Sample records for proactive planning practices

  1. Nurse manager succession planning: synthesis of the evidence.

    PubMed

    Titzer, Jennifer; Phillips, Tracy; Tooley, Stephanie; Hall, Norma; Shirey, Maria

    2013-10-01

    The literature supporting nurse manager succession planning is reviewed and synthesised to discover best practice for identifying and developing future nurse managers. Healthcare succession planning practices are lacking. Nurse managers are historically selected based on clinical skills and lack formal leadership preparation. A systematic literature search appraises and summarises the current literature supporting nurse manager succession planning. Multiple reviewers were used to increase the reliability and validity of article selection and analysis. New nurse managers require months to adapt to their positions. Deliberate nurse manager succession planning should be integrated in the organisation's strategic plan and provide a proactive method for identifying and developing potential leaders. Organisations that identify and develop internal human capital can improve role transition, reduce nurse manager turnover rates and decrease replacement costs. Despite the clear benefits of succession planning, studies show that resource allocation for proactive, deliberate development of current and future nurse leaders is lacking. Additionally, systematic evaluation of succession planning is limited. Deliberate succession planning efforts and appropriate resource allocation require strategic planning and evaluation methods. Detailed evaluation methods demonstrating a positive return on investment utilising a cost-benefit analysis and empirical outcomes are necessary. © 2013 John Wiley & Sons Ltd.

  2. PennDOT transportation security strategy : volume 2 : effective practices of state departments of transportation security planning

    DOT National Transportation Integrated Search

    2004-08-01

    Since September 11, 2001, state departments of transportation (DOTs) have been assuming a more proactive role in security and emergency management. The purpose of this Effective Practices Report is to document key lessons learned by state DOTs as the...

  3. Strategic planning: today's hot buttons.

    PubMed

    Bohlmann, R C

    1998-01-01

    The first generation of mergers and managed care hasn't slowed down group practices' need for strategic planning. Even groups that already went through one merger are asking about new mergers or ownership possibilities, the future of managed care, performance standards and physician unhappiness. Strategic planning, including consideration of bench-marking, production of ancillary services and physician involvement, can help. Even if only a short, general look at the future, strategic planning shows the proactive leadership needed in today's environment.

  4. Effectiveness and cost-effectiveness of a proactive, goal-oriented, integrated care model in general practice for older people. A cluster randomised controlled trial: Integrated Systematic Care for older People--the ISCOPE study.

    PubMed

    Blom, Jeanet; den Elzen, Wendy; van Houwelingen, Anne H; Heijmans, Margot; Stijnen, Theo; Van den Hout, Wilbert; Gussekloo, Jacobijn

    2016-01-01

    older people often experience complex problems. Because of multiple problems, care for older people in general practice needs to shift from a 'problem-based, disease-oriented' care aiming at improvement of outcomes per disease to a 'goal-oriented care', aiming at improvement of functioning and personal quality of life, integrating all healthcare providers. Feasibility and cost-effectiveness of this proactive and integrated way of working are not yet established. cluster randomised trial. all persons aged ≥75 in 59 general practices (30 intervention, 29 control), with a combination of problems, as identified with a structured postal questionnaire with 21 questions on four health domains. for participants with problems on ≥3 domains, general practitioners (GPs) made an integrated care plan using a functional geriatric approach. Control practices: care as usual. (i) quality of life (QoL), (ii) activities of daily living, (iii) satisfaction with delivered health care and (iv) cost-effectiveness of the intervention at 1-year follow-up. Netherlands trial register, NTR1946. of the 11,476 registered eligible older persons, 7,285 (63%) participated in the screening. One thousand nine hundred and twenty-one (26%) had problems on ≥3 health domains. For 225 randomly chosen persons, a care plan was made. No beneficial effects were found on QoL, patients' functioning or healthcare use/costs. GPs experienced better overview of the care and stability, e.g. less unexpected demands, in the care. GPs prefer proactive integrated care. 'Horizontal' care using care plans for older people with complex problems can be a valuable tool in general practice. However, no direct beneficial effect was found for older persons. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society.

  5. Planning documents: a business planning strategy.

    PubMed

    Kaehrle, P A

    2000-06-01

    Strategic planning and business plan development are essential nursing management skills in today's competitive, fast paced, continually changing health care environment. Even in times of great uncertainty, nurse managers need to plan and forecast for the future. A well-written business plan allows nurse managers to communicate their expertise and proactively contribute to the programmatic decisions and changes occurring within their patient population or service area. This article presents the use of planning documents as a practical, strategic business planning strategy. Although the model addresses orthopedic services specifically, nurse managers can gain an understanding and working knowledge of planning concepts that can be applied to all patient populations.

  6. When planning results in loss of control: intention-based reflexivity and working-memory

    PubMed Central

    Meiran, Nachshon; Cole, Michael W.; Braver, Todd S.

    2012-01-01

    In this review, the authors discuss the seemingly paradoxical loss of control associated with states of high readiness to execute a plan, termed “intention-based reflexivity.” The review suggests that the neuro-cognitive systems involved in the preparation of novel plans are different than those involved in preparation of practiced plans (i.e., those that have been executed beforehand). When the plans are practiced, intention-based reflexivity depends on the prior availability of response codes in long-term memory (LTM). When the plans are novel, reflexivity is observed when the plan is pending and the goal has not yet been achieved. Intention-based reflexivity also depends on the availability of working-memory (WM) limited resources and the motivation to prepare. Reflexivity is probably related to the fact that, unlike reactive control (once a plan is prepared), proactive control tends to be relatively rigid. PMID:22586382

  7. Evidence-Based Practices for Addressing Classroom Behavior Problems

    ERIC Educational Resources Information Center

    Park, Hye-Suk Lee; Lynch, Sharon A.

    2014-01-01

    Teachers of young children can plan proactively so that they avoid some of the serious problem behaviors in the classroom. The strategies presented in this article are part of a problem solving approach to challenging behavior based on the principles of positive behavioral support. Although these methods presented here have research-based…

  8. Thriving or Surviving? Managing Pro-Active Environments for Nursing. Midwest Alliance in Nursing Fall Workshop (Columbus, Ohio, September 7-8, 1984).

    ERIC Educational Resources Information Center

    Minckley, Barbara B., Ed.; Young, Lu Ann, Ed.

    Underscoring the importance of active planning for constructive change in the nursing profession, the papers in these proceedings highlight the need for nursing to remain pro-active in the management of nursing education and patient care environments. The proceedings contain: (1) "Pro-Active Planning for Nursing at the Federal Level," by Jo…

  9. Using Proactivity, Time Discounting, and the Theory of Planned Behavior to Identify Predictors of Retirement Planning

    ERIC Educational Resources Information Center

    Griffin, Barbara; Loe, David; Hesketh, Beryl

    2012-01-01

    This study developed and tested a model to identify the predictors of retirement planning based on an extension of the theory of planned behavior ([TPB], Ajzen, 1991) that included individual differences in proactivity and time discounting. The results showed that personal attitudes, sense of control, social influence, and stable traits have a…

  10. Making Schools Safe for Students: Creating a Proactive School Safety Plan.

    ERIC Educational Resources Information Center

    Blauvelt, Peter D.

    This guide offers strategies for creating a proactive school safety plan that encourages parents, teachers, principals, and students to take the initiative and identify threats to school safety. It emphasizes that schools must have an active plan that addresses fights, name calling, bullying, changes in kid's behaviors, and staff who have run out…

  11. Computer screening for palliative care needs in primary care: a mixed-methods study.

    PubMed

    Mason, Bruce; Boyd, Kirsty; Steyn, John; Kendall, Marilyn; Macpherson, Stella; Murray, Scott A

    2018-05-01

    Though the majority of people could benefit from palliative care before they die, most do not receive this approach, especially those with multimorbidity and frailty. GPs find it difficult to identify such patients. To refine and evaluate the utility of a computer application (AnticiPal) to help primary care teams screen their registered patients for people who could benefit from palliative care. A mixed-methods study of eight GP practices in Scotland, conducted in 2016-2017. After a search development cycle the authors adopted a mixed-methods approach, combining analysis of the number of people identified by the search with qualitative observations of the computer search as used by primary care teams, and interviews with professionals and patients. The search identified 0.8% of 62 708 registered patients. A total of 27 multidisciplinary meetings were observed, and eight GPs and 10 patients were interviewed. GPs thought the search identified many unrecognised patients with advanced multimorbidity and frailty, but were concerned about workload implications of assessment and care planning. Patients and carers endorsed the value of proactive identification of people with advanced illness. GP practices can use computer searching to generate lists of patients for review and care planning. The challenges of starting a conversation about the future remain. However, most patients regard key components of palliative care (proactive planning, including sharing information with urgent care services) as important. Screening for people with deteriorating health at risk from unplanned care is a current focus for quality improvement and should not be limited by labelling it solely as 'palliative care'. © British Journal of General Practice 2018.

  12. Use of FMEA analysis to reduce risk of errors in prescribing and administering drugs in paediatric wards: a quality improvement report

    PubMed Central

    Lago, Paola; Bizzarri, Giancarlo; Scalzotto, Francesca; Parpaiola, Antonella; Amigoni, Angela; Putoto, Giovanni; Perilongo, Giorgio

    2012-01-01

    Objective Administering medication to hospitalised infants and children is a complex process at high risk of error. Failure mode and effect analysis (FMEA) is a proactive tool used to analyse risks, identify failures before they happen and prioritise remedial measures. To examine the hazards associated with the process of drug delivery to children, we performed a proactive risk-assessment analysis. Design and setting Five multidisciplinary teams, representing different divisions of the paediatric department at Padua University Hospital, were trained to analyse the drug-delivery process, to identify possible causes of failures and their potential effects, to calculate a risk priority number (RPN) for each failure and plan changes in practices. Primary outcome To identify higher-priority potential failure modes as defined by RPNs and planning changes in clinical practice to reduce the risk of patients harm and improve safety in the process of medication use in children. Results In all, 37 higher-priority potential failure modes and 71 associated causes and effects were identified. The highest RPNs related (>48) mainly to errors in calculating drug doses and concentrations. Many of these failure modes were found in all the five units, suggesting the presence of common targets for improvement, particularly in enhancing the safety of prescription and preparation of endovenous drugs. The introductions of new activities in the revised process of administering drugs allowed reducing the high-risk failure modes of 60%. Conclusions FMEA is an effective proactive risk-assessment tool useful to aid multidisciplinary groups in understanding a process care and identifying errors that may occur, prioritising remedial interventions and possibly enhancing the safety of drug delivery in children. PMID:23253870

  13. Use of FMEA analysis to reduce risk of errors in prescribing and administering drugs in paediatric wards: a quality improvement report.

    PubMed

    Lago, Paola; Bizzarri, Giancarlo; Scalzotto, Francesca; Parpaiola, Antonella; Amigoni, Angela; Putoto, Giovanni; Perilongo, Giorgio

    2012-01-01

    Administering medication to hospitalised infants and children is a complex process at high risk of error. Failure mode and effect analysis (FMEA) is a proactive tool used to analyse risks, identify failures before they happen and prioritise remedial measures. To examine the hazards associated with the process of drug delivery to children, we performed a proactive risk-assessment analysis. Five multidisciplinary teams, representing different divisions of the paediatric department at Padua University Hospital, were trained to analyse the drug-delivery process, to identify possible causes of failures and their potential effects, to calculate a risk priority number (RPN) for each failure and plan changes in practices. To identify higher-priority potential failure modes as defined by RPNs and planning changes in clinical practice to reduce the risk of patients harm and improve safety in the process of medication use in children. In all, 37 higher-priority potential failure modes and 71 associated causes and effects were identified. The highest RPNs related (>48) mainly to errors in calculating drug doses and concentrations. Many of these failure modes were found in all the five units, suggesting the presence of common targets for improvement, particularly in enhancing the safety of prescription and preparation of endovenous drugs. The introductions of new activities in the revised process of administering drugs allowed reducing the high-risk failure modes of 60%. FMEA is an effective proactive risk-assessment tool useful to aid multidisciplinary groups in understanding a process care and identifying errors that may occur, prioritising remedial interventions and possibly enhancing the safety of drug delivery in children.

  14. Threat Assessment Plans

    ERIC Educational Resources Information Center

    Pascopella, Angela

    2008-01-01

    With every new case of school violence, district leaders are urged to be proactive in hopes of averting potential violence. Experts say part of that proactive work comes from a threat assessment plan that every district should have. While every district that receives funds from the U.S. Department of Education for school safety is required to have…

  15. Contribution of reactive and proactive control to children's working memory performance: Insight from item recall durations in response sequence planning.

    PubMed

    Chevalier, Nicolas; James, Tiffany D; Wiebe, Sandra A; Nelson, Jennifer Mize; Espy, Kimberly Andrews

    2014-07-01

    The present study addressed whether developmental improvement in working memory span task performance relies upon a growing ability to proactively plan response sequences during childhood. Two hundred thirteen children completed a working memory span task in which they used a touchscreen to reproduce orally presented sequences of animal names. Children were assessed longitudinally at 7 time points between 3 and 10 years of age. Twenty-one young adults also completed the same task. Proactive response sequence planning was assessed by comparing recall durations for the 1st item (preparatory interval) and subsequent items. At preschool age, the preparatory interval was generally shorter than subsequent item recall durations, whereas it was systematically longer during elementary school and in adults. Although children mostly approached the task reactively at preschool, they proactively planned response sequences with increasing efficiency from age 7 on, like adults. These findings clarify the nature of the changes in executive control that support working memory performance with age. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  16. The nursing human resource planning best practice toolkit: creating a best practice resource for nursing managers.

    PubMed

    Vincent, Leslie; Beduz, Mary Agnes

    2010-05-01

    Evidence of acute nursing shortages in urban hospitals has been surfacing since 2000. Further, new graduate nurses account for more than 50% of total nurse turnover in some hospitals and between 35% and 60% of new graduates change workplace during the first year. Critical to organizational success, first line nurse managers must have the knowledge and skills to ensure the accurate projection of nursing resource requirements and to develop proactive recruitment and retention programs that are effective, promote positive nursing socialization, and provide early exposure to the clinical setting. The Nursing Human Resource Planning Best Practice Toolkit project supported the creation of a network of teaching and community hospitals to develop a best practice toolkit in nursing human resource planning targeted at first line nursing managers. The toolkit includes the development of a framework including the conceptual building blocks of planning tools, manager interventions, retention and recruitment and professional practice models. The development of the toolkit involved conducting a review of the literature for best practices in nursing human resource planning, using a mixed method approach to data collection including a survey and extensive interviews of managers and completing a comprehensive scan of human resource practices in the participating organizations. This paper will provide an overview of the process used to develop the toolkit, a description of the toolkit contents and a reflection on the outcomes of the project.

  17. Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships

    PubMed Central

    Bjerkan, Jorunn; Vatne, Solfrid; Hollingen, Anne

    2014-01-01

    Background and objective The Individual Care Plan (ICP) was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP]) was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles. Methods Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model. Results Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users’ own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred. Conclusion Use of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care documentation and planning tools. PMID:25525367

  18. Road weather information systems : enabling proactive maintenance practices in Washington state

    DOT National Transportation Integrated Search

    2002-03-01

    Washington State Department of Transportation's (WSDOT) rWeather program has significantly integrated and expanded the capabilities of road weather information systems (RWIS) in the state, enabling proactive winter maintenance practices and better-in...

  19. Contribution of Reactive and Proactive Control to Children's Working Memory Performance: Insight from Item Recall Durations in Response Sequence Planning

    ERIC Educational Resources Information Center

    Chevalier, Nicolas; James, Tiffany D.; Wiebe, Sandra A.; Nelson, Jennifer Mize; Espy, Kimberly Andrews

    2014-01-01

    The present study addressed whether developmental improvement in working memory span task performance relies upon a growing ability to proactively plan response sequences during childhood. Two hundred thirteen children completed a working memory span task in which they used a touchscreen to reproduce orally presented sequences of animal names.…

  20. New Tools, New Times: Strategic Planning. A Seminar Focusing on Proactive Management Techniques (Chapel Hill, North Carolina, June 17-19, 1991).

    ERIC Educational Resources Information Center

    Morrison, James L.; Ashley, William C.

    This handbook was designed to accompany a three-day workshop for senior administrators in higher education on proactive management techniques in higher education. Proactive management allows for anticipating change and managing uncertainty in place of crisis management or reactive actions. The workshop covered: (1) strategic thinking; (2)…

  1. The Red Lotus Health Promotion Model: a new model for holistic, ecological, salutogenic health promotion practice.

    PubMed

    Gregg, Jane; O'Hara, Lily

    2007-04-01

    There is a need for a system of values and principles consistent with modern health promotion that enables practitioners to use these values and principles to understand health and in their needs assessment, planning, implementation and evaluation practice. Grounded theory, document analysis and the authors' own practice experience were used to systematically collect and analyse data from key health promotion literature and to develop the Red Lotus Health Promotion Model. The Red Lotus Health Promotion Model is a new model for holistic, ecological, salutogenic health promotion practice. It is distinct from other health promotion models in that it incorporates a system of values and principles that is applied across the phases of health promotion, including determining the health paradigm, needs assessment, planning, implementation and evaluation. The Red Lotus Health Promotion Model enables practitioners to proactively and purposefully put into action a connected system of values and principles across the phases of a health promotion process.

  2. Content Analysis for Proactive Protective Intelligence

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

    Sanfilippo, Antonio P.

    The aim of this paper is to outline a plan for developing and validating a Proactive Protective Intelligence approach that prevents targeted violence through the analysis and assessment of threats overtly or covertly expressed in abnormal communications to USSS protectees.

  3. Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes.

    PubMed

    Fromer, Len

    2011-01-01

    Current primary care patterns for chronic obstructive pulmonary disease (COPD) focus on reactive care for acute exacerbations, often neglecting ongoing COPD management to the detriment of patient experience and outcomes. Proactive diagnosis and ongoing multifactorial COPD management, comprising smoking cessation, influenza and pneumonia vaccinations, pulmonary rehabilitation, and symptomatic and maintenance pharmacotherapy according to severity, can significantly improve a patient's health-related quality of life, reduce exacerbations and their consequences, and alleviate the functional, utilization, and financial burden of COPD. Redesign of primary care according to principles of the chronic care model, which is implemented in the patient-centered medical home, can shift COPD management from acute rescue to proactive maintenance. The chronic care model and patient-centered medical home combine delivery system redesign, clinical information systems, decision support, and self-management support within a practice, linked with health care organization and community resources beyond the practice. COPD care programs implementing two or more chronic care model components effectively reduce emergency room and inpatient utilization. This review guides primary care practices in improving COPD care workflows, highlighting the contributions of multidisciplinary collaborative team care, care coordination, and patient engagement. Each primary care practice can devise a COPD care workflow addressing risk awareness, spirometric diagnosis, guideline-based treatment and rehabilitation, and self-management support, to improve patient outcomes in COPD.

  4. Public Managers Should Be Proactive

    ERIC Educational Resources Information Center

    Carlson, Thomas S.

    1976-01-01

    Future public managers should be proactive by creating management processes before problems arise. Planning prevents reactive or crisis managing. Future managers should also be prepared to meet dilemmas and paradoxes such as centralization versus decentralization of decision-making and work processes, politics versus administration dichotomy, and…

  5. Mapping discussion of canine obesity between veterinary surgeons and dog owners: a provisional study.

    PubMed

    Cairns-Haylor, Theodora; Fordyce, Peter

    2017-02-11

    This study maps communication between veterinary surgeons and dog owners on obesity management in four first-opinion practices in the UK. A total of 74 dog owners who met the study's inclusion criteria and 24 veterinary surgeons were interviewed using oral questionnaires between November 2013 and May 2014. The dog owner questionnaire was based on potential discussion areas that could influence an owner's intention to act (initiate a weight loss regime) based on Ajzen's Theory of Planned Behaviour. The veterinary surgeons' questionnaires assessed perception of canine obesity, their personal communication strategies and current practice-level interventions. The findings identify opportunities for more proactive approaches to obesity management by veterinary surgeons and their practices. British Veterinary Association.

  6. In Search of Joy in Practice: A Report of 23 High-Functioning Primary Care Practices

    PubMed Central

    Sinsky, Christine A.; Willard-Grace, Rachel; Schutzbank, Andrew M.; Sinsky, Thomas A.; Margolius, David; Bodenheimer, Thomas

    2013-01-01

    We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life’s vocation. Innovations identified include (1) proactive planned care, with previsit planning and previsit laboratory tests; (2) sharing clinical care among a team, with expanded rooming protocols, standing orders, and panel management; (3) sharing clerical tasks with collaborative documentation (scribing), nonphysician order entry, and streamlined prescription management; (4) improving communication by verbal messaging and in-box management; and (5) improving team functioning through co-location, team meetings, and work flow mapping. Our observations suggest that a shift from a physician-centric model of work distribution and responsibility to a shared-care model, with a higher level of clinical support staff per physician and frequent forums for communication, can result in high-functioning teams, improved professional satisfaction, and greater joy in practice. PMID:23690328

  7. Promises to Practice: Learning a PROactive Approach to Ethical Dilemmas

    ERIC Educational Resources Information Center

    Ambery, Mary Elizabeth; Steinbrunner, Ruth K.

    2007-01-01

    Learning to be PROactive, as the title of this article suggests, means Pooling one's knowledge, Reflecting respect, and Opening oneself to action. It recognizes early childhood educators' promises to their field of practice, based on widely held beliefs and principles. Educators can apply professional ethics to everyday problem solving and their…

  8. A prototype system to support evidence-based practice.

    PubMed

    Demner-Fushman, Dina; Seckman, Charlotte; Fisher, Cheryl; Hauser, Susan E; Clayton, Jennifer; Thoma, George R

    2008-11-06

    Translating evidence into clinical practice is a complex process that depends on the availability of evidence, the environment into which the research evidence is translated, and the system that facilitates the translation. This paper presents InfoBot, a system designed for automatic delivery of patient-specific information from evidence-based resources. A prototype system has been implemented to support development of individualized patient care plans. The prototype explores possibilities to automatically extract patients problems from the interdisciplinary team notes and query evidence-based resources using the extracted terms. Using 4,335 de-identified interdisciplinary team notes for 525 patients, the system automatically extracted biomedical terminology from 4,219 notes and linked resources to 260 patient records. Sixty of those records (15 each for Pediatrics, Oncology & Hematology, Medical & Surgical, and Behavioral Health units) have been selected for an ongoing evaluation of the quality of automatically proactively delivered evidence and its usefulness in development of care plans.

  9. A Prototype System to Support Evidence-based Practice

    PubMed Central

    Demner-Fushman, Dina; Seckman, Charlotte; Fisher, Cheryl; Hauser, Susan E.; Clayton, Jennifer; Thoma, George R.

    2008-01-01

    Translating evidence into clinical practice is a complex process that depends on the availability of evidence, the environment into which the research evidence is translated, and the system that facilitates the translation. This paper presents InfoBot, a system designed for automatic delivery of patient-specific information from evidence-based resources. A prototype system has been implemented to support development of individualized patient care plans. The prototype explores possibilities to automatically extract patients’ problems from the interdisciplinary team notes and query evidence-based resources using the extracted terms. Using 4,335 de-identified interdisciplinary team notes for 525 patients, the system automatically extracted biomedical terminology from 4,219 notes and linked resources to 260 patient records. Sixty of those records (15 each for Pediatrics, Oncology & Hematology, Medical & Surgical, and Behavioral Health units) have been selected for an ongoing evaluation of the quality of automatically proactively delivered evidence and its usefulness in development of care plans. PMID:18998835

  10. Palliative medicine consultation for preparedness planning in patients receiving left ventricular assist devices as destination therapy.

    PubMed

    Swetz, Keith M; Freeman, Monica R; AbouEzzeddine, Omar F; Carter, Kari A; Boilson, Barry A; Ottenberg, Abigale L; Park, Soon J; Mueller, Paul S

    2011-06-01

    To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT). We retrospectively reviewed the cases of patients who received DT between January 15, 2009, and January 1, 2010. Of 19 patients identified, 13 (68%) received proactive palliative medicine consultation. Median time of palliative medicine consultation was 1 day before DT implantation (range, 5 days before to 16 days after). Thirteen patients (68%) completed advance directives. The DT implantation team and families reported that preimplantation discussions and goals of care planning made postoperative care more clear and that adverse events were handled more effectively. Currently, palliative medicine involvement in patients receiving DT is viewed as routine by cardiac care specialists. Proactive palliative medicine consultation for patients being considered for or being treated with DT improves advance care planning and thus contributes to better overall care of these patients. Our experience highlights focused advance care planning, thorough exploration of goals of care, and expert symptom management and end-of-life care when appropriate.

  11. Proactive Parenting Practices during Early Adolescence: A Cluster Approach

    ERIC Educational Resources Information Center

    Padilla-Walker, Laura M.; Christensen, Katherine J.; Day, Randal D.

    2011-01-01

    The purpose of the current study was to explore clusters of proactive parenting practices, and how they might vary as a function of parental demographics, the quality of the parent-child relationship, and the traits and behaviors of the adolescent child. Data were taken from the "Flourishing Families Project", which includes 500 families with an…

  12. Reciprocal relationship between proactive personality and work characteristics: a latent change score approach.

    PubMed

    Li, Wen-Dong; Fay, Doris; Frese, Michael; Harms, Peter D; Gao, Xiang Yu

    2014-09-01

    Previous proactivity research has predominantly assumed that proactive personality generates positive environmental changes in the workplace. Grounded in recent research on personality development from a broad interactionist theoretical approach, the present article investigates whether work characteristics, including job demands, job control, social support from supervisors and coworkers, and organizational constraints, change proactive personality over time and, more important, reciprocal relationships between proactive personality and work characteristics. Latent change score analyses based on longitudinal data collected in 3 waves across 3 years show that job demands and job control have positive lagged effects on increases in proactive personality. In addition, proactive personality exerts beneficial lagged effects on increases in job demands, job control, and supervisory support, and on decreases in organizational constraints. Dynamic reciprocal relationships are observed between proactive personality with job demands and job control. The revealed corresponsive change relationships between proactive personality and work characteristics contribute to the proactive personality literature by illuminating more nuanced interplays between the agentic person and work characteristics, and also have important practical implications for organizations and employees. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Strategic Goals Implementation Plan V2.0

    DTIC Science & Technology

    2008-01-01

    newest ATARS ground station. (Sep 08) (DDR&E) 3.1.6 Take proactive steps to transition technology programs. DUSD(AS&C) • Proactive steps taken to...increases emphasis on math as gateway to physical science and engineering. • Expanded footprint of S&E education in Middle School. 3.3.4 Support

  14. Employability Transcripts: Proactive Career Planning

    ERIC Educational Resources Information Center

    Metcalf, Elaine

    2010-01-01

    With high school dropout rates at about 30 percent nationwide and an anticipated severe workforce shortage as baby boomers retire, now is the time to engage future workers. Educators must encourage high school students to be proactive career planners. Today's high school students will fuel the workforce pipeline with educated, skilled workers who…

  15. Proactive Strategies to Safeguard Young Adolescents in the Cyberage

    ERIC Educational Resources Information Center

    Miller, Nicole C.; Thompson, Nicole L.; Franz, Dana Pomykal

    2009-01-01

    Schools should be proactive rather than reactive to issues of technology safety, and this requires careful planning and policy implementation. In this article, the authors provide information and recommendations that will help middle grades educators, students, and parents to safely and successfully manage the many technologies they encounter and…

  16. Beyond Academic and Social Integration: Understanding the Impact of a STEM Enrichment Program on the Retention and Degree Attainment of Underrepresented Students

    PubMed Central

    Lane, Tonisha B.

    2016-01-01

    The current study used a case study methodological approach, including document analysis, semistructured interviews, and participant observations, to investigate how a science, technology, engineering, and mathematics (STEM) enrichment program supported retention and degree attainment of underrepresented students at a large, public, predominantly white institution. From this study, a model emerged that encompassed four components: proactive care, holistic support, community building, and catalysts for STEM identity development. These components encompassed a number of strategies and practices that were instrumental in the outcomes of program participants. This paper concludes with implications for practice, such as using models to inform program planning, assessment, and evaluation. PMID:27543638

  17. Health and Safety Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Environmental Restoration Program

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

    Van Hoesen, S.D.; Clark, C. Jr.; Burman, S.N.

    1993-12-01

    The Martin Marietta Energy Systems, Inc. (Energy Systems), policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at Waste Area Grouping (WAG) 6 at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to safety and health (S&H) issues. The plan is written to utilize past experience and best management practices to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactivemore » materials to air, soil, or surface water This plan explains additional site-specific health and safety requirements such as Site Specific Hazards Evaluation Addendums (SSHEAs) to the Site Safety and Health Plan which should be used in concert with this plan and existing established procedures.« less

  18. Improving Risk Management and Resiliency: A Plan for a Proactive National Policy on Insurance Practices in FEMA’s Public Assistance Program

    DTIC Science & Technology

    2013-12-01

    DisasterRecoveryExpenditure/Pag es/default.aspx, Canadian Disaster Database, and www.fema.gov) 116 Table 15. Comparison of declaration criteria and disasters for $30 million...the role of insurance in FEMA’s Public Assistance program. The guidance provided in the 44 CFR has not kept up with the industry since being...the nation. xxix THIS PAGE INTENTIONALLY LEFT BLANK I. INTRODUCTION Insurance is a complex industry , which is a large component of the U.S

  19. Does Motivation Matter? Analysis of a Randomized Trial of Proactive Outreach to VA Smokers.

    PubMed

    Danan, Elisheva R; Joseph, Anne M; Sherman, Scott E; Burgess, Diana J; Noorbaloochi, Siamak; Clothier, Barbara; Japuntich, Sandra J; Taylor, Brent C; Fu, Steven S

    2016-08-01

    Current guidelines advise providers to assess smokers' readiness to quit, then offer cessation therapies to smokers planning to quit and motivational interventions to smokers not planning to quit. We examined the relationship between baseline stage of change (SOC), treatment utilization, and smoking cessation to determine whether the effect of a proactive smoking cessation intervention was dependent on smokers' level of motivation to quit. Secondary analysis of a multicenter randomized controlled trial. A total of 3006 current smokers, aged 18-80 years, at four Veterans Affairs (VA) medical centers. Proactive care included proactive outreach (mailed invitation followed by telephone outreach), offer of smoking cessation services (telephone or face-to-face), and access to pharmacotherapy. Usual care participants had access to VA smoking cessation services and state telephone quitlines. Baseline SOC measured with Readiness to Quit Ladder, and 6-month prolonged abstinence self-reported at 1 year. At baseline, 35.8 % of smokers were in preparation, 38.2 % in contemplation, and 26.0 % in precontemplation. The overall interaction between SOC and treatment arm was not statistically significant (p = 0.30). Among smokers in preparation, 21.1 % of proactive care participants achieved 6-month prolonged abstinence, compared to 13.1 % of usual care participants (OR, 1.8 [95 % CI, 1.2-2.6]). Similarly, proactive care increased abstinence among smokers in contemplation (11.0 % vs. 6.5 %; OR, 1.8 [95 % CI, 1.1-2.8]). Smokers in precontemplation quit smoking at similar rates (5.3 % vs. 5.6 %; OR, 0.9 [95 % CI, 0.5-1.9]). Within each stage, uptake of smoking cessation treatments increased with higher SOC and with proactive care as compared with usual care. Mostly male participants limits generalizability. Randomization was not stratified by SOC. Proactive care increased treatment uptake compared to usual care across all SOC. Proactive care increased smoking cessation among smokers in preparation and contemplation but not in precontemplation. Proactively offering cessation therapies to smokers at all SOC will increase treatment utilization and population-level smoking cessation.

  20. Human Dignity, Decency and Integrity as the Sine Qua Non of Human Rights Education: A Proactive Conceptual and Practical Framework for Promotion of World Peace.

    ERIC Educational Resources Information Center

    Sandhu, Daya Singh

    This paper underscores the significance of personal dignity, decency, and integrity as the core values and symbionic concepts to promote human rights education. It proposes a proactive model with philosophical ramifications and practical applications proposed for educators, researchers, and mental health practitioners interested in human rights…

  1. A/R systems reduce delayed and denied reimbursements.

    PubMed

    Escobar, Carlos

    2007-01-01

    The day-to-day benefits of a comprehensive billing and collections system are pro-active and preventive--administrators are increasingly learning that accelerating billings hastens collections and, ultimately, facility profitability. Effective billing and collections management services work closely with the facility, matching nightly "dumps" of patient files with transcripts. This marriage of otherwise disparate data creates a billing unit that reduces errors and ensures no billable procedures are lost. Ultimately, the goal of any medical practice that engages an ASP application or outsource solution is not to sit idly by while allowing a billing company to take control of a practice's revenue stream. The ability to track the billing process from transcript submission to payment provides a facility with all information necessary to manage cash flow, revenues, and even personal and practice financial planning.

  2. Getting the most out of your practice--the Practice Health Atlas and business modelling opportunities.

    PubMed

    Del Fante, Peter; Allan, Don; Babidge, Elizabeth

    2006-01-01

    The Practice Health Atlas (PHA) is a decision support tool for general practice, designed by the Adelaide Western Division of General Practice (AWDGP). This article describes the features of the PHA and its potential role in enhancing health care. In developing the PHA, the AWDGP utilises a range of software tools and consults with a practice to understand its clinical data management approach. The PHA comprises three sections: epidemiology, business and clinical modelling systems, access to services. The objectives include developing a professional culture around quality health data and synthesis of aggregated de-identified general practice data at both practice and divisional level (and beyond) to assist with local health needs assessment, planning, and funding. Evaluation occurs through group feedback sessions and from the general practitioners and staff. It has demonstrated its potential to fulfill the objectives in outcome areas such as data quality and management, team based care, pro-active practice population health care, and business systems development, thereby contributing to improved patient health outcomes.

  3. Role Breadth Self-Efficacy and Foci of Proactive Behavior: Moderating Role of Collective, Relational, and Individual Self-Concept.

    PubMed

    Hwang, Pin-Chyuan; Han, Ming-Chuan; Chiu, Su-Fen

    2015-01-01

    This study aims to identify the interactive effect of role breadth self-efficacy (RBSE) and the three levels of self-concept (collective, relational, and individual) in predicting of different foci of proactive behaviors. Results from 259 matched responses from an airline company in Taiwan showed that RBSE had a positive effect on (1) pro-organizational proactive behavior among those with higher collective self-concept, (2) pro-supervisor proactive behavior among those with higher relational self-concept, and (3) pro-self proactive behavior among those with higher individual self-concept. Our findings provide insights into the moderating role of different levels of self-concept on RBSE-proactive behavior process in terms of specific targets or beneficiaries. Further implications for organizational research and practice are discussed.

  4. Genetic and Environmental Stability Differs in Reactive and Proactive Aggression

    PubMed Central

    Tuvblad, Catherine; Raine, Adrian; Zheng, Mo; Baker, Laura A.

    2009-01-01

    The aim of this study was to examine stability and change in genetic and environmental influences on reactive (impulsive and affective) and proactive (planned and instrumental) aggression from childhood to early adolescence. The sample was drawn from an ongoing longitudinal twin study of risk factors for antisocial behavior at the University of Southern California (USC). The twins were measured on two occasions: ages 9–10 years (N = 1,241) and 11–14 years (N = 874). Reactive and proactive aggressive behaviors were rated by parents. The stability in reactive aggression was due to genetic and nonshared environmental influences, whereas the continuity in proactive aggression was primarily genetically mediated. Change in both reactive and proactive aggression between the two occasions was mainly explained by nonshared environmental influences, although some evidence for new genetic variance at the second occasion was found for both forms of aggression. These results suggest that proactive and reactive aggression differ in their genetic and environmental stability, and provide further evidence for some distinction between reactive and proactive forms of aggression. PMID:19688841

  5. Employee benefits annual checkup.

    PubMed

    Brossman, M E; Taran, J

    2001-06-01

    An annual checkup is a prudent preventive measure for employee benefit plans. It allows plan fiduciaries to assess the overall "health" of the plans they administer and to make proactive corrections. This article lists some of the most important items to consider in evaluating a plan.

  6. Integrating transportation/transit planning in the overall planning process.

    DOT National Transportation Integrated Search

    2009-07-01

    The purpose of this report is to produce recommendations that will foster more transportation : and land use integration throughout the overall planning process in Delaware. A trend of : population growth and decentralization necessitates a proactive...

  7. Can Payers Use Prices to Improve Quality? Evidence from English Hospitals.

    PubMed

    Allen, Thomas; Fichera, Eleonora; Sutton, Matt

    2016-01-01

    In most activity-based financing systems, payers set prices reactively based on historical averages of hospital reported costs. If hospitals respond to prices, payers might set prices proactively to affect the volume of particular treatments or clinical practice. We evaluate the effects of a unique initiative in England in which the price offered to hospitals for discharging patients on the same day as a particular procedure was increased by 24%, while the price for inpatient treatment remained unchanged. Using national hospital records for 205,784 patients admitted for the incentivised procedure and 838,369 patients admitted for a range of non-incentivised procedures between 1 December 2007 and 31 March 2011, we consider whether this price change had the intended effect and/or produced unintended effects. We find that the price change led to an almost six percentage point increase in the daycase rate and an 11 percentage point increase in the planned daycase rate. Patients benefited from a lower proportion of procedures reverted to open surgery during a planned laparoscopic procedure and from a reduction in long stays. There was no evidence that readmission and death rates were affected. The results suggest that payers can set prices proactively to incentivise hospitals to improve quality. Copyright © 2014 John Wiley & Sons, Ltd.

  8. An intrepreneurial innovative role: integration of the clinical nurse specialist and infection prevention professional.

    PubMed

    Pintar, Paula A

    2013-01-01

    Hospital quality and financial sustainability rely on reducing healthcare-associated events/infections, length of stay, and readmissions. This project focused on designing an integrated role for the clinical nurse specialist (CNS) and the infection prevention professional (IPP) to proactively manage the delivery of evidence-based practice to high-risk surgical patients. The healthcare industry is in the midst of a paradigm shift driven by changing health policy focusing on quality indicators, patient satisfaction, and lowering costs. Coupled with these indicators is the expectation and responsibility to provide evidence-based practice at all levels of the healthcare continuum. This paradigm shift places healthcare facilities in a very competitive atmosphere as they rally for the revenue of a fixed payer mix. A literature search using CINHAL, PubMed, and the CNS national listserve databases was completed to identify if there was any previously written information available on an integrated role of the CNS/IPP. An online business plan template was used to communicate the significance, implications, and return on organizational investment to practice with establishing this role. Chronic health conditions such as diabetes, hypertension, congestive heart failure, and colonization with multidrug-resistant organisms can place patients at an increased risk for developing a surgical site infection or complications. The CNS/IPP will proactively manage these risk factors, including the patient and family in a preventive care model to manage the acute inpatient high-risk surgical patient. Care management will include coordinated, collaborative, and consultative follow-up by the CNS/IPP in the acute care, long-term care facilities, and home settings. The infection prevention skill set brings a level of clinical expertise that makes a unique CNS. The IPP is immersed in using epidemiological principles that examine the impact of comorbidities and the added risk that can contribute to developing a surgical site infection. This CNS/IPP incorporates the CNS Spheres of Influence Model and the Association of Professionals in Infection Prevention Competency Model. This combination advanced practice nurse uses a nurse-managed model of care focused on patient/family education, prevention, and self-care management. Therefore, this specific and specialized practice will bring value to the organization by improving financial outcomes through reducing infections, readmission rates, and length of stay. By providing this level of focused care, patient satisfaction will improve and system financial stability will be supported by decreasing hospital readmissions, length of stay, and other hospital-acquired conditions that the surgical candidate is prone to developing. The critical juncture in healthcare is providing opportunities for innovation by examining the CNS role and considering the feasibility of pairing it with the infection preventionist skills. This pairing provides an unprecedented opportunity to improve patient outcomes across the continuum of care. This provider has the ability to influence the Centers for Medicare and Medicaid Services quality indicators in a positive way by using implementation science to partner with system/organization stakeholders that focuses on prevention rather than reactive care processes. The dynamic trends in healthcare continue to drive "intrepreneurial," innovative, and creative ways of thinking; provide clinical practice that has the ability to perform nimbly; and maintain a proactive vision to provide quality care to a diverse patient population. This CNS/IPP role meets the dynamic proactive planning that will shift with patient, system, and nursing needs to deliver cost-effective managed care to improve the health of our patients.

  9. Conceptualizing 2000: Proactive Planning.

    ERIC Educational Resources Information Center

    Angel, Dan, Ed.; DeVault, Mike, Ed.

    As community, technical, and junior colleges approach the 21st century, faculty shortages, an increasingly diverse student body, dwindling financial resources, and accountability mandates will require careful, action-oriented college planning. This two-part book presents 10 articles on the dynamics of planning and specific planning models, and…

  10. Building a highly available and intrusion tolerant Database Security and Protection System (DSPS).

    PubMed

    Cai, Liang; Yang, Xiao-Hu; Dong, Jin-Xiang

    2003-01-01

    Database Security and Protection System (DSPS) is a security platform for fighting malicious DBMS. The security and performance are critical to DSPS. The authors suggested a key management scheme by combining the server group structure to improve availability and the key distribution structure needed by proactive security. This paper detailed the implementation of proactive security in DSPS. After thorough performance analysis, the authors concluded that the performance difference between the replicated mechanism and proactive mechanism becomes smaller and smaller with increasing number of concurrent connections; and that proactive security is very useful and practical for large, critical applications.

  11. Clinical Practice Informs Secure Messaging Benefits and Best Practices.

    PubMed

    Haun, Jolie N; Hathaway, Wendy; Chavez, Margeaux; Antinori, Nicole; Vetter, Brian; Miller, Brian K; Martin, Tracey L; Kendziora, Lisa; Nazi, Kim M; Melillo, Christine

    2017-10-01

    Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans. Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow. Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics. Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow. Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM to enrich veterans' health care experience.

  12. Beware of "black swans" and "perfect storms:" the principle of plenitude and office-based anesthesia.

    PubMed

    Treasure, Trevor E

    2014-08-01

    A paradigm shift in the training, practice, and study of office-based anesthesia is necessary for our specialty. Practice improvement plans are required to prevent low-probability-high-consequence anesthesia mishaps in our offices. A scarcity of statistical data exists regarding the true risk of office-based anesthesia in oral and maxillofacial surgery. Effective proactive risk management mandates accurate data to correctly outline the problem before solutions can be implemented. Only by learning from our mistakes, will we be able to reduce errors and improve patient safety: "The only real mistake is the one from which we learn nothing"--John Powell. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Reducing disability in community-dwelling frail older people: cost-effectiveness study alongside a cluster randomised controlled trial.

    PubMed

    Metzelthin, Silke F; van Rossum, Erik; Hendriks, Marike R C; De Witte, Luc P; Hobma, Sjoerd O; Sipers, Walther; Kempen, Gertrudis I J M

    2015-05-01

    although proactive primary care, including early detection and treatment of community-dwelling frail older people, is a part of the national healthcare policy in several countries, little is known about its cost-effectiveness. to evaluate the cost-effectiveness of a proactive primary care approach in community-dwelling frail older people. embedded in a cluster randomised trial among 12 Dutch general practitioner practices, an economic evaluation was performed from a societal perspective with a time horizon of 24 months. frail older people in the intervention group received an in-home assessment and interdisciplinary care based on a tailor-made treatment plan and regular evaluation and follow-up. Practices in the control group delivered usual care. The primary outcome for the cost-effectiveness and cost-utility analysis was disability and health-related quality of life, respectively. multilevel analyses among 346 frail older people showed no significant differences between the groups regarding disability and health-related quality of life at 24 months. People in the intervention group used, as expected, more primary care services, but there was no decline in more expensive hospital and long-term care. Total costs over 24 months tended to be higher in the intervention group than in the control group (€26,503 versus €20,550, P = 0.08). the intervention under study led to an increase in healthcare utilisation and related costs without providing any beneficial effects. This study adds to the scarce amount of evidence of the cost-effectiveness of proactive primary care in community-dwelling frail older people. Current Controlled Trials, ISRCTN 31954692. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes.

    PubMed

    Plough, Avery C; Galvin, Grace; Li, Zhonghe; Lipsitz, Stuart R; Alidina, Shehnaz; Henrich, Natalie J; Hirschhorn, Lisa R; Berry, William R; Gawande, Atul A; Peter, Doris; McDonald, Rory; Caldwell, Donna L; Muri, Janet H; Bingham, Debra; Caughey, Aaron B; Declercq, Eugene R; Shah, Neel T

    2017-08-01

    To define, measure, and characterize key competencies of managing labor and delivery units in the United States and assess the associations between unit management and maternal outcomes. We developed and administered a management measurement instrument using structured telephone interviews with both the primary nurse and physician managers at 53 diverse hospitals across the United States. A trained interviewer scored the managers' interview responses based on management practices that ranged from most reactive (lowest scores) to most proactive (highest scores). We established instrument validity by conducting site visits among a subsample of 11 hospitals and established reliability using interrater comparison. Using a factor analysis, we identified three themes of management competencies: management of unit culture, patient flow, and nursing. We constructed patient-level regressions to assess the independent association between these management themes and maternal outcomes. Proactive management of unit culture and nursing was associated with a significantly higher risk of primary cesarean delivery in low-risk patients (relative risk [RR] 1.30, 95% CI 1.02-1.66 and RR 1.47, 95% CI 1.13-1.92, respectively). Proactive management of unit culture was also associated with a significantly higher risk of prolonged length of stay (RR 4.13, 95% CI 1.98-8.64), postpartum hemorrhage (RR 2.57, 95% CI 1.58-4.18), and blood transfusion (RR 1.87, 95% CI 1.12-3.13). Proactive management of patient flow and nursing was associated with a significantly lower risk of prolonged length of stay (RR 0.23, 95% CI 0.12-0.46 and RR 0.27, 95% CI 0.11-0.62, respectively). Labor and delivery unit management varies dramatically across and within hospitals in the United States. Some proactive management practices may be associated with increased risk of primary cesarean delivery and maternal morbidity. Other proactive management practices may be associated with decreased risk of prolonged length of stay, indicating a potential opportunity to safely improve labor and delivery unit efficiency.

  15. 2000 LEPC Survey

    EPA Pesticide Factsheets

    This is the summary report of the 1999 nationwide Local Emergency Planning Committee survey, released in May 2000. It measured their levels of compliance and proactivity, roles in prevention and counter-terrorism, communication, and response plans.

  16. Business owners' action planning and its relationship to business success in three African countries.

    PubMed

    Frese, Michael; Krauss, Stefanie I; Keith, Nina; Escher, Susanne; Grabarkiewicz, Rafal; Luneng, Siv Tonje; Heers, Constanze; Unger, Jens; Friedrich, Christian

    2007-11-01

    A model of business success was developed with motivational resources (locus of control, self-efficacy, achievement motivation, and self-reported personal initiative) and cognitive resources (cognitive ability and human capital) as independent variables, business owners' elaborate and proactive planning as a mediator, and business size and growth as dependent variables. Three studies with a total of 408 African micro and small-scale business owners were conducted in South Africa, Zimbabwe, and Namibia. Structural equation analyses partially supported the hypotheses on the importance of psychological planning by the business owners. Elaborate and proactive planning was substantially related to business size and to an external evaluation of business success and was a (partial) mediator for the relationship between cognitive resources and business success. The model carries important implications for selection, training, and coaching of business owners. (c) 2007 APA

  17. The Role of Affect Spin in the Relationships between Proactive Personality, Career Indecision, and Career Maturity

    PubMed Central

    Park, In-Jo

    2015-01-01

    This study attempted to investigate the influence of proactive personality on career indecision and career maturity, and to examine the moderating effects of affect spin. The author administered proactive personality, career indecision, and career maturity scales to 70 college students. Affect spin was calculated using the day reconstruction method, wherein participants evaluated their affective experiences by using 20 affective terms at the same time each day for 21 consecutive days. Hierarchical regression analyses showed that proactive personality significantly predicted career indecision and career maturity, even after controlling for valence and activation variability, neuroticism, age, and gender. Furthermore, affect spin moderated the associations of proactive personality with career indecision and maturity. The theoretical and practical implications of the moderating effects of affect spin are discussed. PMID:26635665

  18. Night club patrons who feel safe will return: Evidence to encourage management to address club violence

    PubMed Central

    Johnson, Mark B.; Voas, Robert; Miller, Brenda A.; Byrnes, Hilary; Bourdeau, Beth

    2017-01-01

    Introduction There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization’s business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patron’s perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club’s bottom line. Method Data for this study were collected from entry and exit surveys with 1,714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010–2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Results Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. Conclusions The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Practical Applications Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies. PMID:26875162

  19. Social Impact Management Plans: Innovation in corporate and public policy

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

    Franks, Daniel M., E-mail: d.franks@uq.edu.au; Vanclay, Frank, E-mail: frank.vanclay@rug.nl

    Social Impact Assessment (SIA) has traditionally been practiced as a predictive study for the regulatory approval of major projects, however, in recent years the drivers and domain of focus for SIA have shifted. This paper details the emergence of Social Impact Management Plans (SIMPs) and undertakes an analysis of innovations in corporate and public policy that have put in place ongoing processes – assessment, management and monitoring – to better identify the nature and scope of the social impacts that might occur during implementation and to proactively respond to change across the lifecycle of developments. Four leading practice examples aremore » analyzed. The International Finance Corporation (IFC) Performance Standards require the preparation of Environmental and Social Management Plans for all projects financed by the IFC identified as having significant environmental and social risks. Anglo American, a major resources company, has introduced a Socio-Economic Assessment Toolbox, which requires mine sites to undertake regular assessments and link these assessments with their internal management systems, monitoring activities and a Social Management Plan. In South Africa, Social and Labour Plans are submitted with an application for a mining or production right. In Queensland, Australia, Social Impact Management Plans were developed as part of an Environmental Impact Statement, which included assessment of social impacts. Collectively these initiatives, and others, are a practical realization of theoretical conceptions of SIA that include management and monitoring as core components of SIA. The paper concludes with an analysis of the implications for the practice of impact assessment including a summary of key criteria for the design and implementation of effective SIMPs. -- Highlights: • Social impact management plans are effective strategies to manage social issues. • They are developed in partnership with regulatory agencies, investors and community. • SIMPs link assessment to ongoing management and address social and community issues. • SIMPs clarify responsibilities in the management of impacts, opportunities and risks. • SIMPs demonstrate a shift to include management as a core component of SIA practice.« less

  20. Teaching a Systematic Approach for Transitioning Patients to College: An Interactive Continuing Medical Education Program.

    PubMed

    Martel, Adele; Derenne, Jennifer; Chan, Vivien

    2015-10-01

    The purpose of this article is to determine the effectiveness of a hands-on continuing education program for practicing child and adolescent psychiatrists (CAPs) with a focus on best practices in transitioning psychiatric patients to college. The plan was to build on the unique knowledge and skill set of CAPs, use audience and facilitator feedback from prior programs to inform program content, structure, and format, and incorporate findings from the evolving literature. A 3-h interactive workshop was designed with an emphasis on audience participation. The workshop was divided into three main segments: didactics, whole group discussion/brainstorming, and small group discussion of illustrative case vignettes. Improvements and changes in knowledge, skills, and attitudes related to transition planning were identified by program participants. Quantitative feedback in the form of course evaluations, pre- and posttests, and a 6-month follow-up questionnaire indicate that the use of interactive teaching techniques is a productive learning experience for practicing CAPs. Qualitative feedback was that the discussion of the case vignettes was the most helpful. The use of a workshop format is an effective strategy to engage practicing CAPs in learning about and implementing best practices to support the transition of their patients to college and into young adulthood. Comprehensive and proactive transition planning, facilitated by clinicians, should promote the wellness of college-bound patients and help to reduce the potential risks in the setting of an upcoming transition.

  1. Trait impulsivity components correlate differently with proactive and reactive control

    PubMed Central

    Huang, Shihua; Zhu, Zude; Zhang, Wei; Chen, Yu; Zhen, Shuangju

    2017-01-01

    The relationship between impulsivity and cognitive control is still unknown. We hypothesized that trait impulsivity would differentially correlate with specific cognitive control processes. Trait impulsivity was measured by the Barratt Impulsiveness Scale, which assesses motor, attention, and non-planning impulsiveness components. Cognitive control was measured by a hybrid-designed Stroop task, which distinguishes proactive and reactive control. Thirty-three participants performed the Stroop task while they were scanned by functional magnetic resonance imaging. Proactive and reactive control involved increased activity in the fronto-parietal network, and brain activity was associated with impulsivity scores. Specifically, higher motor impulsiveness was associated with a larger proactive control effect in the inferior parietal lobule and a smaller reactive control effect in the right dorsolateral prefrontal cortex (DLPFC) and anterior cingulate contex. Higher attention impulsivity was associated with a smaller proactive control effect in the right DLPFC. Such a correlation pattern suggests that impulsivity trait components are attributable to different cognitive control subsystems. PMID:28423021

  2. Trait impulsivity components correlate differently with proactive and reactive control.

    PubMed

    Huang, Shihua; Zhu, Zude; Zhang, Wei; Chen, Yu; Zhen, Shuangju

    2017-01-01

    The relationship between impulsivity and cognitive control is still unknown. We hypothesized that trait impulsivity would differentially correlate with specific cognitive control processes. Trait impulsivity was measured by the Barratt Impulsiveness Scale, which assesses motor, attention, and non-planning impulsiveness components. Cognitive control was measured by a hybrid-designed Stroop task, which distinguishes proactive and reactive control. Thirty-three participants performed the Stroop task while they were scanned by functional magnetic resonance imaging. Proactive and reactive control involved increased activity in the fronto-parietal network, and brain activity was associated with impulsivity scores. Specifically, higher motor impulsiveness was associated with a larger proactive control effect in the inferior parietal lobule and a smaller reactive control effect in the right dorsolateral prefrontal cortex (DLPFC) and anterior cingulate contex. Higher attention impulsivity was associated with a smaller proactive control effect in the right DLPFC. Such a correlation pattern suggests that impulsivity trait components are attributable to different cognitive control subsystems.

  3. Incident Learning and Failure-Mode-and-Effects-Analysis Guided Safety Initiatives in Radiation Medicine

    PubMed Central

    Kapur, Ajay; Goode, Gina; Riehl, Catherine; Zuvic, Petrina; Joseph, Sherin; Adair, Nilda; Interrante, Michael; Bloom, Beatrice; Lee, Lucille; Sharma, Rajiv; Sharma, Anurag; Antone, Jeffrey; Riegel, Adam; Vijeh, Lili; Zhang, Honglai; Cao, Yijian; Morgenstern, Carol; Montchal, Elaine; Cox, Brett; Potters, Louis

    2013-01-01

    By combining incident learning and process failure-mode-and-effects-analysis (FMEA) in a structure-process-outcome framework we have created a risk profile for our radiation medicine practice and implemented evidence-based risk-mitigation initiatives focused on patient safety. Based on reactive reviews of incidents reported in our departmental incident-reporting system and proactive FMEA, high safety-risk procedures in our paperless radiation medicine process and latent risk factors were identified. Six initiatives aimed at the mitigation of associated severity, likelihood-of-occurrence, and detectability risks were implemented. These were the standardization of care pathways and toxicity grading, pre-treatment-planning peer review, a policy to thwart delay-rushed processes, an electronic whiteboard to enhance coordination, and the use of six sigma metrics to monitor operational efficiencies. The effectiveness of these initiatives over a 3-years period was assessed using process and outcome specific metrics within the framework of the department structure. There has been a 47% increase in incident-reporting, with no increase in adverse events. Care pathways have been used with greater than 97% clinical compliance rate. The implementation of peer review prior to treatment-planning and use of the whiteboard have provided opportunities for proactive detection and correction of errors. There has been a twofold drop in the occurrence of high-risk procedural delays. Patient treatment start delays are routinely enforced on cases that would have historically been rushed. Z-scores for high-risk procedures have steadily improved from 1.78 to 2.35. The initiatives resulted in sustained reductions of failure-mode risks as measured by a set of evidence-based metrics over a 3-years period. These augment or incorporate many of the published recommendations for patient safety in radiation medicine by translating them to clinical practice. PMID:24380074

  4. Incorporating risk communication into highly pathogenic avian influenza preparedness and response efforts.

    PubMed

    Voss, Shauna J; Malladi, Sasidhar; Sampedro, Fernando; Snider, Tim; Goldsmith, Timothy; Hueston, William D; Lauer, Dale C; Halvorson, David A

    2012-12-01

    A highly pathogenic avian influenza (HPAI) outbreak in the United States will initiate a federal emergency response effort that will consist of disease control and eradication efforts, including quarantine and movement control measures. These movement control measures will not only apply to live animals but also to animal products. However, with current egg industry "just-in-time" production practices, limited storage is available to hold eggs. As a result, stop movement orders can have significant unintended negative consequences, including severe disruptions to the food supply chain. Because stakeholders' perceptions of risk vary, waiting to initiate communication efforts until an HPAI event occurs can hinder disease control efforts, including the willingness of producers to comply with the response, and also can affect consumers' demand for the product. A public-private-academic partnership was formed to assess actual risks involved in the movement of egg industry products during an HPAI event through product specific, proactive risk assessments. The risk analysis process engaged a broad representation of stakeholders and promoted effective risk management and communication strategies before an HPAI outbreak event. This multidisciplinary team used the risk assessments in the development of the United States Department of Agriculture, Highly Pathogenic Avian Influenza Secure Egg Supply Plan, a comprehensive response plan that strives to maintain continuity of business. The collaborative approach that was used demonstrates how a proactive risk communication strategy that involves many different stakeholders can be valuable in the development of a foreign animal disease response plan and build working relationships, trust, and understanding.

  5. Strategic Planning for Policy Development--An Evolving Model.

    ERIC Educational Resources Information Center

    Verstegen, Deborah A.; Wagoner, Jennings L., Jr.

    1989-01-01

    Strategic planning, a necessary alternative to logical incrementalism in turbulent environments, will let educators move from a reactive to a proactive posture. This article briefly reviews strategic planning literature, focuses on environmental scanning, and describes an evolving model developed for the chief state school officers of a four-state…

  6. Strategic Planning: Contextual Factors that Facilitated and/or Challenged the Implementation of Strategic Planning in Two Nonprofit Organizations

    ERIC Educational Resources Information Center

    Masilamony, Davadhasan

    2010-01-01

    As the nonprofit sector continues to grow in size and importance in American society, successful organizations proactively initiate strategic planning so they can be more responsive to changing circumstances, underlying trends, and shifting demands. At times, however, organizations develop elaborate plans that are never implemented. Unfortunately,…

  7. Managing travel for planned special events handbook : executive summary

    DOT National Transportation Integrated Search

    2007-06-01

    This report was written to communicate new and proven institutional and high-level operational techniques and strategies for achieving a coordinated, proactive approach to managing travel for all planned special events in a region in addition to faci...

  8. Digital chat reference in health science libraries: challenges in initiating a new service.

    PubMed

    Dee, Cheryl R; Newhouse, Joshua D

    2005-01-01

    Digital reference service adds a valuable new dimension to health science reference services, but the road to implementation can present questions that require carefully considered decisions. This article incorporates suggestions from the published literature, provides tips from interviews with practicing academic health science librarians, and reports on data from students' exploration of academic health science library Web sites' digital reference services. The goal of this study is to provide guidelines to plan new services, assess user needs, and select software, and to showcase potential benefits of collaboration and proactive and user-friendly marketing. In addition, tips for successful operation and evaluation of services are discussed.

  9. Proactivity despite discouraging supervisors: The powerful role of prosocial motivation.

    PubMed

    Lebel, R David; Patil, Shefali V

    2018-03-26

    Although considerable research demonstrates that employees are unlikely to be proactive when they view their supervisors as discouraging this type of behavior, we challenge the assumption that this is true for all employees. Drawing on motivated information processing theory, we argue that prosocial motivation can spark employees to be proactive even when supervisors are perceived as discouraging. Specifically, prosocial motivation may weaken the negative relationship between perceived discouraging supervisor behaviors and proactivity by driving employees to bring about change to impact coworkers or the organization. Because they are less focused on self-interest and more focused on benefitting others, prosocially motivated employees are able to maintain their reason-to (felt responsibility for change) and can-do (efficacy to be proactive) motivation even when supervisors do not welcome proactivity. We test our hypotheses across three studies, using multisource data from employees and supervisors in two organizations (Studies 1a and 1b), and lagged data from employees working in a range of industries (Study 2). By identifying the mechanisms driving prosocially motivated employees to be proactive despite having supervisors who are perceived to be discouraging, we offer novel theoretical and practical insights regarding the effects of context on proactivity at work. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. A Cross-Cultural Examination of Aboriginal and European Canadian Mothers' Beliefs regarding Proactive and Reactive Aggression

    ERIC Educational Resources Information Center

    Cheah, Charissa S. L.; Sheperd, Kelly A.

    2011-01-01

    The purpose of the present study was to examine the maternal beliefs and practices regarding preschool children's proactive and reactive aggression, within a cross-cultural framework. Participants included 30 Aboriginal and 45 European Canadian mothers of preschoolers who provided their emotional reactions, causal attributions, socialization…

  11. Climate change adaptation in regulated water utilities

    NASA Astrophysics Data System (ADS)

    Vicuna, S.; Melo, O.; Harou, J. J.; Characklis, G. W.; Ricalde, I.

    2017-12-01

    Concern about climate change impacts on water supply systems has grown in recent years. However, there are still few examples of pro-active interventions (e.g. infrastructure investment or policy changes) meant to address plausible future changes. Deep uncertainty associated with climate impacts, future demands, and regulatory constraints might explain why utility planning in a range of contexts doesn't explicitly consider climate change scenarios and potential adaptive responses. Given the importance of water supplies for economic development and the cost and longevity of many water infrastructure investments, large urban water supply systems could suffer from lack of pro-active climate change adaptation. Water utilities need to balance the potential for high regret stranded assets on the one side, with insufficient supplies leading to potentially severe socio-economic, political and environmental failures on the other, and need to deal with a range of interests and constraints. This work presents initial findings from a project looking at how cities in Chile, the US and the UK are developing regulatory frameworks that incorporate utility planning under uncertainty. Considering for example the city of Santiago, Chile, recent studies have shown that although high scarcity cost scenarios are plausible, pre-emptive investment to guard from possible water supply failures is still remote and not accommodated by current planning practice. A first goal of the project is to compare and contrast regulatory approaches to utility risks considering climate change adaptation measures. Subsequently we plan to develop and propose a custom approach for the city of Santiago based on lessons learned from other contexts. The methodological approach combines institutional assessment of water supply regulatory frameworks with simulation-based decision-making under uncertainty approaches. Here we present initial work comparing the regulatory frameworks in Chile, UK and USA evaluating their ability to incorporate uncertain climate and other changes into long-term infrastructure investment planning. The potential for regulatory and financial adaptive measures is explored in addition to a discussion on evaluating their appropriateness via various modelling-based intervention decision-making approaches.

  12. A Learning-Based Approach to Reactive Security

    NASA Astrophysics Data System (ADS)

    Barth, Adam; Rubinstein, Benjamin I. P.; Sundararajan, Mukund; Mitchell, John C.; Song, Dawn; Bartlett, Peter L.

    Despite the conventional wisdom that proactive security is superior to reactive security, we show that reactive security can be competitive with proactive security as long as the reactive defender learns from past attacks instead of myopically overreacting to the last attack. Our game-theoretic model follows common practice in the security literature by making worst-case assumptions about the attacker: we grant the attacker complete knowledge of the defender's strategy and do not require the attacker to act rationally. In this model, we bound the competitive ratio between a reactive defense algorithm (which is inspired by online learning theory) and the best fixed proactive defense. Additionally, we show that, unlike proactive defenses, this reactive strategy is robust to a lack of information about the attacker's incentives and knowledge.

  13. The Critical Roles of Task Conflict and Job Autonomy in the Relationship Between Proactive Personalities and Innovative Employee Behavior.

    PubMed

    Giebels, Ellen; de Reuver, Renee S M; Rispens, Sonja; Ufkes, Elze G

    2016-09-01

    We examine why and when proactive personality is beneficial for innovative behavior at work. Based on a survey among 166 employees working in 35 departments of a large municipality in the Netherlands we show that an increase in task conflicts explains the positive relation between a proactive personality and innovative employee behavior. This process is moderated by job autonomy in such a way that the relationship between proactive personality and task conflict is particularly strong under low compared with high autonomy. The present research contributes to the discussion on the potential benefits of task conflict for change processes and highlights the importance of examining the interplay between personality and work context for understanding innovation practices.

  14. Using decision analysis to support proactive management of emerging infectious wildlife diseases

    USGS Publications Warehouse

    Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L. D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieke; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

    2017-01-01

    Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases.

  15. Building Balance: Integrating Interpretive Planning in a Research Institution

    ERIC Educational Resources Information Center

    Hakala, Jim S. H.

    2008-01-01

    Ideally, the process and product of interpretive planning is a living document that serves to guide a museum's interpretation proactively. This case study details the development and resulting benefits of the first institution-wide interpretive plan at the University of Colorado Museum of Natural History. Stimulated by internal growth and change,…

  16. When a Crisis Hits, Will Your School Be Ready?

    ERIC Educational Resources Information Center

    Decker, Robert H.

    This guidebook describes the components involved in proactively developing a comprehensive crisis-management plan. Chapter 1 explains the philosophical underpinnings of a crisis-management plan and discusses the importance of vision and staff development. Chapter 2 answers the questions: Why do we need a crisis-management plan? Who needs to be…

  17. The Critical Roles of Task Conflict and Job Autonomy in the Relationship Between Proactive Personalities and Innovative Employee Behavior

    PubMed Central

    Giebels, Ellen; de Reuver, Renee S.M.; Rispens, Sonja; Ufkes, Elze G.

    2016-01-01

    We examine why and when proactive personality is beneficial for innovative behavior at work. Based on a survey among 166 employees working in 35 departments of a large municipality in the Netherlands we show that an increase in task conflicts explains the positive relation between a proactive personality and innovative employee behavior. This process is moderated by job autonomy in such a way that the relationship between proactive personality and task conflict is particularly strong under low compared with high autonomy. The present research contributes to the discussion on the potential benefits of task conflict for change processes and highlights the importance of examining the interplay between personality and work context for understanding innovation practices. PMID:27536008

  18. Integration of pharmacists into patient-centered medical homes in federally qualified health centers in Texas.

    PubMed

    Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L

    To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider status for pharmacists should be established to sustain this model of care. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  19. Taking a proactive approach to mild to moderate chronic oedema: a case study.

    PubMed

    Jehu, Diane; Jenkins, Linda; Morgan, Karen; Thomas, Melanie J

    2018-02-02

    This case study demonstrates the benefits of early intervention and a proactive approach for a patient with chronic oedema living in the community. These benefited the patient and also supported value-based healthcare in the NHS. The patient's health and wellbeing significantly improved with an assessment of his chronic oedema and a management plan consisting of skincare, an exercise and movement programme and the introduction of a class 1 British standard compression garment.

  20. Advance care planning for cancer patients in primary care: a feasibility study

    PubMed Central

    Boyd, Kirsty; Mason, Bruce; Kendall, Marilyn; Barclay, Stephen; Chinn, David; Thomas, Keri; Sheikh, Aziz; Murray, Scott A

    2010-01-01

    Background Advance care planning is being promoted as a central component of end-of-life policies in many developed countries, but there is concern that professionals find its implementation challenging. Aim To assess the feasibility of implementing advance care planning in UK primary care. Design of study Mixed methods evaluation of a pilot educational intervention. Setting Four general practices in south-east Scotland. Method Interviews with 20 GPs and eight community nurses before and after a practice-based workshop; this was followed by telephone interviews with nine other GPs with a special interest in palliative care from across the UK. Results End-of-life care planning for patients typically starts as an urgent response to clear evidence of a short prognosis, and aims to achieve a ‘good death’. Findings suggest that there were multiple barriers to earlier planning: prognostic uncertainty; limited collaboration with secondary care; a desire to maintain hope; and resistance to any kind of ‘tick-box’ approach. Following the workshop, participants' knowledge and skills were enhanced but there was little evidence of more proactive planning. GPs from other parts of the UK described confusion over terminology and were concerned about the difficulties of implementing inflexible, policy-driven care. Conclusion A clear divide was found between UK policy directives and delivery of end-of-life care in the community that educational interventions targeting primary care professionals are unlikely to address. Advance care planning has the potential to promote autonomy and shared decision making about end-of-life care, but this will require a significant shift in attitudes. PMID:21144189

  1. Using strategic foresight to assess conservation opportunity.

    PubMed

    Cook, Carly N; Wintle, Bonnie C; Aldrich, Stephen C; Wintle, Brendan A

    2014-12-01

    The nature of conservation challenges can foster a reactive, rather than proactive approach to decision making. Failure to anticipate problems before they escalate results in the need for more costly and time-consuming solutions. Proactive conservation requires forward-looking approaches to decision making that consider possible futures without being overly constrained by the past. Strategic foresight provides a structured process for considering the most desirable future and for mapping the most efficient and effective approaches to promoting that future with tools that facilitate creative thinking. The process involves 6 steps: setting the scope, collecting inputs, analyzing signals, interpreting the information, determining how to act, and implementing the outcomes. Strategic foresight is ideal for seeking, recognizing, and realizing conservation opportunities because it explicitly encourages a broad-minded, forward-looking perspective on an issue. Despite its potential value, the foresight process is rarely used to address conservation issues, and previous attempts have generally failed to influence policy. We present the strategic foresight process as it can be used for proactive conservation planning, describing some of the key tools in the foresight tool kit and how they can be used to identify and exploit different types of conservation opportunities. Scanning is an important tool for collecting and organizing diverse streams of information and can be used to recognize new opportunities and those that could be created. Scenario planning explores how current trends, drivers of change, and key uncertainties might influence the future and can be used to identify barriers to opportunities. Backcasting is used to map out a path to a goal and can determine how to remove barriers to opportunities. We highlight how the foresight process was used to identify conservation opportunities during the development of a strategic plan to address climate change in New York State. The plan identified solutions that should be effective across a range of possible futures. Illustrating the application of strategic foresight to identify conservation opportunities should provide the impetus for decision makers to explore strategic foresight as a way to support more proactive conservation policy, planning, and management. © 2014 Society for Conservation Biology.

  2. The Influence of Neurocognitive Functioning on Proactive Coping Behaviors in Adults With HIV.

    PubMed

    Cody, Shameka L; Fazeli, Pariya L; D Moneyham, Linda; Vance, David E

    2016-10-01

    Although many can appreciate the life-sustaining benefits of combination antiretroviral therapy, some adults with HIV continue to have difficulty managing physical, neurocognitive, and everyday stressors. Fortunately, some adults with HIV are able to use accumulated resources (e.g., social networks) to help them engage in proactive coping behaviors such as planning and problem solving. Others, however, manage their stressors by engaging in avoidant coping, isolating themselves, or ruminating about the negative aspects of their situation. Perhaps, the capacity to engage in proactive coping may be influenced by damage to the frontal-striatal-thalamo circuitry, a region of the brain responsible for executive functioning and often compromised in adults with HIV-associated neurocognitive disorders. This study examined potential neurocognitive influences on proactive coping behaviors in adults with HIV (N = 98). Participants were administered a series of neurocognitive and psychosocial measures to determine if neurocognitive functioning and other factors that have been associated with coping in other populations, such as spirituality/religiosity, influenced proactive coping behaviors. Multiple regression analysis revealed that spirituality/religiosity (p = .002), rather than neurocognitive functioning (Useful Field of View, p = .277; Trails A, p = .701; Trails B, p = .365; Wechsler Memory Scale-III Digit Span, p = .864), was a significant predictor of proactive coping. Interventions to address spirituality/religiosity needs of adults with HIV may possibly facilitate proactive coping behaviors and improve mood, both of which are important for healthy neurocognitive functioning.

  3. 75 FR 76345 - Risk Reduction Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... Management Plan Each RRPP must include a Fatigue Management Plan (FMP) that will be designed to reduce the... organizations to develop voluntary proactive safety programs designed to improve railroad safety and build... contractors. A railroad's RRPP may be required to specify how the railroad will periodically review the design...

  4. Crisis Prevention and Response: Is Your School Prepared?

    ERIC Educational Resources Information Center

    Paine, Cathy; Sprague, Jeffrey

    1999-01-01

    This bulletin outlines the major components of a crisis-preparedness and response plan for schools. It lists the critical components of a safe-school plan, such as community coordination, curriculum, proactive student discipline policies and procedures, safe physical environment, school security, staff and student training, evaluation and…

  5. The role of proactive personality in job satisfaction and organizational citizenship behavior: a relational perspective.

    PubMed

    Li, Ning; Liang, Jian; Crant, J Michael

    2010-03-01

    Drawing from a relational approach, the authors conceptualize the quality of leader-member exchange as a mediator and procedural justice climate as a contextual moderator for understanding the role of proactive personality in job satisfaction and organizational citizenship behavior. Data from a sample of 200 Chinese employees within 54 work groups were used to examine the hypothesized models. Results show that having a proactive personality was associated with employees establishing a high-quality exchange relationship with their supervisors; in turn, the quality of leader-member exchange was associated with greater job satisfaction and more organizational citizenship behaviors. Additionally, the relationship between proactive personality and organizational citizenship behavior was positively moderated by procedural justice climate within the group. Implications for management theory and practice are discussed. 2010 APA, all rights reserved

  6. The "is" and the "ought": How do perceived social norms influence safety behaviors at work?

    PubMed

    Fugas, Carla S; Meliá, José L; Silva, Silvia A

    2011-01-01

    Despite a widespread view that social norms have an important contextual influence on health attitudes and behaviors, the impact of normative influences on safety behaviors has received very little attention. The current study proposes that supervisors' and coworkers' descriptive and injunctive safety norms influence proactive and compliance safety behaviors. Longitudinal results from 132 workers in a passenger transportation company support the link between coworkers' descriptive safety norms (at Time 1) and proactive safety practices (at Time 2). Crystallization of supervisor' injunctive safety norms (at Time 2) moderated the effect of coworkers' descriptive safety norms (at Time 1) on self-reported proactive safety behavior (at Time 2). These findings emphasize the differences between supervisors' and coworkers' descriptive and injunctive norms as sources of social influence on compliance and proactive safety behavior.

  7. Bioenergy Research and Strategic Planning: The Need for both Proactive and Reactive research

    USDA-ARS?s Scientific Manuscript database

    Public policy typically refers to governmental actions such as laws, regulatory measures, and funding decisions for a specified issue. As scientists, we should strive to provide unbiased, research information on which strategic planning and long-term goals can be based. However, research can contrib...

  8. Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care.

    PubMed

    Jansen, Daphne L; Heijmans, Monique; Rijken, Mieke

    2015-06-01

    To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care. Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices. A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices. (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC). ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support. Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

  9. Proactive approaches for mold-free interior environments.

    PubMed

    Warsco, Katherine; Lindsey, Patricia F

    2003-08-01

    Interior design education and practice can contribute to the prevention of mold growth in indoor environments. The authors provide an overview of current thinking within the interior design educational and professional communities regarding proactive approaches to achieving mold-free building interiors, including identification of current best practices for the prevention of mold problems in buildings. They also discuss the development of certification programs. A review of recent literature points to the need for interior designers to be educated to specify the use of ecologically sound materials that support the health of building occupants. The authors present trade-offs between best practices for designing mold-free indoor environments (including considerations of cost, maintenance, and operation) and occupant comfort, health, and well-being.

  10. The Nature of Natural Hazards Communication (Invited)

    NASA Astrophysics Data System (ADS)

    Kontar, Y. Y.

    2013-12-01

    Some of the many issues of interest to natural hazards professionals include the analysis of proactive approaches to the governance of risk from natural hazards and approaches to broaden the scope of public policies related to the management of risks from natural hazards, as well as including emergency and environmental management, community development and spatial planning related to natural hazards. During the talk we will present results of scientific review, analysis and synthesis, which emphasize same new trends in communication of the natural hazards theories and practices within an up-to-the-minute context of new environmental and climate change issues, new technologies, and a new focus on resiliency. The presentation is divided into five sections that focus on natural hazards communication in terms of education, risk management, public discourse, engaging the public, theoretical perspectives, and new media. It includes results of case studies and best practices. It delves into natural hazards communication theories, including diffusion, argumentation, and constructivism, to name a few. The presentation will provide information about: (1) A manual of natural hazards communication for scientists, policymakers, and media; (2) An up-to-the-minute context of environmental hazards, new technologies & political landscape; (3) A work by natural hazards scientists for geoscientists working with social scientists and communication principles; (4) A work underpinned by key natural hazards communication theories and interspersed with pragmatic solutions; (5) A work that crosses traditional natural hazards boundaries: international, interdisciplinary, theoretical/applied. We will further explore how spatial planning can contribute to risk governance by influencing the occupation of natural hazard-prone areas, and review the central role of emergency management in risk policy. The goal of this presentation is to contribute to the augmentation of the conceptual framework of risk governance and increase the awareness of practitioners and decision-makers to the need to adopt proactive policies, leading to a more integrated, participative, and adaptive governance that can respond more efficiently to the increasing uncertainty resulting from escalating natural hazards risk exposure.

  11. Begin the Between: Planning for the Transition from High School to Adult Life for Youth with Developmental Disabilities. Second Edition.

    ERIC Educational Resources Information Center

    Matuszak, Trish; And Others

    This guide was developed to provide an overview of the major elements of the transition planning process from school to the adult system of supports and services for youth with developmental disabilities and their families. The workbook format is intended to enable families to be proactive at each stage of the planning process. Initial sections…

  12. Timeless and Timely Advice: A Commentary on "Consultation to Facilitate Planned Organizational Change in Schools," an Article by Joseph E. Zins and Robert J. Illback

    ERIC Educational Resources Information Center

    Hazel, Cynthia E.

    2007-01-01

    This commentary on Zins and Illback's (1995) article, Consultation to Facilitate Planned Organizational Change in Schools, argues that the authors provided a solid foundation for well-planned, proactive, sustainable, internally-driven systemic change in schools that has yet to be widely realized. Their school organizational change model and more…

  13. Doing the right thing without being told: joint effects of initiative climate and general self-efficacy on employee proactive customer service performance.

    PubMed

    Raub, Steffen; Liao, Hui

    2012-05-01

    We developed and tested a cross-level model of the antecedents and outcomes of proactive customer service performance. Results from a field study of 900 frontline service employees and their supervisors in 74 establishments of a multinational hotel chain located in Europe, the Middle East, Africa, and Asia demonstrated measurement equivalence and suggested that, after controlling for service climate, initiative climate at the establishment level and general self-efficacy at the individual level predicted employee proactive customer service performance and interacted in a synergistic way. Results also showed that at the establishment level, controlling for service climate and collective general service performance, initiative climate was positively and indirectly associated with customer service satisfaction through the mediation of aggregated proactive customer service performance. We discuss important theoretical and practical implications of these findings. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  14. Callous unemotional traits and the relationship between aggressive parenting practices and conduct problems in Singaporean families.

    PubMed

    Sng, Khai Imm; Hawes, David J; Raine, Adrian; Ang, Rebecca P; Ooi, Yoon Phaik; Fung, Daniel S S

    2018-05-11

    Research into parenting influences on child conduct problems in Asian countries has been limited compared to that conducted in Western countries, especially with regard to interplay between parenting and callous unemotional (CU) traits (e.g., lack of guilt and empathy). This study examined associations between dimensions of aggressive parenting practices (psychological aggression, mild and severe physical aggression), dimensions of child aggression (proactive, reactive), and child CU traits, in Singapore. Participants were children and adolescents with clinic-referred externalizing problems (N = 282; 87.6% boys), aged 7-16 years. Mild and severe parental physical aggression was found to be uniquely associated with children's proactive aggression, whereas parental psychological aggression was uniquely associated with both proactive and reactive aggression. Consistent with previous evidence regarding CU traits as moderators of the relationship between negative parenting and child conduct problems, physically aggressive parenting was found to be more strongly associated with children's proactive aggression among children with low levels of CU traits, than those with high CU traits. These findings support the need for ongoing research into CU traits in Asian cultures, focused on heterogeneous risk pathways to antisocial behavior and individual differences in response to family-based interventions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Keeping the Language Focus in Content-Based ESL Instruction through Proactive Curriculum-Planning

    ERIC Educational Resources Information Center

    Bigelow, Martha; Ranney, Susan; Dahlman, Anne

    2006-01-01

    For content-based instruction (CBI) to work to its maximum potential, a concerted planning effort must be made to address language objectives, combined with effective instructional strategies that target and assess student performance in relation to those objectives. In this article, after considering various models of content-language…

  16. Using Technology to Facilitate Differentiated High School Science Instruction

    NASA Astrophysics Data System (ADS)

    Maeng, Jennifer L.

    2017-10-01

    This qualitative investigation explored the beliefs and practices of one secondary science teacher, Diane, who differentiated instruction and studied how technology facilitated her differentiation. Diane was selected based on the results of a previous study, in which data indicated that Diane understood how to design and implement proactively planned, flexible, engaging instructional activities in response to students' learning needs better than the other study participants. Data for the present study included 3 h of semi-structured interview responses, 37.5 h of observations of science instruction, and other artifacts such as instructional materials. This variety of data allowed for triangulation of the evidence. Data were analyzed using a constant comparative approach. Results indicated that technology played an integral role in Diane's planning and implementation of differentiated science lessons. The technology-enhanced differentiated lessons employed by Diane typically attended to students' different learning profiles or interest through modification of process or product. This study provides practical strategies for science teachers beginning to differentiate instruction, and recommendations for science teacher educators and school and district administrators. Future research should explore student outcomes, supports for effective formative assessment, and technology-enhanced readiness differentiation among secondary science teachers.

  17. Opportunities to develop the professional role of community pharmacists in the care of patients with asthma: a cross-sectional study

    PubMed Central

    Watkins, Kim; Bourdin, Aline; Trevenen, Michelle; Murray, Kevin; Kendall, Peter A; Schneider, Carl R; Clifford, Rhonda

    2016-01-01

    There are many indications in Australia and globally that asthma management is suboptimal. Ideally, patients need to proactively self-manage the condition with the support of health professionals. Community pharmacists are a highly accessible resource for patients but currently provide inconsistent services. General practitioners also face many barriers to the provision of chronic disease management for asthma patients. The aim of this research was to characterise patients with asthma who present to community pharmacy. The objective was to identify opportunities to develop the role of pharmacists in the context of the primary healthcare setting and in view of the needs of the patients they routinely encounter. The results of a comprehensive survey of 248 patients recruited from community pharmacies indicated there was discordance between patient perceptions of asthma control and actual asthma control. Almost half the patients surveyed had poorly controlled asthma, whereas almost three quarters perceived their asthma to be well or completely controlled. Fewer than 20% of patients were utilising written asthma action plans, and issues around quality use of medicines were identified. The significance of the incongruent perceptions regarding asthma control is that patients are unlikely to proactively seek intervention and support from healthcare professionals. Community pharmacists provide a significant opportunity to address these issues by direct intervention. There is scope to investigate pharmacists preparing written asthma action plans for patients, using software to monitor medication adherence and prescribe on-going medication. To maximise the potential of pharmacists, barriers to practice need to be identified and addressed. PMID:27883003

  18. Super Safety and Health Day at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Employees take a look at this NASCAR auto being displayed during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is '''Safety and Health First.''' KSC's number one goal is to '''Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.'''

  19. Super Safety and Health Day at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Center Director Roy Bridges talks to workers outside the Hazardous Maintenance Facility during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is '''Safety and Health First.''' KSC's number one goal is to '''Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.'''

  20. KSC00pp1578

    NASA Image and Video Library

    2000-10-18

    Center Director Roy Bridges talks to workers outside the Hazardous Maintenance Facility during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  1. KSC-00pp1578

    NASA Image and Video Library

    2000-10-18

    Center Director Roy Bridges talks to workers outside the Hazardous Maintenance Facility during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  2. KSC-00pp1585

    NASA Image and Video Library

    2000-10-18

    Employees at KSC look over a display of work-related shoes in an exhibit tent during Super Safety and Health Day. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  3. KSC00pp1586

    NASA Image and Video Library

    2000-10-18

    Employees take a look at this NASCAR auto being displayed during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  4. KSC00pp1588

    NASA Image and Video Library

    2000-10-18

    In an exhibit tent during Super Safety and Health Day at KSC, employees sample iced tea from a vendor. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of healthand safety-related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  5. KSC00pp1585

    NASA Image and Video Library

    2000-10-18

    Employees at KSC look over a display of work-related shoes in an exhibit tent during Super Safety and Health Day. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  6. KSC-00pp1588

    NASA Image and Video Library

    2000-10-18

    In an exhibit tent during Super Safety and Health Day at KSC, employees sample iced tea from a vendor. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of healthand safety-related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  7. KSC-00pp1586

    NASA Image and Video Library

    2000-10-18

    Employees take a look at this NASCAR auto being displayed during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  8. KSC-00pp1589

    NASA Image and Video Library

    2000-10-18

    Employees gather around a demonstration by Florida Power and Light during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of healthand safety-related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  9. KSC00pp1589

    NASA Image and Video Library

    2000-10-18

    Employees gather around a demonstration by Florida Power and Light during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of healthand safety-related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  10. KSC00pp1579

    NASA Image and Video Library

    2000-10-18

    In the Training Auditorium at KSC, Center Director Roy Bridges addresses attendees at a presentation for Super Safety and Health Day. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  11. KSC-00pp1579

    NASA Image and Video Library

    2000-10-18

    In the Training Auditorium at KSC, Center Director Roy Bridges addresses attendees at a presentation for Super Safety and Health Day. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  12. Super Safety and Health Day at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Employees gather around a demonstration by Florida Power and Light during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health- and safety-related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is '''Safety and Health First.''' KSC's number one goal is to '''Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.'''

  13. Super Safety and Health Day at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    In an exhibit tent during Super Safety and Health Day at KSC, employees sample iced tea from a vendor. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health- and safety-related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is '''Safety and Health First.''' KSC's number one goal is to '''Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.'''

  14. Super Safety and Health Day at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Vendor tents and displays filled the grounds in the Industrial Area as well as LC 39 Area during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is '''Safety and Health First.''' KSC's number one goal is to '''Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.'''

  15. Transit Security Procedures Guide

    DOT National Transportation Integrated Search

    1994-12-01

    To protect passenger, employees, revenue, and property, transit systems are encouraged to take a proactive, prevention-oriented systems approach to transit security. This guide is a compilation of materials for planning and improving transit security...

  16. Land development risks along state transportation corridors.

    DOT National Transportation Integrated Search

    2013-09-01

    Land development that is not coordinated with transportation planning can compromise the performance : of Washingtons state routes. Identifying land at risk for development along state routes can provide : opportunities for proactive, collaborativ...

  17. Native plants for roadside revegetation : field evaluations and best practices identification.

    DOT National Transportation Integrated Search

    2014-02-01

    Establishing native vegetation communities on roadsides can be a proactive approach to sustainable roadways. Revegetation : with native species is the preferred management practice on Idaho roadways. : The environmental and economic benefits of : inc...

  18. Building a Prevention Strategy: Getting Proactive-Getting Results. Preventing Discipline Problems, Unit 1. [Teaching Video, Practice Video, Facilitator's Guide, and Viewer's Guide].

    ERIC Educational Resources Information Center

    1999

    In early childhood settings, an emphasis on preventing discipline problems rather than only dealing with crises as they occur will result in a calmer classroom atmosphere and more teachable time. As Part 1 of a 3-part video series designed to help adults working with 3- to 8-year-olds use a proactive approach to prevent discipline problems, this…

  19. Palliative Care Processes Embedded in the ICU Workflow May Reserve Palliative Care Teams for Refractory Cases.

    PubMed

    Mun, Eluned; Umbarger, Lillian; Ceria-Ulep, Clementina; Nakatsuka, Craig

    2018-01-01

    Palliative Care Teams have been shown to be instrumental in the early identification of multiple aspects of advanced care planning. Despite an increased number of services to meet the rising consultation demand, it is conceivable that the numbers of palliative care consultations generated from an ICU alone could become overwhelming for an existing palliative care team. Improve end-of-life care in the ICU by incorporating basic palliative care processes into the daily routine ICU workflow, thereby reserving the palliative care team for refractory situations. A structured, palliative care, quality-improvement program was implemented and evaluated in the ICU at Kaiser Permanente Medical Center in Hawaii. This included selecting trigger criteria, a care model, forming guidelines, and developing evaluation criteria. These included the early identification of the multiple features of advanced care planning, numbers of proactive ICU and palliative care family meetings, and changes in code status and treatment upon completion of either meeting. Early identification of Goals-of-Care, advance directives, and code status by the ICU staff led to a proactive ICU family meeting with resultant increases in changes in code status and treatment. The numbers of palliative care consultations also rose, but not significantly. Palliative care processes could be incorporated into a daily ICU workflow allowing for integration of aspects of advanced care planning to be identified in a systematic and proactive manner. This reserved the palliative care team for situations when palliative care efforts performed by the ICU staff were ineffective.

  20. Strategic Planning in Distance Education

    ERIC Educational Resources Information Center

    Kilfoil, Wendy R.

    2003-01-01

    The purpose of strategic planning is to align the institution with the external environment. In fact, it is a complex solution to a complex problem. Environmental change is inevitable and it will always impact one's institution sooner or later. It is better to be proactive, thoughtful, and in charge of change, than to be always in a reactive mode…

  1. Preventative services offered by veterinarians on sheep farms in England and Wales: Opinions and drivers for proactive flock health planning.

    PubMed

    Bellet, Camille; Woodnutt, Joanna; Green, Laura E; Kaler, Jasmeet

    2015-12-01

    Recent independent UK government reports and studies have highlighted the importance, but lack, of flock health services provided by veterinarians. Qualitative interviews were analysed by thematic analysis to construct belief statements to understand veterinarians' opinions on preventative advice and drivers for current services to sheep farmers. A postal questionnaire was sent to 515 sheep practices registered with the Royal College of Veterinary Surgeon (RCVS) in England and Wales in 2012 to gather quantitative data on these belief statements and to gather demographic information and current services provided by the veterinarian. Exploratory factor analysis with heuristic approaches was conducted on the respondents' belief statements to identify common factors of veterinarian beliefs. Three main factors were identified: motivation for proactiveness, perceived capability to offer preventative services and perceived opportunity to deliver these services. A beta regression model was built to identify the factors significantly associated with the time veterinarians spent in an advisory role. The relative proportion of time increased by 10% (1.01-1.19), 16% (1.03-1.30) and 29% (CI: 1.09-1.53) for each unit increase in score for factor 1 motivation, factor 2 capability and factor 3 opportunity respectively, indicating that these latent factors explained time veterinarians spent in an advisory role with sheep clients. There was a significant correlation between these factors suggesting influence of the associated beliefs between factors. This study provides insight into the nature and drivers of veterinarians' current behaviour and beliefs. These results could be further tested in behaviour intervention studies and help in designing efficient strategies aiming at promoting proactive health services offered by veterinarians on sheep farms in England and Wales. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. [Implementation of a proactive integrated primary care program for frail older people: from science to evidence-based practice].

    PubMed

    Bleijenberg, Nienke; de Jonge, Artine; Brand, Morris P; O'Flynn, Caitriona; Schuurmans, Marieke J; de Wit, Niek J

    2016-12-01

    Multimorbidity, functional impairment and frailty among community-dwelling older people are causing increasing complexity in primary care. A proactive integrated primary care approach is therefore essential. Between October 2014-2015, an evidence-based proactive care program for frail older people was implemented in the region Noord-West Veluwe en Zeewolde, the Netherlands. This study evaluated the feasibility of the implementation, having a strong focus on the collaboration between the medical and social domain. Using a mixed-methods design we evaluated several process indicators. Data were obtained from electronic routine medical record data within primary care, questionnaires, and interviews with older adults. The questionnaires provided information regarding the expectations and experiences towards the program and were sent to health care professionals at baseline and six months follow-up. Stakeholders from various domains were asked to fill in the questionnaire at baseline and twelve months follow-up. Interviews were conducted to explore the experiences of older adults with the program. Regional work groups were set up in each municipality to enhance the interdisciplinary and domain transcending collaboration. The proactive primary care program was implemented in 42 general practices who provided care to 7904 older adults aged 75 years or older. A total of 101 health care professionals and 44 stakeholders filled in the questionnaires. The need for better structure and interdisciplinary cooperation seemed widespread among the participants. The implementation resulted in a positive significant change in the demand for a better regional healthcare-framework (34% p ≤ .001) among health care professionals, and the needs for transparency regarding the possibilities for referral improved (27% , p = .009). Half of the participants reported that the regional collaboration has been improved after the implementation. Health care professionals and stakeholders gained increased attention and awareness of frail elderly in their area compared to before the implementation. Older people and their caregivers were positive about the proactive approach. The nurses reported that the screenings questionnaire was too lengthy and therefore time consuming. The implementation of the proactive primary care approach in daily practice was feasible. A strong interdisciplinary collaboration was realized. The program was easily adapted to the local context.

  3. Transforming data into action: the Sonoma County Human Services Department.

    PubMed

    Harrison, Lindsay

    2012-01-01

    In order to centralize data-based initiatives, the Director of the Department worked with the Board of Supervisors and the executive team to develop a new Planning, Research, and Evaluation (PRE) division. PRE is establishing rules for data-based decision making and consolidating data collection to ensure quality and consistency. It aims to target resources toward visionary, pro-active program planning and implementation, and inform the public about the role of Human Services in creating a healthy, safe and productive environment. PRE staff spent several months studying the job functions of staff, to determine how they use information to inform practice, consulting other counties about their experiences. The PRE team developed Datascript, outlining two agency aims: (a) foster a decision-making environment that values and successfully uses empirical evidence for strategic change, and (b) manage the role and image of the Human Services Department in the external environment. The case study describes action steps developed to achieve each aim. Copyright © Taylor & Francis Group, LLC

  4. Examining How Proactive Management and Culturally Responsive Teaching Relate to Student Behavior: Implications for Measurement and Practice

    ERIC Educational Resources Information Center

    Larson, Kristine E.; Pas, Elise T.; Bradshaw, Catherine P.; Rosenberg, Michael S.; Day-Vines, Norma L.

    2018-01-01

    The discipline gap between White students and African American students has increased demand for teacher training in culturally responsive and behavior management practices. Extant research, however, is inconclusive about how culturally responsive teaching practices relate to student behavior or how to assess using such practices in the classroom.…

  5. Nurse manager succession planning: a concept analysis.

    PubMed

    Titzer, Jennifer L; Shirey, Maria R

    2013-01-01

    The current nursing leadership pipeline is inadequate and demands strategic succession planning methods. This article provides concept clarification regarding nurse manager succession planning. Attributes common to succession planning include organizational commitment and resource allocation, proactive and visionary leadership approach, and a mentoring and coaching environment. Strategic planning, current and future leadership analysis, high-potential identification, and leadership development are succession planning antecedents. Consequences of succession planning are improved leadership and organizational culture continuity, and increased leadership bench strength. Health care has failed to strategically plan for future leadership. Developing a strong nursing leadership pipeline requires deliberate and strategic succession planning. © 2013 Wiley Periodicals, Inc.

  6. Proactive and retroactive transfer of middle age adults in a sequential motor learning task.

    PubMed

    Verneau, Marion; van der Kamp, John; Savelsbergh, Geert J P; de Looze, Michiel P

    2015-03-01

    We assessed the effects of aging in the transfer of motor learning in a sequential manual assembly task that is representative for real working conditions. On two different days, young (18-30 years) and middle-aged adults (50-65 years) practiced to build two products that consisted of the same six components but which had to be assembled in a partly different order. Assembly accuracy and movement time during tests, which were performed before and after the practice sessions, were compared to determine proactive and retroactive transfer. The results showed proactive facilitation (i.e., benefits from having learned the first product on learning the second one) in terms of an overall shortening of movement time in both age-groups. In addition, only the middle-aged adults were found to show sequence-specific proactive facilitation, in which the shortening of movement time was limited to components that had the same the order in the two products. Most likely, however, the sequence-specific transfer was an epiphenomenon of the comparatively low rate of learning among the middle-aged adults. The results, however, did reveal genuine differences between the groups for retroactive transfer (i.e., effects from learning the second product on performance of the first). Middle-aged adults tended to show more pronounced retroactive interference in terms of a general decrease in accuracy, while younger adults showed sequence-specific retroactive facilitation (i.e., shortening of movement times for components that had the same order in the two products), but only when they were fully accurate. Together this suggests that in the learning of sequential motor tasks the effects of age are more marked for retroactive transfer than for proactive transfer. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Prioritized packet video transmission over time-varying wireless channel using proactive FEC

    NASA Astrophysics Data System (ADS)

    Kumwilaisak, Wuttipong; Kim, JongWon; Kuo, C.-C. Jay

    2000-12-01

    Quality of video transmitted over time-varying wireless channels relies heavily on the coordinated effort to cope with both channel and source variations dynamically. Given the priority of each source packet and the estimated channel condition, an adaptive protection scheme based on joint source-channel criteria is investigated via proactive forward error correction (FEC). With proactive FEC in Reed Solomon (RS)/Rate-compatible punctured convolutional (RCPC) codes, we study a practical algorithm to match the relative priority of source packets and instantaneous channel conditions. The channel condition is estimated to capture the long-term fading effect in terms of the averaged SNR over a preset window. Proactive protection is performed for each packet based on the joint source-channel criteria with special attention to the accuracy, time-scale match, and feedback delay of channel status estimation. The overall gain of the proposed protection mechanism is demonstrated in terms of the end-to-end wireless video performance.

  8. Environmental strategy and performance in small firms: a resource-based perspective.

    PubMed

    Aragón-Correa, J Alberto; Hurtado-Torres, Nuria; Sharma, Sanjay; García-Morales, Víctor J

    2008-01-01

    In spite of the widespread recognition of the important roles that small and medium sized enterprises (SMEs) play in most economies, limited research has focused on their impacts on the natural environment and the strategies such enterprises adopt to reduce these impacts. It is usually assumed that SMEs lack the resources to implement proactive environmental strategies that go beyond minimum regulatory compliance. In this study of 108 SMEs in the automotive repair sector in Southern Spain, we found that SMEs undertake a range of environmental strategies from reactive regulatory compliance to proactive pollution prevention and environmental leadership. These strategies are associated with three organizational capabilities: shared vision, stakeholder management, and strategic proactivity, hypothesized based on the unique strategic characteristics of SMEs--shorter lines of communication and closer interaction within the SMEs, the presence of a founder's vision, flexibility in managing external relationships, and an entrepreneurial orientation. We also found that firms with the most proactive practices exhibited a significantly positive financial performance.

  9. Visual Working Memory Capacity and Proactive Interference

    PubMed Central

    Hartshorne, Joshua K.

    2008-01-01

    Background Visual working memory capacity is extremely limited and appears to be relatively immune to practice effects or the use of explicit strategies. The recent discovery that visual working memory tasks, like verbal working memory tasks, are subject to proactive interference, coupled with the fact that typical visual working memory tasks are particularly conducive to proactive interference, suggests that visual working memory capacity may be systematically under-estimated. Methodology/Principal Findings Working memory capacity was probed behaviorally in adult humans both in laboratory settings and via the Internet. Several experiments show that although the effect of proactive interference on visual working memory is significant and can last over several trials, it only changes the capacity estimate by about 15%. Conclusions/Significance This study further confirms the sharp limitations on visual working memory capacity, both in absolute terms and relative to verbal working memory. It is suggested that future research take these limitations into account in understanding differences across a variety of tasks between human adults, prelinguistic infants and nonlinguistic animals. PMID:18648493

  10. Visual working memory capacity and proactive interference.

    PubMed

    Hartshorne, Joshua K

    2008-07-23

    Visual working memory capacity is extremely limited and appears to be relatively immune to practice effects or the use of explicit strategies. The recent discovery that visual working memory tasks, like verbal working memory tasks, are subject to proactive interference, coupled with the fact that typical visual working memory tasks are particularly conducive to proactive interference, suggests that visual working memory capacity may be systematically under-estimated. Working memory capacity was probed behaviorally in adult humans both in laboratory settings and via the Internet. Several experiments show that although the effect of proactive interference on visual working memory is significant and can last over several trials, it only changes the capacity estimate by about 15%. This study further confirms the sharp limitations on visual working memory capacity, both in absolute terms and relative to verbal working memory. It is suggested that future research take these limitations into account in understanding differences across a variety of tasks between human adults, prelinguistic infants and nonlinguistic animals.

  11. From a "perfect storm" to "smooth sailing": policymaker perspectives on implementation and sustainment of an evidence-based practice in two states.

    PubMed

    Willging, Cathleen E; Green, Amy E; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A

    2015-02-01

    Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. © The Author(s) 2014.

  12. From a “Perfect Storm” to “Smooth Sailing”: Policymaker Perspectives on Implementation and Sustainment of an Evidence-Based Practice in Two States

    PubMed Central

    Willging, Cathleen E.; Green, Amy E.; Gunderson, Lara; Chaffin, Mark; Aarons, Gregory A.

    2015-01-01

    Policymakers shape implementation and sustainment of evidence-based practices (EBPs), whether they are developing or responding to legislation and policies or negotiating public sector resource constraints. As part of a large mixed-method study, we conducted qualitative interviews with 24 policymakers involved in delivery of the same EBP in two U.S. states. We analyzed transcripts via open and focused coding techniques to identify the commonality, diversity, and complexity of implementation challenges; approaches to overcoming those challenges; and the importance of system-level contextual factors in ensuring successful implementation. Key findings centered on building support and leadership for EBPs; funding and contractual strategies; partnering with stakeholders; tackling challenges via proactive planning and problem solving; and the political, legal, and systemic pressures affecting EBP longevity. The policymaker perspectives offer guidance on nurturing system and organizational practice environments to achieve positive outcomes and for optimally addressing macro-level influences that bear upon the instantiation of EBPs in public sector child welfare systems. PMID:25125232

  13. China’s Defense Industry on the Path of Reform

    DTIC Science & Technology

    2009-10-01

    Strategy” (三三三转型升级 战 略). The strategy calls for a proactive approach to the development of three markets simultaneously: military, civilian, and foreign. 46...Plan to Leap Ahead in Core Competitive Power” (核心竞 争 力跃升计划). According to the plan, CETC called for strengthening the competitive power of products in

  14. A Residence Life Plan for Success for At-Risk College Students: Reviving "In Loco Parentis"

    ERIC Educational Resources Information Center

    Johnson, Marques; Flynn, Ellen; Monroe, Maxine

    2016-01-01

    In this study, we explored whether a residence life plan designed to meet the academic and psychosocial development of at-risk housing students, where oversight and support were provided on a weekly basis, and a proactive, intrusive counseling approach was implemented, would be effective for academic success. Participants included 74 urban at-risk…

  15. Early outreach to survivors of the shootings in Norway on the 22nd of July 2011

    PubMed Central

    Dyb, Grete; Jensen, Tine; Glad, Kristin Alve; Nygaard, Egil; Thoresen, Siri

    2014-01-01

    Background Under-treatment and unmet needs among survivors have been documented years after terror attacks. Improved early and proactive outreach strategies, including targeted interventions for individuals in need, are required. After the terrorist attacks in Norway on 22 July 2011, a national, proactive outreach strategy was developed and implemented to help those who were directly affected. Objectives The aims of this study were threefold: (1) to investigate whether the survivors at the island of Utøya had received proactive outreach from the municipalities, (2) to examine the relationships between received health services and the survivors’ level of exposure and post-trauma health problems, and (3) to explore the level of unmet needs among survivors 5 months post-terror. Methods Three hundred and twenty five survivors (M age=19.4, SD=4.6, 47.1% females, response rate 66%) of the 2011 massacre on Utøya Island, Norway, were interviewed face-to-face 4–5 months post-terror. The survivors were asked if they had received proactive outreach from their municipality, and what type of health services they had received. Survivors’ level of peri-trauma exposure, loss and injury, posttraumatic stress reactions, symptoms of anxiety and depression, somatic health problems, and sick leave, were assessed. Results Most participants (87%) reported that they had received early and proactive outreach, and most (84%) had a contact person. In addition a majority of the survivors has received support from their general practitioner (63%), or other municipal help services (66%). Specialized mental health services by psychiatrists or psychologists had been provided to 73.1% of the survivors. Survivors who had been referred to specialized mental health services reported higher levels of exposure to trauma, posttraumatic stress reactions, depression and anxiety, and somatic health problems, compared to non-receivers of such services. Forty-three survivors (14%) reported unmet needs for services. Conclusion In accordance with the national strategy, the vast majority of the participants in this study had received an early and proactive outreach and targeted responses from specialized mental health services had been provided to survivors in need of more extensive help. However, an important minority of the participants had not been reached as planned. The knowledge from this study may guide professionals and decision makers in planning for future disasters and improve the levels of care. PMID:25018858

  16. Professionalism and clinical autonomy in the practice of medicine.

    PubMed

    Morreim, E Haavi

    2002-11-01

    Professionalism in medicine requires a reasonable measure of freedom for physicians to determine patients needs based on their own judgment. However, because virtually every medical decision is also a spending decision, third-party payers concerned about rising health care costs have introduced cost-containment tactics that significantly limit physicians accustomed autonomy. In response, groups of physicians have filed class-action lawsuits against managed care plans, alleging causes of action such as fraud, breach of contract, extortion, and violations of federal RICO (Racketeer-Influenced and Corrupt Organizations) law. Such litigation may have merits, but it also faces significant obstacles, in part because the contracts involved may not actually have promised the broad measure of clinical autonomy that the physicians allege was promised, then denied. As physicians seek to restore and retain their professional autonomy, it will be important for them to be increasingly proactive in structuring or modifying the contracts under whose terms they practice as some physicians have successfully done.

  17. KSC-00pp1580

    NASA Image and Video Library

    2000-10-18

    In the Training Auditorium at KSC, Brig. General Donald P. Pettit, commander of the 45th Space Wing, speaks to attendees at a presentation for Super Safety and Health Day. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  18. KSC-00pp1587

    NASA Image and Video Library

    2000-10-18

    Vendor tents and displays filled the grounds in the Industrial Area as well as LC 39 Area during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  19. KSC00pp1587

    NASA Image and Video Library

    2000-10-18

    Vendor tents and displays filled the grounds in the Industrial Area as well as LC 39 Area during Super Safety and Health Day at KSC. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  20. KSC-00pp1584

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, workers from Florida Power and Light (at left) demonstrate to an interested group of KSC employees how they safely handle high power lines. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  1. KSC00pp1580

    NASA Image and Video Library

    2000-10-18

    In the Training Auditorium at KSC, Brig. General Donald P. Pettit, commander of the 45th Space Wing, speaks to attendees at a presentation for Super Safety and Health Day. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  2. KSC00pp1584

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, workers from Florida Power and Light (at left) demonstrate to an interested group of KSC employees how they safely handle high power lines. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  3. Facilitating Medication Adherence in Patients with Multiple Sclerosis

    PubMed Central

    Rodriguez, Yolanda; Logan, Diana; Williamson, Caroline; Treadaway, Katherine

    2013-01-01

    This article reviews adherence to medication in multiple sclerosis (MS) patients from the perspective of nurse and social worker authors. It reviews data on patient adherence and offers practical, evidence-based strategies that health-care providers can use to facilitate adherence. In addition, it examines how emerging MS therapies may affect patient adherence and associated interventions. To promote adherence, interventions need to incorporate new and creative approaches. A proactive approach includes assessing patient needs and lifestyle before the start of medication and selecting the most appropriate disease-modifying therapy for each individual patient. Including multidisciplinary expertise and services in the treatment plan can be part of a comprehensive, holistic approach to helping patients and families. Optimization of health-care provider roles is likely to facilitate improved adherence. PMID:24453761

  4. Reforming the health care system: implications for health care marketers.

    PubMed

    Petrochuk, M A; Javalgi, R G

    1996-01-01

    Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.

  5. Can business impact analysis play a meaningful role in planning a cost-saving programme?

    PubMed

    Wright, Trevor

    2011-02-01

    Business continuity as it exists today would appear to have reached something of a plateau. Considering the history of the discipline, and how it has developed from 'simple' disaster recovery to its present position, it is clear that the trend has been to move from a reactive discipline to a proactive process. Following on from this broadly-accepted point, it is perhaps time to consider how the discipline may develop and what wider and deeper contribution the business continuity profession may make to add further value for our clients. In the present climate, it seems appropriate to consider how (and if) business continuity practice can make a meaningful contribution to a cost saving exercise. The public and private sectors are considered and the differences are compared.

  6. Community College Library Practices in Developmental Education

    ERIC Educational Resources Information Center

    Roselle, Ann

    2008-01-01

    This qualitative study examines current community college library practices in developmental education. Based on semistructured telephone interviews with 27 librarians across the United States, analysis of the results shows that there are librarians who proactively integrate basic library skills into developmental education and academic success…

  7. Physician views on practicing professionalism in the corporate age.

    PubMed

    Castellani, B; Wear, D

    2000-07-01

    Arnold Relman argues that medical education does not prepare students and residents to practice their profession in today's corporate health care system. Corporate health care administrators agree: Physicians enter the workforce unskilled in contract negotiation, evidence-based medicine, navigating bureaucratic systems, and so forth. What about practicing physicians? Do they agree as well? According to this study, they do. Feeling like decentered double agents and unprepared, physicians find themselves professionally lost, struggling to balance issues of cost and care and expressing lots of negativity toward the cultures of medicine and managed care. However, physicians are resilient. A group of physicians, who may be called proactive, are meeting the professional demands of corporate health care by becoming sophisticated about its bureaucratic organization and the ways in which their professional and personal commitments fit within the system. Following the lead of proactive physicians, the authors support Relman's thesis and education for both students and physicians requires a major overhaul.

  8. Public Relations and Marketing.

    ERIC Educational Resources Information Center

    Savage, Daniel D.

    1987-01-01

    Urges community colleges to adopt pro-active public relations strategies. Examines the role of the public information officer in such areas as coordination of public relations and marketing activities, relations with media, and the development of a comprehensive public relations plan. (AYC)

  9. Engaging youth in research planning, design and execution: Practical recommendations for researchers.

    PubMed

    Hawke, Lisa D; Relihan, Jacqueline; Miller, Joshua; McCann, Emma; Rong, Jessica; Darnay, Karleigh; Docherty, Samantha; Chaim, Gloria; Henderson, Joanna L

    2018-06-01

    Engaging youth as partners in academic research projects offers many benefits for the youth and the research team. However, it is not always clear to researchers how to engage youth effectively to optimize the experience and maximize the impact. This article provides practical recommendations to help researchers engage youth in meaningful ways in academic research, from initial planning to project completion. These general recommendations can be applied to all types of research methodologies, from community action-based research to highly technical designs. Youth can and do provide valuable input into academic research projects when their contributions are authentically valued, their roles are clearly defined, communication is clear, and their needs are taken into account. Researchers should be aware of the risk of tokenizing the youth they engage and work proactively to take their feedback into account in a genuine way. Some adaptations to regular research procedures are recommended to improve the success of the youth engagement initiative. By following these guidelines, academic researchers can make youth engagement a key tenet of their youth-oriented research initiatives, increasing the feasibility, youth-friendliness and ecological validity of their work and ultimately improve the value and impact of the results their research produces. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  10. Developing physician referrals for the new physician: techniques to market your physician's practice.

    PubMed

    Schwarz, Chad; Baum, Neil

    2011-01-01

    New physicians will need to be proactive to market and promote their practices. Generating referrals from colleagues is one of the best ways to attract new patients to a start-up practice. This article will provide techniques that will help new physicians enhance their relationships with their colleagues in the community.

  11. Development by Design in Colombia: Making Mitigation Decisions Consistent with Conservation Outcomes

    PubMed Central

    Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

    2013-01-01

    Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition. PMID:24339972

  12. Development by design in Colombia: making mitigation decisions consistent with conservation outcomes.

    PubMed

    Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

    2013-01-01

    Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition.

  13. Is outcome responsibility at work emotionally exhausting? Investigating employee proactivity as a moderator.

    PubMed

    Schmitt, Antje; Den Hartog, Deanne N; Belschak, Frank D

    2015-10-01

    This study investigates the relationship between outcome responsibility and employees' well-being in terms of emotional exhaustion. Outcome responsibility is a job demand implying that employees' decisions at work have high material and/or nonmaterial consequences. Previous research indicates that outcome responsibility can have both positive and negative effects on employee well-being. Based on the person-job fit approach we hypothesize that whether or not outcome responsibility is positively or negatively related to emotional exhaustion depends on whether employees' behavioral style fits with this job demand. We investigate the role of proactive behavior as a personal resource that fits with high responsibility. We test our hypothesis in a multisource study among 138 employee-colleague dyads. Results of hierarchical moderated regression analysis reveal that peer-rated proactive behavior moderates the relationship between outcome responsibility and emotional exhaustion, such that the relationship is negative for employees showing high and nonsignificant for employees showing low proactivity. This finding holds also when controlling for trait positive and negative affect. The current study contributes to previous research on job design, proactivity, and occupational well-being and offers practical implications in terms of selection and training of employees for jobs high in outcome responsibility. (c) 2015 APA, all rights reserved).

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

    PubMed

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

    2017-06-01

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

  15. The associations between parenting styles and proactive and reactive aggression in Hong Kong children and adolescents.

    PubMed

    Gao, Yu; Zhang, Wei; Fung, Annis Lai Chu

    2015-12-01

    Previous research suggests that reactive and proactive aggression may be differentially related to family contextual (e.g. parenting practices) factors. However, the existing research has focused largely on children and adolescents from Western countries, and no study has examined the parenting-aggression association using a parenting style measure sensitive to Asian culture. In this study parenting styles (i.e. warmth, control and guan/training) and proactive and reactive aggression were assessed in a large sample of school children in Hong Kong, China (N = 4,175, mean age = 11.75). We found that: (a) both low warmth (in boys only) and guan (i.e. high expectation and close supervision, in both boys and girls) were associated with elevated parent-reported proactive aggression, (b) high restrictive control (i.e. dominating and rejecting) was associated with high reactive aggression (in both boys and girls) based on parent- or child-report data, and with high proactive aggression (in boys only) based on parent-report data, and (c) guan was also positively associated with parent-reported reactive aggression. Findings provide more information about the Parenting Inventory using a large Asian sample, and extend existing research on familial correlates of different types of aggression. © 2014 International Union of Psychological Science.

  16. Renewable Energy Zone (REZ) Transmission Planning Process

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

    Lee, Nathan

    A REZ is a geographical area that enables the development of profitable, cost-effective, grid-connected renewable energy (RE). The REZ Transmission Planning Process is a proactive approach to plan, approve, and build transmission infrastructure connecting REZs to the power system which helps to increase the share of solar, wind and other RE resources in the power system while maintaining reliability and economics, and focuses on large-scale wind and solar resources that can be developed in sufficient quantities to warrant transmission system expansion and upgrades.

  17. Federal and tribal lands road safety audits : case studies

    DOT National Transportation Integrated Search

    2009-12-01

    A road safety audit (RSA) is a formal safety performance examination by an independent, multidisciplinary team. RSAs are an effective tool for proactively improving the safety performance of a road project during the planning and design stages, and f...

  18. Strategies for flood hazard adaptation in drought affected regions of Afghanistan

    NASA Astrophysics Data System (ADS)

    Schleupner, Christine

    2010-05-01

    The development and management of water resources in Afghanistan are critically important for the economic development of the country. But Afghanistan presents a number of specific challenges in terms of water resource management and climate change impact assessment. Political instability and war has caused widespread devastation, insecurity, displacement, poverty and severe environmental degradation. Recent droughts have led to the collapse of many livelihoods, and poor national security restricts structured fieldwork. The recent restructuring and rebuilding of the state can be seen as opportunity to integrate climate change mitigation and adaptation measures into national, regional, and local planning. Governmental organizations are responsible to integrate climate change related issues and pro-active planning processes in water management and environmental considerations into relevant legislations, ministry and sector strategies. Integrated water resource management has been practically nonexistent during the last decades and consideration of climate change impacts are widely ignored in regional planning processes. However, flooding, landslides, drought, and extreme heat and freezing weather are already threatening the population. Climate models suggest that Afghanistan will be confronted by an increase of these events. Desertification and land degradation but also floods due to untimely rainfall are expected to broaden. Studies show that the impact of increasingly frequent flash floods may be amplified due to more rapid spring snow melt as a result of higher temperatures, combined with the downstream effects of land degradation, loss of vegetative cover and land mismanagement. It is further exacerbated by drought, which has the effect of hardening soils and reducing their permeability. In 2007 heavy floods already destroyed fields and harvests, killed livestock, damaged buildings, and claimed many lives. The intensified climatic conditions in Afghanistan will continue to impact upon society by creating stresses for specific vulnerable groups. This study discusses and compares existing policies, legislations and strategies considering flood adaptation planning in Afghanistan. It reviews available Flood Hazard Maps and reflects on regional adaptation options. Present and future vulnerability to flooding is assessed through a GIS-based model by using scenario techniques. A strategy is developed how to implement measures into regional and integrated water resource management planning. In general, not a single but the selection of multiple measures will be successful in pro-active planning for climate change adaptation. In this regard a continuous consultation with stakeholders needs to take place to address their demands. Thus the results of this study cannot give solutions but might build the basis for recommended active planning processes.

  19. The inhibition of proactive interference among adults with Internet gaming disorder.

    PubMed

    Ko, Chih-Hung; Wang, Peng-Wei; Liu, Tai-Ling; Yen, Cheng-Fang; Chen, Cheng-Sheng; Yen, Ju-Yu

    2015-06-01

    Cognitive control plays a pivotal role in the mechanism of addictive behavior. The aim of the study was to evaluate the deficit in inhibition of proactive interference of Internet gaming disorder (IGD) using a directed forgetting task among young adults. A total of 64 participants with IGD and 69 controls were recruited on a university campus. They completed the directed forgetting task for online gaming words and neutral words. The results demonstrated that the IGD group had a poorer performance on the directed forgetting task, and this represented a deficit in inhibition of proactive interference. They also had a higher tendency to remember online gaming words rather than neutral words in comparison with the control group. This demonstrated memory bias toward online gaming words. These results suggested that more attention should be paid to deficits in inhibition of proactive interference and memory bias toward gaming content when treating subjects with IGD. Furthermore, it is essential and practical to prevent exposure to online gaming-related cues when endeavoring to control online gaming behavior. © 2014 Wiley Publishing Asia Pty Ltd.

  20. School Social Work in Louisiana: A Model of Practice

    ERIC Educational Resources Information Center

    Richard, Laura A.; Villarreal Sosa, Leticia

    2014-01-01

    Although the role of the school social worker has historically been inconsistent, fragmented, and contextual, concerns about the need to advocate for school social work positions, demonstrate the effectiveness of school social work practice, understand the consequences of role ambiguity, and respond in a proactive way to policy changes has…

  1. Restorative Justice: Pedagogy, Praxis, and Discipline

    ERIC Educational Resources Information Center

    Morrison, Brenda E.; Vaandering, Dorothy

    2012-01-01

    In the ongoing effort of designing school contexts in support of proactive discipline, a range of practices and theoretical frameworks have been advanced, from behaviorist approaches to social and emotional learning. This article describes the theory and practice of restorative justice with the aim of defining this distinctive paradigm, in…

  2. Relational Restorative Justice Pedagogy in Educator Professional Development

    ERIC Educational Resources Information Center

    Vaandering, Dorothy

    2014-01-01

    What would a professional development experience rooted in the philosophy, principles, and practices of restorative justice look and feel like? This article describes how such a professional development project was designed to implement restorative justice principles and practices into schools in a proactive, relational and sustainable manner by…

  3. Diminishing Manufacturing Sources and Material Shortages: A Guidebook of Best Practices and Tools for Implementing a DMSMS Management Program

    DTIC Science & Technology

    2009-09-01

    investment and breakeven point ( BEP ).Two analysts could look at the same data and generate different outcomes if they use different assumptions or modeling...solution. You can then estimate the cost, by year, of a proactive approach to DMSMS management. One principal output of the BCA is the BEP , which shows...approach.The BEP — the point at which the plot crosses the x-axis, as shown in Figure 4—signifies that the cumula- tive investment in the proactive

  4. Insurance in a Climate of Change

    Science.gov Websites

    advancing innovative and proactive solutions. This website compiles information about The impacts of climate of "green" technologies and practices Overview articles in the journal Science: Impacts

  5. Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives

    PubMed Central

    Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen

    2014-01-01

    Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from “a good idea” to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. PMID:25018637

  6. Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.

    PubMed

    Morris, Joanne; Grimmer, Karen; Gilmore, Lisa; Perera, Chandima; Waddington, Gordon; Kyle, Greg; Ashman, Bryan; Murphy, Karen

    2014-01-01

    Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes.

  7. Diagnosis of retrofit fatigue crack re-initiation and growth in steel-girder bridges for proactive repair and emergency planning.

    DOT National Transportation Integrated Search

    2014-07-01

    This report presents a vibration : - : based damage : - : detection methodology that is capable of effectively capturing crack growth : near connections and crack re : - : initiation of retrofitted connections. The proposed damage detection algorithm...

  8. Sustaining Public Involvement in Long Range Planning Using a Stakeholder Based Process: A Case Study from Eugene-Springfield ,Oregon

    DOT National Transportation Integrated Search

    1998-09-16

    The Intermodal Surface Transportation Efficiency Act requires a proactive : public involvement process that provides complete information, timely public : notice, full public access to key decisions, and supports early and continuing : involvement of...

  9. Flexibility in flood management design: proactive planning under uncertainty

    NASA Astrophysics Data System (ADS)

    Smet, K.; de Neufville, R.; van der Vlist, M.

    2016-12-01

    This paper presents a value-enhancing approach for proactive planning and design of long-lived flood management infrastructure given uncertain future flooding threats. Designing infrastructure that can be adapted over time is a method to safeguard the efficacy of current design decisions given future uncertainties. We explore the value of embedding "options" in a physical structure, where an option is the right but not the obligation to do something at a later date (e.g. over-dimensioning a floodwall foundation now facilitates a future height addition in response to observed increases in sea level; building extra pump bays in a drainage pumping station enables the easy addition of pumping capacity whenever increased precipitation warrants an expansion.) The proposed approach couples a simulation model that captures future climate induced changes to the hydrologic operating environment of a structure, with an economic model that estimates the lifetime economic performance of alternative investment strategies. The economic model uses Real "In" Options analysis, a type of cash flow analysis that quantifies the implicit value of options and the flexibility they provide. We demonstrate the approach using replacement planning for the multi-functional pumping station IJmuiden on the North Sea Canal in the Netherlands. The analysis models flexibility in design decisions, varying the size and specific options included in the new structure. Results indicate that the incorporation of options within the structural design has the potential to improve its economic performance, as compared to more traditional, "build it once and build it big" designs where flexibility is not an explicit design criterion. The added value resulting from the incorporation of flexibility varies with the range of future conditions considered, and the specific options examined. This approach could be applied to explore investment strategies for the design of other flood management structures, as well as be expanded to look more at flexibility within an infrastructure network rather than a single structure. Flexibility in flood management design:proactive planning under uncertainty

  10. Project health and safety plan for the Gunite and Associated Tanks at Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

    Abston, J.P.

    1997-04-01

    The Lockheed Martin Energy Systems, Inc. (Energy Systems) policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at the Gunite and Associated Tanks (GAAT) in the North and South Tank Farms (NTF and STF) at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to health and safety (H and S) issues. The policy and procedures in this plan apply to all GAAT operations in the NTF and STF. The provisions of this plan are to bemore » carried out whenever activities identifies s part of the GAAT are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices in order to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to the air. This plan explains additional task-specific health and safety requirements such as the Site Safety and health Addendum and Activity Hazard Analysis, which should be used in concert with this plan and existing established procedures.« less

  11. An empirical study on the driving mechanism of proactive corporate environmental management in China.

    PubMed

    Liu, Xianbing; Liu, Beibei; Shishime, Tomohiro; Yu, Qinqin; Bi, Jun; Fujitsuka, Tetsuro

    2010-08-01

    Environmentalism in China is under transformation from the traditional command and control model to emphasize the advantages of economic tools and encourage the participation of the public. Firms are much more aware of the importance of environmental issues, and some of them have practiced environmental activities beyond compliance. In order to help understand the driving mechanism of proactive corporate environmental behaviors from the firm's perspective, this paper identifies the drivers affecting the proactive environmental management level (EML(p)) based on the institutional theory, and gives an empirical study on the firms based in Changshu city of Jiangsu Province, China. The usable data, collected from the 117 valid respondents in a questionnaire survey, indicates that EML(p) is still moderately low currently. Less than 10% of the samples are practicing all the six categorized types of voluntary environmental activities. The econometric exercise confirms a significantly positive effect of the externally mimetic pressure on EML(p), which may attribute to a higher sensitivity of Chinese companies to the market factors. However, the roles of the general public and industrial associations are not significant, showing the marginal power of selected normative pressures. Regarding internal factors, firms, which view environmental issues as opportunities and often arrange internal environmental training, are more likely to adopt proactive environmental activities. More concerns from the general public like neighborhood communities and mass media shall be addressed to enhance the normative power to improve EML(p) in China from the future perspective. Copyright 2010 Elsevier Ltd. All rights reserved.

  12. Cost-Effectiveness of a Model Infection Control Program for Preventing Multi-Drug-Resistant Organism Infections in Critically Ill Surgical Patients.

    PubMed

    Jayaraman, Sudha P; Jiang, Yushan; Resch, Stephen; Askari, Reza; Klompas, Michael

    2016-10-01

    Interventions to contain two multi-drug-resistant Acinetobacter (MDRA) outbreaks reduced the incidence of multi-drug-resistant (MDR) organisms, specifically methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile in the general surgery intensive care unit (ICU) of our hospital. We therefore conducted a cost-effective analysis of a proactive model infection-control program to reduce transmission of MDR organisms based on the practices used to control the MDRA outbreak. We created a model of a proactive infection control program based on the 2011 MDRA outbreak response. We built a decision analysis model and performed univariable and probabilistic sensitivity analyses to evaluate the cost-effectiveness of the proposed program compared with standard infection control practices to reduce transmission of these MDR organisms. The cost of a proactive infection control program would be $68,509 per year. The incremental cost-effectiveness ratio (ICER) was calculated to be $3,804 per aversion of transmission of MDR organisms in a one-year period compared with standard infection control. On the basis of probabilistic sensitivity analysis, a willingness-to-pay (WTP) threshold of $14,000 per transmission averted would have a 42% probability of being cost-effective, rising to 100% at $22,000 per transmission averted. This analysis gives an estimated ICER for implementing a proactive program to prevent transmission of MDR organisms in the general surgery ICU. To better understand the causal relations between the critical steps in the program and the rate reductions, a randomized study of a package of interventions to prevent healthcare-associated infections should be considered.

  13. Professionalism: Teachers Taking the Reins

    ERIC Educational Resources Information Center

    Helterbran, Valeri R.

    2008-01-01

    It is essential that teachers take a proactive look at their profession and themselves to strengthen areas of professionalism over which they have control. In this article, the author suggests strategies that include collaborative planning, reflectivity, growth in the profession, and the examination of certain personal characteristics.

  14. Predictors of "New Economy" Career Orientation in an Australian Sample of Late Adolescents

    ERIC Educational Resources Information Center

    Creed, Peter; Macpherson, Jennifer; Hood, Michelle

    2011-01-01

    The authors surveyed 207 late adolescents on measures of new economy career orientation (protean and boundaryless career orientation), career adaptability (planning, self-exploration, environmental exploration, decision making, and self-regulation), disposition (proactive disposition), and environmental support (social support) and hypothesized…

  15. Implementing a clinical ethics needs assessment survey: results of a pilot study (part 2 of 2).

    PubMed

    Frolic, Andrea; Andreychuk, Sandra; Seidlitz, Wendy; Djuric-Paulin, Angela; Flaherty, Barb; Jennings, Barb; Peace, Donna

    2013-03-01

    This paper details the implementation of the Clinical Ethics Needs Assessment Survey (CENAS) through a pilot study in five units within Hamilton Health Sciences. We describe how these pilot sites were selected, how we implemented the survey, the significant results and our interpretation of the findings. The primary goal of this paper is to share our experiences using this tool, specifically the challenges we encountered conducting a staff ethics needs assessment across different units in a large teaching hospital, and the facilitators to our success. We conclude with a discussion of the limitations of this study, our plans for using the results to develop a proactive ethics education strategy, and suggestions for other organizations wishing to adapt the CENAS to assess their staff ethics needs. Our secondary goal is to advance the "quality agenda" for ethics programs by demonstrating how a tool like the CENAS can be used to design more effective educational interventions, and to support strategic planning and proactive priority-setting for ethics programs.

  16. Defining and Enabling Resiliency of Electric Distribution Systems With Multiple Microgrids

    DOE PAGES

    Chanda, Sayonsom; Srivastava, Anurag K.

    2016-05-02

    This paper presents a method for quantifying and enabling the resiliency of a power distribution system (PDS) using analytical hierarchical process and percolation theory. Using this metric, quantitative analysis can be done to analyze the impact of possible control decisions to pro-actively enable the resilient operation of distribution system with multiple microgrids and other resources. Developed resiliency metric can also be used in short term distribution system planning. The benefits of being able to quantify resiliency can help distribution system planning engineers and operators to justify control actions, compare different reconfiguration algorithms, develop proactive control actions to avert power systemmore » outage due to impending catastrophic weather situations or other adverse events. Validation of the proposed method is done using modified CERTS microgrids and a modified industrial distribution system. Furthermore, simulation results show topological and composite metric considering power system characteristics to quantify the resiliency of a distribution system with the proposed methodology, and improvements in resiliency using two-stage reconfiguration algorithm and multiple microgrids.« less

  17. Evidence-based practice and related information literacy skills of nurses in Singapore: an exploratory case study.

    PubMed

    Mokhtar, Intan Azura; Majid, Shaheen; Foo, Schubert; Zhang, Xue; Theng, Yin-Leng; Chang, Yun-Ke; Luyt, Brendan

    2012-03-01

    Increased demand for medical or healthcare services has meant that nurses are to take on a more proactive and independent role intending to patients, providing basic treatment and deciding relevant clinical practice. This, in turn, translates into the need for nurses to be able to translate research and evidence into their practice more efficiently and effectively. Hence, competencies in looking for, evaluating, synthesizing and applying documented information or evidence-based practice becomes crucial. This article presents a quantitative study that involved more than 300 nurses from a large government hospital in Singapore. A self-reporting questionnaire was developed to collect data pertaining to evidence-based practice and activities, including those that demonstrate information literacy competencies. Results seem to suggest that the nurses preferred to use print and human information sources compared to electronic information sources; were not proactive in looking up research or evidence-based information and, instead, preferred such information to be fed to them; and that they perceived they lacked the ability to evaluate research papers or effectively search electronic information related to nursing or evidence-based practice. It was also found that more than 80% of the nurses have not had any training related to evidence-based practice.

  18. Proactive health consumerism: an important new tool for worksite health promotion.

    PubMed

    Johnson, Sara S; Cummins, Carol O; Evers, Kerry E; Prochaska, Janice M; Prochaska, James O

    2009-01-01

    Consumerism in health care has taken on the form of a major innovation among employers and health plans. Yet many of our efforts to enhance the skills and attitudes that enable consumerism have met with limited success. Proactive Health Consumerism is proposed as an approach that utilizes many of the hard-won lessons from health promotion research. Along with prerequisites that create the motivation and framework for increased health consumerism, this article provides a theory-driven example of a new tool for health promotion professionals to employ when enhancing the health consumer skills of working populations. Strategies for maximization of effectiveness and integration with supporting resources are also described.

  19. Climate Change Adaptation - Challenges and Opportunities

    DTIC Science & Technology

    2011-11-01

    Humans have been adapting to the vagaries of weather for millennia, sometimes successfully sometimes not. Today, the myriad of important federal laws that regulate the impacts of human activity in our natural environment not only complicates plans for climate change adaptation, but also act as a strong justification for proactive planning, engagement and action. The challenge of adaptation will result in increased opportunities for more effective interaction with other federal agencies, communities and scientific organizations to better

  20. Automated Planning and Scheduling for Space Mission Operations

    NASA Technical Reports Server (NTRS)

    Chien, Steve; Jonsson, Ari; Knight, Russell

    2005-01-01

    Research Trends: a) Finite-capacity scheduling under more complex constraints and increased problem dimensionality (subcontracting, overtime, lot splitting, inventory, etc.) b) Integrated planning and scheduling. c) Mixed-initiative frameworks. d) Management of uncertainty (proactive and reactive). e) Autonomous agent architectures and distributed production management. e) Integration of machine learning capabilities. f) Wider scope of applications: 1) analysis of supplier/buyer protocols & tradeoffs; 2) integration of strategic & tactical decision-making; and 3) enterprise integration.

  1. Proactive restoration: planning, implementation, and early results of silvicultural strategies for increasing resilience against gypsy moth infestation in upland oak forests on the Daniel Boone National Forest, Kentucky

    Treesearch

    Callie Schweitzer; Stacy L. Clark; Kurt W. Gottschalk; Jeff Stringer; Robbie Sitzlar

    2014-01-01

    Determining targets in forest restoration is a complicated task that can be facilitated by cooperative partnerships. Too often restoration plans are implemented after adverse events that cause widespread tree mortality, such as drought or insect outbreaks, have occurred. Reactive management precludes the use of preemptive management techniques that can result in more...

  2. When and how experienced incivility dissuades proactive performance: An integration of sociometer and self-identity orientation perspectives.

    PubMed

    Schilpzand, Pauline; Huang, Lei

    2018-04-16

    In this article we build on relational Sociometer Theory (Leary, 2005; Leary & Baumeister, 2000) to posit the impact of the belongingness threat of experienced incivility in one's work team on employee feelings of ostracism and subsequent engagement in proactive performance. Integrating the social-relational framework of Self-Identity Orientation Theory (Brewer & Gardner, 1996; Cooper & Thatcher, 2010), we nuance our predictions by hypothesizing that chronic self-identification orientations influence both the effect that experiencing incivility in one's work team exerts on feeling ostracized, and the impact that feeling ostracized has on subsequent employee proactive performance. Using a sample of 212 employees and their 51 supervising managers employed in an Internet service and solution company in China, we found support for our hypothesized model. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  3. Evaluating the effectiveness of using personal tailored risk information and taster sessions to increase the uptake of smoking cessation services: study protocol for a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Although government-funded specialist smoking cessation services in England offer advice and support to smokers motivated to quit, only a small proportion of smokers make use of this service. Evidence suggests that if smokers are proactively and personally invited to use services, use will be higher than with a standard referral made by health professionals. Computer-based systems generating personalised tailored communications also have the potential to engage with a larger proportion of the smoking population. In this study smokers are proactively invited to use the NHS Stop Smoking Service (SSS), with a personal computer-tailored letter and the offer of a no-commitment introductory session designed to give more information about the service. The primary objective is to assess the relative effectiveness on attendance at the NHS SSS, of proactive recruitment by a brief personal letter, tailored to individual characteristics, and invitation to a taster session, over a standard generic letter advertising the service. Method/design This randomised controlled trial will recruit smokers from general practice who are motivated to quit and have not recently attended the NHS SSS. Smokers aged 16 years and over, identified from medical records in participating practices, are sent a brief screening questionnaire and cover letter from their GP. Smokers giving consent are randomised to the Control group to receive a standard generic letter advertising the local service, or to the Intervention group to receive a brief personal, tailored letter with risk information and an invitation to attend a ‘Come and Try it’ taster session. The primary outcome, assessed 6 months after the date of randomisation, is the proportion of people attending the NHS SSS for at least one session. Planned recruitment is to secure 4,500 participants, from 18 regions in England served by an NHS SSS. Discussion Personal risk information generated by computer, with the addition of taster sessions, could be widely replicated and delivered cost effectively to a large proportion of the smoking population. The results of this trial will inform the potential of this method to increase referrals to specialised smoking cessation services and prompt more quit attempts. Trial registration Current Controlled Trials ISRCTN76561916 PMID:23078797

  4. 48 CFR 952.204-75 - Public affairs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Contractor is responsible for the development, planning, and coordination of proactive approaches for the... information to the public and news media are coordinated through, and approved by, a management official at an... of communications or contacts with Members of Congress relating to the effort performed under the...

  5. 48 CFR 952.204-75 - Public affairs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Contractor is responsible for the development, planning, and coordination of proactive approaches for the... information to the public and news media are coordinated through, and approved by, a management official at an... of communications or contacts with Members of Congress relating to the effort performed under the...

  6. Life insurance and its effect on estate taxation.

    PubMed

    Blau, Joel M; Paprocki, Ronald J

    2002-01-01

    Estate tax laws are subject to constant changes and revisions. Fortunately for most physicians, this ultimate liability has been drastically reduced, but it also has become much more complex. The key is to plan proactively with an understanding of the most current estate tax savings strategies.

  7. Disciplining Students with Emotional and Behavioral Disorders: A Legal Update.

    ERIC Educational Resources Information Center

    Yell, Mitchell L.; And Others

    1995-01-01

    This article explicates the current legislation, case law, and administrative law governing the discipline of students with disabilities. Guidelines are offered that divide disciplinary procedures into three categories: permitted, controlled, and prohibited. The role of the Individualized Education Program team in planning proactive disciplinary…

  8. Crisis Revisited: An Analysis of Strategies Used by Tylenol in the Second Tampering Episode.

    ERIC Educational Resources Information Center

    Benson, James A.

    1988-01-01

    Illustrates how Johnson & Johnson's crisis communication management adhered to many of the recommended guidelines for managing contingency planning, for mobilizing a crisis communication effort, and for post-crisis communication. Reveals the advantageous use of flexible, proactive, and corollary communication strategies. (MS)

  9. Information processing and proactive interference in children with and without specific language impairment.

    PubMed

    Marton, Klara; Campanelli, Luca; Eichorn, Naomi; Scheuer, Jessica; Yoon, Jungmee

    2014-02-01

    Increasing evidence suggests that children with specific language impairment (SLI) have a deficit in inhibition control, but research isolating specific abilities is scarce. The goal of this study was to examine whether children with SLI differ from their peers in resistance to proactive interference under different conditions. An information processing battery with manipulations in interference was administered to 66 children (SLI, age matched peers, and language-matched controls). In Experiment 1, previously relevant targets were used as distractors to create conflict. Experiment 2 used item repetitions to examine how practice strengthens word representations and how the strength of a response impacts performance on the following item. Children with SLI performed similarly to their peers in the baseline condition but were more susceptible to proactive interference than the controls in both experimental conditions. Children with SLI demonstrated difficulty suppressing irrelevant information, made significantly more interference errors than their peers, and showed a slower rate of implicit learning. Children with SLI show weaker resistance to proactive interference than their peers, and this deficit impacts their information processing abilities. The coordination of activation and inhibition is less efficient in these children, but future research is needed to further examine the interaction between these two processes.

  10. It Takes a (Virtual) Village: Exploring the Role of a Career Community to Support Sensemaking As a Proactive Socialization Practice.

    PubMed

    Good, Darren; Cavanagh, Kevin

    2017-01-01

    Scholars have long advocated for individuals to play a more proactive role during organizational entry rather than relying on institutionally led processes. The primary benefit being that the newcomer moves from passive recipient, dependent on the institution to highlight relevant information, to active agent with self-determined sources and methods to aid in adjustment. A virtual career community made up of 12 first year business faculty members was created to provide such a self-determined source of support during the transition from doctoral studies to full-time assistant professorship. After the entry period (1 academic year), the interactions in this community were used as data for a phenomenon driven research study. The results illustrate how a virtual career community could be used as a proactive socialization tool by encouraging sensemaking amongst first year faculty peers. The sensemaking process consists of perceived contrasts and tensions, followed by positive and negative self-disclosures, community feedback, and the experience of cognitive-behavioral shifts. The findings also expand the proactive use of external referents during organizational entry, which previously had only looked at friends and family members of the newcomer.

  11. It Takes a (Virtual) Village: Exploring the Role of a Career Community to Support Sensemaking As a Proactive Socialization Practice

    PubMed Central

    Good, Darren; Cavanagh, Kevin

    2017-01-01

    Scholars have long advocated for individuals to play a more proactive role during organizational entry rather than relying on institutionally led processes. The primary benefit being that the newcomer moves from passive recipient, dependent on the institution to highlight relevant information, to active agent with self-determined sources and methods to aid in adjustment. A virtual career community made up of 12 first year business faculty members was created to provide such a self-determined source of support during the transition from doctoral studies to full-time assistant professorship. After the entry period (1 academic year), the interactions in this community were used as data for a phenomenon driven research study. The results illustrate how a virtual career community could be used as a proactive socialization tool by encouraging sensemaking amongst first year faculty peers. The sensemaking process consists of perceived contrasts and tensions, followed by positive and negative self-disclosures, community feedback, and the experience of cognitive-behavioral shifts. The findings also expand the proactive use of external referents during organizational entry, which previously had only looked at friends and family members of the newcomer. PMID:28220088

  12. Local health and social care responses to implementing the national cold weather plan.

    PubMed

    Heffernan, C; Jones, L; Ritchie, B; Erens, B; Chalabi, Zaid; Mays, N

    2017-09-18

    The Cold Weather Plan (CWP) for England was launched by the Department of Health in 2011 to prevent avoidable harm to health by cold weather by enabling individuals to prepare and respond appropriately. This study sought the views of local decision makers involved in the implementation of the CWP in the winter of 2012/13 to establish the effects of the CWP on local planning. It was part of a multi-component independent evaluation of the CWP. Ten LA areas were purposively sampled which varied in level of deprivation and urbanism. Fifty-two semi-structured interviews were held with health and social care managers involved in local planning between November 2012 and May 2013. Thematic analysis revealed that the CWP was considered a useful framework to formalize working arrangements between agencies though local leadership varied across localities. There were difficulties in engaging general practitioners, differences in defining vulnerable individuals and a lack of performance monitoring mechanisms. The CWP was welcomed by local health and social care managers, and improved proactive winter preparedness. Areas for improvement include better integration with general practice, and targeting resources at socially isolated individuals in cold homes with specific interventions aimed at reducing social isolation and building community resilience. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  13. Beyond Academic and Social Integration: Understanding the Impact of a STEM Enrichment Program on the Retention and Degree Attainment of Underrepresented Students.

    PubMed

    Lane, Tonisha B

    2016-01-01

    The current study used a case study methodological approach, including document analysis, semistructured interviews, and participant observations, to investigate how a science, technology, engineering, and mathematics (STEM) enrichment program supported retention and degree attainment of underrepresented students at a large, public, predominantly white institution. From this study, a model emerged that encompassed four components: proactive care, holistic support, community building, and catalysts for STEM identity development. These components encompassed a number of strategies and practices that were instrumental in the outcomes of program participants. This paper concludes with implications for practice, such as using models to inform program planning, assessment, and evaluation. © 2016 T. B. Lane. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  14. NASA Educational Product Development and Post-Secondary Program Assessment Planning

    NASA Technical Reports Server (NTRS)

    Salmons, Phyllis A.

    1999-01-01

    Producing "value-added students" involves proactively addressing how successfully students develop their skills, knowledge, and personal, social, and ethical growth due to their association with a program. NASA programs for higher education can certainly be responsive in aiding the academic community strive for quality in terms of "valueadded" students. By identifying essential characteristics of exemplary assessment practices, the standards developed by accrediting agencies serve as guides for developing quality practices and policies. Such a process is an effective tool for communicating the expectations of the educational components of a program to all concerned with the program and its expected results. When standards are connected to student performance, they provide a very compelling argument for refocusing the definition of quality in higher education. By linking standards and performance, student learning and development becomes the starting point for examining program quality. If the multiple stakeholders - faculty, peers, the professional community, addressed assessment issues, then accreditation can be a link among various constituencies, the parties can better understand the needs of each other and develop the necessary trust needed for understanding and support.

  15. Early Discharge Planning and Improved Care Transitions: Pre-Admission Assessment for Readmission Risk in an Elective Orthopedic and Cardiovascular Surgical Population

    PubMed Central

    Mola, Ana; Rosenfeld, Peri; Ford, Shauna

    2016-01-01

    Background/Methods: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan. An 8-item questionnaire, which includes patient self-reported health, was integrated into care managers’ telephonic pre-admission assessments during a 12-month period. Results: Regression models found the questionnaire to be predictive of readmission (p ≤ .005; R2 = .334) and length-of-stay (p ≤ .001; R2 = .314). Independent variables of “lives-alone” and “self-rated health” were statistically significant for increased readmission odds, as was “self-rated health” for increased length-of-stay. Quality measures, patient experience and increased rates of discharges-to-home further supported the benefit of embedding these questions into the pro-active planning process. Conclusion: The pilot discharge risk assessment was predictive of readmission risk and length-of-stay for elective orthopedic/cardiovascular patients. Given the usability of the questionnaire in advance of elective admissions, it can facilitate pro-active discharge planning essential for producing quality outcomes and addressing new reimbursement methodologies for continuum-based episodes of care. PMID:27616965

  16. Proactive and integrated primary care for frail older people: design and methodological challenges of the Utrecht primary care PROactive frailty intervention trial (U-PROFIT).

    PubMed

    Bleijenberg, Nienke; Drubbel, Irene; Ten Dam, Valerie H; Numans, Mattijs E; Schuurmans, Marieke J; de Wit, Niek J

    2012-04-25

    Currently, primary care for frail older people is reactive, time consuming and does not meet patients' needs. A transition is needed towards proactive and integrated care, so that daily functioning and a good quality of life can be preserved. To work towards these goals, two interventions were developed to enhance the care of frail older patients in general practice: a screening and monitoring intervention using routine healthcare data (U-PRIM) and a nurse-led multidisciplinary intervention program (U-CARE). The U-PROFIT trial was designed to evaluate the effectiveness of these interventions. The aim of this paper is to describe the U-PROFIT trial design and to discuss methodological issues and challenges. The effectiveness of U-PRIM and U-CARE is being tested in a three-armed, cluster randomized trial in 58 general practices in the Netherlands, with approximately 5000 elderly individuals expected to participate. The primary outcome is the effect on activities of daily living as measured with the Katz ADL index. Secondary outcomes are quality of life, mortality, nursing home admission, emergency department and out-of-hours General Practice (GP), surgery visits, and caregiver burden. In a large, pragmatic trial conducted in daily clinical practice with frail older patients, several challenges and methodological issues will occur. Recruitment and retention of patients and feasibility of the interventions are important issues. To enable broad generalizability of results, careful choices of the design and outcome measures are required. Taking this into account, the U-PROFIT trial aims to provide robust evidence for a structured and integrated approach to provide care for frail older people in primary care. NTR2288.

  17. Biosimilars: Opportunities to Promote Optimization Through Payer and Provider Collaboration.

    PubMed

    Manolis, Chronis H; Rajasenan, Kiran; Harwin, William; McClelland, Scott; Lopes, Maria; Farnum, Carolyn

    2016-09-01

    A panel was convened that consisted of 1 medical director, 2 pharmacy directors, and 2 oncologists, who represented the University of Pittsburgh Medical Center Health Plan, an integrated delivery network, and Florida Blue, a progressive regional health plan. This panel met in order to share ideas, discuss challenges, and develop practical solutions to promote optimal utilization in order to encourage collaboration between payers and providers to help ensure the success of biosimilar entrants into the marketplace. Live meetings were conducted in Orlando, Florida, and Pittsburgh, Pennsylvania, and were followed by virtual meetings to solidify ideas and concepts for this supplement. It is important for biosimilar manufacturers to identify potential payer, provider, and patient obstacles in order to develop strategic and tactical plans to preemptively address these potential obstacles. Gathering payer and provider insights will shed light on various issues such as access and reimbursement. Biosimilar manufacturers must be proactive in the education of payers, providers, and patients to ensure access to biosimilars. A strong factor emphasized among this group was that the assumption surrounding biosimilar development and use is the potential for health care cost savings. According to the panel, payers and providers must carefully consider economic implications and potential cost-effectiveness in order to increase the acceptance or understanding of biosimilars in clinical practice. The group identified 3 major challenges surrounding biosimilar adoption: (1) provider confidence in biosimilar education and clinical value, (2) provider confidence in reimbursement for new biosimilars, and (3) creating shared payer and provider cost-savings. After identification of the 3 challenges, the group posed potential solutions to help with biosimilar adoption.

  18. Active Canada 20/20: A physical activity plan for Canada.

    PubMed

    Spence, John C; Faulkner, Guy; Costas Bradstreet, Christa; Duggan, Mary; Tremblay, Mark S

    2016-03-16

    Physical inactivity is a pressing public health concern. In this commentary we argue that Canada's approach to increasing physical activity (PA) has been fragmented and has lacked coordination, funding and a strategic approach. We then describe a potential solution in Active Canada 20/20 (AC 20/20), which provides both a national plan and a commitment to action from non-government and public sectors with a view to engaging corporate Canada and the general public. It outlines a road map for initiating, coordinating and implementing proactive initiatives to address this prominent health risk factor. The identified actions are based on the best available evidence and have been endorsed by the majority of representatives in the relevant sectors. The next crucial steps are to engage all those involved in public health promotion, service provision and advocacy at the municipal, provincial and national levels in order to incorporate AC 20/20 principles into practice and planning and thus increase the PA level of every person in Canada. Further, governments, as well as the private, not-for-profit and philanthropic sectors, should demonstrate leadership and continue their efforts toward providing the substantial and sustained resources needed to recalibrate Canadians' habitual PA patterns; this will ultimately improve the overall health of our citizens.

  19. Data Privacy and Security in Higher Education

    ERIC Educational Resources Information Center

    Williams, Tracy

    2003-01-01

    As institutions review and strengthen their plans to secure confidential data, what proactive role does the human resource professional play as a strategic partner? Why are employees a critical part of the solution? And how are they educated regarding their responsibilities with data security? Datatel's HR product manager shares some…

  20. Stay on the ERP Treadmill!

    ERIC Educational Resources Information Center

    Panettieri, Joseph C.

    2007-01-01

    This article discusses University of Central Florida's proactive approach to enterprise resource planning (ERP) and highlights UCF's success with ERP. The article points out that much of this success comes from the strength and management experience of those in leadership positions at UCF, and from the expertise and strong credentials of the team…

  1. Action Regulation Theory and Career Self-Management

    ERIC Educational Resources Information Center

    Raabe, Babette; Frese, Michael; Beehr, Terry A.

    2007-01-01

    Much of the responsibility for managing careers is shifting from employers to adaptive and proactive employees. A career management intervention based on action regulation theory trained 205 white collar employees to engage actively in their own career building by increasing their self-knowledge, career goal commitment, and career plan quality. As…

  2. The Administrator's Role in Insuring Quality in Off-Campus Programs.

    ERIC Educational Resources Information Center

    Massey, T. Benjamin

    The administrator's role in insuring off-campus program quality is considered. An essential difference between administrators and leaders is noted: administrators are status quo oriented, crisis oriented, reactive, and less flexible; leaders are change oriented, planning oriented, proactive, and less flexible. When such factors as new technology…

  3. Advancing knowledge for proactive drought planning and enhancing adaptive management for drought on rangelands: Introduction to a special issue

    USDA-ARS?s Scientific Manuscript database

    Drought is a prolonged period of abnormally low rainfall that adversely affects vegetation growth and negatively impacts land managers, ranching enterprises, and pastoral systems. As an ecological driver, drought historically shaped vegetation composition, structure, diversity, and productivity of r...

  4. A Comprehensive Approach to RtI: Embedding Universal Design for Learning and Technology

    ERIC Educational Resources Information Center

    Basham, James D.; Israel, Maya; Graden, Janet; Poth, Rita; Winston, Markay

    2010-01-01

    Response to intervention (RtI) provides tiered levels of supports to all students and allows for increasingly more intensive and individualized instruction. Similarly, universal design for learning (UDL) addresses needs of students by proactively planning for instructional, environmental, and technology supports to allow all students to…

  5. Environmental Scanning: Assessing Local Business Training Needs.

    ERIC Educational Resources Information Center

    Clagett, Craig A.; Huntington, Robin B.

    Environmental scanning (ES) is a formal process of assessing trends and forecasting events which can influence an institution so that the potential challenges and opportunities can be effectively anticipated during strategic planning activities. The goal of ES is the implementation of proactive, anticipatory policies that will be robust under a…

  6. Language Change and Language Planning and Policy. PREL Briefing Paper.

    ERIC Educational Resources Information Center

    Shigemoto, Joan

    While societies and their languages continually change in response to internal and external circumstances, there are proactive measures that can be implemented to either maintain the particular direction in which that language is moving or to reverse it. Parents and educators can effectuate positive change, individually and collectively. Some…

  7. Working with Angry Parents: Taking a Customer Service Approach.

    ERIC Educational Resources Information Center

    Phipps, Patricia A.

    1998-01-01

    Discusses ways child care personnel can develop a proactive customer service plan that meets families' needs and expectations while minimizing the probability of confrontations with angry parents. Outlines a five-step conflict-resolution strategy that offers a "win-win" approach for both parents and providers when problems do occur. (TJQ)

  8. Teachers' Concerns Regarding the Implementation and Continued Use of an Evidence-Based Educational Practice

    ERIC Educational Resources Information Center

    Becker, Mallory K.

    2011-01-01

    Teachers need practices that can be implemented in the classroom to teach children how to address conflict and solve problems proactively. There are curricula available for teachers to use in promoting improvement in the social behavior of students and for further enhancing their ability to self-regulate their behavior (Smith, Lochman, &…

  9. Marketing a managed care plan: achieving product differentiation.

    PubMed

    Romeo, N C

    1996-01-01

    The health care marketplace is changing dramatically, even without federal reform measures. This is a volatile, yet promising, time to market a managed care plan. Before marketing the product, it is critical that the competition is thoroughly evaluated and consumer and employer needs are researched. The final product should be distinguishable from the competition and address market needs. Promotion can then begin, utilizing a proactive public relations and advertising campaign in addition to traditional methods of marketing.

  10. Environmental Implementation Plan

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

    Not Available

    1993-03-15

    The purpose of the Environmental Implementation Plan (EIP) is to show the current and future (five years) environmental plans from individual site organizations and divisions, as well as site environmental programs and initiatives which are designed to protect the environment and meet or exceed changing environmental/regulatory requirements. Communicating with site organizations, departments, and committees is essential in making the site`s environmental-planning process work. The EIP gives the site the what, when, how, and why for environmental requirements. Through teamwork and proactive planning, a partnership for environmental excellence is formed to achieve the site vision for SRS to become the recognizedmore » model for Environmental Excellence in the Department of Energy`s Nuclear Weapons Complex.« less

  11. Environmental Implementation Plan

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

    Not Available

    1993-03-15

    The purpose of the Environmental Implementation Plan (EIP) is to show the current and future (five years) environmental plans from individual site organizations and divisions, as well as site environmental programs and initiatives which are designed to protect the environment and meet or exceed changing environmental/regulatory requirements. Communicating with site organizations, departments, and committees is essential in making the site's environmental-planning process work. The EIP gives the site the what, when, how, and why for environmental requirements. Through teamwork and proactive planning, a partnership for environmental excellence is formed to achieve the site vision for SRS to become the recognizedmore » model for Environmental Excellence in the Department of Energy's Nuclear Weapons Complex.« less

  12. To stay or to go? Postretirement housing choices of single Baby Boomer women.

    PubMed

    Kopanidis, Foula Z; Robinson, Linda J; Reid, Mike

    2017-01-01

    Single women of the Baby Boomer generation are often financially disadvantaged in the retirement planning process due to their lower accumulated savings compared to male retirees. This disadvantage impacts significant consumption decisions such as postretirement housing choices. This study uses the theory of planned behavior to examine how certainty in intentions influences preparing and planning for postretirement housing. A typology of single Baby Boomer women is developed based on their financial, demographic, and psychological circumstances. Each segment likely requires different informational strategies and financial services to foster proactive planning for retirement. Significant implications exist for social policy and the financial services sector.

  13. Leveraging the principles of osteopathic medicine to improve diabetes outcomes within a new era of health care reform.

    PubMed

    Ciervo, Carman A; Shubrook, Jay H; Grundy, Paul

    2015-04-01

    First introduced conceptually decades before the passage of the Patient Protection and Affordable Care Act, the patient-centered medical home (PCMH) has evolved as a foundational element within the larger health care system or medical neighborhood, highlighting a coordinated and comprehensive disease management approach centered on intensive primary care interventions. More recently, in the wake of health care reform, accountable care organizations (ACOs) have been established to help health plans, physicians, hospitals, home health care practitioners, and other health care providers better coordinate care through an incentive-based payment arrangement. Osteopathic medicine is poised to proactively capitalize on these emerging health care models, with the anticipated end result of improved quality of care and reduced health care costs. As such, osteopathic physicians involved in the prevention and care of patients with type 2 diabetes mellitus need to identify models, best practices, and solutions to advance the medical neighborhood.

  14. KSC-00pp1582

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, keynote speaker Dr. Beck Weathers is given a memento of his visit by Center Director Roy Bridges. Weathers spoke about his ordeal of surviving the 1996 Mt. Everest disaster and the lessons learned from the experience. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  15. Ethics Analysis of Neuroimaging in Alzheimer’s Disease

    PubMed Central

    Illes, J.; Rosen, A.; Greicius, M.; Racine, E.

    2009-01-01

    This article focuses on the prospects and ethics of using neuroimaging to predict Alzheimer’s disease (AD). It is motivated by consideration of the historical roles of science in medicine and society, and considerations specifically contemporary of capabilities in imaging and aging, and the benefits and hope they bring. A general consensus is that combinations of imaging methods will ultimately be most fruitful in predicting disease. Their roll-out into translational practice will not be free of complexity, however, as culture and values differ in terms of what defines benefit and risk, who will benefit and who is at risk, what methods must be in place to assure the maximum safety, comfort, and protection of subjects and patients, and educational and policy needs. Proactive planning for the ethical and societal implications of predicting diseases of the aging brain is critical and will benefit all stakeholders— researchers, patients and families, health care providers, and policy makers. PMID:17413029

  16. KSC00pp1583

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, keynote speaker Dr. Beck Weathers grimaces over the satellite photo of Mt. Everest being presented by Center Director Roy Bridges. Weathers spoke about his ordeal of surviving the 1996 Mt. Everest disaster and the lessons learned from the experience. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  17. KSC00pp1582

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, keynote speaker Dr. Beck Weathers is given a memento of his visit by Center Director Roy Bridges. Weathers spoke about his ordeal of surviving the 1996 Mt. Everest disaster and the lessons learned from the experience. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  18. KSC-00pp1583

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, keynote speaker Dr. Beck Weathers grimaces over the satellite photo of Mt. Everest being presented by Center Director Roy Bridges. Weathers spoke about his ordeal of surviving the 1996 Mt. Everest disaster and the lessons learned from the experience. Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  19. The lost history of American veterinary medicine: the need for preservation.

    PubMed

    Boyd, C Trenton

    2011-01-01

    The objective of this study was to survey holdings of ephemeral veterinary literature. World Cat OCLC catalog, the Library of Congress online catalog, the US National Agricultural Library online catalog, and the Dictionary Catalog of the National Agricultural Library, 1862-1965, were used to determine current library holdings of materials published by veterinary schools that are no longer in existence and veterinary associations that are defunct, veterinary supply catalogs, veterinary house organs, patent medicine publications, and veterinary advertisements. Individual library catalogs were also consulted. In addition, the practice of removing advertisements from bound volumes was examined. There are many gaps in the cataloged library holdings of primary source materials relating to the history of the education of veterinarians in the United States. A proactive action plan needs to be designed and activated to locate, catalog, and preserve this primary source material of veterinary medicine for posterity.

  20. The lost history of American veterinary medicine: the need for preservation*†

    PubMed Central

    Boyd, C. Trenton

    2011-01-01

    Objective: The objective of this study was to survey holdings of ephemeral veterinary literature. Methods: WorldCat OCLC catalog, the Library of Congress online catalog, the US National Agricultural Library online catalog, and the Dictionary Catalog of the National Agricultural Library, 1862–1965, were used to determine current library holdings of materials published by veterinary schools that are no longer in existence and veterinary associations that are defunct, veterinary supply catalogs, veterinary house organs, patent medicine publications, and veterinary advertisements. Individual library catalogs were also consulted. In addition, the practice of removing advertisements from bound volumes was examined. Results: There are many gaps in the cataloged library holdings of primary source materials relating to the history of the education of veterinarians in the United States. Conclusions: A proactive action plan needs to be designed and activated to locate, catalog, and preserve this primary source material of veterinary medicine for posterity. PMID:21243050

  1. Addressing Authorship Issues Prospectively: A Heuristic Approach.

    PubMed

    Roberts, Laura Weiss

    2017-02-01

    Collaborative writing in academic medicine gives rise to more richly informed scholarship, and yet challenging ethical issues surrounding authorship are commonly encountered. International guidelines on authorship help clarify whether individuals who have contributed to a completed scholarly work have been correctly included as authors, but these guidelines do not facilitate intentional and proactive authorship planning or decisions regarding authorship order.In this Commentary, the author presents a heuristic approach to help collaborators clarify, anticipate, and resolve practical and ethically important authorship issues as they engage in the process of developing manuscripts. As this approach illustrates, assignment of authorship should balance work effort and professional responsibility, reflecting the effort and intellectual contribution and the public accountability of the individuals who participate in the work. Using a heuristic approach for managing authorship issues prospectively can foster an ethical, collaborative writing process in which individuals are properly recognized for their contributions.

  2. [Designing the Annual Meeting and Active Learning System].

    PubMed

    Kawamura, Kazumi

    2018-01-01

     At the 10th Annual Meeting of the Japanese Society for Pharmaceutical Palliative Care and Sciences our theme centered on active learning systems where adult learners engage on their own initiative. Many of the participants were pharmacists active in clinical practices. Regardless of their specialized skill-sets, pharmacists are constantly faced with difficult challenges in their daily work. Passive, one-way lectures are one resource for them, but unfortunately such lectures provide limited insights for resolving concrete problems. The present meeting aimed to show participants how to obtain information they need to solve specific real-world problems. This paper summarizes how we planned this year's meeting, including details about the debate symposium, social lunch, and online questionnaires. All these elements had the end goal of enabling learners proactivity to become their own best resource for learning. It is sincerely hoped that the design and execution of this meeting will prove resourceful for future annual meetings.

  3. Engaging primary care patients to use a patient-centered personal health record.

    PubMed

    Krist, Alex H; Woolf, Steven H; Bello, Ghalib A; Sabo, Roy T; Longo, Daniel R; Kashiri, Paulette; Etz, Rebecca S; Loomis, John; Rothemich, Stephen F; Peele, J Eric; Cohn, Jeffrey

    2014-01-01

    Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. © 2014 Annals of Family Medicine, Inc.

  4. Proactive health computing.

    PubMed

    Timpka, T

    2001-08-01

    In an analysis departing from the global health situation, the foundation for a change of paradigm in health informatics based on socially embedded information infrastructures and technologies is identified and discussed. It is shown how an increasing computing and data transmitting capacity can be employed for proactive health computing. As a foundation for ubiquitous health promotion and prevention of disease and injury, proactive health systems use data from multiple sources to supply individuals and communities evidence-based information on means to improve their state of health and avoid health risks. The systems are characterised by: (1) being profusely connected to the world around them, using perceptual interfaces, sensors and actuators; (2) responding to external stimuli at faster than human speeds; (3) networked feedback loops; and (4) humans remaining in control, while being left outside the primary computing loop. The extended scientific mission of this new partnership between computer science, electrical engineering and social medicine is suggested to be the investigation of how the dissemination of information and communication technology on democratic grounds can be made even more important for global health than sanitation and urban planning became a century ago.

  5. Pediatrics in the year 2020 and beyond: preparing for plausible futures.

    PubMed

    Starmer, Amy J; Duby, John C; Slaw, Kenneth M; Edwards, Anne; Leslie, Laurel K

    2010-11-01

    Although the future of pediatrics is uncertain, the organizations that lead pediatrics, and the professionals who practice within it, have embraced the notion that the pediatric community must anticipate and lead change to ultimately improve the health of children and adolescents. In an attempt to proactively prepare for a variety of conceivable futures, the board of directors of the American Academy of Pediatrics established the Vision of Pediatrics 2020 Task Force in 2008. This group was charged to think broadly about the future of pediatrics, to gather input on key trends that are influencing the future, to create likely scenarios of the future, and to recommend strategies to best prepare pediatric clinicians and pediatric organizations for a range of potential futures. The work of this task force led to the development of 8 "megatrends" that were identified as highly likely to have a profound influence on the future of pediatrics. A separate list of "wild-card" scenarios was created of trends with the potential to have a substantial influence but are less likely to occur. The process of scenario-planning was used to consider the effects of the 8 megatrends on pediatrics in the year 2020 and beyond. Consideration of these possible scenarios affords the opportunity to determine potential future pediatric needs, to identify potential solutions to address those needs, and, ultimately, to proactively prepare the profession to thrive if these or other future scenarios become realities.

  6. Implementing graduate entry registration for nursing in England: a scope review.

    PubMed

    DeBell, Diane; Branson, Kathy

    2009-07-01

    A graduate entry workforce for nurse registration has been approved for England by 2010/11. The aim of this research was to discover the immediate tasks facing nurse managers in implementing that change. Previous research has focused on making the case for change rather than on implementation. Similar to the implementation of Project 2000, this change in nurse education and employment will raise questions for employers and for higher education institutions. It will also raise questions about nurse recruitment numbers, workforce development, and the profiles of entrants to a changing workforce. In preparation for these changes, we conducted a scope review of published and grey literature in the English language. We also reviewed the earlier experiences of transfer to graduate status amongst other workforces such as teaching and social work and we investigated reported practice in other industrialised countries. The education provider changes necessary for such a large professional workforce will need considerable leadership skills from within nursing and nurse management. At present, there are too many employers and education providers in England who appear to be relatively unaware of the changes facing nurse education and professional practice and the urgency needed to lead that change. Education, training and development as well as employer/commissioner practice will rely on leadership from within the nurse profession itself. For nurse managers, this requires a rapid planning process in order to ensure smooth implementation. The danger is that either education providers or commissioners of nursing services will react rather than proactively plan for the changes that are already in progress.

  7. Proactive patient rounding to increase customer service and satisfaction on an orthopaedic unit.

    PubMed

    Tea, Christine; Ellison, Michael; Feghali, Fadia

    2008-01-01

    Customer service and patient satisfaction have become increasingly important in the healthcare industry. Given limited resources and a myriad of choices, on which facets of patient satisfaction should healthcare providers focus? An analysis of 40,000 observations across 4 hospitals found 1 important intervention: timely staff responsiveness. Using the Plan-Do-Check-Act (PDCA) quality methodology, the goal was set to improve staff responsiveness to orthopaedic patient needs and requests, thus improving patient satisfaction. A model to improve staff responsiveness was systematically developed and implemented. The I Care Rounding model places the emphasis on proactively meeting patient needs through hourly rounding, rather than caregivers providing care in a reactionary mode. After full implementation, positive improvement was demonstrated.

  8. Risk assessment and management approaches on mental health units.

    PubMed

    Woods, P

    2013-11-01

    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

  9. Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults.

    PubMed

    Schöfer, Helmut; Tatti, Silvio; Lynde, Charles W; Skerlev, Mihael; Hercogová, Jana; Rotaru, Maria; Ballesteros, Juan; Calzavara-Pinton, Piergiacomo

    2017-12-01

    This review about the proactive sequential therapy (PST) of external genital and perianal warts (EGW) is based on the most current available clinical literature and on the broad clinical experience of a group of international experts, physicians who are well versed in the treatment of human papillomavirus-associated diseases. It provides a practical guide for the treatment of EGW, including epidemiology, etiology, clinical appearance, and diagnostic procedures for these viral infections. Furthermore, the treatment goals and current treatment options, elucidating provider- and patient-applied therapies, and the parameters driving treatment decisions are summarized. Specifically, the mode of action of the topical treatments sinecatechins and imiquimod, as well as the PST for EGW to achieve rapid and sustained clearance is discussed. The group of experts has developed a treatment algorithm giving healthcare providers a practical tool for the treatment of EGW which is very valuable in the presence of many different treatment options.

  10. Proactive transfer of learning depends on the evolution of prior learned task in memory.

    PubMed

    Tallet, Jessica; Kostrubiec, Viviane; Zanone, Pier-Giorgio

    2010-06-01

    The aim of the present study was to investigate the processes underlying the proactive interference effect using bimanual coordination. Our rationale was that interference would only occur when the prior learned A coordination pattern enters in competition with the required subsequent B pattern. We hypothesized that competition would arise only if the A pattern persists in memory before introducing the B pattern. In the experimental group, both A and B patterns were practiced and recalled, whereas in the control group only the B pattern was practiced and recalled. In Experiment 1, which involved initially bistable participants, the persistence of the A pattern led to interference, while, surprisingly, the A pattern forgetting entailed facilitation. In Experiment 2, which involved initially tristable participants, no such transfer effect was found. The apparently contradictory results can be interpreted coherently in the light of dynamical principles of learning. (c) 2010 Elsevier B.V. All rights reserved.

  11. Sewer System Management Plan.

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

    Holland, Robert C.

    A Sewer System Management Plan (SSMP) is required by the State Water Resources Control Board (SWRCB) Order No. 2006-0003-DWQ Statewide General Waste Discharge Requirements (WDR) for Sanitary Sewer Systems (General Permit). DOE, National Nuclear Security Administration (NNSA), Sandia Field Office has filed a Notice of Intent to be covered under this General Permit. The General Permit requires a proactive approach to reduce the number and frequency of sanitary sewer overflows (SSOs) within the State. SSMPs must include provisions to provide proper and efficient management, operation, and maintenance of sanitary sewer systems and must contain a spill response plan.

  12. Workplace Violence and Components of a Psychologically Healthy Workplace.

    PubMed

    Hart, Rod; Heybrock, Denise

    2017-01-01

    As episodes of workplace-centered violence have increased in the United States, a focus on emotional and mental health matters is more essential than ever. It is imperative for organizations to be proactive about violence prevention and have a plan that is supported by top management and understood by all managers and employees. Employers can take a number of steps in collaboration with a comprehensive violence prevention plan to promote a supportive and safe work environment. This article addresses workplace violence, risk factors and the components of a violence prevention plan as well as the importance of building a psychologically healthy workplace.

  13. Positive and normative modeling for Palmer amaranth control and herbicide resistance management.

    PubMed

    Frisvold, George B; Bagavathiannan, Muthukumar V; Norsworthy, Jason K

    2017-06-01

    Dynamic optimization models are normative; they solve for what growers 'ought to do' to maximize some objective, such as long-run profits. While valuable for research, such models are difficult to solve computationally, limiting their applicability to grower resistance management education. While discussing properties of normative models in general, this study presents results of a specific positive model of herbicide resistance management, applied to Palmer amaranth control on a representative cotton farm. This positive model compares a proactive resistance management strategy to a reactive strategy with lower short-run costs, but greater risk of herbicide resistance developing. The proactive strategy can pay for itself within 1-4 years, with a yield advantage of 4% or less if the yield advantage begins within 1-2 years of adoption. Whether the proactive strategy is preferable is sensitive to resistance onset and yield losses, but less sensitive to cotton prices or baseline yields. Industry rebates to encourage residual herbicide use (to delay resistance to post-emergence treatments) may be too small to alter grower behavior or they may be paid to growers who would have used residuals anyway. Rebates change grower behavior over a relatively narrow range of model parameters. The size of rebates needed to induce a grower to adopt the proactive strategy declines significantly if growers extend their planning horizon from 1 year to 3-4 years. Whether proactive resistance management is more profitable than a reactive strategy is more sensitive to biological parameters than economic ones. Simulation results suggest growers with longer time horizons (perhaps younger ones) would be more responsive to rebate programs. More empirical work is needed to determine how much rebates increase residual use above what would occur without them. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  14. Deep pockets or blueprint for change: traumatic brain injury (TBI) proactive strategy.

    PubMed

    Wood, D W; Pohl, S; Lawler, S; Okamoto, G

    1998-09-01

    The Pacific Conference scheduled for October 1-3, 1988, is a critical event in the development of an integrated community-based plan for a comprehensive continuum of services to address the "silent epidemic," Traumatic Brain Injured (TBI). This paper provides insights of the complex nature and the special problems faced by the TBI survivors; their families, natural supports and caregivers, as well as the health, social and educational care providers in Hawaii. Process for the development of the community plan is presented.

  15. Failure mode and effect analysis: improving intensive care unit risk management processes.

    PubMed

    Askari, Roohollah; Shafii, Milad; Rafiei, Sima; Abolhassani, Mohammad Sadegh; Salarikhah, Elaheh

    2017-04-18

    Purpose Failure modes and effects analysis (FMEA) is a practical tool to evaluate risks, discover failures in a proactive manner and propose corrective actions to reduce or eliminate potential risks. The purpose of this paper is to apply FMEA technique to examine the hazards associated with the process of service delivery in intensive care unit (ICU) of a tertiary hospital in Yazd, Iran. Design/methodology/approach This was a before-after study conducted between March 2013 and December 2014. By forming a FMEA team, all potential hazards associated with ICU services - their frequency and severity - were identified. Then risk priority number was calculated for each activity as an indicator representing high priority areas that need special attention and resource allocation. Findings Eight failure modes with highest priority scores including endotracheal tube defect, wrong placement of endotracheal tube, EVD interface, aspiration failure during suctioning, chest tube failure, tissue injury and deep vein thrombosis were selected for improvement. Findings affirmed that improvement strategies were generally satisfying and significantly decreased total failures. Practical implications Application of FMEA in ICUs proved to be effective in proactively decreasing the risk of failures and corrected the control measures up to acceptable levels in all eight areas of function. Originality/value Using a prospective risk assessment approach, such as FMEA, could be beneficial in dealing with potential failures through proposing preventive actions in a proactive manner. The method could be used as a tool for healthcare continuous quality improvement so that the method identifies both systemic and human errors, and offers practical advice to deal effectively with them.

  16. Proactive interference and practice effects in visuospatial working memory span task performance.

    PubMed

    Blalock, Lisa Durrance; McCabe, David P

    2011-01-01

    In the current study the influence of proactive interference (PI) and practice on recall from a visuospatial working memory (WM) task was examined. Participants completed a visuospatial WM span task under either high-PI conditions (a traditional span task) or low-PI conditions (a span task with breaks between trials). Trials of each length (i.e., two to five to-be-remembered items) were equally distributed across three blocks in order to examine practice effects. Recall increased across blocks to a greater extent in the low-PI condition than in the high-PI condition, indicating that reducing PI increased recall from WM. Additionally, in the final block the correlation between fluid intelligence and WM recall was stronger for the high-PI condition than the low-PI condition, indicating that practice reduced the strength of the correlation between span task recall and fluid intelligence, but only in the low-PI condition. These results support current theories that propose that one source of variability in recall from WM span task is the build-up of PI, and that PI build-up is an important contributing factor to the relation between visuospatial WM span task recall and higher-level cognition.

  17. [Complaints about bureaucracy in health care? Time for a proactive medical profession].

    PubMed

    Giard, Raimond W M

    2010-01-01

    Health care is in profound transition, its organization changing from being service-oriented to outcomes-oriented. Doctors are complaining of too much bureaucracy. However, the increasing complexity of healthcare demands rationalization, standardization and optimization of processes. At the same time, the practice of medicine is increasingly politicized. If doctors are the key to healthcare reform, how then are they to be motivated? It is imperative that they become more proactive and engage in leadership. They are the first to ensure that the main goals of medicine remain evidence-based prevention and cure of disease. Passivity will create opportunity for bureaucracy.

  18. Using regional bird density distribution models to evaluate protected area networks and inform conservation planning

    Treesearch

    John D. Alexander; Jaime L. Stephens; Sam Veloz; Leo Salas; Josée S. Rousseau; C. John Ralph; Daniel A. Sarr

    2017-01-01

    As data about populations of indicator species become available, proactive strategies that improve representation of biological diversity within protected area networks should consider finer-scaled evaluations, especially in regions identified as important through course-scale analyses. We use density distribution models derived from a robust regional bird...

  19. Promoting Knowledge of Climate Change (CC) amongst Nigerians: Implications for Education Managers

    ERIC Educational Resources Information Center

    Akpomi, Margaret E.; Vipene, Joseph

    2016-01-01

    Rising sea levels, due to thermal expansion of the ocean, and higher frequency and intensity of coastal and inland storms threaten coastal communities worldwide. The implementation of pro-active, planned adaptation to reduce community vulnerability is strongly dependent upon people's awareness of the threat posed to their communities at the local…

  20. An Overview of the State of Environmental Assessment Education at Canadian Universities

    ERIC Educational Resources Information Center

    Stelmack, Colleen M.; Sinclair, John A.; Fitzpatrick, Patricia

    2005-01-01

    Purpose--Environmental assessment (EA) is a proactive planning tool designed to consider the ecological, cultural, socio-political and economic impacts of potential projects, making it a major tool for achieving sustainable development. Meaningful EA requires a bridging of the natural sciences with the social sciences to broaden understanding of…

  1. Global Marketing of Indigenous Culture: Discovering Native America with Lee Tiger and the Florida Miccosukee

    ERIC Educational Resources Information Center

    Wiedman, Dennis

    2010-01-01

    Indigenous scholars such as Seminole/Shawnee historian, Donald Fixico, drew attention to the lack of academic literature about the proactive, planned, and strategic actions of indigenous peoples. Most histories portray indigenous peoples as responding, accommodating, and assimilating to non-Indians and the US government. This article highlights…

  2. Increasing the health promotion practices of workplaces in Australia with a proactive telephone-based intervention.

    PubMed

    Daly, Justine; Licata, Milly; Gillham, Karen; Wiggers, John

    2005-01-01

    The aim of this study was to explore the potential effectiveness of a proactive telephone-based intervention in increasing workplace adoption of health promotion initiatives. A telephone-based direct marketing strategy was used to contact a sample of Australian workplaces to encourage the adoption of health promotion initiatives. Workplaces were offered free services and resources designed to facilitate adoption of health promotion initiatives. A total of 227 (71%) workplaces provided informed consent to participate in both baseline and 4-year follow-up surveys. Significant increases were evident for seven of the eight health promotion initiatives. The findings of this study suggest that a proactive telephone-based intervention has the potential to be effective in increasing the prevalence of health promotion initiatives across a range of health topics in a large population of workplaces. Given the capacity to reach an entire population of workplaces, this approach represents a promising means of achieving the established potential of workplace health promotion.

  3. GREEN + IDMaps: A practical soulution for ensuring fairness in a biased internet

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

    Kapadia, A. C.; Thulasidasan, S.; Feng, W. C.

    2002-01-01

    GREEN is a proactive queue-management (PQM) algorithm that removes TCP's bias against connections with longer round-trip times, while maintaining high link utilization and low packet-loss. GREEN applies knowledge of the steady-state behavior of TCP connections to proactively drop packets, thus preventing congestion from ever occurring. As a result, GREEN ensures much higher fairness between flows than other active queue management schemes like Flow Random Early Drop (FRED) and Stochastic Fair Blue (SFB), which suffer in topologies where a large number of flows have widely varying round-trip times. GREEN'S performance relies on its ability to gauge a flow's round-trip time (RTT).more » In previous work, we presented results for an ideal GREEN router which has accurate RTT information for a flow. In this paper, we present a practical solution based on IDMaps, an Internet distance-estimation service, and compare its performance to an ideal GREEN router. We show that a solution based on IDMaps is practical and maintains high fairness and link utilization, and low packet-loss rates.« less

  4. Information Processing and Proactive Interference in Children With and Without Specific Language Impairment

    PubMed Central

    Marton, Klara; Campanelli, Luca; Eichorn, Naomi; Scheuer, Jessica; Yoon, Jungmee

    2014-01-01

    Purpose Increasing evidence suggests that children with specific language impairment (SLI) have a deficit in inhibition control, but research isolating specific abilities is scarce. The goal of this study was to examine whether children with SLI differ from their peers in resistance to proactive interference under different conditions. Method An information processing battery with manipulations in interference was administered to 66 children (SLI, age-matched peers, and language-matched controls). In Experiment 1, previously relevant targets were used as distractors to create conflict. Experiment 2 used item repetitions to examine how practice strengthens word representations and how the strength of a response impacts performance on the following item. Results Children with SLI performed similarly to their peers in the baseline condition but were more susceptible to proactive interference than the controls in both experimental conditions. Children with SLI demonstrated difficulty suppressing irrelevant information, made significantly more interference errors than their peers, and showed a slower rate of implicit learning. Conclusion Children with SLI show weaker resistance to proactive interference than their peers, and this deficit impacts their information processing abilities. The coordination of activation and inhibition is less efficient in these children, but future research is needed to further examine the interaction between these two processes. PMID:23900030

  5. Patient safety in external beam radiotherapy, results of the ACCIRAD project: Current status of proactive risk assessment, reactive analysis of events, and reporting and learning systems in Europe.

    PubMed

    Malicki, Julian; Bly, Ritva; Bulot, Mireille; Godet, Jean-Luc; Jahnen, Andreas; Krengli, Marco; Maingon, Philippe; Prieto Martin, Carlos; Przybylska, Kamila; Skrobała, Agnieszka; Valero, Marc; Jarvinen, Hannu

    2017-04-01

    To describe the current status of implementation of European directives for risk management in radiotherapy and to assess variability in risk management in the following areas: 1) in-country regulatory framework; 2) proactive risk assessment; (3) reactive analysis of events; and (4) reporting and learning systems. The original data were collected as part of the ACCIRAD project through two online surveys. Risk assessment criteria are closely associated with quality assurance programs. Only 9/32 responding countries (28%) with national regulations reported clear "requirements" for proactive risk assessment and/or reactive risk analysis, with wide variability in assessment methods. Reporting of adverse error events is mandatory in most (70%) but not all surveyed countries. Most European countries have taken steps to implement European directives designed to reduce the probability and magnitude of accidents in radiotherapy. Variability between countries is substantial in terms of legal frameworks, tools used to conduct proactive risk assessment and reactive analysis of events, and in the reporting and learning systems utilized. These findings underscore the need for greater harmonisation in common terminology, classification and reporting practices across Europe to improve patient safety and to enable more reliable inter-country comparisons. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Cerulean Warbler Technical Group: Coordinating international research and conservation

    USGS Publications Warehouse

    Dawson, D.K.; Wigley, T.B.; Keyser, P.D.

    2012-01-01

    Effective conservation for species of concern requires interchange and collaboration among conservationists and stakeholders. The Cerulean Warbler Technical Group (CWTG) is a consortium of biologists and managers from government agencies, non-governmental organizations, academia, and industry, who are dedicated to finding pro-active, science-based solutions for conservation of the Cerulean Warbler (Setophaga cerulea). Formed in the United States in 2001, CWTG’s scope soon broadened to address the species’ ecology and conservation on both the breeding and non-breeding ranges, in partnership with biologists from South and Central America. In 2004, CWTG launched the Cerulean Warbler Conservation Initiative, a set of activities aimed at addressing information and conservation needs for the species. These include (1) studies in the core breeding range to assess Cerulean Warbler response to forest management practices and to identify mined lands that could be reforested to benefit the species, (2) ecological and demographic studies on the winter range, and (3) surveys of Cerulean Warbler distribution on the breeding and winter ranges and during migration. A rangewide conservation action plan has been completed, along with a more detailed conservation plan for the non-breeding range. CWTG and partners now move forward with on-the-ground conservation, while still addressing unmet information needs.

  7. Highway traffic operations and freeway management : state-of-the-practice

    DOT National Transportation Integrated Search

    2003-03-01

    This paper focuses on the proactive management of freeway facilities to balance the capacity of the transportation system and the prevailing demands and to respond to out-of-the-ordinary conditions (e.g., incidents, adverse weather, work zones, speci...

  8. Learning Analytics at Low Cost: At-Risk Student Prediction with Clicker Data and Systematic Proactive Interventions

    ERIC Educational Resources Information Center

    Choi, Samuel P. M.; Lam, S. S.; Li, Kam Cheong; Wong, Billy T. M.

    2018-01-01

    While learning analytics (LA) practices have been shown to be practical and effective, most of them require a huge amount of data and effort. This paper reports a case study which demonstrates the feasibility of practising LA at a low cost for instructors to identify at-risk students in an undergraduate business quantitative methods course.…

  9. Dual Pathways from Reactive Aggression to Depressive Symptoms in Children: Further Examination of the Failure Model.

    PubMed

    Evans, Spencer C; Fite, Paula J

    2018-04-13

    The failure model posits that peer rejection and poor academic performance are dual pathways in the association between early aggressive behavior and subsequent depressive symptoms. We examined this model using an accelerated longitudinal design while also incorporating proactive and reactive aggression and gender moderation. Children in 1st, 3rd, and 5th grades (n = 912; ages 6-12; 48% female) were rated three times annually by their primary teachers on measures of proactive and reactive aggression, peer rejection, academic performance, and depressive symptoms. Using Bayesian cross-classified estimation to account for nested and planned-missing data, path models were estimated to examine whether early reactive aggression predicted subsequent peer rejection and academic performance, and whether these, in turn, predicted subsequent depressive symptoms. From 1st to 3rd grade, reactive aggression predicted peer rejection (not academic performance), proactive aggression predicted academic performance (not peer rejection), and academic performance and peer rejection both predicted depressive symptoms. From 3rd to 5th grade, however, neither peer rejection nor academic performance predicted subsequent depressive symptoms. Results were not moderated by gender. Overall, these findings provide mixed and limited support for the failure model among school-age children. Early reactive aggression may be a key risk factor for social problems, whereas proactive aggression may be linked to improved academic functioning. The "dual pathways" of peer rejection and academic performance may operate during early but not later elementary school. Limitations and implications are discussed.

  10. The passage and initial implementation of Oregon's Measure 44

    PubMed Central

    Goldman, L.; Glantz, S.

    1999-01-01

    OBJECTIVE—To prepare a history of the passage and early implementation of Ballot Measure 44, "An Act to Support the Oregon Health Plan", and tobacco control policymaking in Oregon. Measure 44 raised cigarette taxes in Oregon by US$0.30 per pack, and dedicated 10% of the revenues to tobacco control.
METHODS—Data were gathered from interviews with members of the Committee to Support the Oregon Health Plan, Measure 44's campaign committee, as well as with state and local officials, and tobacco control advocates. Additional information was obtained from public documents, internal memoranda, and news reports.
RESULTS—Although the tobacco industry outspent Measure 44's supporters 7 to 1, the initiative passed with 56% of the vote. Even before the election, tobacco control advocates were working to develop an implementation plan for the tobacco control programme. They mounted a successful lobbying campaign to see that the legislature did not divert tobacco control funds to other uses. They also stopped industry efforts to limit the scope of the programme. The one shortcoming of the tobacco control forces was not getting involved in planning the initiative early enough to influence the amount of money that was devoted to tobacco control. Although public health groups provided 37% of the money it cost to pass Measure 44, only 10% of revenues were devoted to tobacco control.
CONCLUSIONS—Proactive planning and aggressive implementation can secure passage of tobacco control initiatives and see that the associated implementing legislation follows good public health practice.


Keywords: advocacy; legislation; implementation; tobacco tax PMID:10599577

  11. Researching Researchers: Meeting Changing Researcher Needs in a Special Collections Environment

    ERIC Educational Resources Information Center

    Baseby, Francesca

    2017-01-01

    In the competitive Higher Education environment, it is no longer sufficient for special collections to rely on the "uniqueness" of a collection as its unique selling point--it must be supported by a service and strategic plan that is both proactive in anticipating the demands of future researchers and responsive to current researchers'…

  12. Estimating soil seed bank characteristics in ponderosa pine forests using vegetation and forest-floor data

    Treesearch

    Scott R. Abella; Judith D. Springer

    2008-01-01

    Soil seed banks are important for vegetation management because they contain propagules of species that may be considered desirable or undesirable for site colonization after management and disturbance events. Knowledge of seed bank size and composition before planning management activities facilitates proactive management by providing early alerts of exotic species...

  13. Noble or Malevolent in a Moment of Dismay: How Postsecondary Students Construe and Characterize Bystander Action in School Violence Shooting Incidents

    ERIC Educational Resources Information Center

    Underhill, Dyan Whitlow

    2012-01-01

    Multiple incidents of postsecondary school shooting violence have occurred in American society--prompting concern about safety on college campuses, administrators' roles in prevention, and proactive and responsible bystander actions. Active shooter plans have become more established in educational environments, with efforts are directed…

  14. Marshalling Social Support: A “Care-Getting” Model for Persons Living with Cancer

    PubMed Central

    Kahana, Eva; Kahana, Boaz; Wykle, May; Kulle, Diana

    2009-01-01

    This paper offers a stress theory based conceptual framework for understanding proactive options for care-getting for patients living with cancer that is also relevant to patients living with other chronic or life threatening illnesses. Barriers and facilitators to active efforts for obtaining responsive care from both informal and formal sources are discussed. This “Care-Getting” model explores benefits of proactive care-getting for diminishing physical discomfort/suffering, burden of illness and disability, and psychological distress. We highlight unique issues in care-getting that patients face at different stages of the life course. Implications of prior research related to the model for practice and intervention are discussed. PMID:20107524

  15. Developing leadership: management skills for small group practices.

    PubMed

    Brechbill, D D

    1998-01-01

    The role of group administrators is changing as quickly as is the group practice environment. The results of a survey of physicians and administrators in physician-owned group practices with fewer than 15 physicians offers some guidance. Physicians and administrators, the results show, have similar expectations for administrators. They also agree that physician-administrator teamwork has become more professional. The results also suggest that administrators need the tools to be proactive planners for their organizations, rather than passively responding to change.

  16. Impacts Of Climate Change On Ecosystems Management In Africa: An Assessment Of Disaster Risk Management And Adaptation

    NASA Astrophysics Data System (ADS)

    Ndebele-Murisa, M. R.

    2015-12-01

    This paper is a synthesis of eight studies which demonstrate the interface between disaster risk management (DRM) and adaptation. The studies; conducted from November 2011 to July 2012 included diverse ecosystems from forests, coastlines, rural areas to a lake region and showed that climate change/variability are major factors among other factors such as deforestation and land degradation, unsustainable land use practices, overharvesting of natural products and invasive species encroachment that are causing changes in ecosystems. The most common extreme events reported included shifts in and shorter rainfall seasons, extended droughts, increased temperatures, extreme heat, heavy rainfall, flooding, inundation, strong winds and sea level rises. As a result of these climate phenomena, adverse impacts on ecosystems and communities were reported as biodiversity loss, reduced fish catch, reduced water for forests/agriculture/consumption, increased rough waves, coastal erosion/sediment deposition and lastly land/mud slides in order of commonality. In response to these impacts communities are practicing coping and adaptation strategies but there is a huge gap between proper DRM and adaptation. This is mainly because the adaptation is practiced as an aftermath with very little effort propelled towards proactive DRM or preparedness. In addition, national level policies are archaic and do not address the current environmental changes. This was demonstrated in Togo where wood energy potential is deteriorating at an unprecedented rate but is projected to increase between 6.4% and 101% in the near and far future if the national forest action plans are implemented; preventing an energy crisis in the country. This shows that appropriate legal and policy frameworks and well planned responses to projected extreme events and climate changes are crucial in order to prevent disasters and to achieve sustainable utilisation of resources in the continent.

  17. Early career professional development issues for military academic psychiatrists.

    PubMed

    Warner, Christopher H; Bobo, William V; Flynn, Julianne

    2005-01-01

    Academically motivated graduates of military psychiatric residency programs confront serious challenges. In this article, the authors present a junior faculty development model organized around four overlapping domains: mentorship, scholarship, research, and career planning/development. Using these four domains as a platform for discussion, the authors focus on challenges facing academically oriented early-career military psychiatrists and provide guidance. The authors believe that a proactive stance, skillful mentoring, self-awareness through conscious planning and effort, ability to capitalize on existing opportunities for growth, and attention to detail are all vital to the junior military psychiatrist.

  18. The future: a primary care-led NHS.

    PubMed

    Cross, Sue

    2010-04-01

    The NHS is becoming increasingly primary care and community focused and the role of the community nurse is becoming more significant, not just in managing long-term conditions and end of life but in providing vital help and education. Helping people become more knowledgeable about maintaining both their own health and that of their families at home or within the community is vital - the desired end being less need for expensive hospital care. As the demand to implement more complex services grows, so the need for nurses to contribute to the planning and delivery of services becomes more important. Nurses in the community have the experience and practical knowledge and must use it to influence commissioning and engage proactively, and positively, with current policy agendas and with the people whose responsibility it is to implement them. Change in primary care is constant and increasingly it is the frontline deliverers of services that drive that change and help set the agenda. As more care and treatment is devolved from the secondary to primary care setting, there must be greater integration between general practice and the community nursing team, with each helping and informing the other to deliver a world class primary care service.

  19. Patient-Reported Outcomes in Cancer Drug Development and US Regulatory Review: Perspectives From Industry, the Food and Drug Administration, and the Patient.

    PubMed

    Basch, Ethan; Geoghegan, Cindy; Coons, Stephen Joel; Gnanasakthy, Ari; Slagle, Ashley F; Papadopoulos, Elektra J; Kluetz, Paul G

    2015-06-01

    Data reported directly by patients about how they feel and function are rarely included in oncology drug labeling in the United States, in contrast to Europe and to nononcology labeling in the United States, where this practice is more common. Multiple barriers exist, including challenges unique to oncology trials, and industry's concerns regarding cost, logistical complexities, and the Food and Drug Administration's (FDA's) rigorous application of its 2009 guidance on the use of patient-reported outcome (PRO) measures. A panel consisting of representatives of industry, FDA, the PRO Consortium, clinicians, and patients was assembled at a 2014 workshop cosponsored by FDA to identify practical recommendations for overcoming these barriers. Key recommendations included increasing proactive encouragement by FDA to clinical trial sponsors for including PROs in drug development programs; provision of comprehensive PRO plans by sponsors to FDA early in drug development; promotion of an oncology-specific PRO research agenda; development of an approach to existing ("legacy") PRO measures, when appropriate (focused initially on symptoms and functional status); and increased FDA and industry training in PRO methodology. FDA has begun implementing several of these recommendations.

  20. Strategic Planning for Health Care Cost Controls in a Constantly Changing Environment.

    PubMed

    Hembree, William E

    2015-01-01

    Health care cost increases are showing a resurgence. Despite recent years' comparatively modest increases, the projections for 2015 cost increases range from 6.6% to 7%--three to four times larger than 2015's expected underlying inflation. This resurgence is just one of many rapidly changing external and internal challenges health plan sponsors must overcome (and this resurgence advances the date when the majority of employers will trigger the "Cadillac tax"). What's needed is a planning approach that is effective in overcoming all known and yet-to-be-discovered challenges, not just affordability. This article provides detailed guidance in adopting six proven strategic planning steps. Following these steps will proactively and effectively create a flexible strategic plan for the present and future of employers' health plans that will withstand all internal and external challenges.

  1. Enhancing teen pregnancy prevention in local communities: capacity building using the interactive systems framework.

    PubMed

    Duffy, Jennifer L; Prince, Mary Severson; Johnson, Erin E; Alton, Forrest L; Flynn, Shannon; Faye, Amy Mattison; Padgett, Polly Edwards; Rollison, Chris; Becker, Dana; Hinzey, Angela L

    2012-12-01

    Getting To Outcomes (GTO), an innovative framework for planning, implementing, evaluating, and sustaining interventions has been shown to be effective in helping community-based organizations (CBOs) introduce science-based approaches into their prevention work. However, the Interactive Systems Framework (ISF) suggests that adopting innovations like GTO requires a significant amount of capacity building through training and technical assistance (T/TA). In this study, 11 CBOs and three schools in South Carolina entered into a 3 year program of intense and proactive T/TA based on the ISF to learn how to apply an adaptation of GTO (Promoting Science-Based Approaches-Getting To Outcomes, PSBA-GTO) to their teen pregnancy prevention programs. Using semi-structured interviews, the partnering organizations were assessed at three points in time, pre-T/TA, 12 months, and post T/TA (30 months) for their performance of the steps of GTO in their work. The seven organizations which participated in T/TA until the end of the project received an average of 76 h of TA and 112 h of training per organization. Interview results showed increased performance of all 10 steps of PSBA-GTO by these organizations when conducting their teen pregnancy programs. These results suggest targeted and proactive T/TA can successfully bridge the gap between research and practice by using a three part delivery system, as prescribed in the ISF, which relies on an intermediary prevention support system to ensure accurate and effective translation of research to the everyday work of community-based practitioners.

  2. Nurturing Responsible Behavior: A Foundation for Guidance. Preventing Discipline Problems, Unit 3. [Teaching Video, Practice Video, Facilitator's Guide, and Viewer's Guide].

    ERIC Educational Resources Information Center

    2000

    As children learn to practice responsible behaviors, discipline problems in the early childhood classroom can be reduced. As Part 3 of a 3-part video series designed to help adults working with 3- to 8-year-olds use a proactive approach to prevent discipline problems, this video training package is comprised of a Facilitators' Guide, a Viewers'…

  3. The Reduction of Microbial and Chemical Contaminants with Selected POU/POE Systems

    EPA Science Inventory

    Centralized drinking water treatment and distribution alone may not always be the most practical or cost-effective option. Also, some consumers seeking a proactive measure to reduce exposure to pathogens and chemicals not currently monitored or regulated might consider employing...

  4. Foundational Best Practices for Online Sexuality Education

    ERIC Educational Resources Information Center

    Mckee, Ryan W.; Green, Eli R.; Hamarman, Amelia M.

    2012-01-01

    An increasing number of colleges and universities are moving toward online education (Allen & Seaman, 2011; Farnsworth & Bevis, 2006). While there are reservations about the effectiveness of teaching sexuality education online, it is essential that formally trained sexuality educators participate proactively in this paradigm shift. By embracing…

  5. Malpractice and the Communication Consultant: A Proactive Approach.

    ERIC Educational Resources Information Center

    Montgomery, Daniel J.; And Others

    1995-01-01

    Provides communication practitioners with an overview of legal and ethical issues facing individuals who market themselves as professional communication consultants. Discusses the tort of negligence. Outlines court-supported practices that professional consultants might use to help protect clients and themselves. Argues that an understanding of…

  6. Managing Programmatic Risk for Complex Space System Developments

    NASA Technical Reports Server (NTRS)

    Panetta, Peter V.; Hastings, Daniel; Brumfield, Mark (Technical Monitor)

    2001-01-01

    Risk management strategies have become a recent important research topic to many aerospace organizations as they prepare to develop the revolutionary complex space systems of the future. Future multi-disciplinary complex space systems will make it absolutely essential for organizations to practice a rigorous, comprehensive risk management process, emphasizing thorough systems engineering principles to succeed. Project managers must possess strong leadership skills to direct high quality, cross-disciplinary teams for successfully developing revolutionary space systems that are ever increasing in complexity. Proactive efforts to reduce or eliminate risk throughout a project's lifecycle ideally must be practiced by all technical members in the organization. This paper discusses some of the risk management perspectives that were collected from senior managers and project managers of aerospace and aeronautical organizations by the use of interviews and surveys. Some of the programmatic risks which drive the success or failure of projects are revealed. Key findings lead to a number of insights for organizations to consider for proactively approaching the risks which face current and future complex space systems projects.

  7. Acute care clinical pharmacy practice: unit- versus service-based models.

    PubMed

    Haas, Curtis E; Eckel, Stephen; Arif, Sally; Beringer, Paul M; Blake, Elizabeth W; Lardieri, Allison B; Lobo, Bob L; Mercer, Jessica M; Moye, Pamela; Orlando, Patricia L; Wargo, Kurt

    2012-02-01

    This commentary from the 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was developed to compare and contrast the "unit-based" and "service-based" orientation of the clinical pharmacist within an acute care pharmacy practice model and to offer an informed opinion concerning which should be preferred. The clinical pharmacy practice model must facilitate patient-centered care and therefore must position the pharmacist to be an active member of the interprofessional team focused on providing high-quality pharmaceutical care to the patient. Although both models may have advantages and disadvantages, the most important distinction pertains to the patient care role of the clinical pharmacist. The unit-based pharmacist is often in a position of reacting to an established order or decision and frequently is focused on task-oriented clinical services. By definition, the service-based clinical pharmacist functions as a member of the interprofessional team. As a team member, the pharmacist proactively contributes to the decision-making process and the development of patient-centered care plans. The service-based orientation of the pharmacist is consistent with both the practice vision embraced by ACCP and its definition of clinical pharmacy. The task force strongly recommends that institutions pursue a service-based pharmacy practice model to optimally deploy their clinical pharmacists. Those who elect to adopt this recommendation will face challenges in overcoming several resource, technologic, regulatory, and accreditation barriers. However, such challenges must be confronted if clinical pharmacists are to contribute fully to achieving optimal patient outcomes. © 2012 Pharmacotherapy Publications, Inc.

  8. Cotton harvest at 40% versus 75% boll-splitting on yield and economic return under standard and proactive boll weevil (Coleoptera: Curculionidae) spray regimes.

    PubMed

    Showler, A T; Robinson, J R C

    2008-10-01

    The standard practice of two or three preemptive insecticide applications at the start of pinhead (1-2-mm-diameter) squaring followed by threshold-triggered (when 10% of randomly selected squares have oviposition punctures) insecticide applications for boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), control does not provide reliable protection of cotton, Gossypium hirsutum L., lint production. This study, conducted during 2004 and 2005, showed that three to six fewer spray applications in a "proactive" approach, in which spraying began at the start of large (5.5-8-mm-diameter) square formation and continued at approximately 7-d intervals while large squares were abundant, resulted in fewer infested squares and 1.4- to 1.7-fold more lint than the standard treatment. Fewer sprays and increased yield made proactive spraying significantly more profitable than the standard approach, which resulted in relatively low or negative economic returns. Harvest at 75% boll-split in the proactive spray regime of 2005 resulted in four-fold greater economic return than cotton harvested at 40% boll-split because of improved protection of large squares and the elimination of late-season sprays inherent to standard spray regime despite the cost of an extra irrigation in the 75% boll-split treatments. The earlier, 40% harvest trigger does not avoid high late-season boll weevil pressure, which exerts less impact on bolls, the predominant form of fruiting body at that time, than on squares. Proactive spraying and harvest timing are based on an important relationship between nutrition, boll weevil reproduction, and economic inputs; therefore, the tactic of combining proaction with harvest at 75% boll-split is applicable where boll weevils are problematic regardless of climate or region, or whether an eradication program is ongoing.

  9. Implications for cancer genetics practice of pro-actively assessing family history in a General Practice cohort in North West London.

    PubMed

    Kohut, Kelly; D'Mello, Lucia; Bancroft, Elizabeth K; Thomas, Sarah; Young, Mary-Anne; Myhill, Kathryn; Shanley, Susan; Briggs, Brian H J; Newman, Michelle; Saraf, Ifthikhar M; Cox, Penny; Scambler, Sarah; Wagman, Lyndon; Wyndham, Michael T; Eeles, Rosalind A; Ferris, Michelle

    2012-03-01

    At present cancer genetics referrals are reactive to individuals asking for a referral and providing a family history thereafter. A previous pilot study in a single General Practice (GP) catchment area in North London showed a 1.5-fold increase in breast cancer risk in the Ashkenazi Jewish population compared with the non-Ashkenazi mixed population. The breast cancer incidence was equal in the Ashkenazim in both pre- and postmenopausal groups. We wanted to investigate the effect of proactively seeking family history data from the entire female population of the practice to determine the effect on cancer genetics referral. Objectives To determine the need for cancer genetics intervention for women in a single GP catchment area. (1) to determine the incidence and strength of family history of cancer in women aged over 18 in the practice, (2) to offer cancer genetics advice and determine the uptake of counselling in those with a positive family history, (3) to identify potential BRCA1/BRCA2 gene mutation carriers who can be offered clinical follow up with appropriate translational research studies. Design Population-based cohort study of one General Practice female population. Participants Three hundred and eighty-three women over the age of 18 from one General Practice who responded to a questionnaire about family history of cancer. The whole female adult GP population was the target and the total number sampled was 3,820. Results 10% of patients completed the questionnaire (n = 383). A family history of cancer was present in 338 cases, 95 went on to have genetic counselling or had previously had counselling and 47 were genetically tested. We identified three carriers of an Ashkenazi Jewish founder mutation in BRCA1. Conclusions Response rate to a family history questionnaire such as that used in genetics centres was low (10%) and other approaches will be needed to proactively assess family history. Although the Ashkenazim are present in 39% of the GP catchment area, 62% of those who returned a family history questionnaire were from this ethnic group and of those returned, 44% warranted referral to a cancer genetics unit. In the non Ashkenazim, the questionnaire return rate was 38% and 18% of those warranted referral to cancer genetics.

  10. Enhancing reflective practice through online learning: impact on clinical practice

    PubMed Central

    Sim, J; Radloff, A

    2008-01-01

    Purpose Traditionally, radiographers and radiation therapists function in a workplace environment that is protocol-driven with limited functional autonomy. The workplace promotes a culture of conformity and discourages practitioners from reflective and critical thinking, essential attributes for continuing learning and advancing workplace practices. As part of the first author’s doctoral study, a continuing professional development (CPD) educational framework was used to design and implement an online module for radiation therapists’ CPD activities. The study aimed to determine if it is possible to enhance healthcare practitioners’ reflective practice via online learning and to establish the impact of reflective learning on clinical practice. Materials and methods The objectives of the online module were to increase radiation therapists’ knowledge in planning for radiation therapy for the breast by assisting them engage in reflective practice. The cyclical process of action research was used to pilot the module twice with two groups of volunteer radiation therapists (twenty-six participants) from Australia, New Zealand and Canada. Results The online module was evaluated using Kirkpatrick’s four-level evaluation model. Evidence indicated that participants were empowered as a result of participation in the module. They began reflecting in the workplace while assuming a more proactive role and increased clinical responsibilities, engaged colleagues in collaborative reflections and adopted evidence-based approaches in advancing clinical practices. Conclusion The study shows that it is possible to assist practitioners engage in reflective practice using an online CPD educational framework. Participants were able to apply the reflective learning they had developed in their workplace. As a result of their learning, they felt empowered to continue to effect changes in their workplace beyond the cessation of the online module. PMID:21614319

  11. Strategic Planning for Electronic Resources Management: A Case Study at Gustavus Adolphus College

    ERIC Educational Resources Information Center

    Hulseberg, Anna; Monson, Sarah

    2009-01-01

    Electronic resources, the tools we use to manage them, and the needs and expectations of our users are constantly evolving; at the same time, the roles, responsibilities, and workflow of the library staff who manage e-resources are also in flux. Recognizing a need to be more intentional and proactive about how we manage e-resources, the…

  12. The Effectiveness of Universal Design for Learning: A Meta-Analysis of Literature between 2013 and 2016

    ERIC Educational Resources Information Center

    Capp, Matthew James

    2017-01-01

    Universal Design for Learning (UDL) is often promoted as an inclusive teaching methodology for supporting all students within diverse contemporary classrooms. This is achieved by proactively planning to the edges of a classroom by thinking of all the potential needs of students. To examine its effectiveness, a meta-analysis was conducted on…

  13. Fuels planning: science synthesis and integration; social issues fact sheet 02: Developing personal responsibility for fuels reduction: Types of information to encourage proactive behavior

    Treesearch

    Rocky Mountain Research Station USDA Forest Service

    2004-01-01

    Fuels management responsibilities may include providing local property owners with the information for taking responsibility for reducing fuels on their land. This fact sheet discusses three different types of information that may be useful in programs to engage property owners in fuel reduction activities.

  14. The Challenges of Increasing Capacity and Diversity in Japanese Higher Education through Proactive Recruitment Strategies

    ERIC Educational Resources Information Center

    Kuwamura, Akira

    2009-01-01

    There has been fierce competition for a shrinking pool of high school graduates in the higher education market in Japan in recent years. Along came former Prime Minister Fukuda's plan for an intake of 300,000 international students by the year 2020. These have placed Japanese institutions of higher education under further pressure to sustain their…

  15. Following Through: Representing the Voice of Graduate Students

    ERIC Educational Resources Information Center

    Amankwatia, Tonya; Barbour, Michael; Inan, Fethi A.; Parker, Preston; Slagter van Tryon, Patricia J.

    2007-01-01

    The 2006 Class of AECT Interns has from the outset been uniquely involved and proactive in supporting the goals of the ect Foundation and of AECT. This article further illustrates the good work this group is doing to support their mutual mission and goals. In the March/April 2007 issue of "Tech Trends," the authors outlined their plans for the…

  16. Flight doesn't solve everything: Mitigation of road impacts on Birds

    Treesearch

    Angela Kociolek; Clara Grilo; Sandra Jacobson

    2015-01-01

    Roads and traffic are typically more of a threat to the conservation of birds rather than a safety issue for motorists. Some bird species have biological features and life history traits that make them particularly vulnerable to habitat loss from roads and mortality due to wildlife-vehicle collisions (WVC). Road planning that proactively considers the biological needs...

  17. Institutional management of core facilities during challenging financial times.

    PubMed

    Haley, Rand

    2011-12-01

    The economic downturn is likely to have lasting effects on institutions of higher education, prioritizing proactive institutional leadership and planning. Although by design, core research facilities are more efficient and effective than supporting individual pieces of research equipment, cores can have significant underlying financial requirements and challenges. This paper explores several possible institutional approaches to managing core facilities during challenging financial times.

  18. The Role of Social and Personal Identities among At-Risk and Non-at-Risk Singapore Youths during Peer Mediation

    ERIC Educational Resources Information Center

    Huan, Vivien S.

    2006-01-01

    Peer mediation is a school-based intervention program that was implemented in response to the rising violence in schools, and to the need for alternative and more proactive discipline plans. Using the theoretical framework of the Social Identity Theory, this article highlighted the importance of peer mediation in helping adolescents resolve their…

  19. The changing roles of natural resource professionals: providing tools to students to teach the public about fire

    Treesearch

    Pat Stephens Williams; Brian P. Oswald; Karen Stafford; Justice Jones; David Kulhavy

    2011-01-01

    The Arthur Temple College of Forestry and Agriculture (ATCOFA) at Stephen F. Austin State University is taking a proactive stance toward preparing forestry students to work closely with the public on fire planning in wildland-urban interface areas. ATCOFA's incorporation of the "Changing Roles" curriculum provides lessons on how natural resource managers...

  20. Resiliency: Planning Ahead for Disasters - Continuum Magazine | NREL

    Science.gov Websites

    a proactive approach to lessen the impacts of climate change as disasters occur more frequently and approach to lessen the impacts of climate change as disasters occur more frequently and with greater climate change. A photo of the silhouette of three men in construction uniforms as the walk toward the

  1. Students' and teachers' perceptions of aggressive behaviour in adolescents with intellectual disability and typically developing adolescents.

    PubMed

    Pavlović, Miroslav; Zunić-Pavlović, Vesna; Glumbić, Nenad

    2013-11-01

    This study investigated aggressive behaviour in Serbian adolescents with intellectual disability (ID) compared to typically developing peers. The sample consisted of both male and female adolescents aged 12-18 years. One hundred of the adolescents had ID, and 348 adolescents did not have ID. The adolescents were asked to complete the Reactive-Proactive Aggression Questionnaire (RPQ), and their teachers provided ratings of aggression for the adolescents using the Children's Scale of Hostility and Aggression: Reactive-Proactive (C-SHARP). Results indicated that adolescents reported a higher prevalence of aggressive behaviour than their teachers. Reactive aggression was more prevalent than proactive aggression in both subsamples. In the subsample of adolescents with ID, there were no sex or age differences for aggression. However, in the normative subsample, boys and older adolescents scored significantly higher on aggression. According to adolescent self-reports the prevalence of aggression was higher in adolescents without ID, while teachers perceived aggressive behaviour to be more prevalent in adolescents with ID. Scientific and practical implications are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Breastfeeding booklet and proactive phone calls for increasing exclusive breastfeeding rates: RCT protocol.

    PubMed

    Zakarija-Grković, Irena; Puharić, Drita; Malički, Mario; Hoddinott, Pat

    2017-01-01

    Breastfeeding is associated with infant and maternal health benefits and considerable potential savings to health services. Despite this, only 37% of infants globally are exclusively breastfed for 6 months. Interventions are needed to improve breastfeeding rates. The aim of this study is to determine whether written breastfeeding information in pregnancy and proactive breastfeeding-focused support phone calls, provided by a health professional educated in breastfeeding management, increase exclusive breastfeeding rates at 3 months compared with general birth-related information with proactive support calls or standard care. This is a single-centre, randomised, controlled, three-arm, superiority study with blind outcome assessment. Eligible participants will include primigravidae with singleton pregnancies who speak Croatian, attending six primary care obstetric practices. We estimate a total sample size of 459, with computer generated stratified randomisation of 153 women per arm. Participants in the intervention and active control groups will receive booklets in pregnancy, phone calls 2 weeks later, and 2, 6 and 10 weeks after birth. The primary outcome will be the proportion of women exclusively breastfeeding at 3 months. Secondary outcomes will compare: infant feeding practices and attitudes, social support, breastfeeding difficulties, breastfeeding self efficacy and utilisation of breastfeeding support services. Follow-up at 6 months will compare exclusive and any breastfeeding and utilised support services. Analysis will be by intention to treat. This trial will contribute to future evidence syntheses identifying the most effective forms of breastfeeding support. © 2016 John Wiley & Sons Ltd.

  3. Cognitive Elements in Clinical Decision-Making

    ERIC Educational Resources Information Center

    Dunphy, Bruce C.; Cantwell, Robert; Bourke, Sid; Fleming, Mark; Smith, Bruce; Joseph, K. S.; Dunphy, Stacey L

    2010-01-01

    Physician cognition, metacognition and affect may have an impact upon the quality of clinical reasoning. The purpose of this study was to examine the relationship between measures of physician metacognition and affect and patient outcomes in obstetric practice. Reflective coping (RC), proactive coping, need for cognition (NFC), tolerance for…

  4. Defensive Stakeholder Management in European Universities: An Institutional Logics Perspective

    ERIC Educational Resources Information Center

    Mampaey, Jelle; Huisman, Jeroen

    2016-01-01

    Earlier studies on stakeholder management in European universities focused on proactive strategies, that is, substantive organizational practices to establish and maintain mutually beneficial exchanges between universities and their stakeholders. We argue that the literature on stakeholder management has to be extended by theorizing defensive…

  5. The relationship between self-reported oral health, self-regulation, proactive coping, procrastination and proactive attitude.

    PubMed

    Dumitrescu, A L; Dogaru, B C; Dogaru, C D; Manolescu, B

    2011-06-01

    This cross-sectional study investigated the relationship between self-regulation, proactive coping, procrastination and proactive attitude, perceived oral health and self-reported oral-health behaviours. The study sample consisted of 198 first year medical students. The questionnaire included information about socio-demographic factors, behavioural variables, self-reported oral health status, proactive coping (proactive coping subscale of the Proactive Coping Inventory), procrastination (Procrastination Scale) and proactive attitude (Proactive Attitude Scale). Significant differences were found on self-regulation, proactive coping, procrastination and proactive attitude scales between participants who rated their gingival condition as very good/excellent and those who evaluated it as being poor, very poor or normal (p < 0.05). Results revealed significant differences in procrastination level among individuals who never visit their dentist and those who visit their dentist for check-up or for tooth cleaning and scaling (p = 0.001) or when treatment is needed or when in pain (p < 0.05). In multiple linear regression analyses, proactive coping was associated with toothbrushing frequency and reason for dental visiting. The result suggested that procrastination and proactive coping are important determinants of perceived oral health and self-reported oral-health behaviours.

  6. NursesforTomorrow: a proactive approach to nursing resource analysis.

    PubMed

    Bournes, Debra A; Plummer, Carolyn; Miller, Robert; Ferguson-Paré, Mary

    2010-03-01

    This paper describes the background, development, implementation and utilization of NursesforTomorrow (N4T), a practical and comprehensive nursing human resources analysis method to capture regional, institutional and patient care unit-specific actual and predicted nurse vacancies, nurse staff characteristics and nurse staffing changes. Reports generated from the process include forecasted shortfalls or surpluses of nurses, percentage of novice nurses, occupancy, sick time, overtime, agency use and other metrics. Readers will benefit from a description of the ways in which the data generated from the nursing resource analysis process are utilized at senior leadership, program and unit levels to support proactive hiring and resource allocation decisions and to predict unit-specific recruitment and retention patterns across multiple healthcare organizations and regions.

  7. Employer involvement in defined contribution investment education.

    PubMed

    Blau, G; VanDerhei, J L

    2000-01-01

    In this paper the authors consider the personnel problems that may arise for defined contribution plan sponsors if major market corrections cause older employees to delay retirement beyond previous expectations. We move from that basic premise to argue that, given the continued evolution from defined benefit (DB) to defined contribution (DC) retirement plans, employers need to be more "proactive" in educating their employees about their retirement planning. A human resources perspective is used to support this argument, apart from and in addition to legal considerations such as ERISA Section 404(c). Specifics of employer involvement and its place as a component of an organization's culture are discussed. Finally, recommendations are given for employers to consider.

  8. KSC00pp1581

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, two employees were recognized for submitting winning entries in the theme and logo/poster contests. At left, Center Director Roy Bridges congratulates Dave Earhart with United Space Alliance (USA) for his winning logo; at right, Brig. Gen. Ronald D. Pettit congratulates David Koval with Space Gateway Support (SGS) for his winning theme, “Safety and Health: A Working Relationship.” Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  9. KSC-00pp1581

    NASA Image and Video Library

    2000-10-18

    During Super Safety and Health Day at KSC, two employees were recognized for submitting winning entries in the theme and logo/poster contests. At left, Center Director Roy Bridges congratulates Dave Earhart with United Space Alliance (USA) for his winning logo; at right, Brig. Gen. Ronald D. Pettit congratulates David Koval with Space Gateway Support (SGS) for his winning theme, “Safety and Health: A Working Relationship.” Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is “Safety and Health First.” KSC’s number one goal is to “Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.

  10. Super Safety and Health Day at KSC

    NASA Technical Reports Server (NTRS)

    2000-01-01

    During Super Safety and Health Day at KSC, two employees were recognized for submitting winning entries in the theme and logo/poster contests. At left, Center Director Roy Bridges congratulates Dave Earhart with United Space Alliance (USA) for his winning logo; at right, Brig. Gen. Ronald D. Pettit congratulates David Koval with Space Gateway Support (SGS) for his winning theme, '''Safety and Health: A Working Relationship.''' Safety Day is a full day of NASA-sponsored, KSC and 45th Space Wing events involving a number of health and safety related activities: Displays, vendors, technical paper sessions, panel discussions, a keynote speaker, etc. The entire Center and Wing stand down to participate in the planned events. Safety Day is held annually to proactively increase awareness in safety and health among the government and contractor workforce population. The first guiding principle at KSC is '''Safety and Health First.''' KSC's number one goal is to '''Assure sound, safe and efficient practices and processes are in place for privatized/commercialized launch site processing.'''

  11. Psychosocial oncofertility issues faced by adolescents and young adults over their lifetime: a review of the research.

    PubMed

    Crawshaw, Marilyn

    2013-03-01

    This review considers psychosocial oncofertility research relevant to adolescents and young adults over their lifetime. There is growing awareness of the fertility preservation needs of younger males including lowering practical barriers and attending to emotional impact. Despite decisional challenges facing females--the experimental nature of procedures, time involved and potential involvement of partners/donors (for embryo cryopreservation)--findings suggest they too benefit from fertility information at diagnosis and access to fertility specialists. Studies consistently report that fertility concerns affect well-being, relationships and life planning. Both genders thus want fertility issues to be raised proactively by professionals in the years following diagnosis: to help them make informed decisions at a time relevant to them, develop coping strategies for current and future related areas and to be referred to specialist and/or therapeutic help if needed. Little is known about why cancer survivors are less likely to marry or have children, or about their parenthood experiences.

  12. A Practical Comprehensive Approach to Management of Acute 
Decompensated Heart Failure

    PubMed Central

    Nwosu, Chukwunweike; Mezue, Kenechukwu; Bhagatwala, Kunal; Ezema, Nonso

    2016-01-01

    Heart failure (HF) has a high incidence and prevalence in the USA and worldwide. It is a very common cause of significant morbidity and mortality with serious cost implications on the US health sector. The primary focus of this review is to synthesize an effective comprehensive care plan for patients in acute decompensated heart failure (ADHF) based on the most current evidence available. It begins with a brief overview of the pathophysiology, clinical presentation and evaluation of patients in ADHF. It then reviews management goals and treatment guidelines, with emphasis on challenges presented by diuretic resistance and worsening renal function (WRF). It provides information on recognition of advanced HF even during acute presentation, estimation of prognosis and proactive identification of patients that will benefit from mechanical cardiac devices, transplantation and palliative care/hospice. In addition, it presents strategies to address the problem of readmissions, which is an ominous prognostic factor with enormous economic burden. PMID:26926295

  13. "Reacting to the Past" to Be Proactive in the Present: Feminist Roots of High-Impact Practices

    ERIC Educational Resources Information Center

    Lidinsky, April

    2014-01-01

    In this article, the author explains a high-impact role-playing pedagogy developed at Barnard College called "Reacting to the Past," which she uses to introduce first-year and general education students to feminist history, current feminist issues, and feminist pedagogy.

  14. Changing Professional Practice Requires Changing Beliefs

    ERIC Educational Resources Information Center

    Guerra, Patricia L.; Nelson, Sarah W.

    2009-01-01

    Creating schools that are culturally responsive and successful with all students requires doing basic work with educators to uncover their beliefs about children. If school leaders believe, like many people do, that changed behavior will result in changed beliefs, they are mistaken. Leaders must be proactive in identifying what teachers believe…

  15. Safe practices, operating rule compliance, and derailment rates improve at Union Pacific Yards with STEEL process : a risk reduction approach to safety.

    DOT National Transportation Integrated Search

    2008-12-01

    After the success of the Federal Railroad Administration (FRA) Human Factors Program demonstration project at Union Pacific (UP) Railroads San Antonio Service Unit (SASU), which focused on managers and road crews with a proactive safety risk reductio...

  16. Supporting Distance Learners: Making Practice More Effective

    ERIC Educational Resources Information Center

    Pratt, Keryn

    2015-01-01

    This paper reports on a qualitative evaluation of the postgraduate courses offered by distance in one university department. The types and amount of support provided to students was evaluated and compared with Simpson's (2008a) Proactive Motivational Support model (PaMS). While students were largely satisfied with the support they received during…

  17. Advocacy for Native American Indian and Alaska Native Clients and Counselees.

    ERIC Educational Resources Information Center

    Herring, Roger

    Helping professionals need to be more informed and more active advocates for proactive counseling strategies with Native American Indian and Alaska Native peoples. The paper discusses the major advocacy needs of these populations. The negative impact of historical and contemporary discriminatory policies and practices on Native peoples has…

  18. Testing during Study Insulates against the Buildup of Proactive Interference

    ERIC Educational Resources Information Center

    Szpunar, Karl K.; McDermott, Kathleen B.; Roediger, Henry L., III

    2008-01-01

    Recent interest in the benefits of retrieval practice on long-term retention--the testing effect--has spawned a considerable amount of research toward understanding the underlying nature of this ubiquitous memory phenomenon. Taking a test may benefit retention through both direct means (engaging appropriate retrieval processes) and indirect means…

  19. Primed for Patron-Driven Acquisition: A Look at the Big Picture

    ERIC Educational Resources Information Center

    Dahl, Candice

    2012-01-01

    The development of patron-driven acquisition (PDA) as a viable collections practice is encouraging many academic libraries to be proactive about sharing significant collection development responsibilities with their patrons. The adoption of PDA represents a challenge to some long-held understandings about libraries and collections, however, and…

  20. Forget Me Not: Dementia in Prison

    ERIC Educational Resources Information Center

    Maschi, Tina; Kwak, Jung; Ko, Eunjeong; Morrissey, Mary B.

    2012-01-01

    The number of older adults with dementia in U.S. prisons is rapidly rising. Yet, the vast majority of this marginalized subgroup of the aging population is left neglected behind bars without access to adequate medical and mental health care services. We assert that proactive, interdisciplinary collaborative efforts to improve practice, policy, and…

  1. Two year measurement of nitrous oxide emission from high frequency surface and subsurface drip irrigations in pomegranate orchard

    USDA-ARS?s Scientific Manuscript database

    Building resiliency in California agriculture means utilizing adaptive farming practices that will produce better yields while overcoming the State’s current challenges, such as diminishing water supply and deteriorating water quality. In addition, California agriculture also needs to take proactive...

  2. Health communication in primary health care -a case study of ICT development for health promotion.

    PubMed

    Mahmud, Amina Jama; Olander, Ewy; Eriksén, Sara; Haglund, Bo Ja

    2013-01-30

    Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate health communication for promoting health, i.e. 'health promoting communication'.

  3. Guidelines for a palliative approach for aged care in the community setting: A suite of resources.

    PubMed

    Toye, Christine; Blackwell, Scott; Maher, Sean; Currow, David C; Holloway, Kristi; Tieman, Jennifer; Hegarty, Meg

    2012-01-01

    In Australia, many people ageing in their own homes are becoming increasingly frail and unwell, approaching the end of life. A palliative approach, which adheres to palliative care principles, is often appropriate. These principles provide a framework for proactive and holistic care in which quality of life and of dying is prioritised, as is support for families. A palliative approach can be delivered by the general practitioner working with the community aged care team, in collaboration with family carers. Support from specialist palliative care services is available if necessary.The Guidelines for a Palliative Approach for Aged Care in the Community Setting were published by the Australian Government Department of Health and Ageing to inform practice in this area. There are three resource documents. The main document provides practical evidence based guidelines, good practice points, tools, and links to resources. This document is written for general practitioners, nurses, social workers, therapists, pastoral care workers, and other health professionals and responded to needs identified during national consultation. Evidence based guidelines were underpinned by systematic reviews of the research literature. Good practice points were developed from literature reviews and expert opinion. Two 'plain English' booklets were developed in a process involving consumer consultation; one is for older people and their families, the other for care workers.The resources are intended to facilitate home care that acknowledges and plans for the client's deteriorating functional trajectory and inevitable death. At a time when hospitals and residential aged care facilities are under enormous pressure as the population ages, such a planned approach makes sense for the health system as a whole. The approach also makes sense for older people who wish to die in their own homes. Family needs are recognised and addressed. Unnecessary hospitalisations or residential placements and clinically futile interventions are also minimised.

  4. Health communication in primary health care -A case study of ICT development for health promotion

    PubMed Central

    2013-01-01

    Background Developing Information and Communication Technology (ICT) supported health communication in PHC could contribute to increased health literacy and empowerment, which are foundations for enabling people to increase control over their health, as a way to reduce increasing lifestyle related ill health. However, to increase the likelihood of success of implementing ICT supported health communication, it is essential to conduct a detailed analysis of the setting and context prior to the intervention. The aim of this study was to gain a better understanding of health communication for health promotion in PHC with emphasis on the implications for a planned ICT supported interactive health channel. Methods A qualitative case study, with a multi-methods approach was applied. Field notes, document study and focus groups were used for data collection. Data was then analyzed using qualitative content analysis. Results Health communication is an integral part of health promotion practice in PHC in this case study. However, there was a lack of consensus among health professionals on what a health promotion approach was, causing discrepancy in approaches and practices of health communication. Two themes emerged from the data analysis: Communicating health and environment for health communication. The themes represented individual and organizational factors that affected health communication practice in PHC and thus need to be taken into consideration in the development of the planned health channel. Conclusions Health communication practiced in PHC is individual based, preventive and reactive in nature, as opposed to population based, promotive and proactive in line with a health promotion approach. The most significant challenge in developing an ICT supported health communication channel for health promotion identified in this study, is profiling a health promotion approach in PHC. Addressing health promotion values and principles in the design of ICT supported health communication channel could facilitate health communication for promoting health, i.e. ‘health promoting communication’. PMID:23363566

  5. Benefits to blood banks of a sales and operations planning process.

    PubMed

    Keal, Donald A; Hebert, Phil

    2010-12-01

    A formal sales and operations planning (S&OP) process is a decision making and communication process that balances supply and demand while integrating all business operational components with customer-focused business plans that links high level strategic plans to day-to-day operations. Furthermore, S&OP can assist in managing change across the organization as it provides the opportunity to be proactive in the face of problems and opportunities while establishing a plan for everyone to follow. Some of the key outcomes from a robust S&OP process in blood banking would include: higher customer satisfaction (donors and health care providers), balanced inventory across product lines and customers, more stable production rates and higher productivity, more cooperation across the entire operation, and timely updates to the business plan resulting in better forecasting and fewer surprises that negatively impact the bottom line. © 2010 American Association of Blood Banks.

  6. Telemedicine in the Malaysian Multimedia Super Corridor: towards personalized lifetime health plans.

    PubMed

    Abidi, S S; Yusoff, Z

    1999-01-01

    The Malaysian Telemedicine initiative advocates a paradigm shift in healthcare delivery patterns by way of implementing a person-centred and wellness-focused healthcare system. This paper introduces the Malaysian Telemedicine vision, its functionality and associated operational conditions. In particular, we focus on the conceptualisation of one key Telemedicine component i.e. the Lifetime Health Plan (LHP) system--a distributed multimodule application for the periodic monitoring and generation of health-care advisories for all Malaysians. In line with the LHP project, we present an innovative healthcare delivery info-structure--LifePlan--that aims to provide life-long, pro-active, personalised, wellness-oriented healthcare services to assist individuals to manage and interpret their health needs. Functionally, LifePlan based healthcare services are delivered over the WWW, packaged as Personalised Lifetime Health Plans that allow individuals to both monitor their health status and to guide them in healthcare planning.

  7. Prevention of medication errors: detection and audit.

    PubMed

    Montesi, Germana; Lechi, Alessandro

    2009-06-01

    1. Medication errors have important implications for patient safety, and their identification is a main target in improving clinical practice errors, in order to prevent adverse events. 2. Error detection is the first crucial step. Approaches to this are likely to be different in research and routine care, and the most suitable must be chosen according to the setting. 3. The major methods for detecting medication errors and associated adverse drug-related events are chart review, computerized monitoring, administrative databases, and claims data, using direct observation, incident reporting, and patient monitoring. All of these methods have both advantages and limitations. 4. Reporting discloses medication errors, can trigger warnings, and encourages the diffusion of a culture of safe practice. Combining and comparing data from various and encourages the diffusion of a culture of safe practice sources increases the reliability of the system. 5. Error prevention can be planned by means of retroactive and proactive tools, such as audit and Failure Mode, Effect, and Criticality Analysis (FMECA). Audit is also an educational activity, which promotes high-quality care; it should be carried out regularly. In an audit cycle we can compare what is actually done against reference standards and put in place corrective actions to improve the performances of individuals and systems. 6. Patient safety must be the first aim in every setting, in order to build safer systems, learning from errors and reducing the human and fiscal costs.

  8. A Computerized Family Planning Counseling Aid: A Pilot Study Evaluation of Smart Choices.

    PubMed

    Koo, Helen P; Wilson, Ellen K; Minnis, Alexandra M

    2017-03-01

    Resource constraints may make it challenging for family planning clinics to provide comprehensive contraceptive counseling; technological tools that help providers follow recommended practices without straining resources merit evaluation. A pilot study using a two-group, posttest-only experimental design evaluated Smart Choices, a computer-based tool designed to help providers offer more patient-centered counseling and enable patients to participate proactively in the counseling session. In two North Carolina family planning clinics, 214 women received usual counseling in March-May 2013, and 126 women used Smart Choices in May-July 2013. Exit interviews provided data for the evaluation. Multivariate Poisson and multinomial logistic regression analyses were performed to examine group differences in counseling outcomes. Three of 12 hypotheses tested were supported: Compared with controls, women in the intervention group knew more contraceptive methods (adjusted mean, 11.1 vs. 10.7); discussed more topics related to sexual health during counseling (1.2 vs. 0.9 among those reporting any discussion); and rated counseling as more patient-centered, an indication of how well they felt providers understood their family planning circumstances and ideas (3.9 vs. 3.7 on a scale of 1-4). Contrary to another hypothesis, controls were more likely than women in the intervention group to choose IUDs and implants. Computerized counseling aids like Smart Choices are in an early stage of development. Future research is warranted to develop tools that lead to more productive and individualized clinic visits and, ultimately, to more effective contraceptive use and reduced levels of unintended pregnancy. Copyright © 2017 by the Guttmacher Institute.

  9. Proactive control of proactive interference using the method of loci.

    PubMed

    Bass, Willa S; Oswald, Karl M

    2014-01-01

    Proactive interferencebuilds up with exposure to multiple lists of similar items with a resulting reduction in recall. This study examined the effectiveness of using a proactive strategy of the method of loci to reduce proactive interference in a list recall paradigm of categorically similar words. While all participants reported using some form of strategy to recall list words, this study demonstrated that young adults were able to proactively use the method of loci after 25 min of instruction to reduce proactive interference as compared with other personal spontaneous strategies. The implications of this study are that top-down proactive strategies such as the method of loci can significantly reduce proactive interference, and that the use of image and sequence or location are especially useful in this regard.

  10. Proactive control of proactive interference using the method of loci

    PubMed Central

    Bass, Willa S.; Oswald, Karl M.

    2014-01-01

    Proactive interferencebuilds up with exposure to multiple lists of similar items with a resulting reduction in recall. This study examined the effectiveness of using a proactive strategy of the method of loci to reduce proactive interference in a list recall paradigm of categorically similar words. While all participants reported using some form of strategy to recall list words, this study demonstrated that young adults were able to proactively use the method of loci after 25 min of instruction to reduce proactive interference as compared with other personal spontaneous strategies. The implications of this study are that top-down proactive strategies such as the method of loci can significantly reduce proactive interference, and that the use of image and sequence or location are especially useful in this regard. PMID:25157300

  11. When in doubt, seize the day? Security values, prosocial values, and proactivity under ambiguity.

    PubMed

    Grant, Adam M; Rothbard, Nancy P

    2013-09-01

    Researchers have suggested that both ambiguity and values play important roles in shaping employees' proactive behaviors, but have not theoretically or empirically integrated these factors. Drawing on theories of situational strength and values, we propose that ambiguity constitutes a weak situation that strengthens the relationship between the content of employees' values and their proactivity. A field study of 204 employees and their direct supervisors in a water treatment plant provided support for this contingency perspective. Ambiguity moderated the relationship between employees' security and prosocial values and supervisor ratings of proactivity. Under high ambiguity, security values predicted lower proactivity, whereas prosocial values predicted higher proactivity. Under low ambiguity, values were not associated with proactivity. We replicated these findings in a laboratory experiment with 232 participants in which we measured proactivity objectively as initiative taken to correct errors: Participants with strong security values were less proactive, and participants with strong prosocial values were more proactive, but only when performance expectations were ambiguous. We discuss theoretical implications for research on proactivity, values, and ambiguity and uncertainty. PsycINFO Database Record (c) 2013 APA, all rights reserved

  12. Proactive and Adaptive Decision Support Study (PDS)

    DTIC Science & Technology

    2014-12-09

    situations diverge from known models. Note that identifying the mission is not an open -ended problem, and is consequently not intractable. The set of...Simulation ( BRIMS ) Conference, Amelia Island, FL, 2012. [9] L. P. Kaelbling, M. L. Littman, and A. R. Cassandra, “Planning and acting in partially...Simulation Conference ( BRIMS ), Sundance, Utah, 2011. PDS Study Final Report 15 Distribution Statement A. Approved for public release; distribution

  13. Examining maternal effects and genetic differentiation in P. flexilis and P. aristata to improve success of conservation actions

    Treesearch

    Erin M. Borgman

    2013-01-01

    As the climate changes and invasive species continue to spread, proactive management may be needed to conserve native plant populations. Selecting appropriate plant material for restoration or other actions that will sustain populations is an integral part of any such plan and must take into account genetic differentiation to limit maladaptation. Common garden studies...

  14. The Health Policy and Legislative Awareness Initiative at the Pennsylvania State University College of Medicine: theory meets practice.

    PubMed

    Quraishi, Sadeq A; Orkin, Fredrick K; Weitekamp, Michael R; Khalid, Ayesha N; Sassani, Joseph W

    2005-05-01

    In a constantly evolving health care landscape shaped by many voices--including those of third party payers and government--physicians must learn to play a more proactive role to become better advocates for their patients and to uphold the basic tenets of their noble profession. As legislation and public health become increasingly intertwined with the practice of medicine, educators must provide future physicians with the tools to meet these new challenges. Accordingly, in 1996 Pennsylvania State University College of Medicine embarked on its Health Policy and Legislative Awareness Initiative, a medical school elective designed to provide theoretical knowledge as well as practical experience in legislative and policy issues for future physicians early in their careers. The Initiative has three key elements: a series of lectures taught by national and local experts covering a basic health policy curriculum, a mini-internship conducted at the office of a Pennsylvania State legislator, and a practical assignment leading to authorship of a resolution to a national medical organization or assisting in drafting a bill intended for introduction to the Pennsylvania State Legislature. Following several years of successful implementation and a moderate growth in enrollment, recent changes in the local and national scene have peaked the interest of most students to learn about the system in which they will practice medicine. Therefore, in addition to describing the Initiative in its current form, the authors discuss future plans for expanded elective opportunities and consider the issue of integrating health policy education into core medical school curricula.

  15. Using Fluvial Geomorphology as a Physical Template in Process-Based and Recovery Enhancement Approaches to River Management

    NASA Astrophysics Data System (ADS)

    Fryirs, K.

    2016-12-01

    In an `era of river repair' fluvial geomorphology has emerged as a key science in river management practice. Geomorphologists are ideally placed to use their science in an applied manner to provide guidance on the impact of floods and droughts, landuse and climate change, and water use on river forms, processes and evolution. Increasingly, fluvial geomorphologists are also asked to make forecasts about how systems might adjust in the future, and to work with managers to implement strategies on-the-ground. Using case study material from Eastern Australia (Bega, Hunter, Wollombi and Lockyer catchments) I will focus on how process-based understanding of rivers has developed and evolved to provide a coherent physical template for effective and proactive, river management practice. I will focus on four key principles and demonstrate how geomorphology has been, and should continue to be, used in process-based, recovery enhancement approaches to river management. How understanding the difference between river behaviour and river change is used to determine how a river is `expected' to function, and how to identify anomalous processes requiring a treatment response. How understanding evolutionary trajectory is used to make future forecasts on river condition and recovery potential, and how working with processes can enhance river recovery. How geomorphic information can be used as a physical template atop which to analyse a range of biotic processes and habitat outcomes. How geomorphic information is used to effectively prioritise and plan river conservation and rehabilitation activities as part of catchment and region-scale action plans.

  16. Effectiveness of Chinese Martial Arts and Philosophy to Reduce Reactive and Proactive Aggression in Schoolchildren.

    PubMed

    Fung, Annis Lai Chu; Lee, Toney Ka Hung

    2018-06-01

    This study examined the effectiveness of Chinese martial arts in reducing reactive and proactive aggressive behavior among schoolchildren with a cluster-randomized trial. A screening questionnaire was completed by 3511 schoolchildren of Grades 2 to 5 from 13 sites in Hong Kong. We shortlisted 298 children who scored z ≥ 1 on the total score of the Reactive-Proactive Aggression Questionnaire in their respective sites to participate in the experiment. They were divided into 31 clusters that were blinded and randomly assigned to one of the 4 conditions: skills only, philosophy only, skills and philosophy, and physical fitness (placebo). Subjects were assessed at baseline, posttraining, and 6 months after training using aggression scales. Results from the linear mixed model indicated that the time × training interaction effects were significant for aggressive behavior (reactive and proactive), delinquent behavior, anxiety/depression, and attention problems. Although all measures declined in all conditions over time, only the skills-and-philosophy condition showed a significant reduction at posttraining and/or 6-month follow-up compared with the placebo. The results provided a theoretical proof for the relationship between aggression and sport involvement combined with children's moral reasoning. This study gives practical implications to intervention that solely playing sports or teaching moral lessons is not effective enough for high-risk schoolchildren with aggressive behavior. However, combined traditional Chinese martial arts skills and moral philosophy training could be considered in the school curriculum to reduce school violence and facilitate creation of harmonious schools.

  17. Interprofessional communication training: benefits to practicing pharmacists.

    PubMed

    Luetsch, Karen; Rowett, Debra

    2015-10-01

    Interprofessional communication skills are important for pharmacists to build collaborative relationships with other health professionals, integrate into healthcare teams, maximise their effectiveness in patient care in addressing complex care needs and meet the demands of health care reforms. This qualitative study explores clinical pharmacists' experiences and reflections after completing a learning and practice module which introduced them to a framework for successful interprofessional communication. The postgraduate clinical pharmacy program at The University of Queensland and the clinical pharmacy practice environments of forty-eight hospital and seven community based pharmacists. A learning and practice module outlining a framework for successful interprofessional communication was designed and integrated into a postgraduate clinical pharmacy program. Enrolled pharmacists applied newly learnt communication skills in pro-actively initiated, clinical discussions with a health professional in their practice environment. They provided written reflections on their experiences which were analysed using thematic analysis. Pharmacists' perceptions of the impact of applying the communication framework during their interaction with a health professional in their practice setting. Themes which emerged from reflections described pharmacists' confidence and capabilities to successfully conduct a clinical discussion with a health professional after initial apprehension and nervousness about the scheduled interaction. The application of the communication framework enhanced their perception of their professional identity, credibility and ability to build a collaborative working relationship with other health professionals. Pharmacists perceived that a learning and practice module for successful interprofessional practice integrated into a postgraduate clinical pharmacy program enhanced their interprofessional communication skills. The development of pro-active, interprofessional communication skills has the potential to increase interprofessional collaboration and pharmacists' personal role satisfaction. Pharmacists also observed it added value to their professional contribution in health care teams when addressing the demands of increasingly complex health care needs and reforms.

  18. Correlates of Pure and Co-Occurring Proactive and Reactive Aggressors In Hong Kong

    ERIC Educational Resources Information Center

    Chan, Jacob Yuichung; Fung, Annis L.; Gerstein, Lawrence H.

    2013-01-01

    Research on aggression in the West has focused mainly on the dichotomy between proactive and reactive aggression, but not the co-occurring proactive-reactive aggression subtype, despite its prevalence. The authors investigated the differences in psychological and behavioral correlates among proactive, reactive, and proactive-reactive student…

  19. Evaluation of a telenovela designed to improve knowledge and behavioral intentions among Hispanic patients with end-stage renal disease in Southern California.

    PubMed

    Forster, Myriam; Allem, Jon-Patrick; Mendez, Nicole; Qazi, Yasir; Unger, Jennifer B

    2016-01-01

    Culturally relevant education is needed to improve rates of successful kidney transplantation among Hispanic patients with end-stage renal disease (ESRD). This study examined whether patients' knowledge about kidney disease, postoperative care, and proactive health practices improved after watching a telenovela series about ESRD. 334 ESRD patients and 94 family members/caregivers were assigned to watch a telenovela ('Fixing Paco,' a bilingual health education film) or receive standard of care at a transplant center or at a dialysis clinic. Outcomes for pre-transplant patients assigned to standard of care at dialysis centers or at a transplant center were compared to pre-transplant patients in the treatment condition (standard of care + telenovela). Knowledge and behavioral intention scores at baseline across conditions and locations were similar, suggesting that assignment resulted in comparable groups at baseline. Using linear regression, this study found statistically significant improvements in knowledge scores among the telenovela group as compared to the standard of care groups. The telenovela group also had greater improvements in behavioral intention scores compared to the standard of care groups. Family members assigned to the telenovela group had significant improvements in knowledge scores as compared to the standard of care groups. Being well informed about ESRD and adopting proactive health behaviors are important mechanisms in improving transplantation outcomes. These findings suggest that knowledge about kidney disease, postoperative care, and proactive health practices could be improved by viewing a telenovela. Implications, limitations, and directions for future research are discussed.

  20. Web-based proactive system to improve breast cancer screening: a randomized controlled trial.

    PubMed

    Chaudhry, Rajeev; Scheitel, Sidna M; McMurtry, Erin K; Leutink, Dorinda J; Cabanela, Rosa L; Naessens, James M; Rahman, Ahmed S; Davis, Lynn A; Stroebel, Robert J

    2007-03-26

    Screening mammography is recommended for early detection of breast cancer but screening rates remain suboptimal. A primary care portal for a large academic primary practice was developed for all preventive services. Another Web-based system (PRECARES [PREventive CAre REminder System]) was developed for appointment secretaries to manage proactive breast cancer screening. Female patients aged 40 to 75 years were randomly assigned to a control group (usual care) and an intervention group. For the intervention group, 2 monthly letters inviting patients to undergo mammography were sent starting 3 months before they were due for annual screening, followed by a telephone call to nonresponding patients. A subgroup of women employees was further randomized to receive a reminder by either US mail or e-mail. Of the total eligible population of 6665 women identified as having consented to participate in research, 3339 were randomly assigned to the control group and 3326 to the intervention group. The screening rate for annual mammography was 64.3% for the intervention group and 55.3% for the control group (P <.001). There were no significant differences between the 2 groups for any of the other adult preventive services. For the employee subgroup, the screening rate was 57.5% for the control group, 68.1% for the US mail group, and 72.2% for the e-mail group (intervention vs control, P <.001; e-mail vs US mail; P = .24). The breast cancer screening rate improved significantly with the practice redesign of having appointment secretaries proactively manage breast cancer screening needs.

  1. A practical guide to failure mode and effects analysis in health care: making the most of the team and its meetings.

    PubMed

    Ashley, Laura; Armitage, Gerry; Neary, Maria; Hollingsworth, Gillian

    2010-08-01

    Failure Mode and Effects Analysis (FMEA) is a proactive risk assessment tool used to identify potential vulnerabilities in complex, high-risk processes and to generate remedial actions before the processes result in adverse events. FMEA is increasingly used to proactively assess and improve the safety of complex health care processes such as drug administration and blood transfusion. A central feature of FMEA is that it is undertaken by a multidisciplinary team, and because it entails numerous analytical steps, it takes a series of several meetings. Composing a team of busy health care professionals with the appropriate knowledge, skill mix, and logistical availability for regular meetings is, however, a serious challenge. Despite this, information and advice on FMEA team assembly and meetings scheduling are scarce and diffuse and often presented without the accompanying rationale. Assemble an eight-member team composed of clinically active health care staff, from every profession involved in delivery of the process-and who regularly perform it; staff from a range of seniority levels; outsider(s) to the process-and perhaps even to health care; a leader (and facilitator); and researchers. Plan for 10-15 hours of team meeting time for first-time, narrowly defined FMEAs, scheduled as four to six meetings lasting 2 to 3 hours each, spaced weekly to biweekly. Meet in a venue that seats the team around one table and is off the hospital floor but within its grounds. FMEA, generally acknowledged to be a useful addition to the patient safety toolkit, is a meticulous and time- and resource-intensive methodology, and its successful completion is highly dependent on the team members' aptitude and on the facility's and team members' commitment to hold regular, productive meetings.

  2. Perspectives on Culturally and Linguistically Responsive RtI Pedagogics through a Cultural and Linguistic Lens

    ERIC Educational Resources Information Center

    Montalvo, Ricardo; Combes, Bertina H.; Kea, Cathy D.

    2014-01-01

    Response to intervention (RtI) originates from national legislation and critical research of evidence-based practices for low performing students and students at-risk of failing or receiving special education services. RtI proactively facilitates culturally and linguistically responsive pedagogy for culturally and linguistically diverse (CLD)…

  3. Comparison of Administrators' and School Nurses' Perception of the School Nurse Role

    ERIC Educational Resources Information Center

    Green, Rebecca; Reffel, Jim

    2009-01-01

    The current tenuous status of public education funding requires that school nurses be proactive in advocacy efforts on behalf of their school nursing programs. Advocating for nursing practice within an educational setting presents unique challenges. Lack of state or national consensus for support of school nurse services creates an opportunity for…

  4. Managing Risk on the Final Frontier

    NASA Technical Reports Server (NTRS)

    Lengyel, David M.; Newman, J. S.

    2009-01-01

    The National Aeronautics and Space Administration (NASA). Exploration Systems Mission Directorate (ESMD) has combined the Continuous Risk Management (CRM) discipline with innovative knowledge management (KM) practices to more effectively enable the accomplishment of work. CRM enables proactive problem identification and problem solving in the complex world of rocket science. while KM is used to improve this process.

  5. Language Rights in Historical and Contemporary Perspective

    ERIC Educational Resources Information Center

    Bruthiaux, Paul

    2009-01-01

    This paper presents a reconceptualisation of language rights, drawing on historical sources and contemporary practice. It shows that early advocates of rights saw these as limits on the state's ability to deprive citizens of basic liberties. Only later did the concept come to include the requirement that the state be proactive in providing…

  6. Training School Personnel on Implementation of Check-in--Check-out Behavioral Interventions

    ERIC Educational Resources Information Center

    Ruiz, Maria Isolina

    2012-01-01

    Over the last several years, educational policy has advocated for a preventive approach to keep problem behaviors from escalating and interfering with student achievement. Proactive methodologies such as school-wide positive behavior support (SWPBS) and response to intervention (RTI) have become common practice in school districts across the…

  7. Can We Teach Proactive Turtle Conservation in Our Classrooms?

    ERIC Educational Resources Information Center

    Sellers, L. George; Lee, David S.

    2012-01-01

    The opportunities for meaningful classroom learning activities are everywhere. In this article, we explain some of the little known, widespread, horrific issues associated with one aspect of the pet trade. By the time they reach high school age, many students have personally experienced the end result of the deplorable business practices on which…

  8. Proactive Strategies for Advancing Elementary School Counseling Programs: A Blueprint for the New Millennium.

    ERIC Educational Resources Information Center

    Lenhardt, Marie C.; Young, Patti Ann

    2001-01-01

    Professional counselors must assume the responsibility for the continued expansion and growth of the counseling profession. Article provides counselors with practical strategies to strengthen their public image and promote more positions and programming, particularly, at the elementary level. Background information is included on public relations,…

  9. Enforcing Alcohol Policies on College Campuses: Reports from College Enforcement Officials

    ERIC Educational Resources Information Center

    Toomey, Traci L.; Miazga, Mark J.; Lenk, Kathleen M.; Erickson, Darin J.; Winters, Ken C.; Nelson, Toben F.

    2011-01-01

    We assessed alcohol enforcement practices at 343 U.S. colleges via surveys of directors of campus law enforcement. We measured types and frequency of enforcement and barriers to enforcement. We found that 61% of colleges indicated nearly always proactively enforcing alcohol policies, with most frequent enforcement at intercollegiate sporting…

  10. Interventions Promoting Educators' Use of Data: Research Insights and Gaps

    ERIC Educational Resources Information Center

    Marsh, Julie A.

    2012-01-01

    Background/Context: In recent years, states, districts, schools, and external partners have recognized the need to proactively foster the use of data to guide educational decision-making and practice. Understanding that data alone will not guarantee use, individuals at all levels have invested in interventions to support better access to,…

  11. Practical Advice for Teachers and Coaches: Handling Acute Athletic Injuries

    ERIC Educational Resources Information Center

    Hunt, Kevin; Ormond, Tom; Griffin, Lisa; Maina, Michael; Jones, Christopher; Goldman, Alexander Steven; McMichael, Callaway

    2016-01-01

    Safety concerns are among the first considerations in the design and implementation of any curriculum. However, in the dynamic worlds of physical education and coaching, athletic injuries will inevitably arise, regardless of the proactive strategies in place. These situations will vary in nature, and the student's or athlete's risk of further…

  12. Night club patrons who feel safe will return: Evidence to encourage management to address club violence.

    PubMed

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

    2016-02-01

    There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization's business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patrons' perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club's bottom line. Data for this study were collected from entry and exit surveys with 1714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010-2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

  13. A conservation plan for native fishes of the Lower Colorado River

    USGS Publications Warehouse

    Minckley, W.L.; Marsh, P.C.; Deacon, J.E.; Dowling, T.E.; Hedrick, P.W.; Matthews, W.J.; Mueller, G.

    2003-01-01

    The native fish fauna of the lower Colorado River, in the western United States, includes four “big-river” fishes that are federally listed as endangered. Existing recovery implementation plans are inadequate for these critically imperiled species. We describe a realistic, proactive management program founded on demographic and genetic principles and crafted to avoid potential conflicts with nonnative sport fisheries. In this program, native species would breed and their progeny grow in isolated, protected, off-channel habitats in the absence of nonnative fishes. Panmictic adult populations would reside in the main channel and connected waters, exchanging reproductive adults and repatriated subadults with populations occupying isolated habitats. Implementation of the plan would greatly enhance recovery potential of the four listed fishes.

  14. Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study.

    PubMed

    Mills, Jason; Wand, Timothy; Fraser, Jennifer A

    2018-04-18

    Self-care practice within the palliative care workforce is often discussed, yet seemingly under-researched. While palliative care professionals are required to implement and maintain effective self-care strategies, there appears little evidence to guide them. Moreover, there is an apparent need to clarify the meaning of self-care in palliative care practice. This paper reports qualitative findings within the context of a broader mixed-methods study. The aim of the present study was to explore the meaning and practice of self-care as described by palliative care nurses and doctors. A purposive sample of 24 palliative care nurses and doctors across Australia participated in semi-structured, in-depth interviews. Interviews were digitally recorded and transcribed prior to inductive qualitative content analysis, supported by QSR NVivo data management software. Three overarching themes emerged from the analysis: (1) A proactive and holistic approach to promoting personal health and wellbeing to support professional care of others; (2) Personalised self-care strategies within professional and non-professional contexts; and (3) Barriers and enablers to self-care practice. The findings of this study provide a detailed account of the context and complexity of effective self-care practice previously lacking in the literature. Self-care is a proactive, holistic, and personalised approach to the promotion of health and wellbeing through a variety of strategies, in both personal and professional settings, to enhance capacity for compassionate care of patients and their families. This research adds an important qualitative perspective and serves to advance knowledge of both the context and effective practice of self-care in the palliative care workforce.

  15. Supporting Military Families with Young Children throughout the Deployment Lifecycle

    DTIC Science & Technology

    2015-10-01

    and actions or plans to resolve them The research team has been very proactive in anticipating potential delays in IRB approvals. The UTHSCSA...Annual Report PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 DISTRIBUTION STATEMENT...Boston, MA 02215 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army Medical Research d Materiel

  16. A risk-based approach to evaluating wildlife demographics for management in a changing climate: A case study of the Lewis's Woodpecker

    Treesearch

    Erin Towler; Victoria A. Saab; Richard S. Sojda; Katherine Dickinson; Cindy L. Bruyere; Karen R. Newlon

    2012-01-01

    Given the projected threat that climate change poses to biodiversity, the need for proactive response efforts is clear. However, integrating uncertain climate change information into conservation planning is challenging, and more explicit guidance is needed. To this end, this article provides a specific example of how a risk-based approach can be used to incorporate a...

  17. Rendezvous Protocols and Dynamic Frequency Hopping Interference Design for Anti-Jamming Satellite Communication

    DTIC Science & Technology

    2013-11-25

    previously considered this proactive approach to combat unintentional, persistent (non- reactive) interference . In this project, we plan on extending our...channel” (or code ) by chance, through public knowledge of the underlying protocol semantics , or by compromising one of the network devices. An alternative...AFRL-RV-PS- AFRL-RV-PS- TR-2013-0142 TR-2013-0142 RENDEZVOUS PROTOCOLS AND DYNAMIC FREQUENCY HOPPING INTERFERENCE DESIGN FOR ANTI-JAMMING

  18. The Need to Proactively Develop Flexible, Adaptable Plans for Logistics

    DTIC Science & Technology

    2013-03-01

    operational reach.6 The deployment and distribution capability moves forces 4 and logistic support globally and on time meeting the required...forcing function, as supplies were moving efficiently through Pakistan. The northern routes were more expensive, so there was not a keen interest in...products to State valuing relationships more than rank.22 Clarifying the boundaries of what combatant commanders could do to move the agenda along

  19. Stochastic Game Analysis and Latency Awareness for Self-Adaptation

    DTIC Science & Technology

    2014-01-01

    this paper, we introduce a formal analysis technique based on model checking of stochastic multiplayer games (SMGs) that enables us to quantify the...Additional Key Words and Phrases: Proactive adaptation, Stochastic multiplayer games , Latency 1. INTRODUCTION When planning how to adapt, self-adaptive...contribution of this paper is twofold: (1) A novel analysis technique based on model checking of stochastic multiplayer games (SMGs) that enables us to

  20. Cost-effectiveness of possible future smoking cessation strategies in Hungary: results from the EQUIPTMOD.

    PubMed

    Németh, Bertalan; Józwiak-Hagymásy, Judit; Kovács, Gábor; Kovács, Attila; Demjén, Tibor; Huber, Manuel B; Cheung, Kei-Long; Coyle, Kathryn; Lester-George, Adam; Pokhrel, Subhash; Vokó, Zoltán

    2018-01-25

    To evaluate potential health and economic returns from implementing smoking cessation interventions in Hungary. The EQUIPTMOD, a Markov-based economic model, was used to assess the cost-effectiveness of three implementation scenarios: (a) introducing a social marketing campaign; (b) doubling the reach of existing group-based behavioural support therapies and proactive telephone support; and (c) a combination of the two scenarios. All three scenarios were compared with current practice. The scenarios were chosen as feasible options available for Hungary based on the outcome of interviews with local stakeholders. Life-time costs and quality-adjusted life years (QALYs) were calculated from a health-care perspective. The analyses used various return on investment (ROI) estimates, including incremental cost-effectiveness ratios (ICERs), to compare the scenarios. Probabilistic sensitivity analyses assessed the extent to which the estimated mean ICERs were sensitive to the model input values. Introducing a social marketing campaign resulted in an increase of 0.3014 additional quitters per 1 000 smokers, translating to health-care cost-savings of €0.6495 per smoker compared with current practice. When the value of QALY gains was considered, cost-savings increased to €14.1598 per smoker. Doubling the reach of existing group-based behavioural support therapies and proactive telephone support resulted in health-care savings of €0.2539 per smoker (€3.9620 with the value of QALY gains), compared with current practice. The respective figures for the combined scenario were €0.8960 and €18.0062. Results were sensitive to model input values. According to the EQUIPTMOD modelling tool, it would be cost-effective for the Hungarian authorities introduce a social marketing campaign and double the reach of existing group-based behavioural support therapies and proactive telephone support. Such policies would more than pay for themselves in the long term. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  1. Planning factors for developing an enterprise-wide picture archiving and communication system maintenance program.

    PubMed

    Staley, S; Romlein, J; Chacko, A K; Wider, R

    2000-05-01

    Picture archiving and communication system (PACS) maintenance on an individual site basis has historically been a complex and costly challenge. With the advent of enterprise-wide PACS projects such as the Virtual Radiology Environment (VRE) project, the challenge of a maintenance program with even more complexities has presented itself. The approach of the project management team for the VRE project is not one of reactive maintenance, but one of highly proactive planning and negotiations, in hopes of capitalizing on the economies of scale of an enterprise-wide PACS maintenance program. A proactive maintenance program is one aspect of life-cycle management. As with any capital acquisition, life-cycle management may be used to manage the specific project aspects related to PACS. The purpose of an enterprise-wide warranty and maintenance life-cycle management approach is to maintain PACS at its maximum operational efficiency and utilization levels through a flexible, shared, yet symbiotic relationship between local, regional, and vendor resources. These goals include providing maximum operational performance levels on a local, regional, and enterprise basis, while maintaining acceptable costs and resource utilization levels. This goal must be achieved without negatively impacting point of care activities, regardless of changes to the clinical business environment.

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

    PubMed

    Blok, Amanda C

    2017-04-01

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

  3. Should I get a Master of Business Administration? The anesthesiologist with education training: training options and professional opportunities.

    PubMed

    Desai, Arjun M; Trillo, Raul A; Macario, Alex

    2009-04-01

    Many physicians want to know whether they should get a Master of Business Administration (MBA), what type of program is best, and what career paths exist. It is commonly (incorrectly) assumed that a physician successful in clinical practice can easily transfer to managing/leading an organization. To be effective, the MD/MBA must bridge the cultures of the business world and medicine. Often just a single management course is sufficient to give the physician the knowledge they seek. MBA programs come in many forms and require choosing from a range of time commitments. Leaving a good clinical job in favor of the less-defined course of an MD/MBA can be daunting. Although a wide spectrum of opportunities are available, the MD/MBA may have to start over professionally, most likely with a pay cut, and will have to 'work their way up' again. A stigma exists for MD/MBAs because they are often perceived as caring more about business than about patients. Many MD/MBAs eventually choose to stay in full-time medical practice because financial and geographic stability may be more easily attained. The MBA is a good idea for the physicians who enjoy the intellectual challenges of business administration and proactively plan their own career.

  4. Characteristics of effective summer learning programs in practice.

    PubMed

    Bell, Susanne R; Carrillo, Natalie

    2007-01-01

    The Center for Summer Learning examined various summer program models and found that there are nine characteristics that provide a framework for effective summer programs. In this chapter, the authors demonstrate how effective practices lead to positive results for young people. The nine characteristics of effective summer learning programs are (1) accelerating learning, (2) youth development, (3) proactive approach to summer learning, (4) leadership, (5) advanced planning, (6) staff development, (7) strategic partnerships, (8) evaluation and commitment to program improvement, and (9) sustainability and cost-effectiveness. These characteristics are divided into two sections. The first three characteristics address a program's approach to learning. Summer instructional techniques are most effective when academic learning is woven into enrichment activities and youth development. The second section covers program infrastructure to ensure the organization achieves and maintains quality programming. The nine characteristics complement each other to ensure a strong program that works to prevent summer learning loss and narrow the achievement gap. To demonstrate the variety of high-quality programs that include the nine characteristics, thirteen program profiles at the conclusion of the chapter each highlight one of the characteristics. These profiles show the various approaches that different summer programs have developed to accelerate academic achievement and promote positive development for young people in their communities.

  5. World Café: a proactive approach to working with mentors.

    PubMed

    O'Connor, Megan; Cotrel-Gibbons, Liz

    2017-04-27

    Mentors are vital for supporting nursing students' learning in practice, but increasing demands on registered nurses can make this a challenging part of their role. This article describes how a new education team in Jersey used the World Café approach to working with mentors on a mentor update day. It explains how the café environment helped mentors to share ideas, develop opportunities to support students' learning in practice areas, increase interdepartmental working and increased communication between the education department and mentors.

  6. A concept analysis of proactive behaviour in midwifery.

    PubMed

    Mestdagh, Eveline; Van Rompaey, Bart; Beeckman, Katrien; Bogaerts, Annick; Timmermans, Olaf

    2016-06-01

    To report an analysis of the concept of proactive behaviour and apply the findings to midwifery. Proactive behaviour is a universal phenomenon generalizable to multiple professions. The purpose of this work was to establish a link with midwifery. Concept analysis by Walker and Avant's method. Literature was searched in PubMed, ERIC, NARCIS, Emerald and reference lists of related journal articles with a timeline of 1990 - April 2015 in the period of November 2014 - June 2015. Next key words were combined by the use of Boolean operators: 'proactive behaviour', 'midwifery', 'midwife', 'proactivity' and 'proactive'. Fifteen studies were included. A focused review of scientific publications in midwifery, health care, healthcare education and social sciences, which highlighted the concept of proactive behaviour. In the studied literature, several attributes of proactive behaviour were cited. These attributes were narrowed by applying it on a midwifery model case, borderline case and contrary case. Related concepts were elaborated and distinguished of the concept of proactive behaviour in midwifery. Proactive behaviour is triggered by different individual and contextual antecedents and has consequences at multiple levels. A midwife who behaves proactive would not look at changes as a boundary, persistently improves things she experienced as wrong, anticipates future barriers and looks for viable alternatives to carry out her work as efficiently and effectively as possible. Various individual and/or contextual antecedents trigger proactive behaviour in midwifery, and this behaviour could cause multiple future benefits for the constant evolving reproductive health care. © 2016 John Wiley & Sons Ltd.

  7. Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?

    PubMed

    Paul, Christine L; Boyes, Allison W; O'Brien, Lorna; Baker, Amanda L; Henskens, Frans A; Roos, Ian; Clinton-McHarg, Tara; Bellamy, Douglas; Colburn, Glenda; Rose, Shiho; Cox, Martine E; Fradgley, Elizabeth A; Baird, Hannah; Barker, Daniel

    2016-10-26

    Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes. This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support. A consecutive sample of 501 lung cancer outpatients will be recruited from 50 Australian health services to participate in a patient-randomized controlled trial (RCT). Eligible individuals must: be 18 years or older; have received a lung cancer diagnosis (including mesothelioma) within the previous 4 months; have an approximate life expectancy of at least 6 months; and have Internet access. Participants will be randomly allocated to receive: (1) an information booklet, (2) proactive telephone support, or (3) proactive Web support, chat, and/or email. The primary patient outcomes will be measured by the General Health Questionnaire (GHQ-12) and Health Education and Impact Questionnaire (heiQ) at 3 and 6 months post recruitment. The acceptability of proactive recruitment strategies will also be assessed. It is hypothesized that participants receiving telephone or Web support will report reduced distress (GHQ-12 scores that are 0.3 standard deviations (SD) lower) and greater self-efficacy (heiQ scores that are 0.3 SDs higher) than participants receiving booklets. Individuals receiving Web support will report heiQ scores within 0.29 SDs of individuals receiving telephone support. If proven effective, electronic approaches such as live-chat and email have the potential to increase the accessibility and continuity of supportive care delivered by community-based services. This evidence may also inform the redesigning of helpline-style services to be effective and responsive to patient needs.

  8. Proactive palliative care for patients with COPD (PROLONG): a pragmatic cluster controlled trial

    PubMed Central

    Duenk, RG; Verhagen, C; Bronkhorst, EM; van Mierlo, PJWB; Broeders, MEAC; Collard, SM; Dekhuijzen, PNR; Vissers, KCP

    2017-01-01

    Background and aim Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. Trial registration This trial is registered with the Netherlands Trial Register, NTR4037. Patients and methods A pragmatic cluster controlled trial (quasi-experimental design) was performed with hospitals as cluster (three intervention and three control) and a pretrial assessment was performed. Hospitals were selected for the intervention group based on the presence of a specialized palliative care team (SPCT). To control for confounders, a pretrial assessment was performed in which hospitals were compared on baseline characteristics. Patients with COPD with poor prognosis were recruited during hospitalization for acute exacerbation. All patients received usual care while patients in the intervention group received additional proactive palliative care in monthly meetings with an SPCT. Our primary outcome was change in quality of life score after 3 months, which was measured using the St George Respiratory Questionnaire (SGRQ). Secondary outcomes were, among others, quality of life at 6, 9 and 12 months; readmissions: survival; and having made advance care planning (ACP) choices. All analyses were performed following the principle of intention to treat. Results During the year 2014, 228 patients (90 intervention and 138 control) were recruited and at 3 months, 163 patients (67 intervention and 96 control) completed the SGRQ. There was no significant difference in change scores of the SGRQ total at 3 months between groups (−0.79 [95% CI, −4.61 to 3.34], p=0.70). However, patients who received proactive palliative care experienced less impact of their COPD (SGRQ impact subscale) at 6 months (−6.22 [−11.73 to −0.71], p=0.04) and had more often made ACP choices (adjusted odds ratio 3.26 [1.49–7.14], p=0.003). Other secondary outcomes were not significantly different. Conclusion Proactive palliative care did not improve the overall quality of life of patients with COPD. However, patients more often made ACP choices which may lead to better quality of care toward the end of life. PMID:29033560

  9. Avian influenza: risk, preparedness and the roles of public health nurses in Hong Kong.

    PubMed

    Ho, Georgina; Parker, Judith

    2006-03-01

    This paper provides an overview of the Hong Kong government's influenza preparedness plan and the key roles of public health nurses in that plan. The part played by Hong Kong public health nurses in the management of the avian influenza outbreak in Hong Kong in 1997 and the sudden acute respiratory syndrome outbreak in 2003, together with the capacity-building work they are now undertaking in preparing for an influenza pandemic, highlight their crucial role in public health. Recent strengthening of public health infrastructure in Hong Kong and heightened public awareness of public health issues have facilitated more proactive and effective public health nursing activities.

  10. Projections, plans, policies and politics in Prince George: reflections on five years of climate change adaptation in a northern Canadian community

    NASA Astrophysics Data System (ADS)

    Picketts, I. M.; Dery, S. J.; Curry, J.

    2013-12-01

    The City of Prince George, in central British Columbia, Canada, has partnered with academics and collaborators for over five years to address climate change adaptation at the local level. The first phase of research involved conducting a detailed overview of past climate trends and future projections for the region using the outputs of GCMs and downscaled RCMs. This information was communicated to senior local staff and community members, and feedback was applied to create a detailed adaptation strategy for the City, which identified priority impacts and outlined potential strategies to address them at the local level. The top priority impacts for Prince George are forest changes, increased flooding, and impacts to transportation infrastructure. During a second implementation phase of the project, eight local initiatives were completed focusing on: incorporating adaptation into a local sustainability plan and land use plan; exploring impacts related to forests, flooding and transportation infrastructure; and assessing trends and projections in freeze-thaw cycles and heavy rainfall events. This presentation will outline the adaptation initiatives undertaken in the City of Prince George during the second phase of research, and evaluate their effectiveness through reflections from interviews with local planners, engineers, managers, community champions and politicians. The initiatives deemed to be most successful - and most likely to be implemented - focus on topics that: are of high public concern; have clear cost implications; incorporate adaptation into policy; and/or incorporate adaptation into an ongoing project. Outcomes highlight challenges local researchers, practitioners and leaders face as they strive to implement proactive adaptation measures in policy and practice without strong support from policy and professional practices, and with a paucity of successful case study examples to build upon. Outcomes also reveal challenges as municipalities strive to do ';more with less' and work within the reality that adaptation is not generally a high public or political priority. Internal capacity and external support are vital for adaptation success at the local level.

  11. What We Know and Need to Know about Preventing Problem Behavior in Schools

    ERIC Educational Resources Information Center

    Sugai, George; Horner, Robert H.

    2008-01-01

    When chronic problem behaviors occur in schools, the tendency is to react with stringent and restrictive consequences. Recently, emphasis has shifted toward proactive prevention strategies. In this article, we focus on what we know and need to know about school-wide applications of effective practices and systems for preventing problem behaviors.…

  12. Awakening Vision: Examining the Reconceptualization of Aboriginal Education in Canada via Kaupapa Maori Praxis

    ERIC Educational Resources Information Center

    Rico, Braden

    2013-01-01

    Kaupapa Maori theory was conceptualized in the 1980s in New Zealand as a framework for revolutionizing Indigenous education. Its success marks it as a transformational praxis beneficial to educators beyond the shores of Aotearoa. This theory propounds a practical, proactive stance that enables a shift in thinking away from the psychology of…

  13. Changes in Reference Question Complexity Following the Implementation of a Proactive Chat System: Implications for Practice

    ERIC Educational Resources Information Center

    Maloney, Krisellen; Kemp, Jan H.

    2015-01-01

    There has been longstanding debate about whether the level of complexity of questions received at reference desks and via online chat services requires a librarian's expertise. Continued decreases in the number and complexity of reference questions have all but ended the debate; many academic libraries no longer staff service points with…

  14. Staff Development: A Practical Guide. Third Edition.

    ERIC Educational Resources Information Center

    Avery, Elizabeth Fuseler, Ed.; Dahlin, Terry, Ed.; Carver, Deborah A., Ed.

    In this new, expanded edition step-by-step guidelines are provided for customizing a staff development program that is both proactive and goal-oriented. Drawing on the advice of 37 top experts with a variety of skill sets, this book presents information on how to assess a library's needs and set training goals, budget appropriately, develop a set…

  15. Moving a Mountain: Transforming the Role of Contingent Faculty in Composition Studies and Higher Education.

    ERIC Educational Resources Information Center

    Schell, Eileen E., Ed.; Stock, Patricia Lambert, Ed.

    This book addresses the counterproductive conditions in which part-time and non-tenure-track composition faculty must teach, using case studies, local narratives, and models for ethical employment practices. It presents and evaluates a range of proactive strategies for change, both for local conditions and broader considerations. Section 1,…

  16. The Use of Response to Intervention Practices for Behavior: An Examination of the Validity of a Screening Instrument

    ERIC Educational Resources Information Center

    Muyskens, Paul; Marston, Doug; Reschly, Amy L.

    2007-01-01

    Behavioral difficulties of school-aged students are typically dealt with in a reactive, rather than preventative manner. This article examines a proactive approach, consistent with the Response-to-Intervention model, using a screening measure designed to identify students at risk for behavior difficulties and targeting these students for early…

  17. The Youth Worker's Role in Young People's Sexual Health: A Practice Framework

    ERIC Educational Resources Information Center

    Janssen, Marty; Davis, Jackie

    2009-01-01

    Sexual health promotion is of primary importance for young people in Australia, especially for vulnerable and at-risk young people. The authors first identify the important role of youth workers in engaging clients proactively around a broad range of sexual health issues, and then discuss real and perceived barriers that youth workers face in…

  18. Development of an Interactive, Web-Delivered System to Increase Provider–Patient Engagement in Smoking Cessation

    PubMed Central

    Delaughter, Kathryn; Crenshaw, Katie; Sobko, Heather J; Williams, Jessica H; Coley, Heather L; Ray, Midge N; Ford, Daniel E; Allison, Jeroan J; Houston, Thomas K

    2011-01-01

    Background Patient self-management interventions for smoking cessation are effective but underused. Health care providers do not routinely refer smokers to these interventions. Objective The objective of our study was to uncover barriers and facilitators to the use of an e-referral system that will be evaluated in a community-based randomized trial. The e-referral system will allow providers to refer smokers to an online smoking intervention during routine clinical care. Methods We devised a four-step development and pilot testing process: (1) system conceptualization using Delphi to identify key functionalities that would overcome barriers in provider referrals for smoking cessation, (2) Web system programming using agile software development and best programming practices with usability refinement using think-aloud testing, (3) implementation planning using the nominal group technique for the effective integration of the system into the workflow of practices, and (4) pilot testing to identify practice recruitment and system-use barriers in real-world settings. Results Our Delphi process (step 1) conceptualized three key e-referral functions: (1) Refer Your Smokers, allowing providers to e-refer patients at the point of care by entering their emails directly into the system, (2) practice reports, providing feedback regarding referrals and impact of smoking-cessation counseling, and (3) secure messaging, facilitating provider–patient communication. Usability testing (step 2) suggested the system was easy to use, but implementation planning (step 3) suggested several important approaches to encourage use (eg, proactive email cues to encourage practices to participate). Pilot testing (step 4) in 5 practices had limited success, with only 2 patients referred; we uncovered important recruitment and system-use barriers (eg, lack of study champion, training, and motivation, registration difficulties, and forgetting to refer). Conclusions Implementing a system to be used in a clinical setting is complex, as several issues can affect system use. In our ongoing large randomized trial, preliminary analysis with the first 50 practices using the system for 3 months demonstrated that our rigorous preimplementation evaluation helped us successfully identify and overcome these barriers before the main trial. Trial Clinicaltrials.gov NCT00797628; http://clinicaltrials.gov/ct2/show/NCT00797628 (Archived by WebCite at http://www.webcitation.org/61feCfjCy) PMID:22011394

  19. From proactive personality to organizational citizenship behavior: mediating role of harmony.

    PubMed

    Gan, Yiqun; Cheung, Fanny M

    2010-06-01

    The objective of the present study was to examine the moderating role of interpersonal harmony in the relation of proactive personality with organizational citizenship behavior. 158 employees in Chinese state-owned companies completed the Proactive Personality Scale (Bateman & Crant, 1993), Harmony scale, and Organizational Citizenship Behavior Questionnaire. Proactive personality had insignificant correlation with job dedication. The correlation between interpersonal facilitation and proactive personality was significant but quite low. Results of the hierarchical regression analyses indicated that when demographic variables were controlled, Harmony had significant moderating effects on the relations of proactive behavior and job dedication/interpersonal facilitation. In the high Harmony group, the correlation between proactive personality and organizational citizenship behavior was significant; whereas in the low Harmony group, this correlation was not significant.

  20. What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand.

    PubMed

    Haigh, Fiona; Harris, Elizabeth; Harris-Roxas, Ben; Baum, Fran; Dannenberg, Andrew L; Harris, Mark F; Keleher, Helen; Kemp, Lynn; Morgan, Richard; Ng Chok, Harrison; Spickett, Jeff

    2015-10-03

    While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas' conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the conceptual framework. A stakeholder forum was utilised to test face validity and practical adequacy of the findings. We found that some features of HIA are essential, such as the stepwise but flexible process, and evidence based approach. Non-essential features that can enhance the impact of HIAs include capacity and experience; 'right person right level'; involvement of decision-makers and communities; and relationships and partnerships. There are contextual factors outside of HIA such as fit with planning and decision making context, broader global context and unanticipated events, and shared values and goals that may influence a HIA. Crosscutting factors include proactive positioning, and time and timeliness. These all operate within complex open systems, involving multiple decision-makers, levels of decision-making, and points of influence. The Harris and Harris-Roxas framework was generally supported. We have confirmed previously identified factors influencing effectiveness of HIA and identified new factors such as proactive positioning. Our findings challenge some presumptions about 'right' timing for HIA and the rationality and linearity of decision-making processes. The influence of right timing on decision making needs to be seen within the context of other factors such as proactive positioning. This research can help HIA practitioners and researchers understand and identify what can be enhanced within the HIA process. Practitioners can adapt the flexible HIA process to accommodate the external contextual factors identified in this report.

  1. Proactive Risk Assessments and the Continuity of Business Principles: Perspectives on This Novel, Combined Approach to Develop Guidance for the Permitted Movement of Agricultural Products during a Foot-and-Mouth Disease Outbreak in the United States.

    PubMed

    Goldsmith, Timothy J; Culhane, Marie Rene; Sampedro, Fernando; Cardona, Carol J

    2016-01-01

    Animal diseases such as foot-and-mouth disease (FMD) have the potential to severely impact food animal production systems. Paradoxically, the collateral damage associated with the outbreak response may create a larger threat to the food supply, social stability, and economic viability of rural communities than the disease itself. When FMD occurs in domestic animals, most developed countries will implement strict movement controls in the area surrounding the infected farm(s). Historically, stopping all animal movements has been considered one of the most effective ways to control FMD and stop disease spread. However, stopping all movements in an area comes at a cost, as there are often uninfected herds and flocks within the control area. The inability to harvest uninfected animals and move their products to processing interrupts the food supply chain and has the potential to result in an enormous waste of safe, nutritious animal products, and create animal welfare situations. In addition, these adverse effects may negatively impact agriculture businesses and the related economy. Effective disease control measures and the security of the food supply thus require a balanced approach based on science and practicality. Evaluating the risks associated with the movement of live animals and products before an outbreak happens provides valuable insights for risk management plans. These plans can optimize animal and product movements while preventing disease spread. Food security benefits from emergency response plans that both control the disease and keep our food system functional. Therefore, emergency response plans must aim to minimize the unintended negative consequence to farmers, food processors, rural communities, and ultimately consumers.

  2. The Paris Declaration in practice: challenges of health sector aid coordination at the district level in Zambia

    PubMed Central

    Sundewall, Jesper; Forsberg, Birger C; Jönsson, Kristina; Chansa, Collins; Tomson, Göran

    2009-01-01

    Background The increasing resources available for and number of partners providing health sector aid have stimulated innovations, notably, the Paris Declaration on Aid Effectiveness, which aim to improve aid coordination. In this, one of the first studies to analyse implementation of aid coordination below national level, the aim was to investigate the effect of the Paris Declaration on coordination of health sector aid at the district level in Zambia. Methods The study was carried out in three districts of Zambia. Data were collected via interviews with health centre staff, district managers and officials from the Ministry of Health, and from district action plans, financial reports and accounts, and health centre ledger cards. Four indicators of coordination related to external-partner activity, common arrangements used by external partners and predictability of funding were analysed and assessed in relation to the 2010 targets set by the Paris Declaration. Findings While the activity of external partners at the district level has increased, funding and activities provided by these partners are often not included in local plans. HIV/AIDS support show better integration in planning and implementation at the district level than other support. Regarding common arrangements used for fund disbursement, the share of resources provided as programme-based support is not increasing. The predictability of funds coming from outside the government financing mechanism is low. Conclusion Greater efforts to integrate partners in district level planning and implementation are needed. External partners must improve the predictability of their support and be more proactive in informing the districts about their intended contributions. With the deadline for achieving the targets set by the Paris Declaration fast approaching, it is time for the signatories to accelerate its implementation. PMID:19505300

  3. When staff is underpaid: dealing with the individual coping strategies of health personnel.

    PubMed Central

    Van Lerberghe, Wim; Conceicao, Claudia; Van Damme, Wim; Ferrinho, Paulo

    2002-01-01

    Health sector workers respond to inadequate salaries and working conditions by developing various individual "coping strategies"--some, but not all, of which are of a predatory nature. The paper reviews what is known about these practices and their potential consequences (competition for time, brain drain and conflicts of interest). By and large, governments have rarely been proactive in dealing with such problems, mainly because of their reluctance to address the issue openly. The effectiveness of many of these piecemeal reactions, particularly attempts to prohibit personnel from developing individual coping strategies, has been disappointing. The paper argues that a more proactive approach is required. Governments will need to recognize the dimension of the phenomenon and systematically assess the consequences of policy initiatives on the situation and behaviour of the individuals that make up their workforce. PMID:12163923

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

    PubMed

    Chilcutt, Alexa Stough

    2009-10-01

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

  5. Drawbacks of proactivity: Effects of daily proactivity on daily salivary cortisol and subjective well-being.

    PubMed

    Fay, Doris; Hüttges, Annett

    2017-10-01

    The benefit of proactive work behaviors for performance-related outcomes has been well established. However, this approach to studying proactivity has not yet acknowledged its potential implications for the actor's well-being. Drawing on the fact that resources at work are limited and that the workplace is a social system characterized by interdependencies, we proposed that daily proactivity could have a negative effect on daily well-being. We furthermore proposed that this effect should be mediated by work overload and negative affect. We conducted a daily diary study (N = 72) to test the potential negative effects of proactivity on daily well-being. Data was collected across 3 consecutive work days. During several daily measurement occasions, participants reported proactivity, work overload, negative affect, and fatigue. They also provided 4 saliva samples per day, from which cortisol was assayed. Based on the 4 samples, a measure of daily cortisol output was produced. Multilevel analyses showed that daily proactivity was positively associated with higher daily cortisol output. The positive association of daily proactivity with bedtime fatigue was marginally significant. There was no support for a mediating effect of work overload and negative affect. Implications for theory-building on the proactivity-well-being link are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Go Ahead of Malware’s Infections and Controls: Towards New Techniques for Proactive Cyber Defense

    DTIC Science & Technology

    2016-12-08

    in SDN (such as topology poisoning attacks and data-to-control plan saturation attacks) and developed new defense for SDN (such as TopoGuard and... Poisoning Network Visibility in Software-Defined Networks: New Attacks and Countermeasures As part of our research on discovering new vulnerabilities...future network- ing paradigm. We demonstrate that this new attacks can effectively poison the network topology information, then further successfully

  7. Worksite wellness: increasing adoption of workplace health promotion programs.

    PubMed

    Michaels, Carol Noel; Greene, Amanda Marie

    2013-07-01

    Worksite wellness programs are important interventions to protect and promote employee health. They help reduce direct and indirect health care costs, absenteeism, and presenteeism; avoid illness or injury; and improve the quality of work life and morale. This Tool introduces key concepts and strategic tips for planning workplace-based wellness programs rather than individual health promotion events, while highlighting organizational change and development theories central to introducing and implementing effective proactive worksite wellness programs.

  8. 2006 DoD Diminishing Manufacturing Sources and Material Shortages (DMSMS) Conference, Exhibition and Workshop

    DTIC Science & Technology

    2006-07-13

    echnology T ervicesS Integrated Systems & Solutions Integrated yste s S olutionsS • 30,000 Employees • 5 Principal Businesses Organized Into 3 Major...Solutions -Data Sources -Search Engine -Notification Policy -DSCC/IST Lead -Industry Capabilities - Organic Capabilities -Pro-active upgrades -DMEA Lead...needs to TLCSM EC. Cathi Crabtree Voting Members Accomplishments WG Organization we can build on DAU Distance Leaning Modules WG Strategic Plan Re

  9. Exploring Attitudes and Beliefs towards Implementing Cattle Disease Prevention and Control Measures: A Qualitative Study with Dairy Farmers in Great Britain.

    PubMed

    Brennan, Marnie L; Wright, Nick; Wapenaar, Wendela; Jarratt, Susanne; Hobson-West, Pru; Richens, Imogen F; Kaler, Jasmeet; Buchanan, Heather; Huxley, Jonathan N; O'Connor, Heather M

    2016-10-11

    Disease prevention and control practices are frequently highlighted as important to ensure the health and welfare of farmed animals, although little is known as to why not many practices are carried out. The aim of this study was to identify the motivators and barriers of dairy cattle farmers towards the use of biosecurity measures on dairy farms using a health psychology approach. Twenty-five farmers on 24 farms in Great Britain (GB) were interviewed using the Theory of Planned Behaviour framework. Results indicated that farmers perceived they had the ability to control what happened on their farms in terms of preventing and controlling disease, and described benefits from being proactive and vigilant. However, barriers were cited in relation to testing inaccuracies, effectiveness and time-efficiency of practices, and disease transmission route (e.g., airborne transmission). Farmers reported they were positively influenced by veterinarians and negatively influenced by the government (Department for Environment Food & Rural Affairs (DEFRA)) and the general public. Decisions to implement practices were influenced by the perceived severity of the disease in question, if disease was diagnosed on the farm already, or was occurring on other farms. Farmers described undertaking a form of personal risk assessment when deciding if practices were worth doing, which did not always involve building in disease specific factors or opinions from veterinarians or other advisors. These results indicate that further guidance about the intricacies of control and prevention principles in relation to specific animal diseases may be required, with an obvious role for veterinarians. There appears to be an opportunity for farm advisors and herd health professionals to further understand farmer beliefs behind certain attitudes and target communication and advice accordingly to further enhance dairy cattle health and welfare.

  10. A service model for delivering care closer to home.

    PubMed

    Dodd, Joanna; Taylor, Charlotte Elizabeth; Bunyan, Paul; White, Philippa Mary; Thomas, Siân Myra; Upton, Dominic

    2011-04-01

    Upton Surgery (Worcestershire) has developed a flexible and responsive service model that facilitates multi-agency support for adult patients with complex care needs experiencing an acute health crisis. The purpose of this service is to provide appropriate interventions that avoid unnecessary hospital admissions or, alternatively, provide support to facilitate early discharge from secondary care. Key aspects of this service are the collaborative and proactive identification of patients at risk, rapid creation and deployment of a reactive multi-agency team and follow-up of patients with an appropriate long-term care plan. A small team of dedicated staff (the Complex Care Team) are pivotal to coordinating and delivering this service. Key skills are sophisticated leadership and project management skills, and these have been used sensitively to challenge some traditional roles and boundaries in the interests of providing effective, holistic care for the patient.This is a practical example of early implementation of the principles underlying the Department of Health's (DH) recent Best Practice Guidance, 'Delivering Care Closer to Home' (DH, July 2008) and may provide useful learning points for other general practice surgeries considering implementing similar models. This integrated case management approach has had enthusiastic endorsement from patients and carers. In addition to the enhanced quality of care and experience for the patient, this approach has delivered value for money. Secondary care costs have been reduced by preventing admissions and also by reducing excess bed-days. The savings achieved have justified the ongoing commitment to the service and the staff employed in the Complex Care Team. The success of this service model has been endorsed recently by the 'Customer Care' award by 'Management in Practice'. The Surgery was also awarded the 'Practice of the Year' award for this and a number of other customer-focussed projects.

  11. Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial.

    PubMed

    Ruikes, Franca G H; Zuidema, Sytse U; Akkermans, Reinier P; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M

    2016-01-01

    The increasing number of community-dwelling frail elderly people poses a challenge to general practice. We evaluated the effectiveness of a general practitioner-led extensive, multicomponent program integrating cure, care, and welfare for the prevention of functional decline. We performed a cluster controlled trial in 12 general practices in Nijmegen, the Netherlands. Community-dwelling frail elderly people aged ≥70 years were identified with the EASY-Care two-step older persons screening instrument. In 6 general practices, 287 frail elderly received care according to the CareWell primary care program. This consisted of proactive care planning, case management, medication reviews, and multidisciplinary team meetings with a general practitioner, practice and/or community nurse, elderly care physician, and social worker. In another 6 general practices, 249 participants received care as usual. The primary outcome was independence in functioning during (instrumental) activities of daily living (Katz-15 index). Secondary outcomes were quality of life [EuroQol (EQ5D+C) instrument], mental health and health-related social functioning (36-item RAND Short Form survey instrument), institutionalization, hospitalization, and mortality. Outcomes were assessed at baseline and at 12 months, and were analyzed with linear mixed-model analyses. A total of 204 participants (71.1%) in the intervention group and 165 participants (66.3%) in the control group completed the study. No differences between groups regarding independence in functioning and secondary outcomes were found. We found no evidence for the effectiveness of a multifaceted integrated care program in the prevention of adverse outcomes in community-dwelling frail elderly people. Large-scale implementation of this program is not advocated. © Copyright 2016 by the American Board of Family Medicine.

  12. Towards evidence-based, GIS-driven national spatial health information infrastructure and surveillance services in the United Kingdom

    PubMed Central

    Boulos, Maged N Kamel

    2004-01-01

    The term "Geographic Information Systems" (GIS) has been added to MeSH in 2003, a step reflecting the importance and growing use of GIS in health and healthcare research and practices. GIS have much more to offer than the obvious digital cartography (map) functions. From a community health perspective, GIS could potentially act as powerful evidence-based practice tools for early problem detection and solving. When properly used, GIS can: inform and educate (professionals and the public); empower decision-making at all levels; help in planning and tweaking clinically and cost-effective actions, in predicting outcomes before making any financial commitments and ascribing priorities in a climate of finite resources; change practices; and continually monitor and analyse changes, as well as sentinel events. Yet despite all these potentials for GIS, they remain under-utilised in the UK National Health Service (NHS). This paper has the following objectives: (1) to illustrate with practical, real-world scenarios and examples from the literature the different GIS methods and uses to improve community health and healthcare practices, e.g., for improving hospital bed availability, in community health and bioterrorism surveillance services, and in the latest SARS outbreak; (2) to discuss challenges and problems currently hindering the wide-scale adoption of GIS across the NHS; and (3) to identify the most important requirements and ingredients for addressing these challenges, and realising GIS potential within the NHS, guided by related initiatives worldwide. The ultimate goal is to illuminate the road towards implementing a comprehensive national, multi-agency spatio-temporal health information infrastructure functioning proactively in real time. The concepts and principles presented in this paper can be also applied in other countries, and on regional (e.g., European Union) and global levels. PMID:14748927

  13. Proactive Regional Pharmacovigilance System Versus National Spontaneous Reporting for Collecting Safety Data on Concerning Off-Label Prescribing Practices: An Example with Baclofen and Alcohol Dependence in France.

    PubMed

    Auffret, Marine; Labreuche, Julien; Duhamel, Alain; Deheul, Sylvie; Cottencin, Olivier; Bordet, Régis; Gautier, Sophie; Rolland, Benjamin

    2017-03-01

    Off-label prescribing (OLP) may raise serious safety concerns that traditional spontaneous reporting of adverse drug reactions (ADRs) may not identify in a timely manner. In France, the 'Multidisciplinary Consultation Service for Off-Label Prescribing in Addiction Medicine' (CAMTEA) is a proactive regional system established to identify ADRs associated with the OLP of baclofen for alcohol dependence. The aim was to demonstrate, using the French pharmacovigilance database (FPVD), that CAMTEA allowed for the reporting of a substantial amount of ADRs, comparable in nature to those provided via spontaneous reporting. The 2012-2013 FPVD notifications associated with baclofen OLP were extracted. The ten most frequent types of ADRs among 'serious' and 'non-serious' reports were listed. The frequency of each type of ADR was compared between CAMTEA and spontaneous reporting, and the magnitudes of the differences were assessed using standardized differences. A total of 428 baclofen reports (1043 ADRs) were identified, among which 221 (51.64%) originated from CAMTEA. The ten most frequent ADRs in 'serious' reports were (1) confusion (17.3%), (2) seizures (11.5%), (3) drowsiness/sedation (11.5%), (4) agitation (10.9%), (5) coma (9.6%), (6) hallucinations (7.7%), (7) falls (7.1%), (8) behavioral disorders (5.8%), (9) withdrawal syndrome (5.1%), and (10) space-time disorientation (5.1%). A standardized difference of <0.2 was identified for six out of the ten most frequent 'serious' ADRs, and eight of the ten 'non-serious' ADRs. A proactive regional pharmacovigilance system could collect a substantial amount of safety data on a specific OLP practice. The profile of the ADRs collected was similar to that seen in the nationwide spontaneous reporting system.

  14. Initiatives on early detection and intervention to proactively identify health and social problems in older people: experiences from the Netherlands.

    PubMed

    Lette, Manon; Baan, Caroline A; van den Berg, Matthijs; de Bruin, Simone R

    2015-10-30

    Over the last years, several initiatives on early detection and intervention have been put in place to proactively identify health and social problems in (frail) older people. An overview of the initiatives currently available in the Netherlands is lacking, and it is unknown whether they meet the preferences and needs of older people. Therefore, the objectives of this study were threefold: 1. To identify initiatives on early detection and intervention for older people in the Netherlands and compare their characteristics; 2. To explore the experiences of professionals with these initiatives; and 3. To explore to what extent existing initiatives meet the preferences and needs of older people. We performed a qualitative descriptive study in which we conducted semi-structured interviews with seventeen experts in preventive elderly care and three group interviews with volunteer elderly advisors. Data were analysed using the framework analysis method. We identified eight categories of initiatives based on the setting (e.g. general practitioner practice, hospital, municipality) in which they were offered. Initiatives differed in their aims and target groups. The utilization of peers to identify problems and risks, as was done by some initiatives, was seen as a strength. Difficulties were experienced with identifying the target group that would benefit from proactive delivery of care and support most, and with addressing prevalent issues among older people (e.g. psychosocial issues, self-reliance issues). Although there is a broad array of initiatives available, there is a discrepancy between supply and demand. Current initiatives insufficiently address needs of (frail) older people. More insight is needed in "what should be done by whom, for which target group and at what moment", in order to improve current practice in preventive elderly care.

  15. Planning for disaster resilience in rural, remote, and coastal communities: moving from thought to action.

    PubMed

    Murphy, Brenda L; Anderson, Gregory S; Bowles, Ron; Cox, Robin S

    2014-01-01

    Disaster resilience is the cornerstone of effective emergency management across all phases of a disaster from preparedness through response and recovery. To support community resilience planning in the Rural Disaster Resilience Project (RDRP) Planning Framework, a print-based version of the guide book and a suite of resilience planning tools were field tested in three communities representing different regions and geographies within Canada. The results provide a cross-case study analysis from which lessons learned can be extracted. The authors demonstrate that by encouraging resilience thinking and proactive planning even very small rural communities can harness their inherent strengths and resources to enhance their own disaster resilience, as undertaking the resilience planning process was as important as the outcomes.The resilience enhancement planning process must be flexible enough to allow each community to act independently to meet their own needs. The field sites demonstrate that any motivated group of individuals, representing a neighborhood or some larger area could undertake a resilience initiative, especially with the assistance of a bridging organization or tool such as the RDRP Planning Framework.

  16. Involving patients in a multidisciplinary European consensus process and in the development of a 'patient summary of the consensus document for colon and rectal cancer care'.

    PubMed

    Boelens, Petra G; Taylor, Claire; Henning, Geoffrey; Marang-van de Mheen, Perla J; Espin, Eloy; Wiggers, Theo; Gore-Booth, Jola; Moss, Barbara; Valentini, Vincenzo; van de Velde, Cornelis J H

    2014-01-01

    High-quality cancer care should be accessible for patients and healthcare professionals. Involvement of patients as partners in guideline formation and consensus processes is still rarely found. EURECCA, short for European Registration of Cancer Care, is the platform to improve outcomes of cancer care by reducing variation in the diagnostic and treatment process. EURECCA acknowledges the important role of patients in implementation of consensus information in clinical practice. The aim of this article is to describe the process of involving patients in the consensus process and in developing the patient summary of the consensus for colon and rectal cancer care. The Delphi method for achieving consensus was used. Three online voting rounds and one tele-voting round were offered to an expert panel of oncology professionals and patient representatives. At four different stages, patients and/or patient representatives were involved in the process: (1) during the consensus process, (2) lecturing about the role of the patient, (3) development of the patient summary, and (4) testing the patient summary. Representatives were invited to the voting and commenting rounds of this process and given an equal vote. Although patients were not consulted during the planning stages of this process, patient involvement increased following the panel's discussion of the implementation of the consensus among the patient population. After the consensus meeting, the patient summary was written by patient representatives, oncologists and nurses. A selection of proactive patients reviewed the draft patient summary; responses were positive and several patient-reported outcomes were added. Questionnaires to evaluate the use and implementation of the patient summary in daily practice are currently being developed and tested. Patient consultation will be needed in future planning for selection of topics. The present study may function as a model for future consensus processes to involve patients at different stages and to implement both patient and healthcare professional versions in daily practice.

  17. Heterogeneity in the development of proactive and reactive aggression in childhood: Common and specific genetic - environmental factors

    PubMed Central

    Lacourse, Eric; Brendgen, Mara; Vitaro, Frank; Dionne, Ginette; Tremblay, Richard Ernest; Boivin, Michel

    2017-01-01

    Background Few studies are grounded in a developmental framework to study proactive and reactive aggression. Furthermore, although distinctive correlates, predictors and outcomes have been highlighted, proactive and reactive aggression are substantially correlated. To our knowledge, no empirical study has examined the communality of genetic and environmental underpinning of the development of both subtypes of aggression. The current study investigated the communality and specificity of genetic-environmental factors related to heterogeneity in proactive and reactive aggression’s development throughout childhood. Methods Participants were 223 monozygotic and 332 dizygotic pairs. Teacher reports of aggression were obtained at 6, 7, 9, 10 and 12 years of age. Joint development of both phenotypes were analyzed through a multivariate latent growth curve model. Set point, differentiation, and genetic maturation/environmental modulation hypotheses were tested using a biometric decomposition of intercepts and slopes. Results Common genetic factors accounted for 64% of the total variation of proactive and reactive aggression’s intercepts. Two other sets of uncorrelated genetic factors accounted for reactive aggression’s intercept (17%) on the one hand, and for proactive (43%) and reactive (13%) aggression’s slopes on the other. Common shared environmental factors were associated with proactive aggression’s intercept (21%) and slope (26%) and uncorrelated shared environmental factors were also associated with reactive aggression’s slope (14%). Common nonshared environmental factors explained most of the remaining variability of proactive and reactive aggression slopes. Conclusions A genetic differentiation hypothesis common to both phenotypes was supported by common genetic factors associated with the developmental heterogeneity of proactive and reactive aggression in childhood. A genetic maturation hypothesis common to both phenotypes, albeit stronger for proactive aggression, was supported by common genetic factors associated with proactive and reactive aggression slopes. A shared environment set point hypothesis for proactive aggression was supported by shared environmental factors associated with proactive aggression baseline and slope. Although there are many common features to proactive and reactive aggression, the current research underscores the advantages of differentiating them when studying aggression. PMID:29211810

  18. How to renovate a 50-year-old wastewater treating plant: Part 1

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

    Hunter, M.L.

    1996-01-01

    How does an existing refinery cost-effectively renovate wastewater/stormwater treating systems to meet today`s environmental regulations and standards? Faced with solving this problem, Amoco`s Whiting Refinery developed a project team consisting of plant and operations engineers, corporate project and design engineers, contractors and vendors to map out a strategy to re-engineer the existing wastewater treating plant (WWTP) and auxiliary functions. This case history shows how an old refinery limited by existing equipment, building space, operation`s availability requirements and costs divided the project into several design phases. The design team used a proactive approach with empowerment responsibilities to solve construction, equipment usagemore » and regulatory problems throughout the project`s lifetime. Focusing on front-end planning and customer service (the refinery), team members applied value-based engineering designs to keep costs down, implemented safe work practices during construction, used HAZOP reviews to scrutinize proposed designs for operating and maintenance procedures, etc. The result has been the renovation of a 50-year-old WWTP completed under budget, ontime and in compliance with federal mandates.« less

  19. Marketing and strategic management: integrating skills for a better hospital.

    PubMed

    Hunter, S S

    1987-05-01

    Participants in a 1985 one-day seminar sponsored by the American Hospital Association's Society for Hospital Planning and Marketing were asked two questions: How many of the hospitals represented here have conducted marketing surveys in the recent past? How many of you were satisfied with the results of the survey or could integrate it into the strategic management of your institution? While all but two of the 125 participants answered yes to the first question, only two responded affirmatively to the second. A gap between having a survey done and implementing the results had been identified. The administrators had probably rushed into "marketing" with little forethought and even less effort to comprehend how this management skill fits into existing institutional skills, capabilities, roles, and goals. To close the gap between marketing theory and practice an institution must adopt a more far-reaching, proactive stance toward integrating marketing into the management routine at an early stage. This article presents a case study that may help health care administrators rethink the role of marketing in management and its place in the sequence of strategic decision making for their institution.

  20. Recruitment of Dual-Career Academic Medicine Couples.

    PubMed

    Putnam, Charles W; DiMarco, Judy; Cairns, Charles B

    2017-11-28

    Today it is not uncommon to discover that a candidate for a faculty position has a partner or spouse who is also an academician, adding complexity to the recruitment process. Here, the authors address two practical obstacles to the recruitment of faculty who have an academic partner: dual recruitment and conflict-of-interest. The authors have found that tandem recruitment works best when suitable positions for both spouses are first identified so that recruitment can proceed synchronously. This approach decreases misperceptions of favoritism toward either's candidacy. Managing conflict-of-interest, generated by the appointment of one spouse in a supervisory position over the other, requires a proactive, transparent, well-designed plan. After canvassing human resource policies and conducting interviews with national academic leaders, the authors have developed an administrative structure that places "key" decisions (hiring and retention; promotion and tenure; salary, bonuses, and benefits; performance evaluations; and disciplinary matters) regarding the supervised spouse in the jurisdiction of an alternate administrator or committee. The authors also offer suggestions both for mitigating misperceptions of bias in day-to-day decisions and for the support and mentoring of the supervised partner or spouse.

  1. Warfighter nutrition: current opportunities and advanced technologies report from a Department of Defense workshop.

    PubMed

    Deuster, Patricia A; Weinstein, Ali A; Sobel, Annette; Young, Andrew J

    2009-07-01

    The Uniformed Services University hosted a conference in July 2008 entitled "Warfighter Nutrition: Advanced Technologies and Opportunities" with Health Affairs and the Defense Advanced Research Projects Agency to develop strategic and tactical plans that could enhance Force Health Protection (FHP) by optimizing warfighter nutrition within the Department of Defense (DoD). The conference focused on three aspects of military nutrition: (1) fueling the forces, or garrison feeding; (2) performance optimization or operational feeding during deployment; and (3) nutritional interventions to support health reset and healing. Presentations by speakers addressed practical interventions (i.e., ready for implementation now) and advanced technologies (i.e., approaches meriting prioritized research and development efforts to transition into application). The conference concluded that nutritional optimization represents an integral and proactive approach to prevent illness, injury, and performance degradation throughout all phases of military service. The overarching consensus achieved was that warfighter nutrition, as a cornerstone of FHP, warrants the critical attention of both medical and line leadership to move quickly to support current initiatives and future advanced technologies.

  2. Occupational safety and health training in Alaska.

    PubMed

    Hild, C M

    1992-01-01

    We have eleven years of experience delivering a wide variety of worker education programs in cross-cultural settings to reduce the levels of occupational fatalities and injuries in Alaska. We published an instructional manual and informational poster for workers, on Alaska's "Right-To-Know" law regarding chemical and physical hazards. The "Job Hazard Recognition Program" curriculum for high school students has received national acclaim for being proactive in dealing with worker safety education before the student becomes a member of the work force. Adult educational programs and materials have been designed to include less lecture and formal presentation, and more practical "hands on" and on-the-job experience for specific trades and hazards. New industry specific manuals deal with hazardous waste reduction as a method to reduce harm to the employee. Difficulty in getting instructors and training equipment to rural locations is dealt with by becoming creative in scheduling classes, using locally available equipment, and finding regional contacts who support the overall program. Alternative approaches to funding sources include building on regional long-term plans and establishing complementary program objectives.

  3. Crisis management teams in health organisations.

    PubMed

    Canyon, Deon V

    2012-01-01

    Crisis management teams (CMT) are necessary to ensure adequate and appropriate crisis management planning and response to unforeseen, adverse events. This study investigated the existence of CMTs, the membership of CMTs, and the degree of training received by CMTs in Australian health and allied health organisations. This cross-sectional study draws on data provided by executive decision makers in a broad selection of health and allied health organisations. Crisis management teams were found in 44.2 per cent of the health-related organisations surveyed, which is ten per cent lower than the figure for business organisations. Membership of these CMTs was not ideal and did not conform to standard CMT membership profiles. Similarly, the extent of crisis management training in health-related organisations is 20 per cent lower than the figure for business organisations. If organisations do not become pro-active in their crisis management practices, the onus is on government to improve the situation through regulation and the provision of more physical, monetary and skill resources to ensure that the health services of Australia are sufficiently prepared to respond to adverse events.

  4. Proactive Policing by Post and Community Officers

    ERIC Educational Resources Information Center

    Famega, Christine N.

    2009-01-01

    Using data collected through social observations of 188 police officer shifts, the current research examines the time allocated to proactive and reactive activities by traditional and community police officers to assess (a) the extent to which post officers engage in proactive activities, (b) whether these activities differ from the (proactive)…

  5. The power of instructions: Proactive configuration of stimulus-response translation.

    PubMed

    Meiran, Nachshon; Pereg, Maayan; Kessler, Yoav; Cole, Michael W; Braver, Todd S

    2015-05-01

    Humans are characterized by an especially highly developed ability to use instructions to prepare toward upcoming events; yet, it is unclear just how powerful instructions can be. Although prior work provides evidence that instructions can be sufficiently powerful to proactively program working memory to execute stimulus-response (S-R) translations, in a reflexlike fashion (intention-based reflexivity [IBR]), the results to date have been equivocal. To overcome this shortcoming, we developed, and tested in 4 studies, a novel paradigm (the NEXT paradigm) that isolates IBR effects even prior to first task execution. In each miniblock, participants received S-R mapping instructions for a new task. Prior to implementing this mapping, responses were required to advance through screens during a preparatory (NEXT) phase. When the NEXT response was incompatible with the instructed S-R mapping, interference (IBR effect) was observed. This NEXT compatibility effect and performance in the implementation (GO) trials barely changed when prior practice of a few trials was provided. Finally, a manipulation that encouraged preparation resulted in relatively durable NEXT compatibility effects (indicating durable preparatory efforts) coupled with improved GO performance (indicating the success of these efforts). Together, these findings establish IBR as a marker of instructed proactive control. (c) 2015 APA, all rights reserved).

  6. Youth Risk Taking Behavior: The Role of Schools. A Center Policy & Practice Analysis Brief

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2007

    2007-01-01

    Risk taking is natural. As the bumper stickers says: "Risk taking happens!" Risk taking behavior may be beneficial or harmful. Some risk taking is unintentional. But a considerable amount stems from proactive or reactive motivation. For schools, some forms of student risk taking behavior are a necessity, and some forms are a problem. With respect…

  7. Toward the 21st Century: Preparing Proactive Visionary Transformational Leaders for Building Learning Communities. Human Resource Development. Tampa Cluster. Winter 1994.

    ERIC Educational Resources Information Center

    Groff, Warren H.

    This document describes the Tampa Cluster human resources development (HRD) seminar that was conducted as part of Nova University's distance education program in higher education (PHE). Discussed first are HRD in the agricultural and business industrial eras and changing HRD practices/needs, Nova University's PHE and HRD program, the proceedings…

  8. Using Action Learning Sets to Support Students Managing Transition into the Clinical Learning Environment in a UK Medical School

    ERIC Educational Resources Information Center

    McKee, Anne; Markless, Sharon

    2017-01-01

    This paper reports on a Curriculum Innovation Project to empower third-year Undergraduate Medical students to recognise learning opportunities in their clinical placements and to proactively use them to develop their understanding and practice. The project created action learning sets (ALS) in response to the challenges students face when trying…

  9. Ten Things New Teachers Need To Succeed. A SkyLight Guide.

    ERIC Educational Resources Information Center

    Fogarty, Robin

    This guide for novice teachers includes ten sections: (1) "A Knowing Colleague as Counsel...About the Policies, Practices, and Politics!" (proactively seek a mentor); (2) "A Place Called 'My Room' for Students To Grow, To Groom, and To Zoom!" (create a climate that fosters growth and pride); (3) "A Method for Managing 1,500 Decisions: On Your…

  10. Practice schedules for surgical skills: the role of task characteristics and proactive interference on psychomotor skills acquisition.

    PubMed

    Willis, Ross E; Curry, Eileen; Gomez, Pedro Pablo

    2013-01-01

    Although break periods during training sessions are desirable, it is unclear what learners should do during these breaks. Some educators recommend that learners abstain from all task-related practice; however, it is possible that switching to an alternate exercise during break periods can also be effective. The construct of proactive interference (PI) posits that new learning is disrupted by prior learning. PI can be "released" when the nature of the task is changed after several practice trials. In this study, we examined the existence of PI in motor learning under 5 training conditions that differed in contrast to a target exercise. Preclinical medical students (n = 75) performed 1 trial of peg transfer as a pretest. Participants were then randomly assigned to 1 of 5 training conditions: mass practice, similar exercise (laparoscopic bean transfer), dissimilar exercise (open suturing), observation, or rest. Participants in the mass practice condition practiced peg transfer in 3 training blocks of 15 minutes, each separated by a 5-minute break. Participants in the other conditions performed 3 training blocks consisting of 15 minutes of peg transfer followed by an interspersed alternate exercise. On completion of 3 training blocks, participants performed 1 additional peg transfer trial as a posttest. Despite having trained for the same amount of time on the target task, Analysis of Covariance on posttest scores using pretest scores as the covariate indicated a significant main effect for training condition (p = 0.009). Participants engaging in mass practice performed significantly worse than participants in the dissimilar (p = 0.012), observation (p = 0.022), and rest (p < 0.001) conditions. Additionally, participants in the similar exercise condition performed worse than participants in the rest condition (p = 0.03). When learning a laparoscopic task, a break comprised of dissimilar practice or unrelated activities is effective in releasing PI and improving performance. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. End-User Computing Strategy in the United States Marine Corps

    DTIC Science & Technology

    1990-03-01

    views it as a way to restrict acquisition. 4. Marketing Strategy Of the strategies discussed so far, the Marketing strategy is the most proactive...toward the development of EUC in the organization. Under the Marketing strategy , the organization has a firm idea of where it desires EUC to progress. It...seeks to increase EUC use, but the increase will be in consonance with organizational goals. The policies and plans under the Marketing strategy are

  12. When does transformational leadership enhance employee proactive behavior? The role of autonomy and role breadth self-efficacy.

    PubMed

    Den Hartog, Deanne N; Belschak, Frank D

    2012-01-01

    Two multisource studies address the interactive effects of personal and contextual variables on employees' proactive behavior. In line with previous work, we find positive main effects of transformational leadership, role breadth self-efficacy, and job autonomy on employee proactive behavior (personal initiative in Study 1 and prosocial proactive behavior in Study 2). As expected, a 3-way interaction qualifies these main effects: In situations of high autonomy, transformational leadership relates positively to proactive behavior for individuals high (but not low) on self-efficacy. Vice versa, in situations low on job autonomy, transformational leadership relates positively to proactive behavior for individuals low (but not high) on self-efficacy. This pattern is found both for self-ratings and peer-ratings of employees' proactive behavior in Study 1 and for supervisor ratings of such behavior in Study 2.

  13. Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

    PubMed

    von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

    2017-09-10

    Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

  14. Predicting Defects Using Information Intelligence Process Models in the Software Technology Project

    PubMed Central

    Selvaraj, Manjula Gandhi; Jayabal, Devi Shree; Srinivasan, Thenmozhi; Balasubramanie, Palanisamy

    2015-01-01

    A key differentiator in a competitive market place is customer satisfaction. As per Gartner 2012 report, only 75%–80% of IT projects are successful. Customer satisfaction should be considered as a part of business strategy. The associated project parameters should be proactively managed and the project outcome needs to be predicted by a technical manager. There is lot of focus on the end state and on minimizing defect leakage as much as possible. Focus should be on proactively managing and shifting left in the software life cycle engineering model. Identify the problem upfront in the project cycle and do not wait for lessons to be learnt and take reactive steps. This paper gives the practical applicability of using predictive models and illustrates use of these models in a project to predict system testing defects thus helping to reduce residual defects. PMID:26495427

  15. Predicting Defects Using Information Intelligence Process Models in the Software Technology Project.

    PubMed

    Selvaraj, Manjula Gandhi; Jayabal, Devi Shree; Srinivasan, Thenmozhi; Balasubramanie, Palanisamy

    2015-01-01

    A key differentiator in a competitive market place is customer satisfaction. As per Gartner 2012 report, only 75%-80% of IT projects are successful. Customer satisfaction should be considered as a part of business strategy. The associated project parameters should be proactively managed and the project outcome needs to be predicted by a technical manager. There is lot of focus on the end state and on minimizing defect leakage as much as possible. Focus should be on proactively managing and shifting left in the software life cycle engineering model. Identify the problem upfront in the project cycle and do not wait for lessons to be learnt and take reactive steps. This paper gives the practical applicability of using predictive models and illustrates use of these models in a project to predict system testing defects thus helping to reduce residual defects.

  16. Luring anglers to enhance fisheries

    USGS Publications Warehouse

    Martin, Dustin R.; Pope, Kevin L.

    2011-01-01

    Current fisheries management is, unfortunately, reactive rather than proactive to changes in fishery characteristics. Furthermore, anglers do not act independently on waterbodies, and thus, fisheries are complex socio-ecological systems. Proactive management of these complex systems necessitates an approach-adaptive fisheries management-that allows learning to occur simultaneously with management. A promising area for implementation of adaptive fisheries management is the study of luring anglers to or from specific waterbodies to meet management goals. Purposeful manipulation of anglers, and its associated field of study, is nonexistent in past management. Evaluation of different management practices (i.e., hypotheses) through an iterative adaptive management process should include both a biological and sociological survey to address changes in fish populations and changes in angler satisfaction related to changes in management. We believe adaptive management is ideal for development and assessment of management strategies targeted at angler participation. Moreover these concepts and understandings should be applicable to other natural resource users such as hunters and hikers.

  17. Nurse manager succession planning: A cost-benefit analysis.

    PubMed

    Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

    2018-03-01

    This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

  18. Strengthening the Federal Emergency Management Agency's disaster response capabilities.

    PubMed

    Cannon, Glenn M

    2008-04-01

    The Federal Emergency Management Agency's (FEMA) Disaster Operations Directorate provides the core federal response capability to save lives and to protect property in US communities that have been overwhelmed by the impact of a major disaster or emergency. The directorate executes its mission through three main programme areas: operational direction, command and control; operational teams; and operational planning. Based on lessons learned from years of disaster response experience, FEMA is now taking a more proactive and collaborative approach with its partners. This paper discusses how FEMA is placing a greater emphasis on response operations and strengthening capabilities across the full range of operational and support missions by comprehensively revamping its disaster operations model; enhancing its headquarters and regional operations centres; enhancing its headquarters and regional operational planning capabilities; and addressing catastrophic disaster planning and related critical preparedness issues.

  19. Enhanced early warning system impact on nursing practice: A phenomenological study.

    PubMed

    Burns, Kathleen A; Reber, Tracey; Theodore, Karen; Welch, Brenda; Roy, Debra; Siedlecki, Sandra L

    2018-05-01

    To determine how an enhanced early warning system has an impact on nursing practice. Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied. Phenomenological design. Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed. Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition. Rather than hinder critical thinking, as many early warning systems' critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration. © 2017 John Wiley & Sons Ltd.

  20. Improving Hypertension Control in Diabetes Mellitus The Effects of Collaborative and Proactive Health Communication

    PubMed Central

    Naik, Aanand D.; Kallen, Michael A.; Walder, Annette; Street, Richard L.

    2013-01-01

    Background Communication between patients and clinicians using collaborative goals and treatment plans may overcome barriers to achieving hypertension control in routine diabetes mellitus care. We assessed the interrelation of patient–clinician communication factors to determine their independent associations with hypertension control in diabetes care. Methods and Results We identified 566 older adults with diabetes mellitus and hypertension at the DeBakey VA Medical Center in Houston, Tex. Clinical and pharmacy data were collected, and a patient questionnaire was sent to all participants. A total of 212 individuals returned surveys. Logistic regression analyses were performed to assess the effect of patient characteristics, self-management behaviors, and communication factors on hypertension control. Three communication factors had significant associations with hypertension control. Two factors, patients' endorsement of a shared decision-making style (odds ratio 1.61, 95% confidence interval 1.01 to 2.57) and proactive communication with one's clinician about abnormal results of blood pressure self-monitoring (odds ratio 1.89, 95% confidence interval 1.10 to 3.26), had direct, independent associations in multivariate regression. Path analysis was used to investigate the direct and indirect effects of communication factors and hypertension control. Decision-making style (β=0.20, P<0.01) and proactive communication (β=0.50, P<0.0001) again demonstrated direct effects on hypertension control. A third factor, clinicians' use of collaborative communication when setting treatment goals, had a total effect on hypertension control of 0.16 (P<0.05) through its direct effects on decision-making style (β=0.28, P<0.001) and proactive communication (β=0.22, P<0.01). Conclusions Three communication factors were found to have significant associations with hypertension control. Patient–clinician communication that facilitates collaborative blood pressure goals and patients' input related to the progress of treatment may improve rates of hypertension control in diabetes care independent of medication adherence. PMID:18316489

  1. Interest in an online smoking cessation program and effective recruitment strategies: results from Project Quit.

    PubMed

    McClure, Jennifer B; Greene, Sarah M; Wiese, Cheryl; Johnson, Karin E; Alexander, Gwen; Strecher, Victor

    2006-08-22

    The Internet is a promising venue for delivering smoking cessation treatment, either as a stand-alone program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online smoking cessation services or how best to recruit smokers to Internet-based programs. Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies. Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations). An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees. Smokers were interested in receiving online smoking cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this program were comparable to those seen when smokers are advised to quit and are referred to other forms of smoking cessation treatment. In this sample, proactive mailings were the best method for recruiting smokers to Project Quit.

  2. Delivering Integrated Care to the Frail Elderly: The Impact on Professionals’ Objective Burden and Job Satisfaction

    PubMed Central

    Huijsman, Robbert; de Kuyper, Ruben Dennis Maurice; Fabbricotti, Isabelle Natalina

    2016-01-01

    Background: The impact of integrated working on professionals’ objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary care practice as a single entry point, and included proactive frailty screening, a comprehensive assessment of patient needs, case management, multidisciplinary teams, care plans and protocols, task delegation and task specialisation, a shared information system, a geriatric care network and integrated funding. Methods: A quasi-experimental design with a control group was used. Data regarding objective burden involved the professionals’ time investments over a 12-month period that were collected from patient medical records (n = 377) time registrations, transcripts of meetings and patient questionnaires. Data regarding job satisfaction were collected using questionnaires that were distributed to primary care and home-care professionals (n = 180) after the intervention’s implementation. Within- and between-groups comparisons and regression analyses were performed. Results: Non-patient related time was significantly higher in the experimental group than in the control group, whereas patient-related time did not differ. Job satisfaction remained unaffected by the intervention. Conclusion and Discussion: Integrated working is likely to increase objective burden as it requires professionals to perform additional activities that are largely unrelated to actual patient care. Implications for research and practice are discussed. [Current Controlled Trials ISRCTN05748494]. PMID:28413364

  3. Impact Challenges in Community Science-with-Practice: Lessons from PROSPER on Transformative Practitioner-Scientist Partnerships and Prevention Infrastructure Development

    PubMed Central

    Greenberg, Mark

    2011-01-01

    At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships—networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy. PMID:21222151

  4. Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

    PubMed

    Spoth, Richard; Greenberg, Mark

    2011-09-01

    At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

  5. Development and usability evaluation of the mHealth Tool for Lung Cancer (mHealth TLC): A virtual world health game for lung cancer patients

    PubMed Central

    Brown-Johnson, Cati G.; Berrean, Beth; Cataldo, Janine K.

    2015-01-01

    Objective To test the feasibility and usability of mHealth TLC, an interactive, immersive 3-dimensional iPad health game that coaches lung cancer patients toward assertive communication strategies during first-person virtual clinics visits. Method We observed players and conducted semi-structured interviews. Research questions focused on scenario believability, the impact of technical issues, transparency of game goals, and potential of mHealth TLC to decrease lung cancer stigma (LCS) and improve patient–clinician communication. Results Eight users confirmed mHealth TLC to be: (1) believable, (2) clinic-appropriate, and (3) helpful in support of informed healthcare consumers. Concerns were expressed about emotionally charged content and plans to use mHealth TLC in clinic settings as opposed to at home. Conclusions Although the dialog and interactions addressed emotionally charged issues, players were able to engage, learn, and benefit from role-play in a virtual world. Health games have the potential to improve patient–clinician communication, and mHealth TLC specifically may decrease LCS, and promote optimal self-management. Practice implications Process reflection revealed the need for health games to be created by experienced game developers in collaboration with health care experts. To prepare for this best practice, research institutions and game developers interested in health games should proactively seek out networking and collaboration opportunities. PMID:25620075

  6. Evolving from reactive to proactive medicine: community lead (Pb) and clinical disparities in pre- and post-Katrina New Orleans.

    PubMed

    Mielke, Howard W; Gonzales, Christopher; Powell, Eric; Mielke, Paul W

    2014-07-21

    In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children's blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children's Pb exposure. Here we review mapping environmental Pb and children's blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children's blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place.

  7. Evolving from Reactive to Proactive Medicine: Community Lead (Pb) and Clinical Disparities in Pre- and Post-Katrina New Orleans

    PubMed Central

    Mielke, Howard W.; Gonzales, Christopher; Powell, Eric; Mielke, Paul W.

    2014-01-01

    In 2012 the U.S. Centers for Disease Control (CDC) set the blood Pb reference value at ≥5 µg/dL. Clinical analysis of children’s blood Pb levels is the common way to diagnose environmental Pb contamination, and intervention ensues with education and household dust cleanup. Recent review indicates that education and household dust cleanup are not effective at reducing children’s Pb exposure. Here we review mapping environmental Pb and children’s blood Pb response as an alternative approach for proactive Pb dust intervention. New Orleans was divided into a high (≥100 mg/kg) and low (<100 mg/kg) soil Pb communities. The children’s blood Pb prevalence ≥5 µg/dL for the high and low Pb domains were 58.5% and 24.8% respectively pre-Katrina vs. 29.6% and 7.5% post-Katrina. Elevated soil Pb (mg/kg) and consequently Pb loading (µg/square area) permeates the high Pb domain and outdoor locations lack Pb dust safe play areas. The U.S. EPA 400 mg/kg soil Pb standard poses an outside Pb dust loading burden >37 times larger than allowed on interior residential floor environments. Environmental Pb dust is decreasing because of the transfer of large quantities of low Pb soil into selected communities. City-scale soil Pb mapping is an alternative diagnostic tool that provides information for planning proactive medicine to prevent clinical Pb exposure in the first place. PMID:25050655

  8. What Is Engagement? Proactivity as the Missing Link in the HEXACO Model of Personality.

    PubMed

    de Vries, Reinout E; Wawoe, Kilian W; Holtrop, Djurre

    2016-04-01

    We tested the hypothesis that proactivity represents the engagement vector in the HEXACO model of personality. Questionnaire data were obtained in five studies, three of which consisted (mostly) of students: Study 1 (N = 188, Mage  = 20.0, 89.4% women), Study 3 (N = 315, Mage  = 20.4, 80.6% women), and Study 4 (N = 309 self-ratings, Mage  = 20.0, 78.3% women; N = 307 other-ratings, Mage  = 24.5, 62.2% women). Participants in the other two studies came from an ISO-certified representative community panel: Study 2 (N = 525, Mage  = 51.2, 52.0% women) and Study 5 (N = 736, Mage  = 42.2, 48.0% women). Proactive Personality and Proactivity were positively related to Extraversion, Conscientiousness, and Openness to Experience, but only weakly related or unrelated to Honesty-Humility, Emotionality, and Agreeableness, supporting the alignment of Proactive Personality/Proactivity with the hypothesized HEXACO engagement vector. Additionally, Proactivity explained incremental variance in self-rated job performance on top of the HEXACO facets that were most closely associated with Proactive Personality/Proactivity, that is, Social Boldness (an Extraversion facet), Diligence (a Conscientiousness facet), and Creativity (an Openness to Experience facet), but not in entrepreneurship and intrapreneurship. Proactivity is the missing engagement link in the HEXACO model of personality. The results are discussed in light of higher-order factors (e.g., general factor of personality and Alpha and Beta) of personality and bandwidth-fidelity controversies. © 2014 Wiley Periodicals, Inc.

  9. Proactive Classroom Management, K-8: A Practical Guide to Empower Students and Teachers

    ERIC Educational Resources Information Center

    Denti, Louis G.

    2012-01-01

    Every teacher dreams of the perfect, well-behaved class, but the reality can be quite different. On those less-than-perfect days, having a system in place helps you and your students stay on track. This gold mine of teacher-developed and -approved strategies goes beyond classroom management theory and gives you ready-to-use tools that not only…

  10. Understanding the relationship between proactive and reactive aggression, and cyberbullying across United States and Singapore adolescent samples.

    PubMed

    Ang, Rebecca P; Huan, Vivien S; Florell, Dan

    2014-01-01

    This study examined cyberbullying among adolescents across United States and Singapore samples. Specifically, the purpose of the investigation was to study the differential associations between proactive and reactive aggression, and cyberbullying across two cultures. A total of 425 adolescents from the United States (M age = 13 years) and a total of 332 adolescents from Singapore (M age = 14.2 years) participated in the study. Results of the moderator analyses suggested that nationality was not a moderator of the relationship between proactive aggression and cyberbullying, and between reactive aggression and cyberbullying. As expected, findings showed proactive aggression to be positively associated with cyberbullying, after controlling for reactive aggression, across both samples. Likewise, as hypothesized, reactive aggression and cyberbullying was not found to be significant after controlling for proactive aggression across both samples. Implications of these findings were discussed: (a) Proactive aggression is a possible risk factor for both bullying and cyberbullying; (b) proactive and reactive aggression could be argued to be distinct as they have different correlates-only proactive aggression contributed to cyberbullying after controlling for reactive aggression; (c) this research extends previous work and contributes toward cross-cultural work using similar and comparable measures across different samples; and (d) prevention and intervention programs targeted at proactive aggressive adolescents could adopt a two-pronged approach by changing mind sets, and by understanding and adopting a set of rules for Internet etiquette.

  11. Differences in cortisol response affect the distinction of observed reactive and proactive aggression in children with aggressive behaviour disorders.

    PubMed

    Kempes, M; de Vries, H; Matthys, W; van Engeland, H; van Hooff, J

    2008-01-01

    Various researchers distinguished two categories of aggressive behaviour, namely reactive and proactive aggression. Reactive aggression is an aggressive response to a perceived threat or provocation, whereas proactive aggression is behaviour that anticipates a reward. In the present study, including both a sample of disruptive behaviour disordered (DBD) and normal control (NC) children, we observed reactive and proactive aggressive behaviour during an experimental dyadic play session. DBD children showed more observed reactive and proactive aggression. Subsequently, we investigated whether the observed measures correlated with parent-rated measures of reactive and proactive aggression in. We distinguished in both NC and DBD children a subgroup showing a rise in cortisol level, i.e. responders, and a subgroup who did not show a rise in cortisol, i.e. non-responders. Results suggest that differences in the cortisol response affects the correspondence between observed and parent-rated reactive and proactive aggression since only DBD non-responders showed the expected correlations.

  12. Building Resilient Warriors: Taking the Canadian Army’s Resilience Training Beyond the Classroom

    DTIC Science & Technology

    2012-05-17

    Germany , (June 2009). 7 will be more agile and more proactive, and more able to react positively to unexpected or drastic changes.11 Imagine the... Insurance to Pay for Service-Related Health Care,” 17 March 2009, online: http://www.foxnews.com/politics/2009/03/17/veterans-groups- blast-obama-plan...private- insurance -pay-service-related-health/#ixzz1dss4fbGy (accessed 16 November 2011). 23 Don McCeary, PhD, and Deniz Fikretoglu, PhD, Defence Research

  13. Using a Theory-Driven Approach to Manage the Relocation of an Intensive Care Unit: An Exemplar.

    PubMed

    Lin, Frances; Marshall, Andrea; Hervey, Lucy; Foster, Michelle; Hancock, Jane; Chaboyer, Wendy

    Proactive planning and managing moving from old to newly built hospitals, and the relocation process of patients for complex specialized units such as intensive care units, are necessary for both patient safety and staff well-being. This article provides an exemplar for how theory can be used to facilitate a positive relocation experience. Using change management theory, a systematic approach to cocreate implementation strategy among researchers and clinicians was critical to the success of this project.

  14. Managing effectively in the downsized organization.

    PubMed

    Arnold, Edwin; Pulich, Marcia

    2003-01-01

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

  15. Callous-Unemotional Traits, Proactive Aggression, and Treatment Outcomes of Aggressive Children with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Blader, Joseph C.; Pliszka, Steven R.; Kafantaris, Vivian; Foley, Carmel A.; Crowell, Judith A.; Carlson, Gabrielle A.; Sauder, Colin; Margulies, David M.; Sinha, Christa; Sverd, Jeffrey; Matthews, Thomas L.; Bailey, Brigitte Y.; Daviss, W. Burleson

    2013-01-01

    Objective Stimulant treatment improves impulse control among children with attention-deficit/hyperactivity disorder (ADHD). Decreased aggression often accompanies stimulant pharmacotherapy, suggesting that impulsiveness is integral to their aggressive behavior. However, children with high callous-unemotional (CU) traits and proactive aggression may benefit less from ADHD pharmacotherapy because their aggressive behavior seems more purposeful and deliberate. This study’s objective was to determine if pretreatment CU traits and proactive aggression affect treatment outcomes among aggressive children with ADHD receiving stimulant monotherapy. Method We implemented a stimulant optimization protocol with 160 6- to 13-year-olds (mean [SD] age of 9.31 [2.02] years; 78.75% males) with ADHD, oppositional defiant or conduct disorder, and significant aggressive behavior. Family-focused behavioral intervention was provided concurrently. Primary outcome was the Retrospective Modified Overt Aggression Scale. The Antisocial Process Screening Device and the Aggression Scale, also completed by parents, measured CU traits and proactive aggression, respectively. Analyses examined moderating effects of CU traits and proactive aggression on outcomes. Results 82 children (51%) experienced remission of aggressive behavior. Neither CU traits nor proactive aggression predicted remission (CU traits: odds ratio=0.94, 95% CI=0.80–1.11; proactive aggression, odds ratio=1.05, 95% CI=0.86–1.29). Children whose overall aggression remitted showed decreases in CU traits (effect size=−0.379, 95% CI=−0.60 to −0.16) and proactive aggression (effect size=−0.463, 95% CI=−0.69 to −0.23). Conclusions Findings suggest that pretreatment CU traits and proactive aggression do not forecast worse outcomes for aggressive children with ADHD receiving optimized stimulant pharmacotherapy. With such treatment, CU traits and proactive aggression may decline alongside other behavioral improvements. PMID:24290461

  16. Proactivity in VTE prevention: a concept analysis.

    PubMed

    Adams, Averil

    Venous thromboembolism (VTE) prevention is an international patient safety issue. The author has observed gaps in prescription and provision of VTE prophylaxis, and that the attitude to VTE is often reactive rather than proactive. This concept analysis aims to explore proactivity and apply it to VTE prevention to address this. Ten databases were searched (1992-2012) using the keywords proactive, proactivity, nurse, nursing, VTE/venous thromboembolism, prevent/prevention/preventing, behaviour, DVT/PE (deep vein thrombosis, pulmonary embolism). The Walker and Avant (2010) method of concept analysis identified the defining attributes as personal initiative, taking charge and feedback-seeking behaviour. Antecedents and consequences have been identified, and empirical referents are demonstrated. Defining proactivity in VTE prevention has the potential to increase prescription and, crucially, provision of prophylaxis, thereby improving patient care, reducing avoidable harm and improving the patient experience.

  17. Proactive aggression in early school-aged children with externalizing behavior problems: A longitudinal study on the influence of empathy in response to distress.

    PubMed

    Deschamps, Peter K; Verhulp, Esmee E; de Castro, Bram Orobio; Matthys, Walter

    2018-01-01

    The course of proactive aggressive behavior may be affected by empathy in response to sadness and distress of others. The aim of the current study is to examine empathy in response to sadness and distress and its relation to proactive and reactive aggression in a clinical sample of children with externalizing behavior problems. At baseline (T1) and 12 months later (T2), parents and teachers of 104 six- and seven-year-old children completed the Instrument for Reactive and Proactive Aggression. At T1, parents and teachers also reported empathy in response to sadness and distress on the Griffith Empathy Measure. Findings show that low levels of parent-reported empathy at baseline were specifically associated with high parent-reported proactive aggression but not with reactive aggression. Similarly, low teacher-reported empathy was specifically related to high teacher-reported proactive aggression. Furthermore, high parent-reported but not teacher-reported empathy at baseline was associated with low proactive aggression at 12 months after controlling for proactive aggression at baseline. The conclusions support the notion that in the study of the course of aggression in clinical groups, the distinction between proactive and reactive aggression as well as the study of empathy in response to distress is relevant for a better understanding and might be taken into account in the development of future interventions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Reducing the risks of diabetes complications through diabetes self-management education and support.

    PubMed

    Kent, Dan; D'Eramo Melkus, Gail; Stuart, Patricia Mickey W; McKoy, June M; Urbanski, Patti; Boren, Suzanne Austin; Coke, Lola; Winters, Janis E; Horsley, Neil L; Sherr, Dawn; Lipman, Ruth

    2013-04-01

    People with diabetes are at risk of developing complications that contribute to substantial morbidity and mortality. In 2011, the American Association of Diabetes Educators convened an invitational Reducing Risks Symposium, during which an interdisciplinary panel of 11 thought leaders examined current knowledge about the reduction and prevention of diabetes-related risks and translated evidence into diabetes care and self-management education. Symposium participants reviewed findings from the literature and engaged in a moderated roundtable discussion. This report summarizes the discussion and presents recommendations to incorporate into practice to improve outcomes. The objective of the symposium was to develop practical advice for diabetes educators and other members of the diabetes care team regarding the reduction of diabetes-related risks. Optimal diabetes management requires patients to actively participate in their care, which occurs most effectively with a multidisciplinary team. Diabetes education is an integral part of this team approach because it not only helps the patient understand diabetes, its progression, and possible complications, but also provides guidance and encouragement to the patient to engage in proactive risk-reduction decisions for optimal health. A variety of tools are available to help the diabetes educator develop an individualized, patient-centered plan for risk reduction. More research is needed regarding intervention efficacy, best practices to improve adherence, and quantification of benefits from ongoing diabetes support in risk reduction. Diabetes educators are urged to stay abreast of evolving models of care and to build relationships with health care providers both within and beyond the diabetes care team.

  19. Studying physician-adolescent patient communication in community-based practices: recruitment challenges and solutions.

    PubMed

    Bodner, Michael E; Bilheimer, Alicia; Gao, Xiaomei; Lyna, Pauline; Alexander, Stewart C; Dolor, Rowena J; Østbye, Truls; Bravender, Terrill; Tulsky, James A; Graves, Sidney; Irons, Alexis; Pollak, Kathryn I

    2015-11-13

    Practice-based studies are needed to assess how physicians communicate health messages about weight to overweight/obese adolescent patients, but successful recruitment to such studies is challenging. This paper describes challenges, solutions, and lessons learned to recruit physicians and adolescents to the Teen Communicating Health Analyzing Talk (CHAT) study, a randomized controlled trial of a communication skills intervention for primary care physicians to enhance communication about weight with overweight/obese adolescents. A "peer-to-peer" approach was used to recruit physicians, including the use of "clinic champions" who liaised between study leaders and physicians. Consistent rapport and cooperative working relationships with physicians and clinic staff were developed and maintained. Adolescent clinic files were reviewed (HIPAA waiver) to assess eligibility. Parents could elect to opt-out for their children. To encourage enrollment, confidentiality of audio recordings was emphasized, and financial incentives were offered to all participants. We recruited 49 physicians and audio-recorded 391 of their overweight/obese adolescents' visits. Recruitment challenges included 1) physician reticence to participate; 2) variability in clinic operating procedures; 3) variability in adolescent accrual rates; 4) clinic open access scheduling; and 5) establishing communication with parents and adolescents. Key solutions included the use of a "clinic champion" to help recruit physicians, pro-active, consistent communication with clinic staff, and adapting calling times to reach parents and adolescents. Recruiting physicians and adolescents to audio-recorded, practice-based health communication studies can be successful. Anticipated challenges to recruiting can be met with advanced planning; however, optimal solutions to challenges evolve as recruitment progresses.

  20. Neurologists and technology: The changing "Facebook" of practice.

    PubMed

    Potts, Daniel C; Hohler, Anna D

    2013-04-01

    Social and traditional media are revolutionizing health care. Medicine, once an art practiced behind closed doors, is now part of the public domain. This article will help neurologists navigate a complex maze of technology to optimize patient care without compromising privacy. We offer ideas for improving our digital "footprint." Guidance is given on maintaining professional demeanor in all private and public interactions to help us avoid personal or patient insult and injury. Acknowledging that neurology is becoming a specialty of increased personal and social education, we outline ways to proactively improve our patient care and education locally and globally.

  1. Young onset Parkinson's disease. Practical management of medical issues.

    PubMed

    Calne, Susan M; Kumar, Ajit

    2008-01-01

    Young Onset Parkinson's disease (YOPD) is defined as Parkinson's disease diagnosed between the ages of 21 and 40 years. Problems faced by this group are different from those faced by older subjects because they face decades with the illness. This article reviews current literature and offers suggestions for intervention when appropriate and practical suggestions in the areas of drug treatment, rehabilitation, nutrition, sexuality, pregnancy, menstruation and menopause. The suggestions are not exclusively restricted to the management of YOPD, but emphasis is placed on items where people with YOPD have either had particular difficulties or where they can proactively self-manage their illness.

  2. Cosmetic surgery in times of recession: macroeconomics for plastic surgeons.

    PubMed

    Krieger, Lloyd M

    2002-10-01

    Periods of economic downturn place special demands on the plastic surgeon whose practice involves a large amount of cosmetic surgery. When determining strategy during difficult economic times, it is useful to understand the macroeconomic background of these downturns and to draw lessons from businesses in other service industries. Business cycles and monetary policy determine the overall environment in which plastic surgery is practiced. Plastic surgeons can take both defensive and proactive steps to maintain their profits during recessions and to prepare for the inevitable upturn. Care should also be taken when selecting pricing strategy during economic slowdowns.

  3. Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia.

    PubMed

    Nozmi, Noramira; Samsudin, Suhailah; Sukeri, Surianti; Shafei, Mohd Nazri; Wan Mohd, Wan Mohd Zahiruddin; Idris, Zawaha; Arifin, Wan Nor; Idris, Norazlin; Saudi, Siti Nor Sakinah; Abdullah, Nurul Munirah; Abdul Wahab, Zainudin; Tengku Jamaluddin, Tengku Zetty Maztura; Abd Rahman, Hejar; Masri, Siti Norbaya; Daud, Aziah; Osman, Malina; Awang Hamat, Rukman

    2018-04-06

    Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew "rat-urine disease" as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively ( p -values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated ( p -values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222-0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204-2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239-0.665), income (AOR = 1.58, 95% CI = 1.041-2.385) and education type (AOR = 3.69, 95% CI = 1.237-10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613-7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community.

  4. Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia

    PubMed Central

    Nozmi, Noramira; Samsudin, Suhailah; Sukeri, Surianti; Shafei, Mohd Nazri; Wan Mohd, Wan Mohd Zahiruddin; Idris, Zawaha; Arifin, Wan Nor; Idris, Norazlin; Abdullah, Nurul Munirah; Abdul Wahab, Zainudin; Abd Rahman, Hejar; Masri, Siti Norbaya; Daud, Aziah

    2018-01-01

    Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew “rat-urine disease” as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (p-values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated (p-values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222–0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204–2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239–0.665), income (AOR = 1.58, 95% CI = 1.041–2.385) and education type (AOR = 3.69, 95% CI = 1.237–10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613–7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community. PMID:29642390

  5. Factor Structure of the Reactive-Proactive Aggression Questionnaire in Turkish Children and Gender, Grade-Level, and Socioeconomic Status Differences in Reactive and Proactive Aggression

    ERIC Educational Resources Information Center

    Uz Bas, Asli; Yurdabakan, Irfan

    2012-01-01

    The present study aimed to evaluate the factor structure of the Reactive-Proactive Aggression Questionnaire (RPQ) with Turkish children, and to investigate gender, grade-level, and socioeconomic status (SES) differences in reactive and proactive aggression. Participants consisted of 1,081 Turkish children (544 boys and 537 girls) aged 9 to 14…

  6. Are Empowered Employees More Proactive? The Contingency of How They Evaluate Their Leader

    PubMed Central

    Yin, Kui; Xing, Lu; Li, Can; Guo, Yungui

    2017-01-01

    Finding ways to enhance employee proactive behavior is a focal concern for academics and practitioners. Previous studies have found a positive association between empowering leadership and proactive behavior (Martin et al., 2013; Li et al., 2017). However, these studies lack elaboration on mechanisms and do not rule out the effect of employees’ proactive personality during empirical testing. We investigate empowering leadership from individual perspective due to the variation of empowerment levels even in the same team. Our research proposes a more elaborated theoretical model that explains why, and when, empowering leadership might promote employee proactive behavior. Specifically, we examine mediating mechanisms based on social cognitive theory and propose trust in leader competency as boundary condition. Using a sample of 280 leader–follower dyads from a large state-owned Chinese company, our results revealed that (1) empowering leadership was positively related to proactive behavior, with role breadth self-efficacy acting as a mediator for this relationship; (2) employees’ trust in leader competency moderated both the empowering leadership–subordinate proactive behavior relationship and the mediating effect of role breadth self-efficacy, such that the empowering leadership–subordinate proactive behavior relationship was weaker, and the mediating effect of role breadth self-efficacy was stronger, for employees with high levels of trust in leader competency. PMID:29163249

  7. Are Empowered Employees More Proactive? The Contingency of How They Evaluate Their Leader.

    PubMed

    Yin, Kui; Xing, Lu; Li, Can; Guo, Yungui

    2017-01-01

    Finding ways to enhance employee proactive behavior is a focal concern for academics and practitioners. Previous studies have found a positive association between empowering leadership and proactive behavior (Martin et al., 2013; Li et al., 2017). However, these studies lack elaboration on mechanisms and do not rule out the effect of employees' proactive personality during empirical testing. We investigate empowering leadership from individual perspective due to the variation of empowerment levels even in the same team. Our research proposes a more elaborated theoretical model that explains why, and when, empowering leadership might promote employee proactive behavior. Specifically, we examine mediating mechanisms based on social cognitive theory and propose trust in leader competency as boundary condition. Using a sample of 280 leader-follower dyads from a large state-owned Chinese company, our results revealed that (1) empowering leadership was positively related to proactive behavior, with role breadth self-efficacy acting as a mediator for this relationship; (2) employees' trust in leader competency moderated both the empowering leadership-subordinate proactive behavior relationship and the mediating effect of role breadth self-efficacy, such that the empowering leadership-subordinate proactive behavior relationship was weaker, and the mediating effect of role breadth self-efficacy was stronger, for employees with high levels of trust in leader competency.

  8. Adolescents' aggressive and prosocial behavior: associations with jealousy and social anxiety.

    PubMed

    Culotta, Carmen M; Goldstein, Sara E

    2008-03-01

    The authors examined how relational aggression, physical aggression, and proactive prosocial behavior were associated with jealousy and social anxiety in a diverse sample of 60 middle school students. After the authors controlled for gender and race, jealousy predicted relational aggression and proactive prosocial behavior, but it did not predict physical aggression. Additionally, social anxiety predicted proactive prosocial behavior. Adolescents who were more jealous in their peer relationships also tended to engage in relational aggression and proactive prosocial behavior, and adolescents who were more socially anxious also tended to be proactively prosocial. The authors discuss the implications of these findings and suggest directions for future research.

  9. Proactive personality and career success.

    PubMed

    Seibert, S E; Crant, J M; Kraimer, M L

    1999-06-01

    This study examined the relationship between proactive personality and career success by surveying a sample of 496 employees (320 men and 176 women) from a diverse set of occupations and organizations. Proactive personality was positively associated with both self-reported objective (salary and promotions) and subjective (career satisfaction) indicators of career success. Hierarchical regression analyses showed that proactive personality explained additional variance in both objective and subjective career success even after controlling for several relevant variables (demographic, human capital, motivational, organizational, and industry) that have previously been found to be predictive of career outcomes. These findings were consistent using both self-report and significant--other ratings of proactive personality.

  10. Using prospective hazard analysis to assess an active shooter emergency operations plan.

    PubMed

    Card, Alan J; Harrison, Heidi; Ward, James; Clarkson, P John

    2012-01-01

    Most risk management activity in the healthcare sector is retrospective, based on learning from experience. This is feasible where the risks are routine, but emergency operations plans (EOP) guide the response to events that are both high risk and rare. Under these circumstances, it is important to get the response right the first time, but learning from experience is usually not an option. This case study presents the rationale for taking a proactive approach to improving healthcare organizations' EOP. It demonstrates how the Prospective Hazard Analysis (PHA) Toolkit can drive organizational learning and argues that this toolkit may lead to more efficient improvement than drills and exercises. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

  11. Responding to Sea Level Rise: Does Short-Term Risk Reduction Inhibit Successful Long-Term Adaptation?

    NASA Astrophysics Data System (ADS)

    Keeler, A. G.; McNamara, D. E.; Irish, J. L.

    2018-04-01

    Most existing coastal climate-adaptation planning processes, and the research supporting them, tightly focus on how to use land use planning, policy tools, and infrastructure spending to reduce risks from rising seas and changing storm conditions. While central to community response to sea level rise, we argue that the exclusive nature of this focus biases against and delays decisions to take more discontinuous, yet proactive, actions to adapt—for example, relocation and aggressive individual protection investments. Public policies should anticipate real estate market responses to risk reduction to avoid large costs—social and financial—when and if sea level rise and other climate-related factors elevate the risks to such high levels that discontinuous responses become the least bad alternative.

  12. The History of Evidence-Based Practice in Nursing Education and Practice.

    PubMed

    Mackey, April; Bassendowski, Sandra

    Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. e-Learning competency for practice nurses: an evaluation report.

    PubMed

    Heartfield, Marie; Morello, Andrea; Harris, Melanie; Lawn, Sharon; Pols, Vincenza; Stapleton, Carolyn; Battersby, Malcolm

    2013-01-01

    Practice nurses in Australia are now funded to facilitate chronic condition management, including self-management support. Chronic disease management requires an established rapport, support and proactivity between general practitioners, patients and the practice nurses. To achieve this, training in shared decision making is needed. e-Learning supports delivery and achievement of such policy outcomes, service improvements and skill development. However, e-learning effectiveness for health care professionals' is determined by several organisational, economic, pedagogical and individual factors, with positive e-learning experience linked closely to various supports. This paper reinforces previous studies showing nurses' expanding role across general practice teams and reports on some of the challenges of e-learning. Merely providing practice nurses with necessary information via web-based learning systems does not ensure successful learning or progress toward improving health outcomes for patients.

  14. Effectiveness of a Proactive Primary Care Program on Preserving Daily Functioning of Older People: A Cluster Randomized Controlled Trial.

    PubMed

    Bleijenberg, Nienke; Drubbel, Irene; Schuurmans, Marieke J; Dam, Hester Ten; Zuithoff, Nicolaas P A; Numans, Mattijs E; de Wit, Niek J

    2016-09-01

    To determine the effectiveness of a proactive primary care program on the daily functioning of older people in primary care. Single-blind, three-arm, cluster-randomized controlled trial with 1-year follow-up. Primary care setting, 39 general practices in the Netherlands. Community-dwelling people aged 60 and older (N = 3,092). A frailty screening intervention using routine electronic medical record data to identify older people at risk of adverse events followed by usual care from a general practitioner; after the screening intervention, a nurse-led care program consisting of a comprehensive geriatric assessment, evidence-based care planning, care coordination, and follow-up; usual care. Primary outcome was daily functioning measured using the Katz-15 (6 activities of daily living (ADLs), 8 instrumental activities of daily living (IADLs), one mobility item (range 0-15)); higher scores indicate greater dependence. Secondary outcomes included quality of life, primary care consultations, hospital admissions, emergency department visits, nursing home admissions, and mortality. The participants in both intervention arms had less decline in daily functioning than those in the usual care arm at 12 months (mean Katz-15 score: screening arm, 1.87, 95% confidence interval (CI) = 1.77-1.97; screening and nurse-led care arm, 1.88, 95% CI = 1.80-1.96; control group, 2.03, 95% CI = 1.92-2.13; P = .03). No differences in quality of life were observed. Participants in both intervention groups had less decline than those in the control group at 1-year follow-up. Despite the statistically significant effect, the clinical relevance is uncertain at this point because of the small differences. Greater customizing of the intervention combined with prolonged follow-up may lead to more-robust results. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  15. Leveraging certified nursing assistant documentation and knowledge to improve clinical decision making: the on-time quality improvement program to prevent pressure ulcers.

    PubMed

    Sharkey, Siobhan; Hudak, Sandra; Horn, Susan D; Spector, William

    2011-04-01

    The goal of this article was to enhance understanding of the On-Time Quality Improvement for Long-term Care Program, a practical approach to embed health information technology into quality improvement in nursing homes that leverages certified nursing assistant documentation and knowledge, supports frontline clinical decision making, and establishes proactive intervention for pressure ulcer prevention.

  16. Policies and Procedures To Develop Effective School-Wide Discipline Practices at the Elementary School Level. CASE/CCBD Mini-Library Series on Safe, Drug-Free, and Effective Schools.

    ERIC Educational Resources Information Center

    Newcomer, Lori L.; Lewis, Timothy J.; Powers, Lisa J.

    Elementary schools can play an important role in early identification of and intervention for children with problem behavior by creating the infrastructure to provide preventive, proactive supports for all students. This monograph provides an overview of key features of effective school-wide systems of positive behavior support (PBS) at the…

  17. Including Families of Children with Special Needs. A How-To-Do-It Manual for Librarians. How-To-Do-It Manuals for Librarians, Number 88.

    ERIC Educational Resources Information Center

    Feinberg, Sandra; Jordan, Barbara; Deerr, Kathleen; Langa, Michelle

    This publication is a guide to assist librarians in taking a proactive stance to include families of children with special needs in programs and services. The focus is on families with children up to age five, and covers the basic principles underlying inclusion, family-centered service, resource-based practice, and the provision of library…

  18. Does war beget child aggression? Military violence, gender, age and aggressive behavior in two Palestinian samples.

    PubMed

    Qouta, Samir; Punamäki, Raija-Leena; Miller, Thomas; El-Sarraj, Eyad

    2008-01-01

    We examined, first, the relations between children's exposure to military violence and their aggressive behavior and the role of age and gender in that relation in two Palestinian samples. Second, we tested parenting practices as a moderator of the relation between exposure to military violence and aggressive behavior, and third, whether exposure to military violence of different nature (direct victimization versus witnessing) has specific associations with different forms of aggression (reactive, proactive and aggression-enjoyment). Study I was conducted in a relatively calm military-political atmosphere in Palestine-Gaza, and included 640 children, aged 6-16 years whose parents (N=622) and teachers (N=457) provided reports. Older children (> or =12 years) provided self-reports (N=211). Study II included 225 Palestinian children aged 10-14-year, who participated during a high-violence period of the Al Aqsa Intifada characterized by air raids, killing and destruction. Results showed that witnessing severe military violence was associated with children's aggressive and antisocial behavior (parent-reported) in study I, and with proactive, reactive and aggression-enjoyment (child-reported) in the study II. As hypothesized, good and supporting parenting practices could moderate the link between exposure to military violence and aggressive behavior. Aggr. Copyright 2007 Wiley-Liss, Inc.

  19. Meta-cognitive processes in executive control development: The case of reactive and proactive control

    PubMed Central

    Chevalier, Nicolas; Martis, Shaina Bailey; Curran, Tim; Munakata, Yuko

    2015-01-01

    Young children engage cognitive control reactively in response to events, rather than proactively preparing for events. Such limitations in executive control have been explained in terms of fundamental constraints on children’s cognitive capacities. Alternatively, young children might be capable of proactive control but differ from older children in their meta-cognitive decisions regarding when to engage proactive control. We examined these possibilities in three conditions of a task-switching paradigm, varying in whether task cues were available before or after target onset. Reaction times, ERPs, and pupil dilation showed that 5-year-olds did engage in advance preparation, a critical aspect of proactive control, but only when reactive control was made more difficult, whereas 10-year-olds engaged proactive control whenever possible. These findings highlight meta-cognitive processes in children’s cognitive control, an understudied aspect of executive control development. PMID:25603026

  20. Proactive responses to human impacts that balance development and Atlantic salmon (Salmo salar) conservation: An integrative model

    USGS Publications Warehouse

    Wilzbach, M.A.; Mather, M. E.; Folt, C.L.; Moore, A.; Naiman, R.J.; Youngson, A.F.; McMenemy, J.

    1998-01-01

    Incorporating human impacts into conservation plans is critical to protect natural resources. Using a model that examines how anthropogenic changes might be proactively influenced to promote conservation, we argue that a denser human population does not spell inevitable doom for Atlantic salmon (Salmo salar). Humans affect the Atlantic salmon ecosystem deleteriously through landscape alteration, exploitation, external inputs, and resource competition. An intact ecosystem provides positive feedback to society by providing food, ecosystem services, and improving the quality of life. As Atlantic salmon and associated ecosystem benefits are increasingly valued by society, policies, laws, and regulations that protect salmon populations and habitats are codified into a 'control system' or institutional infrastructure. Via research that helps maintain wild salmon populations and in informing the public about the benefits of a healthy Atlantic salmon ecosystem, scientists can influence public attitudes and facilitate the implementation of environmental policies that moderate harmful anthropogenic changes. Because exchange among scientists is of paramount importance in increasing our understanding of important interrelationships between humans and fish, we recommend the establishment of an international salmon organizational for research.

  1. Emergency Preparedness for Catastrophic Events at Small and Medium Sized Airports: Lacking or Not?

    NASA Technical Reports Server (NTRS)

    Sweet, Kathleen M.

    2007-01-01

    The implementation of security methods and processes in general has had a decisive impact on the aviation industry. However, efforts to effectively coordinate varied aspects of security protocols between agencies and general aviation components have not been adequately addressed. Whether or not overall security issues, especially with regard to planning for catastrophic terrorist events, have been neglected at the nation's smaller airports is the main topic of this paper. For perspective, the term general aviation is generally accepted to include all flying except for military and scheduled airline operations. Genera aviation makes up more than 1 percent of the U.S. Gross Domestic Product and supports almost 1.3 mission high-skilled jobs in professional services and manufacturing and hence is an important component of the aviation industry (AOPA, n.d.). In both conceptual and practical terms, this paper argues for the proactive management of security planning and repeated security awareness training from both an individual and an organizational perspective within the general aviation venue. The results of a research project incorporating survey data from general aviation and small commercial airport managers as well as Transportation Security Administration (TSA) employees are reported. Survey findings suggest that miscommunication does take place on different organizational levels and that between TSA employees and airport management interaction can be contentious and cooperation diminished. The importance of organizational training for decreasing conflict and increasing security and preparedness is discussed as a primary implication.

  2. Prospective environmental restoration/ restoration up front: a concept for an incentive-based program to increase restoration planning and implementation in the United States.

    PubMed

    Stahl, Ralph G; Gouguet, Ron; DeSantis, Amanda; Liu, Jenny; Ammann, Michael

    2008-01-01

    This article describes a concept variously termed prospective environmental restoration, restoration up front, or restoration banking. Briefly, the concept centers on the ability of an entity, public or private, to gain durable credits for undertaking proactive restoration activities. Once obtained, these credits can be applied to an existing liability, held in the event of a future liability, or traded or sold to others that might have need for the credits. In the case of a natural resource damage claim or response action, possessing or applying the credits does not negate the need for responsible entities to clean up spills or releases of hazardous substances or oil or to address their clean-up requirements under applicable federal and state statutes. Concepts similar to prospective environmental restoration/restoration up front include wetlands mitigation banking, conservation habitat banking, and emissions trading. Much of the concept and details provided herein stem from the practice of natural resource damage assessment, although that is not the sole driver for the concept. The concept could also apply where the credits could be used to offset other environmental liabilities, for example, to provide habitat mitigation where development is being planned. The authors believe that the concept, if widely applied, could reduce the time and costs associated with restoration and perhaps lead to an increase in voluntary restoration and conservation nationally. Currently, there are no state or federal regulations or policies that directly provide for this approach.

  3. Proactive tobacco treatment and population-level cessation: a pragmatic randomized clinical trial.

    PubMed

    Fu, Steven S; van Ryn, Michelle; Sherman, Scott E; Burgess, Diana J; Noorbaloochi, Siamak; Clothier, Barbara; Taylor, Brent C; Schlede, Carolyn M; Burke, Randy S; Joseph, Anne M

    2014-05-01

    Current tobacco use treatment approaches require smokers to request treatment or depend on the provider to initiate smoking cessation care and are therefore reactive. Most smokers do not receive evidence-based treatments for tobacco use that include both behavioral counseling and pharmacotherapy. To assess the effect of a proactive, population-based tobacco cessation care model on use of evidence-based tobacco cessation treatments and on population-level smoking cessation rates (ie, abstinence among all smokers including those who use and do not use treatment) compared with usual care among a diverse population of current smokers. The Veterans Victory Over Tobacco Study, a pragmatic randomized clinical trial involving a population-based registry of current smokers aged 18 to 80 years. A total of 6400 current smokers, identified using the Department of Veterans Affairs (VA) electronic medical record, were randomized prior to contact to evaluate both the reach and effectiveness of the proactive care intervention. Current smokers were randomized to usual care or proactive care. Proactive care combined (1) proactive outreach and (2) offer of choice of smoking cessation services (telephone or in-person). Proactive outreach included mailed invitations followed by telephone outreach to motivate smokers to seek treatment with choice of services. The primary outcome was 6-month prolonged smoking abstinence at 1 year and was assessed by a follow-up survey among all current smokers regardless of interest in quitting or treatment utilization. A total of 5123 participants were included in the primary analysis. The follow-up survey response rate was 66%. The population-level, 6-month prolonged smoking abstinence rate at 1 year was 13.5% for proactive care compared with 10.9% for usual care (P = .02). Logistic regression mixed model analysis showed a significant effect of the proactive care intervention on 6-month prolonged abstinence (odds ratio [OR], 1.27 [95% CI, 1.03-1.57]). In analyses accounting for nonresponse using likelihood-based not-missing-at-random models, the effect of proactive care on 6-month prolonged abstinence persisted (OR, 1.33 [95% CI, 1.17-1.51]). Proactive, population-based tobacco cessation care using proactive outreach to connect smokers to evidence-based telephone or in-person smoking cessation services is effective for increasing long-term population-level cessation rates. clinicaltrials.gov Identifier: NCT00608426.

  4. Cue competition effects in human causal learning.

    PubMed

    Vogel, Edgar H; Glynn, Jacqueline Y; Wagner, Allan R

    2015-01-01

    Five experiments involving human causal learning were conducted to compare the cue competition effects known as blocking and unovershadowing, in proactive and retroactive instantiations. Experiment 1 demonstrated reliable proactive blocking and unovershadowing but only retroactive unovershadowing. Experiment 2 replicated the same pattern and showed that the retroactive unovershadowing that was observed was interfered with by a secondary memory task that had no demonstrable effect on either proactive unovershadowing or blocking. Experiments 3a, 3b, and 3c demonstrated that retroactive unovershadowing was accompanied by an inflated memory effect not accompanying proactive unovershadowing. The differential pattern of proactive versus retroactive cue competition effects is discussed in relationship to amenable associative and inferential processing possibilities.

  5. The interactive effects of proactive personality and work-family interference on well-being.

    PubMed

    Cunningham, Christopher J L; De La Rosa, Gabriel M

    2008-07-01

    Proactive personality was expected to moderate the relationship between controllable work and nonwork stressors (e.g., time-based work-family interference) and job/life satisfaction. Moderated multiple regression analyses of survey data from a sample of professionals (N=133) revealed a significant interaction between time-based family interfering-with work and proactive personality predicting life satisfaction and several main effects offering partial support for the hypothesized relationships (alpha<.05). No other interactions between proactive personality and other forms of work-family interference were observed. The benefits of proactive personality may only emerge when personal control over occupational stressors can be exercised. Copyright (c) 2008 APA, all rights reserved.

  6. Proactive Interference Does Not Meaningfully Distort Visual Working Memory Capacity Estimates in the Canonical Change Detection Task

    PubMed Central

    Lin, Po-Han; Luck, Steven J.

    2012-01-01

    The change detection task has become a standard method for estimating the storage capacity of visual working memory. Most researchers assume that this task isolates the properties of an active short-term storage system that can be dissociated from long-term memory systems. However, long-term memory storage may influence performance on this task. In particular, memory traces from previous trials may create proactive interference that sometimes leads to errors, thereby reducing estimated capacity. Consequently, the capacity of visual working memory may be higher than is usually thought, and correlations between capacity and other measures of cognition may reflect individual differences in proactive interference rather than individual differences in the capacity of the short-term storage system. Indeed, previous research has shown that change detection performance can be influenced by proactive interference under some conditions. The purpose of the present study was to determine whether the canonical version of the change detection task – in which the to-be-remembered information consists of simple, briefly presented features – is influenced by proactive interference. Two experiments were conducted using methods that ordinarily produce substantial evidence of proactive interference, but no proactive interference was observed. Thus, the canonical version of the change detection task can be used to assess visual working memory capacity with no meaningful influence of proactive interference. PMID:22403556

  7. Proactive interference does not meaningfully distort visual working memory capacity estimates in the canonical change detection task.

    PubMed

    Lin, Po-Han; Luck, Steven J

    2012-01-01

    The change detection task has become a standard method for estimating the storage capacity of visual working memory. Most researchers assume that this task isolates the properties of an active short-term storage system that can be dissociated from long-term memory systems. However, long-term memory storage may influence performance on this task. In particular, memory traces from previous trials may create proactive interference that sometimes leads to errors, thereby reducing estimated capacity. Consequently, the capacity of visual working memory may be higher than is usually thought, and correlations between capacity and other measures of cognition may reflect individual differences in proactive interference rather than individual differences in the capacity of the short-term storage system. Indeed, previous research has shown that change detection performance can be influenced by proactive interference under some conditions. The purpose of the present study was to determine whether the canonical version of the change detection task - in which the to-be-remembered information consists of simple, briefly presented features - is influenced by proactive interference. Two experiments were conducted using methods that ordinarily produce substantial evidence of proactive interference, but no proactive interference was observed. Thus, the canonical version of the change detection task can be used to assess visual working memory capacity with no meaningful influence of proactive interference.

  8. Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: A qualitative study

    PubMed Central

    Kaler, Jasmeet; Green, L.E.

    2013-01-01

    A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers’ perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n = 45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to provide consistency and wide expertise beyond knowledge of disease and a model of how flock planning would be financially beneficial but until sheep farmers keep production records flock health planning cannot be rigorous and the financial benefits cannot be evaluated. Given the reliance on SPS by farmers an alternative model would be to require farmers to keep production records to comply with SPS. This might lead to flock health planning being adopted at a faster rate and so develop the UK sheep industry and make it more environmentally sustainable by reducing waste from disease and low productivity. PMID:24120236

  9. Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: a qualitative study.

    PubMed

    Kaler, Jasmeet; Green, L E

    2013-11-01

    A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers' perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n=45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to provide consistency and wide expertise beyond knowledge of disease and a model of how flock planning would be financially beneficial but until sheep farmers keep production records flock health planning cannot be rigorous and the financial benefits cannot be evaluated. Given the reliance on SPS by farmers an alternative model would be to require farmers to keep production records to comply with SPS. This might lead to flock health planning being adopted at a faster rate and so develop the UK sheep industry and make it more environmentally sustainable by reducing waste from disease and low productivity. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam

    PubMed Central

    Harris, Jody; Nguyen, Phuong H.; To, Quyen; Frongillo, Edward A.; Menon, Purnima

    2016-01-01

    Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009–2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. PMID:27198978

  11. Resumes as a Proactive Career Development Tool: An Innovation at Keuka College Career Center.

    ERIC Educational Resources Information Center

    Miner, Todd

    2000-01-01

    A proactive resume can help individuals understand workplace demands and their fit with them. Development of proactive resumes focuses first on employability skills and then on skills and attributes of specific professions or careers. (SK)

  12. More effective and less expensive: lessons from five studies examining community approaches to care.

    PubMed

    Browne, G; Roberts, J; Gafni, A; Weir, R; Watt, S; Byrne, C

    1995-11-01

    Does the nature of community health services used by chronically ill clients and their caregivers have an impact on utilization of services, expenditure and well-being outcomes? A series of five studies, (four historic cohort and one randomized trial) examined clients suffering from a variety of chronic conditions in a number of community settings in different regions of Southern Ontario. Study sample composition and size varied. Each study was designed to quantify the well-being outcomes, and expenditure associated with different community approaches is covered under a nation-wide system of health insurance plans. As a collective, these studies represent increasing methodological rigor. Multiple-perspective client well-being outcome measures were used. Caregiver burden was also analyzed. A common approach to quantification and evaluation of expenditure for service consumption was applied across all five studies. The nature of community health services (proactive versus reactive approaches to care) was found to have direct and measurable impact on total expenditure for health service utilization and client well-being outcomes. A recurring pattern of lower expenditure for community health service utilization and equal or better client outcomes was associated with well-integrated proactive services when compared with individual fragmented, reactive approaches to care. The main lesson emerging from examining the five studies on approaches to community care is that it is as, or more, effective and less expensive to offer complete proactive health care services to chronically ill people in the early stages of their illness than to provide services on demand in a piecemeal manner.

  13. Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: a randomised clinical trial

    PubMed Central

    Fu, Steven S; van Ryn, Michelle; Nelson, David; Burgess, Diana J; Thomas, Janet L; Saul, Jessie; Clothier, Barbara; Nyman, John A; Hammett, Patrick; Joseph, Anne M

    2016-01-01

    Background Evidenced-based tobacco cessation treatments are underused, especially by socioeconomically disadvantaged smokers. This contributes to widening socioeconomic disparities in tobacco-related morbidity and mortality. Methods The Offering Proactive Treatment Intervention trial tested the effects of a proactive outreach tobacco treatment intervention on population-level smoking abstinence and tobacco treatment use among a population-based sample of socioeconomically disadvantaged smokers. Current smokers (n=2406), regardless of interest in quitting, who were enrolled in the Minnesota Health Care Programs, the state's publicly funded healthcare programmes for low-income populations, were randomly assigned to proactive outreach or usual care. The intervention comprised proactive outreach (tailored mailings and telephone calls) and free cessation treatment (nicotine replacement therapy and intensive, telephone counselling). Usual care comprised access to a primary care physician, insurance coverage of Food and Drug Administration-approved smoking cessation medications, and the state's telephone quitline. The primary outcome was self-reported 6-month prolonged smoking abstinence at 1 year and was assessed by follow-up survey. Findings The proactive intervention group had a higher prolonged abstinence rate at 1 year than usual care (16.5% vs 12.1%, OR 1.47, 95% CI 1.12 to 1.93). The effect of the proactive intervention on prolonged abstinence persisted in selection models accounting for non-response. In analysis of secondary outcomes, use of evidence-based tobacco cessation treatments were significantly greater among proactive outreach participants compared with usual care, particularly combination counselling and medications (17.4% vs 3.6%, OR 5.69, 95% CI 3.85 to 8.40). Interpretation Population-based proactive tobacco treatment increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers. Findings suggest that dissemination of population-based proactive treatment approaches is an effective strategy to reduce the prevalence of smoking and socioeconomic disparities in tobacco use. Trial registration number NCT01123967. PMID:26931362

  14. Identifying cognitive predictors of reactive and proactive aggression.

    PubMed

    Brugman, Suzanne; Lobbestael, Jill; Arntz, Arnoud; Cima, Maaike; Schuhmann, Teresa; Dambacher, Franziska; Sack, Alexander T

    2015-01-01

    The aim of this study was to identify implicit cognitive predictors of aggressive behavior. Specifically, the predictive value of an attentional bias for aggressive stimuli and automatic association of the self and aggression was examined for reactive and proactive aggressive behavior in a non-clinical sample (N = 90). An Emotional Stroop Task was used to measure an attentional bias. With an idiographic Single-Target Implicit Association Test, automatic associations were assessed between words referring to the self (e.g., the participants' name) and words referring to aggression (e.g., fighting). The Taylor Aggression Paradigm (TAP) was used to measure reactive and proactive aggressive behavior. Furthermore, self-reported aggressiveness was assessed with the Reactive Proactive Aggression Questionnaire (RPQ). Results showed that heightened attentional interference for aggressive words significantly predicted more reactive aggression, while lower attentional bias towards aggressive words predicted higher levels of proactive aggression. A stronger self-aggression association resulted in more proactive aggression, but not reactive aggression. Self-reports on aggression did not additionally predict behavioral aggression. This implies that the cognitive tests employed in our study have the potential to discriminate between reactive and proactive aggression. Aggr. Behav. 41:51-64 2015. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

  15. The relationship between personality disorder traits and reactive versus proactive motivation for aggression.

    PubMed

    Lobbestael, Jill; Cima, Maaike; Lemmens, Anke

    2015-09-30

    There is a strong link between personality disorders (PDs) and aggression. This is reflected in high prevalence rates of PD diagnoses in forensic samples, and in several diagnostic criteria of PDs directly referring to elevated levels of aggression. Aggression can stem from two distinct types of motivation; reactive or impulsive aggression that serves as a defensive reaction to provocation, and proactive or premeditated aggression used to gain extrinsic benefits. Although some clinical conditions like antisocial, borderline, and narcissistic PDs or PD traits, have been empirically linked to reactive and/or proactive aggression, the current study pioneers assessing the relationship between reactive and proactive aggression and traits of all 10 PDs. A mixed sample of patient and non-patient (N=238) participants were administered with the SCID II to assess the level of PD traits; they also completed the Reactive Proactive Questionnaire to determine levels of reactive and proactive aggression. Results showed that paranoid PD traits were positively related to reactive aggression, whereas proactive aggression was uniquely related to antisocial PD traits. This highlights the importance of differentiating between distinct motivations for aggression in PD samples. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Contracting for nurse education: nurse leader experiences and future visions.

    PubMed

    Moule, P

    1999-02-01

    The integration of nurse education into higher education establishments following Working for Patients, Working Paper 10 (DOH 1989a) has seen changes to the funding and delivery of nurse education. The introduction of contracting for education initiated a business culture which subsumed previous relationships, affecting collaborative partnerships and shared understanding. Discourse between the providers and purchasers of nurse education is vital to achieve proactive curriculum planning, which supports the development of nursing practitioners who are fit for award and fit for purpose. Research employed philosophical hermeneutics to guide the interviewing of seven nurse leaders within one region. Data analysis occurred within a hermeneutic circle and was refined using NUDIST. Two key themes were seen as impacting on the development of an effective educational strategy. Firstly, the development of collaborative working was thought to have been impeded by communication difficulties between the Trusts and higher education provider. Secondly, there was concern that curriculum developments would support the future evolution of nursing, acknowledging the professional issues impacting on nursing roles. The research findings suggest purchasers and providers of nurse education must move towards achieving mutual understanding and collaborate in developing a curriculum which will prepare nurses for practice and for award.

  17. Toward a zero VAP rate: personal and team approaches in the ICU.

    PubMed

    Fox, Maria Y

    2006-01-01

    In a fast-paced setting like the intensive care unit (ICU), nurses must have appropriate tools and resources in order to implement appropriate and timely interventions. Ventilator-associated pneumonia (VAP) is a costly and potentially fatal outcome for ICU patients that requires timely interventions. Even with established guidelines and care protocols, nurses do not always incorporate best practice interventions into their daily plan of care. Despite the plethora of information and guidelines about how to apply interventions in order to save lives, managers of ICUs are challenged to involve the bedside nurse and other ICU team members to apply these bundles of interventions in a proactive, rather than reactive, manner in order to prevent complications of care. The purpose of this article is to illustrate the success of 2 different methods utilized to improve patient care in the ICU. The first method is a personal process improvement model, and the second method is a team approach model. Both methods were utilized in order to implement interventions in a timely and complete manner to prevent VAP and its related problem, hospital-associated pneumonia, in the ICU setting. Success with these 2 methods has spurred an interest in other patient care initiatives.

  18. Self-regulation and performance level of elite and non-elite youth soccer players.

    PubMed

    Toering, T T; Elferink-Gemser, M T; Jordet, G; Visscher, C

    2009-12-01

    In learning and development, self-regulation can be described as the extent to which individuals are metacognitively, motivationally, and behaviourally proactive participants in their learning process (Zimmerman, 1989, 2006). We examined the relationship between self-regulation and performance level in elite (n = 159) and non-elite (n = 285) youth soccer players aged 11-17 years (mean 14.5 years, s = 1.4). The players completed a questionnaire that assessed planning, self-monitoring, evaluation, reflection, effort, and self-efficacy. A logistic regression analysis was performed (controlling for age) to determine which self-regulatory aspects were associated with players' performance level (elite vs. non-elite). High scores on reflection and effort were associated with a higher level of performance. Findings suggest that elite players may be more aware of their strong and weak points as well as better able to translate this awareness into action. In addition, elite players appear to be more willing to invest effort into practice and competition. It is suggested that these better developed self-regulatory skills may translate into a more effective learning environment and ultimately result in an increased capacity for performance in elite players relative to their non-elite peers.

  19. [Therapeutic Aggressiveness and Liquid Oncology].

    PubMed

    Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

    2017-01-01

    Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

  20. Paradoxical effects of testing: retrieval enhances both accurate recall and suggestibility in eyewitnesses.

    PubMed

    Chan, Jason C K; Langley, Moses M

    2011-01-01

    Although retrieval practice typically enhances memory retention, it can also impair subsequent eyewitness memory accuracy (Chan, Thomas, & Bulevich, 2009). Specifically, participants who had taken an initial test about a witnessed event were more likely than nontested participants to recall subsequently encountered misinformation—an effect we called retrieval-enhanced suggestibility (RES). Here, we sought to test the generality of RES and to further elucidate its underlying mechanisms. To that end, we tested a dual mechanism account, which suggests that RES occurs because initial testing (a) enhances learning of the later misinformation by reducing proactive interference and (b) causes the reactivated memory trace to be more susceptible to later interference (i.e., a reconsolidation account). Three major findings emerged. First, RES was found after a 1-week delay, where a robust testing benefit occurred for event details that were not contradicted by later misinformation. Second, blockage of reconsolidation was unnecessary for RES to occur. Third, initial testing enhanced learning of the misinformation even when proactive interference played a minimal role.

  1. Initiating and utilizing shared leadership in teams: The role of leader humility, team proactive personality, and team performance capability.

    PubMed

    Chiu, Chia-Yen Chad; Owens, Bradley P; Tesluk, Paul E

    2016-12-01

    The present study was designed to produce novel theoretical insight regarding how leader humility and team member characteristics foster the conditions that promote shared leadership and when shared leadership relates to team effectiveness. Drawing on social information processing theory and adaptive leadership theory, we propose that leader humility facilitates shared leadership by promoting leadership-claiming and leadership-granting interactions among team members. We also apply dominance complementary theory to propose that team proactive personality strengthens the impact of leader humility on shared leadership. Finally, we predict that shared leadership will be most strongly related to team performance when team members have high levels of task-related competence. Using a sample composed of 62 Taiwanese professional work teams, we find support for our proposed hypothesized model. The theoretical and practical implications of these results for team leadership, humility, team composition, and shared leadership are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Parents' and Adolescents' Perspectives on Parenting: Evaluating Conceptual Structure, Measurement Invariance, and Criterion Validity.

    PubMed

    Janssens, Annelies; Goossens, Luc; Van Den Noortgate, Wim; Colpin, Hilde; Verschueren, Karine; Van Leeuwen, Karla

    2015-08-01

    Uncertainty persists regarding adequate measurement of parenting behavior during early adolescence. The present study aimed to clarify the conceptual structure of parenting by evaluating three different models that include support, psychological control, and various types of behavioral control (i.e., proactive, punitive, and harsh punitive control). Furthermore, we examined measurement invariance of parenting ratings by 1,111 Flemish adolescents from Grade 7 till 9, their mother, and father. Finally, criterion validity of parenting ratings was estimated in relation to adolescent problem behavior. Results supported a five-factor parenting model indicating multiple aspects of behavioral control, with punitive and harsh punitive control as more intrusive forms and proactive control as a more supportive form. Similar constructs were measured for adolescents, mothers, and fathers (i.e., configural and metric invariance), however on a different scale (i.e., scalar noninvariance). Future research and clinical practices should acknowledge these findings in order to fully grasp the parenting process. © The Author(s) 2014.

  3. Piloting proactive marketing to recruit disadvantaged adults to a community-wide obesity prevention program.

    PubMed

    O'Hara, Blythe J; Eggins, Dianne; Phongsavan, Philayrath; Milat, Andrew J; Bauman, Adrian E; Wiggers, John

    2015-03-30

    Population-wide obesity prevention and treatment programs are fundamental to addressing the increasing overweight and obesity rates in socioeconomically disadvantaged populations. Innovative recruitment strategies, including proactive marketing strategies, are needed to ensure such programs have universal reach and target vulnerable populations. This study aimed to determine the success of proactive recruitment to Australia's Get Healthy Information and Coaching Service® (GHS) and to assess whether the recruitment strategy influenced participants' outcomes. Sociodemographic information was collected from all GHS participants who joined the service between February 2009 and August 2013, and anthropometric information regarding behavioural risk factors was collected from all GHS coaching participants at baseline and six months. Data were analysed according to the participants' referral source (self-referral and secondary referral versus proactive recruitment). Participants recruited through proactive marketing were more likely to be male, aged 50 years or older, have high school education, not be in paid employment and be from the lowest three quintiles of socioeconomic advantage. The risk factor profile of coaching participants recruited through proactive marketing did not vary significantly from those recruited via other mechanisms, although they were less likely to be obese and less likely to have a higher 'at risk' waist circumference measurement. Proactively recruited coaching participants reported significant improvements from baseline to six months (consistent with improvements made by participants recruited through other strategies), although they were significantly more likely to withdraw from coaching before they completed the six-month program.Proactive marketing facilitated use of an obesity prevention service; similar services may have greater reach if proactive marketing recruitment strategies are used. These strategies could be encouraged to assist such services to achieve optimal population impact among hard-to-reach populations.

  4. Cybersecurity and medical devices: A practical guide for cardiac electrophysiologists

    PubMed Central

    Kramer, Daniel B.; Foo Kune, Denis; Auto de Medeiros, Julio; Yan, Chen; Xu, Wenyuan; Crawford, Thomas; Fu, Kevin

    2017-01-01

    Abstract Medical devices increasingly depend on software. While this expands the ability of devices to perform key therapeutic and diagnostic functions, reliance on software inevitably causes exposure to hazards of security vulnerabilities. This article uses a recent high‐profile case example to outline a proactive approach to security awareness that incorporates a scientific, risk‐based analysis of security concerns that supports ongoing discussions with patients about their medical devices. PMID:28512774

  5. Incorporating Social Determinants into a Groundwater Risk Framework

    NASA Astrophysics Data System (ADS)

    Simpson, M.; Allen, D. M.; Journeay, M.; Korteling, B.

    2009-12-01

    The remediation of polluted groundwater is often very costly, therefore water managers utilize various proactive measures, such as wellhead protection planning, to prevent contamination events. With limited available resources, it is essential to prioritize where these measures are introduced; systematic and integrated methodologies of assessing risk to groundwater can be utilized for this prioritization. To quantify the resistance of the physical system to pollution, Aquifer Vulnerability is commonly mapped for the area of interest. This information is useful for focusing monitoring efforts and identifying data gaps, but is a relative measure of contaminant risk. To more accurately assess the probability of contamination, an inventory of hazards can be integrated with intrinsic vulnerability of the physical system. This Threat indicator links land-use with chemicals and quantifies the risk based on the toxicity and environmental fate of these substances. Local knowledge of the quantity stored and likelihood of release can be utilized to further assess these threats. Both of these steps form part of an existing frameworks for assessing risk to groundwater. In this study, a groundwater risk framework is developed and tested in two study areas; Pender Island and the Lower Fraser Valley in British Columbia, Canada. Enhancements of a basic groundwater risk framework include not only incorporating points sources such as septic systems, landfills and fuel storage, but also various social determinants of risk. These social determinants include the Resistance of a community, which represents the planning and protection initiatives designed to safeguard the resource. These include items such as land-use planning that consider groundwater vulnerability and best management practices enforced by local governments. The ability to recover following an event is the Capacity of a community; indicators include the presence or absence of spill response plans, treatment systems or an alternative supply of water. The determinant of Loss quantifies the financial impact of this work. This indicator may be altered in future applications to include loss associated with human health and/or that stemming from a reduction in ecosystem health.

  6. Popularity differentially predicts reactive and proactive aggression in early adolescence.

    PubMed

    Stoltz, Sabine; Cillessen, Antonius H N; van den Berg, Yvonne H M; Gommans, Rob

    2016-01-01

    Previous research has indicated that peer popularity is associated with aggressive behavior. However, it is not yet clear whether popularity is uniquely related to different functions of aggression. In this study, we examined associations between peer-perceived popularity, and reactive and proactive aggression using a cross-sectional and a longitudinal design. Yearly sociometric measures of popularity, and reactive and proactive aggression were gathered from 266 seventh and eight grade adolescents (Mage grade 7 = 12.80, SDage  = .40). Popularity was positively correlated with proactive aggression and negatively correlated with reactive aggression, both concurrently as over time. Curvilinear trends indicated that a significant minority of low versus high popular adolescents showed both functions of aggression. Somewhat stronger effects of popularity on proactive aggression were found for boys than girls. Stably popular adolescents showed the highest levels of proactive aggression, whereas stably unpopular youth showed the highest levels of reactive aggression. Implications and directions for future research are discussed. © 2015 Wiley Periodicals, Inc.

  7. Making things happen through challenging goals: leader proactivity, trust, and business-unit performance.

    PubMed

    Crossley, Craig D; Cooper, Cecily D; Wernsing, Tara S

    2013-05-01

    Building on decades of research on the proactivity of individual performers, this study integrates research on goal setting and trust in leadership to examine manager proactivity and business unit sales performance in one of the largest sales organizations in the United States. Results of a moderated-mediation model suggest that proactive senior managers establish more challenging goals for their business units (N = 50), which in turn are associated with higher sales performance. We further found that employees' trust in the manager is a critical contingency variable that facilitates the relationship between challenging sales goals and subsequent sales performance. This research contributes to growing literatures on trust in leadership and proactivity by studying their joint effects at a district-unit level of analysis while identifying district managers' tendency to set challenging goals as a process variable that helps translate their proactivity into the collective performance of their units. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  8. Risk and resilience in an uncertain world

    DOE PAGES

    Dale, Virginia H.; Jager, Henriette I.; Wolfe, Amy K.; ...

    2018-02-01

    We report that because the future is uncertain and to some extent unknowable, it is imperative that ecologists become involved in the discussion and planning of future infrastructure and protection from the effects of altered disturbance regimes. Research can test and demonstrate the benefits of protecting or proactively managing important features and places, and processes that enhance provisioning of ecosystem services such as flood control and fire mitigation. In conclusion, it is time to demonstrate how ecological science, when applied to human–environmental systems, can reduce risks and enhance resilience in a complex, changing world.

  9. Risk and resilience in an uncertain world

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

    Dale, Virginia H.; Jager, Henriette I.; Wolfe, Amy K.

    We report that because the future is uncertain and to some extent unknowable, it is imperative that ecologists become involved in the discussion and planning of future infrastructure and protection from the effects of altered disturbance regimes. Research can test and demonstrate the benefits of protecting or proactively managing important features and places, and processes that enhance provisioning of ecosystem services such as flood control and fire mitigation. In conclusion, it is time to demonstrate how ecological science, when applied to human–environmental systems, can reduce risks and enhance resilience in a complex, changing world.

  10. Never Let the Opportunity to Prepare for a Crisis Go to Waste: The Need for Proactive Measures in the Asia-Pacific Region to Mitigate the Impacts of Climate Change

    DTIC Science & Technology

    2015-05-21

    mitigation plan in place. In the long term, it is likely that the Filipinos will contend with both rising sea levels and acidification of the ocean . The... acidification of the oceans will likely have a deleterious effect on fisheries, increasing the potential for food...Persian Gulf to both the South China Sea and the Pacific Ocean . 34 With such enormous economic value, it should come as no surprise that nations

  11. Transforming home health nursing with telehealth technology.

    PubMed

    Farrar, Francisca Cisneros

    2015-06-01

    Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Proactive effects of memory in young and older adults: The role of change recollection

    PubMed Central

    Wahlheim, Christopher N.

    2015-01-01

    Age-related deficits in episodic memory are sometimes attributed to older adults being more susceptible to proactive interference. These deficits have been explained by impaired abilities to inhibit competing information and to recollect target information. In the present article, I propose that a change recollection deficit also contributes to age differences in proactive interference. Change recollection occurs when individuals can remember how information changed across episodes, and this counteracts proactive interference by preserving the temporal order of information. Three experiments were conducted to determine whether older adults are less likely to counteract proactive interference by recollecting change. Paired-associate learning paradigms with two lists of word pairs included pairs that repeated across lists, pairs that only appeared in List 2 (control items), and pairs with cues that repeated and responses that changed across lists. Young and older adults’ abilities to detect changed pairs in List 2 and to later recollect those changes at test were measured, along with cued recall of the List 2 responses and confidence in recall performance. Change recollection produced proactive facilitation in the recall of changed pairs, whereas the failure to recollect change resulted in proactive interference. Confidence judgments were sensitive to these effects. The critical finding was that older adults recollected change less than did young adults, and this partially explained older adults’ greater susceptibility to proactive interference. These findings have theoretical implications, showing that a change recollection deficit contributes to age-related deficits in episodic memory. PMID:24710672

  13. Proactive effects of memory in young and older adults: the role of change recollection.

    PubMed

    Wahlheim, Christopher N

    2014-08-01

    Age-related deficits in episodic memory are sometimes attributed to older adults being more susceptible to proactive interference. These deficits have been explained by impaired abilities to inhibit competing information and to recollect target information. In the present article, I propose that a change recollection deficit also contributes to age differences in proactive interference. Change recollection occurs when individuals can remember how information changed across episodes, and this counteracts proactive interference by preserving the temporal order of information. Three experiments were conducted to determine whether older adults are less likely to counteract proactive interference by recollecting change. Paired-associate learning paradigms with two lists of word pairs included pairs that repeated across lists, pairs that only appeared in List 2 (control items), and pairs with cues that repeated and responses that changed across lists. Young and older adults' abilities to detect changed pairs in List 2 and to later recollect those changes at test were measured, along with cued recall of the List 2 responses and confidence in recall performance. Change recollection produced proactive facilitation in the recall of changed pairs, whereas the failure to recollect change resulted in proactive interference. Confidence judgments were sensitive to these effects. The critical finding was that older adults recollected change less than did young adults, and this partially explained older adults' greater susceptibility to proactive interference. These findings have theoretical implications, showing that a change recollection deficit contributes to age-related deficits in episodic memory.

  14. Practice-Informed Approaches to Addressing Substance Abuse and Trauma Exposure in Urban Native Families Involved with Child Welfare.

    PubMed

    Lucero, Nancy M; Bussey, Marian

    2015-01-01

    Similar to families from other groups, urban-based American Indian and Alaska Native ("Native") family members involved with the child welfare system due to substance abuse issues are also often challenged by untreated trauma exposure. The link between these conditions and the history of genocidal policies aimed at destroying Native family ties, as well as experiences of ongoing discrimination, bring added dimensions for consideration when pro- viding services to these families. Practice-based evidence indicates that the trauma-informed and culturally responsive model developed by the Denver Indian Family Resource Center (DIFRC) shows promise in reducing out-of-home placements and re-referrals in urban Native families with substance abuse and child welfare concerns, while also increasing caregiver capabilities, family safety, and child well-being. This article provides strategies from the DIFRC approach that non-Native caseworkers and supervisors can utilize to create an environment in their own agencies that supports culturally based practice with Native families while incorporating a trauma-informed understanding of service needs of these families. Casework consistent with this approach demonstrates actions that meet the Active Efforts requirement of the Indian Child Welfare Act (ICWA) as well as sound clinical practice. Intensive and proactive case management designed specifically for families with high levels of service needs is a key strategy when combined with utilizing a caseworker brief screening tool for trauma exposure; training caseworkers to recognize trauma symptoms, making timely referrals to trauma treatment by behavioral health specialists experienced in working with Native clients, and providing a consistent service environment that focuses on client safety and worker trustworthiness. Finally, suggestions are put forth for agencies seeking to enhance their cultural responsiveness and include increasing workers' understanding of cultural values, worldview, and historical issues; working from a relational perspective; listening deeply to families' experiences; and being open to incorporating traditional healing and cultural practice into service plans.

  15. Roadmap to risk evaluation and mitigation strategies (REMS) success

    PubMed Central

    Balian, John D.; Malhotra, Rachpal; Perentesis, Valerie

    2010-01-01

    Medical safety-related risk management is a rapidly evolving and increasingly important aspect of drug approval and market longevity. To effectively meet the challenges of this new era, we describe a risk management roadmap that proactively yet practically anticipates risk-management requirements, provides the foundation for enduring yet appropriately flexible risk-management practices, and leverages these techniques to efficiently and effectively utilize risk evaluation and mitigation strategies (REMS)/risk minimization programs as market access enablers. This fully integrated risk-management paradigm creates exciting opportunities for newer tools, techniques, and approaches to more successfully optimize product development, approval, and commercialization, with patients as the ultimate beneficiaries. PMID:25083193

  16. Proactive and Early Aggressive Wound Management: A Shift in Strategy Developed by a Consensus Panel Examining the Current Science, Prevention, and Management of Acute and Chronic Wounds.

    PubMed

    Bohn, Gregory A; Schultz, Gregory S; Liden, Brock A; Desvigne, Michael N; Lullove, Eric J; Zilberman, Igor; Regan, Mary B; Ostler, Marta; Edwards, Karen; Arvanitis, Georgia M; Hartman, Jodi F

    2017-11-01

    Normal wound healing is accomplished through a series of well-coordinated, progressive events with overlapping phases. Chronic wounds are described as not progressing to healing or not being responsive to management in a timely manner. A consensus panel of multidisciplinary wound care professionals was assembled to (1) educate wound care practitioners by identifying key principles of the basic science of chronic wound pathophysiology, highlighting the impact of metalloproteinases and biofilms, as well as the role of the extracellular matrix; and (2) equip practitioners with a systematic strategy for the prevention and healing of acute injuries and chronic wounds based upon scientific evidence and the panel members' expertise. An algorithm is presented that represents a shift in strategy to proactive and early aggressive wound management. With proactive management, adjunct therapies are applied preemptively to acute injuries to reduce wound duration and risk of chronicity. For existing chronic wounds, early aggressive wound management is employed to break the pathophysiology cycle and drive wounds toward healing. Reducing bioburden through debridement and bioburden management and using collagen dressings to balance protease activity prior to the use of advanced modalities may enhance their effectiveness. This early aggressive wound management strategy is recommended for patients at high risk for chronic wound development at a minimum. In their own practices, the panel members apply this systematic strategy for all patients presenting with acute injuries or chronic wounds.

  17. Cognitive and Affective Empathy as Predictors of Proactive and Reactive Aggression

    ERIC Educational Resources Information Center

    Gordon, Gina M.

    2013-01-01

    This study examined cognitive and affective empathy as predictors of proactive and reactive aggression. This study also explored whether levels of cognitive and affective empathy differed among children who use proactive and reactive aggression. Cognitive and affective empathy were measured by the Basic Empathy Scale (Jolliffe & Farrington,…

  18. Individual Differences in Digit Span, Susceptibility to Proactive Interference, and Aptitude/Achievement Test Scores.

    ERIC Educational Resources Information Center

    Dempster, Frank N.; Cooney, John B.

    1982-01-01

    Individual differences in digit span, susceptibility to proactive interference, and various aptitude/achievement test scores were investigated in two experiments with college students. Results indicated that digit span was strongly correlated with aptitude/achievement scores, but did not indicate that susceptibility to proactive interference…

  19. Developmental Change in Proactive Interference.

    ERIC Educational Resources Information Center

    Kail, Robert

    2002-01-01

    Two studies examined age-related change in proactive interference from previously learned material. The meta-analysis of 26 studies indicated that proactive interference decreased with age. The cross-sectional study found that third through sixth graders' and college students' recall was accurate on Trial 1, but became less so over Trials 2…

  20. Proactive and Preventive Coping in Adjustment to College

    ERIC Educational Resources Information Center

    Gan, Yiqun; Hu, Yueqin; Zhang, Yiwen

    2010-01-01

    The current study compared the relative importance of proactive coping and preventive coping in the adjustment to university life among 403 freshmen at a Chinese university and evaluated the function of proactive coping in the stress process. Participants completed the Future-Oriented Coping Inventory (Gan, Yang, Zhou, & Zhang, 2007), the…

  1. The Role of Hostile Attributions in the Associations between Child Maltreatment and Reactive and Proactive Aggression

    PubMed Central

    Richey, Allora; Brown, Shaquanna; Fite, Paula J.; Bortolato, Marco

    2017-01-01

    The present study examined the relations between child maltreatment and reactive and proactive functions of aggression, and whether hostile attribution biases partially accounted for these associations in a sample of 339 college students (mean age = 19; 51% male). Child maltreatment was associated with reactive, but not proactive, aggression, and instrumental hostile attribution biases accounted for this association. Relational hostile attributions were correlated with both reactive and proactive aggression, but did not play a role in the link between child maltreatment and reactive aggression. PMID:29386881

  2. Callous-unemotional traits, proactive aggression, and treatment outcomes of aggressive children with attention-deficit/hyperactivity disorder.

    PubMed

    Blader, Joseph C; Pliszka, Steven R; Kafantaris, Vivian; Foley, Carmel A; Crowell, Judith A; Carlson, Gabrielle A; Sauder, Colin L; Margulies, David M; Sinha, Christa; Sverd, Jeffrey; Matthews, Thomas L; Bailey, Brigitte Y; Daviss, W Burleson

    2013-12-01

    Stimulant treatment improves impulse control among children with attention-deficit/hyperactivity disorder (ADHD). Decreased aggression often accompanies stimulant pharmacotherapy, suggesting that impulsiveness is integral to aggressive behavior in these children. However, children with high callous-unemotional (CU) traits and proactive aggression may benefit less from ADHD pharmacotherapy, because their aggressive behavior seems more purposeful and deliberate. This study's objective was to determine whether pretreatment CU traits and proactive aggression affect treatment outcomes among aggressive children with ADHD receiving stimulant monotherapy. We implemented a stimulant optimization protocol with 160 children 6 to 13 years of age (mean [SD] age of 9.31 [2.02] years; 78.75% male) with ADHD, oppositional defiant or conduct disorder, and significant aggressive behavior. Family-focused behavioral intervention was provided concurrently. The primary outcome was the Retrospective Modified Overt Aggression Scale. The Antisocial Process Screening Device and the Aggression Scale, also completed by parents, measured CU traits and proactive aggression, respectively. Analyses examined moderating effects of CU traits and proactive aggression on outcomes. In all, 82 children (51%) experienced remission of aggressive behavior. Neither CU traits nor proactive aggression predicted remission (CU traits: odds ratio [OR] = 0.94, 95% CI = 0.80-1.11; proactive aggression, OR = 1.05, 95% CI = 0.86-1.29). Children whose overall aggression remitted showed decreases in CU traits (effect size = -0.379, 95% CI = -0.60 to -0.16) and proactive aggression (effect size = -0.463, 95% CI = -0.69 to -0.23). Findings suggest that pretreatment CU traits and proactive aggression do not forecast worse outcomes for aggressive children with ADHD receiving optimized stimulant pharmacotherapy. With such treatment, CU traits and proactive aggression may decline alongside other behavioral improvements. Clinical trial registration information--Medication Strategies for Treating Aggressive Behavior in Youth With Attention Deficit Hyperactivity Disorder; http://clinicaltrials.gov/; NCT00228046; and Effectiveness of Combined Medication Treatment for Aggression in Children With Attention Deficit With Hyperactivity Disorder (The SPICY Study); http://clinicaltrials.gov/; NCT00794625. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: a randomised clinical trial.

    PubMed

    Fu, Steven S; van Ryn, Michelle; Nelson, David; Burgess, Diana J; Thomas, Janet L; Saul, Jessie; Clothier, Barbara; Nyman, John A; Hammett, Patrick; Joseph, Anne M

    2016-05-01

    Evidenced-based tobacco cessation treatments are underused, especially by socioeconomically disadvantaged smokers. This contributes to widening socioeconomic disparities in tobacco-related morbidity and mortality. The Offering Proactive Treatment Intervention trial tested the effects of a proactive outreach tobacco treatment intervention on population-level smoking abstinence and tobacco treatment use among a population-based sample of socioeconomically disadvantaged smokers. Current smokers (n=2406), regardless of interest in quitting, who were enrolled in the Minnesota Health Care Programs, the state's publicly funded healthcare programmes for low-income populations, were randomly assigned to proactive outreach or usual care. The intervention comprised proactive outreach (tailored mailings and telephone calls) and free cessation treatment (nicotine replacement therapy and intensive, telephone counselling). Usual care comprised access to a primary care physician, insurance coverage of Food and Drug Administration-approved smoking cessation medications, and the state's telephone quitline. The primary outcome was self-reported 6-month prolonged smoking abstinence at 1 year and was assessed by follow-up survey. The proactive intervention group had a higher prolonged abstinence rate at 1 year than usual care (16.5% vs 12.1%, OR 1.47, 95% CI 1.12 to 1.93). The effect of the proactive intervention on prolonged abstinence persisted in selection models accounting for non-response. In analysis of secondary outcomes, use of evidence-based tobacco cessation treatments were significantly greater among proactive outreach participants compared with usual care, particularly combination counselling and medications (17.4% vs 3.6%, OR 5.69, 95% CI 3.85 to 8.40). Population-based proactive tobacco treatment increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers. Findings suggest that dissemination of population-based proactive treatment approaches is an effective strategy to reduce the prevalence of smoking and socioeconomic disparities in tobacco use. NCT01123967. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Cost-effectiveness of a multicomponent primary care program targeting frail elderly people.

    PubMed

    Ruikes, Franca G H; Adang, Eddy M; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M; Zuidema, Sytse U

    2018-05-16

    Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L). Adjusted mean costs directly related to the intervention were €456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were €1583 (95% CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care. The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended. The study was registered in the ClinicalTrials.govProtocol Registration System: ( NCT01499797 ; December 26, 2011). Retrospectively registered.

  5. Testosterone and Proactive-Reactive Aggression in Youth: the Moderating Role of Harsh Discipline.

    PubMed

    Chen, Frances R; Raine, Adrian; Granger, Douglas A

    2018-01-20

    This study tests a biosocial model of the link between testosterone and proactive-reactive aggression in youth at varying levels of harsh discipline. Given that proactive aggression is used to gain power and status and the importance of social learning in its formation, we hypothesized that testosterone would be associated with proactive aggression at higher levels of harsh discipline, and that this relationship would be more pronounced in boys than girls. Participants (n = 445; 50% male; M age = 11.92 years; 80% African-American) and their caregivers completed questionnaires including demographics, conflict tactics, and proactive-reactive aggression. Youth also provided a saliva sample for testosterone. Analyses revealed an interaction between testosterone and harsh discipline on proactive aggression in both boys and girls, and an interaction between testosterone and harsh discipline on reactive aggression in boys only. For those experiencing high levels of harsh discipline, testosterone was positively associated with proactive aggression, with the magnitude of the association increasing as harsh discipline increased. For below average levels of harsh discipline, there were protective effects of high testosterone for boy's reactive aggression and for girl's proactive aggression. The findings support basic tenets of the biosocial model which suggest that links between testosterone and aggressive behavior are dependent on contextual forces, highlighting the complex relationship between hormones, social context, and aggression. Novel findings include protective effects of high testosterone for those exposed to low levels of harsh discipline. Findings are discussed in light of the context-contingency effect and also within the differential susceptibility framework.

  6. Linking Extroversion and Proactive Personality to Career Success: The Role of Mentoring Received and Knowledge

    ERIC Educational Resources Information Center

    Turban, Daniel B.; Moake, Timothy R.; Wu, Sharon Yu-Hsien; Cheung, Yu Ha

    2017-01-01

    Although extroversion and proactive personality are related to career success, the mechanisms through which the relationships occur are unclear. Based on the contest- and sponsored-mobility processes, we examine a model linking extroversion and proactive personality to career success through the mediating effects of mentoring received and…

  7. Associations among Empathy, Social Competence, & Reactive/Proactive Aggression Subtypes

    ERIC Educational Resources Information Center

    Mayberry, Megan L.; Espelage, Dorothy L.

    2007-01-01

    Differences between proactive and reactive aggression subtypes on self-reported measures of empathy, social competence, and expectation for reward were examined among 433 middle school students (65.4% White, 33.9% Black). As hypothesized, males scored higher on proactive and reactive aggression scales and lower on empathy measures than females.…

  8. Improved Academic Performance and Enhanced Employability? The Potential Double Benefit of Proactivity for Business Graduates

    ERIC Educational Resources Information Center

    Tymon, Alex; Batistic, Sasa

    2016-01-01

    This study contributes to proactivity theory and debate on how universities meet competing stakeholder demands in an increasingly marketized higher education environment. We explore how the interplay between the stable facet of proactive personality and the situated behaviour of personal initiative influence academic performance. We hypothesized…

  9. The Influence of Proactive Socialization Behaviors and Team Socialization on Individual Performance in the Team

    ERIC Educational Resources Information Center

    Pennaforte, Antoine

    2016-01-01

    On the basis of the role and the social exchange theories, this research investigated the direct and indirect antecedents of three dimensions of team performance (proficiency, adaptivity, proactivity) developed through cooperative education. The theoretical model examined how proactive socialization behaviors led to team socialization and team…

  10. New Directions in Measuring Reactive and Proactive Aggression: Validation of a Teacher Questionnaire

    ERIC Educational Resources Information Center

    Polman, Hanneke; de Castro, Bram Orobio; Thomaes, Sander; van Aken, Marcel

    2009-01-01

    The well-known distinction between reactive and proactive aggression is theoretically important but empirically controversial. Recently, aggression researchers have argued that we should separate the form and function of aggression to make a clearer distinction between reactive and proactive aggression. This article describes the validation of a…

  11. Rewarding proactive practice.

    PubMed

    2004-06-01

    This month marks the 60th anniversary of the D-Day landings and, through media coverage, we will be able to learn more about the experiences of those who participated in this remarkable event in history. Many young men were killed. Others, such as Fred Bentley and Bob Osborne (shown on page 4 ) returned home having lost their sight or limbs. Now in their late seventies and eighties, these people have lived with the legacies of D-Day, overcome handicap and rebuilt their lives.

  12. Best Practices in Developing Proactive Supply Strategies for Air Force Low-Demand ServiceParts

    DTIC Science & Technology

    2010-01-01

    research clients and sponsors. R ® is a registered trademark. © Copyright 2010 RAND Corporation Permission is given to duplicate this document for personal...RAND Corporation, MG-274-AF, 2005 • Nancy Y. Moore, Cynthia R . Cook, Clifford A. Grammich, and Charles Lindenblatt, Using a Spend Analysis to...poration, DB-434-AF, 2004 • Nancy Y. Moore, Laura H. Baldwin, Frank Camm, and Cynthia R . Cook, Implementing Best Purchasing and Supply Management Preface

  13. Current Practices in Injury Prevention and Safety Helmet Use Among Head Injury Patients in an Army Outpatient Care Setting

    DTIC Science & Technology

    2000-05-01

    health promotion activities ( Pender , 1996). Health care providers activities in prevention of injuries are explained by Nola Pender s theory identifying...prevention behaviors can be explained by Nola Pender s behavior theory model. Primary care providers need to be more proactive in counseling patients...Theoretical Framework The Health Promotion Model (HPM) ( Pender , 1996) was designed as a framework to predict overall health-promoting lifestyles and

  14. The focus of attention is similar to other memory systems rather than uniquely different

    PubMed Central

    Beaudry, Olivia; Neath, Ian; Surprenant, Aimée M.; Tehan, Gerald

    2014-01-01

    According to some current theories, the focus of attention (FOA), part of working memory, represents items in a privileged state that is more accessible than items stored in other memory systems. One line of evidence supporting the distinction between the FOA and other memory systems is the finding that items in the FOA are immune to proactive interference (when something learned earlier impairs the ability to remember something learned more recently). The FOA, then, is held to be unique: it is the only memory system that is not susceptible to proactive interference. We review the literature used to support this claim, and although there are many studies in which proactive interference was not observed, we found more studies in which it was observed. We conclude that the FOA is not immune to proactive interference: items in the FOA are susceptible to proactive interference just like items in every other memory system. And, just as in all other memory systems, it is how the items are represented and processed that plays a critical role in determining whether proactive interference will be observed. PMID:24574996

  15. Traditional test administration and proactive interference undermine visual-spatial working memory performance in schizophrenia-spectrum disorders.

    PubMed

    Girard, Todd A; Wilkins, Leanne K; Lyons, Kathleen M; Yang, Lixia; Christensen, Bruce K

    2018-05-31

    Introduction Working-memory (WM) is a core cognitive deficit among individuals with Schizophrenia Spectrum Disorders (SSD). However, the underlying cognitive mechanisms of this deficit are less known. This study applies a modified version of the Corsi Block Test to investigate the role of proactive interference in visuospatial WM (VSWM) impairment in SSD. Methods Healthy and SSD participants completed a modified version of the Corsi Block Test involving both high (typical ascending set size from 4 to 7 items) and low (descending set size from 7 to 4 items) proactive interference conditions. Results The results confirmed that the SSD group performed worse overall relative to a healthy comparison group. More importantly, the SSD group demonstrated greater VSWM scores under low (Descending) versus high (Ascending) proactive interference; this pattern is opposite to that of healthy participants. Conclusions This differential pattern of performance supports that proactive interference associated with the traditional administration format contributes to VSWM impairment in SSD. Further research investigating associated neurocognitive mechanisms and the contribution of proactive interference across other domains of cognition in SSD is warranted.

  16. Mechanisms and neuronal networks involved in reactive and proactive cognitive control of interference in working memory.

    PubMed

    Irlbacher, Kerstin; Kraft, Antje; Kehrer, Stefanie; Brandt, Stephan A

    2014-10-01

    Cognitive control can be reactive or proactive in nature. Reactive control mechanisms, which support the resolution of interference, start after its onset. Conversely, proactive control involves the anticipation and prevention of interference prior to its occurrence. The interrelation of both types of cognitive control is currently under debate: Are they mediated by different neuronal networks? Or are there neuronal structures that have the potential to act in a proactive as well as in a reactive manner? This review illustrates the way in which integrating knowledge gathered from behavioral studies, functional imaging, and human electroencephalography proves useful in answering these questions. We focus on studies that investigate interference resolution at the level of working memory representations. In summary, different mechanisms are instrumental in supporting reactive and proactive control. Distinct neuronal networks are involved, though some brain regions, especially pre-SMA, possess functions that are relevant to both control modes. Therefore, activation of these brain areas could be observed in reactive, as well as proactive control, but at different times during information processing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Functions of Aggression and Delinquency: The Moderating Role of Parent Criminality and Friends' Gang Membership.

    PubMed

    Ang, Rebecca P; Huan, Vivien S; Li, Xiang; Chan, Wei Teng

    2016-03-02

    This study examined the relationships between two functions of aggression (i.e., reactive and proactive) and delinquency, including the moderating effects of parent criminality and friends' gang membership, in a sample of 1,027 Singaporean adolescents from Grade 7 to Grade 9, with age ranging from 12 to 19 years (M = 14.10, SD = 1.15). Findings suggested that both reactive aggression and proactive aggression significantly and positively predicted delinquency (after controlling for proactive aggression and reactive aggression, respectively), with proactive aggression being a stronger predictor. Friends' gang membership was found to moderate the relationship between reactive aggression and delinquency, and proactive aggression and delinquency, with stronger moderator effects for the latter. Those who were aggressive proactively and who had friends in a gang appear to be impacted most negatively with respect to delinquency. Parent criminality did not moderate these relationships. These findings highlight the need to effectively address the issues of child and adolescent aggression. Also, developing positive peer relations early is crucial for delinquency prevention. © The Author(s) 2016.

  18. The work left undone. Understanding the challenge of providing holistic lung cancer nursing care in the UK.

    PubMed

    Leary, Alison; White, John; Yarnell, Laura

    2014-02-01

    In England best practice guidance in cancer recommends that all patients have access to a specialist nurse such as the tumour specific clinical nurse specialist. The role has become pivotal providing aspects of care e.g. meeting information needs, holistic nurse led follow up including symptom control, managing care and providing psychological and social interventions including referral to others in the role of keyworker. There are approximately 295 lung cancer nurse specialists in England and recent study to model optimum caseload used an on line survey to look at workload of lung cancer specialist nurses. A survey of 100 lung cancer nurses from across the UK (RR78%) examined the perception of the work left undone against best practice guidance, caseload size, workload and other factors. 67 of 78 respondents perceived they left work such as proactive management (52) undertaking holistic needs assessments (46) providing appropriate psychological care (26) and meeting information needs (16). The majority (70) worked unpaid overtime (mean 3.8 h range 1-10 h) per week. Although proactive management is thought to result in better outcomes for lung cancer patients in terms of survival, quality of life and decisions of end of life a substantial number of the specialist nurses felt that factors such as caseload and organisational factors inhibited this. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. A qualitative study examining the influences on situation awareness and the identification, mitigation and escalation of recognised patient risk.

    PubMed

    Brady, Patrick W; Goldenhar, Linda M

    2014-02-01

    Situation awareness (SA)-the perception of data elements, comprehension of their meaning and projection of their status in the near future-has been associated with human performance in high-risk environments, including aviation and the operating room. The influences on SA in inpatient medicine are unknown. We conducted seven focus groups with nurses, respiratory therapists and resident physicians using a standardised semistructured focus group guide to promote discussion. Recordings of the focus groups were transcribed verbatim, and transcripts were qualitatively analysed by two independent reviewers to identify convergent and divergent themes. Three themes emerged: (1) team-based care, (2) availability of standardised data and (3) standardised processes and procedures. We categorised these into social, technological and organisational influences on SA. Subthemes that emerged from each focus group were shared language to describe at-risk patients, provider experience in critical care/deterioration and interdisciplinary huddles to identify and plan for at-risk patients. An objective early warning score, proactive assessment and planning, adequate clinician staffing and tools for entering, displaying and monitoring data trends were identified by six of seven groups. Our data better reflected the concepts of team SA and shared SA than individual SA. Team-based care and standardisation support SA and the identification and treatment of patient risk in the complex environment of inpatient care. These findings can be used to guide the development and implementation of targeted interventions such as huddles to proactively scan for risk and electronic health record displays of data trends.

  20. Are proactive personalities always beneficial? Political skill as a moderator.

    PubMed

    Sun, Shuhua; van Emmerik, Hetty I J

    2015-05-01

    Does proactive personality always enhance job success? The authors of this study draw on socioanalytic theory of personality and organizational political perspectives to study employees' political skill in moderating the effects of proactive personality on supervisory ratings of employee task performance, helping behaviors, and learning behaviors. Multisource data from 225 subordinates and their 75 immediate supervisors reveal that proactive personality is associated negatively with supervisory evaluations when political skill is low, and the negative relationship disappears when political skill is high. Implications and future research directions are discussed. (c) 2015 APA, all rights reserved.

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