and also the informally acquired information about having an MRI scan i.e. the shared experiences of friends and family. All themes highlighted the need for an inclusive and individually tailored approach to pre-scan information provision. Qualitative data collected throughout the trial is supportive of the statistical findings, where it is asserted that the use of a short video clip or a radiographer having a short conversation with patients before their scan reduces pre-scan anxiety. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Crucial factors preceding compulsory psychiatric admission: a qualitative patient-record study.

PubMed

de Jong, Mark H; Oorschot, Margreet; Kamperman, Astrid M; Brussaard, Petra E; Knijff, Esther M; van de Sande, Roland; Van Gool, Arthur R; Mulder, Cornelis L

2017-10-24

Compulsory admissions have a strong effect on psychiatric patients and represent a deprivation of personal liberty. Although the rate of such admissions is tending to rise in several Western countries, there is little qualitative research on the mental health-care process preceding compulsory admission. The objective of the study was to identify crucial factors in the mental health-care process preceding compulsory admission of adult psychiatric patients. This retrospective, qualitative multiple-case study was based on the patient records of patients with severe mental illness, mainly schizophrenia and other psychotic disorders. Twenty two patient records were analyzed. Patients' demographic and clinical characteristics were heterogeneous. All were treated by Flexible Assertive Community Treatment teams (FACT teams) at two mental health institutions in the greater Rotterdam area in the Netherlands and had a compulsory admission in a predefined inclusion period. The data were analyzed according to the Prevention and Recovery System for Monitoring and Analysis (PRISMA) method, assessing acts, events, conditions, and circumstances, failing protective barriers and protective recovery factors. The most important patient factors in the process preceding compulsory admission were psychosis, aggression, lack of insight, care avoidance, and unauthorized reduction or cessation of medication. Neither were health-care professionals as assertive as they could be in managing early signs of relapse and care avoidance of these particular patients. The health-care process preceding compulsory admission is complex, being influenced by acts, events, conditions and circumstances, failing barriers, and protective factors. The most crucial factors are patients' lack of insight and cessation of medication, and health-care professionals' lack of assertiveness.

Effectiveness of assertive community management in Singapore.

PubMed

Low, Lambert; Tan, Yu Yuan; Lim, Boon Leng; Poon, Weng Cheong; Lee, Cheng

2013-03-01

Assertive Community Treatment (ACT) was introduced in the 1970s as a comprehensive and assertive approach to community-based case management of patients with chronic and serious mental illness. Launched in Singapore in 2003, the Assertive Community Management (ACM) was modelled after the ACT, but with the main difference of 24 hour availability for the latter only. In line with the move towards de-institutionalisation of psychiatric patients, ACM was introduced to provide a mobile community-based multidisciplinary team approach to manage patients with severe chronic psychiatric illness. This article aims to evaluate and provide an update on this service programme in Singapore following an earlier study by Fam Johnson in 2007. A naturalistic and retrospective study was conducted. One hundred and fifty-five patients recruited into ACM from 1 September 2008 to 1 September 2009 and had completed 1 year of ACM were included in our study. Outcomes were defined as number of admissions (NOA) and length of stay (LOS) one year before and one year following induction into the programme. Baseline socio-demographic factors were also investigated to see if they predicted outcome with ACM. The mean NOA was 1.9 pre-ACM and 0.6 post-ACM, with mean reduction in NOA of 1.3 (P <0.01). The mean LOS was 72.2 days pre-ACM and 17.1 days post ACM, mean reduction in LOS 55.1 days (P <0.01). In addition, it was found that gender, diagnoses and ethnicity were not predictive of the outcome measures of NOA or LOS. ACM in Singapore had been well established since its inception and continued to show effectiveness in reducing inpatient hospitalisation among the chronically mentally ill.

Social Skills Training for Young Adolescents.

ERIC Educational Resources Information Center

Wise, Kathryn L.; And Others

1991-01-01

Six-session systematic assertiveness training program based on social cognitive theory and focusing on peer interactions and social responsibility was presented to 22 sixth graders. Compared to control group, students who received training performed significantly better on test of cognitive acquisition of the information at posttest and six-month…

The Effectiveness of Group Assertiveness Training on Happiness in Rural Adolescent Females With Substance Abusing Parents.

PubMed

Hojjat, Seyed Kaveh; Golmakani, Ebrahim; Norozi Khalili, Mina; Shakeri Chenarani, Maryam; Hamidi, Mahin; Akaberi, Arash; Rezaei Ardani, Amir

2015-06-12

Parental substance abuse confronts children with a variety of psychological, social, and behavioral problems. Children of substance abusing parents show higher levels of psychiatric disorders including anxiety and depression and exert lower levels of communication skills. Weak social skills in this group of adolescents put them at a higher risk for substance abuse. Many studies showed school based interventions such as life skill training can effective on future substance abusing in these high risk adolescences. The participants consisted of 57 middles schools girls, all living in rural areas and having both parents with substance dependency. The participants were randomly assigned to intervention (n=28) and control (n=29) groups. The data were collected before and six weeks after training in both group. The intervention group received eight sessions of group assertiveness training. Participants were compared in terms of changes in scores on the Oxford Happiness Questionnaire and the Gambrills-Richey Assertion Inventory. The total score for happiness change from 43.68 ±17.62 to 51.57 ±16.35 and assertiveness score changed from 110.33±16.05 to 90.40±12.84. There was a significant difference in pretest-posttest change in scores for intervention (7.89±4.13) and control (-2.51±2.64) groups; t (55) =2.15, p = 0.049. These results suggest that intervention really does have an effect on happiness and assertiveness. Determining the effectiveness of these school based interventions on other life aspects such as substance abuse calls for further study on these rural adolescent girls.

Alexithymia, Assertiveness and Psychosocial Functioning in HIV: Implications for Medication Adherence and Disease Severity.

PubMed

McIntosh, Roger C; Ironson, Gail; Antoni, Michael; Fletcher, Mary Ann; Schneiderman, Neil

2016-02-01

Psychosocial function and adherence to antiretroviral regimen are key factors in human immunodeficiency virus (HIV) disease management. Alexithymia (AL) is a trait deficit in the ability to identify and describe feelings, emotions and bodily sensations. A structural equation model was used to test whether high levels of AL indirectly relate to greater non-adherent behavior and HIV disease severity via psychosocial dysfunction. Blood draws for HIV-1 viral load and CD4 T-lymphocyte, along with psychosocial surveys were collected from 439 HIV positive adults aged 18-73 years. The structural model supports significant paths from: (1) AL to non-active patient involvement, psychological distress, and lower social support, (2) psychological distress and non-active involvement to non-adherent behavior, and (3) non-adherence to greater HIV disease severity (CFI = .97, RMSEA = .04, SRMR = .05). A second model confirmed the intermediary effect of greater patient assertiveness on the path from AL to social support and non-active patient involvement (CFI = .94, RMSEA = .04, SRMR = .05). Altogether, AL is indirectly linked with HIV disease management through it's association with poor psychosocial function, however greater patient assertiveness buffers the negative impact of AL on relationship quality with healthcare providers and members of one's social support network.

Assertive Anger Mediates Effects of Dialectical Behaviour-informed Skills Training for Borderline Personality Disorder: A Randomized Controlled Trial.

PubMed

Kramer, Ueli; Pascual-Leone, Antonio; Berthoud, Laurent; de Roten, Yves; Marquet, Pierre; Kolly, Stéphane; Despland, Jean-Nicolas; Page, Dominique

2016-05-01

Dialectical behaviour therapy (DBT)-informed skills training for borderline personality disorder (BPD) aims at the development of specific emotion regulation skills in patients, particularly with regard to the regulation of problematic anger. While the effects of dialectical behaviour skills training have been shown, their processes of change are rarely examined. Neacsiu, Rizvi and Linehan (2010) found that patient's self-reported use of emotion regulation skills was a mediator of therapeutic change in these treatments; however, they found no effect for problematic anger. From an integrative perspective on anger (Pascual-Leone & Greenberg, 2007; Pascual-Leone & Paivio, 2013), there are several forms of anger, varying in their degree of therapeutic productivity. The present add-on randomized controlled trial included n = 41 patients with BPD (n = 21 DBT-informed skills training versus n = 20 treatment as usual). The first study examined the outcome of the DBT-informed skills training encompassing basic components of training in mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. Results showed that symptom reduction was significantly greater in the DBT-informed skills training, compared with the treatment as usual. The second study used process assessment, for which all patient completers underwent a 50-min-long psychological interview both early and late in treatment, which was rated using the Classification of Affective Meaning States. DBT-informed skills training produced increased levels of primary 'assertive' anger, as compared with the treatment as usual, whereas no effect was found for 'rejecting' secondary anger. Most importantly, we showed that changes in assertive anger mediated the reported symptom reduction, in particular in patient's social roles. We discuss these results in the context of underlying mechanisms of change in DBT skills group treatments, in particular towards developing more productive forms of anger in this patient population. Copyright © 2015 John Wiley & Sons, Ltd. A 20-session dialectical behaviour therapy (DBT)-informed skills training is a promising adjunct intervention for patients with borderline personality disorder, in particular for reducing problems related to social role. Increases in assertive anger mediate the effects of DBT-informed skills training, whereas rejecting anger remains unchanged over the course of treatment. Short-term objectives for intervention might involve the specific increase of assertive anger in BPD, by using DBT-informed skills training; long-term objectives for intervention might involve a specific decrease of rejecting anger in BPD. Copyright © 2015 John Wiley & Sons, Ltd.

42 CFR 2.51 - Medical emergencies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a...

42 CFR 2.51 - Medical emergencies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a...

42 CFR 2.51 - Medical emergencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a...

42 CFR 2.51 - Medical emergencies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a...

42 CFR 2.51 - Medical emergencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF ALCOHOL AND DRUG ABUSE PATIENT RECORDS Disclosures Without Patient Consent § 2.51 Medical... information may be disclosed to medical personnel of the Food and Drug Administration (FDA) who assert a...

Strings Attached? Linking Historically Black Colleges and Universities Public Revenue Sources with Efficiency

ERIC Educational Resources Information Center

Coupet, Jason

2017-01-01

Historically Black Colleges and Universities (HBCUs), a set of US higher education institutions historically tasked with educating African-American students, receive both state and federal funding. However, state governments often assert operational control through the political process, potentially influencing how key resources are used. Do these…

ESP--Things Fall Apart?

ERIC Educational Resources Information Center

Waters, Alan

This paper asserts that a gap is developing in English for Special Purposes (ESP) between theory and practice, between received wisdom and grassroots activity that are important to understand when considering the future of ESP. Evidence for these gaps in ESP are discussed in detail in the context of course design, academic input, and the…

Student Self-Grading in Social Statistics

ERIC Educational Resources Information Center

Edwards, Nelta M.

2007-01-01

This article analyzes a social statistics class that engaged in self-grading. Students liked self-grading because they identified their own mistakes, it reinforced what they learned, and they received immediate feedback. Some students worried that others would cheat, but this assertion was not confirmed in the data and the possibility of cheating…

Assertive community treatment and associations with delinquency.

PubMed

van Vugt, Maaike D; Kroon, Hans; Delespaul, Philippe A E G; Mulder, Cornelis L

This article draws on a prospective longitudinal study in which Assertive Community Treatment (ACT) model fidelity and patient outcomes were assessed in twenty outpatient treatment teams. 530 severely mentally ill patients participated in the study. Delinquency outcomes were assessed three times during a two-year follow-up period. At baseline, 49% of the patients had a recent criminal history, meaning that they had at least one reported contact with the police and/or the justice system in the past year. Patients with a recent criminal history had more serious psychosocial problems at baseline compared to those without a recent criminal history. Delinquency outcomes showed improvement over time, but this was not associated with ACT model fidelity. The study shows an association for homelessness and criminal activity. The persistent criminal activities of some of the patients showed that for this group extra interventions are needed that specifically target reduction of criminal behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social problem-solving and mild intellectual disabilities: relations with externalizing behavior and therapeutic context.

PubMed

van Nieuwenhuijzen, Maroesjka; de Castro, Bram Orobio; Wijnroks, Lex; Vermeer, Adri; Matthys, Walter

2009-01-01

Relations among externalizing behavior, therapeutic context (community care vs. residential care), and social problem-solving by children with mild intellectual disabilities or borderline intelligence were examined. Participants were 186 children (12 to 14 years of age) who responded to a video-based social problem-solving task. Of these, 130 received residential care and the majority suffered from severe externalizing behavior problems. The results indicated that externalizing behavior was related to encoding, generation of aggressive responses, and negative evaluation of assertive responses. Therapeutic context was related to encoding, positive evaluation of assertive responses, and negative evaluation of aggressive responses. Results indicate a discrepancy between appropriate problem-solving skills and behavior in daily life. Implications for interventions are discussed.

A Comparison of Assertive Community Treatment Fidelity Measures and Patient-Centered Medical Home Standards

PubMed Central

Vanderlip, Erik R.; Cerimele, Joseph M.; Monroe-DeVita, Maria

2014-01-01

Objective This study compared program measures of assertive community treatment (ACT) with standards of accreditation for the patient-centered medical home (PCMH) to determine whether there were similarities in the infrastructure of the two methods of service delivery and whether high-fidelity ACT teams would qualify for medical home accreditation. Methods The authors compared National Committee for Quality Assurance PCMH standards with two ACT fidelity measures (the Dartmouth Assertive Community Treatment Scale and the Tool for Measurement of Assertive Community Treatment [TMACT]) and with national ACT program standards. Results PCMH standards pertaining to enhanced access and continuity, management of care, and self-care support demonstrated strong overlap across ACT measures. Standards for identification and management of populations, care coordination and follow-up, and quality improvement demonstrated less overlap. The TMACT and the program standards had sufficient overlap to score in the range of a level 1 PCMH, but no ACT measure sufficiently detailed methods of population-based screening and tracking of referrals to satisfy “must-pass” elements of the standards. Conclusions ACT measures and medical home standards had significant overlap in innate infrastructure. ACT teams following the program standards or undergoing TMACT fidelity review could have the necessary infrastructure to serve as medical homes if they were properly equipped to supervise general medical care and administer activities to improve management of chronic diseases. PMID:23820753

Wikipedia vs peer-reviewed medical literature for information about the 10 most costly medical conditions.

PubMed

Hasty, Robert T; Garbalosa, Ryan C; Barbato, Vincenzo A; Valdes, Pedro J; Powers, David W; Hernandez, Emmanuel; John, Jones S; Suciu, Gabriel; Qureshi, Farheen; Popa-Radu, Matei; San Jose, Sergio; Drexler, Nathaniel; Patankar, Rohan; Paz, Jose R; King, Christopher W; Gerber, Hilary N; Valladares, Michael G; Somji, Alyaz A

2014-05-01

Since its launch in 2001, Wikipedia has become the most popular general reference site on the Internet and a popular source of health care information. To evaluate the accuracy of this resource, the authors compared Wikipedia articles on the most costly medical conditions with standard, evidence-based, peer-reviewed sources. The top 10 most costly conditions in terms of public and private expenditure in the United States were identified, and a Wikipedia article corresponding to each topic was chosen. In a blinded process, 2 randomly assigned investigators independently reviewed each article and identified all assertions (ie, implication or statement of fact) made in it. The reviewer then conducted a literature search to determine whether each assertion was supported by evidence. The assertions found by each reviewer were compared and analyzed to determine whether assertions made by Wikipedia for these conditions were supported by peer-reviewed sources. For commonly identified assertions, there was statistically significant discordance between 9 of the 10 selected Wikipedia articles (coronary artery disease, lung cancer, major depressive disorder, osteoarthritis, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, back pain, and hyperlipidemia) and their corresponding peer-reviewed sources (P<.05) and for all assertions made by Wikipedia for these medical conditions (P<.05 for all 9). Most Wikipedia articles representing the 10 most costly medical conditions in the United States contain many errors when checked against standard peer-reviewed sources. Caution should be used when using Wikipedia to answer questions regarding patient care.

The Effectiveness of Group Assertiveness Training on Happiness in Rural Adolescent Females with Substance Abusing Parents

PubMed Central

Hojjat, Seyed Kaveh; Golmakani, Ebrahim; Khalili, Mina Norozi; Chenarani, Maryam Shakeri; Hamidi, Mahin; Akaberi, Arash; Ardani, Amir Rezaei

2016-01-01

Background: Parental substance abuse confronts children with a variety of psychological, social, and behavioral problems. Children of substance abusing parents show higher levels of psychiatric disorders including anxiety and depression and exert lower levels of communication skills. Weak social skills in this group of adolescents put them at a higher risk for substance abuse. Many studies showed school based interventions such as life skill training can effective on future substance abusing in these high risk adolescences. Materials and Methods: The participants consisted of 57 middles schools girls, all living in rural areas and having both parents with substance dependency. The participants were randomly assigned to intervention (n=28) and control (n=29) groups. The data were collected before and six weeks after training in both group. The intervention group received eight sessions of group assertiveness training. Participants were compared in terms of changes in scores on the Oxford Happiness Questionnaire and the Gambrills-Richey Assertion Inventory. Results: The total score for happiness change from 43.68 ±17.62 to 51.57 ±16.35 and assertiveness score changed from 110.33±16.05 to 90.40±12.84. There was a significant difference in pretest-posttest change in scores for intervention (7.89±4.13) and control (-2.51±2.64) groups; t (55) =2.15, p = 0.049. These results suggest that intervention really does have an effect on happiness and assertiveness. Conclusion: Determining the effectiveness of these school based interventions on other life aspects such as substance abuse calls for further study on these rural adolescent girls. PMID:26383218

26 CFR 1.461-2 - Contested liabilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... property taxes are assessed and become a lien on December 1, but are not payable until March 1 of the... assessed and became a lien on December 1, 1964. On March 1, 1965, Y pays the entire $100 to the taxing... and a bill received for services may represent asserted liabilities. (2) Definition of the term...

26 CFR 1.461-2 - Contested liabilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... property taxes are assessed and become a lien on December 1, but are not payable until March 1 of the... assessed and became a lien on December 1, 1964. On March 1, 1965, Y pays the entire $100 to the taxing... and a bill received for services may represent asserted liabilities. (2) Definition of the term...

26 CFR 1.461-2 - Contested liabilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... are assessed and become a lien on December 1, but are not payable until March 1 of the following year... became a lien on December 1, 1964. On March 1, 1965, Y pays the entire $100 to the taxing authority. In... bill received for services may represent asserted liabilities. (2) Definition of the term “contest...

26 CFR 1.461-2 - Contested liabilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... property taxes are assessed and become a lien on December 1, but are not payable until March 1 of the... assessed and became a lien on December 1, 1964. On March 1, 1965, Y pays the entire $100 to the taxing... and a bill received for services may represent asserted liabilities. (2) Definition of the term...

26 CFR 1.461-2 - Contested liabilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... property taxes are assessed and become a lien on December 1, but are not payable until March 1 of the... assessed and became a lien on December 1, 1964. On March 1, 1965, Y pays the entire $100 to the taxing... and a bill received for services may represent asserted liabilities. (2) Definition of the term...

A Missing Piece of the Departure Puzzle: Student-Institution Fit and Intent to Persist

ERIC Educational Resources Information Center

Bowman, Nicholas A.; Denson, Nida

2014-01-01

According to prevailing theory and anecdotal evidence, the congruence between institutional attributes and students' needs, interests, and preferences plays a key role in promoting college satisfaction and retention. However, this assertion has received little direct empirical attention, and the few available studies appear to have some key…

The First Amendment, the Public Schools, and the Inculcation of Community Values.

ERIC Educational Resources Information Center

Stewart, Malcolm

1989-01-01

Focuses First Amendment claims within the public schools: (1) claims of students to free expression; (2) right of students to receive information; (3) right of teachers to use materials and teaching methods of choice; and (4) right of parents to have their children exempted from assertedly objectionable materials. (MLF)

The Need for Educational Freedom in the Nation's Capital. Policy Analysis.

ERIC Educational Resources Information Center

Lartigue, Casey J.

This report asserts that the the District of Columbia Public Schools (DCPS) are failing. The report claims that teacher incompetence, bureaucratic corruption, crumbling infrastructure, violence, lax academic standards, and wasteful spending are some of the many problems, and children attending the DCPS are not receiving a quality education.…

Breaking Ground: A Study of Gestalt Therapy Theory and Holland's Theory of Vocational Choice.

ERIC Educational Resources Information Center

Hartung, Paul J.

In both Gestalt therapy and Holland's theory of vocational choice, person-environment interaction receives considerable emphasis. Gestalt therapy theory suggests that people make contact (that is, meet needs) through a characteristic style of interacting with the environment. Holland identifies six personality types in his theory and asserts that…

12 CFR Supplement I to Part 1024 - Official Bureau Interpretations

Code of Federal Regulations, 2014 CFR

2014-01-01

... servicer receives a notification of cancellation or non-renewal from the borrower's insurance company... charge; or iv. A charge for force-placed insurance in a circumstance not permitted by § 1024.37. 35(c) Contact information for borrowers to assert errors. 1. Exclusive address not required. A servicer is not...

Cultural factors influencing Japanese nurses' assertive communication: Part 2 - hierarchy and power.

PubMed

Omura, Mieko; Stone, Teresa E; Levett-Jones, Tracy

2018-03-23

Hierarchy and power characterize health-care relationships around the world, constituting a barrier to assertive communication and a risk to patient safety. This issue is more problematic and complex in countries such as Japan, where deep-seated cultural values related to hierarchy and power persist. The current paper is the second of two that present the findings from a study exploring Japanese nurses' views and experiences of how cultural values impact assertive communication for health-care professionals. We conducted semistructured interviews with 23 registered nurses, following which data were analyzed using directed content analysis. Two overarching themes emerged from the analysis: hierarchy/power and collectivism. In the present study, we focus on cultural values related to hierarchy and power, including differences in professional status, gender imbalance, seniority/generation gap, bullying, and humility/modesty. The findings from our research provide meaningful insights into how Japanese cultural values influence and constrain nurses' communication and speaking up behaviors, and can be used to inform educational programs designed to teach assertiveness skills. © 2018 John Wiley & Sons Australia, Ltd.

Depression, automatic thoughts, alexithymia, and assertiveness in patients with tension-type headache.

PubMed

Yücel, Basak; Kora, Kaan; Ozyalçín, Süleyman; Alçalar, Nilüfer; Ozdemir, Ozay; Yücel, Aysen

2002-03-01

The role of psychological factors related to headache has long been a focus of investigation. The aim of this study was to evaluate depression, automatic thoughts, alexithymia, and assertiveness in persons with tension-type headache and to compare the results with those from healthy controls. One hundred five subjects with tension-type headache (according to the criteria of the International Headache Society classification) and 70 controls were studied. The Beck Depression Inventory, Automatic Thoughts Scale, Toronto Alexithymia Scale, and Rathus Assertiveness Schedule were administered to both groups. Sociodemographic variables and headache features were evaluated via a semistructured scale. Compared with healthy controls, the subjects with headache had significantly higher scores on measures of depression, automatic thoughts, and alexithymia and lower scores on assertiveness. Subjects with chronic tension-type headache had higher depression and automatic thoughts scores than those with episodic tension-type headache. These findings suggested that persons with tension-type headache have high depression scores and also may have difficulty with expression of their emotions. Headache frequency appears to influence the likelihood of coexisting depression.

Spacecraft particulate sizing spectrometer

NASA Technical Reports Server (NTRS)

Miranda, Henry A., Jr.

1992-01-01

An evaluation prototype device is described, together with conclusions and several recommendations for follow-on flight hardware. The device detects individual particles crossing an external sensing zone, and produces a histogram displaying the size distribution of particles sensed, over the nominal range of 5 to 50 microns. The output is totally independent of the particle refractive index, and is also largely unaffected by particle shape. The reported diameters are in terms of the equivalent sphere, as judged by the scattered light intercepted by the receiving channels, which develop signals whenever a particle crosses the beam of illumination in the sensing zone. Supporting evidence for the latter assertion is discussed on the basis of experimental test data for non-spherical particulates. Also included is a technical appendix which presents theoretical arguments that provide a firm foundation for this assertion.

The Relationship between Principals' Confidence, Humility, and Effectiveness: A Study of Teacher Perceptions

ERIC Educational Resources Information Center

Oyer, Brenda J.

2011-01-01

Humility in leadership has received growing attention in both the popular press and academic journals in recent years. A number of studies have asserted, based on theoretical or conceptual analyses, that humility plays an important role in effective leadership. However, there is a paucity of empirical research on the relationship between humility…

Health Care, Nutrition, and Goal One. ERIC Digest.

ERIC Educational Resources Information Center

Cesarone, Bernard

Goal One of the six national education goals now embodied in the Goals 2000: Educate America Act states that "By the year 2000, all children in America will start school ready to learn." One of the objectives formulated to meet this goal asserts that "Children will receive the nutrition and health care needed to arrive at school…

77 FR 7568 - Freeport LNG Expansion, L.P. and FLNG Liquefaction, LLC; Application for Long-Term Authorization...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... asserts that while Europe receives pipeline gas from various sources, the long supply chains and relative..., LLC; Application for Long-Term Authorization To Export Domestically Produced Liquefied Natural Gas to... authorization to export domestically produced liquefied natural gas (LNG) in an amount up to the equivalent of...

Broken Promises: How the Bush Administration is Failing America's Children [with] Executive Summary.

ERIC Educational Resources Information Center

Children's Defense Fund, Washington, DC.

Asserting that President Bush's proposal to shift responsibility for Head Start to the states would allow the federal government to abandon its promise to truly give children a head start, this report, with accompanying executive summary, outlines what is known about children receiving Head Start services and how the program addresses their needs.…

Lost at Sea: Without a Curriculum, Navigating Instruction Can be Tough--Especially for New Teachers.

ERIC Educational Resources Information Center

Kauffman, David; Johnson, Susan Moore; Kardos, Susan M.; Liu, Edward; Peske, Heather G.

2002-01-01

Interviewed beginning teachers in Massachusetts to determine how they experienced curriculum and state-mandated assessments they encountered. Most respondents received little or no guidance about what to teach or how to teach it and spent inordinate amounts of time and money developing their own content and materials from scratch. Asserts that…

Mediated Language Immersion and Teacher Ideologies: Investigating Trauma Pedagogy within a "Physics in Spanish" Course Activity

ERIC Educational Resources Information Center

Settlage, John; Gort, Mileidis; Ceglie, Robert J.

2014-01-01

Trauma pedagogy occupies an intriguing space within the discourse about effective teaching of culturally and linguistically diverse students, particularly in relation to preservice teacher notions of power. One set of messages received by future teachers strongly advocates for asserting authority within the classroom by taking control via strict…

The association between interpersonal problems and treatment outcome in patients with eating disorders.

PubMed

Ung, Elise Meyn; Erichsen, Cecilie Birkmose; Poulsen, Stig; Lau, Marianne Engelbrecht; Simonsen, Sebastian; Davidsen, Annika Helgadóttir

2017-01-01

Interpersonal problems are thought to play an essential role in the development and maintenance of eating disorders. The aim of the current study was to investigate whether a specific interpersonal profile could be identified in a group of patients diagnosed with Bulimia Nervosa, Binge Eating Disorder, or Eating Disorders Not Otherwise Specified, and to explore if specific types of interpersonal problems were systematically related to treatment outcome in this group of patients. The participants were 159 patients who received systemic/narrative outpatient group psychotherapy. Interpersonal problems were measured at baseline, and eating disorder symptoms were measured pre- and post treatment. Data were analysed with the Structural Summary Method, a particular method for the analysis of the Inventory of Interpersonal Problems, and hierarchical regression analysis was conducted. The patients demonstrated a generally Non-assertive and Friendly-submissive interpersonal style. No significant association between the overall level of interpersonal problems and treatment outcome was identified. However, the results showed a correlation between being cold and hostile and poor treatment outcome, while being domineering showed a trend approaching significance in predicting better treatment outcome. The results indicate that patients with eating disorders show a specific interpersonal profile, and suggest that particular types of interpersonal problems are associated with treatment outcome.

Skills training for pregnancy and AIDS prevention in Anglo and Latino youth.

PubMed

Hovell, M; Blumberg, E; Sipan, C; Hofstetter, C R; Burkham, S; Atkins, C; Felice, M

1998-09-01

This study tested social skills training (SST), didactic training (DT), and no training (NT) on adolescents' social skills for resisting peer pressure to engage in acquired immunodeficiency syndrome (AIDS) and pregnancy risk behavior. A total of 307 Latino and Anglo youth ages 13-18 years were assigned at random to receive 18 h of SST, 18 h of DT, or NT. Significantly (p < 0.05) greater increases in assertiveness followed SST compared to DT or NT for three trained skills: condom negotiation, asking a friend about their sex/drug history, and discussing a friend's risk of AIDS. Untrained negotiation skills (e.g., purchasing a condom) did not increase significantly. SST did not result in increased assertiveness for refusal skills. DT increased knowledge of AIDS significantly more than SST; both DT and SST increased knowledge significantly more than NT. Social skills training can increase assertiveness for certain negotiation skills that may decrease risk of AIDS for Latino, Anglo, and male and female adolescents. Both DT and SST can increase knowledge of AIDS prevention. Differences between experimental groups were supported by differences between trained and untrained skills within the SST condition, adding to discriminant validity.

Differences in Dihydrotetrabenazine Isomer Concentrations Following Administration of Tetrabenazine and Valbenazine.

PubMed

Skor, Heather; Smith, Evan B; Loewen, Gordon; O'Brien, Christopher F; Grigoriadis, Dimitri E; Bozigian, Haig

2017-09-01

Tetrabenazine (TBZ) activity is thought to result from four isomeric dihydrotetrabenazine (HTBZ) metabolites ([+]-α-HTBZ, [-]-α-HTBZ, [+]-β-HTBZ, [-]-β-HTBZ). Each isomer has a unique profile of vesicular monoamine transporter 2 (VMAT2) inhibition and off-target binding. Previously published data only report total isomer (α) and (β) concentrations. We developed a method to quantify the individual HTBZ isomers in samples from patients with Huntington's disease receiving TBZ. For comparison, concentrations of [+]-α-HTBZ, the single active metabolite shared by valbenazine (VBZ) and TBZ, were determined in samples from patients with tardive dyskinesia receiving VBZ. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for quantitation of the four individual HTBZ isomers. Concentrations were determined in serum from patients with Huntington's disease administered TBZ and plasma from patients with tardive dyskinesia administered VBZ once daily. In patients administered TBZ, [-]-α-HTBZ and [+]-β-HTBZ were the most abundant HTBZ isomers while [-]-β-HTBZ and [+]-α-HTBZ were present as minor metabolites. Only [+]-α-HTBZ was observed in patients administered VBZ. Based on relative abundance and potency, [+]-β-HTBZ appears to be the primary contributor to VMAT2 inhibition by TBZ, a finding in contrast with the generally held assertion that [+]-α-HTBZ is the major contributor. [-]-α-HTBZ, the other abundant TBZ metabolite, has much lower VMAT2 inhibitory potency than [+]-β-HTBZ, but increased affinity for other CNS targets, which may contribute to off-target effects of TBZ. In contrast, pharmacological activity for VBZ is derived primarily from [+]-α-HTBZ. Individual HTBZ isomer concentrations provide a more clinically relevant endpoint for assessing on- and off-target effects of TBZ than total isomer concentrations.

Associations Between Quality of Life and Functioning in an Assertive Community Treatment Population.

PubMed

Clausen, Hanne; Landheim, Anne; Odden, Sigrun; Heiervang, Kristin Sverdvik; Stuen, Hanne Kilen; Killaspy, Helen; Šaltytė Benth, Jurate; Ruud, Torleif

2015-11-01

Level of functioning is positively associated with subjective quality of life for people with severe mental illness, but a detailed relationship between functioning and satisfaction with various life domains is largely unknown, and this gap prompted this study. Demographic and clinical data were obtained from 149 patients engaged with 12 assertive community treatment teams in Norway. Multivariate regression analyses were used to explore associations between subjective quality of life and patient characteristics. Analyses confirmed positive associations between quality of life and age, functioning, and weekly contact with family and friends and a negative association with anxiety and depressive symptoms. Positive associations between several areas of practical and social functioning and satisfaction with related life domains also were found. Although a causal direction of the associations between functioning and life satisfaction has not been determined in this study, the positive findings might indicate that programs aiming to improve functioning could affect patients' quality of life.

Assertive outreach in Slovenia; identification of target group and goals of treatment in a new program.

PubMed

Furlan, Mirjana

2009-09-01

A team from the Rehabilitation unit of Ljubljana psychiatric clinic attended a course on community care in London in October and November 2005. Because we decided that the methods presented to us could be of great use in Slovenia where the Health system is lacking such services we decided to implement them after our return. Immediately after we returned we started to carry out our plan. We designated our target group which were patients who poorly participated in treatment or had multiple and severe difficulties functioning and retaining their progress after discharge. Our goals were to improve patient participation in treatment before and after discharge, less and shorter hospitalizations and better integration of patients into society. Initial results are very positive, which leaves me much hope for further implementation of assertive outreach and community care in Slovenia.

Medical Students' Opinions About the Commercialization of Healthcare: A Cross-Sectional Survey.

PubMed

Civaner, M Murat; Balcioglu, Harun; Vatansever, Kevser

2016-06-01

There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients' best interests in the face of market demands.

Social conversational skills development in early implanted children.

PubMed

Guerzoni, Letizia; Murri, Alessandra; Fabrizi, Enrico; Nicastri, Maria; Mancini, Patrizia; Cuda, Domenico

2016-09-01

Social conversational skills are a salient aspect of early pragmatic development in young children. These skills include two different abilities, assertiveness and responsiveness. This study investigated the development of these abilities in early implanted children and their relationships with lexical development and some language-sensitive variables. Prospective, observational, nonrandomized study. Participants included 28 children with congenital profound sensorineural hearing loss. The mean age at device activation was 13.3 months (standard deviation [SD] ±4.2). The Social-Conversational Skills Rating Scale was used to evaluate assertiveness and responsiveness. The MacArthur-Bates Communicative Development Inventory (Words and Sentences form) was used to analyze the lexical development. The device experience was 12 months for each child, and the mean age at testing was 25.9 months (SD ±4.6). Assertiveness and responsiveness scores were within the normal range of normal-hearing age-matched peers. Age at cochlear implant activation exerted a significant impact, with the highest scores associated to the youngest patients. The residual correlations between assertiveness and responsiveness with the lexical development were positive and strongly significant (r = 0.69 and 0.73, respectively). Preoperative hearing threshold demonstrated an associated significant coefficient on the assertiveness score. Age at diagnosis and maternal education level were not correlated with the social conversational skills. Early-implanted children developed social conversational skills that are similar to normal-hearing peers matched for age 1 year after device activation. Social conversational skills and lexical development were strongly correlated, but the present study design cannot specify the direction of this relationship. Children with better preoperative residual hearing exhibited better assertive ability. 4 Laryngoscope, 126:2098-2105, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

"She Has Received Many Honours": Identity Construction in Article Bio Statements

ERIC Educational Resources Information Center

Hyland, Ken; Tse, Polly

2012-01-01

In contrast to the prescribed anonymity of the research article, the bio which accompanies it is perhaps the most explicit assertion of self-representation in scholarly life. Here is a rhetorical space where, in 50-100 words, authors are able to craft a narrative of expertise for themselves. It is a key opening for academics, both novice and…

Function assertive community treatment (FACT) and psychiatric service use in patients diagnosed with severe mental illness.

PubMed

Drukker, M; van Os, J; Sytema, S; Driessen, G; Visser, E; Delespaul, P

2011-09-01

Previous work suggests that the Dutch variant of assertive community treatment (ACT), known as Function ACT (FACT), may be effective in increasing symptomatic remission rates when replacing a system of hospital-based care and separate community-based facilities. FACT guidelines propose a different pattern of psychiatric service consumption compared to traditional services, which should result in different costing parameters than care as usual (CAU). South-Limburg FACT patients, identified through the local psychiatric case register, were matched with patients from a non-FACT control region in the North of the Netherlands (NN). Matching was accomplished using propensity scoring including, among others, total and outpatient care consumption. Assessment, as an important ingredient of FACT, was the point of departure of the present analysis. FACT patients, compared to CAU, had five more outpatient contacts after the index date. Cost-effectiveness was difficult to assess. Implementation of FACT results in measurable changes in mental health care use.

Assertiveness expectancies: how hard people push depends on the consequences they predict.

PubMed

Ames, Daniel R

2008-12-01

The present article seeks to explain varying levels of assertiveness in interpersonal conflict and negotiations with assertiveness expectancies, idiosyncratic predictions people make about the social and instrumental consequences of assertive behavior. This account complements motivation-based models of assertiveness and competitiveness, suggesting that individuals may possess the same social values (e.g., concern for relationships) but show dramatically different assertiveness due to different assumptions about behavioral consequences. Results clarify the form of assertiveness expectancies, namely that most people assume increasing assertiveness can yield positive social and instrumental benefits up to a point, beyond which benefits decline. However, people vary in how assertive this perceived optimal point is. These individual differences in expectancies are linked in 4 studies to assertiveness, including self-reported assertiveness, rated behavioral preferences in assorted interpersonal conflict scenarios, partner ratings of participants' behavior in a face-to-face dyadic negotiation, and work colleague ratings of participants' assertiveness in the workplace. In each case, the link between expectancies and behavior remained after controlling for values. The results suggest a place for expectancies alongside values in psychological models of interpersonal assertiveness.

Social Desirability Responding in the Measurement of Assertive Behavior.

ERIC Educational Resources Information Center

Kiecolt, Janice; McGrath, Ellen

1979-01-01

Women completed behavioral measures of assertion and anxiety before and after assertiveness training. High social desirability scorers described themselves as more assertive and less anxious, but were behaviorally less assertive than low scorers. Although all scorers improved their assertion skills, high scorers did not appear less anxious after…

A Principal Components Analysis of the Rathus Assertiveness Schedule.

ERIC Educational Resources Information Center

Law, H. G.; And Others

1979-01-01

Investigated the adequacy of the Rathus Assertiveness Schedule (RAS) as a global measure of assertiveness. Analysis indicated that the RAS does not provide a unidimensional index of assertiveness, but rather measures a number of factors including situation-specific assertive behavior, aggressiveness, and a more general assertiveness. (Author)

The relationship between attitude, assertiveness and condom use.

PubMed

Treffke, H; Tiggemann, M; Ross, M W

1992-01-01

The Australian study investigated condom-specific assertiveness and condom use as a means of prevention infection from sexually transmitted diseases. 211 men participated including 83 homosexual men (aged 19-62 years) and 128 heterosexual men (aged 17-49) who completed a questionnaire that comprised demographic details such as age, monogamy, and sexual activity as well as attitudinal and assertiveness measures. General assertiveness was measured by the Rathus Assertiveness Schedule (RAS) which had been widely used across a wide range of social situations. Assertiveness relating specifically to situations involving condoms was measured by the Condom Assertiveness Scale (CAS). Intention to use condoms was positively related to favorable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. For both groups, the condom-specific measure of assertiveness was positively correlated with attitudes toward condoms. Condom-specific assertiveness was positively related to general social assertiveness as measured by the Rathus Assertiveness Schedule for the homosexual, but not for the heterosexual men. The negative relationship between general assertiveness and attitude to condoms among the heterosexual men implies that the risk reducing behavior of condom use did not seem to accord with the perceptions of masculinity and social assertiveness among heterosexual men. Thus, female partners of such heterosexual men exhibiting negative attitudes toward condom use combined with assertiveness would have to overcome resistance to insist on the use of condoms. Recently some advertising campaigns have been directed at women. The promotion of condom use among heterosexual men has to deal with the perceptions of condom use as unmasculine behavior.

Assertive communication in condom negotiation: Insights from late adolescent couples’ subjective ratings of self and partner

PubMed Central

Schmid, Amy; Leonard, Noelle R.; Ritchie, Amanda S.; Gwadz, Marya V.

2015-01-01

Purpose Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically-involved couples in the context of a condom negotiation task. Methods Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners’ level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Results Individuals’ assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, while moderate levels of assertiveness were associated with higher condom use. Conclusions Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths’ ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. PMID:25937470

A Perspective for Assertiveness Training for Blacks

ERIC Educational Resources Information Center

Minor, Billy Joe

1978-01-01

This article discussess assertiveness in the Black-White encounter. The author delineates the assertive options available to Blacks, distortions in interpretation of assertive messages, and strategies for more effective and efficient assertions. (Author)

[Therapeutic goals and indications: psychotherapy patient's self-reports during diagnostic assessment].

PubMed

Faller, H

2000-07-01

Although individual therapeutic goals are considered to be important factors motivating patients to engage in therapeutic work, they have gained little attention in empirical research. In the present study, patients were given a questionnaire containing 24 therapeutic goals which could be rated according to their subjective relevance on a 5-point scale. N = 152 patients (mean age 34.5 years, 59.2% female) who presented at a university psychotherapy outpatient department to attend a diagnostic interview participated in the study. "To solve my problems" and "to get relief from my complaints" were the goals that were rated as most important. Goals pertaining to mental health such as more contentness and calmness, self-assertion and insight scored high, too. Three rational scales were constructed: 1. insight, 2. sociability, and 3. self-assertion. These scales were correlated with both patients' causal attributions and therapy expectations in plausible ways. However, the general strength of intercorrelations point of the conception patients goals were not very succinct at the time of the intake interview. Indication groups regarding specific therapeutic measures did not differ with respect to therapy goals. Only the general decision whether to recommend a psychotherapeutic intervention or not seemed to be influenced by patients' therapeutic aims.

Executable assertions and flight software

NASA Technical Reports Server (NTRS)

Mahmood, A.; Andrews, D. M.; Mccluskey, E. J.

1984-01-01

Executable assertions are used to test flight control software. The techniques used for testing flight software; however, are different from the techniques used to test other kinds of software. This is because of the redundant nature of flight software. An experimental setup for testing flight software using executable assertions is described. Techniques for writing and using executable assertions to test flight software are presented. The error detection capability of assertions is studied and many examples of assertions are given. The issues of placement and complexity of assertions and the language features to support efficient use of assertions are discussed.

Relationship Between the Children's Assertiveness Inventory (CAI) and the Revised Behavioral Assertiveness Test for Children (BAT-CR)

ERIC Educational Resources Information Center

Ollendick, Thomas H.; And Others

1986-01-01

The relationship between a self-report measure of assertive behavior in children and a role-play measure was examined in 69 elementary school children. Self-report of positive assertion related more closely to role-play measures and expert ratings of assertiveness than did self-report of negative assertion. (Author/LHW)

Assertiveness: making yourself heard in district nursing.

PubMed

Lawton, Sally; Stewart, Fiona

2005-06-01

Being assertive is not the same as being aggressive. Assertiveness is a tool for expressing ourselves confidently, and a way of saying 'yes' and 'no' in an appropriate way. This article explores issues concerned with assertiveness in district nurse settings. It outlines helpful techniques to develop assertiveness, such as the broken record, fogging, negative assertion and negative inquiry.

Company Training in the United States 1970-2000: What Have Been the Trends over Time?

ERIC Educational Resources Information Center

Stern, David; Song, Yingquan; O'Brien, Bridget

2004-01-01

This study uses data from surveys of U.S. employees to determine whether any trends are apparent in the proportion who say they receive some form of training at work. Discussions of economic change in the U.S. and elsewhere have frequently asserted that work has become more intellectually demanding. This implies that training in workplaces should…

Assertive Communication in Condom Negotiation: Insights From Late Adolescent Couples' Subjective Ratings of Self and Partner.

PubMed

Schmid, Amy; Leonard, Noelle R; Ritchie, Amanda S; Gwadz, Marya V

2015-07-01

Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically involved couples in the context of a condom negotiation task. Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners' level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Individuals' assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, whereas moderate levels of assertiveness were associated with higher condom use. Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths' ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Assertiveness training for undergraduate midwifery students.

PubMed

Warland, Jane; McKellar, Lois; Diaz, Monica

2014-11-01

Assertiveness can be defined as an interpersonal behaviour that promotes the fact all people in a relationship are equally important. All health professionals including midwives must work with and care for people. At times this will include facilitating interactions that require skilful negotiation and assertiveness. Yet embedding assertiveness education into undergraduate midwifery curricula has not been widely adopted. This paper explores one method of delivering assertiveness training in an undergraduate midwifery course and provides comment on the effectiveness of this strategy in developing assertiveness skills in a cohort of undergraduate midwifery students. We used an assertiveness survey which was administered immediately before and 3-4 months after an assertiveness training workshop. All students (n = 55) attending the training day were invited to participate. Of these 41 (77% response) chose to participate in the pre intervention survey and 32 participated (9 students lost to follow-up) in the follow up survey. There was an overall improvement in self-perceived assertiveness scores following the assertiveness training workshop. These findings provide encouraging evidence that educational institutions that offer specific and targeted assertiveness education will be rewarded with more assertive graduates. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reliability and validity of aggressive driving measures in China.

PubMed

Li, Fengzhi; Li, Changji; Long, Yunfang; Zhan, Chenglie; Hennessy, Dwight

2004-12-01

The present research was designed to examine the psychometric properties of Chinese versions of the Self Report Driver Behavior Aggression and Assertiveness subscales, the Driving Vengeance Questionnaire, and the Violent Driving Questionnaire. Study 1 found that the all scales demonstrated good internal consistency, with alphas ranging from .76 to .87 and that assertive driving was related to demerit points received over the past 12 months while driver aggression and violence were linked to collisions over the past 12 months. Study 2 found that the scales exhibited reasonable test-retest reliability, with correlations ranging from .82 to .89. Finally, Study 3 showed that each scale was predicted by other dangerous driving attitudes and behaviors, similar to the original versions. The consistency between the translated and original scales, the implications for use in a Chinese sample, and the uniformity of actions in the traffic environment across cultures are discussed.

Interprofessional education: preparing psychologists for success in integrated primary care.

PubMed

Cubic, Barbara; Mance, Janette; Turgesen, Jeri N; Lamanna, Jennifer D

2012-03-01

Rapidly occurring changes in the healthcare arena mean time is of the essence for psychology to formalize a strategic plan for training in primary care settings. The current article articulates factors affecting models of integrated care in Academic Health Centers (AHCs) and describes ways to identify and utilize resources at AHCs to develop interprofessional educational and clinical integrated care opportunities. The paper asserts that interprofessional educational experiences between psychology and other healthcare providers are vital to insure professionals value one another's disciplines in health care reform endeavors, most notably the patient-centered initiatives. The paper highlights ways to create shared values and common goals between primary care providers and psychologists, which are needed for trainee internalization of integrated care precepts. A developmental perspective to training from pre-doctoral, internship and postdoctoral levels for psychologists in integrated care is described. Lastly, a call to action is given for the field to develop more opportunities for psychology trainees to receive education and training within practica, internships and postdoctoral fellowships in primary care settings to address the reality that most patients seek their mental health treatment in primary care settings.

Group versus Individual Assertion Training.

ERIC Educational Resources Information Center

Linehan, Marsha M.; And Others

1979-01-01

Compared effectiveness of group assertion therapy with individual assertion therapy. Results indicated no significant differences between group v individual assertion training. Pre-, post-, and follow-up measures demonstrated that both treatments were effective in increasing assertive behavior skills and in reducing hostility and anger. Treatment…

Familiarity knowledge in student nurses' clinical studies: exemplified by student nurses in palliative care.

PubMed

Haugan, Grethe; Hanssen, Ingrid

2012-01-01

In this article based on a literary study, the form of knowledge named familiarity knowledge is examined. Although rooted in the philosophical tradition of Wittgenstein and Polanyi, the development of familiarity knowledge is tied in with clinical practice and particular patients and contexts while paying attention to the framework factors influencing the setting as a whole as well as with theoretical knowledge relevant to the situation at hand. Palliative care makes a backdrop for some of the discussion. Familiarity knowledge can never be context free and attends to that which is unique in every nurse-patient relationship. Both assertive and familiarity knowledge are needed to care for dying patients in a competent, sensitive, and truly caring manner. Mentors need to help students synthesize assertive knowledge and familiarity knowledge during their clinical studies to enrich both kinds of knowledge and deepen their understanding. Student nurses expertly mentored and tutored while caring for dying patients living at home become, for instance, less apprehensive about facing dying patients than students not so mentored. Nurses need to understand the complexity of nursing care to be able to see the uniqueness of the situation and approach the individual patient on the bases of experience and insight.

Inter-group and intra-group assertiveness: adolescents' social skills following cultural transition.

PubMed

Korem, Anat; Horenczyk, Gabriel; Tatar, Moshe

2012-08-01

The goals of this study were to examine intra-group and inter-group assertiveness among adolescents, and to compare these two domains of assertiveness between cultural groups in Israel. Measures of intra-group and inter-group assertiveness were developed, and questionnaires were administrated to 441 immigrants from the Former Soviet Union (FSU), 242 immigrants from Ethiopia and 333 non-immigrants. Compared to non-immigrants, FSU and Ethiopian immigrants' inter-group assertiveness was lower. Girls reported higher levels of inter-group assertiveness than boys. Each of the immigrant groups rates itself as equally assertive as the non-immigrant group and more assertive than the other immigrant group. Also, a difference between inter-group and intra-group assertiveness was found among the FSU immigrants. It is argued that adolescents' assertiveness following cultural transition is associated with socio-cultural context, and the implications of this conclusion are discussed. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

To assert or not to assert: conflict management and occupational therapy students.

PubMed

Landa-Gonzalez, Belkis

2008-01-01

As occupational therapists prepare to fulfill the vision of the profession and face the challenges of this century, asserting themselves professionally and effectively collaborating with others is of critical importance. The conflict resolution behaviors used to manage current and future practice environments have significant implications for job retention, work climate, patient care and the development of professional relationships. The literature suggests that occupational therapy students tend to use unassertive forms of conflict management. In an effort to identify potential inconsistencies between students' tendencies and professional demands, this study examined the conflict resolution behaviors that graduate, traditional, and nontraditional occupational therapy students, are likely to use (n = 145). The design of the study was descriptive and correlational. The Thomas Kilmann's MODE instrument and a Conflict Case questionnaire were used as measures of the conflict resolution styles. Results indicated that traditional students favored collaborating while nontraditional students preferred competing and avoiding. The management strategies used by the two groups differed based on the outcome focus and the power relationship between disputants. Findings are relevant for occupational therapy education and continuing professional development. Training in conflict management strategies that would strengthen students' assertiveness and interpersonal skills would be helpful in fostering the leadership needed for fulfilling the profession's vision.

The Reciprocal Relationship Between Sexual Victimization and Sexual Assertiveness

PubMed Central

Livingston, Jennifer A.; Testa, Maria; VanZile-Tamsen, Carol

2007-01-01

Low sexual assertiveness has been proposed as a possible mechanism through which sexual revictimization occurs, yet evidence for this has been mixed. In this study, prospective path analysis was used to examine the relationship between sexual refusal assertiveness and sexual victimization over time among a community sample of women. Results provide support for a reciprocal relationship, with historical victimization predicting low sexual assertiveness and low sexual assertiveness predicting subsequent victimization. The effect of recent sexual victimization on subsequent sexual assertiveness also was replicated prospectively. These findings suggest that strengthening sexual assertiveness may help reduce vulnerability to future victimization. PMID:17322273

The reciprocal relationship between sexual victimization and sexual assertiveness.

PubMed

Livingston, Jennifer A; Testa, Maria; VanZile-Tamsen, Carol

2007-03-01

Low sexual assertiveness has been proposed as a possible mechanism through which sexual revictimization occurs, yet evidence for this has been mixed. In this study, prospective path analysis was used to examine the relationship between sexual refusal assertiveness and sexual victimization over time among a community sample of women. Results provide support for a reciprocal relationship, with historical victimization predicting low sexual assertiveness and low sexual assertiveness predicting subsequent victimization. The effect of recent sexual victimization on subsequent sexual assertiveness also was replicated prospectively. These findings suggest that strengthening sexual assertiveness may help reduce vulnerability to future victimization.

A critique of Theory Z.

PubMed

Sullivan, J J

1983-01-01

Ouchi's Theory Z prescribes how employees should be motivated for increased productivity. Based on the theoretical work of Emile Durkheim, it views the modern large corporation as a communal alternative to the shortcomings of other institutions in industrial mass society. Ouchi's assertion that Japan is the industrial society in which Theory Z has flourished received limited support from research findings. Moreover, Ouchi's grounding of the theory in humanistic management seem unwarranted.

Where Is the Evidence for "Evidence-Based" Therapy?

PubMed

Shedler, Jonathan

2018-06-01

The term evidence-based therapy is a de facto code word for manualized therapy, most often brief cognitive behavior therapy and its variants. It is widely asserted that "evidence-based" therapy is scientifically proven, superior to other forms of psychotherapy, and the gold standard of care. Research findings do not support such assertions. Research on evidence-based therapies demonstrates that they are weak treatments. They have not shown superiority to other forms of psychotherapy, few patients get well, and treatment benefits do not last. Questionable research practices create a distorted picture of the actual benefits of these therapies. Copyright © 2018 Jonathan Shedler. Published by Elsevier Inc. All rights reserved.

Assertive Training: Teaching Women Not to Discriminate Against Themselves.

ERIC Educational Resources Information Center

Butler, Pamela E.

The process of assertive training is described with emphasis placed on its applicability to problems in female assertiveness. Male and female members of four assertive training groups were compared on the Wolpe-Lazarus assertive inventory. Male members obtained a significantly lower score than female members i.e., men reported themselves as…

The Effects of Assertive Training on Performance in Highly Anxious Adolescents.

ERIC Educational Resources Information Center

Wehr, Sara H.; Kaufman, Melvin E.

1987-01-01

Investigated the effects of assertive training on measures of assertiveness, state anxiety, and mathematics performance in highly anxious ninth graders (N=96). Found that assertive training resulted in increased assertiveness and decreased state anxiety, with no significant effect on mathematics performance, and no significant effect due to sex.…

The test of truth: an experimental investigation of the norm of assertion.

PubMed

Turri, John

2013-11-01

Assertion is fundamental to our lives as social and cognitive beings. Philosophers have recently built an impressive case that the norm of assertion is factive. That is, you should make an assertion only if it is true. Thus far the case for a factive norm of assertion been based on observational data. This paper adds experimental evidence in favor of a factive norm from six studies. In these studies, an assertion's truth value dramatically affects whether people think it should be made. Whereas nearly everyone agreed that a true assertion supported by good evidence should be made, most people judged that a false assertion supported by good evidence should not be made. The studies also suggest that people are consciously aware of criteria that guide their evaluation of assertions. Evidence is also presented that some intuitive support for a non-factive norm of assertion comes from a surprising tendency people have to misdescribe cases of blameless rule-breaking as cases where no rule is broken. Copyright © 2013 Elsevier B.V. All rights reserved.

Measurement of assertive behavior: construct and predictive validity of self-report, role-playing, and in-vivo measures.

PubMed

Burkhart, B R; Green, S B; Harrison, W H

1979-04-01

Examined the predictive validity and construct equivalence of the three major procedures used to measure assertive behavior: Self-report, behavioral role-playing, and in-vivo assessment. Seventy-five Ss, who spanned the range of assertiveness, completed two self-report measures of assertiveness, the Rathus Assertiveness Scale (RAS) and the College Self-Expression Scale (CSES); two scales from the Endler S-R Inventory of General Trait Anxiousness, the interpersonal and general anxiety scales; eight role-playing situations that involved the expression of positive and negative assertiveness; and a telephone in-vivo task. In general, the study revealed the following: (1) assertiveness measures are task-dependent in that there was more overlap within task than between tasks; (2) there is a moderate degree of correspondence between self-report and role-playing measures, although this was true only for negative assertion; (3) positive and negative assertion do not appear to have the same topography of responding; and (4) there appears to be no consistent relationship between the in-vivo measure and any other type of assertiveness measure.

Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers.

PubMed

Winger, Joseph G; Rand, Kevin L; Hanna, Nasser; Jalal, Shadia I; Einhorn, Lawrence H; Birdas, Thomas J; Ceppa, DuyKhanh P; Kesler, Kenneth A; Champion, Victoria L; Mosher, Catherine E

2018-05-01

Little research has explored coping skills practice in relation to symptom outcomes in psychosocial interventions for cancer patients and their family caregivers. To examine associations of coping skills practice to symptom change in a telephone symptom management (TSM) intervention delivered concurrently to lung cancer patients and their caregivers. This study was a secondary analysis of a randomized pilot trial. Data were examined from patient-caregiver dyads (n = 51 dyads) that were randomized to the TSM intervention. Guided by social cognitive theory, TSM involved four weekly sessions where dyads were taught coping skills including a mindfulness exercise, guided imagery, pursed lips breathing, cognitive restructuring, problem solving, emotion-focused coping, and assertive communication. Symptoms were assessed, including patients' and caregivers' psychological distress and patients' pain interference, fatigue interference, and distress related to breathlessness. Multiple regression analyses examined associations of coping skills practice during the intervention to symptoms at six weeks after the intervention. For patients, greater practice of assertive communication was associated with less pain interference (β = -0.45, P = 0.02) and psychological distress (β = -0.36, P = 0.047); for caregivers, greater practice of guided imagery was associated with less psychological distress (β = -0.30, P = 0.01). Unexpectedly, for patients, greater practice of a mindfulness exercise was associated with higher pain (β = 0.47, P = 0.07) and fatigue interference (β = 0.49, P = 0.04); greater practice of problem solving was associated with higher distress related to breathlessness (β = 0.56, P = 0.01) and psychological distress (β = 0.36, P = 0.08). Findings suggest that the effectiveness of TSM may have been reduced by competing effects of certain coping skills. Future interventions should consider focusing on assertive communication training for patients and guided imagery for caregivers. Copyright © 2018 American Academy of Hospice and Palliative Medicine. All rights reserved.

Hospital utilization outcome of an assertive outreach model for schizophrenic patients - results of a quasi-experimental study.

PubMed

Büchtemann, Dorothea; Kästner, Denise; Warnke, Ingeborg; Radisch, Jeanett; Baumgardt, Johanna; Giersberg, Steffi; Kleine-Budde, Katja; Moock, Jörn; Kawohl, Wolfram; Rössler, Wulf

2016-07-30

We assessed whether an Assertive Outreach (AO) program for patients with schizophrenia implemented in German routine care in rural areas reduces psychiatric hospital admissions and/or psychiatric hospital days. We conducted a quasi-experimental controlled study with 5 assessments in 12 months. Data collection included health care utilization (Client Sociodemographic and Service Receipt Inventory), and clinical parameters. The assessments took place in the practices of the psychiatrists. Admission incidence rates were calculated. For bivariate group comparison, we used U-tests, T-tests and Chi(2)-Tests, multivariate analysis was conducted using zero-inflated regression models. For hospital outcomes, data of 295 patients was analysed. No statistically significant differences between AO and TAU patients in terms of hospital admissions or hospital days were found. Overall hospital utilization was low (8%). Advantages of AO over TAU referring to hospital utilization were not found. However, a spill-over effect might have reduced hospital utilization in both groups. Further research should differentiate patient subgroups. These two appear to be key factors to explain effects or absence of effects and to draw conclusions for the mental health care delivery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

If it is published in the peer-reviewed literature, it must be true?

PubMed

Wagner, Louis K

2014-10-01

Epidemiological research correlating cancer rates in a population of patients with radiation doses from medical X-rays is fraught with confounding factors that obfuscate the likelihood that any positive relationship is causal. This is a review of four studies involving some of those confounding factors. Comparisons of findings with other studies not encumbered by similar confounding factors can enhance assertions of causation between medical X-rays and cancer rates. Even so, such assertions rest significantly on opinions of researchers regarding the degree of consistency between findings among various studies. The question as to what degree any findings truly represent cause and effect will likely still meet with controversy. The importance of these findings to medicine should therefore not lie in any controversy regarding causation, but in what the findings potentially mean with regard to benefit and risk for patients and the professional practice of medicine.

What breaks a leader: the curvilinear relation between assertiveness and leadership.

PubMed

Ames, Daniel R; Flynn, Francis J

2007-02-01

The authors propose that individual differences in assertiveness play a critical role in perceptions about leaders. In contrast to prior work that focused on linear effects, the authors argue that individuals seen either as markedly low in assertiveness or as high in assertiveness are generally appraised as less effective leaders. Moreover, the authors claim that observers' perceptions of leaders as having too much or too little assertiveness are widespread. The authors linked the curvilinear effects of assertiveness to underlying tradeoffs between social outcomes (a high level of assertiveness worsens relationships) and instrumental outcomes (a low level of assertiveness limits goal achievement). In 3 studies, the authors used qualitative and quantitative approaches and found support for their account. The results suggest that assertiveness (and other constructs with nonlinear effects) might have been overlooked in research that has been focused on identifying what makes a leader rather than on identifying what breaks a leader. ((c) 2007 APA, all rights reserved).

32 CFR 842.118 - Assertable claims.

Code of Federal Regulations, 2011 CFR

2011-07-01

... it merits assertion. Claims for $150 or less need not be asserted; they should be asserted only if... party offers payment and demands a release from the United States before paying damages to the injured...

32 CFR 842.118 - Assertable claims.

Code of Federal Regulations, 2010 CFR

2010-07-01

... it merits assertion. Claims for $150 or less need not be asserted; they should be asserted only if... party offers payment and demands a release from the United States before paying damages to the injured...

Trial and evaluation of assertion training involving nursing students.

PubMed

Nishina, Yuko; Tanigaki, Shizuko

2013-09-01

The concept of assertion and conceptual/practical methods of assertion (assertiveness) training were originally developed in the United States and Europe. These principles were embraced and adapted in Japan in 1970's. However, only a few studies relating to assertion (assertiveness) have been undertaken thus far in Japan, especially so in the domain of nursing students in comparison with other countries. The purpose of this study was to design and implement assertion training with nursing students and to clarify its effects. The participants were all volunteers, invited from a class of 3rd year nursing students. Ten students (intervention group) participated in the assertion training comprised of five sessions in February 2006. Fifty-six students (control group) were participated only in the questionnaire. Both groups were asked to complete the same questionnaire twice, before and after the assertion training. The questionnaire measured levels of assertiveness, social skills, self-esteem, social support and satisfaction with university life. The results and variances, both before and after assertion training, between the intervention group and the control group were analyzed. The effectiveness of the assertion training was determined by changes in pre and post training questionnaire scores. The scores for social skills in the control group had a tendency to decline while the scores for social skills in the intervention group remained constant. Although there were no statistically significant results in the intervention group, the present study highlights areas appropriate for further study.

Trial and Evaluation of Assertion Training Involving Nursing Students

PubMed Central

Nishina, Yuko; Tanigaki, Shizuko

2013-01-01

Background The concept of assertion and conceptual/practical methods of assertion (assertiveness) training were originally developed in the United States and Europe. These principles were embraced and adapted in Japan in 1970’s. However, only a few studies relating to assertion (assertiveness) have been undertaken thus far in Japan, especially so in the domain of nursing students in comparison with other countries. The purpose of this study was to design and implement assertion training with nursing students and to clarify its effects. Methods The participants were all volunteers, invited from a class of 3rd year nursing students. Ten students (intervention group) participated in the assertion training comprised of five sessions in February 2006. Fifty-six students (control group) were participated only in the questionnaire. Both groups were asked to complete the same questionnaire twice, before and after the assertion training. The questionnaire measured levels of assertiveness, social skills, self-esteem, social support and satisfaction with university life. The results and variances, both before and after assertion training, between the intervention group and the control group were analyzed. The effectiveness of the assertion training was determined by changes in pre and post training questionnaire scores. Results The scores for social skills in the control group had a tendency to decline while the scores for social skills in the intervention group remained constant. Conclusion Although there were no statistically significant results in the intervention group, the present study highlights areas appropriate for further study. PMID:24174705

Creating Discursive Order at the End of Life: The Role of Genres in Palliative Care Settings

ERIC Educational Resources Information Center

Schryer, Catherine; McDougall, Allan; Tait, Glendon R.; Lingard, Lorelei

2012-01-01

This article investigates an emerging practice in palliative care: dignity therapy. Dignity therapy is a psychotherapeutic intervention that its proponents assert has clinically significant positive impacts on dying patients. Dignity therapy consists of a physician asking a patient a set of questions about his or her life and returning to the…

Dimensions of assertiveness: factor analysis of five assertion inventories.

PubMed

Henderson, M; Furnham, A

1983-09-01

Five self report assertiveness inventories were factor analyzed. In each case two major factors emerged, accounting for approximately one-quarter to a third of the variance. The findings emphasize the multidimensional nature of current measures of assertiveness, and suggest the construction of a more systematic and psychometrically evaluated scale that would yield subscale scores assessing the separate dimensions of assertiveness.

Irish nursing students' changing levels of assertiveness during their pre-registration programme.

PubMed

Begley, Cecily M; Glacken, Michèle

2004-10-01

Stress and bullying have been found to be common problems in a number of studies of Irish nursing and midwifery. Victims of bullying need high levels of assertiveness to enable them to withstand the stress of victimization. It was deemed important to measure nursing students' level of assertiveness prior to, and near completion of, their pre-registration education programme. Aim. To ascertain nursing students' perceived levels of assertiveness prior to, and nearing the completion of, their three-year pre-registration programme. Ethical approval was given. The students commencing general nurse education programmes in two schools in Southern Ireland agreed to take part (n=72). A questionnaire adapted from a number of assertiveness scales, and tested for validity and reliability in this population, was used to collect data. In general, students' reported assertiveness levels rose as they approached completion of their three-year education programme. The resource constrained health service of the 21st century requires nurses who are assertive to meet the needs of its users. Nursing students' assertiveness skills could be augmented through concentrated efforts from nurse educationalists and clinicians to reduce the communication theory practice gap in nurse education today. To address the multi-dimensional nature of assertiveness, strategies to increase assertiveness should operate at the individual, interface and organisational level. The students in this study reported an increase in levels of assertiveness as they approached completion of their three-year education programme. To function as effective, safe practitioners registered nurses need to be assertive, therefore education in assertiveness should be an integral part of their preparation. The precise composition and mode of delivery of this education requires exploration and evaluation.

Aspects of Predisposition to Assertiveness, Resistance to Assertiveness and Insight into Assertiveness Based Upon Race and Sex.

DTIC Science & Technology

1977-12-15

reflecting assertive behavior are presented to the subjects and (b) the subjects respond by using a scale that permits him or her to indicate his...responses of sub— - jects are not assessed in terms of how assertive ~j~y perceive them to be. For example, an item might ask a subject to scale how...possible actions. This time we want you to tell us how strong or assertive each action is, in your opinion. Each action can be rated on a scale from 1 to 5

Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA.

PubMed

Díaz Zuluaga, Ana M; Duica, Kelly; Ruiz Galeano, Carlos; Vargas, Cristian; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio-occupational intervention within a multimodal intervention (MI) programme. To describe the socio-occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients. A prospective, longitudinal, therapeutic-comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self-care and performance in home, work and community tasks. After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups. Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Response to comment on "Nuclear genomic sequences reveal that polar bears are an old and distinct bear lineage".

PubMed

Hailer, Frank; Kutschera, Verena E; Hallström, Björn M; Fain, Steven R; Leonard, Jennifer A; Arnason, Ulfur; Janke, Axel

2013-03-29

Nakagome et al. reanalyzed some of our data and assert that we cannot refute the mitochondrial DNA-based scenario for polar bear evolution. Their single-locus test statistic is strongly affected by introgression and incomplete lineage sorting, whereas our multilocus approaches are better suited to recover the true species relationships. Indeed, our sister-lineage model receives high support in a Bayesian model comparison.

Factors affecting assertiveness among student nurses.

PubMed

Ibrahim, Sanaa Abd El Azim

2011-05-01

This study aimed to investigate the factors affecting assertiveness among student nurses. The study was carried out at Faculty of Nursing, Port-Said University, on 207 student nurses from four different grades. Rathus Assertiveness Schedule, consisted of 30 items, was used to measure the students' assertiveness level and a 12-item scale developed by Spreitzer was used to measure students' psychological empowerment. The study results showed that 60.4% of the students were assertive, while about half of the students were empowered. A positive relation between student assertiveness and psychological empowerment was detected. Moreover, positive relations regarding family income and students' assertiveness and psychological empowerment were determined. The study recommended introduction of specific courses aiming at enhancing the acquisition of assertiveness skills, in addition, nurse educators must motivate their students to express their opinion and personal rights and also they must pay attention for students' empowerment and enhance students' autonomy. Copyright © 2010 Elsevier Ltd. All rights reserved.

Relationship between Gender Roles and Sexual Assertiveness in Married Women.

PubMed

Azmoude, Elham; Firoozi, Mahbobe; Sadeghi Sahebzad, Elahe; Asgharipour, Neghar

2016-10-01

Evidence indicates that sexual assertiveness is one of the important factors affecting sexual satisfaction. According to some studies, traditional gender norms conflict with women's capability in expressing sexual desires. This study examined the relationship between gender roles and sexual assertiveness in married women in Mashhad, Iran. This cross-sectional study was conducted on 120 women who referred to Mashhad health centers through convenient sampling in 2014-15. Data were collected using Bem Sex Role Inventory (BSRI) and Hulbert index of sexual assertiveness. Data were analyzed using SPSS 16 by Pearson and Spearman's correlation tests and linear Regression Analysis. The mean scores of sexual assertiveness was 54.93±13.20. According to the findings, there was non-significant correlation between Femininity and masculinity score with sexual assertiveness (P=0.069 and P=0.080 respectively). Linear regression analysis indicated that among the predictor variables, only Sexual function satisfaction was identified as the sexual assertiveness summary predictor variables (P=0.001). Based on the results, sexual assertiveness in married women does not comply with gender role, but it is related to Sexual function satisfaction. So, counseling psychologists need to consider this variable when designing intervention programs for modifying sexual assertiveness and find other variables that affect sexual assertiveness.

Relationship between Gender Roles and Sexual Assertiveness in Married Women

PubMed Central

Azmoude, Elham; Firoozi, Mahbobe; Sadeghi Sahebzad, Elahe; Asgharipour, Neghar

2016-01-01

ABSTRACT Background: Evidence indicates that sexual assertiveness is one of the important factors affecting sexual satisfaction. According to some studies, traditional gender norms conflict with women’s capability in expressing sexual desires. This study examined the relationship between gender roles and sexual assertiveness in married women in Mashhad, Iran. Methods: This cross-sectional study was conducted on 120 women who referred to Mashhad health centers through convenient sampling in 2014-15. Data were collected using Bem Sex Role Inventory (BSRI) and Hulbert index of sexual assertiveness. Data were analyzed using SPSS 16 by Pearson and Spearman’s correlation tests and linear Regression Analysis. Results: The mean scores of sexual assertiveness was 54.93±13.20. According to the findings, there was non-significant correlation between Femininity and masculinity score with sexual assertiveness (P=0.069 and P=0.080 respectively). Linear regression analysis indicated that among the predictor variables, only Sexual function satisfaction was identified as the sexual assertiveness summary predictor variables (P=0.001). Conclusion: Based on the results, sexual assertiveness in married women does not comply with gender role, but it is related to Sexual function satisfaction. So, counseling psychologists need to consider this variable when designing intervention programs for modifying sexual assertiveness and find other variables that affect sexual assertiveness. PMID:27713899

Nutrient intake and contribution of home enteral nutrition to meeting nutritional requirements after oesophagectomy and total gastrectomy.

PubMed

Baker, M L; Halliday, V; Robinson, P; Smith, K; Bowrey, D J

2017-09-01

This study evaluated nutrition after oesophago-gastric resection and the influence of home jejunostomy feeding in the six months after surgery. Data on nutritional intake and physiologic measures were collected as part of a randomised trial with measurements taken before and up to six months after surgery. A total of 41 participants (32 oesophagectomy, 9 total gastrectomy) received home jejunostomy feeding (n=18) or usual care without feeding (n=23). At hospital discharge, oral intakes were adequate for energy and protein in 9% and 6%, respectively. By three and six months, these values had increased to 61% and 55%, 94% and 77% respectively. Six participants (26%) who received usual care required rescue feeding. Six weeks after hospital discharge, energy intakes were met in those who received jejunal feeding because of the contribution of enteral nutrition. Jejunal feeding did not affect oral intake, being similar in both groups (fed: 77% estimated need, usual care: 79%). At three months, inadequate micronutrient intakes were seen in over one third. Compared to baseline values, six weeks after surgery, weight loss exceeding 5% was seen in 5/18 (28%) who received feeding, 14/17 (82%) who received usual care and 5/6 (83%) of those who required rescue feeding, P=0.002. Weight loss averaged 4.1% (fed), 10.4% (usual care) and 9.2% (rescue fed), P=0.004. These trends persisted out to six months. Supplementary jejunostomy feeding made an important contribution to meeting nutrition after oesophago-gastric resection. Importantly, oral nutritional intake was not compromised dispelling the assertion that jejunal feeding deincentivises patients from eating.

Nutrient Intake and Contribution of Home Enteral Nutrition to Meeting Nutritional Requirements after Oesophagectomy and Total Gastrectomy

PubMed Central

Baker, Melanie L; Halliday, Vanessa; Robinson, Pauline; Smith, Karen; Bowrey, David J

2017-01-01

Background/Objectives This study evaluated nutrition after oesophago-gastric resection and the influence of home jejunostomy feeding in the six months after surgery. Subjects/Methods Data on nutritional intake and physiologic measures were collected as part of a randomised trial with measurements taken before and up to six months after surgery. Results 41 participants (32 oesophagectomy, 9 total gastrectomy) received home jejunostomy feeding (n=18) or usual care without feeding (n=23). At hospital discharge, oral intakes were adequate for energy and protein in 9% and 6% respectively. By three and six months, these values had increased to 61% & 55%, 94% & 77% respectively. Six participants (26%) who received usual care required rescue feeding. Six weeks after hospital discharge, energy intakes were met in those who received jejunal feeding due to the contribution of enteral nutrition. Jejunal feeding did not affect oral intake, being similar in both groups (fed: 77% estimated need, usual care: 79%). At three months, inadequate micronutrient intakes were seen in over one third. Compared to baseline values, six weeks after surgery, weight loss exceeding 5% was seen in 5/18 (28%) who received feeding, 14/17 (82%) who received usual care and 5/6 (83%) of those who required rescue feeding, p=0.002. Weight loss averaged 4.1% (fed), 10.4% (usual care) and 9.2% (rescue fed), p=0.004. These trends persisted out to six months. Conclusions Supplementary jejunostomy feeding made an important contribution to meeting nutrition after oesophago-gastric resection. Importantly, oral nutritional intake was not compromised dispelling the assertion that jejunal feeding deincentivises patients from eating. PMID:28656968

Beyond Assertiveness Training: A Problem-Solving Approach.

ERIC Educational Resources Information Center

Scott, Nancy A.

1979-01-01

Assertiveness training models show shortcomings in those situations where assertiveness results in stalemates or conflicts, or both. Deadlocks may occur when antagonists demonstrate appropriate assertive behavior. Conflict management using problem-solving skills allows individuals to learn appropriate methods of dealing with conflictual or…

Sexual Assertiveness Scale (SAS) for women: development and validation.

PubMed

Morokoff, P J; Quina, K; Harlow, L L; Whitmire, L; Grimley, D M; Gibson, P R; Burkholder, G J

1997-10-01

Four studies were conducted to develop and validate the Sexual Assertiveness Scale (SAS), a measure of sexual assertiveness in women that consists of factors measuring initiation, refusal, and pregnancy-sexually transmitted disease prevention assertiveness. A total of 1,613 women from both university and community populations were studied. Confirmatory factor analyses demonstrated that the 3 factors remained stable across samples of university and community women. A structural model was tested in 2 samples, indicating that sexual experience, anticipated negative partner response, and self-efficacy are consistent predictors of sexual assertiveness. Sexual assertiveness was found to be somewhat related to relationship satisfaction, power, and length. The community sample was retested after 6 months and 1 year to establish test-retest reliability. The SAS provides a reliable instrument for assessing and understanding women's sexual assertiveness.

Dynamic assertion testing of flight control software

NASA Technical Reports Server (NTRS)

Andrews, D. M.; Mahmood, A.; Mccluskey, E. J.

1985-01-01

An experiment in using assertions to dynamically test fault tolerant flight software is described. The experiment showed that 87% of typical errors introduced into the program would be detected by assertions. Detailed analysis of the test data showed that the number of assertions needed to detect those errors could be reduced to a minimal set. The analysis also revealed that the most effective assertions tested program parameters that provided greater indirect (collateral) testing of other parameters.

Method and apparatus for efficiently tracking queue entries relative to a timestamp

DOEpatents

Blumrich, Matthias A.; Chen, Dong; Gara, Alan G.; Giampapa, Mark E.; Heidelberger, Philip; Ohmacht, Martin; Salapura, Velentina; Vranas, Pavlos

2014-06-17

An apparatus and method for tracking coherence event signals transmitted in a multiprocessor system. The apparatus comprises a coherence logic unit, each unit having a plurality of queue structures with each queue structure associated with a respective sender of event signals transmitted in the system. A timing circuit associated with a queue structure controls enqueuing and dequeuing of received coherence event signals, and, a counter tracks a number of coherence event signals remaining enqueued in the queue structure and dequeued since receipt of a timestamp signal. A counter mechanism generates an output signal indicating that all of the coherence event signals present in the queue structure at the time of receipt of the timestamp signal have been dequeued. In one embodiment, the timestamp signal is asserted at the start of a memory synchronization operation and, the output signal indicates that all coherence events present when the timestamp signal was asserted have completed. This signal can then be used as part of the completion condition for the memory synchronization operation.

Processing of Basic Speech Acts Following Localized Brain Damage: A New Light on the Neuroanatomy of Language

ERIC Educational Resources Information Center

Soroker, N.; Kasher, A.; Giora, R.; Batori, G.; Corn, C.; Gil, M.; Zaidel, E.

2005-01-01

We examined the effect of localized brain lesions on processing of the basic speech acts (BSAs) of question, assertion, request, and command. Both left and right cerebral damage produced significant deficits relative to normal controls, and left brain damaged patients performed worse than patients with right-sided lesions. This finding argues…

The Meta-Nudge - A Response to the Claim That the Use of Nudges During the Informed Consent Process is Unavoidable.

PubMed

Gelfand, Scott D

2016-10-01

Richard Thaler and Cass Sunstein, in Nudge: Improving Decisions About Health, Wealth, and Happiness, assert that rejecting the use nudges is 'pointless' because '[i]n many cases, some kind of nudge is inevitable'. Schlomo Cohen makes a similar claim. He asserts that in certain situations surgeons cannot avoid nudging patients either toward or away from consenting to surgical interventions. Cohen concludes that in these situations (assuming surgeons believe that surgery is the best option for their patients), nudging patients toward consenting to surgical interventions is (at the very least) uncriticizable or morally permissible. I call this argument: The Unavoidability Argument. In this essay, I will respond to Cohen's use of the unavoidability argument in support of using nudges during the process of informed consent. Specifically, I argue that many so-called 'unavoidable nudges' are, in fact, avoidable. Although my argument is directed toward Cohen's use of the unavoidability argument, it is applicable to the unavoidability argument more generally. © 2016 John Wiley & Sons Ltd.

Relation of assertiveness and anxiety among Iranian University students.

PubMed

Larijani, T T; Aghajani, M; Baheiraei, A; Neiestanak, N S

2010-12-01

• The findings from the present study revealed that less than 30% of nursing and midwifery students have high assertiveness and only half of them have low anxiety. • Assertiveness and anxiety have negative correlations in nursing and midwifery students and affect the mental health and educational and occupational performance of the students. • Many factors such as years of education and working while studying influence the level of assertiveness in the students. • The anxiety in students had a significant relation with the father's level of education, family income, etc. The simultaneous existence of low assertiveness and high anxiety in nursing and midwifery students leads to the disruption of study performance. There exists little information concerning their assertiveness. The purpose of this study was to determine the relation of assertiveness and anxiety in nursing and midwifery students. In this correlational, cross-sectional study, 173 nursing students (68 males and 105 females) and 77 midwifery students were recruited from the Tehran University of Medical Sciences in Iran. Data were collected using a questionnaire including personal-social factors, the Spielberger Trait Anxiety Inventory and the Assertion Inventory of Gambrill and Richey. More than half of the nursing and midwifery students (59.5% and 59.7%, respectively) had moderate assertiveness. Also, 43.3% and 36.4% of them had moderate and high levels of anxiety. Pearson correlation test revealed that assertiveness and anxiety had negative correlations in nursing (r=-0.51, P < 0.001) and midwifery (r=-0.449, P < 0.001) students. Some demographic variables had significant correlations with assertiveness and anxiety among the students. Considering the relation of assertiveness and anxiety and its effects on mental health and educational and occupational performance, students should be informed of the required skills for positive interaction with others and to increase assertiveness and decrease anxiety. © 2010 Blackwell Publishing.

The New Assertive You.

ERIC Educational Resources Information Center

Bondanza, Julie

This workbook provides exercises, role-playing activities, and self-evaluation activities to help deaf adolescents become more aware of their level of assertiveness and the ways assertive behavior can assist in daily living situations. Assertiveness is different from aggressiveness and passiveness, and many people learn through their families and…

Writing executable assertions to test flight software

NASA Technical Reports Server (NTRS)

Mahmood, A.; Andrews, D. M.; Mccluskey, E. J.

1984-01-01

An executable assertion is a logical statement about the variables or a block of code. If there is no error during execution, the assertion statement results in a true value. Executable assertions can be used for dynamic testing of software. They can be employed for validation during the design phase, and exception and error detection during the operation phase. The present investigation is concerned with the problem of writing executable assertions, taking into account the use of assertions for testing flight software. They can be employed for validation during the design phase, and for exception handling and error detection during the operation phase The digital flight control system and the flight control software are discussed. The considered system provides autopilot and flight director modes of operation for automatic and manual control of the aircraft during all phases of flight. Attention is given to techniques for writing and using assertions to test flight software, an experimental setup to test flight software, and language features to support efficient use of assertions.

On Secure Implementation of an IHE XUA-Based Protocol for Authenticating Healthcare Professionals

NASA Astrophysics Data System (ADS)

Masi, Massimiliano; Pugliese, Rosario; Tiezzi, Francesco

The importance of the Electronic Health Record (EHR) has been addressed in recent years by governments and institutions.Many large scale projects have been funded with the aim to allow healthcare professionals to consult patients data. Properties such as confidentiality, authentication and authorization are the key for the success for these projects. The Integrating the Healthcare Enterprise (IHE) initiative promotes the coordinated use of established standards for authenticated and secure EHR exchanges among clinics and hospitals. In particular, the IHE integration profile named XUA permits to attest user identities by relying on SAML assertions, i.e. XML documents containing authentication statements. In this paper, we provide a formal model for the secure issuance of such an assertion. We first specify the scenario using the process calculus COWS and then analyse it using the model checker CMC. Our analysis reveals a potential flaw in the XUA profile when using a SAML assertion in an unprotected network. We then suggest a solution for this flaw, and model check and implement this solution to show that it is secure and feasible.

The relationship of extraversion and neuroticism to two measures of assertive behavior.

PubMed

Vestewig, R E; Moss, M K

1976-05-01

One hundred forty-four college students completed the Eysenck Personality Inventory and the Rathus Assertiveness Schedule (RAS) and wrote their behavioral reactions to five scenarios in which an assertive behavior was an appropriate response. Extraversion showed a significant positive correlation with the RAS in both males and females. Neuroticism was negatively correlated with RAS in both sexes. Extraversion and RAS correlated significantly with rated Assertiveness in the scenarios only in the male sample. The RAS predicted variance in Assertiveness beyond that predicted by Extraversion. Overall low correlations of the measures with rated Assertiveness were discussed in terms of the low internal consistency reliability of that scale.

The Development of the Sexual Assertiveness Questionnaire (SAQ): A Comprehensive Measure of Sexual Assertiveness for Women.

PubMed

Loshek, Eevett; Terrell, Heather K

2015-01-01

Sexual assertiveness has been defined in a number of ways by many researchers, with different aspects of sexual assertiveness emphasized in different measures. Most previous measures have included condom insistence as an important aspect of sexual assertiveness, but this may not translate well to women at all life stages or in varied types of relationships. The goal of the current study was to develop a comprehensive measure of sexual assertiveness that encompasses the aspects of sexual assertiveness that have been emphasized by previous researchers, with the exception of condom insistence. Items were generated based on previous measures and definitions, and an exploratory factor analysis was conducted (Study 1) to better understand the dimensions of sexual assertiveness. The proposed scale was revised and further refined using both exploratory factor analysis and confirmatory factor analysis in Study 2. The final scale consisted of 18 items that seem to capture three dimensions of sexual assertiveness: the ability to initiate and communicate about desired sex, the ability to refuse unwanted sex, and the ability to communicate about sexual history and risk. Model fit indices indicate that this three-factor solution fits the data well. Implications and suggestions for future research are discussed.

Physical Attractiveness, Locus of Control, Sex Role, and Conversational Assertiveness.

ERIC Educational Resources Information Center

Campbell, Keith F.; And Others

1990-01-01

Analyzes the relationship among physical attractiveness, locus of control, sex role orientation, and assertiveness in undergraduate students. Reviews videotapes of mixed-sex student groups engaged in discussion. Finds an internal locus of control positively correlated with assertiveness. Uses a behavioral measure of assertiveness rather than…

A Self-Report Measure of Assertiveness in Young Adolescents.

ERIC Educational Resources Information Center

Connor, Jane M.; And Others

1982-01-01

Reported a self-report measure of adolescents' assertiveness. Items for the scale were presented to sixth-grade students. Factor analysis revealed factors of submissiveness, aggressiveness, and assertiveness. After the validational study, a small assertiveness training program indicated that training effects were obtained and could be generalized…

"Evidence-debased medicine" and the integrity of the medical profession.

PubMed

Elliott, Richard L

2011-01-01

Patients trust physicians to prescribe based on their fiduciary duty to act in the best interests of their patients, and physicians prescribe based on confidence in research data and clinical guidelines. Recent reports erode confidence in evidence-based medicine. Through self-regulation and a willingness to change, the medical profession can assert its status as a profession distinct from outside influence, serving one interest: the healthcare of patients and the public.

Investigating the Climate Change Beliefs, Knowledge, Behaviors, and Cultural Worldviews of Rural Middle School Students and Their Families during an Out-of-School Intervention: A Mixed-Methods Study

ERIC Educational Resources Information Center

Gutierrez, Kristie Susan

2016-01-01

In a recent nationwide survey, 63% of American adults believe that there is global warming, yet 52% received a "grade" of "F" on climate change knowledge and beliefs. Climate change is a politically-charged topic in the 21st century. Even for those who support the 97% of scientists who assert that climate change is occurring,…

Coping with early stage breast cancer: examining the influence of personality traits and interpersonal closeness.

PubMed

Saita, Emanuela; Acquati, Chiara; Kayser, Karen

2015-01-01

The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of 72 Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire), interpersonal closeness (Inclusion of the Other in the Self Scale), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale). We hypothesized that diverse personality traits and degrees of closeness contribute to determine the coping styles shown by participants. Multiple regression analyses were conducted for each of the five coping styles (Helplessness/Hopelessness, Anxious Preoccupation, Avoidance, Fatalism, and Fighting Spirit) using personality traits and interpersonal closeness variables (Strength of Support Relations, and Number of Support Relations) as predictors. Women who rated high on assertiveness and social anxiety were more likely to utilize active coping strategies (Fighting Spirit). Perceived strength of relationships was predictive of using an active coping style while the number of supportive relationships did not correlate with any of the coping styles. Implications for assessment of breast cancer patients at risk for negative adaptation to the illness and the development of psychosocial interventions are discussed.

78 FR 51677 - Children's Online Privacy Protection Rule Proposed Parental Consent Method; AssertID, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

...-AB20 Children's Online Privacy Protection Rule Proposed Parental Consent Method; AssertID, Inc. Application for Approval of Parental Consent Method AGENCY: Federal Trade Commission (FTC or Commission... concerning the proposed parental consent method submitted by AssertID, Inc. (``AssertID'') under the...

Application of the Elaboration Likelihood Model of Attitude Change to Assertion Training.

ERIC Educational Resources Information Center

Ernst, John M.; Heesacker, Martin

1993-01-01

College students (n=113) participated in study comparing effects of elaboration likelihood model (ELM) based assertion workshop with those of typical assertion workshop. ELM-based workshop was significantly better at producing favorable attitude change, greater intention to act assertively, and more favorable evaluations of workshop content.…

Measurement of Assertive Behavior: Construct and Predictive Validity of Self-Report, Role-Playing, and In-Vivo Measures.

ERIC Educational Resources Information Center

Burkhart, Barry R.

1979-01-01

Seventy-five subjects, who spanned the range of assertiveness, completed two self-report measures of assertiveness, eight role-playing situations involving positive and negative assertiveness, and a telephone in-vivo task. Correlations between the three measurement methods were examined. (Author/SJL)

Dimensions of Assertiveness in an Asian-American Student Population.

ERIC Educational Resources Information Center

Fukuyama, Mary A.; Greenfield, Tom K.

1983-01-01

Analyzed components of assertiveness, assessed by the College Self-Expression Scale, for Asian-American (N=105) and Caucasian (N=135) students. Results showed a significant difference in full-scale assertion scores indicating lower levels of overall assertion in Asian Americans, interpreted as consistent with value differences between…

Clinical and functional outcome of assertive outreach for patients with schizophrenic disorder: Results of a quasi-experimental controlled trial.

PubMed

Kästner, D; Büchtemann, D; Warnke, I; Radisch, J; Baumgardt, J; Giersberg, S; Kopke, K; Moock, J; Kawohl, W; Rössler, W

2015-09-01

The majority of studies support modern assertive health service models. However, the evidence is limited for parts of continental Europe, as well as for the pharmacological adherence outcome parameter. We conducted a quasi-experimental controlled trial including adult patients with a schizophreniform disorder and a maximum of 60 points on the Global Assessment of Functioning Scale (GAF). Interventions (n=176) and controls (TAU, n=142) were assessed every six-month within one year in 17 study practices in rural areas. Mental and functional state were rated using the Brief Psychiatric Rating Scale (BPRS) and the GAF. Functional limitations and pharmacological adherence were patient-rated using the WHO-Disability Assessment Schedule II (WHODAS-II) and the Medication Adherence Report Scale (MARS). We computed multilevel mixed models. The GAF and BPRS of both groups improved significantly, yet the increase in the intervention group was significantly higher. In contrast, patient-rated variables - WHODAS-II and MARS - neither showed a stable temporal improvement nor a difference between groups. Our findings only partly support the investigated AO intervention, because of conflicting results between clinician- and patient-ratings. Accordingly, the benefits of AO need to be further evaluated. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Technical skills acquisition in surgery-bound senior medical students: an evaluation of student assertiveness.

PubMed

Talbott, Vanessa A; Marks, Joshua A; Bodzin, Adam S; Comeau, Jason A; Maxwell, Pinckney J; Isenberg, Gerald A; Martin, Niels D

2012-01-01

To prepare students pursuing surgical careers, we devised a senior subinternship curriculum supplement that focused on the acquisition of technical skills required of surgical residents. We hypothesized that more assertive students, those that accomplished more of the curriculum, would perform better on a technical skills Objective Structured Clinical Examination (OSCE). Senior medical students rotating on their first general surgery subinternship were administered a 6-station OSCE on the first day of their subinternship and again during the final week of the month-long rotation. A self-directed, 38-task "scavenger hunt" representing common intern level clinical skills, procedures, and patient care activities was provided to each student. The study was performed at Jefferson Medical College, a large, private medical school in Philadelphia, PA. Forty-nine senior students completed surgical subinternships between July 2009 and September 2010, and participated both in the pre-/post-OSCEs and the scavenger hunt. Students performed significantly better on the post-rotation OSCE than on the pre-rotation OSCE; 70.2% ± 8.1% vs. 60.4% ± 12.0%, p < 0.0001. Assertiveness scores from the "scavenger hunt" did not correlate with final OSCE scores (r = -0.328, p = 0.25), and were negatively correlated with the change between pre- and post-OSCE scores (r = -0.573, p < 0.04). Individual student assertiveness scores were determined by the number of tasks completed over the course of the rotation. As surgical education becomes more streamlined with evolving work hour restrictions, medical school education is playing an increasingly pivotal role in preparing students for internship. In our study, individual assertiveness in completing structured self-directed learning tasks did not directly predict the acquisition of proficiency in technical skills. We feel assertiveness is overshadowed by other factors that may carry more weight in terms of technical skills acquisition. Further studies are required to delineate these factors and ultimately enhance technical skills acquisition during medical school. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Assertiveness, submissive behaviour and social comparison.

PubMed

Gilbert, P; Allan, S

1994-09-01

This paper explores the relationship between a new assertiveness measure (the Scale for Interpersonal Behaviour--SIB), social comparison and submissive behaviour. The paper investigates these measures in relation to the personality traits of neuroticism and introversion. Findings suggest: (a) that social comparison may be an important variable in assertiveness and submissive behaviour and shows a strong relationship to neuroticism and introversion; (b) that submissive behaviour is not the mirror opposite of assertive behaviour; and (c) submissive behaviour seems more strongly associated with introversion and neuroticism than assertive performance.

The effect of high and low assertiveness on locus of control and health problems.

PubMed

Williams, J M; Stout, J K

1985-03-01

The effect of high and low assertiveness on locus of control and health problems was examined with 78 direct-service workers in mental health and mental retardation settings in northeastern Pennsylvania. The direct-service workers completed the Rathus (1973) Assertiveness Schedule, the Rotter (1966) Internal-External Locus of Control Scale, and a health-problems inventory. Highly assertive individuals were found to be more internally controlled and to experience fewer health problems than were individuals low in assertiveness.

Sexual victimization, fear of sexual powerlessness, and cognitive emotion dysregulation as barriers to sexual assertiveness in college women.

PubMed

Zerubavel, Noga; Messman-Moore, Terri L

2013-12-01

The current study examined sexual victimization and two barriers to young women's sexual assertiveness: fear of sexual powerlessness and cognitive emotion dysregulation. College women (N = 499) responded to surveys and indicated that fear of sexual powerlessness and, to a lesser extent, cognitive emotion dysregulation were barriers to sexual assertiveness. Compared with nonvictims, sexually victimized women had greater problems with sexual assertiveness, fear of sexual powerlessness, and cognitive emotion dysregulation. Among victims, fear of sexual powerlessness and emotion dysregulation interacted to impede sexual assertiveness. Findings support targeting identified barriers in interventions to improve sexual assertiveness and reduce risk for unwanted sexual experiences and sexual victimization.

[A concept analysis of assertiveness].

PubMed

Park, Hyoung-Sook; Yang, Young-Ok

2006-06-01

The purpose of this study was to analyze and clarify the meaning of the concept, assertiveness. This study used Walker and Avant's process of concept analysis. 1. Attributes of assertiveness were defined as 1) Self-esteem 2) Comprehension to others 3) Clarification of the subject 4) Verbal communication 5) Non-verbal communication. 2. The antecedents of assertiveness consist of these facts 1) The occurrence of a conflict situation 2) The occurrence of will to stick to one's opinions. 3. There are consequences occurring as a result of assertiveness 1) Positive self-confidence 2) Increased comprehension or consideration to others 3) Expand of mutual respect 4) Maintenance of continuously cooperative relationship with each other 5) Output of acceptable results to each other. Assertiveness is a core human behavior and is key to interpersonal relationships. Using the components of the concept of assertiveness, many conflicts in a nursing situation can be effectively prevented.

Examining communication and assertiveness as predictors of condom use: implications for HIV prevention.

PubMed

Zamboni, B D; Crawford, I; Williams, P G

2000-12-01

The current study explored the relationship between communication and assertiveness in general and sexual contexts and examined each construct's differential ability to predict reported condom use among college students. The results suggest that the constructs are positively related to each other, but general communication does not predict sexual assertiveness. Although sexual assertiveness is a better predictor of condom use than general assertiveness, general communication, and sexual communication, it needs to be considered within the context of other variables (e.g., normative beliefs regarding condom use). HIV prevention programs and models of health behavior should incorporate individual characteristics such as sexual assertiveness. The results of this study suggest that sexual assertiveness, social norm perceptions of condom use, self-efficacy for HIV prevention, and condom attitudes are among the critical variables that should be examined in an integrated model of sexual health behavior.

Verification of reliability and validity of a Japanese version of the Rathus Assertiveness Schedule.

PubMed

Suzuki, Eiko; Kanoya, Yuka; Katsuki, Takeshi; Sato, Chifumi

2007-07-01

To verify the reliability and validity of a Japanese version of the Rathus Assertiveness Schedule in novice nurses to contribute to nursing management. An adequate scale is needed to measure the assertiveness and the effect of assertion training for Japanese nurses and to compare them with those in other countries. Rathus Assertiveness Schedule was adapted to Japanese with back-translation and its validity was examined in 989 novice nurses. The Japanese version showed a high coefficient of reliability in a split-half reliability test (r=0.76; P<0.01). The coefficient of reliability of Cronbach's alpha was high (r=0.84; P<0.01) indicating high internal consistency. The similarity with the concept of stress coping was shown. We extracted eight principal factors using factor analysis with varimax rotation. Elements of these factors were similar to those of the original Rathus Assertiveness Schedule. The Japanese version of Rathus Assertiveness Schedule was verified.

Assertiveness process of Iranian nurse leaders: a grounded theory study.

PubMed

Mahmoudirad, Gholamhossein; Ahmadi, Fazlollah; Vanaki, Zohreh; Hajizadeh, Ebrahim

2009-06-01

The purpose of this study was to explore the assertiveness process in Iranian nursing leaders. A qualitative design based on the grounded theory approach was used to collect and analyze the assertiveness experiences of 12 nurse managers working in four hospitals in Iran. Purposeful and theoretical sampling methods were employed for the data collection and selection of the participants, and semistructured interviews were held. During the data analysis, 17 categories emerged and these were categorized into three themes: "task generation", "assertiveness behavior", and "executive agents". From the participants' experiences, assertiveness theory emerged as being fundamental to the development of a schematic model describing nursing leadership behaviors. From another aspect, religious beliefs also played a fundamental role in Iranian nursing leadership assertiveness. It was concluded that bringing a change in the current support from top managers and improving self-learning are required in order to enhance the assertiveness of the nursing leaders in Iran.

Dimensions of Assertiveness: Differential Relationships to Substance Use in Early Adolescence.

ERIC Educational Resources Information Center

Wills, Thomas Ashby; And Others

1989-01-01

Tested multidimensional formulation of assertiveness and substance use in 3 metropolitan-area school samples (N=675, N=1,430, and N=5,545) of adolescents including White, Black, and Hispanic students aged 12-14 years. Found Substance-specific Assertiveness inversly associated with substance use and Social Dating Assertiveness positively associated…

The Effects of Assertiveness Training on Enhancing the Social Skills of Adolescents with Visual Impairments.

ERIC Educational Resources Information Center

Kim, Young-il

2003-01-01

A study of the effects of assertiveness training to enhance the social/assertiveness skills of 36 adolescents with visual impairments found that parents, the students, teachers, and observers judged the adolescents' social skills differently. However, the training did have some specific effect on increasing assertiveness. (Contains references.)…

Children's Assertive Behavior: The Reliability and Validity of Three Self-Report Measures.

ERIC Educational Resources Information Center

Scanlon, Elizabeth M.; Ollendick, Thomas H.

1985-01-01

The internal consistency and validity of three new scales for measuring assertiveness in children were tested. Two of the scales were able to "unbind" aggressive from assertive behavior, while the third was able to "unbind" submissive from assertive behavior. At present, a combination of the three scales is recommended. (KH)

The Effects of Two Types of Assertion Training on Self-Assertion, Anxiety and Self Actualization.

ERIC Educational Resources Information Center

Langelier, Regis

The standard assertion training package includes a selection of techniques from behavior therapy such as modeling, behavior rehearsal, and role-playing along with lectures and discussion, bibliotherapy, and audiovisual feedback. The effects of a standard assertion training package with and without videotape feedback on self-report measures of…

"I'll Repeat Myself, "Again?!"" Empowering Students through Assertive Communication Strategies

ERIC Educational Resources Information Center

Kolb, Sharon M.; Griffith, Amy C. Stevens

2009-01-01

One goal parents and educators should have is to help children become assertive and emotionally intelligent individuals. In furthering this goal, it helps to have an understanding of the three basic communication styles: (1) passive; (2) aggressive; and (3) assertive. Because communication is most effective when a message is delivered assertively,…

Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2001-09-01

Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

Nurses in OR are more assertive than radiographers.

PubMed

Johnson, L

1993-01-01

This study investigated two hypotheses: that there is a positive correlation between assertiveness and self-esteem, and that nurses rate lower than non-nurses on the constructs. A self-report survey incorporating scales for general assertiveness, situationally-specific assertiveness, global self-esteem and differentiated self-esteem was utilised. For the sample of 83 operating room nurses and 81 radiographers, correlations significant at the p < .001 level between the respective scales supported the first hypothesis. Analysis of variance yielded no significant differences between the two groups on either self-esteem measures or general assertiveness, with the nurses scoring significantly higher than radiographers on the situationally-specific assertiveness scale. Findings challenge the stereotype of the 'shrinking violet' nurse. Additional analysis revealed that the power component of differentiated self-esteem had a higher correlation with global self-esteem and with both assertiveness measures than any other component. Further, the operating room nurses were significantly more power-oriented than radiographers. The pre-eminence of power in the findings suggests that assertiveness and self-esteem are issues relating to the empowerment of nurses.

Prevalence of stroke and the need for thromboprophylaxis in young patients with atrial fibrillation: a cohort study.

PubMed

Lin, Andrew H; Oakley, Luke S; Phan, Hoanganh L; Shutt, Brennan J; Birgersdotter-Green, Ulrika; Francisco, Gregory M

2014-03-01

Atrial fibrillation is the most common cardiac arrhythmia, and age is a well-established independent risk factor for stroke in these patients. Whereas high-risk patients clearly benefit from anticoagulation to prevent stroke, less is known about how to treat low-risk patients. Despite the recent guidelines and studies demonstrating no benefit and excess bleeding risk with aspirin, many low-risk patients still receive this medication. Our objective was to determine the stroke rate in young patients with atrial fibrillation, a group of previously unstudied and predominantly low-risk patients. We hypothesized that the event rate would be so low as to preclude benefit from antithrombotic medications. A retrospective chart review identified patients with atrial fibrillation between the age of 18 and 35. Exclusion criteria included no ECG documentation of atrial fibrillation, anticoagulation, except around the time of cardioversion, and surgical valve disease. The primary outcome was stroke during the period of observation. The final cohort included 99 patients, mean age 27.6 years, followed for a mean of 4.3 years. Mean CHADS2 and CHA2DS2-VASc scores were 0.26 and 0.4, respectively. A total of 42.4% were taking aspirin for over 50% of the time. There was one event identified, a transient ischemic attack in a man not on aspirin with CHADS2 and CHADS2-VASc scores of 1, resulting in event rates of 0.234 per 100 patient-years overall or 0.392 among those not on aspirin. Patients with nonvalvular atrial fibrillation under age 35 have an exceedingly low stroke risk. We assert that aspirin may be unnecessary for most patients in this population, especially those with a CHA2DS2-VASc score of 0.

Assertiveness and Attitudes of HIV/AIDS Orphaned Girls Towards Education in Kampala (Uganda).

PubMed

Kitara, David Lagoro; Amongin, Hellen Christine; Oonyu, Joseph C; Baguma, Peter K

2013-08-09

Whereas HIV/AIDS prevalence has been declining in Uganda from 30% to less than 10% in the last 2 decades, the number of HIV/AIDS orphaned girls in secondary schools is still high and girl children have tended to carry the heaviest burdens of family responsibilities thereby adversely affecting their assertiveness and attitudes towards education. Assertiveness is a critical life skill that enables a person to state an opinion, claim a right, or establish authority and it is important to improve attitude towards education. This study examined the relationship between assertiveness and attitude towards education of HIV/AIDS orphaned and non-orphaned adolescent school girls in Kampala. The California Psychological Inventory (CPI) Dominance (Do) Assertiveness Scale and the Attitude Scale were administered to 225 students consecutively selected from 6 secondary schools in Kampala. HIV/AIDS Orphaned girls had lower levels of assertiveness and most had a negative attitude towards education compared to non-orphaned girls. Girls orphaned to HIV/AIDS were less assertive compared to those orphaned by other causes. There was a positive relationship between assertiveness and attitude towards education among orphaned adolescent secondary school girls in Kampala. Girls orphaned to HIV/AIDS were less assertive compared to other school girls and have a poor attitude towards education.

Can you please put it out? Predicting non-smokers' assertiveness intentions at work.

PubMed

Aspropoulos, Eleftherios; Lazuras, Lambros; Rodafinos, Angelos; Eiser, J Richard

2010-04-01

The present study aimed to identify the psychosocial predictors of non-smoker employee intentions to ask smokers not to smoke at work. The predictive effects of past behaviour, anticipated regret, social norms, attitudinal, outcome expectancy and behavioural control beliefs were investigated in relation to the Attitudes-Social influence-self-Efficacy (ASE) model. Data were collected from Greek non-smoker employees (n=137, mean age=33.5, SD=10.5, 54.7% female) in 15 companies. The main outcome measure was assertiveness intention. Data on participants' past smoking, age, gender and on current smoking policy in the company were also collected. The majority of employees (77.4%) reported being annoyed by exposure to passive smoking at work, but only 37% reported having asked a smoker colleague not to smoke in the last 30 days. Regression analysis showed that the strongest predictor of non-smokers' assertiveness intentions was how often they believed that other non-smokers were assertive. Perceived control over being assertive, annoyance with secondhand smoke (SHS) exposure at work and past assertive behaviour also significantly predicted assertiveness intentions. Assertiveness by non-smoker employees seems to be guided mainly by normative and behavioural control beliefs, annoyance with SHS exposure at work, and past behaviour. Interventions to promote assertiveness in non-smokers might benefit from efficacy training combined with conveying the messages that the majority of other non-smokers are frequently annoyed by exposure to SHS, and that nearly half of all non-smokers are assertive towards smokers.

Social Functions of Denial of Death.

ERIC Educational Resources Information Center

Beilin, Robert

1981-01-01

Explores the social nature of denial and the functionality of denial in preserving relationships threatened by knowledge of terminal illness. Asserts that denial serves to forestall social withdrawal by the patient and his/her social circle, as well as promoting role enactments necessary to medical treatment. (Author)

Routine implantation of cardioverter/defibrillator devices in patients aged 75 years and older with prior myocardial infarction and left ventricular ejection fraction < 30: antagonist viewpoint.

PubMed

Basta, Lofty L

2003-01-01

The Multicenter Automatic Defibrillator Implantation Trial (MADIT II) investigators assert that their results justify the placement of artificial implantable defibrillator cardioverter devices in patients aged 75 years and older with prior myocardial infarction and left ventricular dysfunction (ejection fraction of 30 or less). The authors claim that the results of the trial do not justify this conclusion. The majority of patients were male (84%) and aged 64+/-10 years. Also, 2.8% of patients assigned to the defibrillator group and 1.5% had their device removed. Of the latter subgroup, nine patients (1.3%) received a heart transplant. Twelve had their artificial implantable defibrillator cardioverter device deactivated mostly because of terminal illness. Although the study results show a significant reduction in mortality over the control group (absolute reduction=5.6%), almost the same percentage required hospitalization because of manifestation of congestive heart failure (absolute value 5%; p=0.09). Also, 1.8% had lead problems, 0.7% had infections, and the benefits were only seen after the first year. Caution is needed before the results of this study are applied to a much older cohort comprised mainly of women in whom heart transplant is contraindicated and who have multiple health problems, including cognitive impairment. Artificial implantable cardioverter/defibrillator devices are expensive and this study's results need to be duplicated in other comparable cohorts.

Consumer Behavior: Developing Skills for Assertiveness. Consumer Education Training Module.

ERIC Educational Resources Information Center

Thayer, Lou

The goal of this inservice guide for teaching consumer education at the secondary and adult level is to help consumers become more assertive when buying goods and services. A major section in the guide defines assertiveness. The four basic components of assertive behavior are the ability to express emotions openly, the capacity to exercise one's…

Using Simulations in the Middle School: Does Assertiveness of Dyad Partners Influence Conceptual Change?

ERIC Educational Resources Information Center

Windschitl, Mark

2001-01-01

Examines how academic assertiveness in junior high school students was related to conceptual change and the degree to which their assertiveness affected conceptual change in the partners paired with them for a series of activities using a simulation of the human cardiovascular system. Indicates that the assertiveness ratings of the individuals'…

Inter-Group and Intra-Group Assertiveness: Adolescents' Social Skills Following Cultural Transition

ERIC Educational Resources Information Center

Korem, Anat; Horenczyk, Gabriel; Tatar, Moshe

2012-01-01

The goals of this study were to examine intra-group and inter-group assertiveness among adolescents, and to compare these two domains of assertiveness between cultural groups in Israel. Measures of intra-group and inter-group assertiveness were developed, and questionnaires were administrated to 441 immigrants from the Former Soviet Union (FSU),…

Effect of the Creative Drama-Based Assertiveness Program on the Assertiveness Skill of Psychological Counsellor Candidates

ERIC Educational Resources Information Center

Gundogdu, Rezzan

2012-01-01

The purpose of this quasi-experimental research is to study the effects of the creative drama-based assertiveness program (CDBAP) on the assertiveness skill of Psychological Counselling and Guidance (PCG) department students. The opinions of experimental group students on the program were obtained through the CDBAP evaluation form. The sample of…

Personality Correlates of Self-Report, Role-Playing, and In Vivo Measures of Assertiveness.

ERIC Educational Resources Information Center

Green, Samuel B.; And Others

1979-01-01

Undergraduates completed self-report inventories of assertiveness, participated in behavior role-playing tasks and in vivo measures of assertiveness, and completed the Personality Research Form E (PRF-E). Of 22 PRF-E scales, 11 had at least one significant correlation with assertiveness measures. Some composites of PRF-E scales were related to…

Relations of children's proactive and reactive assertiveness to peer acceptance: moderating effects of social interest.

PubMed

Lee, Han-Jong

2014-06-01

Previous studies on the social outcome of assertiveness reported mixed findings, failing to support the assumption that assertiveness promotes peer acceptance. In an attempt to provide explanations for the inconsistencies in prior findings, this study proposed making a distinction between proactive and reactive assertiveness and examined the moderating effects of social interest. A total of 441 fifth and sixth graders (232 boys, 209 girls; M age = 10.6 yr., SD = 0.6) participated in the study. Results indicated that proactive assertiveness was positively related to peer acceptance regardless of social interest. By contrast, reactive assertiveness was positively related to peer acceptance but only when social interest is high. When social interest is low, it was negatively associated with peer acceptance.

A Study of China’s Possible Military Intervention in the Event of a Sudden Change in North Korea

DTIC Science & Technology

2011-06-10

Kim Jong - nam , Kim Jong -chul or Kim Jong -un as Kim‘s successor. Some have asserted that there might not be a third generation of Kim ...The power struggle between Kim Jong - nam (eldest son) who is residing in China and Kim Jong -un has been observed in many places over time. Kim 29... Jong - nam , who is known to be receiving Chinese support, revealed his opposition to a third generation of dynastic succession in

High estradiol and low progesterone are associated with high assertiveness in women.

PubMed

Blake, Khandis R; Bastian, Brock; O'Dean, Siobhan M; Denson, Thomas F

2017-01-01

Sexual selection theory posits that women are more selective than men are when choosing a mate. This evolutionary theory suggests that "choosiness" increases during the fertile window because the costs and benefits of mate selection are highest when women are likely to conceive. Little research has directly investigated reproductive correlates of choice assertion. To address this gap, in the present research we investigated whether fertility, estradiol, and progesterone influenced general assertiveness in women. We recruited 98 naturally cycling, ethnically diverse women. Using a within-subjects design and ovarian hormone concentrations at fertile and non-fertile menstrual cycle phases, we measured implicit assertiveness and self-reported assertive behavior. To see if fertility-induced high assertiveness was related to increased sexual motivation, we also measured women's implicit sexual availability and interest in buying sexy clothes. Results showed that high estradiol and low progesterone predicted higher assertiveness. Sexual availability increased during periods of high fertility. Low progesterone combined with high estradiol predicted greater interest in buying sexy clothes. Results held when controlling for individual differences in mate value and sociosexual orientation. Our findings support the role of fluctuating ovarian hormones in the expression and magnitude of women's assertiveness. High assertiveness during the fertile window may be a psychological adaptation that promotes mate selectivity and safeguards against indiscriminate mate choice when conception risk is highest. Copyright © 2016 Elsevier Ltd. All rights reserved.

Undergraduate nursing students' level of assertiveness in Greece: a questionnaire survey.

PubMed

Deltsidou, Anna

2009-09-01

A number of studies of nursing and midwifery have found stress and bullying to be frequent problems. Those suffering from bullying and stress need to have high levels of assertiveness to resist and to cope successfully. Hence, it was considered vital to assess the assertiveness level of nursing students throughout their training curriculum. The study population was composed of nursing students in different semesters at one school in Central Greece (n=298) who agreed to complete a questionnaire on assertiveness level assessment, which had been translated into Greek and adapted to this population. All students present in class completed the questionnaire, representing 80% of the total population of active students. Mean assertiveness scores between semesters were compared by ANOVA and comparisons between the responses of the first semester students and responses of advanced semester students were done by Pearson's chi square. The main finding of this study was that the assertiveness levels displayed by students increase slightly in advanced semesters by comparison to those displayed by first-semester students. Assertive behavior should be encouraged through learning methods. Nurses should preferably obtain this training throughout their studies. Instructors have an essential role in the improvement and achievement of assertiveness training curriculums for undergraduate nursing students.

Sexual assertiveness mediates the effect of social interaction anxiety on sexual victimization risk among college women.

PubMed

Schry, Amie R; White, Susan W

2013-03-01

Sexual victimization is prevalent among college women and is associated with adverse psychological consequences. Social anxiety, particularly related to interpersonal interaction, may increase risk of sexual victimization among college women by decreasing sexual assertiveness and decreasing the likelihood of using assertive resistance techniques. This study examined social interaction anxiety as a risk factor for sexual victimization. College women (n=672) completed online measures of social interaction anxiety, sexual assertiveness, and sexual victimization experiences. Social interaction anxiety was significantly positively related to likelihood of experiencing coerced sexual intercourse, and significant indirect effects, via decreased sexual refusal assertiveness, were found for both coerced sexual intercourse and rape. Social anxiety may be an important psychological barrier to assertive resistance during risky sexual situations, and developers of risk reduction programs for college women should consider including methods to help women overcome their social anxiety in order to successfully use assertive resistance techniques. Copyright © 2012. Published by Elsevier Ltd.

Number of sexual partners and sexual assertiveness predict sexual victimization: do more partners equal more risk?

PubMed

Walker, Dave P; Messman-Moore, Terri L; Ward, Rose Marie

2011-01-01

In previous studies, number of sexual partners and sexual assertiveness were examined as independent risk factors for sexual victimization among college women. Using a sample of 335 college women, this study examined the interaction of number of sexual partners and sexual assertiveness on verbal sexual coercion and rape. Approximately 32% of the sample reported unwanted sexual intercourse, 6.9% (n = 23) experienced verbal sexual coercion, 17.9% (n = 60) experienced rape, and 7.2% (n = 24) experienced both. As number of sexual partners increased, instances of verbal sexual coercion increased for women low in relational sexual assertiveness but not for women high in relational sexual assertiveness. A similar relationship was not found for rape. Among women who experienced both verbal sexual coercion and rape, increases in number of partners in the context of low refusal and relational assertiveness were associated with increases in verbal sexual coercion and rape. Findings suggest sexual assertiveness is related to fewer experiences of sexual coercion.

Predictors of sexual assertiveness: the role of sexual desire, arousal, attitudes, and partner abuse.

PubMed

Santos-Iglesias, Pablo; Sierra, Juan Carlos; Vallejo-Medina, Pablo

2013-08-01

This study was conducted to test interpersonal, attitudinal, and sexual predictors of sexual assertiveness in a Spanish sample of 1,619 men and 1,755 women aged 18-87 years. Participants completed measures of sexual assertiveness, solitary and dyadic sexual desire, sexual arousal, erectile function, sexual attitudes, and frequency of partner abuse. In men, higher sexual assertiveness was predicted by less non-physical abuse, more positive attitudes toward sexual fantasies and erotophilia, higher dyadic desire, and higher sexual arousal. In women, higher sexual assertiveness was predicted by less non-physical abuse, less solitary sexual desire and higher dyadic sexual desire, arousal, erotophilia, and positive attitudes towards sexual fantasies. Results were discussed in the light of prevention and educational programs that include training in sexual assertiveness skills.

Correlates of adolescent assertiveness with HIV avoidance in a four-nation sample.

PubMed

Onuoha, Francis N; Munakata, Tsunetsugu

2005-01-01

Adolescents are frequently admonished to be socially assertive in order to confront negative interpersonal peer influences. Since the advent of HIV/AIDS in human social chemistry, the admonition has become more critical than ever. But the warning is often proffered in the misguided presumption that social assertiveness is the all-required psycho-structure against risk. The present cross-national study examines social and sexual assertiveness in four-country adolescent samples of Nigerian, Thai, Chinese, and Japanese college students. The findings reveal that sexual rather than social assertiveness was the sine qua non against risk, cross-culturally.

Subclinical atrial fibrillation and the risk of stroke.

PubMed

Healey, Jeff S; Connolly, Stuart J; Gold, Michael R; Israel, Carsten W; Van Gelder, Isabelle C; Capucci, Alessandro; Lau, C P; Fain, Eric; Yang, Sean; Bailleul, Christophe; Morillo, Carlos A; Carlson, Mark; Themeles, Ellison; Kaufman, Elizabeth S; Hohnloser, Stefan H

2012-01-12

One quarter of strokes are of unknown cause, and subclinical atrial fibrillation may be a common etiologic factor. Pacemakers can detect subclinical episodes of rapid atrial rate, which correlate with electrocardiographically documented atrial fibrillation. We evaluated whether subclinical episodes of rapid atrial rate detected by implanted devices were associated with an increased risk of ischemic stroke in patients who did not have other evidence of atrial fibrillation. We enrolled 2580 patients, 65 years of age or older, with hypertension and no history of atrial fibrillation, in whom a pacemaker or defibrillator had recently been implanted. We monitored the patients for 3 months to detect subclinical atrial tachyarrhythmias (episodes of atrial rate >190 beats per minute for more than 6 minutes) and followed them for a mean of 2.5 years for the primary outcome of ischemic stroke or systemic embolism. Patients with pacemakers were randomly assigned to receive or not to receive continuous atrial overdrive pacing. By 3 months, subclinical atrial tachyarrhythmias detected by implanted devices had occurred in 261 patients (10.1%). Subclinical atrial tachyarrhythmias were associated with an increased risk of clinical atrial fibrillation (hazard ratio, 5.56; 95% confidence interval [CI], 3.78 to 8.17; P<0.001) and of ischemic stroke or systemic embolism (hazard ratio, 2.49; 95% CI, 1.28 to 4.85; P=0.007). Of 51 patients who had a primary outcome event, 11 had had subclinical atrial tachyarrhythmias detected by 3 months, and none had had clinical atrial fibrillation by 3 months. The population attributable risk of stroke or systemic embolism associated with subclinical atrial tachyarrhythmias was 13%. Subclinical atrial tachyarrhythmias remained predictive of the primary outcome after adjustment for predictors of stroke (hazard ratio, 2.50; 95% CI, 1.28 to 4.89; P=0.008). Continuous atrial overdrive pacing did not prevent atrial fibrillation. Subclinical atrial tachyarrhythmias, without clinical atrial fibrillation, occurred frequently in patients with pacemakers and were associated with a significantly increased risk of ischemic stroke or systemic embolism. (Funded by St. Jude Medical; ASSERT ClinicalTrials.gov number, NCT00256152.).

[Delusional parasitosis intestinal and dermatological: clinical cases].

PubMed

Pérez de Arce, Edith; Rosset, Daniela; Arcos, Mario; Castillo, Douglas; Gil, Carlos; Beltrán, Caroll; Gil, Luis Carlos

2017-06-01

Illusory parasitosis, better known as delusional parasitosis, is a neuropsychiatric syndrome in which patients have the belief of suffering a parasitic disease, that can not be demonstrated after an exhaustive medical study. These patients are characterized by being polyconsultants in different medical specialties and, many of them, have antecedents of psychiatric disorders, some of them undiagnosed. Knowing the existence of the clinical picture, diagnosing early and empathizing with the patient, could give to clinician some clues for a timely and assertive psychiatric referral, and improve patient adherence to the proposed treatment.

Psychological and Spiritual Factors in Chronic Illness.

ERIC Educational Resources Information Center

Leifer, Ron

1996-01-01

Asserts the importance of psychological and spiritual factors in the treatment of chronic illness. Discusses the inevitably of sickness, old age, and death, as well as the presence of the physician, patience, pain, and hope. Maintains that reflection on these qualities can benefit both the physician and patient. (MJP)

An Action Research Study Exploring How Education May Enhance Pain Management in Children.

ERIC Educational Resources Information Center

Simons, Joan M.

2002-01-01

Focus groups (n=14) and a study day (n=10) on pain management for child patients were held for pediatric nurses. Participants felt they increased their knowledge of pharmacology and their confidence and assertiveness in the practice of pain management. (Contains 37 references.) (SK)

Exercise and Diabetes Mellitus: Optimizing Performance in Patients Who Have Type 1 Diabetes.

ERIC Educational Resources Information Center

Birrer, Richard B.; Sedaghat, Vahid-David

2003-01-01

Asserts that people with type 1 diabetes should include regular sports or recreational activities in their overall health care programs, noting that physicians must provide preparticipation clearance, education about blood glucose self-monitoring, exercise prescription, aggressive dietary and insulin management plans, identification of risk…

"Physician, Heal Thyself": How Teaching Holistic Medicine Differs from Teaching CAM.

ERIC Educational Resources Information Center

Graham-Pole, John

2001-01-01

Describes the fundamental difference between complementary and alternative medicine (CAM) and holistic medicine, highlighting holistic medicine's emphasis on the promotion of healthy lifestyles for practitioners and patients alike. Asserts that offering physicians-to-be more course work in holistic medicine could lay the groundwork for future…

How Should Alternative Medicine Be Taught to Medical Students and Physicians?

ERIC Educational Resources Information Center

Marcus, Donald M.

2001-01-01

Analyzes alleged deficiencies in medical education and concludes they are based on misrepresentations (for example, that physicians ignore mind-body interactions). Examines fundamental differences between traditional and alternative medicine and asserts that physicians need additional education in order to provide guidance to patients, but that…

Assertive Behavior and Cognitive Performance in Preschool Children

ERIC Educational Resources Information Center

Dorman, Lynn

1973-01-01

Assertive behaviors were related to each other and to intelligence test scores. An item analysis revealed that more assertive children did better on certain intelligence test items: comprehension, verbal, and discrimination. (ST)

Effects of music on assertive behavior during exercise by middle-school-age students.

PubMed

Mills, B D

1996-10-01

The purpose of this study was to assess the association of a particular style of music and assertive behavior in middle-school-aged students during exercise. Participants were students enrolled in a public middle school (Grades 6, 7, and 8, N = 502). A statistically significant relationship was found between the number of assertive behaviors occurring while listening to fast tempo music and grades and between difference scores and grades. Difference scores were obtained by subtracting the number of assertive behaviors occurring while listening to fast tempo music from those while listening to slow tempo music. Discriminant function analysis showed the number of assertive behaviors when listening to fast tempo music and difference scores were predictive of membership by grade. The higher the more assertive behaviors were emitted when listening to fast tempo music.

Assertiveness and problem solving in midwives.

PubMed

Yurtsal, Zeliha Burcu; Özdemir, Levent

2015-01-01

Midwifery profession is required to bring solutions to problems and a midwife is expected to be an assertive person and to develop midwifery care. This study was planned to examine the relationship between assertiveness and problem-solving skills of midwives. This cross-sectional study was conducted with 201 midwives between July 2008 and February 2009 in the city center of Sivas. The Rathus Assertiveness Schedule (RAS) and Problem Solving Inventory (PSI) were used to determine the level of assertiveness and problem-solving skills of midwives. Statistical methods were used as mean, standard deviation, percentage, Student's T, ANOVA and Tukey HSD, Kruskal Wallis, Fisher Exact, Pearson Correlation and Chi-square tests and P < 0.05. The RAS mean scores and the PSI mean scores showed statistically significant differences in terms of a midwife's considering herself as a member of the health team, expressing herself within the health care team, being able to say "no" when necessary, cooperating with her colleagues, taking part in problem-solving skills training. A statistically significant negative correlation was found between the RAS and PSI scores. The RAS scores decreased while the problem-solving scores increased (r: -0451, P < 0.01). There were significant statistical differences between assertiveness levels and problem solving skills of midwives, and midwives who were assertive solved their problems better than did others. Assertiveness and problem-solving skills training will contribute to the success of the midwifery profession. Midwives able to solve problems, and display assertive behaviors will contribute to the development of midwifery profession.

[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.

Children's responses to hypothetical provocation by peers: coordination of assertive and aggressive strategies.

PubMed

Dirks, Melanie A; Suor, Jennifer H; Rusch, Dana; Frazier, Stacy L

2014-10-01

Children often respond to aggression by peers with assertive bids or aggressive retaliation. Little is known, however, about whether and how children coordinate these strategies across different types of provocation. The present study examined endorsement of aggressive and assertive responses to hypothetical physical, relational, and verbal provocation in a sample of lower-income children (N = 402, M age = 10.21, SD = 1.46). Latent-profile analysis revealed 3-class models for both aggression and assertion, each reflecting low, moderate, and high levels of endorsement. There was no association between children's reported use of aggression and assertion. For example, children who endorsed high levels of aggression were equally likely to be classified as low, moderate, or high on assertive responding. For both assertion and aggression, parental ratings of children's externalizing behavior and social skills differed across the low and high groups. No such differences were found between the low and moderate groups, despite the latter groups endorsing markedly higher levels of assertive and aggressive responses. This pattern of findings may be due, in part, to the situation specificity of children's responding. Our findings hint at the complexity of children's behavioral repertoires and contribute to a growing literature that suggests the need for intervention models that consider both social skills and social situations.

Perspective of vaccine manufacturers on financing pediatric and adolescent vaccines in the United States.

PubMed

Shen, Angela K; Rodewald, Lance E; Birkhead, Guthrie S

2009-12-01

The goal was to understand vaccine manufacturers' perspectives on vaccine financing as a barrier to immunization. Individual telephone interviews with representatives of the 6 manufacturers that produce routinely recommended vaccines for children and adolescents in the United States were conducted in November and December 2006. Although manufacturers acknowledged that the price of newer vaccines presents challenges to optimal vaccine use, they asserted that children and adolescents have access to vaccinations through public and private insurance. Respondents suggested that the system could be improved through adequate funding of the public-sector safety net. Respondents stated that providers should receive timely reimbursement for the full costs of vaccine purchase and administration, and manufacturers who sell directly to health care providers may provide flexible payment terms for vaccine purchases. Manufacturers supported targeted expansion of the Vaccines for Children program to allow children with incomplete insurance coverage for vaccines to receive vaccines at health department clinics. Manufacturers perceived delays in publication of Advisory Committee on Immunization Practices recommendations as a potential barrier to vaccine uptake. They viewed the perceived lack of public value for vaccines as a potential barrier to adequate reimbursement and optimal utilization. Respondents also maintained that their ability to negotiate vaccine prices through the private market is a crucial priority. Manufacturers assert that children and adolescents have access to immunizations through public and private insurance. Manufacturers think that they have mitigated the challenge most directly in their control: the large financial outlays required for up-front vaccine purchases.

Noradrenaline might enhance assertive human social behaviours: an investigation in a flatmate relationship.

PubMed

Tse, W S; Bond, A J

2006-09-01

The aim of the present study was to explore the role of noradrenaline on the social behaviour of healthy volunteers when they were interacting with a familiar person, their flatmate. Interaction with the flatmate was explored in a cooperative game situation. Ten pairs of same-sex healthy volunteer flatmates aged 18-25 years were recruited for the experiment. All volunteers gave written informed consent and the study was approved by the institutional ethical committee. A randomised, double blind, placebo-controlled crossover trial of reboxetine versus placebo was conducted. In each of the 10 pairs of volunteers, one (subject) volunteered to take the tablets and the other (flatmate) received no treatment. Reboxetine (4 mg/bd) and placebo were administered orally as identical capsules for 2 weeks. The subjects were randomly assigned to receive either reboxetine or placebo first and there was a two-week washout period following the first treatment. At baseline and the end of each treatment, they filled in the Beck Depression Inventory (BDI), Social Adapation Self-Evaluation Scale (SASS), and Aggression Questionnaire (AQ). Then, they were instructed to play the Tangrams game. This task elicits face-valid social behaviours such as cooperation, giving commands and unilateral grasps. Analysis of covariance showed that there was a statistical trend for reboxetine treatment to increase commands (p=0.055). This study presents preliminary evidence that two weeks' enhancement of noradrenaline transmission induced by reboxetine makes healthy volunteers more self-confident and assertive.

Satisfaction and burnout among staff of crisis resolution, assertive outreach and community mental health teams. A multicentre cross sectional survey.

PubMed

Nelson, Tanya; Johnson, Sonia; Bebbington, Paul

2009-07-01

The NHS Plan required extensive changes in the configuration of mental health services in the UK, including introduction of crisis resolution teams, CRTs. Little is known about the effects of these changes on mental health staff and their recruitment and retention. To assess levels of burnout and sources of satisfaction and stress in CRT staff and compare them with assertive outreach team (AOT) and community mental health team (CMHT) staff. Cross sectional survey using questionnaires, including the Maslach Burnout Inventory, the Minnesota Satisfaction Scale and global job satisfaction item from the Job Diagnostic Survey. All staff in 11 CRTs in 7 London boroughs were included. One hundred and sixty-nine questionnaires were received (response rate 78%). CRT staff were moderately satisfied with their jobs and scores for the three components of burnout were low or average. Their sense of personal accomplishment was greater than in the other types of team. Our results suggest that CRTs may be sustainable from a workforce morale perspective, but longer term effects will need to be assessed.

Cross-cultural validity of the scale for interpersonal behavior.

PubMed

Nota, Laura; Arrindell, Willem A; Soresi, Salvatore; van der Ende, Jan; Sanavio, Ezio

2011-01-01

The Scale for Interpersonal Behavior (SIB) is a 50-item multidimensional measure of difficulty and distress in assertiveness. The SIB assesses negative assertion, expression of and dealing with personal limitations, initiating assertiveness and positive assertion. The SIB was originally developed in the Netherlands. The present study attempted to replicate the original factors with an Italian student sample (n = 995). The four distress and four performance factors were replicable across two methods of analysis (the multiple group method of confirmatory analysis and Tucker's coefficient of congruence (phi). The corresponding scales were internally consistent and showed predicted patterns of correlations with a measure of self-efficacy. Sex and age differences in assertiveness were generally negligible. Italian students had higher positive assertion-performance scores than the Dutch and comparable scores on other performance scales; by contrast, the Italian subjects had significantly higher scores on all SIB distress scales than their Dutch equivalents. This was ascribed to the stronger pressure on people in Italian society to behave assertively (Hofstede's National Masculinity score = 70) as opposed to the Dutch society (National Masculinity score = 14).

Assessment of MLA assertiveness training for librarians: students' behavior changes after taking C.E. 669, Assertiveness and Human Relations Skills.

PubMed Central

Caputo, J S

1985-01-01

C.E. 669, offered for three years, was MLA's first personal development continuing education course. Participants were asked to respond to a follow-up survey about their current assertive philosophy, awareness, and behavioral repertoire. They were also assessed by the Librarian's Assertiveness Inventory, a tool that indicates patterns of behavioral responses, for which some normative data were available from librarians who had not taken the class. Class participants were found to be more likely to behave assertively and less likely to behave aggressively than librarians who had not taken the class. In nine out of ten situational categories, librarians who had taken the class demonstrated assertive response patterns. They also reported remembering and using more than one third of the behavioral techniques covered in class, with particular use of the nonverbal techniques. A majority saw themselves as more assertive since taking the class, although most believed that others viewed them much the same as they had prior to the class. Positive progress toward reaching specific behavioral goals was also reported. PMID:4052676

The Impact of Pain on Patient and Physician

PubMed Central

Longhurst, Mark F.

1984-01-01

A patient's pain has lost its status as an expression of personal suffering and is seen by both physician and patient as a strictly physical attribute. Because of this, their communication may become oblique and subversive, effectively destroying a therapeutic relationship. The patient's failure to recover causes the physician to suffer unease and begin assuming pain-reducing postures of anger, indifference and assertiveness. The physician, to avoid this scenario, must acknowledge the existential component of the patient's pain, the reality of his own discomfort, and be open enough to give personal suffering a place in the relationship. PMID:21279065

A dismantling study of assertive outreach services: comparing activity and outcomes following replacement with the FACT model.

PubMed

Firn, Mike; Hindhaugh, Keelyjo; Hubbeling, Dieneke; Davies, Gwyn; Jones, Ben; White, Sarah Jane

2013-06-01

Financial constraints and some disappointing research evaluations have seen English assertive outreach (AO) teams subject to remodelling, decommissioning and integration into standard care. We tested a specific alternative model of integrating the AO function from two AO teams into six standard community mental health teams (CMHT). The Flexible Assertive Community Treatment model (FACT) was adopted from the Netherlands (Van Veldhuizen, Commun Mental Health J 43(4):421-433, 2007; Bond and Drake, Commun Mental Health J 43(4):435-438, 2007). We aimed to demonstrate non-inferiority in clinical effectiveness and thereby show cost efficiencies associated with FACT. Outcomes were compared in a mirror-image study of the 12 months periods pre- and post-service change with eligible individuals from the AO teams' caseloads (n = 112) acting as their own controls. We also conducted a cost-consequence analysis of the changes. Outcome data regarding admissions, use of crisis and home treatment, frequency of contact and DNA rate were extracted from the electronic patient record. The results show AO patients (n = 112) transferred to standard CMHTs with FACT had significantly fewer admissions and a halving of bed use (21 fewer admission and 2,394 fewer occupied bed days) whilst being in receipt of a less intensive service (2,979 fewer contacts). This was offset by significantly poorer engagement but not by increased use of crisis and home treatment services. Enhancing multi-disciplinary CMHTs with FACT provides a clinically effective alternative to AO teams. FACT offers a cost-effective model compared to AO.

RADICALLY CONTESTED ASSERTIONS IN ECOSYSTEM MANAGEMENT

EPA Science Inventory

Ecosystem management is a magnet for controversy, in part because some of its formulations rest on questionable assertions that are radically contested. These assertions are important to understanding much of the conflict surrounding ecosystem management and, therrefore, deserve...

Validity of a Measure of Assertiveness

ERIC Educational Resources Information Center

Galassi, John P.; Galassi, Merna D.

1974-01-01

This study was concerned with further validation of a measure of assertiveness. Concurrent validity was established for the College Self-Expression Scale using the method of contrasted groups and through correlations of self-and judges' ratings of assertiveness. (Author)

Assertiveness Training and Christian Values.

ERIC Educational Resources Information Center

Bolsinger, Scot A.; McMinn, Mark R.

1989-01-01

Studies exploring the relationship between religious values and assertiveness are reviewed. Ideological obstacles in assertion training with religious clients are considered, and appropriate therapeutic strategies suggested. Emphasizes importance of presenting rationale for treatment and understanding client's value system. (Author/TE)

Assertiveness and problem solving in midwives

PubMed Central

Yurtsal, Zeliha Burcu; Özdemir, Levent

2015-01-01

Background: Midwifery profession is required to bring solutions to problems and a midwife is expected to be an assertive person and to develop midwifery care. This study was planned to examine the relationship between assertiveness and problem-solving skills of midwives. Materials and Methods: This cross-sectional study was conducted with 201 midwives between July 2008 and February 2009 in the city center of Sivas. The Rathus Assertiveness Schedule (RAS) and Problem Solving Inventory (PSI) were used to determine the level of assertiveness and problem-solving skills of midwives. Statistical methods were used as mean, standard deviation, percentage, Student's T, ANOVA and Tukey HSD, Kruskal Wallis, Fisher Exact, Pearson Correlation and Chi-square tests and P < 0.05. Results: The RAS mean scores and the PSI mean scores showed statistically significant differences in terms of a midwife's considering herself as a member of the health team, expressing herself within the health care team, being able to say “no” when necessary, cooperating with her colleagues, taking part in problem-solving skills training. A statistically significant negative correlation was found between the RAS and PSI scores. The RAS scores decreased while the problem-solving scores increased (r: -0451, P < 0.01). Conclusions: There were significant statistical differences between assertiveness levels and problem solving skills of midwives, and midwives who were assertive solved their problems better than did others. Assertiveness and problem-solving skills training will contribute to the success of the midwifery profession. Midwives able to solve problems, and display assertive behaviors will contribute to the development of midwifery profession. PMID:26793247

Observed assertive and intrusive maternal feeding behaviors increase child adiposity123

PubMed Central

Ozbeki, Tina N; Appugliese, Danielle P; Kaciroti, Niko; Corwyn, Robert F; Bradley, Robert H

2012-01-01

Background: Few studies have examined observed maternal feeding behaviors and their potential association with child adiposity. The association between maternal prompting to eat and child adiposity has been inconsistent. Objectives: This study sought to identify factors associated with maternal feeding behaviors and to test the hypothesis that more maternal prompts to eat, more assertive prompts, and more intrusiveness are associated with greater child adiposity. Design: Children (n = 1218) and their mothers were videotaped eating a standardized snack at ages 15, 24, and 36 mo. Maternal prompts to eat, the percentage of prompts that were assertive, and intrusiveness were coded. Adjusted regression analyses evaluated predictors of prompts, the percentage of assertive prompts, and intrusiveness and the relation of each of these factors with child adiposity (weight-for-length z score at 15 mo and BMI z score at 24 and 36 mo) after control for the child's race-ethnicity and sex, family income-to-needs ratio, and maternal education, weight status, and depressive symptoms. Results: At 36 mo, mothers gave an average of 9.3 prompts; 61% of prompts were assertive, and 48% of mothers were intrusive. Lower maternal education and minority race-ethnicity were associated with a greater percentage of assertive prompts and intrusiveness. A greater percentage of assertive prompts and intrusiveness, but not total prompts, was associated with higher child adiposity. Conclusions: Assertive prompting and an intrusive style had small but significant associations with greater child adiposity. Future work should focus on maternal motivations for assertive and intrusive feeding styles and mechanisms through which these feeding styles might increase child adiposity. PMID:22277552

The Level of Depression and Assertiveness among Nursing Students.

PubMed

Rezayat, Fatemeh; Dehghan Nayeri, Nahid

2014-07-01

Nursing students are susceptible to a higher risk of depression. Recognition of depression, assertiveness and the relationship between them is important since if a relationship exists, probably enhancing the level of assertiveness can reduce depression in this high risk group. We aimed to investigate depression and assertiveness levels and the relationship between them in nursing students of Tehran University of Medical Sciences. The target population of this cross-sectional study was bachelor nursing students of Tehran University of Medical Sciences, as the largest and one of the most prestigious Iranian universities. For selecting samples, the convenience sampling method was used. Having no previous information about classes, the researcher selected the students from the courses held while the researcher was present for sampling at the faculty and studied all the students willing to participate in the study in selected classes. The questionnaire consisted of demographic information, Gambrill and Richey assertion inventory, and Beck's depression inventory. SPSS software, version 16, was used to analyze the data. ANOVA and independent samples t test were used for as appropriated. 55.6% of students indicated average and low levels of assertiveness and 38.7% were suffering from mild to severe depression. Pearson correlation test showed a significant inverse relationship (r=0.314 and P<0.001) between assertiveness and depression. There were significant relationships between depression and interest in the field of study (P=0.001) and between assertiveness and gender (P=0.035). There was an inverse significant relationship between depression and assertiveness among nursing students. We suggest a cohort study design that can determine the effect of these variables on each other completely.

Sex Differences in Assertiveness in College Students

ERIC Educational Resources Information Center

Stebbins, Charles; And Others

1977-01-01

Validates the "College Self-Expression Scale." Shows that females are significantly more assertive, and that in one of the criterion situations each sex was significantly more assertive toward members of the same sex than members of the opposite sex. (RL)

Development of a flight software testing methodology

NASA Technical Reports Server (NTRS)

Mccluskey, E. J.; Andrews, D. M.

1985-01-01

The research to develop a testing methodology for flight software is described. An experiment was conducted in using assertions to dynamically test digital flight control software. The experiment showed that 87% of typical errors introduced into the program would be detected by assertions. Detailed analysis of the test data showed that the number of assertions needed to detect those errors could be reduced to a minimal set. The analysis also revealed that the most effective assertions tested program parameters that provided greater indirect (collateral) testing of other parameters. In addition, a prototype watchdog task system was built to evaluate the effectiveness of executing assertions in parallel by using the multitasking features of Ada.

The effectiveness of assertiveness training for school-aged children on bullying and assertiveness level.

PubMed

Avşar, Fatma; Ayaz Alkaya, Sultan

The aim of this study was to determine the effectiveness of an assertive training for school-aged children on peer bullying and assertiveness. A quasi-experimental design using pre- and post-testing was conducted. Data were collected using a demographic questionnaire, an assertiveness scale, and the peer victimization scale. The training program was comprised of eight sessions which were implemented to intervention group. Descriptive characteristics were not statistically different between the groups (p>0.05). The peer victimization victim dimension results show that post-test mean scores of the students in the intervention group were lower than the pre-test mean scores (p<0.05). For the control group, no significant change was found in the pre-test and post-test mean scores (p>0.05). A comparison of the mean pre-test/post-test scores of peer-victimization bully dimension of the students' intervention and control groups revealed that the mean post-test scores of the students in the each group decreased (p>0.05). An assertiveness training program increased the assertiveness level and reduced the state of being victims, but did not affect the state of being bullies. The results of this study can help children acquire assertive behaviors instead of negative behaviors such as aggression and shyness, and help them to build effective social communication. Copyright © 2017 Elsevier Inc. All rights reserved.

The contribution of hospital library information services to clinical care: a study in eight hospitals.

PubMed Central

King, D N

1987-01-01

Hospital health sciences libraries represent, for the vast majority of health professionals, the most accessible source for library information and services. Most health professionals do not have available the specialized services of a clinical medical librarian, and rely instead upon general information services for their case-related information needs. The ability of the hospital library to meet these needs and the impact of the information on quality patient care have not been previously examined. A study was conducted in eight hospitals in the Chicago area as a quality assurance project. A total of 176 physicians, nurses, and other health professionals requested information from their hospital libraries related to a current case or clinical situation. They then assessed the quality of information received, its cognitive value, its contribution to patient care, and its impact on case management. Nearly two-thirds of the respondents asserted that they would definitely or probably handle their cases differently as a result of the information provided by the library. Almost all rated the libraries' performance and response highly. An overview of the context and purpose of the study, its methods, selected results, limitations, and conclusions are presented here, as is a review of selected earlier research. PMID:3450340

Silencing the Patient: Freud, Sexual Abuse, and "The Etiology of Hysteria."

ERIC Educational Resources Information Center

McOmber, James B.

1996-01-01

States that, in "The Etiology of Hysteria," Sigmund Freud's "seduction theory" asserted that child sexual abuse was the single cause of adult hysteria. Argues that Freud's failure to persuade his audience can be attributed not only to their denial of sexual abuse but also to his failure to clarify how pschyoanalysis could…

Using Video-Reflexive Ethnography to Capture the Complexity of Leadership Enactment in the Healthcare Workplace

ERIC Educational Resources Information Center

Gordon, Lisi; Rees, Charlotte; Ker, Jean; Cleland, Jennifer

2017-01-01

Current theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. However, much healthcare leadership education focusses on the training and competence of individuals and little attention is paid to the interprofessional workplace and how…

[Development and Effects of Assertiveness Training applying Dongsasub Training for Nursing Students in Clinical Practice].

PubMed

Kim, Myoungsuk

2016-08-01

This study was conducted to develop assertiveness training applying Dongsasub training for junior nursing students, and to verify effectiveness of the training on assertiveness behavior, self-esteem, clinical practice stress, and clinical competence. The study design was a non-equivalent control group non-synchronized design. Participants were 63 nursing students in clinical training (31 students in the experimental group and 32 students in the control group). The assertiveness training applying Dongsasub training consisted of four sessions. Outcome variables included assertiveness behavior, self-esteem, clinical practice stress, and clinical competence. Data were analyzed using Chi-square, Fisher's exact test and independent samples t-test with SPSS/WIN 21.0. Scores of assertiveness behavior (t=-2.49, p=.015), self-esteem (t=-4.80, p<.001) and clinical competence (t=-2.33, p=.023) were significantly higher and clinical practice stress (t=4.22, p<.001) was significantly lower in the experimental group compared to the control group. Results indicate that the assertiveness training applying Dongsasub training can be used as a nursing intervention to lower clinical practice stress and improve the clinical competence of nursing students.

Smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness for smoke-free air in the workplace: a study from the Balkans.

PubMed

Lazuras, Lambros; Zlatev, Martin; Rodafinos, Angelos; Eiser, J Richard

2012-10-01

Identify the psychosocial variables that predict smokers’ compliance with smoke-free policies at work, and non-smokers’ assertiveness for smoke-free rights in Greek and Bulgarian workplaces. Data were collected from employees in Greece and Bulgaria. The main outcome measures were smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness intentions. Demographic variables, tobacco use and dependence, as well as beliefs about second-hand smoke (SHS) exposure and smoking at work were also assessed. Regression analyses showed that smokers’ compliance with smoke-free policies was predicted by age, perceived health risks of smoking, and beliefs related to the benefits of smoking at work. Non-smokers’ assertiveness was predicted by annoyance from exposure to SHS at work, and assertiveness-related social cognitions (e.g., attitudes, social norms, and self-efficacy). Interventions to promote support for tobacco control policies at work in Greece and Bulgaria may benefit from targeting smokers’ beliefs about the actual effects of tobacco use on health and job performance. Accordingly, efforts to promote non-smokers assertiveness should build stronger assertiveness-related attitudes, convey anti-smoking normative messages, and strengthen self-efficacy skills.

The Effectiveness of Nurse-Led Preoperative Assessment Clinics for Patients Receiving Elective Orthopaedic Surgery: A Systematic Review.

PubMed

Sau-Man Conny, Chan; Wan-Yim, Ip

2016-12-01

Nurse-led preoperative assessment clinics (POAC) have been introduced in different specialty areas to assess and prepare patients preoperatively in order to avoid last-minute surgery cancellations. Not all patients are referred to POACs before surgery, and the benefits of nurse-led POACs are not well documented in Hong Kong. The purpose of this systemic review was to identify the best available research evidence to inform current clinical practice, guide health care decision making and promote better care. The Joanna Briggs Institute (JBI) approach for conducting systematic review of quantitative research was used. Data bases searched included all published and unpublished studies in Chinese and English. All studies with adult patients who required elective orthopaedic surgery e.g. total knee replacement, total hip replacement, reduction of fracture or reconstruction surgery etc. in a hospital or day surgery center and attended a nurse-led POAC before surgery were included. Ten studies were critically appraised. Results showed that nurse-led POACs can reduce surgery cancellation rates. These studies suggested a reduction in the rate of postoperative mortality and length of hospital stay. In addition, the level of satisfaction towards services provided was significantly high. Although POACs are being increasingly implemented worldwide, the development of clinical guidelines, pathways and protocols was advocated. The best available evidence asserted that nurses in the POAC could serve as effective coordinators, assessors and educators. The nurse-led practice optimized patients' condition before surgery and hence minimized elective surgery cancellations. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

The Level of Depression and Assertiveness among Nursing Students

PubMed Central

Rezayat, Fatemeh; Dehghan Nayeri, Nahid

2014-01-01

Background: Nursing students are susceptible to a higher risk of depression. Recognition of depression, assertiveness and the relationship between them is important since if a relationship exists, probably enhancing the level of assertiveness can reduce depression in this high risk group. We aimed to investigate depression and assertiveness levels and the relationship between them in nursing students of Tehran University of Medical Sciences. Methods: The target population of this cross-sectional study was bachelor nursing students of Tehran University of Medical Sciences, as the largest and one of the most prestigious Iranian universities. For selecting samples, the convenience sampling method was used. Having no previous information about classes, the researcher selected the students from the courses held while the researcher was present for sampling at the faculty and studied all the students willing to participate in the study in selected classes. The questionnaire consisted of demographic information, Gambrill and Richey assertion inventory, and Beck’s depression inventory. SPSS software, version 16, was used to analyze the data. ANOVA and independent samples t test were used for as appropriated. Results: 55.6% of students indicated average and low levels of assertiveness and 38.7% were suffering from mild to severe depression. Pearson correlation test showed a significant inverse relationship (r=0.314 and P<0.001) between assertiveness and depression. There were significant relationships between depression and interest in the field of study (P=0.001) and between assertiveness and gender (P=0.035). Conclusion: There was an inverse significant relationship between depression and assertiveness among nursing students. We suggest a cohort study design that can determine the effect of these variables on each other completely. PMID:25349860

Predictive factors of alcohol and tobacco use in adolescents.

PubMed

Alvarez-Aguirre, Alicia; Alonso-Castillo, María Magdalena; Zanetti, Ana Carolina Guidorizzi

2014-01-01

to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents. a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used. the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year. this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users.

'Every disease has its cure': faith and HIV therapies in Islamic northern Nigeria.

PubMed

Tocco, Jack Ume

2010-12-01

Northern Nigeria has one of the highest levels of HIV prevalence among societies that are predominantly Muslim. In the last decade the region has experienced marked expansion of religiously-oriented healing practices following the formal adoption of Islamic sharia law. Since 2005, international funding has also made antiretroviral therapy (ART) more widely available throughout Nigeria. This study uses ethnographic data collected in Kano, northern Nigeria's largest city, to examine Muslims' perspectives on HIV treatment in the context of popular health beliefs and expanding therapeutic options. The research found that passages from classical Islamic texts are regularly cited by both HIV/AIDS practitioners and patients, especially when talking about the supposition that Allah sends a cure to humankind for every disease. Some religious scholar-practitioners (malamai) working in the Islamic traditions of prophetic medicine insist that HIV can be completely cured given sufficient faith in the supernatural power of the Quran; others claim that the natural ingredients prescribed in Islamic texts can cure HIV. Such assertions contradict the mainstream biomedical position that, with the proper therapeutic regimen, infection with HIV can be managed as a chronic illness, although not cured. Thus, these assertions constitute a challenge to the increasing therapeutic hegemony of antiretroviralbased care in Nigeria. Without falsifying the proposition that a divine cure for HIV exists, many Muslim patients on ART, and the predominantly Muslim biomedical staff who treat them, express scepticism about whether the cure has yet to be revealed to humans. These findings suggest that despite recent efforts in Nigeria to assert a unified Islamic perspective on HIV and AIDS, substantive disagreements persist over the causes, treatments and curability of the disease. The healing systems in which practitioners and patients operate influence how they interpret Islamic texts concerning the divinely ordained relationships between Allah, humans, diseases and cures.

A social work contribution to suicide prevention through assertive brief psychotherapy and community linkage: use of the Manchester Short Assessment of Quality of Life (MANSA).

PubMed

Petrakis, Melissa; Joubert, Lynette

2013-01-01

There is a striking absence of literature articulating and evaluating clinical social work contributions to suicide prevention, despite considerable practice in this important field. This article reports on a model of assertive brief psychotherapeutic intervention and facilitated linkage to community services utilized in a prospective cohort study of emergency department suicide attempt aftercare. A key outcome measure, the Manchester Short Assessment of Quality of Life (MANSA), was used with 65 patients to assess psychosocial domains at initial presentation, 4-weeks, 3-months, and 6-months. There were significant improvements in the domains of work, finance, leisure, social life, living situation, personal safety and health by 3 months. There were highly significant correlations between psychosocial improvements and improved depression scores.

An Assertiveness Scale for Adolescents.

ERIC Educational Resources Information Center

Lee, Dong Yul; And Others

1985-01-01

Developed a 33-item, situation-specific instrument that measures assertiveness of adolescents. Based on data from 682 elementary and secondary school students, adequate reliability and validity of the Assertiveness Scale for Adolescents (ASA) were obtained when tested against several variables about which predictions could be made. (BH)

Assertiveness and Physical Attractiveness.

ERIC Educational Resources Information Center

Kleim, David M.; And Others

Earlier research investigating the relationship between physical attractiveness and assertiveness found that physically attractive females were more assertive than other females. To investigate this relationship further and to broaden the scope of the study, 69 students were videotaped in groups of five to ten while responding to open-ended…

Revisiting the Interactive Effect of Narcissism and Self-Esteem on Responses to Ego Threat: Distinguishing Between Assertiveness and Intent to Harm.

PubMed

Hart, William; Richardson, Kyle; Tortoriello, Gregory K

2018-05-01

We addressed whether narcissism and self-esteem synergize to enhance assertive responses and deter aggressive responses to ego-threatening provocation. Participants ( N = 448) completed measures of narcissism and self-esteem, imagined ego-threatening provocation, and indicated their aggressive and assertive responses. Participants also completed individual difference measures of agreeableness, openness, status/dominance motivation, and endorsement of the notion that aggression begets power. Narcissism and self-esteem interacted to reduce aggressive responses but enhance assertive responses to ego-threat; moreover, this interaction related to enhanced agreeableness, openness, status/dominance motivation, and reduced endorsement of the belief that aggression begets power, and these relations accounted, in part, for relations between the interaction and aggressive and assertive responses. Broadly, the findings contribute to the contentious issue of how self-evaluation influences responses to ego-threat; specifically, we would suggest that this issue be conceptualized in terms of synergistic effects of narcissism and self-esteem and distinguish between assertive versus aggressive responding.

Developing a short form of the simple Rathus assertiveness schedule using a sample of adults with sickle cell disease.

PubMed

Jenerette, Coretta; Dixon, Jane

2010-10-01

Ethnic and cultural norms influence an individual's assertiveness. In health care, assertiveness may play an important role in health outcomes, especially for predominantly minority populations, such as adults with sickle cell disease. Therefore, it is important to develop measures to accurately assess assertiveness. It is also important to reduce response burden of lengthy instruments while retaining instrument reliability and validity. The purpose of this article is to describe development of a shorter version of the Simple Rathus Assertiveness Schedule (SRAS). Data from a cross-sectional descriptive study of adults with sickle cell disease were used to construct a short form of the SRAS, guided by stepwise regression analysis. The 19-item Simple Rathus Assertiveness Scale-Short Form (SRAS-SF) had acceptable reliability (α = .81) and construct validity and was highly correlated with the SRAS (r = .98, p = .01). The SRAS-SF reduces response burden, while maintaining reliability and validity.

Effectiveness of Group Training of Assertiveness on Social Anxiety among Deaf and Hard of Hearing Adolescents.

PubMed

Ahmadi, Hamed; Daramadi, Parviz Sharifi; Asadi-Samani, Majid; Givtaj, Hamed; Sani, Mohammad Reza Mahmoudian

2017-06-01

The present study was conducted to compare the effectiveness of assertiveness group training on social anxiety (SAD) between deaf and hearing impaired adolescents. Forty eight (24 deaf and 24 hearing impaired) people participated in this study. First, participants with SAD, i.e. attaining the scores above 40 for Connor's Social Inventory Scale 2000 (SPIN), were selected according to convenience sampling and randomly assigned to two groups, i.e. intervention and control. Then, assertiveness group training was conducted for intervention group within 10 sessions, and immediately after completion of the training sessions, SPIN was re-administered to the two groups. ANCOVA showed that the effectiveness of assertiveness group training on SAD is different between deaf and hearing impaired participants, i.e. assertiveness group training was effective on improvement of SAD in hearing impaired participants but not deaf ones. Therefore, it is recommended to incorporate assertiveness group training in the educational programs developed for adolescents with ear disorders especially hearing impairment.

The moderating role of risk-taking tendency and refusal assertiveness on social influences in alcohol use among inner-city adolescents.

PubMed

Epstein, Jennifer A; Botvin, Gilbert J

2002-07-01

Many etiological models of adolescent alcohol use concentrate on the main effects of risk and protective factors. This study examined the moderating influence of risk-taking tendency and refusal assertiveness on perceived friends' drinking as associated with alcohol use among inner-city adolescents. Participants (N = 2,400; 54% female) completed questionnaires that included measures of risk-taking tendency, refusal assertiveness, perceived friends' drinking and alcohol use (drinking frequency, drinking amount and drunkenness). Main effects for perceived friends' drinking, risk-taking tendency and refusal assertiveness were found for all three drinking measures, consistent with prior work. Furthermore, significant interactions were found between (1) risk-taking tendency and perceived friends' drinking and (2) refusal assertiveness and perceived friends' drinking. High risk-taking tendency and low refusal assertiveness increased the impact of perceived friends' drinking on alcohol use among inner-city adolescents. This suggests that these factors are important components in preventing alcohol use.

The relationship between psychosocial maturity and assertiveness in males and females.

PubMed

Goldman, J A; Olczak, P V

1981-02-01

The relationship between psychosocial maturity (psychological health) and assertiveness was investigated in a sample of United States college males and females. Results revealed a moderately high positive relationship between psychosocial maturity (PSM) and self-reported assertiveness on the Rathus and Galassi scales for both sexes. This relationship was slightly stronger (in terms of variance accounted for) for males than females, significant differences being obtained for Intimacy on the Rathus scale and PSM and Intimacy on the Galassi scale. Multiple regression analyses revealed that the personality components most consistently accounting for major portions of the variance in predicting male assertiveness scores on both the Rathus Assertiveness Schedule and the College Self-Expression Scale were Intimacy and Initiative, while in predicting female assertiveness, only Initiative was involved. The findings were related to previous research, recent work on the androgyny construct (instrumental vs. expressive behaviors), and exhortations for increased cooperation between schools of psychotherapy to establish it as a more unified discipline.

Patient Reactions to Surgeon Recommendations About Contralateral Prophylactic Mastectomy for Treatment of Breast Cancer.

PubMed

Katz, Steven J; Janz, Nancy K; Abrahamse, Paul; Wallner, Lauren P; Hawley, Sarah T; An, Lawrence C; Ward, Kevin C; Hamilton, Ann S; Morrow, Monica; Jagsi, Reshma

2017-07-01

Guidelines assert that contralateral prophylactic mastectomy (CPM) should be discouraged in patients without an elevated risk for a second primary breast cancer. However, little is known about the impact of surgeons discouraging CPM on patient care satisfaction or decisions to seek treatment from another clinician. To examine the association between patient report of first-surgeon recommendation against CPM and the extent of discussion about it with 3 outcomes: patient satisfaction with surgery decisions, receipt of a second opinion, and receipt of surgery by a second surgeon. This population-based survey study was conducted in Georgia and California. We identified 3880 women with stages 0 to II breast cancer treated in 2013-2014 through the Surveillance, Epidemiology, and End Results registries of Georgia and Los Angeles County. Surveys were sent approximately 2 months after surgery (71% response rate, n = 2578). In this analysis conducted from February to May 2016, we included patients with unilateral breast cancer who considered CPM (n = 1140). Patients were selected between July 2013 and September 2014. We examined report of surgeon recommendations, level of discussion about CPM, satisfaction with surgical decision making, receipt of second surgical opinion, and surgery from a second surgeon. The mean (SD) age of patients included in this study was 56 (10.6) years. About one-quarter of patients (26.7%; n = 304) reported that their first surgeon recommended against CPM and 30.1% (n = 343) reported no substantial discussion about CPM. Dissatisfaction with surgery decision was uncommon (7.6%; n = 130), controlling for clinical and demographic characteristics. One-fifth of patients (20.6%; n = 304) had a second opinion about surgical options and 9.8% (n = 158) had surgery performed by a second surgeon. Dissatisfaction was very low (3.9%; n = 42) among patients who reported that their surgeon did not recommend against CPM but discussed it. Dissatisfaction was substantively higher for those whose surgeon recommended against CPM with no substantive discussion (14.5%; n = 37). Women who received a recommendation against CPM were not more likely to seek a second opinion (17.1% among patients with recommendation against CPM vs 15.1% of others; P = .52) nor to receive surgery by a second surgeon (7.9% among patients with recommendation against CPM vs 8.3% of others; P = .88). Most patients are satisfied with surgical decision making. First-surgeon recommendation against CPM does not appear to substantively increase patient dissatisfaction, use of second opinions, or loss of the patient to a second surgeon.

Assertiveness with 'Special' Children.

ERIC Educational Resources Information Center

Rosenberg, Shelley K.; Stillman-Powell, Patricia

The author examines issues related to adult assertiveness in controlling and setting limits for handicapped children. Reasons for adults not wishing to be in charge include feelings of guilt, lack of consistency in enforcing rules, and a sense of sympathy for special children. Assertiveness is distinguished from aggressiveness, and suggestions for…

Enhancement of Self-Regulation, Assertiveness, and Empathy.

ERIC Educational Resources Information Center

Sanz de Acedo Lizarraga, M. Luisa; Ugarte, M. Dolores; Cardelle-Elawar, Maria; Iriarte, M. Dolores; Sanz de Acedo Baquedano, M. Teresa

2003-01-01

Examined the effects of teaching self-regulation strategies and social skills to 40 middle school students who presented difficulties in self-reflection, self-inquiry, assertiveness, and empathy. Significant gains were observed in the experimental group in self-regulation of learning, self-control of behavior, assertiveness, empathy, and…

The Assertiveness Scale for Children.

ERIC Educational Resources Information Center

Peeler, Elizabeth; Rimmer, Susan M.

1981-01-01

Described an assertiveness scale for children developed to assess four dimensions of assertiveness across three categories of interpersonal situations. The scale was administered to elementary and middle school children (N=609) and readministered to students (N=164) to assess test-retest reliability. Test-retest reliability was low while internal…

Peer interaction in migrant children: observational data and parents' evaluations.

PubMed

Dikaiou, M

1989-03-01

This study 1) investigates the social behaviors characterizing the interaction between migrants and nonmigrants in both home and host countries, and 2) measures directly the behavior of the child. 2 samples of Greek migrant children, 8-10 years old, were selected. The group from the home country came from 5 villages in the District of Drama in East Macedonia; the group from the receiving country came from 5 areas in the District of Baden-Wurtenberg in West Germany. All subjects were divided into 6 groups (including control groups), for a total of 133 children. The researcher paired each child with a classmate, matched for sex, age, class-achievement, friendship status and parents' financial situation, occupation, and educational level. The task assigned to the children, painting of a free choice theme, focused on children's interactional patterns. The 3 stages of the task were 1) pre-task interview, 2) the painting together of a common picture, and 3) post-interview. Coders categorized the children's behaviors as either friendly-cooperative or unfriendly-uncooperative and noted periods of working alone or working with the playmate. Interviews with mothers or mother substitutes supplemented the direct observation data. Using the Orthogonal Factor Analysis (Principal Factoring with Rotation), significant differences were found on 5 of the 7 composite variables: 1) submissive/friendly behavior, 2) assertive/friendly behavior, 3) assertive/unfriendly behavior, 4) initiative/opinion expression, and 5) solitary play behavior. Using data from the interviews with mothers and mother substitutes, significant differences were found on attention seeking behavior and dependence. Children who have always lived with their parents in West Germany (2nd generation migrants) present a submissive and friendly behavior towards the German playmates' unfriendly activities. Upon returning to the home country, the child is low in assertiveness/unfriendliness, which is a more neutral expression of submissiveness. Children who recently moved to join their grandparents in Greece scored low on initiative/opinion expression and assertiveness/friendliness. Mothers'/grandmothers' views about children's interactions were not always consistent with the actual interactions of the children. No sex differences existed in the direct observation of children's interactions with peers. Finally, type of family correlated significantly with child dependence.

A causal role for the anterior mid-cingulate cortex in negative affect and cognitive control.

PubMed

Tolomeo, Serenella; Christmas, David; Jentzsch, Ines; Johnston, Blair; Sprengelmeyer, Reiner; Matthews, Keith; Douglas Steele, J

2016-06-01

Converging evidence has linked the anterior mid-cingulate cortex to negative affect, pain and cognitive control. It has previously been proposed that this region uses information about punishment to control aversively motivated actions. Studies on the effects of lesions allow causal inferences about brain function; however, naturally occurring lesions in the anterior mid-cingulate cortex are rare. In two studies we therefore recruited 94 volunteers, comprising 15 patients with treatment-resistant depression who had received bilateral anterior cingulotomy, which consists of lesions made within the anterior mid-cingulate cortex, 20 patients with treatment-resistant depression who had not received surgery and 59 healthy control subjects. Using the Ekman 60 faces paradigm and two Stroop paradigms, we tested the hypothesis that patients who received anterior cingulotomy were impaired in recognizing negative facial affect expressions but not positive or neutral facial expressions, and impaired in Stroop cognitive control, with larger lesions being associated with more impairment. Consistent with this hypothesis, we found that larger volume lesions predicted more impairment in recognizing fear, disgust and anger, and no impairment in recognizing facial expressions of surprise or happiness. However, we found no impairment in recognizing expressions of sadness. Also consistent with the hypothesis, we found that larger volume lesions predicted impaired Stroop cognitive control. Notably, this relationship was only present when anterior mid-cingulate cortex lesion volume was defined as the overlap between cingulotomy lesion volume and Shackman's meta-analysis-derived binary masks for negative affect and cognitive control. Given substantial evidence from healthy subjects that the anterior mid-cingulate cortex is part of a network associated with the experience of negative affect and pain, engaging cognitive control processes for optimizing behaviour in the presence of such stimuli, our findings support the assertion that this region has a causal role in these processes. While the clinical justification for cingulotomy is empirical and not theoretical, it is plausible that lesions within a brain region associated with the subjective experience of negative affect and pain may be therapeutic for patients with otherwise intractable mood, anxiety and pain syndromes. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

75 FR 4812 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

... Businesses Assert Business Confidentiality Claims AGENCY: Environmental Protection Agency (EPA). ACTION... purpose of this notice is to inform ``affected businesses'' about the documents or data sought by these types of FOIA requests in order to provide the businesses with the opportunity to assert claims that any...

Assertiveness Training: A Program for High School Students.

ERIC Educational Resources Information Center

Jean-Grant, Deborah S.

1980-01-01

Proposes an assertiveness training program suitable for adolescents in a high school group setting. After role-playing examples, students should begin formulating their own responses. Early work in this area indicates that students eagerly participate in assertiveness training groups, and are quick to pick up the skills required for assertive…

Social Skills Training for Young Adolescents: Symbolic and Behavioral Components.

ERIC Educational Resources Information Center

Thompson, Kathryn L.; And Others

1995-01-01

Expanded the curriculum of an assertiveness training program. Found that boys and girls benefited similarly in the cognitive acquisition of assertiveness information from this program. Discusses results in terms of the difference between having stored symbolic information regarding assertive responses and in recognizing appropriate contexts for…

Social Skills Training for Young Adolescents: Cognitive and Performance Components.

ERIC Educational Resources Information Center

Thompson, Kathryn L.; And Others

1996-01-01

An assertiveness training curriculum that was an expansion of two previous programs with young adolescents was presented to 22 fifth graders. Results did not show that training facilitated assertiveness on the performance components. Suggestions are offered for designing programs aimed at developing adolescents' assertive behavior in ways that…

Four-Year Results of a Youth Smoking Prevention Program Using Assertiveness Training.

ERIC Educational Resources Information Center

Del Greco, Linda; And Others

1986-01-01

Seventh graders (N=161) participated in health education classes consisting of either an innovative smoking education program, the program plus assertiveness training, or a traditional smoking education program. Data collected four years later revealed no significant differences in smoking behavior, changes in assertion, or sex differences among…

Can Assertiveness be Distinguished From Aggressiveness Using Self Report Data?

ERIC Educational Resources Information Center

Mauger, Paul A.; And Others

The differences between aggressiveness and assertiveness were examined using the Interpersonal Behavior Survey (IBS), a 136-item self-report questionnaire which was developed to distinguish between assertive and aggressive behaviors. Item level factor analysis was used in scale construction. Results indicated that: (1) the correlation between the…

Relation between Assertiveness, Academic Self-Efficacy, and Psychosocial Adjustment among International Graduate Students.

ERIC Educational Resources Information Center

Poyrazli, Senel; Arbona, Consuelo; Nora, Amaury; McPherson, Robert; Pisecco, Stewart

2002-01-01

Rathus Assertiveness Schedule, Academic Self-Efficacy Scale, The Inventory for Student Adjustment Strain, and UCLA Loneliness Scale were used to examine a total of 122 graduate international students. Findings indicate that English proficiency, assertiveness, and academic self-efficacy contributed uniquely to the variance in students' general…

A Comparison of Three Covert Assertion Training Procedures.

ERIC Educational Resources Information Center

Twentyman, Craig T.; And Others

1980-01-01

Assessed the effectiveness of covert modification procedures in an assertion training program. All treatment groups were superior to the control in behavioral ratings of assertiveness during the posttest in those situations that had been employed previously in treatment; two were superior in those that had not been used, providing evidence of…

Cross-Cultural Perspectives on Assertiveness and Self-Image.

ERIC Educational Resources Information Center

Lau, Estelle Pau-on

In an examination of some relationships between culture, assertiveness, decisionmaking, and self image among Chinese Americans, this paper focuses on themes such as: (1) how cultural factors impinge on individual capability to be assertive; (2) specific ways in which cultural conditioning affects decisionmaking skills and other behavior patterns;…

48 CFR 227.7103-13 - Government right to review, verify, challenge and validate asserted restrictions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... contracting officer shall not challenge a contractor's assertion that a commercial item, component, or process... to development of the item, component or process. (2) Presumption regarding development exclusively... validation of asserted restrictions for technical data related to commercial items, and to major systems, on...

48 CFR 227.7103-13 - Government right to review, verify, challenge and validate asserted restrictions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... contracting officer shall not challenge a contractor's assertion that a commercial item, component, or process... to development of the item, component or process. (2) Presumption regarding development exclusively... validation of asserted restrictions for technical data related to commercial items, and to major systems, on...

48 CFR 227.7103-13 - Government right to review, verify, challenge and validate asserted restrictions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... contracting officer shall not challenge a contractor's assertion that a commercial item, component, or process... to development of the item, component or process. (2) Presumption regarding development exclusively... validation of asserted restrictions for technical data related to commercial items, and to major systems, on...

48 CFR 227.7103-13 - Government right to review, verify, challenge and validate asserted restrictions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... contracting officer shall not challenge a contractor's assertion that a commercial item, component, or process... to development of the item, component or process. (2) Presumption regarding development exclusively... validation of asserted restrictions for technical data related to commercial items, and to major systems, on...

Re-examination of assertiveness and aggressiveness as potential moderators of verbal intentions.

PubMed

Swanson, S R

1999-06-01

This research reports the results of a replication of Swanson and McIntyre's 1998 study of assertiveness and aggressiveness as potential moderators of verbal intentions. A convenience sample of 119 women and 71 men participated. Nonassertive subjects were least likely, while Resort-to-Aggressive subjects were the most likely, to talk with acquaintances and others. Nonassertive and Assertive subjects were significantly more likely than Aggressive ones to make recommendations. Finally, men and women scored equally assertive, but men were more likely to score aggressive. The findings generally support the earlier work.

Predictive factors of alcohol and tobacco use in adolescents

PubMed Central

Alvarez-Aguirre, Alicia; Alonso-Castillo, María Magdalena; Zanetti, Ana Carolina Guidorizzi

2014-01-01

OBJECTIVES: to analyze the effect of self-esteem, assertiveness, self-efficacy and resiliency on alcohol and tobacco consumption in adolescents. METHOD: a descriptive and correlational study was undertaken with 575 adolescents in 2010. The Self-Esteem Scale, the Situational Confidence Scale, the Assertiveness Questionnaire and the Resiliency Scale were used. RESULTS: the adjustment of the logistic regression model, considering age, sex, self-esteem, assertiveness, self-efficacy and resiliency, demonstrates significance in the consumption of alcohol and tobacco. Age, resiliency and assertiveness predict alcohol consumption in the lifetime and assertiveness predicts alcohol consumption in the last year. Similarly, age and sex predict tobacco consumption in the lifetime and age in the last year. CONCLUSION: this study can offer important information to plan nursing interventions involving adolescent alcohol and tobacco users. PMID:25591103

Relationships of assertiveness, depression, and social support among older nursing home residents.

PubMed

Segal, Daniel L

2005-07-01

This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age = 75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r = -.33), but the correlations between social support and depression (r = -.15) and between social support and assertiveness (r = -.03) were small and nonsignificant. The correlation between overall physical health (a subjective self-rating) and depression was strong and negative (r = -.50), with lower levels of health associated with higher depression. An implication of this study is that an intervention for depression among nursing home residents that is targeted at increasing assertiveness and bolstering health status may be more effective than the one that solely targets social support.

Anxiety and assertiveness in the relatives of alcoholics and controls.

PubMed

Schuckit, M A

1982-06-01

The Rathus Assertiveness Schedule (RAS) and the Spielberger State-Trait Anxiety Inventory A-Trait Scale (STAI) were administered to male university students and nonacademic staff. Subjects classified as "at-risk" on the basis of a history of alcoholism in a first-degree relative (N = 30) were compared to controls with no such family histories (N = 30). The two groups were matched on demographic variables and drinking history. No significant differences were found between the groups on the traits of anxiety or assertiveness, although the subjects hypothesized to be at higher risk for alcoholism showed a trend toward higher assertiveness scores. These findings are not consistent with the hypothesis that higher levels of anxiety and/or lower levels of assertiveness predispose an individual toward the development of alcoholism.

Long-term auxological and pubertal outcome of patients with hereditary insulin-like growth factor-I deficiency (Laron and growth hormone-gene deletion syndrome) treated with recombinant human insulin-like growth factor-I.

PubMed

Messina, M F; Arrigo, T; Valenzise, M; Ghizzoni, L; Caruso-Nicoletti, M; Zucchini, S; Chiabotto, P; Crisafulli, G; Zirilli, G; De Luca, F

2011-04-01

GH-IGF-I axis is mainly involved in the complex process of somatic growth but emerging evidence suggests that it also influences hypothalamic-pituitary-gonadal (HPG) function. We report some data regarding long-term auxological and pubertal outcome of five female patients with hereditary forms of GH-IGF-I deficiency (Laron and GH-gene deletion syndrome) and a mean age of 23.4±5.3 yr (range 19-32). All the patients received recombinant human IGF-I (rhIGF-I, Pharmacia and Upjohn, Stockholm, Sweden, and rhIGF-I, Genentech, San Francisco, CA, USA) from a mean age of 8.6 yr (range 3.2-14.2) up to the final height. Final height was very disappointing (≤ -5.0 SD scores) and lower than target height in all the patients. Pubertal onset was delayed in most of them but menarche occurred spontaneously in all the patients. Median age at menarche was 15.1 yr. Menstrual cycles were regular for several years. Median duration of gynecological follow- up was 8.3 yr with the longest span of 17.2 yr. We can assert that GH-IGF-I axis has an essential role in promoting linear growth in humans and its physiological action cannot be replaced by pharmacological treatment in most patients with hereditary forms of IGF-I insufficiency as demonstrated by their subnormal final height. Our clinical observations can also support an essential role of IGF-I in genitalia growth but not in the function of HPG axis as demonstrated by the maintenance of regular menstrual cycles in the presence of subnormal levels of IGF-I after treatment discontinuation.

[Environmental health education].

PubMed

Pétard, Élodie

2018-03-01

Environmental health education aims to reduce the impact of risk factors for patients. The caregiver's role is to adopt a positive education approach with concrete ways of controlling the living environment. He or she must support people in asserting their choices in terms of health and to make their own contribution to reducing risks. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

The case against showing patients their records.

PubMed

Ross, A P

1986-03-01

The author, a British consultant surgeon, expresses his reservations about patients' having access to their medical records. The nature of communication between doctors may change if it is known that patients will see the material; potentially helpful yet tentative diagnoses may be excluded while other information is watered down. Physicians will have additional, perhaps burdensome, demands placed on them to explain the records--including parts written by deceased or otherwise unavailable doctors, medical students, or nonphysicians. Persons other than patients may see the records, further complicating the issue. Ross asserts that, while patients do have the right to see records, full access could be more harmful than beneficial to patients and could be fraught with problems for physicians.

Development and validation of the Stirling Eating Disorder Scales.

PubMed

Williams, G J; Power, K G; Miller, H R; Freeman, C P; Yellowlees, A; Dowds, T; Walker, M; Parry-Jones, W L

1994-07-01

The development and reliability/validity check of an 80-item, 8-scale measure for use with eating disorder patients is presented. The Stirling Eating Disorder Scales (SEDS) assess anorexic dietary behavior, anorexic dietary cognitions, bulimic dietary behavior, bulimic dietary cognitions, high perceived external control, low assertiveness, low self-esteem, and self-directed hostility. The SEDS were administered to 82 eating disorder patients and 85 controls. Results indicate that the SEDS are acceptable in terms of internal consistency, reliability, group validity, and concurrent validity.

22 CFR 40.25 - Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Certain aliens involved in serious criminal activity who have asserted immunity from prosecution. [Reserved] 40.25 Section 40.25 Foreign Relations... Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

22 CFR 40.25 - Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Certain aliens involved in serious criminal activity who have asserted immunity from prosecution. [Reserved] 40.25 Section 40.25 Foreign Relations... Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

22 CFR 40.25 - Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Certain aliens involved in serious criminal activity who have asserted immunity from prosecution. [Reserved] 40.25 Section 40.25 Foreign Relations... Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

22 CFR 40.25 - Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Certain aliens involved in serious criminal activity who have asserted immunity from prosecution. [Reserved] 40.25 Section 40.25 Foreign Relations... Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

22 CFR 40.25 - Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Certain aliens involved in serious criminal activity who have asserted immunity from prosecution. [Reserved] 40.25 Section 40.25 Foreign Relations... Certain aliens involved in serious criminal activity who have asserted immunity from prosecution...

Correlates of Postassault Self-Defense/Assertiveness Training Participation for Sexual Assault Survivors

ERIC Educational Resources Information Center

Brecklin, Leanne R.; Ullman, Sarah E.

2004-01-01

Past research has shown that self-defense/assertiveness training may have positive implications for sexual assault survivors. However, little is known about the correlates of self-defense/assertiveness training participation for sexually victimized women. In this study we examined the assault characteristics and experiences that relate to women's…

Rational-Emotive, Self-Instructional, and Behavioral Assertion Training: Enhancing the Generalization and Maintenance of Treatment Gains.

ERIC Educational Resources Information Center

Carmody, Timothy P.

A sample of 63 subassertive adults participated in four 90-minute sessions of group assertion training. The treatment components of challenging maladaptive cognitions and learning self-instructions were examined by comparing Rational-Emotive, Self-Instructional, and Behavioral Assertion Training. A delayed-treatment control group was also…

Sexual Assertiveness Mediates the Effect of Social Interaction Anxiety on Sexual Victimization Risk among College Women

ERIC Educational Resources Information Center

Schry, Amie R.; White, Susan W.

2013-01-01

Sexual victimization is prevalent among college women and is associated with adverse psychological consequences. Social anxiety, particularly related to interpersonal interaction, may increase risk of sexual victimization among college women by decreasing sexual assertiveness and decreasing the likelihood of using assertive resistance techniques.…

Assertion and Overcontrolled Hostility among Mentally Disordered Murderers.

ERIC Educational Resources Information Center

Quinsey, Vernon L.; And Others

1983-01-01

Studied whether men (N=19) who had committed very severe assaults and who score high on the Overcontrolled Hostility (O-H) scale had assertion deficits that could be measured behaviorally. Results showed the high O-H group was significantly less assertive than control groups in role playing tasks and on questionnaire items. (WAS)

Evaluation of Assertive Training and Homosexual Guidance Service Groups Designed to Improve Homosexual Functioning

ERIC Educational Resources Information Center

Russell, A.; Winkler, R.

1977-01-01

It is proposed that clinicians should develop research-based assertiveness training procedures for homosexuals that are designed to facilitate homosexual functioning. Subjects (N=27) were assigned to a behaviorally oriented assertive training group or a non-directive group run by a homosexual guidance service. Self-report measures indicated…

Correlates of Adolescent Assertiveness with HIV Avoidance in a Four-Nation Sample

ERIC Educational Resources Information Center

Onuoha, Francis N.; Munakata, Tsunetsugu

2005-01-01

Adolescents are frequently admonished to be socially assertive in order to confront negative interpersonal peer influences. Since the advent of HIV/AIDS in human social chemistry, the admonition has become more critical than ever. But the warning is often proffered in the misguided presumption that social assertiveness is the all-required…

The Rathus Assertiveness Schedule: Reliability at the Junior High School Level

ERIC Educational Resources Information Center

Vaal, Joseph J.; McCullagh, James

1977-01-01

This research was an attempt to determine the usefullness of the Rathus Assertiveness Schedule with pre-adolescent and early adolescent students. Previously it has been used with outpatients, institutionalized adults, or with college students. The RAS is a thirty item schedule that was developed for measuring assertiveness. (Author/RK)

Conversational Skills for Autistic Adolescents: Teaching Assertiveness in Naturalistic Game Settings.

ERIC Educational Resources Information Center

McGee, Gail G.; And Others

1984-01-01

A naturalistic social skills training program was used to teach assertive responses to three autistic adolescents in the context of two game situations. Results demonstrated the effectiveness of the procedure in generating high levels of positive and negative assertions that maintained across a 4.5-month follow-up interval. (Author/CL)

Relationships of Assertiveness, Depression, and Social Support Among Older Nursing Home Residents

ERIC Educational Resources Information Center

Segal, Daniel

2005-01-01

This study assessed the relationships of assertiveness, depression, and social support among nursing home residents. The sample included 50 older nursing home residents (mean age=75 years; 75% female; 92% Caucasian). There was a significant correlation between assertiveness and depression (r=-.33), but the correlations between social support and…

The Influences of Gender, School Year, and Socioeconomic Status on Assertiveness for Blacks at Predominantly White Universities.

ERIC Educational Resources Information Center

Haralson, Mitchel, Jr.

This study investigated the influences of gender, school year, and socioeconomic status on assertiveness for black students attending four predominantly white, southeastern universities. The study employed a combination of quantitative and qualitative techniques. Quantitative data on assertiveness were collected from 560 black freshmen and juniors…

Women’s Condom Use Assertiveness and Sexual Risk-Taking: Effects of Alcohol Intoxication and Adult Victimization

PubMed Central

Norris, Jeanette; George, William H.; Morrison, Diane M.; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M.

2008-01-01

This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N = 161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex – perceived health consequences and situational condom insistence – and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication. PMID:18556139

The connection between young women's body esteem and sexual assertiveness.

PubMed

Auslander, Beth A; Baker, Jaqwiana; Short, Mary B

2012-04-01

Healthy sexuality includes having positive feelings about one's body and developing positive romantic relationships. Previous research predicts that women dissatisfied with their bodies may be less likely to enforce their rights of sexual autonomy (i.e., sexual assertiveness). We assessed whether the body esteem of young women was related to their reports of sexual assertiveness. Young women from local colleges (N = 127) completed a questionnaire that included demographics, self reported weight and height, sexual history, along with body esteem and sexual assertiveness. Overall, body esteem was related to sexual assertiveness regarding condom use when controlling for other variables. Women with less body esteem were less likely to insist that their partner use a condom. Individual components of body esteem did not independently predict insistence of condom use. Body esteem was not related to initiation of sex or refusal of unwanted sex. The current study found relationships between body esteem and sexual assertiveness regarding STI prevention behaviors. Given these findings, implications for STI prevention programs are discussed. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Women's condom use assertiveness and sexual risk-taking: effects of alcohol intoxication and adult victimization.

PubMed

Stoner, Susan A; Norris, Jeanette; George, William H; Morrison, Diane M; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M

2008-09-01

This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N=161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex - perceived health consequences and situational condom insistence - and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication.

Probability of assertive behaviour, interpersonal anxiety and self-efficacy of South African registered dietitians.

PubMed

Paterson, Marie; Green, J M; Basson, C J; Ross, F

2002-02-01

There is little information on the probability of assertive behaviour, interpersonal anxiety and self-efficacy in the literature regarding dietitians. The objective of this study was to establish baseline information of these attributes and the factors affecting them. Questionnaires collecting biographical information and self-assessment psychometric scales measuring levels of probability of assertiveness, interpersonal anxiety and self-efficacy were mailed to 350 subjects, who comprised a random sample of dietitians registered with the Health Professions Council of South Africa. Forty-one per cent (n=145) of the sample responded. Self-assessment inventory results were compared to test levels of probability of assertive behaviour, interpersonal anxiety and self-efficacy. The inventory results were compared with the biographical findings to establish statistical relationships between the variables. The hypotheses were formulated before data collection. Dietitians had acceptable levels of probability of assertive behaviour and interpersonal anxiety. The probability of assertive behaviour was significantly lower than the level noted in the literature and was negatively related to interpersonal anxiety and positively related to self-efficacy.

Gender by assertiveness interaction in delayed auditory feedback.

PubMed

Elias, J W; Rosenzweig, C M; Dippel, R L

1981-04-01

The College Self-Expression and the Marlowe-Crowne Social Desirability Scales were given to 144 undergraduates. High (N; 10 M; 10 F) and Low (N; 10 M 10 F) Assertiveness Ss were given a DAF test with a 'Phonic Mirror" and the Stroop test (naming the color of a word printed in a different color). DAF performance did not differ among the 4 subgroups (M and F, High and Low Assertiveness), except that Low Assertiveness women showed significantly greater DAF interference than the other subgroups. There was no significant correlation between the continuous interference of the DAF vs the discontinuous of the Stroop test. The difference may reside in the time available and the consequent reduction in anxiety, for the next stimulus in the Stroop test. These data show that, under certain circumstances, personality factors such as assertiveness can interact with gender to affect speech fluency and production. The ability to overcome feedback-related disfluencies in speech may be partially aided by improvement in self-concept or specific training in such behaviors as assertiveness, and this may be more important for females than males.

Safer sexual practices among African American women: intersectional socialisation and sexual assertiveness.

PubMed

Brown, Danice L; Blackmon, Sha'Kema; Shiflett, Alexandra

2018-06-01

Scholars have posited that childhood socialisation experiences may play a key role in influencing behaviours and attitudes that contribute to the acquisition of HIV. This study examined the links between past ethnic-racial and gender socialisation, sexual assertiveness and the safe sexual practices of African American college women utilising a cluster analytic approach. After identifying separate racial-gender and ethnic-gender socialisation profiles, results indicated that ethnic-gender socialisation cluster profiles were directly associated with sexual assertiveness and safer sex behaviour. Greater levels of ethnic socialisation and low traditional gender role socialisation were found to be associated with greater sexual assertiveness and safer sex behaviour. Further analysis showed that sexual assertiveness mediated the links between the identified ethnic-gender socialisation profiles and safer sex behaviour. Implications for policy and programme development are discussed.

[Relationship between members' egoistic self-assertion and captains' leadership in athletic clubs].

PubMed

Yoshimura, Hitoshi

2005-02-01

This study examined the relationships between club members' egoistic self-assertion and their captains' leadership with respect to the adjustment to activities in extracurricular athletic clubs. Participants were 638 junior high school students who belong to the athletic clubs. The research was conducted by means of a questionnaire and the following results were obtained. When the captains took a laissez-faire command, club members who did not assert themselves egoistically were not satisfied with their captains, and did not participate in the club activities very diligently. On the other hand, when the captains took an authoritative command, the members who asserted themselves egoistically were not satisfied with club activities. These results suggest that the relationships between egoistic self-assertion by club members and leadership by captains have a great influence on the adjustment to club activities.

Depression as a mediator between family factors and peer-bullying victimization in Latino adolescents.

PubMed

Yabko, Brandon A; Hokoda, Audrey; Ulloa, Emilio C

2008-01-01

The purpose of this study was to assess the mediating role of depression in three different relationships: (a) sibling bullying and peer victimization, (b) mothers' power-assertive parenting and peer victimization, and (c) fathers' power-assertive parenting and peer victimization. Results from 242 Latino middle school adolescents from a large southwestern city bordering Mexico revealed that both boys' and girls' peer victimization were related to familial factors and depression. Regression analyses for boys revealed that depression mediated three relationships: (a) sibling bullying and peer victimization, (b) mothers' power-assertive parenting and peer victimization, and (c) fathers' power-assertive parenting and peer victimization. Depression also mediated the relationship between fathers' power-assertive parenting and girls' victimization by peers. The findings support the development of family-based interventions for peer victimization that include curriculum addressing depression.

The engineering of cybernetic systems

NASA Astrophysics Data System (ADS)

Fry, Robert L.

2002-05-01

This tutorial develops a logical basis for the engineering of systems that operate cybernetically. The term cybernetic system has a clear quantitative definition. It is a system that dynamically matches acquired information to selected actions relative to a computational issue that defines the essential purpose of the system or machine. This notion requires that information and control be further quantified. The logic of questions and assertions as developed by Cox provides one means of doing this. The design and operation of cybernetic systems can be understood by contrasting these kinds of systems with communication systems and information theory as developed by Shannon. The joint logic of questions and assertions can be seen to underlie and be common to both information theory as applied to the design of discrete communication systems and to a theory of discrete general systems. The joint logic captures a natural complementarity between systems that transmit and receive information and those that acquire and act on it. Specific comparisons and contrasts are made between the source rate and channel capacity of a communication system and the acquisition rate and control capacity of a general system. An overview is provided of the joint logic of questions and assertions and the ties that this logic has to both conventional information theory and to a general theory of systems. I-diagrams, the interrogative complement of Venn diagrams, are described as providing valuable reasoning tools. An initial framework is suggested for the design of cybernetic systems. Two examples are given to illustrate this framework as applied to discrete cybernetic systems. These examples include a predator-prey problem as illustrated through "The Dog Chrysippus Pursuing its Prey," and the derivation of a single-neuron system that operates cybernetically and is biologically plausible. Future areas of research are highlighted which require development for a mature engineering framework.

Psychological functioning and predictors of father-infant relationship in IVF fathers and controls.

PubMed

Hjelmstedt, Anna; Collins, Aila

2008-03-01

The psychological functioning of fathers with children born after in vitro fertilization (IVF) has received little attention. Among men in general, little is known about predictors of early father-infant relationship (here also defined as attachment). The first aim was to compare IVF fathers and control fathers regarding personality traits, state anxiety, depressive symptoms and early father-infant attachment. The second aim was to assess whether early father-infant relationship is explained by the father's prenatal relationship with the unborn infant, his personality traits, state anxiety and symptoms of depression. Fifty-three IVF fathers and 36 controls filled in self-rating scales measuring father-infant attachment, personality, anxiety and symptoms of depression at 2 months postpartum. At gestational week 26 their prenatal relationship to the unborn infant was assessed. It was found that IVF fathers rated more somatic and psychic anxiety, indirect aggression and less assertiveness. They were as strongly attached to their infant as the controls. Fathers, who had rated higher attachment to their unborn infant during pregnancy, who were less anxious, more assertive and less irritable, were more attached to their infants than men who had been less attached to their unborn infants and who were more anxious, less assertive and more irritable. In conclusion, although IVF fathers are as strongly attached to their infants as other fathers, they may benefit from emotional support as they have elevated levels of anxiety proneness and indirect aggression. It is important to pay attention during pregnancy to fathers who have a less optimal attachment to their unborn infant and who have high levels of anxiety and irritability, as those three factors are related to a weak emotional father-infant relationship.

Mental and behavioral health environments: critical considerations for facility design.

PubMed

Shepley, Mardelle McCuskey; Watson, Angela; Pitts, Francis; Garrity, Anne; Spelman, Elizabeth; Kelkar, Janhawi; Fronsman, Andrea

2016-01-01

The purpose of the study was to identify features in the physical environment that are believed to positively impact staff and patients in psychiatric environments and use these features as the foundation for future research regarding the design of mental and behavioral health facilities. Pursuant to a broad literature review that produced an interview script, researchers conducted 19 interviews of psychiatric staff, facility administrators and architects. Interview data were analyzed using the highly structured qualitative data analysis process authored by Lincoln and Guba (1985). Seventeen topics were addressed ranging from the importance of a deinstitutionalized environment to social interaction and autonomy. The interviewees reinforced the controversy that exists around the implications of a deinstitutionalized environment, when the resulting setting diminishes patient and staff safety. Respondents tended to support open nurse stations vs. enclosed stations. Support for access to nature and the provision of an aesthetic environment was strong. Most interviewees asserted that private rooms were highly desirable because lower room density reduces the institutional character of a unit. However, a few interviewees adamantly opposed private rooms because they considered the increased supervision of one patient by another to be a deterrent to self-harm. The need to address smoking rooms in future research received the least support of all topics. Responses of interviews illustrate current opinion regarding best practice in the design of psychiatric facilities. The findings emphasize the need for more substantive research on appropriate physical environments in mental and behavioral health settings. Copyright © 2016 Elsevier Inc. All rights reserved.

The quality of life among first-episode psychotic patients in the OPUS trial.

PubMed

Thorup, Anne; Petersen, Lone; Jeppesen, Pia; Nordentoft, Merete

2010-01-01

From an 'objective' perspective, treatment of first-episode psychosis has improved in many ways with the development of specialised early and intensive team-based treatment like e.g. the 'OPUS' treatment. However, the patients' perspective is also important and was investigated in the 'OPUS' study by analysing data concerning quality of life. We aimed to investigate the 'quality of life from patients' perspective' among a cohort of young adults with a first-episode psychosis at the time of treatment initiation and after two years. Especially, we were interested in analysing if there were any significant effects on the subjective quality of life of receiving an intensive psychosocial assertive community treatment called 'OPUS' compared to standard treatment (ST). This study is part of the Danish 'OPUS' trial, a randomised controlled trial (RCT) comparing 'treatment as usual' (standard treatment, ST) with 'OPUS' treatment. The Lancashire Quality of Life Profile (LQoLP), which is a combined objective and subjective instrument, was administered at baseline and after two years of treatment, N=280. The intensive 'OPUS' treatment did not affect the quality of life measured by Lancashire QoLP in a significantly different way from the standard treatment (ST). There were no significant differences in quality of life between the ST group and the OPUS group concerning the 9 life domains. Quality of life correlated with psychopathology (both psychotic and negative symptoms) to a minor extent and more strongly with the affective balance and level of self-esteem.

[Forensic (flexible) assertive community treatment: client characteristics and treatment outcomes].

PubMed

Neijmeijer, L; Verwoerd, J; van Vugt, M; Place, C; Kroon, H

(Flexible) Assertive community treatment ((f)act) is applied increasingly to forensic psychiatric clients. However, evidence about the effectiveness of forensic (f)act is scanty. To investigate to what extent (subgroups of) clients receiving care from forensic (f)act teams show, after a year, changes in their social and psychological functioning and are subjected to fewer justicial outcome measures. Between 2009 and 2011, eight forensic (f)act teams collected, at two measurement moments separated by an average of 12 months, data relating to client characteristics and outcomes of care. The study involved 202 clients. After a year clients showed significant improvements in psychological and social functioning, and had fewer confrontations with the police and the law. They were detained less often and for shorter periods and were considered to be less likely to reoffend. The number of admissions to mental health care and to addiction and forensic care remained constant. Clients with a psychiatric disorder and likely to display criminal behaviour showed improvement while being treated by forensic (f)act teams. Further research is needed to prove whether forensic (f)act treatment will have the desired effects in the longer term and will enjoy the status of being regarded as evidence based practice.

Learning in Earth and space science: a review of conceptual change instructional approaches

NASA Astrophysics Data System (ADS)

Mills, Reece; Tomas, Louisa; Lewthwaite, Brian

2016-03-01

In response to calls for research into effective instruction in the Earth and space sciences, and to identify directions for future research, this systematic review of the literature explores research into instructional approaches designed to facilitate conceptual change. In total, 52 studies were identified and analyzed. Analysis focused on the general characteristics of the research, the conceptual change instructional approaches that were used, and the methods employed to evaluate the effectiveness of these approaches. The findings of this review support four assertions about the existing research: (1) astronomical phenomena have received greater attention than geological phenomena; (2) most studies have viewed conceptual change from a cognitive perspective only; (3) data about conceptual change were generated pre- and post-intervention only; and (4) the interventions reviewed presented limited opportunities to involve students in the construction and manipulation of multiple representations of the phenomenon being investigated. Based upon these assertions, the authors recommend that new research in the Earth and space science disciplines challenges traditional notions of conceptual change by exploring the role of affective variables on learning, focuses on the learning of geological phenomena through the construction of multiple representations, and employs qualitative data collection throughout the implementation of an instructional approach.

The feminization of school hypothesis called into question among junior and high school students.

PubMed

Verniers, Catherine; Martinot, Delphine; Dompnier, Benoît

2016-09-01

The feminization of school hypothesis suggests that boys underachieve in school compared to girls because school rewards feminine characteristics that are at odds with boys' masculine features. The feminization of school hypothesis lacks empirical evidence. The aim of this study was to test this hypothesis by examining the extent to which school demands are actually associated with female more than male students. A large sample of 1,954 students (1,115 girls and 839 boys) from grades seven, nine, 10, and 12 took part in the study. The participants were asked to rate the extent to which various characteristics valued in the school setting were exhibited by girls or boys who succeed in school. Three sets of characteristics related to school success emerged from the analyses: compliance, assertiveness, and effort/intelligence. Compliance and effort/intelligence were associated with the girls more than with the boys, while assertiveness was associated with the boys more than with the girls. The feminization of school hypothesis received weak support. This study discusses the limits of this hypothesis to explain boys' underachievement in comparison with girls. © 2016 The British Psychological Society.

Mental health professional experiences of the flexible assertive community treatment model: a grounded theory study.

PubMed

Lexén, Annika; Svensson, Bengt

2016-08-01

Despite the lack of evidence for effectiveness of the Flexible Assertive Community Treatment (Flexible ACT), the model is considered feasible and is well received by mental health professionals. No current studies have adequately examined mental health professional experiences of working with Flexible ACT. The aim of this study was to explore mental health professional experiences of working with the Flexible ACT model compared with standard care. The study was guided by grounded theory and based on the interviews with 19 theoretically chosen mental health professionals in Swedish urban areas primarily working with consumers with psychosis, who had worked with the Flexible ACT model for at least 6 months. The analysis resulted in the core category: "Flexible ACT and the shared caseload create a common action space" and three main categories: (1) "Flexible ACT fills the need for a systematic approach to crisis intervention"; (2) "Flexible ACT has advantages in the psychosocial working environment"; and (3) "Flexible ACT increases the quality of care". Mental health professionals may benefit from working with the Flexible ACT model through decreased job-strain and stress, increased feeling of being in control over their work situation, and experiences of providing higher quality of care.

Promoting African American women and sexual assertiveness in reducing HIV/AIDS: an analytical review of the research literature.

PubMed

Kennedy, Bernice Roberts; Jenkins, Chalice C

2011-01-01

African American women, including adolescents and adults, are disproportionately affected by the transmission of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). HIV/AID is a health disparity issue for African American females in comparison to other ethnic groups. According to data acquired from 33 states in 2005, 64% of women who have HIV/ AIDS are African American women. It is estimated that during 2001-2004, 61% of African Americans under the age of 25 had been living with HIV/AIDS. This article is an analytical review of the literature emphasizing sexual assertiveness of African American women and the gap that exists in research literature on this population. The multifaceted model of HIV risk posits that an interpersonal predictor of risky sexual behavior is sexual assertiveness. The critical themes extracted from a review of the literature reveal the following: (a) sexual assertiveness is related to HIV risk in women, (b) sexual assertiveness and sexual communication are related, and (c) women with low sexual assertiveness are at increased risk of HIV As a result of this comprehensive literature, future research studies need to use models in validating sexual assertiveness interventions in reducing the risk of HIV/AIDS in African American women. HIV/AIDs prevention interventions or future studies need to target reducing the risk factors of HIV/AIDS of African Americans focusing on gender and culture-specific strategies.

Assertiveness in Women Reporting Symptoms of Bulimia.

ERIC Educational Resources Information Center

Ruhl, Berenice; McCanne, Thomas R.

It has been suggested that a lack of assertiveness may be an important component of the psychological make-up of bulimic women, and that bulimic women may experience particular difficulties in asserting themselves in interactions with men. In this study, 23 women reporting the symptoms of bulimia by high scores on the Bulimia Test (BULIT) and 21…

Use of Hypnotherapy for Assertive Training and Behavioral Rehearsal: An Active Mode of Therapy.

ERIC Educational Resources Information Center

DeVoge, Susan D.

This paper describes a treatment approach which uses hypnotherapy techniques in combination with assertive training and behavioral rehearsal. It discusses the use of this treatment with a client who exhibited psychogenic symptoms due to personal anxiety. At the beginning of the treatment the client was shy, non-assertive and extremely…

Effects of Gender, Age, and Education on Assertiveness in a Nigerian Sample

ERIC Educational Resources Information Center

Onyeizugbo, Eucharia U.

2003-01-01

Two hundred fourteen (214) married persons, 101 men and 113 women aged 20-60, with at least high school education, participated in the study which investigated the effects of gender, age, and educational attainment on assertiveness among married persons in Nigeria. The Assertive Behavior Assessment scale (ABAS; Onyeizugbo, 1998) was used to…

Assertive Skills and Academic Performance in Primary and Secondary Education, Giftedness, and Conflictive Students

ERIC Educational Resources Information Center

Marugan de Miguelsanz, Montserrat; Carbonero Martin, Miguel Angel; Palazuelo Martinez, Ma Marcela

2012-01-01

Introduction: This study explores the level of assertiveness in various samples of students from Primary and Secondary Education. With the data obtained, on the one hand, we analyzed the relation between assertiveness and academic performance and, on the other, we verified whether students who are excluded from the norm, either because of their…

A Factor Analytic Study of the Items in the Personal Report of Communication Apprehension and the Rathus Assertiveness Schedule.

ERIC Educational Resources Information Center

Pearson, Judy C.

A study was undertaken to determine the relationship between assertiveness and communication apprehension by examining common factors that exist between the items on the Rathus Assertiveness Schedule and the Personal Report of Communication Apprehension. The two instruments were administered to students at a large midwestern university. Responses…

Aggression, Assertion, and Openness to Experience: A Comparison of Men and Women

ERIC Educational Resources Information Center

Wyrick, Linda C.; And Others

1977-01-01

Investigates the degree of correlation between social constriction, i.e., lack of assertiveness as measured by the Bates-Zimmerman scale (1971), and assertiveness, as measured by the College Self-Expression Scale (1974) and further examines the relationship of scores on both of these scales to aggression/hostility as measured by the Buss-Durkee…

"You Don't Have to Like Me, but You Have to Respect Me": The Impacts of Assertiveness, Cooperativeness, and Group Satisfaction in Collaborative Assignments

ERIC Educational Resources Information Center

Lambertz-Berndt, Megan M.; Blight, Michael G.

2016-01-01

This study investigates cooperativeness, assertiveness, group satisfaction, leader grade, and leadership negotiation in a collaborative assignment conducted in a small group. Researchers manipulated the assignment of team members who reported on measures of group satisfaction and original scales of assertiveness and cooperativeness. Respondents…

Communication Skills for Career Success. A Programmed Textbook. Book II: Assertive Communication.

ERIC Educational Resources Information Center

Lombana, Judy H.; Pratt, Phillip A.

This programmed text for self-study provides information on assertive communication in business. Part of a series of such texts, the book presents examples of familiar work situations involving interpersonal problems. The text then discusses each of the answers and explains why one or the other is appropriate for communicating assertively. Some of…

Mental health issues in the workplace: maintaining a productive work force.

PubMed

Raderstorf, Mark; Kurtz, Jennifer

2006-08-01

Occupational health nurses must intervene early and validate the conditions and experiences of employees with psychiatric disabilities. Occupational health nurses must ensure employees are receiving appropriate treatment. They must be aware of and prepared to mitigate iatrogenic influences. Occupational health nurses can facilitate resolution of workplace conflicts and issues regarding changing supervisors or departments. They can also facilitate return to work by establishing clear restrictions and coordinating accommodations. compassionate and supportive, yet assertive, approach is key to managing mental health disability. It will, in most cases, facilitate successful return to full-time work.

Gender role models in fictional novels for emerging adult lesbians.

PubMed

Cook, Jennifer R; Rostosky, Sharon S; Riggle, Ellen D B

2013-01-01

Novels provide role models for young adult lesbians and thus may influence their identity development. This study focused on 16 lesbian protagonists identified in 11 young adult novels that received 2011 Lambda Literary Award nominations. Content analyses revealed six themes. Three themes defied traditional gender stereotypes: Asserting Oneself, Pursuing Intimacy with Another Woman, and Breaking Free of Constraints to Authentic Self-Expression. Three themes reinforced gender stereotypes: Negative Emotional Experiences Associated with Lesbian Identity, Traditional Masculine Gender Expression, and Traditional Gender Role-Based Sexual Scripts. Each theme is discussed in light of its possible contribution to lesbian identity development.

Vision, knowledge, and assertion.

PubMed

Turri, John

2016-04-01

I report two experiments studying the relationship among explicit judgments about what people see, know, and should assert. When an object of interest was surrounded by visibly similar items, it diminished people's willingness to judge that an agent sees, knows, and should tell others that it is present. This supports the claim, made by many philosophers, that inhabiting a misleading environment intuitively decreases our willingness to attribute perception and knowledge. However, contrary to stronger claims made by some philosophers, inhabiting a misleading environment does not lead to the opposite pattern whereby people deny perception and knowledge. Causal modeling suggests a specific psychological model of how explicit judgments about perception, knowledge, and assertability are made: knowledge attributions cause perception attributions, which in turn cause assertability attributions. These findings advance understanding of how these three important judgments are made, provide new evidence that knowledge is the norm of assertion, and highlight some important subtleties in folk epistemology. Copyright © 2016 Elsevier Inc. All rights reserved.

Mediators of sexual revictimization risk in adult sexual assault victims.

PubMed

Ullman, Sarah E; Vasquez, Amanda L

2015-01-01

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women.

Mediators of Sexual Revictimization Risk in Adult Sexual Assault Victims

PubMed Central

Ullman, Sarah E.; Vasquez, Amanda L.

2015-01-01

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse (CSA), emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior, and sexual refusal assertiveness mediational pathways by which CSA severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to CSA severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the CSA severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women. PMID:25942287

Goal preference shapes confrontations of sexism.

PubMed

Mallett, Robyn K; Melchiori, Kala J

2014-05-01

Although most women assume they would confront sexism, assertive responses are rare. We test whether women's preference for respect or liking during interpersonal interactions explains this surprising tendency. Women report preferring respect relative to liking after being asked sexist, compared with inappropriate, questions during a virtual job interview (Study 1, n = 149). Women's responses to sexism increase in assertiveness along with their preference for being respected, and a respect-preference mediates the relation between the type of questions and response assertiveness (Studies 1 and 2). In Study 2 (n = 105), women's responses to sexist questions are more assertive when the sense of belonging is enhanced with a belonging manipulation. Moreover, preference for respect mediates the effect of the type of questions on response assertiveness, but only when belonging needs are met. Thus the likelihood of confrontation depends on the goal to be respected outweighing the goal to be liked.

Changes in women's assertiveness in response to status and roles: a cross-temporal meta-analysis, 1931-1993.

PubMed

Twenge, J M

2001-07-01

Across two meta-analyses, American women's assertiveness rose and fell with their social status from 1931 to 1993. College women and high school girls' self-reports on assertiveness and dominance scales increased from 1931 to 1945, decreased from 1946 to 1967, and increased from 1968 to 1993, explaining about 14% of the variance in the trait. Women's scores have increased enough that many recent samples show no sex differences in assertiveness. Correlations with social indicators (e.g., women's educational attainment, women's median age at first marriage) confirm that women's assertiveness varies with their status and roles. Social change is thus internalized in the form of a personality trait. Men's scores do not demonstrate a significant birth cohort effect overall. The results suggest that the changing sociocultural environment for women affected their personalities, most likely beginning in childhood.

[Causal relationship between assertiveness and adjustment in children: A short-term longitudinal study].

PubMed

Eguchi, Megumi; Hamaguchi, Yoshikazu

2015-08-01

This study examined the causal relationships between assertiveness and both internal and external adjustment in children. Elementary school children in grades four through six (N = 284) participated in the study, which used a short-term longitudinal design. The children completed questionnaires twice during a 6-months period. They responded to assertiveness questionnaires that included two components: "self-expression" and "consideration of others". They also completed a self-esteem scale as an index of internal adjustment, and the Class Life Satisfaction scale as an index of external adjustment. There was a positive causative relationship between "self-expression" and internal adjustment and between "consideration for others" and external adjustment. In addition, the effects on adjustment varied according to the type of assertiveness. Cluster analysis and MANOVA indicated that the group with high "self-expression" and "consideration for others" had high internal and external adjustment, while the children with poor assertiveness showed the lowest degree of adaptivity.

Validity of the Inventory of Interpersonal Problems (IIP-64) for predicting assertiveness in role-play situations.

PubMed

Leising, Daniel; Rehbein, Diana; Sporberg, Doreen

2007-10-01

The Inventory of Interpersonal Problems (IIP-64; Horowitz, Alden, Wiggins, & Pincus, 2000) is a self-report measure of maladaptive relationship behavior. Ninety-five adult female participants completed the IIP-64 and then interacted with a same-sex confederate in three diagnostic role plays, designed to evoke assertive responses. After each role play, both the participant and the confederate judged how assertive the participant had been, using two subscales from the Interpersonal Adjective Scales (IAS; Wiggins, 1995). The participants' general self-images, assessed with the IIP-64, were quite congruent with how they judged their own assertiveness in the role plays. But when role-play assertiveness was judged by the confederate, the match with the participants' general self-images was considerably lower. Our results indicate that self-reported interpersonal problems do not converge well with external judgments of interpersonal behavior.

An open trial of outpatient group therapy for bulimic disorders: combination program of cognitive behavioral therapy with assertive training and self-esteem enhancement.

PubMed

Shiina, Akihiro; Nakazato, Michiko; Mitsumori, Makoto; Koizumi, Hiroki; Shimizu, Eiji; Fujisaki, Mihisa; Iyo, Masaomi

2005-12-01

The purposes of this study were to examine the therapeutic efficacy of combined group cognitive behavioral therapy (CGCBT) and to explore the characteristics of the patients who failed to complete it. Our group cognitive behavioral therapy combined with assertiveness training for alexithymia and self-esteem enhancement therapy were attended over a 10-week period. Twenty-five participants were enrolled in the study. The clinical symptoms were assessed before and after treatment, using rating scales including the Eating Disorder Inventory-2, the Bulimic Investigatory Test, Edinburgh, the Toronto Alexithymia Scale, the Rosenberg Self-Esteem Scale, and Global Assessment of Functioning. Sixteen participants (64%) completed the CGCBT program. Completion of the CGCBT resulted in significant improvements in reducing binge-eating behavior and improving social functioning. Eight patients (32%) significantly improved using the Clinical Global Impression Change (CGI-C). Stepwise logistic regression analysis of the results indicated that a lower age (P=0.04) and psychiatric comorbidity (P=0.06) were predictors of dropout from the CGCBT program. Our CGCBT program is a promising first-line treatment for bulimic outpatients. Lower age and the presence of comorbidity had effects on dropout rates.

[Endoscopic follow-up of translaryngeal Fantoni tracheostomy].

PubMed

Succo, G; Crosetti, E; Mattalia, P; Voltolina, M; Bramardi, F; Di Lisi, D; Riva, F; Sartoris, A

2002-08-01

Dilatational tracheotomy techniques are widely used in the long-term management of the respiratory tract in patients in intensive care units (ICU). The translaryngeal tracheotomy technique (TLT) was first described by Fantoni in 1993 and rapidly asserted itself, especially in Europe. This technique basically differs from the other percutaneous techniques in that it involves a progressive, retrograde, dilatation of the trachea in a single session conducted from inside the trachea, working outward, simultaneously exerting a counter-pressure on the pre-tracheal soft tissues with the fingers. The present study involves an endoscopy follow-up of 130 patients who had undergone TLT at the Intensive Care Unit of our Hospital between November 2000 and May 2001. The pre-operative oro-tracheal intubation time varied from 1 to 42 days. All patients filled out a brief questionnaire containing validated questions on their general health and quality of life with particular attention focused on respiratory conditions. Then, after receiving informed consent, the patients underwent laryngo-tracheoscopy with local anesthetic using a flexible tracheobronchoscope. All tests were recorded and viewed later by two operators in order to identify and divide the patients according to the level of execution of the tracheotomy and the presence of sequelae. The results obtained have shown that, like other percutaneous tracheotomy techniques, TLT provides some benefits including the fact that procedure can be performed at the bedside in a short time, with few post-operative complications, simpler nursing and fewer sequelae in time. Analysis of data concerning time of tracheostomy execution, tracheal level of stomia and nursing times has revealed three factors that determine severe sequelae: delay in tracheostomy execution, high level of execution with cricoid involvement and onset of problems during first tracheal cannula change.

Generator exchange is associated with an increased rate of Sprint Fidelis lead failure.

PubMed

Lovelock, Joshua D; Patel, Ayesha; Mengistu, Andenet; Hoskins, Michael; El-Chami, Mikhael; Lloyd, Michael S; Leon, Angel; DeLurgio, David; Langberg, Jonathan J

2012-10-01

The Medtronic Sprint Fidelis defibrillator lead is at an increased risk for failure and was recalled in October 2007. Approximately 268,000 leads were implanted, and more than 100,000 patients still have active Fidelis leads. A number of studies have examined the rate and clinical predictors of lead failure, but none has addressed the effect of an implantable cardioverter-defibrillator generator exchange on subsequent lead failure. Although the manufacturer asserts that "Sprint Fidelis performance after device change-out is similar to lead performance without device change-out," published data are lacking. To assess the effect of implantable cardioverter-defibrillator generator exchange on the rate of Fidelis lead failure. A chart review was conducted in patients who underwent implantation of a Fidelis lead. Patients with a functioning Fidelis lead at generator exchange were compared with controls with leads implanted for a comparable amount of time not undergoing ICD replacement. A total of 1366 patients received a Fidelis lead prior to the recall, of which 479 were still actively followed. Seventy-two patients with a functioning lead underwent generator exchange without lead replacement. Following generator replacement, 15 leads failed. Sixty percent of the Fidelis leads failed within 3 months. Generator exchange increased the rate of lead failure compared with matched controls (20.8% vs 2.54%; P < .001). Generator exchange is associated with a higher than expected rate of Fidelis lead failure, often within 3 months. The risk-benefit ratio of Fidelis lead replacement at the time of generator exchange may be greater than appreciated. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Assertive outreach handbook will aid mental health staff in maintaining client engagement.

PubMed

Gregory, Nathan; Macpherson, Rob

The model of assertive outreach is one of the most internationally researched areas of community mental healthcare. An assertive outreach team at a mental health trust developed a handbook on the model, involving contributions from service users, carers, local clinicians and the voluntary sector. This article outlines the process of developing the handbook, summarises its content and user feedback.

Aspect-Oriented Programming is Quantification and Implicit Invocation

NASA Technical Reports Server (NTRS)

Filman, Robert E.; Friedman, Daniel P.; Koga, Dennis (Technical Monitor)

2001-01-01

We propose that the distinguishing characteristic of Aspect-Oriented Programming (AOP) languages is that they allow programming by making quantified programmatic assertions over programs that lack local notation indicating the invocation of these assertions. This suggests that AOP systems can be analyzed with respect to three critical dimensions: the kinds of quantifications allowed, the nature of the interactions that can be asserted, and the mechanism for combining base-level actions with asserted actions. Consequences of this perspective are the recognition that certain systems are not AOP and that some mechanisms are metabolism: they are sufficiently expressive to allow straightforwardly programming an AOP system within them.

Apparatus for controlling system state based on unique identifiers

DOEpatents

Drotning, William D.

2002-01-01

An apparatus allows workers to assert and release control over the energization of a system. The apparatus does not require the workers to carry any additional paraphernalia, and is not be easily defeated by other workers. Users asserting and releasing control present tokens uniquely identifying each user to a reader, and the apparatus prevents transition of the system to an undesired state until an appropriate number of users are currently asserting control. For example, a dangerous manufacturing robot can be prevented from energizing until all the users that have asserted control when entering the robot's controlled space have subsequently released control when leaving the robot's controlled space.

Perceived and Actual Behavior in Female Sexual Assertiveness: A Within-Couple Analysis in Hong Kong.

PubMed

Zhang, Huiping; Yip, Paul S F

2018-01-02

Studies in female sexual assertiveness have generally focused on individuals rather than couples, and little research has been conducted in the Chinese context. This study examined perceived and actual female sexual assertiveness at the couple level, and also explored its impact on marital and sexual satisfaction with a representative sample of 770 couples in Hong Kong. The results showed that husbands reported a higher level of acceptance of female sexual assertiveness in both perception and actual behavior; furthermore, couples reported greater congruence in their perception of female sexual initiation than actual behavior. Multiple logistic regressions showed that actual female sexual assertiveness, not the perception of it, affects both spouses' marital and sexual satisfaction. Compared with couples in which neither accepted female sexual initiation in practice, husbands where both spouses accepted this were more likely to be satisfied with the marriage. Husbands who accepted female sexual refusal whilst their wives did not were also more likely to be satisfied with both the marital and sexual relationship. Similarly, wives who did accept female sexual assertiveness but whose husbands did not were more likely to be satisfied with both the marital and sexual relationship.

Speaking up about Lighting up in Public: Examining Psychosocial Correlates of Smoking and Vaping Assertive Communication Intentions among U.S. Adults.

PubMed

Bigman, Cabral A; Mello, Susan; Sanders-Jackson, Ashley; Tan, Andy S L

2018-01-24

Against a backdrop of increasing smoke-free policies, electronic cigarette use, and discussion about public health risks posed by smoking and vaping, this study examines psychosocial predictors of intentions to ask others not to use e-cigarettes (vape) and smoke - i.e., assertive communication intentions. A national sample of U.S. adults (n = 474) reported assertive communication intentions for public venues. Psychosocial correlates included perceived risks of exposure to secondhand smoke (SHSe) and secondhand vapor (SHVe), SHSe and SHVe attitudes, subjective norms, and perceived self-efficacy. Separate linear regression models were conducted for smoking and vaping assertive communication intention outcomes. Perceived risks and self-efficacy were associated with greater vaping and smoking assertive communication intentions; subjective norms were only significant for vaping assertive communication intentions. Although a majority of respondents indicated they were unlikely to intervene to voice objections about SHSe and SHVe in public venues, this study suggests that incidental or intentional messages and policies that influence perceptions of risk, norms, and efficacy could affect willingness to voice objections about others' vaping and smoking in public.

Rape myth acceptance and rape acknowledgment: The mediating role of sexual refusal assertiveness.

PubMed

Newins, Amie R; Wilson, Laura C; White, Susan W

2018-05-01

Unacknowledged rape, defined as when an individual experiences an event that meets a legal or empirical definition of rape but the individual does not label it as such, is prevalent. Research examining predictors of rape acknowledgment is needed. Sexual assertiveness may be an important variable to consider, as an individual's typical behavior during sexual situations may influence rape acknowledgment. To assess the indirect effect of rape myth acceptance on rape acknowledgment through sexual refusal assertiveness, an online survey of 181 female rape survivors was conducted. The indirect effects of two types of rape myths (He didn't mean to and Rape is a deviant event) were significant and positive. Specifically, acceptance of these two rape myths was negatively related to sexual refusal assertiveness, which was negatively associated with likelihood of rape acknowledgment. The results of this study indicate that sexual refusal assertiveness is associated with lower likelihood of rape acknowledgment among rape survivors. As a result, it appears that, under certain circumstances, women high in rape myth acceptance may be more likely to acknowledge rape when it results in decreased sexual refusal assertiveness. Copyright © 2018 Elsevier B.V. All rights reserved.

The role of self-efficacy and assertiveness in aggression among high-school students in Isfahan.

PubMed

Khademi Mofrad, S H; Mehrabi, T

2015-01-01

Background. Nowadays, one sixth of the world's population is represented by adolescents, nearly 1.2 billion people being of age 10-19. According to the 2011 census in Iran, the estimation of adolescent population was 12 million, which represents 16% of the Iran population. Undoubtedly, adolescence is the most dominant stage of life. During this period, adolescents face biological, cognitive, and emotional changes that may be accompanied by inappropriate behavioral responses such as aggression. Considering pressures of peer groups during adolescence, assertiveness has an important role as a social skill. It seems that the success of adolescents in dealing with these problems depends on their self-efficacy. This study was designed to explore the role of self-efficacy and assertiveness in aggression among high-school students. Material and methods. This cross-sectional and correlational study was conducted among 321 first grade high-school students during 2014 and 2015. Samples were extracted from six education and training regions by a multi-stage random sampling. In this study, the questionnaire included demographic, Rathus Assertiveness, self-efficacy for children and aggression data. Results. The results showed that there was a notable negative association between aggression and assertiveness (p < 0.003) and also between assault and self-efficacy (p < 0.001). Conclusions. An increase in assertiveness and self-efficacy resulted in a decrease of aggression. So, training was recommended to reinforce self-efficacy beliefs and assertiveness behaviors for mental health promotion.

The role of self-efficacy and assertiveness in aggression among high-school students in Isfahan

PubMed Central

Khademi Mofrad, SH; Mehrabi, T

2015-01-01

Background. Nowadays, one sixth of the world’s population is represented by adolescents, nearly 1.2 billion people being of age 10-19. According to the 2011 census in Iran, the estimation of adolescent population was 12 million, which represents 16% of the Iran population. Undoubtedly, adolescence is the most dominant stage of life. During this period, adolescents face biological, cognitive, and emotional changes that may be accompanied by inappropriate behavioral responses such as aggression. Considering pressures of peer groups during adolescence, assertiveness has an important role as a social skill. It seems that the success of adolescents in dealing with these problems depends on their self-efficacy. This study was designed to explore the role of self-efficacy and assertiveness in aggression among high-school students. Material and methods. This cross-sectional and correlational study was conducted among 321 first grade high-school students during 2014 and 2015. Samples were extracted from six education and training regions by a multi-stage random sampling. In this study, the questionnaire included demographic, Rathus Assertiveness, self-efficacy for children and aggression data. Results. The results showed that there was a notable negative association between aggression and assertiveness (p < 0.003) and also between assault and self-efficacy (p < 0.001). Conclusions. An increase in assertiveness and self-efficacy resulted in a decrease of aggression. So, training was recommended to reinforce self-efficacy beliefs and assertiveness behaviors for mental health promotion. PMID:28316736

Normative studies with the Scale for Interpersonal Behaviour (SIB): II. US students. A cross-cultural comparison with Dutch data.

PubMed

Arrindell, W A; Bridges, K R; van der Ende, J; St Lawrence, J S; Gray-Shellberg, L; Harnish, R; Rogers, R; Sanderman, R

2001-12-01

The Scale for Interpersonal Behaviour (SIB), a multidimensional, self-report measure of state assertiveness, was administered to a nationwide sample of 2375 undergraduates enrolled at 11 colleges and universities across the USA. The SIB was developed in the Netherlands for the independent assessment of both distress associated with self-assertion in a variety of social situations and the likelihood of engaging in a specific assertive response. This is done with four factorially-derived, first-order dimensions: (i) Display of negative feelings (Negative assertion); (ii) Expression of and dealing with personal limitations; (iii) Initiating assertiveness; and (iv) Praising others and the ability to deal with compliments/praise of others (Positive assertion). The present study was designed to determine the cross-national invariance of the original Dutch factors and the construct validity of the corresponding dimensions. It also set out to develop norms for a nationwide sample of US students. The results provide further support for the reliability, factorial and construct validity of the SIB. Compared to their Dutch equivalents, US students had meaningfully higher distress in assertiveness scores on all SIB scales (medium to large effect sizes), whereas differences on the performance scales reflected small effect sizes. The cross-national differences in distress scores were hypothesized to have originated from the American culture being more socially demanding with respect to interpersonal competence than the Dutch, and from the perceived threats and related cognitive appraisals that are associated with such demands.

No longer "if," but "when": the coming abbreviated approval pathway for follow-on biologics.

PubMed

Kelly, Jeremiah J; David, Michael

2009-01-01

Abbreviated approval of follow-on biologics involves answering complex scientific, legal, and policy questions. The Food and Drug Administration (FDA or the Agency) asserts that it lacks the statutory authority to approve follow-on versions of biologics licensed under Section 351 of the Public Health Service Act (PHSA). Despite persuasive arguments to the contrary the one hundred and tenth Congress entertained four legislative proposals to give FDA this authority, each markedly different. It is no longer a question of "if," but "when" FDA will receive authority to review and license abbreviated applications for follow-on biologics. Any legislation in the one hundred and eleventh Congress must determine: (1) if FDA should be granted authority to develop an abbreviated pathway through rulemaking or guidance; (2) if human clinical trials should be mandatory or discretionary; (3) the feasibility of interchangeability determinations in light of patient safety concerns; (4) the duration of marketing exclusivity for associated products; (5) which products are eligible for follow-on approval; and (6) the degree to which uniformity is achievable between the FD&C Act and the PHSA. This paper recommends the one hundred and eleventh Congress strike a balance between patient safety, incentives for product innovation, price competition, and the need for a flexible, transparent process that capitalizes on FDA's growing expertise with follow-on biologics approvals under Section 505(b)(2) of the FD&C Act.

An Investigation of High School Seniors' Assertiveness Levels Based on Their Demographic Characteristics

ERIC Educational Resources Information Center

Çam, Ibrahim

2015-01-01

High school students who are in the development age or in the last class and have chance to win the university exams or disposal stage of the business life must also have a high level of assertiveness. In this context, the purpose of this research is to compare the assertiveness levels of high school seniors. The study group consists of 312 high…

Aspect-Oriented Programming is Quantification and Obliviousness

NASA Technical Reports Server (NTRS)

Filman, Robert E.; Friedman, Daniel P.; Norvig, Peter (Technical Monitor)

2000-01-01

This paper proposes that the distinguishing characteristic of Aspect-Oriented Programming (AOP) systems is that they allow programming by making quantified programmatic assertions over programs written by programmers oblivious to such assertions. Thus, AOP systems can be analyzed with respect to three critical dimensions: the kinds of quantifications allowed, the nature of the actions that can be asserted, and the mechanism for combining base-level actions with asserted actions. Consequences of this perspective are the recognition that certain systems are not AOP and that some mechanisms are expressive enough to allow programming an AOP system within them. A corollary is that while AOP can be applied to Object-Oriented Programming, it is an independent concept applicable to other programming styles.

[Evaluation of the factorial and metric equivalence of the Sexual Assertiveness Scale (SAS) by sex].

PubMed

Sierra, Juan Carlos; Santos-Iglesias, Pablo; Vallejo-Medina, Pablo

2012-05-01

Sexual assertiveness refers to the ability to initiate sexual activity, refuse unwanted sexual activity, and use contraceptive methods to avoid sexually transmitted diseases, developing healthy sexual behaviors. The Sexual Assertiveness Scale (SAS) assesses these three dimensions. The purpose of this study is to evaluate, using structural equation modeling and differential item functioning, the equivalence of the scale between men and women. Standard scores are also provided. A total of 4,034 participants from 21 Spanish provinces took part in the study. Quota sampling method was used. Results indicate a strict equivalent dimensionality of the Sexual Assertiveness Scale across sexes. One item was flagged by differential item functioning, although it does not affect the scale. Therefore, there is no significant bias in the scale when comparing across sexes. Standard scores show similar Initiation assertiveness scores for men and women, and higher scores on Refusal and Sexually Transmitted Disease Prevention for women. This scale can be used on men and women with sufficient psychometric guarantees.

Assertiveness levels of nursing students who experience verbal violence during practical training.

PubMed

Unal, Sati; Hisar, Filiz; Görgülü, Ulkü

2012-08-01

The aim of the study was to investigate students' verbal violence experiences, the effect of assertiveness on being subjected to violence, the behaviour of students after the violence and the experience of psychological distress during practical training. The study sample consisted of 274 students attending a school of nursing. A questionnaire form and the Rathus Assertiveness Schedule (RAS) were used for data collection. Percentages, means and the independent samples t-test were used for the evaluation of data. During practical training, the students suffered verbal violence from teachers, department nurses and doctors. The students had higher mean scores of RAS for most types of violence committed by the teachers and being reprimanded by the nurses and 69.3% had not responded to the violence. Students with a high level of assertiveness are subjected to violence more frequently. Being subjected to verbal violence and feeling psychological distress during practical training are a major problem among nursing students. Students should be supported in terms of assertiveness and dealing with violence effectively.

Assertiveness.

PubMed

Chambers, David W

2009-01-01

Assertiveness means speaking up for one's interpersonal freedoms or as required by one's role responsibilities to engage others in finding viable, stable solutions. Assertiveness is a learnable skill rather than a personality characteristic. The first step in assertiveness is recognizing the nature of one's problem in order to avoid the objectionable and usually ineffective practice of trying to solve other people's problems. A simple assertive approach is to suggest a solution. A more structured technique involves identifying the behavior that is causing a problem and expressing one's feelings about the problem (I-messages). The most powerful technique combines portions of suggested solutions and I-messages with a clear statement of consequences (DESC scripts). Although there may be a small number of circumstances where they are appropriate, acquiescence (temporarily forgoing one's interpersonal freedoms or role responsibilities) or aggression (insisting on one's own solution to the detriment of others) have several disadvantages. An example of justifiable criticism in the case of recognized gross or continuous faulty work by another dentist is presented.

[Relationship between assertiveness including consideration for others and adjustment in children].

PubMed

Eguchi, Megumi; Hamaguchi, Yoshikazu

2012-06-01

The relationship between assertiveness and internal and external adjustment was investigated. Elementary school children in grades four to six (n=207) and their classroom teachers (n=8) participated in the study. Internal and external adjustments were measured by using self-ratings, and self- and other- ratings respectively. The children responded to a questionnaires inquiring about assertiveness that included two components of assessment: "self expression" and "consideration for others". Then, the children were divided into 4 groups according to their scores on these two components of assertiveness. The results indicated that children scoring high on both components of assertiveness had higher self-rating scores than those scoring low on both components. Moreover, children that scored high on "consideration for others" tended to have high external adjustment. Also, boys that scored low on "self expression" had lower external adjustment as indicated by the negative ratings of teachers. Furthermore, girls that scored high on "consideration for others" had high external adjustment as indicated by positive ratings of teachers and same-sexed classmates.

[Approaches to the immunological problems of leukocyte transfusions].

PubMed

Gualde, N; Malinvaud, G; Gaillard, S

1975-01-01

51 leukocyte transfusions from healthy donors and 3 from chronic myelogenous leukemia were given to 16 patients with acute leukemia and 4 with aplasia. During 14 transfusions we have observed clinicals reactions which are of immunological origin. The part of the transfusions and of the pregnancies in the presence of antibodies is argued. The necessity of utilisation of HL-A compatible donors during leukocyte transfusions is asserted.

[Magnetic fields in physical therapy. Experience in orthopedics and traumatology rehabilitation].

PubMed

Borg, M J; Marcuccio, F; Poerio, A M; Vangone, A

1996-10-01

The present research is based on the premise that magnetic fields stimulate biological tissues, as many international works assert. They believe in the real aid of this therapeutical treatment in orthopedy and traumatology. The authors work in Rehabilitation Department of a traumatological hospital, so they have studied therapeutical results in ELF magnetotherapy on their patients for as long as six months.

Medical error reduction and tort reform through private, contractually-based quality medicine societies.

PubMed

MacCourt, Duncan; Bernstein, Joseph

2009-01-01

The current medical malpractice system is broken. Many patients injured by malpractice are not compensated, whereas some patients who recover in tort have not suffered medical negligence; furthermore, the system's failures demoralize patients and physicians. But most importantly, the system perpetuates medical error because the adversarial nature of litigation induces a so-called "Culture of Silence" in physicians eager to shield themselves from liability. This silence leads to the pointless repetition of error, as the open discussion and analysis of the root causes of medical mistakes does not take place as fully as it should. In 1993, President Clinton's Task Force on National Health Care Reform considered a solution characterized by Enterprise Medical Liability (EML), Alternative Dispute Resolution (ADR), some limits on recovery for non-pecuniary damages (Caps), and offsets for collateral source recovery. Yet this list of ingredients did not include a strategy to surmount the difficulties associated with each element. Specifically, EML might be efficient, but none of the enterprises contemplated to assume responsibility, i.e., hospitals and payers, control physician behavior enough so that it would be fair to foist liability on them. Likewise, although ADR might be efficient, it will be resisted by individual litigants who perceive themselves as harmed by it. Finally, while limitations on collateral source recovery and damages might effectively reduce costs, patients and trial lawyers likely would not accept them without recompense. The task force also did not place error reduction at the center of malpractice tort reform -a logical and strategic error, in our view. In response, we propose a new system that employs the ingredients suggested by the task force but also addresses the problems with each. We also explicitly consider steps to rebuff the Culture of Silence and promote error reduction. We assert that patients would be better off with a system where physicians cede their implicit "right to remain silent", even if some injured patients will receive less than they do today. Likewise, physicians will be happier with a system that avoids blame-even if this system placed strict requirements for high quality care and disclosure of error. We therefore conceive of de facto trade between patients and physicians, a Pareto improvement, taking form via the establishment of "Societies of Quality Medicine." Physicians working within these societies would consent to onerous processes for disclosing, rectifying and preventing medical error. Patients would in turn contractually agree to assert their claims in arbitration and with limits on recovery. The role of plaintiffs' lawyers would be unchanged, but due to increased disclosure, discovery costs would diminish and the likelihood of prevailing will more than triple. This article examines the legal and policy issues surrounding the establishment of Societies of Quality Medicine, particularly the issues of contracting over liability, and outlines a means of overcoming the theoretical and practical difficulties with enterprise liability, alternative dispute resolution and the imposition of limits on recovery for non-pecuniary damages. We aim to build a welfare enhancing system that rebuffs the culture of silence and promotes error reduction, a system that is at the same time legally sound, fiscally prudent and politically possible.

Perceptions of sexual assertiveness among adolescent girls: initiation, refusal, and use of protective behaviors.

PubMed

Auslander, Beth A; Perfect, Michelle M; Succop, Paul A; Rosenthal, Susan L

2007-06-01

We describe adolescent girls' perceptions of sexual assertiveness and examine the relationship of these perceptions with developmental and interpersonal variables. Cross-sectional analysis. Participants were recruited from a school-based health clinic and local colleges, and through snowballing to participate in a 6-month study examining microbicide acceptability. 106 sexually experienced girls (ages 14 through 21 years). Girls described their demographics, sexual history, and romantic relationships and completed the Sexual Assertiveness Scale for Women (SAS-W), which assesses perceptions of sexual assertiveness: Initiation of Sex, Refusal of Unwanted Sex, and Pregnancy-STD Prevention. Girls perceived themselves as asserting themselves between 50% and 75% of the time with their current or most recent partner. The Initiation subscale was not related to the other two subscales. In final models, girls with a prior pregnancy perceived themselves as initiating sex more than girls without a prior pregnancy. Having a greater number of lifetime partners was related to perceptions of less refusal, whereas greater number of partners, being sexually experienced longer, and engaging in more unprotected sex were related to perceptions of less implementation of preventive methods. None of the relationship variables were related to scores on any subscale. Most of these girls perceived themselves as sexually assertive. Given that sexual experience, not relationship factors, were related to perceptions of sexual assertiveness, the design of counseling messages should incorporate sexual experience. These messages should find effective ways to help girls both to communicate their sexual desires and to enhance their ability to protect themselves.

Perceptions of Sexual Assertiveness among Adolescent Girls: Initiation, Refusal, and Use of Protective Behaviors

PubMed Central

Auslander, Beth A.; Perfect, Michelle M.; Succop, Paul A.; Rosenthal, Susan L.

2007-01-01

Study Objective: We describe adolescent girls' perceptions of sexual assertiveness and examine the relationship of these perceptions with developmental and interpersonal variables. Design: Cross-sectional analysis Setting: Participants were recruited from a school-based health clinic, local colleges, and through snowballing to participate in a 6-month study examining microbicide acceptability. Participants: 106 sexually experienced girls (ages 14 through 21 years). Methods: Girls described their demographics, sexual history, and romantic relationships and completed the Sexual Assertiveness Scale for Women (SAS-W), which assesses perceptions of sexual assertiveness: Initiation of Sex, Refusal of Unwanted Sex, and Pregnancy-STD Prevention. Results: Girls perceived themselves as asserting themselves between 50 and 75% of the time with their current or most recent partner. The Initiation subscale was not related to the other two subscales. In final models, girls with a prior pregnancy perceived themselves as initiating sex more than girls without a prior pregnancy. Having a greater number of lifetime partners was related to perceptions of less refusal and greater number of partners, being sexually experienced longer, and engaging in more unprotected sex were related to perceptions of less implementation of preventive methods. None of the relationship variables were related to scores on any subscale. Conclusions: Most of these girls perceived themselves as sexually assertive. Given that sexual experience not relationship factors were related to perceptions of sexual assertiveness, the design of counseling messages should incorporate sexual experience. These messages should find effective ways to help girls communicate both their sexual desires and enhance their ability to protect themselves. PMID:17561183

Forward-Chaining Versus A Graph Approach As The Inference Engine In Expert Systems

NASA Astrophysics Data System (ADS)

Neapolitan, Richard E.

1986-03-01

Rule-based expert systems are those in which a certain number of IF-THEN rules are assumed to be true. Based on the verity of some assertions, the rules deduce as many new conclusions as possible. A standard technique used to make these deductions is forward-chaining. In forward-chaining, the program or 'inference engine' cycles through the rules. At each rule, the premises for the rule are checked against the current true assertions. If all the premises are found, the conclusion is added to the list of true assertions. At that point it is necessary to start over at the first rule, since the new conclusion may be a premise in a rule already checked. Therefore, each time a new conclusion is deduced it is necessary to start the rule checking procedure over. This process continues until no new conclusions are added and the end of the list of rules is reached. The above process, although quite costly in terms of CPU cycles due to the necessity of repeatedly starting the process over, is necessary if the rules contain 'pattern variables'. An example of such a rule is, 'IF X IS A BACTERIA, THEN X CAN BE TREATED WITH ANTIBIOTICS'. Since the rule can lead to conclusions for many values of X, it is necessary to check each premise in the rule against every true assertion producing an association list to be used in the checking of the next premise. However, if the rule does not contain variable data, as is the case in many current expert systems, then a rule can lead to only one conclusion. In this case, the rules can be stored in a graph, and the true assertions in an assertion list. The assertion list is traversed only once; at each assertion a premise is triggered in all the rules which have that assertion as a premise. When all premises for a rule trigger, the rule's conclusion is added to the END of the list of assertions. It must be added at the end so that it will eventually be used to make further deductions. In the current paper, the two methods are described in detail, the relative advantages of each is discussed, and a benchmark comparing the CPU cycles consumed by each is included. It is also shown that, in the case of reasoning under uncertainty, it is possible to properly combine the certainties derived from rules arguing for the same conclusion when the graph approach is used.

Framing, Engagement, and Policy Change: Lessons for the ACA.

PubMed

Karch, Andrew; Rosenthal, Aaron

2017-04-01

Supporters of the Patient Protection and Affordable Care Act (ACA) sometimes speculate that public attitudes toward the law will shift if proponents succeed in focusing attention on its more popular components, but the scholarly literature on framing effects provides ample reason to question their assertion. This article contends that engagement, an alternative rhetorical strategy where advocates address the same policy dimensions as their opponents, is a more promising approach. Extending the engagement literature to the elite context in which most ACA-related decisions are made, it argues that elite-level engagement necessitates the additional task of linking policy change to opponents' broader philosophical and policy goals. Current debates surrounding the application of sales taxes to electronic commerce-a policy arena that seems far removed from health care policy but overlaps with the ACA in ways that make it an appropriate source of lesson drawing-illustrate the potential of an engagement strategy. Recently, many conservative lawmakers who previously opposed policy change have instead embraced online sales taxes as a mechanism for additional tax cuts. Analogous connections may facilitate the diffusion of ACA provisions that presently receive hostile receptions in Republican-leaning states. Copyright © 2017 by Duke University Press.

Newborn screening by tandem mass spectrometry: ethical and social issues.

PubMed

Avard, Denise; Vallance, Hilary; Greenberg, Cheryl; Potter, Beth

2007-01-01

Emerging technologies like Tandem Mass Spectrometry (TMS) enable multiple tests on a single blood sample and allow the expansion of Newborn Screening (NBS) to include various metabolic diseases. Introducing TMS for NBS raises important social and ethical questions: what are the criteria for adding disorders to screening panels? What evidence justifies expansion of screening? How can equity in NBS access and standards be ensured? How can policy standards be set, given the multiplicity of stakeholders? To address emerging issues, policy-makers, patient advocates, clinicians and researchers had a workshop during the 2005 Garrod Symposium. The participants received a summary of the discussion and understood the workshop's goal was to provide a basis for further discussion. This article contributes to this ongoing discussion. Several proposed recommendations assert the centrality of including social and ethical issues in the assessment of whether or not to introduce TMS. The article outlines five key recommendations for advancing the NBS agenda: national public health leadership; transparency; increased national consistency in NBS strategy, including minimum standards; collaboration between the federal and provincial/territorial governments and diverse stakeholders; and supporting research and/or programs based on effectiveness, which integrate ethical and social issues into assessment.

[Studies of the personality of nursing students].

PubMed

Martín, M J; Vila, J; Capellas, R

2000-09-01

This study evaluates diverse psychological variables in 35 third-year nursing students. Personality is studied according to Eysenck's theories, by means of the E.P.Q. questionnaire; assertive behavior is studied by means of the Gambrill and Richey assertiveness questionnaire; and the hostility set is also measured by means of the Buss-Durkee questionnaire. Likewise, due to the results obtained, the authors point out the necessity to work on the theme of assertiveness in nursing students.

A proposal for evaluating cognition in assertiveness.

PubMed

Vagos, Paula; Pereira, Anabela

2010-09-01

This article presents the development process and initial psychometric features of an instrument for evaluating cognition in assertiveness. This is an essential social skill for adolescent development and seems to encompass emotional, behavioral, and cognitive aspects. The instrument was created by combining both empirical and theoretical methods for item construction, aiming to evaluate the cognitive realm of assertiveness. A sample of 996 adolescent students was used to test for reliability and validity. Results indicate good psychometric properties. The instrument is composed of 4 subscales: Outer Emotional Support, Functional Personal Ability, Interpersonal Management, and Affective Personal Ability. The Assertive Interpersonal Schema Questionnaire may potentially be a useful tool in the diagnosis of, understanding of, and development of a treatment plan for individuals with persistent difficulties in social events.

3rd Circuit hints it may reconsider McNemar reasoning.

PubMed

1997-10-17

The [name removed] v. The Disney Store ruling is under criticism and the 3rd U.S. Circuit Court of Appeals may reconsider its 1996 decision to not allow employees who receive disability benefits to sue under the Americans with Disabilities Act (ADA). A panel of 3rd Circuit judges, working on [name removed] v. American Sterilizer Co., asserts that the [name removed] decision should not be used to assume that an individual's ADA claims are barred because of prior representations of disability. [Name removed] is suing American Sterilizer under the retaliation provisions of the ADA. Other courts are criticizing the [name removed] decision, including the District of Columbia Court in [name removed] v. Washington Metropolitan Area Transit Authority. The [name removed] court assets that a statement made in the context of a disability application does not preclude an ADA claim brought by a worker for illegal discrimination because the ADA and the Social Security Act differ in their statutory intent. AIDS advocates state that the [name removed] decision places a plaintiff in the position of having to choose between asserting a legal right or maintaining an income. Alan Epstein, who represented [name removed], is pleased by the criticism but explains that [name removed], who died this summer, will not be vindicated.

Training the "assertive practitioner of behavioral science": advancing a behavioral medicine track in a family medicine residency.

PubMed

Butler, Dennis J; Holloway, Richard L; Fons, Dominique

2013-01-01

This article describes the development of a Behavioral Medicine track in a family medicine residency designed to train physicians to proactively and consistently apply advanced skills in psychosocial medicine, psychiatric care, and behavioral medicine. The Behavioral Medicine track emerged from a behavioral science visioning retreat, an opportunity to restructure residency training, a comparative family medicine-psychiatry model, and qualified residents with high interest in behavioral science. Training was restructured to increase rotational opportunities in core behavioral science areas and track residents were provided an intensive longitudinal counseling seminar and received advanced training in psychopharmacology, case supervision, and mindfulness. The availability of a Behavioral Medicine track increased medical student interest in the residency program and four residents have completed the track. All track residents have presented medical Grand Rounds on behavioral science topics and have lead multiple workshops or research sessions at national meetings. Graduate responses indicate effective integration of behavioral medicine skills and abilities in practice, consistent use of brief counseling skills, and good confidence in treating common psychiatric disorders. As developed and structured, the Behavioral Medicine track has achieved the goal of producing "assertive practitioners of behavioral science in family medicine" residents with advanced behavioral science skills and abilities who globally integrate behavioral science into primary care.

"We are the best to stand in for patients": a qualitative study on nurses' advocacy characteristics in Ghana.

PubMed

Dadzie, Grace; Aziato, Lydia; Aikins, Ama de-Graft

2017-01-01

Patient advocacy has been identified as a core duty of the nurse, and certain nurse characteristics influence the performance of the role. However, these characteristics have not been adequately explored in Ghana. This study aimed to explore the perspectives of nurses about the characteristics of nurses that influence their role as patient advocates. An exploratory descriptive qualitative study was conducted among 15 nurses from a regional hospital in Ghana. Purposive sampling was used to select participants and individual in-depth interviews were conducted in English using a semi-structured interview guide. The interviews were audio-taped and transcribed. Data analysis was done concurrently employing the principles of thematic analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute of Medical Research and the Ghana Health Service Ethical Review Committee. Themes generated revealed nurse traits which enhanced the advocacy role of nurses such as being empathetic, nurturing, ethical, assertive and persistent and nurse states which hindered the performance of the role such as fatigue and frustration. However, "compassionate" emerged as an additional nurse trait from this study. Out of empathy, participants availed themselves for patients to share their problems with them. In their nurturing roles, spending more time with patients and providing personal care fostered closeness which helped in identifying patients' problems. Helping patients navigate the health system was also found. They perceived patient advocacy as a moral responsibility and identified good communication skills and determination to help patients get their problems solved as important in patient advocacy. Some participants also described compassion-based activities such as pleading on patients' behalf, providing material and financial assistance, facilitating care and providing emotional support in their advocacy. However, heavy workload and lack of appreciation from patients were found to hinder the performance of the advocacy role. We concluded that nurse characteristics that influence patient advocacy are comparable to those identified internationally such as being empathetic, assertiveness and fatigue. Enhancing these characteristics could help nurses overcome the negative states that undermine the patient advocacy role of nurses.

Count Your Calories and Share Them: Health Benefits of Sharing mHealth Information on Social Networking Sites.

PubMed

Oeldorf-Hirsch, Anne; High, Andrew C; Christensen, John L

2018-04-23

This study investigates the relationship between sharing tracked mobile health (mHealth) information online, supportive communication, feedback, and health behavior. Based on the Integrated Theory of mHealth, our model asserts that sharing tracked health information on social networking sites benefits users' perceptions of their health because of the supportive communication they gain from members of their online social networks and that the amount of feedback people receive moderates these associations. Users of mHealth apps (N = 511) completed an online survey, and results revealed that both sharing tracked health information and receiving feedback from an online social network were positively associated with supportive communication. Network support both corresponded with improved health behavior and mediated the association between sharing health information and users' health behavior. As users received greater amounts of feedback from their online social networks, however, the association between sharing tracked health information and health behavior decreased. Theoretical implications for sharing tracked health information and practical implications for using mHealth apps are discussed.

An Automated Approach to Reasoning Under Multiple Perspectives

NASA Technical Reports Server (NTRS)

deBessonet, Cary

2004-01-01

This is the final report with emphasis on research during the last term. The context for the research has been the development of an automated reasoning technology for use in SMS (symbolic Manipulation System), a system used to build and query knowledge bases (KBs) using a special knowledge representation language SL (Symbolic Language). SMS interpreters assertive SL input and enters the results as components of its universe. The system operates in two basic models: 1) constructive mode (for building KBs); and 2) query/search mode (for querying KBs). Query satisfaction consists of matching query components with KB components. The system allows "penumbral matches," that is, matches that do not exactly meet the specifications of the query, but which are deemed relevant for the conversational context. If the user wants to know whether SMS has information that holds, say, for "any chow," the scope of relevancy might be set so that the system would respond based on a finding that it has information that holds for "most dogs," although this is not exactly what was called for by the query. The response would be qualified accordingly, as would normally be the case in ordinary human conversation. The general goal of the research was to develop an approach by which assertive content could be interpreted from multiple perspectives so that reasoning operations could be successfully conducted over the results. The interpretation of an SL statement such as, "{person believes [captain (asserted (perhaps)) (astronaut saw (comet (bright)))]}," which in English would amount to asserting something to the effect that, "Some person believes that a captain perhaps asserted that an astronaut saw a bright comet," would require the recognition of multiple perspectives, including some that are: a) epistemically-based (focusing on "believes"); b) assertion-based (focusing on "asserted"); c) perception-based (focusing on "saw"); d) adjectivally-based (focusing on "bight"); and e) modally-based (focusing on "perhaps"). Any conclusion reached under a line of reasoning that employs such an assertion or its associated implications should somehow reflect the employed perspectives. The investigators made significant progress in developing an approach that would enable a system to conduct reasoning operations over assertions of this kind while maintaining consistency in its knowledge bases. Significant accomplishments were made in the areas of: 1) integration and inferencing; 2) generation of perspectives, including wholistic ad composite views; and 3) consistency maintenance.

Development and Validation of a Natural Language Processing Tool to Identify Patients Treated for Pneumonia across VA Emergency Departments.

PubMed

Jones, B E; South, B R; Shao, Y; Lu, C C; Leng, J; Sauer, B C; Gundlapalli, A V; Samore, M H; Zeng, Q

2018-01-01

Identifying pneumonia using diagnosis codes alone may be insufficient for research on clinical decision making. Natural language processing (NLP) may enable the inclusion of cases missed by diagnosis codes. This article (1) develops a NLP tool that identifies the clinical assertion of pneumonia from physician emergency department (ED) notes, and (2) compares classification methods using diagnosis codes versus NLP against a gold standard of manual chart review to identify patients initially treated for pneumonia. Among a national population of ED visits occurring between 2006 and 2012 across the Veterans Affairs health system, we extracted 811 physician documents containing search terms for pneumonia for training, and 100 random documents for validation. Two reviewers annotated span- and document-level classifications of the clinical assertion of pneumonia. An NLP tool using a support vector machine was trained on the enriched documents. We extracted diagnosis codes assigned in the ED and upon hospital discharge and calculated performance characteristics for diagnosis codes, NLP, and NLP plus diagnosis codes against manual review in training and validation sets. Among the training documents, 51% contained clinical assertions of pneumonia; in the validation set, 9% were classified with pneumonia, of which 100% contained pneumonia search terms. After enriching with search terms, the NLP system alone demonstrated a recall/sensitivity of 0.72 (training) and 0.55 (validation), and a precision/positive predictive value (PPV) of 0.89 (training) and 0.71 (validation). ED-assigned diagnostic codes demonstrated lower recall/sensitivity (0.48 and 0.44) but higher precision/PPV (0.95 in training, 1.0 in validation); the NLP system identified more "possible-treated" cases than diagnostic coding. An approach combining NLP and ED-assigned diagnostic coding classification achieved the best performance (sensitivity 0.89 and PPV 0.80). System-wide application of NLP to clinical text can increase capture of initial diagnostic hypotheses, an important inclusion when studying diagnosis and clinical decision-making under uncertainty. Schattauer GmbH Stuttgart.

Cue-based assertion classification for Swedish clinical text – developing a lexicon for pyConTextSwe

PubMed Central

Velupillai, Sumithra; Skeppstedt, Maria; Kvist, Maria; Mowery, Danielle; Chapman, Brian E.; Dalianis, Hercules; Chapman, Wendy W.

2014-01-01

Objective The ability of a cue-based system to accurately assert whether a disorder is affirmed, negated, or uncertain is dependent, in part, on its cue lexicon. In this paper, we continue our study of porting an assertion system (pyConTextNLP) from English to Swedish (pyConTextSwe) by creating an optimized assertion lexicon for clinical Swedish. Methods and material We integrated cues from four external lexicons, along with generated inflections and combinations. We used subsets of a clinical corpus in Swedish. We applied four assertion classes (definite existence, probable existence, probable negated existence and definite negated existence) and two binary classes (existence yes/no and uncertainty yes/no) to pyConTextSwe. We compared pyConTextSwe’s performance with and without the added cues on a development set, and improved the lexicon further after an error analysis. On a separate evaluation set, we calculated the system’s final performance. Results Following integration steps, we added 454 cues to pyConTextSwe. The optimized lexicon developed after an error analysis resulted in statistically significant improvements on the development set (83% F-score, overall). The system’s final F-scores on an evaluation set were 81% (overall). For the individual assertion classes, F-score results were 88% (definite existence), 81% (probable existence), 55% (probable negated existence), and 63% (definite negated existence). For the binary classifications existence yes/no and uncertainty yes/no, final system performance was 97%/87% and 78%/86% F-score, respectively. Conclusions We have successfully ported pyConTextNLP to Swedish (pyConTextSwe). We have created an extensive and useful assertion lexicon for Swedish clinical text, which could form a valuable resource for similar studies, and which is publicly available. PMID:24556644

Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers.

PubMed

Saw, Anne; Tang, Hao; Tsoh, Janice Y; Chen, Moon S; Tong, Elisa K

2017-11-01

Non-smokers' assertive behaviour towards smokers by asking them not to smoke is important in promoting smoke-free environments. Korean and Chinese Americans come from countries where most women are non-smokers and assertive behaviour may not be prevalent but may increase after migration because of social-ecological factors. This study assessed the extent to which Korean and Chinese American non-smokers ask someone not to smoke and associated factors. The 2003 California Chinese American and Korean American Tobacco Use Surveys were analysed. Multivariate logistic regression analyses examined factors related to non-smoker self-reports that they asked someone not to smoke within the past year. About 40% reported past-year assertive behaviour against smoking, with higher rates among Koreans than Chinese (60.4% vs. 34.5%), those living with smokers (63.5%), ever exposed with a smoke-free home rule (62.3%), recently exposed at work without a smoke-free work policy (67.6%) and regularly exposed at other locations (52.3%). In combined multivariate analyses of both ethnic groups, assertive behaviour was associated with individual factors (single vs. married; tobacco exposure knowledge), family factors (living with smokers, exposed at home despite a smoke-free rule), community factors (exposed at work with no smoke-free policy, exposed at other locations) and cultural factors (Korean vs. Chinese ethnicity; lower acculturation). Chinese and Korean American non-smokers report assertive behaviour against smoking, which is associated with social-ecological factors. Results help identify target groups and strategies for future intervention, including the need to implement or enforce smoke-free environments and promote empowerment. [Saw A, Tang H, Tsoh JY, Chen MS Jr, Tong EK. Non-smoker assertive behaviour against smoke exposure: Chinese and Korean American non-smokers. © 2017 Australasian Professional Society on Alcohol and other Drugs.

The effects of enactment on communicative competence in aphasic casual conversation: a functional linguistic perspective.

PubMed

Groenewold, Rimke; Armstrong, Elizabeth

2018-05-14

Previous research has shown that speakers with aphasia rely on enactment more often than non-brain-damaged language users. Several studies have been conducted to explain this observed increase, demonstrating that spoken language containing enactment is easier to produce and is more engaging to the conversation partner. This paper describes the effects of the occurrence of enactment in casual conversation involving individuals with aphasia on its level of conversational assertiveness. To evaluate whether and to what extent the occurrence of enactment in speech of individuals with aphasia contributes to its conversational assertiveness. Conversations between a speaker with aphasia and his wife (drawn from AphasiaBank) were analysed in several steps. First, the transcripts were divided into moves, and all moves were coded according to the systemic functional linguistics (SFL) framework. Next, all moves were labelled in terms of their level of conversational assertiveness, as defined in the previous literature. Finally, all enactments were identified and their level of conversational assertiveness was compared with that of non-enactments. Throughout their conversations, the non-brain-damaged speaker was more assertive than the speaker with aphasia. However, the speaker with aphasia produced more enactments than the non-brain-damaged speaker. The moves of the speaker with aphasia containing enactment were more assertive than those without enactment. The use of enactment in the conversations under study positively affected the level of conversational assertiveness of the speaker with aphasia, a competence that is important for speakers with aphasia because it contributes to their floor time, chances to be heard seriously and degree of control over the conversation topic. © 2018 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Cognitive group therapy for depressive students: The case study

PubMed Central

Tiuraniemi, Juhani; Korhola, Jarno

2009-01-01

The aims of this study were to assess whether a course of cognitive group therapy could help depressed students and to assess whether assimilation analysis offers a useful way of analysing students' progress through therapy. “Johanna” was a patient in a group that was designed for depressive students who had difficulties with their studies. The assimilation of Johanna's problematic experience progressed as the meetings continued from level one (unpleasant thoughts) to level six (solving the problem). Johanna's problematic experience manifested itself as severe and excessive criticism towards herself and her study performance. As the group meetings progressed, Johanna found a new kind of tolerance that increased her determination and assertiveness regarding the studies. The dialogical structure of Johanna's problematic experience changed: she found hope and she was more assertive after the process. The results indicated that this kind of psycho-educational group therapy was an effective method for treating depression. The assimilation analysis offered a useful way of analysing the therapy process. PMID:20523883

Predictors of family conflict at the end of life: the experience of spouses and adult children of persons with lung cancer.

PubMed

Kramer, Betty J; Kavanaugh, Melinda; Trentham-Dietz, Amy; Walsh, Matthew; Yonker, James A

2010-04-01

Guided by an explanatory matrix of family conflict at the end of life, the purpose of this article was to examine the correlates and predictors of family conflict reported by 155 spouses and adult children of persons with lung cancer. A cross-sectional statewide survey of family members of persons who died from lung cancer was conducted as part of the larger study on the Assessment of Cancer CarE and SatiSfaction in Wisconsin. Significant bivariate correlations were found between family conflict and family context variables (i.e., a history of conflict, younger respondent age, race, and specified end-of-life care wishes of the patient), conditions (i.e., greater physical and psychological clinical care needs of the patient), and contributing factors (i.e., communication constraints and family asserting control). In the multivariate model, significant predictors of family conflict included prior family conflict, race, communication constraints, and family members asserting control; the model explained 72% of the variance in conflict. Implications for routine assessment and screening to identify families at risk and recommendations for the development and testing of interventions to facilitate shared decision making and enhance open communication among at-risk families are highlighted.

Those who hesitate lose: the relationship between assertiveness and response latency.

PubMed

Collins, L H; Powell, J L; Oliver, P V

2000-06-01

Individuals who are low in assertiveness may take longer to sort out, process, and state their own perceptions, attitudes and priorities, which puts them at a disadvantage in getting their needs met. The reason for this may not be inhibition in social situations or cognitive ability, but a lack of clarity regarding their own attitudes, opinions, preferences, goals, and priorities. 101 undergraduate students (57% women and 43% men) completed a demographics questionnaire, the Wonderlic Personnel Test, a self-monitoring scale, the Marlowe-Crowne Social Desirability Scale, the Rosenberg Self-esteem Scale, the College Self-expression Scale, and a test of the false-consensus effect. Response latencies to questions were measured. Individuals with higher scores on the Wonderlic Personnel Test answered items more quickly but, even when cognitive ability was controlled, individuals low in assertiveness still took significantly longer to respond to questions about themselves, their opinions, and their preferences. If individuals fall behind at this early step in the process of asserting themselves, then they may be more likely to miss opportunities to be assertive.

[Short-term effects of a cognitive-behavioural group therapy in social phobia: evaluation of sixty patients].

PubMed

Camart, N; André, C; Trybou, V; Bourdel, M-C

2006-01-01

This study analyses the short term effects of a cognitive-behavioral group therapy with 60 patients suffering from social phobia according to the diagnostic criteria of the DSM IV. The therapeutic program is based on 12 sessions of 2 hours (for 6 to 9 subjects) and includes exposure, cognitive restructuring and social skills training. The sample included 34 women and 26 men, with an average age of 34.8 years (SD=9.3). Most patients presented generalized social phobia (n=42; not generalized social phobia: n=18), and 24 received at least one comorbid axis I diagnosis. Subjects were evaluated before and after the therapy with instruments measuring the intensity of social phobia (Liebowitz Social Anxiety Scale), the assertiveness (Rathus Assertiveness Schedule), the disability associated with the disorder (Sheehan Disability Scale), anxiety and depression (Hospital Anxiety Depression Scale and Beck shortened Depression Inventory), and self-esteem (Rosenberg Self-Esteem Scale). The results show significant differences (p<0.001) between the pre and the post-test for all instruments. The effect sizes (ES) range from 1.29 (Liebowitz Scale, total score) to 0.51 (Sheehan item 3), exhibiting patients' improvement on all variables. The highest effect sizes are observed with the instruments specifically designed for the assessment of social phobia (Liebowitz, Rathus and Sheehan scales). Our patients show the major improvements in the Liebowitz Scale (ES=1.29), the best indicator for social phobia, concerning the intensity of anxiety in social situations (ES=1.28) and concerning the frequency of avoidance (ES=1.16). Logically, the effect sizes are somehow lower on Sheehan (ES=1.06) and Rathus (ES=1.00) scales, which are less specifically centered on the score symptoms of social phobia. The improvement is also significant but less remarkable in the other measurements. The Hospital Anxiety Depression Scale reveals a reduction in the level of anxiety and depression, however more significant for anxiety (ES=0.88) than for depression (ES=0.60), that is consistent with the fact that social phobia is an anxious disorder. The shortened Beck Depression Inventory confirms the level of depression decreases after therapy (ES=0.67) and we also observe a significant enhancement of self-esteem (ES=0.85). These findings confirm the short-term strong effectiveness of this therapeutic program. The present study shows that the therapeutic cognitive-behavior group techniques used are specifically effective both on the principal symptoms of social phobia as on other psychological aspects, which were not specifically the focus of this therapy, like general anxiety, depression, and self-esteem. However, this efficient study on 60 subjects needs to be extended to the evaluation of long term effects. It also needs to be reproduced to assess personality disorders that may make the treatment more difficult and are frequently comorbid with generalized social phobia.

Biometric Subject Verification Based on Electrocardiographic Signals

NASA Technical Reports Server (NTRS)

Dusan, Sorin V. (Inventor); Jorgensen, Charles C. (Inventor)

2014-01-01

A method of authenticating or declining to authenticate an asserted identity of a candidate-person. In an enrollment phase, a reference PQRST heart action graph is provided or constructed from information obtained from a plurality of graphs that resemble each other for a known reference person, using a first graph comparison metric. In a verification phase, a candidate-person asserts his/her identity and presents a plurality of his/her heart cycle graphs. If a sufficient number of the candidate-person's measured graphs resemble each other, a representative composite graph is constructed from the candidate-person's graphs and is compared with a composite reference graph, for the person whose identity is asserted, using a second graph comparison metric. When the second metric value lies in a selected range, the candidate-person's assertion of identity is accepted.

The effect of nurse education on the self-esteem and assertiveness of nursing students: A four-year longitudinal study.

PubMed

İlhan, Nesrin; Sukut, Özge; Akhan, Latife Utaş; Batmaz, Makbule

2016-04-01

The nurse education program affects many aspects of personal development. Nursing students gain skills in critical thinking and analysis and also develop communication and management skills. The four-year program may also have an effect on students' assertiveness and self-esteem. This study was conducted to determine the impact of the four-year higher nursing school educational program on students' self-esteem and assertiveness. Descriptive longitudinal design. The study took place at a Foundation University in Istanbul, Turkey over the period 2006-2010. The students' levels of self-esteem and assertiveness were assessed at the beginning and end of the first, second, third and fourth years of the program. Copyright © 2016 Elsevier Ltd. All rights reserved.

The assessment of social skills deficits in the elderly.

PubMed

Furnham, A; Pendleton, D

1983-01-01

This paper tested the hypothesis that a sample of elderly people compared to a matched sample of younger people reports an increase in difficulty and social anxiety in dealing with a wide range of everyday social situations. The literature on assertiveness and social skills training with the elderly was first reviewed. Then an assertiveness and social difficulty scale was administered to a group of eighty participants divided by age and sex. It was found that older people experienced less discomfort in situations requiring assertiveness, yet were less likely to respond assertively. Older people reported higher incidence of social anxiety across forty everyday situations. In general females reported more difficulty than males, though there were no interaction effects. The results are discussed in terms of the assessment and training of social skills in the elderly.

Essentials for effective communication in oncology nursing: assertiveness, conflict management, delegation, and motivation.

PubMed

Walczak, M B; Absolon, P L

2001-01-01

The ability to communicate effectively with a multidisciplinary team in an assertive manner to resolve conflict, motivate others, and delegate tasks is a prerequisite skill to promote a harmonious work environment. Acquisition of this skill is often a combination of inherent attributes and learned experiences. This article describes a program on assertiveness, conflict resolution, motivation of others, and delegation. Nurses are encouraged to seek expertise from other departments (e.g., Human Resources) to help them develop similar programs.

Social competence: evaluation of assertiveness in Spanish adolescents.

PubMed

Castedo, Antonio López; Juste, Margarita Pino; Alonso, José Domínguez

2015-02-01

Relations between assertiveness in adolescents' social behavior and demographic variables were assessed in 4,943 Spanish adolescents, ages 12 to 17 years, enrolled in 32 schools for Compulsory Secondary Education. Province of residence, school size, age, grade, and academic focus were statistically significant sources of variance in assertiveness scores. All effects were small. Patterns in responses indicate the items should be reviewed to improve the measure for adolescents, and as a tool for addressing teens' social competence in real life situations.

Human Factors Research in Anesthesia Patient Safety

PubMed Central

Weinger, Matthew B.; Slagle, Jason

2002-01-01

Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. This paper describes data obtained recently using task analysis and workload assessment during actual patient care and the use of cognitive task analysis to study clinical decision making. A novel concept of “non-routine events” is introduced and pilot data are presented. The results support the assertion that human factors research can make important contributions to patient safety. Information technologies play a key role in these efforts.

Human factors research in anesthesia patient safety.

PubMed Central

Weinger, M. B.; Slagle, J.

2001-01-01

Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment. This paper describes data obtained recently using task analysis and workload assessment during actual patient care and the use of cognitive task analysis to study clinical decision making. A novel concept of "non-routine events" is introduced and pilot data are presented. The results support the assertion that human factors research can make important contributions to patient safety. Information technologies play a key role in these efforts. PMID:11825287

Agoraphobia and Melancholia: Thoughts on Milrod's "Emptiness in Agoraphobia Patients".

PubMed

Yates, Sheena

2015-08-01

Milrod (2007) identifies persistent emptiness in agoraphobic patients whose symptoms of anxiety and avoidance have remitted. To this important identification, a number of critical considerations may be raised regarding the meanings of emptiness in the psychoanalytic clinic. Milrod's admonishment to distinguish between an emptiness that indicates a deficit in the structure and stability of self-representation, and an emptiness that is strictly defensive, is a case in point. While much of the literature supports an interpretation of emptiness as a defense against overwhelming rage, these patients' assertions and experiences of emptiness can be better explained by the presence of traumatic, unmourned losses. Several explanations are offered as to why agoraphobic patients, in particular, defend unconsciously against mourning. © 2015 by the American Psychoanalytic Association.

Enhancing patient well-being: advocacy or negotiation?

PubMed Central

Bird, A W

1994-01-01

The United Kingdom Central Council for Nursing, Midwifery and Health Visitors (UKCC) document, Exercising Accountability, states that the role of patient's advocate is an essential aspect of good professional nursing practice (1). The author examines the case for and against the nurse being the best person to act as advocate, and critically evaluates the criteria of advocacy. The problematic moral issues arising are discussed, and a case made for negotiation between the members of the multidisciplinary team and the patient/client (or a significant person to the patient) in order to promote the well-being of the patient and to minimise suffering. She concludes that the health care professional's (including the nurse's) role is to help people to assert control over the factors which affect their lives, that is empowerment, rather than advocacy. PMID:7996560

Veterans Affairs Intensive Case Management for older veterans.

PubMed

Mohamed, Somaia; Neale, Michael S; Rosenheck, Robert

2009-08-01

There is a growing need for information on evidence-based practices that may potentially address needs of elderly people with severe mental illness (SMI), and more specifically on community-based services such as assertive community treatment (ACT). This study examines national evaluation data from fiscal year 2001-2005 from Veterans Affairs Mental Health Intensive Case Management (MHICM) program (N = 5,222), an ACT-based service model, to characterize the age distribution of participants and the distinctive needs, patterns of service delivery, and treatment outcomes for elderly veterans. Altogether, 24.8% of participants were 55-64 years; 7.4% 65-74 years; and 2.8% were older than 75. Veterans over 75 formed a distinct subgroup that had a later age of onset of primarily nonpsychotic illnesses without comorbid substance abuse and had experienced more limited lifetime hospital treatment than younger participants. Older veterans were less symptomatic and more satisfied with their social relationships than younger clients. They mostly live independently or in minimally restrictive housing, but they received less recovery-focused services and more crisis intervention and medical services. They thus do not appear to be young patients with SMI who have aged but rather constitute a distinct group with serious late-onset problems. It is possible that MHICM services keep them in the community and avoid costly nursing home placement while providing a respite service that reduces family burden. These data highlight the unique characteristics of older veterans receiving ACT-like services and the need to focus greater attention on recovery-oriented services as well as community support for this subgroup.

Valuing Treatment With Infliximab for Ankylosing Spondylitis Using a Willingness-to-Pay Approach.

PubMed

Webers, Casper; Essers, Ivette; van Tubergen, Astrid; Braun, Jürgen; Heldmann, Frank; Baraliakos, Xenofon; Boonen, Annelies

2018-04-01

To investigate willingness to pay (WTP) for treatment with infliximab by patients with ankylosing spondylitis (AS) and explore factors associated with WTP. Data from 85 patients participating in the European AS Infliximab Cohort (EASIC) open-label extension of the AS Study for the Evaluation of Recombinant Infliximab Therapy (ASSERT) were used. WTP was included at baseline in EASIC and comprised a hypothetical scenario exploring whether the patient would be willing to pay for beneficial effects of infliximab and, if so, what amount they would be willing to pay per administration. Factors associated with WTP were explored using zero-inflated negative binomial (ZINB) regressions. Of the 85 patients, 63 (74.1%) were willing to pay, and among these, the mean amount they were willing to pay per administration was €275 (median €100 [interquartile range €50-200]). Multivariable ZINB analysis showed that Assessment of SpondyloArthritis international Society criteria for 20% improvement (ASAS20) response was associated with a 7-fold lower likelihood to pay 0 euros (odds ratio [OR] 0.14 [95% confidence interval (95% CI) 0.03-0.71]) and a 3-fold increase in the amount willing to pay (exp(β) = 3.32 [95% CI 1.44-7.69]). In addition, the country of residence was associated with a lower likelihood to pay 0 euros (OR 0.07 [95% CI 0.02-0.36]), while increased age was associated with the amount willing to pay (exp(β) = 1.05 [95% CI 1.01-1.09]). In a hypothetical scenario, three-quarters of patients with AS receiving long-term infliximab stated that they were willing to pay an out-of-pocket contribution for this treatment. Treatment response contributed to the willingness as well as to the amount patients were willing to pay. © 2017, The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

Patient and nurse safety: how information technology makes a difference.

PubMed

Simpson, Roy L

2005-01-01

The Institute of Medicine's landmark report asserted medical error is seldom the fault of individuals, but the result of faulty healthcare policy/procedure systems. Numerous studies have shown that information technology can shore up weak systems. For nursing, information technology plays a key role in protecting patients by eliminating nursing mistakes and protecting nurses by reducing their negative exposure. However, managing information technology is a function of managing the people who use it. This article examines critical issues that impact patient and nurse safety, both physical and professional. It discusses the importance of eliminating the culture of blame, the requirements of process change, how to implement technology in harmony with the organization and the significance of vision.

Tinnitus retraining therapy--the experiences in Slovakia.

PubMed

Suchova, L

2005-01-01

Since Mai 1999 Tinnitus Retraining Therapy (TRT) according to Jastreboff has been used in the management of 55 patients with tinnitus of various origin. Tinnitus isn't a disease, it is only a symptom. Therefore we needed to do an exact examination of the patient. We needed to apply causal therapy whenever it was possible. After six months of continuous therapy more than 50% patients reported improvement of tinnitus or it has disappeared. Concomitantly, we found hyperacusis, hypersensitivity to loud sounds. We could not assert that it was the cause or the consequence of the tinnitus. Considering these findings, it would appear TRT can be useful for extending the possibilities of tinnitus treatment. (Tab. 5, Fig. 1, Ref. 13.)

Towards quality indicators for assertive outreach programmes for severely impaired substance abusers: concept mapping with Dutch experts.

PubMed

Roeg, Diana; van de Goor, Ien; Garretsen, Henk

2005-06-01

We investigated the concept of 'quality of assertive outreach programmes for severely impaired substance abusers' with the aim of developing a conceptual framework as the basis for an assessment instrument. We held a concept-mapping session with 13 experts in 2003. Fifty measurable elements of quality were mentioned and rated in terms of relative importance on a Likert-type response scale. Subsequently, the experts grouped the statements that were similar in content. The resulting concept map and additional interpretation made up the final quality framework. SETTING/STUDY PARTICIPANTS: Theoretical sampling was used to select Dutch managers, team leaders, and service providers from different assertive outreach delivery systems for substance abusers. Variation in both perspective and region was reflected in the sample. Nine aspects of quality were formulated: preconditions for care, preconditions for service providers' work, relationship to regular care, service providers' activities and goals, service providers' skills, the role of repression, optimal care for the client, goals of assertive outreach, and nuisance reduction to society. Each aspect was presented using a selection of measurable elements. According to the experts, optimal assertive outreach depends on a broad range of aspects that were later classified in three regions: structure, process, and outcomes. Saturation of the elements has not been proved so far. Nevertheless, it is promising that the framework's regions are supported by theory and that it is largely in accordance with clients' perspectives on assertive community treatment.

Cultural mismatch and the education of Aboriginal youths: the interplay of cultural identities and teacher ratings.

PubMed

Fryberg, Stephanie A; Troop-Gordon, Wendy; D'Arrisso, Alexandra; Flores, Heidi; Ponizovskiy, Vladimir; Ranney, John D; Mandour, Tarek; Tootoosis, Curtis; Robinson, Sandy; Russo, Natalie; Burack, Jacob A

2013-01-01

In response to the enduring "deficit" approach to the educational attainment of Aboriginal students in North America, we hypothesized that academic underperformance is related to a cultural mismatch between Aboriginal students' cultural background, which emphasizes connectedness and interdependence, and the mainstream White model of education, which focuses on independence and assertiveness. The participants included virtually all the secondary students (N = 115) in the Naskapi community of Kawawachikamach, Quebec, Canada. We obtained self-reports of identification with Aboriginal and White culture, teacher reports of assertiveness, and official grades. We found that high identification with either Aboriginal or White culture was related to higher grades, regardless of whether the students were perceived as assertive by their teacher. Conversely, at low levels of cultural identification toward Aboriginal or White culture, being perceived as low in assertiveness by one's teacher predicted lower grades. This suggests that both high cultural identification and assertiveness can contribute to enhancing the educational outcomes of Aboriginal students, but that Aboriginal students with low levels of both cultural identification and assertiveness are at particular risk as they are mismatched with the culture of mainstream schools and do not benefit from the protective effects of identity. The relationships among identity, cultural values, and academic performance point to the need to reject the notion of an inherent deficit in education among Aboriginal youths in favor of a different framework in which success can be attained when alternative ways of being are fostered and nurtured in schools.

MachineProse: an Ontological Framework for Scientific Assertions

PubMed Central

Dinakarpandian, Deendayal; Lee, Yugyung; Vishwanath, Kartik; Lingambhotla, Rohini

2006-01-01

Objective: The idea of testing a hypothesis is central to the practice of biomedical research. However, the results of testing a hypothesis are published mainly in the form of prose articles. Encoding the results as scientific assertions that are both human and machine readable would greatly enhance the synergistic growth and dissemination of knowledge. Design: We have developed MachineProse (MP), an ontological framework for the concise specification of scientific assertions. MP is based on the idea of an assertion constituting a fundamental unit of knowledge. This is in contrast to current approaches that use discrete concept terms from domain ontologies for annotation and assertions are only inferred heuristically. Measurements: We use illustrative examples to highlight the advantages of MP over the use of the Medical Subject Headings (MeSH) system and keywords in indexing scientific articles. Results: We show how MP makes it possible to carry out semantic annotation of publications that is machine readable and allows for precise search capabilities. In addition, when used by itself, MP serves as a knowledge repository for emerging discoveries. A prototype for proof of concept has been developed that demonstrates the feasibility and novel benefits of MP. As part of the MP framework, we have created an ontology of relationship types with about 100 terms optimized for the representation of scientific assertions. Conclusion: MachineProse is a novel semantic framework that we believe may be used to summarize research findings, annotate biomedical publications, and support sophisticated searches. PMID:16357355

What is a Question?

NASA Technical Reports Server (NTRS)

Knuth, Kevin H.; Clancy, Daniel (Technical Monitor)

2002-01-01

A given question can be defined in terms of the set of statements or assertions that answer it. Application of the logic of inference to this set of assertions allows one to derive the logic of inquiry among questions. There are interesting symmetries between the logics of inference and inquiry; where probability describes the degree to which a premise implies an assertion, there exists an analogous quantity that describes the bearing or relevance that a question has on an outstanding issue. These have been extended to suggest that the logic of inquiry results in functional relationships analogous to, although more general than, those found in information theory. Employing lattice theory, I examine in greater detail the structure of the space of assertions and questions demonstrating that the symmetries between the logical relations in each of the spaces derive directly from the lattice structure. Furthermore, I show that while symmetries between the spaces exist, the two lattices are not isomorphic. The lattice of assertions is described by a Boolean lattice 2(sup N) whereas the lattice of real questions is shown to be a sublattice of the free distributive lattice FD(N) = 2(sup 2(sup N)). Thus there does not exist a one-to-one mapping of assertions to questions, there is no reflection symmetry between the two spaces, and questions in general do not possess unique complements. Last, with these lattice structures in mind, I discuss the relationship between probability, relevance and entropy.

Attachment, Sexual Assertiveness, and Sexual Outcomes in Women with Provoked Vestibulodynia and Their Partners: A Mediation Model.

PubMed

Leclerc, Bianca; Bergeron, Sophie; Brassard, Audrey; Bélanger, Claude; Steben, Marc; Lambert, Bernard

2015-08-01

Provoked vestibulodynia (PVD) is a prevalent women's sexual pain disorder, which is associated with sexual function difficulties. Attachment theory has been used to understand adult sexual outcomes, providing a useful framework for examining sexual adaptation in couples confronted with PVD. Research to date indicates that anxious and avoidant attachment dimensions correlate with worse sexual outcomes in community and clinical samples. The present study examined the association between attachment, pain, sexual function, and sexual satisfaction in a sample of 101 couples in which the women presented with PVD. The actor-partner interdependence model was used in order to investigate both actor and partner effects. This study also examined the role of sexual assertiveness as a mediator of these associations via structural equation modeling. Women completed measures of pain intensity and both members of the couple completed measures of romantic attachment, sexual assertiveness, sexual function, and satisfaction. Results indicated that attachment dimensions did not predict pain intensity. Both anxious and avoidant attachment were associated with lower sexual satisfaction. Only attachment avoidance predicted lower sexual function in women. Partner effects indicated that higher sexual assertiveness in women predicted higher sexual satisfaction in men. Finally, women's sexual assertiveness was found to be a significant mediator of the relationship between their attachment dimensions, sexual function, and satisfaction. Findings highlight the importance of examining how anxious and avoidant attachment may lead to difficulties in sexual assertiveness and to less satisfying sexual interactions in couples where women suffer from PVD.

Direct-to-consumer advertising of prescription medication in New Zealand.

PubMed

Every-Palmer, Susanna; Duggal, Rishi; Menkes, David B

2014-08-29

The last decade has seen increasing measures aimed at regulating the influence of 'Big Pharma' following a number of scandals relating to unethical marketing. Despite these international trends, New Zealand continues to tolerate direct-to-consumer advertising (DTCA) of prescription medication, a controversial pharmaceutical marketing strategy that has been prohibited in all but two countries in the industrialised world. While the pharmaceutical industry asserts that DTCA is informational and empowers consumers, in this viewpoint article we argue that DTCA is a heavily biased source of health information that favours representation of benefits over harms, and is associated with unnecessary prescribing, iatrogenic harm and increased costs to the taxpayer. In this paper, we show that DTCA provides unbalanced information to consumers who may misconstrue DTCA as public health messages, and fail to recognise inherent commercial bias. We describe how DTCA has been linked with inappropriate prescribing and overtreatment, with evidence indicating that patients request and receive specific medications in response to DTCA, even when treatment is not clinically indicated. This exposes patients to unnecessary adverse effects and iatrogenic harm, and increases costs for the health-care sector through the prescription of expensive branded medication. We use local examples to illustrate these points. New Zealand remains an outlier in allowing DTCA to continue which, in our view, is a controversial and harmful practice. The available evidence suggests that consumers and health care professionals are generally opposed to DTCA. Therefore, we believe that the New Zealand government should review its stance on DTCA.

Deficits in eye gaze during negative social interactions in patients with schizophrenia.

PubMed

Choi, Soo-Hee; Ku, Jeonghun; Han, Kiwan; Kim, Eosu; Kim, Sun I; Park, Junyoung; Kim, Jae-Jin

2010-11-01

Impaired social functioning has been reported in patients with schizophrenia. This study aimed to examine characteristics of interpersonal behaviors in patients with schizophrenia during various social interactions using the virtual reality system. Twenty-six patients and 26 controls engaged in the virtual conversation tasks, including 3 positive and 3 negative emotion-laden conversations. Eye gaze and other behavioral parameters were recorded during the listening and answering phases. The amount of eye gaze was assessed as smaller in the patients than in the controls. A significant interaction effect of group status and emotional type was found for the listening phase. The amount of eye gaze in the patients inversely correlated with self-rated scores of assertiveness for the listening phase. These results suggest that the patients displayed inadequate levels of augmentations in eye gaze during negative emotional situations. These deficits should be considered in the treatment and social skills training for patients with schizophrenia.

Association of Optimism with Emotional and Cardiovascular Reactivity in Coronary Patients, and Healthy Controls

DTIC Science & Technology

2007-04-12

Scholars in psychology and related disciplines incorporated optimistic or pessimistic views of human nature into their theories. For example, Sigmund ... Freud (1856-1939) included both optimism and pessimism as concepts in his theory of human nature and development. He asserted that humans have a drive...drive towards death represents the pessimistic aspect of human nature ( Freud , 1964). Psychologist William James (1842-1910), was the first to consider

Women are Warmer but No Less Assertive than Men: Gender and Language on Facebook.

PubMed

Park, Gregory; Yaden, David Bryce; Schwartz, H Andrew; Kern, Margaret L; Eichstaedt, Johannes C; Kosinski, Michael; Stillwell, David; Ungar, Lyle H; Seligman, Martin E P

2016-01-01

Using a large social media dataset and open-vocabulary methods from computational linguistics, we explored differences in language use across gender, affiliation, and assertiveness. In Study 1, we analyzed topics (groups of semantically similar words) across 10 million messages from over 52,000 Facebook users. Most language differed little across gender. However, topics most associated with self-identified female participants included friends, family, and social life, whereas topics most associated with self-identified male participants included swearing, anger, discussion of objects instead of people, and the use of argumentative language. In Study 2, we plotted male- and female-linked language topics along two interpersonal dimensions prevalent in gender research: affiliation and assertiveness. In a sample of over 15,000 Facebook users, we found substantial gender differences in the use of affiliative language and slight differences in assertive language. Language used more by self-identified females was interpersonally warmer, more compassionate, polite, and-contrary to previous findings-slightly more assertive in their language use, whereas language used more by self-identified males was colder, more hostile, and impersonal. Computational linguistic analysis combined with methods to automatically label topics offer means for testing psychological theories unobtrusively at large scale.

Hispanic construction workers and assertiveness training.

PubMed

Shrestha, Pramen P; Menzel, Nancy N

2014-01-01

Hispanic (Latino) construction workers experience disparities in occupational death and injury rates in the United States. The cultural value of respect for those in authority may hinder these workers from requesting safe working conditions from supervisors. To evaluate whether Hispanic construction workers in Las Vegas, Nevada found assertiveness training more useful than non-Hispanic trainees and whether or not they practiced this behavior at work after the training. An assertiveness training simulation was part of fall prevention classes offered to area construction workers. Eight weeks after the training, participants were interviewed by telephone about class topics they found most useful and whether or not they had made any subsequent behavior changes at work. More than half of the 760 fall prevention trainees completed telephone interviews. A smaller proportion of Hispanic trainees found assertiveness training to be useful (11%) than non-Hispanics (28%) (p⩽ 0.001). Only 2% of both groups identified practicing assertiveness at work. A large proportion of Hispanic trainees valued other knowledge more highly. They may weigh job security as more important than speaking up about safety issues, which might threaten their employment. Interventions to improve safety should focus instead on improving work safety climate and engineering controls.

Women are Warmer but No Less Assertive than Men: Gender and Language on Facebook

PubMed Central

Park, Gregory; Schwartz, H. Andrew; Kern, Margaret L.; Eichstaedt, Johannes C.; Kosinski, Michael; Stillwell, David; Ungar, Lyle H.; Seligman, Martin E. P.

2016-01-01

Using a large social media dataset and open-vocabulary methods from computational linguistics, we explored differences in language use across gender, affiliation, and assertiveness. In Study 1, we analyzed topics (groups of semantically similar words) across 10 million messages from over 52,000 Facebook users. Most language differed little across gender. However, topics most associated with self-identified female participants included friends, family, and social life, whereas topics most associated with self-identified male participants included swearing, anger, discussion of objects instead of people, and the use of argumentative language. In Study 2, we plotted male- and female-linked language topics along two interpersonal dimensions prevalent in gender research: affiliation and assertiveness. In a sample of over 15,000 Facebook users, we found substantial gender differences in the use of affiliative language and slight differences in assertive language. Language used more by self-identified females was interpersonally warmer, more compassionate, polite, and—contrary to previous findings—slightly more assertive in their language use, whereas language used more by self-identified males was colder, more hostile, and impersonal. Computational linguistic analysis combined with methods to automatically label topics offer means for testing psychological theories unobtrusively at large scale. PMID:27223607

Stress Management: Being Assertive

MedlinePlus

... assertively can help you: Gain self-confidence and self-esteem Understand and recognize your feelings Earn respect from others Improve communication Create win-win situations Improve your decision-making skills Create honest relationships Gain more job satisfaction Learning ...

Understanding why GPs see pharmaceutical representatives: a qualitative interview study.

PubMed Central

Prosser, Helen; Walley, Tom

2003-01-01

BACKGROUND: Doctors are aware of the commercial bias in pharmaceutical representative information; nevertheless, such information is known to change doctors' prescribing, and augment irrational prescribing and prescribing costs. AIM: To explore GPs, reasons for receiving visits from pharmaceutical representatives. DESIGN OF STUDY: Qualitative study with semi-structured interviews. SETTING: One hundred and seven general practitioners (GPs) in practices from two health authorities in the North West of England. RESULTS: The main outcome measures of the study were: reasons for receiving/not receiving representative visits; advantages/disadvantages in receiving visits; and quality of representative-supplied information. Most GPs routinely see pharmaceutical representatives, because they bring new drug information speedily; they are convenient and accessible; and can be consulted with a saving of time and effort. Many GPs asserted they had the skills to critically appraise the evidence. Furthermore, the credibility and social characteristics of the representative were instrumental in shaping GPs' perceptions of representatives as legitimate information providers. GPs also received visits from representatives for reasons other than information acquisition. These reasons are congruent with personal selling techniques used in marketing communications. CONCLUSIONS: The study draws attention to the social and cultural contexts of GP-representative encounters and the way in which the acquisition of pharmacological information within the mercantile context of representative visits is legitimated. This highlights the need for doctors to critically appraise information supplied by representatives in relation to other information sources. PMID:12879831

Patient participation in medical consultations: why some patients are more involved than others.

PubMed

Street, Richard L; Gordon, Howard S; Ward, Michael M; Krupat, Edward; Kravitz, Richard L

2005-10-01

Patients vary in their willingness and ability to actively participate in medical consultations. Because more active patient participation contributes to improved health outcomes and quality of care, it is important to understand factors affecting the way patients communicate with healthcare providers. The objectives of this study were to examine the extent to which patient participation in medical interactions is influenced by 1) the patient's personal characteristics (age, gender, education, ethnicity); 2) the physician's communication style (eg, use of partnership-building and supportive talk); and 3) the clinical setting (eg, the health condition, medical specialty). The authors conducted a post hoc cross-sectional analysis of 279 physician-patient interactions from 3 clinical sites: 1) primary care patients in Sacramento, California, 2) patients with systemic lupus erythematosus (SLE) from the San Francisco Bay area, and 3) patients with lung cancer from a VA hospital in Texas. The outcome measures included the degree to which patients asked questions, were assertive, and expressed concerns and the degree to which physicians used partnership-building and supportive talk (praise, reassurance, empathy) in their consultations. The majority of active participation behaviors were patient-initiated (84%) rather than prompted by physician partnership-building or supportive talk. Patients who were more active participants received more facilitative communication from physicians, were more educated, and were more likely to be white than of another ethnicity. Women more willingly expressed negative feelings and concerns. There was considerable variability in patient participation across the 3 clinical settings. Female physicians were more likely to use supportive talk than males, and physicians generally used less supportive talk with nonwhite compared with white patients. Patient participation in medical encounters depends on a complex interplay of personal, physician, and contextual factors. Although more educated and white patients tended to be more active participants than their counterparts, the strongest predictors of patient participation were situation-specific, namely the clinical setting and the physician's communicative style. Physicians could more effectively facilitate patient involvement by more frequently using partnership-building and supportive communication. Future research should investigate how the nuances of individual clinical settings (eg, the health condition, time allotted for the visit) impose constraints or opportunities for more effective patient involvement in care.

Negative symptoms, anxiety, and depression as mechanisms of change of a 12-month trial of assertive community treatment as part of integrated care in patients with first- and multi-episode schizophrenia spectrum disorders (ACCESS I trial).

PubMed

Schmidt, Stefanie J; Lange, Matthias; Schöttle, Daniel; Karow, Anne; Schimmelmann, Benno G; Lambert, Martin

2017-05-24

Assertive community treatment (ACT) has shown to be effective in improving both functional deficits and quality of life (QoL) in patients with severe mental illness. However, the mechanisms of this beneficial effect remained unclear. We examined mechanisms of change by testing potential mediators including two subdomains of negative symptoms, i.e. social amotivation as well as expressive negative symptoms, anxiety, and depression within a therapeutic ACT model (ACCESS I trial) in a sample of 120 first- and multi-episode patients with a schizophrenia spectrum disorder (DSM-IV). Path modelling served to test the postulated relationship between the respective treatment condition, i.e. 12-month ACT as part of integrated care versus standard care, and changes in functioning and QoL. The final path model resulted in 3 differential pathways that were all significant. Treatment-induced changes in social amotivation served as a starting point for all pathways, and had a direct beneficial effect on functioning and an additional indirect effect on it through changes in anxiety. Expressive negative symptoms were not related to functioning but served as a mediator between changes in social amotivation and depressive symptoms, which subsequently resulted in improvements in QoL. Our results suggest that social amotivation, expressive negative symptoms, depression, and anxiety functioned as mechanisms of change of ACCESS. An integrated and sequential treatment focusing on these mediators may optimise the generalisation effects on functioning as well as on QoL by targeting the most powerful mechanism of change that fits best to the individual patient.

The effect of assertiveness training on student's academic anxiety.

PubMed

Mohebi, S; Sharifirad, G H R; Shahsiah, M; Botlani, S; Matlabi, M; Rezaeian, M

2012-03-01

Academic anxiety is an important educational problem that affects millions of students in colleges and schools over the world each year. Although a low level of anxiety can cause positive motivation for improvement of educational functioning, high levels of it can cause a disturbance in concentration, attention, storage of knowledge, recall and educational reduction. It has also been recently determined that there is a relationship between anxiety and assertiveness. Therefore, this study is an attempt to determine the effect of assertiveness training on reducing anxiety levels in pre-college academic students in Gonabad city in 2008. In this clinical trial study, all the pre-college students of Gonabad city were invited to participate and 89 students were divided into experimental and control groups. There were 3 questionnaires, namely demographic, academic anxiety and assertiveness Rathus questionnaires in which the validity and reliability were calculated and approved. The intervention for the experimental group was 5 sessions of assertiveness training using the PRECEDE model and 1 session for parents and teachers to help and support the intervention program. We had a post-test 8 weeks after the last training session for each group was conducted. The data was analyzed by SPSS. The results showed that anxiety levels and decisiveness in the target group were moderate to high and it is seen as a significant reverse relationship between these two factors (r = -0.69 and p < 0.001). The results also showed that there was a significant anxiety decrease in the experimental group after the intervention. On the one hand, there was a significant increase in decisiveness for both groups, but there was not a significant difference between academic anxiety and assertiveness in the control group.before and after the intervention. Due to a significant decrease in anxiety and increased decisiveness in the experimental group, it can be claimed that assertiveness training is an effective non-pharmacological method for reducing academic anxiety and it can improve academic performance.

Congruent Validity of the Rathus Assertiveness Schedule.

ERIC Educational Resources Information Center

Harris, Thomas L.; Brown, Nina W.

1979-01-01

The validity of the Rathus Assertiveness Schedule (RAS) was investigated by correlating it with the six Class I scales of the California Psychological Inventory on a sample of undergraduate students. Results supported the validity of the RAS. (JKS)

Social Awareness and Influence Workshop. Student Handbook

DTIC Science & Technology

2008-07-01

aggressive in social relationships . High Low • It is important to be assertive, dominant, and tough • Competition is healthy...10 11 Assertiveness Degree to which individuals are direct, confrontational, and aggressive in social relationships Regions High in

Decreased risk of alcohol dependence and/or misuse in women with high self-assertiveness and leadership abilities.

PubMed

Hensing, G; Spak, F; Thundal, K L; Ostlund, A

2003-01-01

To analyse dimensions of gender identity and its association to psychiatric disorders and alcohol consumption. The study was performed in two stages: an initial screening (n = 8335) for alcohol consumption, followed by a structured psychiatric interview (n = 1054). The Masculinity/Femininity-Questionnaire was used as an indicator of gender identity. The final study group included 836 women. Leadership, caring, self-assertiveness and emotionality were dimensions of gender identity found in a factor analysis. Low self-assertiveness, high emotionality and to some extent low leadership were associated with increased odds for having bipolar disorders, severe anxiety disorders and alcohol dependence and misuse. Low self-assertiveness and high emotionality were not only associated with alcohol dependence and misuse, but also with high episodic drinking. There was an association between some of the dimensions of gender identity and psychiatric disorders and alcohol consumption. Further attention is needed in both clinical work and research.

The Hurst exponent over time: testing the assertion that emerging markets are becoming more efficient

NASA Astrophysics Data System (ADS)

Cajueiro, Daniel O.; Tabak, Benjamin M.

2004-05-01

This paper is concerned with the assertion found in the financial literature that emerging markets are becoming more efficient over time. To verify whether this assertion is true or not, we propose the calculation of the Hurst exponent over time using a time window with 4 years of data. The data used here comprises the bulk of emerging markets for Latin America and Asia. Our empirical results show that this assertion seems to be true for most countries, but it does not hold for countries such as Brazil, The Philippines and Thailand. Moreover, in order to check whether or not these results depend on the short term memory and the volatility of returns common in such financial asset return data, we filter the data by an AR-GARCH procedure and present the Hurst exponents for this filtered data.

[Styles of interpersonal conflict in patients with panic disorder, alcoholism, rheumatoid arthritis and healthy controls: a cluster analysis study].

PubMed

Eher, R; Windhaber, J; Rau, H; Schmitt, M; Kellner, E

2000-05-01

Conflict and conflict resolution in intimate relationships are not only among the most important factors influencing relationship satisfaction but are also seen in association with clinical symptoms. Styles of conflict will be assessed in patients suffering from panic disorder with and without agoraphobia, in alcoholics and in patients suffering from rheumatoid arthritis. 176 patients and healthy controls filled out the Styles of Conflict Inventory and questionnaires concerning severity of clinical symptoms. A cluster analysis revealed 5 types of conflict management. Healthy controls showed predominantely assertive and constructive styles, patients with panic disorder showed high levels of cognitive and/or behavioral aggression. Alcoholics showed high levels of repressed aggression, and patients with rheumatoid arthritis often did not exhibit any aggression during conflict. 5 Clusters of conflict pattern have been identified by cluster analysis. Each patient group showed considerable different patterns of conflict management.

Detecting the presence of an indwelling urinary catheter and urinary symptoms in hospitalized patients using natural language processing.

PubMed

Gundlapalli, Adi V; Divita, Guy; Redd, Andrew; Carter, Marjorie E; Ko, Danette; Rubin, Michael; Samore, Matthew; Strymish, Judith; Krein, Sarah; Gupta, Kalpana; Sales, Anne; Trautner, Barbara W

2017-07-01

To develop a natural language processing pipeline to extract positively asserted concepts related to the presence of an indwelling urinary catheter in hospitalized patients from the free text of the electronic medical note. The goal is to assist infection preventionists and other healthcare professionals in determining whether a patient has an indwelling urinary catheter when a catheter-associated urinary tract infection is suspected. Currently, data on indwelling urinary catheters is not consistently captured in the electronic medical record in structured format and thus cannot be reliably extracted for clinical and research purposes. We developed a lexicon of terms related to indwelling urinary catheters and urinary symptoms based on domain knowledge, prior experience in the field, and review of medical notes. A reference standard of 1595 randomly selected documents from inpatient admissions was annotated by human reviewers to identify all positively and negatively asserted concepts related to indwelling urinary catheters. We trained a natural language processing pipeline based on the V3NLP framework using 1050 documents and tested on 545 documents to determine agreement with the human reference standard. Metrics reported are positive predictive value and recall. The lexicon contained 590 terms related to the presence of an indwelling urinary catheter in various categories including insertion, care, change, and removal of urinary catheters and 67 terms for urinary symptoms. Nursing notes were the most frequent inpatient note titles in the reference standard document corpus; these also yielded the highest number of positively asserted concepts with respect to urinary catheters. Comparing the performance of the natural language processing pipeline against the human reference standard, the overall recall was 75% and positive predictive value was 99% on the training set; on the testing set, the recall was 72% and positive predictive value was 98%. The performance on extracting urinary symptoms (including fever) was high with recall and precision greater than 90%. We have shown that it is possible to identify the presence of an indwelling urinary catheter and urinary symptoms from the free text of electronic medical notes from inpatients using natural language processing. These are two key steps in developing automated protocols to assist humans in large-scale review of patient charts for catheter-associated urinary tract infection. The challenges associated with extracting indwelling urinary catheter-related concepts also inform the design of electronic medical record templates to reliably and consistently capture data on indwelling urinary catheters. Published by Elsevier Inc.

Predictors of Likelihood of Speaking Up about Safety Concerns in Labour and Delivery

PubMed Central

Lyndon, Audrey; Sexton, J. Bryan; Simpson, Kathleen Rice; Rosenstein, Alan; Lee, Kathryn A.; Wachter, Robert M.

2011-01-01

Background Despite widespread emphasis on promoting “assertive communication” by caregivers as essential to patient safety improvement efforts, fairly little is known about when and how clinicians speak up to address safety concerns. In this cross-sectional study we use a new measure of speaking up to begin exploring this issue in maternity care. Methods We developed a scenario-based measure of clinician’s assessment of potential harm and likelihood of speaking up in response to perceived harm. We embedded this scale in a survey with measures of safety climate, teamwork climate, disruptive behaviour, work stress, and personality traits of bravery and assertiveness. The survey was distributed to all registered nurses and obstetricians practicing in two US Labour & Delivery units. Results The response rate was 54% (125 of 230 potential respondents). Respondents were experienced clinicians (13.7 ± 11 years in specialty). Higher perception of harm, respondent role, specialty experience, and site predicted likelihood of speaking up when controlling for bravery and assertiveness. Physicians rated potential harm in common clinical scenarios lower than nurses did (7.5 vs. 8.4 on 2–10 scale; p<0.001). Some participants (12%) indicated they were unlikely to speak up despite perceiving high potential for harm in certain situations. Discussion This exploratory study found nurses and physicians differed in their harm ratings, and harm rating was a predictor of speaking up. This may partially explain persistent discrepancies between physicians and nurses in teamwork climate scores. Differing assessments of potential harms inherent in everyday practice may be a target for teamwork intervention in maternity care. PMID:22927492

Mothers’ Power Assertion, Children’s Negative, Adversarial Orientation, and Future Behavior Problems in Low-Income Families: Early Maternal Responsiveness as a Moderator of the Developmental Cascade

PubMed Central

Kim, Sanghag; Kochanska, Grazyna

2014-01-01

Parental power assertion, a key dimension of family environment, generally sets in motion detrimental developmental cascades; however, evidence suggests that other qualities of parenting, such as responsiveness, can significantly moderate those processes. Mechanisms that account for such moderating effects are not fully understood. We propose a conceptual model of processes linking parental power assertion, parental responsiveness, children’s negative, adversarial, rejecting orientation toward the parent, and behavior problems. We test that model in a short-term longitudinal design involving 186 low-income, ethnically diverse mothers and their toddlers. When children were 30 months, the dyads were observed in multiple, lengthy, naturalistic laboratory interactions to assess behaviorally mothers’ responsiveness and their power-assertive control style. At 33 months, we observed behavioral indicators of children’s negative, adversarial, rejecting orientation toward the mothers in several naturalistic and standardized paradigms. At 40 months, mothers rated children’s behavior problems. The proposed moderated mediation sequence, tested using a new approach, PROCESS (Hayes, 2013), was supported. The indirect effect from maternal power assertion to children’s negative, adversarial orientation to future behavior problems was present when mothers’ responsiveness was either low or average but absent when mothers were highly responsive. This study elucidates a potential process that may link parental power assertion with behavior problems and highlights how positive aspects of parenting can moderate this process and defuse maladaptive developmental cascades. It also suggests possible targets for parenting intervention and prevention efforts. PMID:25401483

Mothers' power assertion; children's negative, adversarial orientation; and future behavior problems in low-income families: early maternal responsiveness as a moderator of the developmental cascade.

PubMed

Kim, Sanghag; Kochanska, Grazyna

2015-02-01

Parental power assertion, a key dimension of family environment, generally sets in motion detrimental developmental cascades; however, evidence suggests that other qualities of parenting, such as responsiveness, can significantly moderate those processes. Mechanisms that account for such moderating effects are not fully understood. We propose a conceptual model of processes linking parental power assertion, parental responsiveness, children's negative, adversarial, rejecting orientation toward the parent, and behavior problems. We test that model in a short-term longitudinal design involving 186 low-income, ethnically diverse mothers and their toddlers. When children were 30 months, the dyads were observed in multiple, lengthy, naturalistic laboratory interactions to assess behaviorally mothers' responsiveness and their power-assertive control style. At 33 months, we observed behavioral indicators of children's negative, adversarial, rejecting orientation toward the mothers in several naturalistic and standardized paradigms. At 40 months, mothers rated children's behavior problems. The proposed moderated mediation sequence, tested using a new approach, PROCESS (Hayes, 2013), was supported. The indirect effect from maternal power assertion to children's negative, adversarial orientation to future behavior problems was present when mothers' responsiveness was either low or average but absent when mothers were highly responsive. This study elucidates a potential process that may link parental power assertion with behavior problems and highlights how positive aspects of parenting can moderate this process and defuse maladaptive developmental cascades. It also suggests possible targets for parenting intervention and prevention efforts. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Do we need informed consent?

PubMed

Baum, M

1986-10-18

A British surgeon contends that the requirement of informed consent for randomized, controlled clinical trials of alternative therapies would result in a double standard, because physicians are free to conduct informal, unreliable comparisons of different treatments without such a requirement. He asserts that patients' rights are not seriously endangered in trials that are scrutinized by award-granting bodies and local ethics committees to ensure that their aims are to improve quality of care and to increase knowledge. Baum argues that, while informed consent promotes respect for patient autonomy and increases understanding of the illness and treatment, it is chiefly a legalistic device to shift unpleasant physician responsibilities onto the patient and will result in fewer patients entering clinical trials because of negative attitudes induced by uncertainty of treatment and diminished confidence in the physician.

Ethical leadership.

PubMed

Keselman, David

2012-01-01

In today's climate and environment, the conventional relationship between caring, economic, and administrative practices no longer serves the interest of patients, clinicians, or systems. A shift toward human caring values and an ethic of authentic healing relationships is required as systems now have to value human resources and life purposes, inner meaning, and processes for providers and patients alike. The costs of unethical behavior can be even greater for followers. When we assume the benefits of leadership, we also assume ethical burdens. It is the assertion and experience of the author that the triangle of ethics and ethical behavior, followers, and patient's outcomes are closely interrelated and affect each other in a very intimate and direct way. Unethical leadership may lead to follower disappointment and distrust, leading to lack of interest and commitment, consequently negatively impacting patient outcomes and organizational effectiveness.

Assertion: A Technique for Handling Troublesome Library Patrons.

ERIC Educational Resources Information Center

Groark, James J.

1979-01-01

Encourages the use of assertion training for librarians to aid them in providing reference service, interviewing for employment, and handling difficult patrons. A list of references and a selection of readers' comments on the article is included. (FM)

48 CFR 252.227-7023 - Drawings and other data to become property of Government.

Code of Federal Regulations, 2013 CFR

2013-10-01

... may be used on any other design or construction without additional compensation to the Contractor. The... assert or authorize others to assert any rights nor establish any claim under the design patent or...

48 CFR 252.227-7023 - Drawings and other data to become property of Government.

Code of Federal Regulations, 2012 CFR

2012-10-01

... may be used on any other design or construction without additional compensation to the Contractor. The... assert or authorize others to assert any rights nor establish any claim under the design patent or...

48 CFR 252.227-7023 - Drawings and other data to become property of Government.

Code of Federal Regulations, 2011 CFR

2011-10-01

... may be used on any other design or construction without additional compensation to the Contractor. The... assert or authorize others to assert any rights nor establish any claim under the design patent or...

48 CFR 252.227-7023 - Drawings and other data to become property of Government.

Code of Federal Regulations, 2010 CFR

2010-10-01

... may be used on any other design or construction without additional compensation to the Contractor. The... assert or authorize others to assert any rights nor establish any claim under the design patent or...

Was Nazi Germany on the Road to an Atomic Bomb after all?

NASA Astrophysics Data System (ADS)

Lustig, Harry

2006-04-01

The story of Germany's efforts to develop a nuclear weapon during World War II is a much written about and contentious subject. However there has been agreement on one thing: by the end of the War the Germans had not achieved and were nowhere near to building a bomb. The dispute therefore has been about why Germany did not succeed. Now, from Germany, comes a challenge to this truth, in the provocative book Hitlers Bombe by Rainer Karlsch. The bombshell in Hitler's Bombe is the assertion that German scientists developed and tested a primitive fission and fusion nuclear weapon in March 1945. Karlsch bases this claim on testimony of witnesses in 1962, previously secret Russian documents, and the results of soil tests carried out in 2004 and 2005. However the physics is very murky and it seems out of the question that Germany had enough Uranium 235 or produced any Plutonium for a bomb. Hitlers Bombe also makes other, better documented and more credible revisionist assertions. These include the claim that the Nazis did continue to try to build a bomb after 1942 and that not Werner Heisenberg, but Kurt Diebner and Walther Gerlach were then the leaders of the German Uranium project. Karlsch's book therefore deserves more attention from physicists and historians than it has received in the United States.

Developmental interplay between children’s biobehavioral risk and the parenting environment from toddler to early school age: Prediction of socialization outcomes in preadolescence

PubMed Central

Kochanska, Grazyna; Boldt, Lea J.; Kim, Sanghag; Yoon, Jeung Eun; Philibert, Robert A.

2014-01-01

We followed 100 community families from toddler age to preadolescence. Each mother- and father-child dyad was observed at 25, 38, 52, 67, and 80 months (10 hours per child) to assess positive and power-assertive parenting. At age 10 (N=82), we obtained parent- and child-reported outcome measures of children’s acceptance of parental socialization: cooperation with parental monitoring, negative attitude toward substance use, internalization of adult values, and callous-unemotional (CU) tendencies. Children who carried a short 5-HTTLPR allele and were highly anger prone, based on anger observed in laboratory from 25 to 80 months, were classified as high in biobehavioral risk. The remaining children were classified as low in biobehavioral risk. Biobehavioral risk moderated links between parenting history and outcomes. For low-risk children, parenting measures were unrelated to outcomes. For children high in biobehavioral risk, variations in positive parenting predicted cooperation with monitoring and negative attitude toward substance use, and variations in power-assertive parenting predicted internalization of adult values and CU tendencies. Suboptimal parenting combined with high biobehavioral risk resulted in the poorest outcomes. The effect for attitude toward substance use supported differential susceptibility: Children high in biobehavioral risk who received optimal parenting had a more adaptive outcome than their low-risk peers. The remaining effects were consistent with diathesis-stress. PMID:25154427

Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

PubMed

Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

2011-11-01

This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

Invisible nursing research: thoughts about mixed methods research and nursing practice.

PubMed

Fawcett, Jacqueline

2015-04-01

In this this essay, the author addresses the close connection between mixed methods research and nursing practice. If the assertion that research and practice are parallel processes is accepted, then nursing practice may be considered "invisible mixed methods research," in that almost every encounter between a nurse and a patient involves collection and integration of qualitative (word) and quantitative (number) information that actually is single-case mixed methods research. © The Author(s) 2015.

Do I dare? Using role-play as a teaching strategy.

PubMed

Kuipers, J C; Clemens, D L

1998-07-01

Role-play is a teaching strategy that models patient behaviors and nursing interventions that students need to learn in psychiatric nursing. Applications of this strategy can be used in both classroom and clinical settings. Benefits of using role-play range from cost effectiveness and active learning to modeling expected performance/skill levels and increasing self-confidence and assertiveness. Perceived drawbacks can be minimized by using the planning steps prior to the use of role-play.

The distinct temperament profiles of bipolar I, bipolar II and unipolar patients.

PubMed

Akiskal, Hagop S; Kilzieh, Nael; Maser, Jack D; Clayton, Paula J; Schettler, Pamela J; Traci Shea, M; Endicott, Jean; Scheftner, William; Hirschfeld, Robert M A; Keller, Martin B

2006-05-01

Despite a plethora of studies, controversies abound on whether the long-term traits of unipolar and bipolar patients could be differentiated by temperament and whether these traits, in turn, could be distinguished from subthreshold affective symptomatology. 98 bipolar I (BP-I), 64 bipolar II (BP-II), and 251 unipolar major depressive disorder (UP-MDD) patients all when recovered from discrete affective episodes) and 617 relatives, spouses or acquaintances without lifetime RDC diagnoses (the comparison group, CG) were administered a battery of 17 self-rated personality scales chosen for theoretical relevance to mood disorders. Subsamples of each of the four groups also received the General Behavior Inventory (GBI). Of the 436 personality items, 103 that significantly distinguished the three patient groups were subjected to principal components analysis, yielding four factors which reflect the temperamental dimensions of "Mood Lability", "Energy-Assertiveness," "Sensitivity-Brooding," and "Social Anxiety." Most BP-I described themselves as near normal in emotional stability and extroversion; BP-II emerged as labile in mood, energetic and assertive, yet sensitive and brooding; MDD were socially timid, sensitive and brooding. Gender and age did not have marked influence on these overall profiles. Within the MDD group, those with baseline dysthymia were the most pathological (i.e., high in neuroticism, insecurity and introversion). Selected GBI items measuring hypomania and biphasic mood changes were endorsed significantly more often by BP-II. Finally, it is relevant to highlight a methodologic finding about the precision these derived temperament factors brought to the UP-BP differentiation. Unlike BP-I who were low on neuroticism, both BP-II and UP scored high on this measure: yet, in the case of BP-II high neuroticism was largely due to mood lability, in UP it reflected subdepressive traits. We used self-rated personality measures, a possible limitation generic to the paper-and-pencil personality literature. It is therefore likely that BP-I may have over-rated their "sanguinity"; or should one consider such self-report as a reliable reflection of one's temperament? One can raise similar unanswerable questions about "depressiveness" and "mood lability." As contrasted to CG and published norms, the postmorbid self-described "usual" personality is 1) sanguine among many, but not all, BP-I; 2) labile or cyclothymic among BP-II; and 3) subanxious and subdepressive among UP. It is further noteworthy that with the exception of BP-II, the temperament scores of BP-I and MDD were within one SD from published norms. Rather than being pathological, these attributes are best conceived as subclinical temperamental variants of the normal, thereby supporting the notion of continuity between interepisodic and episodic phases of affective disorders. These findings overall are in line with Kraepelin's views and contrary to the DSM-IV formulation of axis-II constructs as being pathological and sharply demarcated from affective episodes.

Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines.

PubMed

Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P

2010-09-01

Poor adherence to medication can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey (39 questions, 521 options) on adherence problems in schizophrenia and bipolar disorder was completed by 41 experts in 2008. This article first reviews the literature on interventions aimed at improving adherence. It then presents the experts' recommendations for targeting factors that can contribute to nonadherence and relates them to the literature. The following psychosocial/programmatic and pharmacologic interventions were rated first line for specific problems that can lead to nonadherence: ongoing symptom/ side-effect monitoring for persistent symptoms or side effects; services targeting logistic problems; medication monitoring/environmental supports (e.g., Cognitive Adaptation Training, assertive community treatment) for lack of routines or cognitive deficits; and adjusting the dose or switching to a different oral antipsychotic for persistent side effects (also high second-line for persistent symptoms). Among pharmacologic interventions, the experts gave high second-line ratings to switching to a long-acting antipsychotic when lack of insight, substance use, persistent symptoms, logistic problems, lack of routines, or lack of family/ social support interfere with adherence and to simplifying the treatment regimen when logistic problems, lack of routines, cognitive deficits, or lack of family/social support interfere with adherence. Psychosocial/programmatic interventions that received high second-line ratings in a number of situations included medication monitoring/environmental supports, patient psychoeducation, more frequent and/or longer visits if possible, cognitive behavioral therapy (CBT), family-focused therapy, and services targeting logistic problems. It is important to identify specific factors that may be contributing to a patient's adherence problems in order to customize interventions and to consider using a multifaceted approach since multiple problems may be involved.

[Self-esteem: a comparison study between eating disorders and social phobia].

PubMed

Eiber, R; Vera, L; Mirabel-Sarron, C; Guelfi, J-D

2003-01-01

Eating disorder patients evidenced very often a low self-esteem. Self-esteem in eating disorder patients is excessively based on body dissatisfaction. In eating disorders there seems to be a link between body image dissatisfaction and social anxiety. We hypothesised: self-esteem would be as low in eating disorder patients as in social phobia patients; self-esteem would be lower in eating disorder patients with social phobia than in patients with social phobia alone; self-esteem would be lower in eating disorder patients with depressive cognitions than in social phobia patients with depressive cognitions; self-esteem could have different characteristics in the two disorders; self-esteem would be as low in anorexia as in bulimia; 103 eating disorder patients (33 restrictive anorectics, 34 anorectics-bulimics, 36 bulimics) and 26 social phobia patients diagnosed according to DSM IV and ICD-10 criteria have been investigated by the Self-Esteem Inventory of Coopersmith, the Assertiveness Schedule of Rathus, the Fear Survey Schedule of Wolpe (FSS III) and the Beck Depression Inventory (BDI). Patients were free of medication and presented no episode of major depression according to DSM IV criteria. Evaluations took place before any psychotherapy. Self-esteem in eating disorder patients is reduced at the same level as in social phobia patients; 86.1% of the total sample and 84.5% of the eating disorder patients have a very low self-esteem (score 33 in the SEI). Eating disorder patients have significantly higher scores in the Social (p=0.016) and Professional (p=0.0225) sub-scales of the SEI than social phobia patients. Eating disorder patients show higher scores on the Assertiveness Schedule of Rathus (p=0.0013) than social phobia patients. Eating disorder patients disclose higher scores on the BDI (p=0.0003) but eating disorder patients with depressive cognitions do not differ from social phobia patients with depressive cognitions in the level of self-esteem. The FSS III scores are significantly lower in eating disorder patients (p<0.0001). There is a difference in the nature of the deficit of self-esteem between the two patient populations. Self-esteem is not influenced by the Body Mass Index (BMI) and is identically reduced in all groups of eating disorder patients. Whereas eating disorder patients have the same complaints compared to social phobia, they differ significantly from social phobia patients in their characteristics of social phobia and self-esteem.

Inducing Assertive Behavior in Chronic Schizophrenics: A Comparison of Socioenvironmental Desensitization, and Relaxation Therapies

ERIC Educational Resources Information Center

Weinman, Bernard; And Others

1972-01-01

It is concluded that systematic desensitization or relaxation therapy is not effective in inducing assertive behavior in the male chronic schizophrenic. The treatment of choice for the older chronic male schizophrenic remains socioenvironmental therapy. (Author)

School Violence, the Media's Phanton Epidemic.

ERIC Educational Resources Information Center

Best, Joel

2002-01-01

Argues that public perceptions of an epidemic of school violence are media-induced; asserts that violence in schools declined during the 1990s; supports assertion with evidence from the National School Safety Center; states the estimates of bullying in school are exaggerated. (PKP)

CNAs Making Meaning of Direct Care

PubMed Central

Pfefferle, Susan G.; Weinberg, Dana Beth

2009-01-01

Using qualitative data from 87 focus groups with CNAs in 16 nursing homes in Massachusetts, this study explores ways CNAs make meaning of their work despite devaluations such as lack of respect from management and residents, and the physical and emotional demands of such low status work. CNAs' meaning-making represents an effort to assert a positive identity rather than accept the stigmatization associated with their work. Assertions of the value help CNAs reconstitute their identities. Assertions of meaning, which depend upon providing good care to residents regardless of financial reward or management respect and support, make CNAs vulnerable to exploitation. PMID:18552321

Expression of anger as a function of assertiveness and sex.

PubMed

Doyle, M A; Biaggio, M K

1981-01-01

Examined differences between asserters and nonasserters and between the sexes on anger expression. Thirty-seven male and 53 female college students were administered the College Self-Expression Scale, the Buss Durkee Hostility Inventory, and the Anger Self-Report. As hypothesized, asserters and males expressed more anger and aggression, and nonasserters experienced more covert anger. The clinical/treatment implications of these findings were discussed. A finding discrepant with previous research and the present researchers' expectations, that men scored higher than women on guilt and condemnation of anger, was thought to reflect this study's sample rather than an actual population difference.

Curation accuracy of model organism databases

PubMed Central

Keseler, Ingrid M.; Skrzypek, Marek; Weerasinghe, Deepika; Chen, Albert Y.; Fulcher, Carol; Li, Gene-Wei; Lemmer, Kimberly C.; Mladinich, Katherine M.; Chow, Edmond D.; Sherlock, Gavin; Karp, Peter D.

2014-01-01

Manual extraction of information from the biomedical literature—or biocuration—is the central methodology used to construct many biological databases. For example, the UniProt protein database, the EcoCyc Escherichia coli database and the Candida Genome Database (CGD) are all based on biocuration. Biological databases are used extensively by life science researchers, as online encyclopedias, as aids in the interpretation of new experimental data and as golden standards for the development of new bioinformatics algorithms. Although manual curation has been assumed to be highly accurate, we are aware of only one previous study of biocuration accuracy. We assessed the accuracy of EcoCyc and CGD by manually selecting curated assertions within randomly chosen EcoCyc and CGD gene pages and by then validating that the data found in the referenced publications supported those assertions. A database assertion is considered to be in error if that assertion could not be found in the publication cited for that assertion. We identified 10 errors in the 633 facts that we validated across the two databases, for an overall error rate of 1.58%, and individual error rates of 1.82% for CGD and 1.40% for EcoCyc. These data suggest that manual curation of the experimental literature by Ph.D-level scientists is highly accurate. Database URL: http://ecocyc.org/, http://www.candidagenome.org// PMID:24923819

Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention

PubMed Central

Mercer Kollar, Laura M.; Davis, Teaniese L.; Monahan, Jennifer L.; Samp, Jennifer A.; Coles, Valerie B.; Bradley, Erin L. P.; Sales, Jessica McDermott; Comer, Sarah K.; Worley, Timothy; Rose, Eve; DiClemente, Ralph J.

2016-01-01

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18–24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET’s efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one’s sexual partner as an assertive communication behavior within sexual health contexts. PMID:27164847

Do As I Say: Using Communication Role-Plays to Assess Sexual Assertiveness Following an Intervention.

PubMed

Mercer Kollar, Laura M; Davis, Teaniese L; Monahan, Jennifer L; Samp, Jennifer A; Coles, Valerie B; Bradley, Erin L P; Sales, Jessica McDermott; Comer, Sarah K; Worley, Timothy; Rose, Eve; DiClemente, Ralph J

2016-12-01

Sexual risk reduction interventions are often ineffective for women who drink alcohol. The present study examines whether an alcohol-related sexual risk reduction intervention successfully trains women to increase assertive communication behaviors and decrease aggressive communication behaviors. Women demonstrated their communication skills during interactive role-plays with male role-play partners. Young, unmarried, and nonpregnant African American women (N = 228, ages 18-24) reporting unprotected vaginal or anal sex and greater than three alcoholic drinks in the past 90 days were randomly assigned to a control, a sexual risk reduction, or a sexual and alcohol risk reduction (NLITEN) condition. Women in the NLITEN condition significantly increased assertive communication behavior compared to women in the control condition, yet use of aggressive communicative behaviors was unchanged. These data suggest assertive communication training is an efficacious component of a sexual and alcohol risk reduction intervention. Public health practitioners and health educators may benefit from group motivational enhancement therapy (GMET) training and adding a GMET module to existing sexual health risk reduction interventions. Future research should examine GMET's efficacy in combination with other evidence-based interventions within other populations and examine talking over and interrupting one's sexual partner as an assertive communication behavior within sexual health contexts. © 2016 Society for Public Health Education.

Method and apparatus for granting processors access to a resource

DOEpatents

Blumrich, Matthias A.; Salapura, Valentina

2010-03-16

An apparatus and method for granting one or more requesting entities access to a resource in a predetermined time interval. The apparatus includes a first circuit receiving one or more request signals, and implementing logic for assigning a priority to the one or more request signals, and, generating a set of first_request signals based on the priorities assigned. One or more priority select circuits for receiving the set of first_request signals and generating corresponding one or more fixed grant signals representing one or more highest priority request signals when asserted during the predetermined time interval. A second circuit device receives the one or more fixed grant signals generates one or more grant signals associated with one or more highest priority request signals assigned, the grant signals for enabling one or more respective requesting entities access to the resource in the predetermined time interval, wherein the priority assigned to the one or more request signals changes each successive predetermined time interval. In one embodiment, the assigned priority is based on a numerical pattern, the first circuit changing the numerical pattern with respect to the first_request signals generated at each successive predetermined time interval.

Constraining Assertion: An Account of Context-Sensitivity

ERIC Educational Resources Information Center

Villanueva Chigne, Eduardo

2012-01-01

Many philosophers believe that if "S" is an unambiguous, context-sensitive, declarative sentence and "p" is a proposition asserted (without conversational implicatures) by a literal utterance of "S" in a context "c," then "p" is fully determined by the linguistic meaning of "S" in…

A study of sertraline in dialysis (ASSertID): a protocol for a pilot randomised controlled trial of drug treatment for depression in patients undergoing haemodialysis.

PubMed

Friedli, Karin; Almond, Michael; Day, Clara; Chilcot, Joseph; Gane, Maria da Silva; Davenport, Andrew; Guirguis, Ayman; Fineberg, Naomi; Spencer, Benjamin; Wellsted, David; Farrington, Ken

2015-10-26

The prevalence of depression in people receiving haemodialysis is high with estimates varying between 20 and 40 %. There is little research on the effectiveness of antidepressants in dialysis patients with the few clinical trials suffering significant methodological issues. We plan to carry out a study to evaluate the feasibility of conducting a randomised controlled trial in patients on haemodialysis who have diagnosed Major Depressive Disorder. The study has two phases, a screening phase and the randomised controlled trial. Patients will be screened initially with the Beck Depression Inventory to estimate the number of patients who score 16 or above. These patients will be invited to an interview with a psychiatrist who will invite those with a diagnosis of Major Depressive Disorder to take part in the trial. Consenting patients will be randomised to either Sertraline or placebo. Patients will be followed-up for 6 months. Demographic and clinical data will be collected at screening interview, baseline interview and 2 weeks, and every month (up to 6 months) after baseline. The primary outcome is to evaluate the feasibility of conducting a randomised, double blind, placebo pilot trial in haemodialysis patients with depression. Secondary outcomes include estimation of the variability in the outcome measures for the treatment and placebo arms, which will allow for a future adequately powered definitive trial. Analysis will primarily be descriptive, including the number of patients eligible for the trial, drug exposure of Sertraline in haemodialysis patients and the patient experience of participating in this trial. There is an urgent need for this research in the dialysis population because of the dearth of good quality and adequately powered studies. Research with renal patients is particularly difficult as they often have complex medical needs. This research will therefore not only assess the outcome of anti-depressants in haemodialysis patients with depression but also the process of running a randomised controlled trial in this population. Hence, the outputs of this feasibility study will be used to inform the design and methodology of a definitive study, adequately powered to determine the efficacy of anti-depressants in patient on haemodialysis with depression. ISRCTN registry ISRCTN06146268 and EudraCT reference: 2012-000547-27.

Leaders in Interdependent Contexts Suppress Nonverbal Assertiveness: A Multilevel Analysis of Japanese University Club Leaders' and Members' Rank Signaling.

PubMed

Ito, Atsuki; Gobel, Matthias S; Uchida, Yukiko

2018-01-01

Previous research has shown that leadership is signaled through nonverbal assertiveness. However, those studies have been mostly conducted in individualistic cultural contexts, such as in the U.S. Here, we suggest that one important strategy for goal attainment in collectivistic cultures is for leaders to self-regulate their behaviors. Thus, contrary to the previous evidence from individualistic cultural contexts, in collectivistic cultural contexts, leaders might suppress nonverbal assertiveness. To test this possibility, we assessed nonverbal behaviors (NVB) of Japanese leaders and members, and how they were evaluated by observers. We recruited Japanese leaders and members of university clubs and video-recorded them while introducing their club. Then, we coded their nonverbal rank signaling behavior. Finally, we asked a new set of naïve observers to watch these video-clips and to judge targets' suitability for being possible club leaders. Results of a multilevel analysis (level 1: individual participants, level 2: clubs) suggested that the more the club culture focused on tasks (rather than relationships), the more likely were leaders (but not members) of those clubs to suppress their nonverbal assertiveness. Naïve observers judged individuals who restrained from emitting nonverbal assertiveness as being more suitable and worthy club leaders. Thus, our findings demonstrate the cultural fit between contextual effects at the collective level (i.e., cultural orientation of a group) and the signaling and perceiving of social ranks at the individual level (i.e., suppression of nonverbal assertiveness). We discuss the importance of studying the cultural fit between the collective reality that people inhabit and people's psychology for future research in cultural psychology.

32 CFR 757.15 - Claims not asserted.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Claims not asserted. 757.15 Section 757.15 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... self-insured, non-appropriated-fund activities but does not include private associations. (b) Injured...

32 CFR 757.15 - Claims not asserted.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Claims not asserted. 757.15 Section 757.15 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... self-insured, non-appropriated-fund activities but does not include private associations. (b) Injured...

32 CFR 757.15 - Claims not asserted.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Claims not asserted. 757.15 Section 757.15 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... self-insured, non-appropriated-fund activities but does not include private associations. (b) Injured...

32 CFR 757.15 - Claims not asserted.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Claims not asserted. 757.15 Section 757.15 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... self-insured, non-appropriated-fund activities but does not include private associations. (b) Injured...

32 CFR 757.15 - Claims not asserted.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Claims not asserted. 757.15 Section 757.15 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY CLAIMS AFFIRMATIVE CLAIMS... self-insured, non-appropriated-fund activities but does not include private associations. (b) Injured...

Aligning Montessori Schools with "True" Montessori Essentials.

ERIC Educational Resources Information Center

Kahn, David

2003-01-01

Describes evolution of the Montessori perspective as Montessori adolescent programs attempt to reinforce the elementary and early childhood stages. Asserts that although development of these programs is experimental and undefined, a crystallization point around the whole of Montessori may occur amid diverse implementation. Asserts that Montessori…

Taking Another Look at Behavior Modification and Assertive Discipline.

ERIC Educational Resources Information Center

Palardy, J. Michael

1996-01-01

Behavior modification and assertive discipline approaches use rewards and negative consequences (extinction procedures) to deal with students' maladaptive behavior. Behavior modification has significant limitations, as it treats symptoms, not causes; yields only short-term benefits; has limited transfer value for other environments; and values…

Doubts about Decentralized Decisions.

ERIC Educational Resources Information Center

Summers, Anita A.; Johnson, Amy W.

1995-01-01

Examines 20 systematic SBM studies for insights about authority delegation, fiscal inputs, objectives, and student outcomes. SBM's effects on achievement were mixed. Nine studies gave no results; three asserted positive results but gave no achievement data; one asserted negative results but gave no achievement data; two with achievement data…

Fifteen-month follow up of an assertive community treatment program for chronic patients with mental illness.

PubMed

Kim, Tae-Won; Jeong, Jong-Hyun; Kim, Young-Hee; Kim, Yura; Seo, Ho-Jun; Hong, Seung-Chul

2015-09-16

The aim of this study was to evaluate the effect of an Assertive Community Treatment (ACT) program on psychiatric symptoms, global functioning, life satisfaction, and recovery-promoting relationships among individuals with mental illness. Participants were patients at the Suwon Mental Health Center. Thirty-two patients were part of the ACT program and 32 patients matched for age, sex, and mental illness were in a standard case-management program and served as a control group. Follow-up with patients occurred every 3 months during the 15 months after a baseline interview. Participants completed the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Functioning (GAF) Scale, Life Satisfaction Scale, and Recovery-Promoting Relationship Scale (RPRS). No significant differences were noted in the sociodemographic characteristics of the ACT and the case-management group. According to the BPRS, the ACT group showed a significant reduction in symptom severity, but the ACT program was not significantly more effective at reducing psychiatric symptoms from baseline to the 15-month follow-up compared to the case-management approach. The ACT group showed more significant improvement than the control group in terms of the GAF Scale. Both groups showed no significant differences in the change of life satisfaction and in the change of recovery-promoting relationships. We observed a significant increase in recovery-promoting relationships in the control group, but the degree of change of recovery-promoting relationships through time flow between groups was not significantly different. In this study, we observed that ACT was significantly better at improving the GAF than case management and that participation in ACT was associated with a significant decrease in BPRS scores. However, ACT did not demonstrate an absolute superiority over the standard case-management approach in terms of the BPRS and the measures of life satisfaction and recovery-promoting relationships. ACT may have some advantages over a standard case management approach.

Proof of causation in informed consent cases: establishing what the plaintiff would have done.

PubMed

Cockburn, Tina; Madden, Bill

2010-12-01

A degree of judicial caution in accepting the assertion of a plaintiff as to what he or she would have done, if fully informed of risks, is clearly evident upon a review of decisions applying the common law. Civil liability legislation in some jurisdictions now precludes assertion evidence by a plaintiff. Although this legislative change was seen as creating a significant challenge for plaintiffs seeking to discharge the onus of proof of establishing causation in such cases, recent decisions suggest a more limited practical effect. While a plaintiff's ex post facto assertions as to what he or she would have done if fully informed of risks may now be inadmissible, objective and subjective evidence as to the surrounding facts and circumstances, in particular the plaintiff's prior attitudes and conduct, and the assertion evidence of others remains admissible. Given the court's reliance on both objective and subjective evidence, statistical evidence may be of increasing importance.

Extraversion and behavioral activation: integrating the components of approach.

PubMed

Quilty, Lena C; DeYoung, Colin G; Oakman, Jonathan M; Bagby, R Michael

2014-01-01

This investigation evaluates the structure and correlates of lower order traits related to approach, specifically, facets of extraversion and behavioral activation system (BAS) sensitivity. A 3-factor structure of approach was derived in community and clinical samples: assertiveness, enthusiasm, and sensation seeking. All factors were positively associated with Openness/Intellect scores. Enthusiasm and assertiveness were both negatively associated with Neuroticism scores, but were distinguished by associations with Agreeableness and Conscientiousness. Sensation seeking was negatively associated with Conscientiousness scores. The 3 factors demonstrated a unique profile of association with components of impulsivity. Enthusiasm and assertiveness were negatively related to psychopathological symptoms, whereas sensation seeking was largely independent of psychopathology. Results suggest that approach is associated with 3 subfactors, which differ in their pattern or magnitude of associations with other variables, thus underscoring the importance of distinguishing among them. Further, results support the construct validity of the Assertiveness and Enthusiasm aspect scales of the Big Five Aspect Scales to assess traits at this level of the personality hierarchy.

Medication-assisted recovery from opioid addiction: historical and contemporary perspectives.

PubMed

White, William L

2012-01-01

Recovery is being used as a conceptual fulcrum for the redesign of addiction treatment and related support services in the United States. Efforts by policy, research, and clinical leaders to define recovery and calls for assertive models of long-term recovery management raise critical questions about how transformation efforts of recovery-focused systems will affect the pharmacotherapeutic treatment of opioid addiction and the status of patients participating in such treatment. This article highlights recent work advocating a recovery-oriented approach to medication-assisted treatment.

Sublingual and oral morphine administration. Review and new findings.

PubMed

Robison, J M; Wilkie, D J; Campbell, B

1995-12-01

Clinical reports rave about the efficacy of sublingual morphine, but most research data suggest that sublingual morphine lacks the necessary physical characteristics to be absorbed through sublingual tissues. This article clarifies these assertions by reviewing the clinical literature that supports sublingual administration, the theories relevant to sublingual morphine administration, and the pharmacokinetic research that supports or negates the benefit of this route. Recommendations for clinical nursing practice are provided to guide decision-making in care of patients with cancer pain.

Predicting effective contraceptive behavior in college females.

PubMed

Hughes, C B; Torre, C

1987-09-01

This article reports the results of a preliminary research project that explored the relationship between assertiveness, cognitive development and contraceptive behavior among single young women in their freshman and senior years at college. A total of 60 college women at a university health center volunteered to participate in this pilot study. They filled out three instruments: the Galassi College Self-Expression Scale (SES), the Measure of Intellectual Development (MID) tool and an author-developed sexuality questionnaire. Although there was a significant relationship between cognitive development and assertiveness, no significant relationships were found between cognitive development, assertiveness and use of effective contraception. Interesting descriptive characteristics were identified. Clinical implications are discussed.

Therapeutic horseback riding for ACT patients with schizophrenia.

PubMed

Corring, Deborah; Lundberg, Erica; Rudnick, Abraham

2013-02-01

One form of psychiatric leisure rehabilitation which has only recently been explored for individuals with schizophrenia is Therapeutic Horseback Riding (THBR). This study is the first to examine THBR for Assertive Community Treatment (ACT) patients with schizophrenia. A sample of 6 ACT patients with schizophrenia or schizoaffective disorder who reside in the community and 6 mental health care staff participated in 10 weeks of weekly horseback riding sessions with an experienced THBR instructor. Participating patients, staff and the THBR instructor were qualitatively interviewed at the start, during and at the end of the THBR program and these semi-structured interviews were analyzed for recurrent themes. We found that THBR benefitted this group of patients. In spite of our study's limitations, such as its exploratory nature and the small sample size, it demonstrates that THBR has promise and should be further developed and studied for individuals with schizophrenia.

8 CFR 342.4 - Answer asserting defense; personal appearance requested.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Answer asserting defense; personal appearance requested. 342.4 Section 342.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY... defense; personal appearance requested. If the respondent files an answer within the prescribed period...

8 CFR 342.4 - Answer asserting defense; personal appearance requested.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Answer asserting defense; personal appearance requested. 342.4 Section 342.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY... defense; personal appearance requested. If the respondent files an answer within the prescribed period...

8 CFR 342.4 - Answer asserting defense; personal appearance requested.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Answer asserting defense; personal appearance requested. 342.4 Section 342.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY... defense; personal appearance requested. If the respondent files an answer within the prescribed period...

8 CFR 342.4 - Answer asserting defense; personal appearance requested.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Answer asserting defense; personal appearance requested. 342.4 Section 342.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY... defense; personal appearance requested. If the respondent files an answer within the prescribed period...

8 CFR 342.4 - Answer asserting defense; personal appearance requested.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Answer asserting defense; personal appearance requested. 342.4 Section 342.4 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY NATIONALITY... defense; personal appearance requested. If the respondent files an answer within the prescribed period...

25 CFR 84.006 - Under what circumstances will the Secretary disapprove a contract or agreement that requires...

Code of Federal Regulations, 2010 CFR

2010-04-01

... of the tribe to assert sovereign immunity as a defense in an action brought against the tribe; or (iii) Includes an express waiver of the right of the tribe to assert sovereign immunity as a defense in...

25 CFR 84.006 - Under what circumstances will the Secretary disapprove a contract or agreement that requires...

Code of Federal Regulations, 2013 CFR

2013-04-01

... of the tribe to assert sovereign immunity as a defense in an action brought against the tribe; or (iii) Includes an express waiver of the right of the tribe to assert sovereign immunity as a defense in...

25 CFR 84.006 - Under what circumstances will the Secretary disapprove a contract or agreement that requires...

Code of Federal Regulations, 2011 CFR

2011-04-01

... of the tribe to assert sovereign immunity as a defense in an action brought against the tribe; or (iii) Includes an express waiver of the right of the tribe to assert sovereign immunity as a defense in...

A Proposal for Evaluating Cognition in Assertiveness

ERIC Educational Resources Information Center

Vagos, Paula; Pereira, Anabela

2010-01-01

This article presents the development process and initial psychometric features of an instrument for evaluating cognition in assertiveness. This is an essential social skill for adolescent development and seems to encompass emotional, behavioral, and cognitive aspects. The instrument was created by combining both empirical and theoretical methods…

40 CFR 68.151 - Assertion of claims of confidential business information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Assertion of claims of confidential business information. 68.151 Section 68.151 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.151...

Analysis and Design of a Distributed System for Management and Distribution of Natural Language Assertions

DTIC Science & Technology

2010-09-01

5 2. SCIL Architecture ...............................................................................6 3. Assertions...137 x THIS PAGE INTENTIONALLY LEFT BLANK xi LIST OF FIGURES Figure 1. SCIL architecture...Database Connectivity LAN Local Area Network ODBC Open Database Connectivity SCIL Social-Cultural Content in Language UMD

78 FR 73512 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-06

.... This system will be used to evaluate and settle Admiralty tort claims asserted for and against the..., citizenship, race/ethnicity, physically descriptive characteristics, birth date, personal cell telephone....'' Purpose(s): Delete entry and replace with ``To evaluate and settle Admiralty tort claims asserted for and...

Adolescent Assertiveness: Problems and Programs.

ERIC Educational Resources Information Center

Reece, Randi S.; Wilborn, Bobbie L.

1980-01-01

Assertiveness training programs in the school setting provide a method to work with students with behavior problems. When students can manage their environments more effectively, they view the educational experience more positively and find that their present world and their transition to the adult world proceeds more productively. (Author)

Assertion Training with Korean College Students: Effects on Self-Expression and Anxiety.

ERIC Educational Resources Information Center

Hong, Kyung-Ja; Cooker, Philip G.

1984-01-01

Examined the effects of assertiveness training on the self-expression skills of 65 Korean college students. Results showed the treatment group scored significantly higher on the College Self Expression Scale than placebo or control groups, and males scored significantly higher than females. (JAC)

Asserive Training in Groups Using Video Feedback

ERIC Educational Resources Information Center

Galassi, John P.; And Others

1974-01-01

The study investigated the effectiveness of group assertive training with nonassertive college students. Significant differences were found between experimental and control subjects on the College Self-Expression Scale, the Subjective Unit of Disturbance Scale, eye contact, length of scene, and assertive content but not on response latency.…

40 CFR 68.151 - Assertion of claims of confidential business information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Assertion of claims of confidential business information. 68.151 Section 68.151 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.151...

Prescription and Underprescription of Clozapine in Dutch Ambulatory Care.

PubMed

van der Zalm, Yvonne C; Termorshuizen, Fabian; Schulte, Peter F; Bogers, Jan P; Marcelis, Machteld; Sommer, Iris E; Selten, Jean Paul

2018-01-01

Purpose: To our knowledge, no study has examined in a structured way the extent of underprescription of clozapine in ambulatory patients with Non-Affective Psychotic Disorder (NAPD). In the Netherlands, psychiatric care for such patients is provided by Flexible Assertive Community Treatment (FACT) teams and by early intervention teams. In 20 FACT teams and 3 early intervention teams we assessed the proportion of patients who: use clozapine (type 1 patients), previously used this drug (type 2), have an unfulfilled indication for this drug, by type of indication (type 3), or were at least markedly psychotic, but had not yet received two adequate treatments with other antipsychotic drugs (type 4). We expected to find major differences between teams. To rule out that these differences are caused by differences in severity of psychopathology, we also calculated the proportions of patients who use clozapine given an indication at any time (number of type 1 patients divided by the sum of type 1, 2, and 3 patients). Materials and methods: The nurse practitioner of each team identified the patients already on clozapine. Next, using a highly-structured decision tree, the nurse practitioner and psychiatrist assessed whether the remaining patients had an indication for this drug. Indications were treatment-resistant positive symptoms, tardive dyskinesia, aggression and suicidality. The severity of positive symptoms was determined using the Clinical Global Impression-Schizophrenia Scale (CGI-SCH). Results: In the participating FACT-teams 2,286 NAPD patients were assessed. The range among teams in proportions was: type 1: 8.8-34.7% (mean: 23.0%), type 2: 0-8.2% (mean: 3.5%), type 3: 1.7-15.6% (mean: 6.9%), type 4: 1.8-16.3% (mean: 8.6%). The range in proportions of patients using this drug given an indication was 49.0-90.9% (mean: 68.8%). These figures were lower in early intervention teams. Conclusions: The proportion of patients in FACT-teams who have an unfulfilled indication for clozapine is 6.9%. There were considerable differences between teams with respect to this proportion. Almost a third of the outpatients had at any time an indication for clozapine. If one takes type 4 patients into account, this proportion may be higher. Registration number: NTR5135 http://www.trialregister.nl/trialreg/index.asp.

A critical view of the quest for brain structural markers of Albert Einstein's special talents (a pot of gold under the rainbow).

PubMed

Colombo, Jorge A

2018-06-01

Assertions regarding attempts to link glial and macrostructural brain events with cognitive performance regarding Albert Einstein, are critically reviewed. One basic problem arises from attempting to draw causal relationships regarding complex, delicately interactive functional processes involving finely tuned molecular and connectivity phenomena expressed in cognitive performance, based on highly variable brain structural events of a single, aged, formalin fixed brain. Data weaknesses and logical flaws are considered. In other instances, similar neuroanatomical observations received different interpretations and conclusions, as those drawn, e.g., from schizophrenic brains. Observations on white matter events also raise methodological queries. Additionally, neurocognitive considerations on other intellectual aptitudes of A. Einstein were simply ignored.

Accommodating Presuppositions Is Inappropriate in Implausible Contexts.

PubMed

Singh, Raj; Fedorenko, Evelina; Mahowald, Kyle; Gibson, Edward

2016-04-01

According to one view of linguistic information (Karttunen, 1974; Stalnaker, 1974), a speaker can convey contextually new information in one of two ways: (a) by asserting the content as new information; or (b) by presupposing the content as given information which would then have to be accommodated. This distinction predicts that it is conversationally more appropriate to assert implausible information rather than presuppose it (e.g., von Fintel, 2008; Heim, 1992; Stalnaker, 2002). A second view rejects the assumption that presuppositions are accommodated; instead, presuppositions are assimilated into asserted content and both are correspondingly open to challenge (e.g., Gazdar, 1979; van der Sandt, 1992). Under this view, we should not expect to find a difference in conversational appropriateness between asserting implausible information and presupposing it. To distinguish between these two views of linguistic information, we performed two self-paced reading experiments with an on-line stops-making-sense judgment. The results of the two experiments-using the presupposition triggers the and too-show that accommodation is inappropriate (makes less sense) relative to non-presuppositional controls when the presupposed information is implausible but not when it is plausible. These results provide support for the first view of linguistic information: the contrast in implausible contexts can only be explained if there is a presupposition-assertion distinction and accommodation is a mechanism dedicated to reasoning about presuppositions. Copyright © 2015 Cognitive Science Society, Inc.

Role of general and specific competence skills in protecting inner-city adolescents from alcohol use.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2000-05-01

The purpose of this longitudinal investigation was to test whether higher levels of general competence are linked to greater refusal assertiveness that is, in turn, related to less subsequent alcohol use among inner-city adolescents. A large sample of students attending 22 middle and junior high schools in New York City participated. Students completed surveys at baseline, at 1-year follow-up and at 2-year follow-up (N = 1,459; 54% female). The students self-reported alcohol use. decision-making skills, self-efficacy and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardized protocol. The data were collected in school during a regular 40-minute class period. According to the tested structural equation model, Decision Making (beta = .07, p < .05) and Self-Efficacy (beta = .24, p < .001) predicted higher Refusal Assertiveness and this greater assertiveness predicted less drinking at the 2-year follow-up (beta = -.21, p < .001). Earlier drinking predicted 2-year follow-up drinking (beta = .40, p < .001). Goodness-of-fit indices were excellent (chi2 = 1107.9, 238 df, N = 1,438, p < .001; NFI = .93, NNFI = .94, CFI = .95). The tested model had a good fit and was parsimonious and consistent with theory. This research highlights the importance of addressing decision-making skills, self-efficacy and refusal assertiveness within adolescent alcohol prevention programs.

Lack of association between digit ratio (2D:4D) and assertiveness: replication in a large sample.

PubMed

Voracek, Martin

2009-12-01

Findings regarding within-sex associations of digit ratio (2D:4D), a putative pointer to long-lasting effects of prenatal androgen action, and sexually differentiated personality traits have generally been inconsistent or unreplicable, suggesting that effects in this domain, if any, are likely small. In contrast to evidence from Wilson's important 1983 study, a forerunner of modern 2D:4D research, two recent studies in 2005 and 2008 by Freeman, et al. and Hampson, et al. showed assertiveness, a presumably male-typed personality trait, was not associated with 2D:4D; however, these studies were clearly statistically underpowered. Hence this study examined this question anew, based on a large sample of 491 men and 627 women. Assertiveness was only modestly sexually differentiated, favoring men, and a positive correlate of age and education and a negative correlate of weight and Body Mass Index among women, but not men. Replicating the two prior studies, 2D:4D was throughout unrelated to assertiveness scores. This null finding was preserved with controls for correlates of assertiveness, also in nonparametric analysis and with tests for curvilinear relations. Discussed are implications of this specific null finding, now replicated in a large sample, for studies of 2D:4D and personality in general and novel research approaches to proceed in this field.

High Prevalence of Multidrug-Resistant Tuberculosis, Swaziland, 2009–2010

PubMed Central

Dlamini, Themba; Ascorra, Alexandra; Rüsch-Gerdes, Sabine; Tefera, Zerihun Demissie; Calain, Philippe; de la Tour, Roberto; Jochims, Frauke; Richter, Elvira; Bonnet, Maryline

2012-01-01

In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world’s highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009–2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated case-patients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new case-patients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking. PMID:22260950

Nameless desire: alexithymia and the anorexic patient.

PubMed

Petterson, Regina

2004-03-01

In this article, the author attempts to provide a psychoanalytic understanding of the anorexic patient who is disconnected from her affective experience and is considered to be alexithymic. Through her restrictive food ritual, this type of patient may organize her internal states by repeatedly creating an illusion of what it is that she needs and desires. The author asserts that the task of the therapist working with the anorexic patient with alexithymia is to be aware of his own sensation-based reverie as lived within the intersubjective arena. This will enable the therapist to assist the patient in building an affective vocabulary to accurately identify, differentiate, and label the internal signals of her body. It is suggested that the subjective emotional experience of the patient will continue to be reorganized, expanded, and enriched as the therapist and patient mutually influence one another in this unique relational matrix. A clinical vignette is provided to illustrate intersubjective treatment interventions with a difficult-to-reach anorexic patient.

Predicting Adverse Drug Effects from Literature- and Database-Mined Assertions.

PubMed

La, Mary K; Sedykh, Alexander; Fourches, Denis; Muratov, Eugene; Tropsha, Alexander

2018-06-06

Given that adverse drug effects (ADEs) have led to post-market patient harm and subsequent drug withdrawal, failure of candidate agents in the drug development process, and other negative outcomes, it is essential to attempt to forecast ADEs and other relevant drug-target-effect relationships as early as possible. Current pharmacologic data sources, providing multiple complementary perspectives on the drug-target-effect paradigm, can be integrated to facilitate the inference of relationships between these entities. This study aims to identify both existing and unknown relationships between chemicals (C), protein targets (T), and ADEs (E) based on evidence in the literature. Cheminformatics and data mining approaches were employed to integrate and analyze publicly available clinical pharmacology data and literature assertions interrelating drugs, targets, and ADEs. Based on these assertions, a C-T-E relationship knowledge base was developed. Known pairwise relationships between chemicals, targets, and ADEs were collected from several pharmacological and biomedical data sources. These relationships were curated and integrated according to Swanson's paradigm to form C-T-E triangles. Missing C-E edges were then inferred as C-E relationships. Unreported associations between drugs, targets, and ADEs were inferred, and inferences were prioritized as testable hypotheses. Several C-E inferences, including testosterone → myocardial infarction, were identified using inferences based on the literature sources published prior to confirmatory case reports. Timestamping approaches confirmed the predictive ability of this inference strategy on a larger scale. The presented workflow, based on free-access databases and an association-based inference scheme, provided novel C-E relationships that have been validated post hoc in case reports. With refinement of prioritization schemes for the generated C-E inferences, this workflow may provide an effective computational method for the early detection of potential drug candidate ADEs that can be followed by targeted experimental investigations.

Scoring systems for outcome prediction in patients with perforated peptic ulcer.

PubMed

Thorsen, Kenneth; Søreide, Jon Arne; Søreide, Kjetil

2013-04-10

Patients with perforated peptic ulcer (PPU) often present with acute, severe illness that carries a high risk for morbidity and mortality. Mortality ranges from 3-40% and several prognostic scoring systems have been suggested. The aim of this study was to review the available scoring systems for PPU patients, and to assert if there is evidence to prefer one to the other. We searched PubMed for the mesh terms "perforated peptic ulcer", "scoring systems", "risk factors", "outcome prediction", "mortality", "morbidity" and the combinations of these terms. In addition to relevant scores introduced in the past (e.g. Boey score), we included recent studies published between January 2000 and December 2012) that reported on scoring systems for prediction of morbidity and mortality in PPU patients. A total of ten different scoring systems used to predict outcome in PPU patients were identified; the Boey score, the Hacettepe score, the Jabalpur score the peptic ulcer perforation (PULP) score, the ASA score, the Charlson comorbidity index, the sepsis score, the Mannheim Peritonitis Index (MPI), the Acute physiology and chronic health evaluation II (APACHE II), the simplified acute physiology score II (SAPS II), the Mortality probability models II (MPM II), the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity physical sub-score (POSSUM-phys score). Only four of the scores were specifically constructed for PPU patients. In five studies the accuracy of outcome prediction of different scoring systems was evaluated by receiver operating characteristics curve (ROC) analysis, and the corresponding area under the curve (AUC) among studies compared. Considerable variation in performance both between different scores and between different studies was found, with the lowest and highest AUC reported between 0.63 and 0.98, respectively. While the Boey score and the ASA score are most commonly used to predict outcome for PPU patients, considerable variations in accuracy for outcome prediction were shown. Other scoring systems are hampered by a lack of validation or by their complexity that precludes routine clinical use. While the PULP score seems promising it needs external validation before widespread use.

Scoring systems for outcome prediction in patients with perforated peptic ulcer

PubMed Central

2013-01-01

Background Patients with perforated peptic ulcer (PPU) often present with acute, severe illness that carries a high risk for morbidity and mortality. Mortality ranges from 3-40% and several prognostic scoring systems have been suggested. The aim of this study was to review the available scoring systems for PPU patients, and to assert if there is evidence to prefer one to the other. Material and methods We searched PubMed for the mesh terms “perforated peptic ulcer”, “scoring systems”, “risk factors”, ”outcome prediction”, “mortality”, ”morbidity” and the combinations of these terms. In addition to relevant scores introduced in the past (e.g. Boey score), we included recent studies published between January 2000 and December 2012) that reported on scoring systems for prediction of morbidity and mortality in PPU patients. Results A total of ten different scoring systems used to predict outcome in PPU patients were identified; the Boey score, the Hacettepe score, the Jabalpur score the peptic ulcer perforation (PULP) score, the ASA score, the Charlson comorbidity index, the sepsis score, the Mannheim Peritonitis Index (MPI), the Acute physiology and chronic health evaluation II (APACHE II), the simplified acute physiology score II (SAPS II), the Mortality probability models II (MPM II), the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity physical sub-score (POSSUM-phys score). Only four of the scores were specifically constructed for PPU patients. In five studies the accuracy of outcome prediction of different scoring systems was evaluated by receiver operating characteristics curve (ROC) analysis, and the corresponding area under the curve (AUC) among studies compared. Considerable variation in performance both between different scores and between different studies was found, with the lowest and highest AUC reported between 0.63 and 0.98, respectively. Conclusion While the Boey score and the ASA score are most commonly used to predict outcome for PPU patients, considerable variations in accuracy for outcome prediction were shown. Other scoring systems are hampered by a lack of validation or by their complexity that precludes routine clinical use. While the PULP score seems promising it needs external validation before widespread use. PMID:23574922

Impact of health instructions on improving knowledge and practices of haemophilia A adolescents: a single centre experience.

PubMed

El Dakhakhny, A M; Hesham, M A; Hassan, T H; El Awady, S; Hanfy, M M

2014-07-01

Nowadays, health education has been elevated to a higher standing in healthcare systems in managing chronic illness; yet, this approach has not received sufficient support in developing countries as these societies still tend to the traditional stage of 'treatment after disease'. Adolescence is a critical period and voyage into adulthood can be more challenging for haemophilia teens. For teens with haemophilia, learning to care for their own disorder is a giant step forward in asserting their independence and preparation for adult life. We aimed to determine impact of health instructions on improving knowledge and practices of haemophilia A adolescents. An interventional study was conducted on 50 haemophilia A adolescents at outpatient clinic of Pediatric Hematology Unit of Zagazig University Hospitals. Three tools were used. The first was a structured interview sheet to evaluate patients' knowledge. The second was a clinical checklist to evaluate patients' practices. The third was health instructions program. Tools were developed by the researchers based on a thorough review of related literature and a full understanding of the needs of haemophilic adolescents. Evaluation of health instructions success was based on comparing scores of tool I and tool II before health instructions (pretest) and after health instructions immediately (posttest) and after 2 months (follow-up test). There was a significant improvement in knowledge and practices of haemophilia A adolescents in posttest and follow-up test compared to pretest. Health instructions have an impact on improving knowledge and practices of haemophilia A adolescents. © 2014 John Wiley & Sons Ltd.

Children with Diabetes: Peer Status, Academic Achievement, and Behavior Problems.

ERIC Educational Resources Information Center

Childers, Glenna J.; Carroll, James L.

While the clinical literature frequently asserts that chronic illness negatively affects children's social development, data in support of such assertions are almost without exception obtained in clinical settings from children with chronic illness and their parents, without data from the school or community environment and without control or…

The Use of Stress-Management Training for Obese Women.

ERIC Educational Resources Information Center

Sternberg, Daniel; Del Porto, Delbert

Stress management training contributes to weight loss, maintenance of weight loss and improved social and occupational functioning in obese women. Data from the Beck Depression Inventory and the Assertiveness Questionnaire indicate that obese persons have poor self-concepts which result in depression which is inversely related to assertiveness.…

Differentiating between Confrontive and Coercive Kinds of Parental Power-Assertive Disciplinary Practices

ERIC Educational Resources Information Center

Baumrind, Diana

2012-01-01

In this essay, I differentiate between coercive and confrontive kinds of power assertion to elucidate the significantly different effects on children's well-being of authoritarian and authoritative styles of parental authority. Although both parenting styles (in contrast to the permissive style) are equally demanding, forceful, and…

The Assertive Consumer: Credit and Warranties. Administrative Model.

ERIC Educational Resources Information Center

Clark, Barbara; Veraska, Wanda

This administrative model contains materials to be used in setting up a workshop designed to train members of action organizations (consumer, community, educational) in techniques such as role playing, modeling, and developing strong communications skills for assertively securing legal consumer rights in the areas of credits and warranties, and to…

32 CFR 842.120 - Asserting the claim.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Asserting the claim. 842.120 Section 842.120 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE CLAIMS AND LITIGATION... include the facts and legal basis for liability. Bases for liability could include local foreign law, US...

Cognitive Therapy and Assertive Training in the Treatment of Depression in Women.

ERIC Educational Resources Information Center

LaPointe, Karen A.

Little empirical study has been done on the efficacy of the variety of psychological approaches used to treat depression. The author reviews theoretical points of view: psychoanalytic, cognitive and behavioral, and constructs an experimental design to compare the relative effectiveness of cognitive therapy, assertiveness training and insight…

Do the Big-Five Personality Traits Predict Empathic Listening and Assertive Communication?

ERIC Educational Resources Information Center

Sims, Ceri M.

2017-01-01

As personality traits can influence important social outcomes, the current research investigated whether the Big-Five had predictive influences on communication competences of active-empathic listening (AEL) and assertiveness. A sample of 245 adults of various ages completed the self-report scales. Both Agreeableness and Openness uniquely…

Contempt, like any other social affect, can be an emotion as well as a sentiment.

PubMed

Giner-Sorolla, Roger; Fischer, Agneta H

2017-01-01

Gervais & Fessler assert that contempt is (a) not an emotion (or an attitude) but (b) a sentiment. Here, we challenge the validity and empirical basis of these two assertions, arguing that contempt, like many other emotions, can be both an emotion and a sentiment.

76 FR 362 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Businesses Assert Business Confidentiality Claims AGENCY: Environmental Protection Agency (EPA). ACTION... participate or have participated. The purpose of this notice is to inform ``affected businesses'' about the documents or data sought by these types of FOIA requests in order to provide the businesses with the...

75 FR 44951 - Inquiry To Learn Whether Businesses Assert Business Confidentiality Claims

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... Businesses Assert Business Confidentiality Claims AGENCY: Environmental Protection Agency (EPA). ACTION... participate or have participated. The purpose of this notice is to inform ``affected businesses'' about the documents or data sought by these types of FOIA requests in order to provide the businesses with the...

The Effect of Repetition on the Discrimination of Asserted and Implied Claims in Advertising.

ERIC Educational Resources Information Center

Bruno, Kristin J.; Harris, Richard J.

1980-01-01

Describes testing of a method for teaching people how to identify implied claims in advertising and keep from remembering them as asserted facts. Results show that training may have an effect on teaching the naive consumer to recognize potentially misleading statements. (Author/BK)

Are Dual Enrollment Students College Ready? Evidence from the Wabash National Study of Liberal Arts Education

ERIC Educational Resources Information Center

An, Brian P.; Taylor, Jason L.

2015-01-01

We examine whether dual enrolled students display greater levels of college readiness than nonparticipants. Advocates assert that dual enrollment improves students' college readiness, but despite these assertions, few researchers have evaluated this relationship. Moreover, researchers that do consider whether dual enrollment improves college…

Reading and Engineering: Elementary Students' Co-Application of Comprehension Strategies and Engineering Design Processes

ERIC Educational Resources Information Center

Wilson-Lopez, Amy; Gregory, Stacie; Larsen, Victor

2016-01-01

For decades, researchers have asserted that K-12 teachers should embed reading comprehension instruction within each academic discipline, including "technical subjects" such as engineering. Recently, this assertion has become a source of controversy among researchers and practitioners who believe that time spent on teaching reading…

Reflections on the Cognitive-Learning Trend in Psychotherapy

ERIC Educational Resources Information Center

Mahoney, Michael J.

1977-01-01

Asserting that recent efforts to combine cognitive and behavioristic approaches to psychotherapy are one indication "that psychology is undergoing some sort of 'revolution' in the sense that cognitive processes have become a very popular topic," this paper discusses the trend's development, as well as some of its fundamental assertions,…