Understanding Health Information Seeking: A Test of the Risk Perception Attitude Framework.

PubMed

Grasso, Katherine L; Bell, Robert A

2015-01-01

The authors used the Risk Perception Attitude framework, which is grounded in the Extended Parallel Process Model, to predict people's intentions to seek health information. In an online survey, 689 participants recruited from a crowdsource website were queried about their anticipated health information seeking, perceived risk, and efficacy in response to four scenarios pertaining to hypertension, hypercholesterolemia, alcohol dependence, and diabetes. Each participant was categorized for each scenario as responsive (higher risk, higher efficacy), avoidant (higher risk, lower efficacy), proactive (lower risk, higher efficacy), or indifferent (lower risk, lower efficacy). As predicted, responsive individuals were more likely to seek information than avoidant individuals, but only in three of the four scenarios. Also as expected, there was no difference between proactive and indifferent individuals' likelihood of seeking health information for any scenario. Risk and efficacy, while significant predictors of anticipated health information seeking, left much of the variance unexplained. An analysis of the reasons for information seeking and nonseeking among nonconforming cases suggests that a wider range of influences on health information seeking should be investigated, including curiosity, prior knowledge, social expectations, and situational norms.

A cost-effectiveness analysis of a proactive management strategy for the Sprint Fidelis recall: a probabilistic decision analysis model.

PubMed

Bashir, Jamil; Cowan, Simone; Raymakers, Adam; Yamashita, Michael; Danter, Matthew; Krahn, Andrew; Lynd, Larry D

2013-12-01

The management of the recall is complicated by the competing risks of lead failure and complications that can occur with lead revision. Many of these patients are currently undergoing an elective generator change--an ideal time to consider lead revision. To determine the cost-effectiveness of a proactive management strategy for the Sprint Fidelis recall. We obtained detailed clinical outcomes and costing data from a retrospective analysis of 341 patients who received the Sprint Fidelis lead in British Columbia, where patients younger than 60 years were offered lead extraction when undergoing generator replacement. These population-based data were used to construct and populate a probabilistic Markov model in which a proactive management strategy was compared to a conservative strategy to determine the incremental cost per lead failure avoided. In our population, elective lead revisions were half the cost of emergent revisions and had a lower complication rate. In the model, the incremental cost-effectiveness ratio of proactive lead revision versus a recommended monitoring strategy was $12,779 per lead failure avoided. The proactive strategy resulted in 21 fewer failures per 100 patients treated and reduced the chance of an additional complication from an unexpected surgery. Cost-effectiveness analysis suggests that prospective lead revision should be considered when patients with a Sprint Fidelis lead present for pulse generator change. Elective revision of the lead is justified even when 25% of the population is operated on per year, and in some scenarios, it is both less costly and provides a better outcome. © 2013 Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.

A platform for proactive, risk-based slope asset management, phase II.

DOT National Transportation Integrated Search

2015-03-01

The lidar visualization technique developed by this project enables highway managers to understand changes in slope characteristics : along highways. This change detection and analysis can be the basis of informed decisions for slope inspection and r...

A platform for proactive, risk-based slope asset management, phase II.

DOT National Transportation Integrated Search

2015-08-01

The lidar visualization technique developed by this project enables highway managers to understand changes : in slope characteristics along highways. This change detection and analysis can be the basis of informed : decisions for slope inspection and...

Risk, Issues and Lessons Learned: Maximizing Risk Management in the DoD Ground Domain

DTIC Science & Technology

2011-10-01

Carnegie Mellon University “Risk Management Overview for TACOM” Benefits of Risk Management include: • Risk is a proactive approach - preventing... Chili (no beans) 13 • Hot dog sub-assy Unclassified How does the FMEA work? Execute the analysis and discover the potential failures and effects...34 - --· . -· A c u i.rition Benefits of FMEAs • Prevent major risks, reduce failures, minimize cost and reduce development time - Do it right the first time

Failure mode and effect analysis in blood transfusion: a proactive tool to reduce risks.

PubMed

Lu, Yao; Teng, Fang; Zhou, Jie; Wen, Aiqing; Bi, Yutian

2013-12-01

The aim of blood transfusion risk management is to improve the quality of blood products and to assure patient safety. We utilize failure mode and effect analysis (FMEA), a tool employed for evaluating risks and identifying preventive measures to reduce the risks in blood transfusion. The failure modes and effects occurring throughout the whole process of blood transfusion were studied. Each failure mode was evaluated using three scores: severity of effect (S), likelihood of occurrence (O), and probability of detection (D). Risk priority numbers (RPNs) were calculated by multiplying the S, O, and D scores. The plan-do-check-act cycle was also used for continuous improvement. Analysis has showed that failure modes with the highest RPNs, and therefore the greatest risk, were insufficient preoperative assessment of the blood product requirement (RPN, 245), preparation time before infusion of more than 30 minutes (RPN, 240), blood transfusion reaction occurring during the transfusion process (RPN, 224), blood plasma abuse (RPN, 180), and insufficient and/or incorrect clinical information on request form (RPN, 126). After implementation of preventative measures and reassessment, a reduction in RPN was detected with each risk. The failure mode with the second highest RPN, namely, preparation time before infusion of more than 30 minutes, was shown in detail to prove the efficiency of this tool. FMEA evaluation model is a useful tool in proactively analyzing and reducing the risks associated with the blood transfusion procedure. © 2013 American Association of Blood Banks.

Proactive assessment of accident risk to improve safety on a system of freeways : [research brief].

DOT National Transportation Integrated Search

2012-05-01

As traffic safety on freeways continues to be a growing concern, much progress has been made in shifting from reactive (incident detection) to proactive (real-time crash risk assessment) traffic strategies. Reliable models that can take in real-time ...

Accidental falls in hospitalized children: an analysis of the vulnerabilities linked to the presence of caregivers.

PubMed

Bagnasco, A; Sobrero, M; Sperlinga, L; Tibaldi, L; Sasso, L

2010-06-01

This study stemmed from the data gathered by a research conducted by the coordinator of the Department of Healthcare Services and a group of nurses involved in a research on accidental falls in hospitalized children at the "G. Gaslini" Children's Hospital and Scientific Research Institute in Genoa, Italy. The first retrospective study evaluated the accidental falls in hospitalized children referred to the three-year period 2003-2006, while the second perspective study, referred to the trimester March-May 2007, found that the main cause of falls in children was parent's distraction. The method adopted in the first phase of our study was a proactive risk analysis (The Basics of Healthcare Failure Mode and Effect Analysis), identified in the first place by the VA National Centre for Patient Safety and applied to the "Child and parent hospital admission process". This proactive risk analysis has proven to be very effective in preventing the risk of accidental falls in hospitalized children through effective communication and educational interventions. The second phase of our study consisted of two Focus Groups for accidental traumatic events. The analysis of the results of the study showed how effective communication is instrumental, not only to have a better awareness of the children and their parents during their stay in hospital, but also to implement educational sessions on prevention to reduce the risk of accidental traumatic events. The present study contributes to improve safety and the quality of care by motivating nurses to keep their attention high on falls in hospitalized children, by monitoring and the development of new risk assessment tools.

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.

Interrelations between Principals' Risk of Burnout Profiles and Proactive Self-Regulation Strategies

ERIC Educational Resources Information Center

Tikkanen, Lotta; Pyhältö, Kirsi; Pietarinen, Janne; Soini, Tiina

2017-01-01

School leadership is a demanding job. Those involved in school leadership have shown to experience high levels of work stress that may, if prolonged, result in burnout. The purpose of this study was to examine school leaders' risks of burnout in terms of work stress and burnout symptoms, and their relationship with proactive self-regulation…

Adversarial Risk Analysis for Urban Security Resource Allocation.

PubMed

Gil, César; Rios Insua, David; Rios, Jesus

2016-04-01

Adversarial risk analysis (ARA) provides a framework to deal with risks originating from intentional actions of adversaries. We show how ARA may be used to allocate security resources in the protection of urban spaces. We take into account the spatial structure and consider both proactive and reactive measures, in that we aim at both trying to reduce criminality as well as recovering as best as possible from it, should it happen. We deal with the problem by deploying an ARA model over each spatial unit, coordinating the models through resource constraints, value aggregation, and proximity. We illustrate our approach with an example that uncovers several relevant policy issues. © 2016 Society for Risk Analysis.

Effects of organizational safety on employees' proactivity safety behaviors and occupational health and safety management systems in Chinese high-risk small-scale enterprises.

PubMed

Mei, Qiang; Wang, Qiwei; Liu, Suxia; Zhou, Qiaomei; Zhang, Jingjing

2018-06-07

Based on the characteristics of small-scale enterprises, the improvement of occupational health and safety management systems (OHS MS) needs an effective intervention. This study proposed a structural equation model and examined the relationships of perceived organization support for safety (POSS), person-organization safety fit (POSF) and proactivity safety behaviors with safety management, safety procedures and safety hazards identification. Data were collected from 503 employees of 105 Chinese high-risk small-scale enterprises over 6 months. The results showed that both POSS and POSF were positively related to improvement in safety management, safety procedures and safety hazards identification through proactivity safety behaviors. Our findings provide a new perspective on organizational safety for improving OHS MS for small-scale enterprises and extend the application of proactivity safety behaviors.

Proactive and reactive sibling aggression and adjustment in adolescence.

PubMed

Tucker, Corinna Jenkins; Van Gundy, Karen T; Wiesen-Martin, Desireé; Hiley Sharp, Erin; Rebellon, Cesar J; Stracuzzi, Nena F

2015-03-01

Existing research on aggression tends to narrowly focus on peers; less is known about sibling aggression, most likely due to its historical acceptance. Aggression is characterized by its forms (i.e., physical vs. social or relational aggression) and its functions (i.e., the motivations behind the aggressive act and categorized as proactive vs. reactive aggression). We use data from a two-wave study of middle (n = 197; M age = 12.63 years at Wave 1) and older (n = 159; M age = 16.50 years at Wave 1) adolescents to assess the extent to which proactive and reactive functions of sibling aggression make unique or conditional contributions to adolescent adjustment (i.e., depression, delinquency, and substance use). We find that proactive sibling aggression increases risk for problem substance use and delinquent behavior, reactive sibling aggression increases risk for depressed mood and delinquent behavior, and such results are observed even with statistical adjustments for sociodemographic and family variables, stressful life events, and prior adjustment. Few conditional effects of proactive or reactive sibling aggression by sex or grade are observed; yet, for all three outcomes, the harmful effects of reactive sibling aggression are strongest among adolescents who report low levels of proactive sibling aggression. The results speak to the importance of understanding the proactive and reactive functions of sibling aggressive behaviors for adolescent adjustment. © The Author(s) 2014.

Multisite Parent-Centered Risk Assessment to Reduce Pediatric Oral Chemotherapy Errors

PubMed Central

Walsh, Kathleen E.; Mazor, Kathleen M.; Roblin, Douglas; Biggins, Colleen; Wagner, Joann L.; Houlahan, Kathleen; Li, Justin W.; Keuker, Christopher; Wasilewski-Masker, Karen; Donovan, Jennifer; Kanaan, Abir; Weingart, Saul N.

2013-01-01

Purpose: Observational studies describe high rates of errors in home oral chemotherapy use in children. In hospitals, proactive risk assessment methods help front-line health care workers develop error prevention strategies. Our objective was to engage parents of children with cancer in a multisite study using proactive risk assessment methods to identify how errors occur at home and propose risk reduction strategies. Methods: We recruited parents from three outpatient pediatric oncology clinics in the northeast and southeast United States to participate in failure mode and effects analyses (FMEA). An FMEA is a systematic team-based proactive risk assessment approach in understanding ways a process can fail and develop prevention strategies. Steps included diagram the process, brainstorm and prioritize failure modes (places where things go wrong), and propose risk reduction strategies. We focused on home oral chemotherapy administration after a change in dose because prior studies identified this area as high risk. Results: Parent teams consisted of four parents at two of the sites and 10 at the third. Parents developed a 13-step process map, with two to 19 failure modes per step. The highest priority failure modes included miscommunication when receiving instructions from the clinician (caused by conflicting instructions or parent lapses) and unsafe chemotherapy handling at home. Recommended risk assessment strategies included novel uses of technology to improve parent access to information, clinicians, and other parents while at home. Conclusion: Parents of pediatric oncology patients readily participated in a proactive risk assessment method, identifying processes that pose a risk for medication errors involving home oral chemotherapy. PMID:23633976

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.

Improving guideline sensitivity and specificity for the identification of proactive gastrostomy placement in patients with head and neck cancer.

PubMed

Brown, Teresa E; Crombie, Jane; Spurgin, Ann-Louise; Tripcony, Lee; Keller, Jacqui; Hughes, Brett G M; Dickie, Graeme; Kenny, Lizbeth Moira; Hodge, Robert A

2016-04-01

Swallowing and nutrition guidelines for patients with head and neck cancer are available for identification of proactive gastrostomy placement in patients with high nutritional risk. The purpose of this study was to investigate improvements to the validity of these guidelines. A multivariate analysis was fitted to the original dataset (n = 501) to examine the variables that may predict gastrostomy placement (eg, tumor site, treatment, sex, and age). Using these factors, the high risk category was modified and retrospectively validated in the same cohort to provide new measures of sensitivity and specificity. The following were positive predictors of gastrostomy placement: T3 (p = .01), T4 (p < .001), and chemoradiotherapy (p < .001). Laryngeal (p = .02) and skin cancer (p < .001) were negative predictors. Modification of the high risk definition improved sensitivity to 58% and maintained specificity at 92%. Minor modifications to the high risk definition in the guidelines have improved the guideline sensitivity for future use. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1163-E1171, 2016. © 2015 Wiley Periodicals, Inc.

Human error mitigation initiative (HEMI) : summary report.

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

Stevens, Susan M.; Ramos, M. Victoria; Wenner, Caren A.

2004-11-01

Despite continuing efforts to apply existing hazard analysis methods and comply with requirements, human errors persist across the nuclear weapons complex. Due to a number of factors, current retroactive and proactive methods to understand and minimize human error are highly subjective, inconsistent in numerous dimensions, and are cumbersome to characterize as thorough. An alternative and proposed method begins with leveraging historical data to understand what the systemic issues are and where resources need to be brought to bear proactively to minimize the risk of future occurrences. An illustrative analysis was performed using existing incident databases specific to Pantex weapons operationsmore » indicating systemic issues associated with operating procedures that undergo notably less development rigor relative to other task elements such as tooling and process flow. Future recommended steps to improve the objectivity, consistency, and thoroughness of hazard analysis and mitigation were delineated.« less

The safer clinical systems project in renal care.

PubMed

Weale, Andy R

2013-09-01

Current systems in place in healthcare are designed to detect harm after it has happened (e.g critical incident reports) and make recommendations based on an assessment of that event. Safer Clinical Systems, a Health Foundation funded project, is designed to proactively search for risk within systems, rather than being reactive to harm. The aim of the Safer Clinical Systems project in Renal Care was to reduce the risks associated with shared care for patients who are undergoing surgery but are looked after peri-operatively by nephrology teams on nephrology wards. This report details our findings of the diagnostic phase of Safer Clinical Systems: the proactive search for risk. We have evaluated the current system of care using a set of risk evaluation and process mapping tools (Failure Modes and Effects Analysis (FMEA) and Hierarchical Task Analysis HTA). We have engaged staff with the process mapping and risk assessment tools. We now understand our system and understand where the highest risk tasks are undertaken during a renal in-patient stay during which a patient has an operation. These key tasks occur across the perioperaive period and are not confined to one aspect of care. A measurement strategy and intervention plan have been designed around these tasks. Safer Clinical Systems has identified high risk, low reliability tasks in our system. We look forward to fully reporting these data in 2014. © 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Entrepreneurial Skills and Socio-Cultural Factors: An Empirical Analysis in Secondary Education Students

ERIC Educational Resources Information Center

Rosique-Blasco, Mario; Madrid-Guijarro, Antonia; García-Pérez-de-Lema, Domingo

2016-01-01

Purpose: The purpose of this paper is to explore how entrepreneurial skills (such as creativity, proactivity and risk tolerance) and socio-cultural factors (such as role model and businessman image) affect secondary education students' propensity towards entrepreneurial options in their future careers. Design/methodology/approach: A sample of…

Climates of risk: a field analysis of global climate change in US media discourse, 1997-2004.

PubMed

Sonnett, John

2010-11-01

How are industry and environmentalist discourses of climate risk related to dominant scientific and political discourses? This study operationalizes Bourdieu's concept of symbolic capital in order to map dimensions of risk description and prescription onto a journalistic field of industry, environmentalist, scientific, and political media. Results show that conventional definitions of risk mirror an opposition between scientific and political discourses. Prescriptions for action on risk are partly autonomous from definitions however. Environmentalist and scientific media feature more proactive discourse, and industry and political media feature more reactive discourse. Implications for future research on climate risk and relational studies of media discourse are discussed.

NASA's Agency-Wide Strategy for Environmental Regulatory Risk Analysis and Communication

NASA Technical Reports Server (NTRS)

Scroggins, Sharon

2008-01-01

NASA's Agency-wide.resource for identifying and managing risks associated with changing environmental regulations Goals of the RRAC PC: 1) Proactively. detect, analyze and communicate environmental regulatory risks to NASA Programs and facilities; 2) Communicate with regulators and participate in the mitigation of such risks; and 3) Provide centralized support on emerging regulations to NASA HQ Environmental Management Division. When significant regulatory changes are identified, timely communication is essential. Communication of changing requirements to the regulatory stakeholders - NASA Programs and Facilities. Communication of potential issues to management and, when appropriate, back to the regulating agency.

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

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.

Coping with constraints: Achieving effective conservation with limited resources

USGS Publications Warehouse

Walls, Susan

2018-01-01

Conservation resources have become increasingly limited and, along with social, cultural and political complexities, this shortfall frequently challenges effectiveness in conservation. Because conservation can be costly, efforts are often only initiated after a species has declined below a critical threshold and/or when statutory protection is mandated. However, implementing conservation proactively, rather than reactively, is predicted to be less costly and to decrease a species' risk of extinction. Despite these benefits, I document that the number of studies that have implemented proactive conservation around the world are far fewer than those that simply acknowledge the need for such action. I provide examples of proactive actions that can ameliorate shortfalls in funding and other assets, thus helping conservation practitioners and managers cope with the constraints that resource limitation imposes. Not all of these options are new; however, the timing of their implementation is critical for effective conservation, and the need for more proactive conservation is increasingly recognized. These actions are (1) strengthening and diversifying stakeholder involvement in conservation projects; (2) complementing time-consuming and labor-intensive demographic studies with alternative approaches of detecting declines and estimating extinction risk; and (3) minimizing future costly conservation and management by proactively keeping common species common. These approaches may not constitute a cure-all for every conservation crisis. However, given escalating rates of species' losses, perhaps a reminder that these proactive actions can reduce conservation costs, save time, and potentially thwart population declines is warranted.

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.

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

Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations.

PubMed

Bui, David P; Pollack Porter, Keshia; Griffin, Stephanie; French, Dustin D; Jung, Alesia M; Crothers, Stephen; Burgess, Jefferey L

2017-11-17

Emergency service vehicle crashes (ESVCs) are a leading cause of death in the United States fire service. Risk management (RM) is a proactive process for identifying occupational risks and reducing hazards and unwanted events through an iterative process of scoping hazards, risk assessment, and implementing controls. We describe the process, outputs, and lessons learned from the application of a proactive RM process to reduce ESVCs in US fire departments. Three fire departments representative of urban, suburban, and rural geographies, participated in a facilitated RM process delivered through focus groups and stakeholder discussion. Crash reports from department databases were reviewed to characterize the context, circumstances, hazards and risks of ESVCs. Identified risks were ranked using a risk matrix that considered risk likelihood and severity. Department-specific control measures were selected based on group consensus. Interviews, and focus groups were used to assess acceptability and utility of the RM process and perceived facilitators and barriers of implementation. Three to six RM meetings were conducted at each fire department. There were 7.4 crashes per 100 personnel in the urban department and 10.5 per 100 personnel in the suburban department; the rural department experienced zero crashes. All departments identified emergency response, backing, on scene struck by, driver distraction, vehicle/road visibility, and driver training as high or medium concerns. Additional high priority risks varied by department; the urban department prioritized turning and rear ending crashes; the suburban firefighters prioritized inclement weather/road environment and low visibility related crashes; and the rural volunteer fire department prioritized exiting station, vehicle failure, and inclement weather/road environment related incidents. Selected controls included new policies and standard operating procedures to reduce emergency response, cameras to enhance driver visibility while backing, and increased training frequency and enhanced training. The RM process was generally acceptable to department participants and considered useful. All departments reported that the focused and systematic analysis of crashes was particularly helpful. Implementation of controls was a commonly cited challenge. Proactive RM of ESVCs in three US fire departments was positively received and supported the establishment of interventions tailored to each department's needs and priorities.

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.

Introducing a change in hospital policy using FMEA methodology as a tool to reduce patient hazards.

PubMed

Ofek, Fanny; Magnezi, Racheli; Kurzweil, Yaffa; Gazit, Inbal; Berkovitch, Sofia; Tal, Orna

2016-01-01

Intravenous potassium chloride (IV KCl) solutions are widely used in hospitals for treatment of hypokalemia. As ampoules of concentrated KCL must be diluted before use, critical incidents have been associated with its preparation and administration. Currently, we have introduced ready-to-use diluted KCl infusion solutions to minimize the use of high-alert concentrated KCl. Since this process may be associated with considerable risks, we embraced a proactive hazard analysis as a tool to implement a change in high-alert drug usage in a hospital setting. Failure mode and effect analysis (FMEA) is a systematic tool to analyze and identify risks in system operations. We used FMEA to examine the hazards associated with the implementation of the ready-to-use solutions. A multidisciplinary team analyzed the risks by identifying failure modes, conducting a hazard analysis and calculating the criticality index (CI) for each failure mode. A 1-day survey was performed as an evaluation step after a trial run period of approximately 4 months. Six major possible risks were identified. The most severe risks were prioritized and specific recommendations were formulated. Out of 28 patients receiving IV KCl on the day of the survey, 22 received the ready-to-use solutions and 6 received the concentrated solutions as instructed. Only 1 patient received inappropriate ready-to-use KCl. Using the FMEA tool in our study has proven once again that by creating a gradient of severity of potential vulnerable elements, we are able to proactively promote safer and more efficient processes in health care systems. This article presents a utilization of this method for implementing a change in hospital policy regarding the routine use of IV KCl.

Data article on disposition towards enhancing SMEs' performance through entrepreneurial orientations: Perspectives from a developing economy.

PubMed

Ibidunni, Ayodotun Stephen; Ibidunni, Oyebisi Mary; Olokundun, Maxwell Ayodele; Falola, Hezekiah Olubusayo; Salau, Odunayo Paul; Borishade, Taiye Tairat

2018-06-01

This article present data on the disposition of SME operators towards enhancing SMEs Performance through entrepreneurial orientations. Copies of structured questionnaire were administered to 102 SME owners/managers. Using descriptive and standard multiple regression statistical analysis, the data described how proactiveness, risk-taking and autonomy orientations significantly influenced SMEs' profitability, sales growth, customer satisfaction and new product success.

Improving Student Retention through Evidence Based Proactive Systems at the Open University (UK)

ERIC Educational Resources Information Center

Gibbs, Graham; Regan, Peter; Simpson, Ormond

2007-01-01

The Open University has been undertaking an extended initiative to improve student retention through enhanced support for at-risk students. This initiative has evolved through a series of stages from ad hoc small scale local interventions relying largely on tutors and student self-referral, to an institution-wide pro-active system implemented by…

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…

NASA's Agency-Wide Strategy for Environmental Regulatory Risk Analysis and Communication

NASA Technical Reports Server (NTRS)

Duda, Kristen; Scroggins, Sharon

2008-01-01

NASA's mission is to pioneer the future in space exploration, scientific discovery, and aeronautics research. To help enable existing and future programs to pursue this mission, NASA has established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) to proactively identify, analyze, and communicate environmental regulatory risks to the NASA community. The RRAC PC is chartered to evaluate the risks posed to NASA Programs and facilities by environmentally related drivers. The RRAC PC focuses on emerging environmental regulations, as well as risks related to operational changes that can trigger existing environmental requirements. Changing regulations have the potential to directly affect program activities. For example, regulatory changes can restrict certain activities or operations by mandating changes in how operations may be done or limiting where or how certain operations can take place. Regulatory changes also can directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Such changes can result in NASA undertaking material replacement efforts. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented several strategies for proactively managing regulatory change to minimize potential adverse impacts to NASA Programs and facilities. This presentation highlights the lessons learned through establishing the RRAC PC, the process by which the RRAC PC monitors and distributes information about emerging regulatory requirements, and the cross-Agency cooperation that is vital to supporting NASA's mission.

NASA's Agency-wide Strategy for Environmental Regulatory Risk Analysis and Communication

NASA Technical Reports Server (NTRS)

Duda, Kristen; Scroggins. Sharon

2008-01-01

NASA's mission is to pioneer the future in space exploration, scientific discovery, and aeronautics research. To help enable existing and future programs to pursue this mission, NASA has established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) to proactively identify, analyze, and communicate environmental regulatory risks to the NASA community. The RRAC PC is chartered to evaluate the risks posed to NASA Programs and facilities by environmentally related drivers. The RRAC PC focuses on emerging environmental regulations, as well as risks related to operational changes that can trigger existing environmental requirements. Changing regulations have the potential to directly affect program activities. For example, regulatory changes can restrict certain activities or operations by mandating changes in how operations may be done or limiting where or how certain operations can take place. Regulatory changes also can directly affect the ability to use certain materials by mandating a production phase-out or restricting usage aPi'iications of certain materials. Such changes can result in NASA undertaking material replacement efforts. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented several strategies for proactively managing regulatory change to minimize potential adverse impacts to NASA Programs and facilities. This presentation highlights the lessons learned through establishing the RRAC PC, the process by which the RRAC PC monitors and distributes information about emerging regulatory requirements, and the cross-Agency cooperation that is vital to supporting NASA's mission.

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.

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.

Reactive and proactive aggression as meaningful distinctions at the variable and person level in primary school-aged children.

PubMed

Carroll, Annemaree; McCarthy, Molly; Houghton, Stephen; Sanders O'Connor, Emma; Zadow, Corinne

2018-04-24

Reactive and proactive aggression is a dichotomous classification of aggression in adults and children. This distinction has been supported by a number of variable-based and factor analytic studies. Due to high inter-correlations, however, the reactive-proactive aggression distinction may not be entirely useful for understanding how group or individual aggressive behavior varies in children and adolescents. Drawing on a sample of primary school-aged children (N = 242) aged 7-12 years, this study sought to determine whether reactive and proactive aggression could be distinguished at the variable-level and the person-level in children. Exploratory Factor Analysis of data from an aggression instrument measuring both functions and forms of aggression, found a two-factor construct of aggression constituted by a reactive and proactive aggression factor. A person-based analysis was then conducted after classifying children according to the presence of reactive and/or proactive aggression. Discriminant function analysis was used to discern whether classifications on the basis of aggression function produced meaningful distinctions in terms of antisocial traits and emotional valence and intensity measures. Two functions were identified which distinguished children with different combinations of reactive and proactive aggression. Reactive-only aggressive children were defined primarily by high levels of impulsivity, while proactive-only children were defined primarily by higher levels of antisocial traits. Children high in both types of aggression exhibited both the presence of antisocial traits and impulsivity. Contrary to recent findings, this suggests that differences in aggression functions remain meaningful at the person level in children. Implications for interventions are discussed. © 2018 Wiley Periodicals, Inc.

Longitudinal Relations between Beliefs Supporting Aggression,Anger Regulation, and Dating Aggression among Early Adolescents.

PubMed

Sullivan, Terri N; Garthe, Rachel C; Goncy, Elizabeth A; Carlson, Megan M; Behrhorst, Kathryn L

2017-05-01

Dating aggression occurs frequently in early to mid-adolescence and has negative repercussions for psychosocial adjustment and physical health. The patterns of behavior learned during this developmental timeframe may persist in future dating relationships, underscoring the need to identify risk factors for this outcome. The current study examined longitudinal relations between beliefs supporting aggression, anger regulation, and dating aggression. Participants were 176 middle school students in sixth, seventh, and eighth grade (50 % female; 82 % African American). No direct effects were found between beliefs supporting reactive or proactive aggression and dating aggression. Beliefs supporting reactive aggression predicted increased rates of anger dysregulation, and beliefs supporting proactive aggression led to subsequent increases in anger inhibition. Anger dysregulation and inhibition were associated with higher frequencies of dating aggression. An indirect effect was found for the relation between beliefs supporting reactive aggression and dating aggression via anger dysregulation. Another indirect effect emerged for the relation between beliefs supporting proactive aggression and dating aggression through anger inhibition. The study's findings suggested that beliefs supporting proactive and reactive aggression were differentially related to emotion regulation processes, and identified anger dysregulation and inhibition as risk factors for dating aggression among adolescents.

Proactive Strategies to Address Health Equity and Disparities: Recommendations from a Bi-National Symposium.

PubMed

Haggerty, Jeannie; Chin, Marshall H; Katz, Alan; Young, Kue; Foley, Jonathan; Groulx, Antoine; Pérez-Stable, Eliseo J; Turnbull, Jeff; DeVoe, Jennifer E; Uchendo, Uche

2018-01-01

Health inequities persist in Canada and the United States. Both countries show differential health status and health care quality by social characteristics, making zip or postal code a greater predictor of health than genetics. Many social determinants of health overlap in the same individuals or communities, exacerbating their vulnerability. Many of the contributing factors and problems are structural and evade simple solutions. In March 2017 a binational Canada-US symposium was held in Washington DC involving 150 primary care thought leaders, including clinicians, researchers, patients, and policy makers to address transformation in integrated primary care. This commentary summarizes the session's principal insights and solutions of the session tackling health inequities at policy and delivery levels. The solution lies in intervening proactively to reduce disparities-developing risk-adjustment measures that integrate social factors; increasing the socioeconomic, racial, and ethnic diversity of health providers; teaching cultural humility; supporting community-oriented primary care; and integrating equity considerations into health system funding. We propose moving from retrospective analysis to proactive measures; from equality to equity; from needs-based to strength-based approaches; and from an individual to a population focus. © Copyright 2018 by the American Board of Family Medicine.

[A systemic risk analysis of hospital management processes by medical employees--an effective basis for improving patient safety].

PubMed

Sobottka, Stephan B; Eberlein-Gonska, Maria; Schackert, Gabriele; Töpfer, Armin

2009-01-01

Due to the knowledge gap that exists between patients and health care staff the quality of medical treatment usually cannot be assessed securely by patients. For an optimization of safety in treatment-related processes of medical care, the medical staff needs to be actively involved in preventive and proactive quality management. Using voluntary, confidential and non-punitive systematic employee surveys, vulnerable topics and areas in patient care revealing preventable risks can be identified at an early stage. Preventive measures to continuously optimize treatment quality can be defined by creating a risk portfolio and a priority list of vulnerable topics. Whereas critical incident reporting systems are suitable for continuous risk assessment by detecting safety-relevant single events, employee surveys permit to conduct a systematic risk analysis of all treatment-related processes of patient care at any given point in time.

Can Link Analysis Be Applied to Identify Behavioral Patterns in Train Recorder Data?

PubMed

Strathie, Ailsa; Walker, Guy H

2016-03-01

A proof-of-concept analysis was conducted to establish whether link analysis could be applied to data from on-train recorders to detect patterns of behavior that could act as leading indicators of potential safety issues. On-train data recorders capture data about driving behavior on thousands of routine journeys every day and offer a source of untapped data that could be used to offer insights into human behavior. Data from 17 journeys undertaken by six drivers on the same route over a 16-hr period were analyzed using link analysis, and four key metrics were examined: number of links, network density, diameter, and sociometric status. The results established that link analysis can be usefully applied to data captured from on-vehicle recorders. The four metrics revealed key differences in normal driver behavior. These differences have promising construct validity as leading indicators. Link analysis is one method that could be usefully applied to exploit data routinely gathered by on-vehicle data recorders. It facilitates a proactive approach to safety based on leading indicators, offers a clearer understanding of what constitutes normal driving behavior, and identifies trends at the interface of people and systems, which is currently a key area of strategic risk. These research findings have direct applications in the field of transport data monitoring. They offer a means of automatically detecting patterns in driver behavior that could act as leading indicators of problems during operation and that could be used in the proactive monitoring of driver competence, risk management, and even infrastructure design. © 2015, Human Factors and Ergonomics Society.

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.

Safety Assurance Factors for Electronic Health Record Resilience (SAFER): study protocol

PubMed Central

2013-01-01

Background Implementation and use of electronic health records (EHRs) could lead to potential improvements in quality of care. However, the use of EHRs also introduces unique and often unexpected patient safety risks. Proactive assessment of risks and vulnerabilities can help address potential EHR-related safety hazards before harm occurs; however, current risk assessment methods are underdeveloped. The overall objective of this project is to develop and validate proactive assessment tools to ensure that EHR-enabled clinical work systems are safe and effective. Methods/Design This work is conceptually grounded in an 8-dimension model of safe and effective health information technology use. Our first aim is to develop self-assessment guides that can be used by health care institutions to evaluate certain high-risk components of their EHR-enabled clinical work systems. We will solicit input from subject matter experts and relevant stakeholders to develop guides focused on 9 specific risk areas and will subsequently pilot test the guides with individuals representative of likely users. The second aim will be to examine the utility of the self-assessment guides by beta testing the guides at selected facilities and conducting on-site evaluations. Our multidisciplinary team will use a variety of methods to assess the content validity and perceived usefulness of the guides, including interviews, naturalistic observations, and document analysis. The anticipated output of this work will be a series of self-administered EHR safety assessment guides with clear, actionable, checklist-type items. Discussion Proactive assessment of patient safety risks increases the resiliency of health care organizations to unanticipated hazards of EHR use. The resulting products and lessons learned from the development of the assessment guides are expected to be helpful to organizations that are beginning the EHR selection and implementation process as well as those that have already implemented EHRs. Findings from our project, currently underway, will inform future efforts to validate and implement tools that can be used by health care organizations to improve the safety of EHR-enabled clinical work systems. PMID:23587208

Employee Participation in Non-Mandatory Professional Development--The Role of Core Proactive Motivation Processes

ERIC Educational Resources Information Center

Sankey, Kim S.; Machin, M. Anthony

2014-01-01

With a focus on the self-initiated efforts of employees, this study examined a model of core proactive motivation processes for participation in non-mandatory professional development (PD) within a proactive motivation framework using the Self-Determination Theory perspective. A multi-group SEM analysis conducted across 439 academic and general…

Proactive enteral tube feeding in pediatric patients undergoing chemotherapy.

PubMed

Sacks, Nancy; Hwang, Wei-Ting; Lange, Beverly J; Tan, Kay-See; Sandler, Eric S; Rogers, Paul C; Womer, Richard B; Pietsch, John B; Rheingold, Susan R

2014-02-01

To determine feasibility and safety of proactive enteral tube feeding (ETF) in pediatric oncology patients. Pediatric patients with newly diagnosed brain tumors, myeloid leukemia or high-risk solid tumors were eligible. Subjects agreeing to start ETF before cycle 2 chemotherapy were considered proactive participants (PPs). Those who declined could enroll as chart collection receiving nutritional standard of care. Nutritional status was assessed using standard anthropometric measurements. Episodes of infection and toxicity related to ETF were documented from diagnosis to end of therapy. A descriptive comparison between PPs and controls was conducted. One hundred four eligible patients were identified; 69 enrolled (20 PPs and 49 controls). At diagnosis, 17% of all subjects were underweight and 26% overweight. Barriers to enrollment included physician, subject and/or family refusal, and inability to initiate ETF prior to cycle 2 of chemotherapy. Toxicity of ETF was minimal, but higher percentage of subjects in the proactive group had episodes of infection than controls. Thirty-nine percent of controls eventually started ETF and were twice as likely to receive parenteral nutrition. PPs experienced less weight loss at ETF initiation than controls receiving ETF and were the only group to demonstrate improved nutritional status at end of study. Proactive ETF is feasible in children with cancer and results in improved nutritional status at end of therapy. Episodes of infection in this study are concerning; therefore, a larger randomized trial is required to further delineate infectious risks and toxicities that may be mitigated by improved nutritional status. © 2013 Wiley Periodicals, Inc.

Analysis of interactions among barriers in project risk management

NASA Astrophysics Data System (ADS)

Dandage, Rahul V.; Mantha, Shankar S.; Rane, Santosh B.; Bhoola, Vanita

2018-03-01

In the context of the scope, time, cost, and quality constraints, failure is not uncommon in project management. While small projects have 70% chances of success, large projects virtually have no chance of meeting the quadruple constraints. While there is no dearth of research on project risk management, the manifestation of barriers to project risk management is a less dwelt topic. The success of project management is oftentimes based on the understanding of barriers to effective risk management, application of appropriate risk management methodology, proactive leadership to avoid barriers, workers' attitude, adequate resources, organizational culture, and involvement of top management. This paper represents various risk categories and barriers to risk management in domestic and international projects through literature survey and feedback from project professionals. After analysing the various modelling methods used in project risk management literature, interpretive structural modelling (ISM) and MICMAC analysis have been used to analyse interactions among the barriers and prioritize them. The analysis indicates that lack of top management support, lack of formal training, and lack of addressing cultural differences are the high priority barriers, among many others.

Defining the pharmaceutical system to support proactive drug safety.

PubMed

Lewis, Vicki R; Hernandez, Angelica; Meadors, Margaret

2013-02-01

The military, aviation, nuclear, and transportation industries have transformed their safety records by using a systems approach to safety and risk mitigation. This article creates a preliminary model of the U.S. pharmaceutical system using available literature including academic publications, policies, and guidelines established by regulatory bodies and drug industry trade publications. Drawing from the current literature, the goals, roles, and individualized processes of pharmaceutical subsystems will be defined. Defining the pharmaceutical system provides a vehicle to assess and address known problems within the system, and provides a means to conduct proactive risk analyses, which would create significant pharmaceutical safety advancement.

Tools for developing a quality management program: proactive tools (process mapping, value stream mapping, fault tree analysis, and failure mode and effects analysis).

PubMed

Rath, Frank

2008-01-01

This article examines the concepts of quality management (QM) and quality assurance (QA), as well as the current state of QM and QA practices in radiotherapy. A systematic approach incorporating a series of industrial engineering-based tools is proposed, which can be applied in health care organizations proactively to improve process outcomes, reduce risk and/or improve patient safety, improve through-put, and reduce cost. This tool set includes process mapping and process flowcharting, failure modes and effects analysis (FMEA), value stream mapping, and fault tree analysis (FTA). Many health care organizations do not have experience in applying these tools and therefore do not understand how and when to use them. As a result there are many misconceptions about how to use these tools, and they are often incorrectly applied. This article describes these industrial engineering-based tools and also how to use them, when they should be used (and not used), and the intended purposes for their use. In addition the strengths and weaknesses of each of these tools are described, and examples are given to demonstrate the application of these tools in health care settings.

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.

Proactive Parent Engagement in Public Schools: Using a Brief Strengths and Needs Assessment in a Multiple-Gating Risk Management Strategy

ERIC Educational Resources Information Center

Moore, Kevin J.; Garbacz, S. Andrew; Gau, Jeff M.; Dishion, Thomas J.; Brown, Kimbree L.; Stormshak, Elizabeth A.; Seeley, John R.

2016-01-01

This study examined the viability of a brief, parent-reported strengths and needs assessment as the first step in a multiple-gating approach to proactive positive behavior support for families. The "Positive Family Support--Strengths and Needs Assessment" (PFS-SaNA) was designed to collaboratively engage parents early in the school year…

The neurobiological basis of human aggression: A review on genetic and epigenetic mechanisms.

PubMed

Waltes, Regina; Chiocchetti, Andreas G; Freitag, Christine M

2016-07-01

Aggression is an evolutionary conserved behavior present in most species including humans. Inadequate aggression can lead to long-term detrimental personal and societal effects. Here, we differentiate between proactive and reactive forms of aggression and review the genetic determinants of it. Heritability estimates of aggression in general vary between studies due to differing assessment instruments for aggressive behavior (AB) as well as age and gender of study participants. In addition, especially non-shared environmental factors shape AB. Current hypotheses suggest that environmental effects such as early life stress or chronic psychosocial risk factors (e.g., maltreatment) and variation in genes related to neuroendocrine, dopaminergic as well as serotonergic systems increase the risk to develop AB. In this review, we summarize the current knowledge of the genetics of human aggression based on twin studies, genetic association studies, animal models, and epigenetic analyses with the aim to differentiate between mechanisms associated with proactive or reactive aggression. We hypothesize that from a genetic perspective, the aminergic systems are likely to regulate both reactive and proactive aggression, whereas the endocrine pathways seem to be more involved in regulation of reactive aggression through modulation of impulsivity. Epigenetic studies on aggression have associated non-genetic risk factors with modifications of the stress response and the immune system. Finally, we point to the urgent need for further genome-wide analyses and the integration of genetic and epigenetic information to understand individual differences in reactive and proactive AB. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

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...

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.

Is bad intent negligible? Linking victim justice sensitivity, hostile attribution bias, and aggression.

PubMed

Bondü, Rebecca

2018-05-03

The hostile attribution bias (HAB) is a well-established risk factor for aggression. It is considered part of the suspicious mindset that may cause highly victim-justice sensitive individuals to behave uncooperatively. Thus, links of victim justice sensitivity (JS) with negative behavior, such as aggression, may be better explained by HAB. The present study tested this hypothesis in N = 279 German adolescents who rated their JS, HAB, and physical, relational, verbal, reactive, and proactive aggression. Victim JS predicted physical, relational, verbal, reactive, and proactive aggression when HAB was controlled. HAB only predicted physical and proactive aggression. There were no moderator effects. Injustice seems an important reason for aggression irrespective of whether or not it is intentionally caused, particularly among those high in victim JS. Thus, victim JS should be considered as a potential important risk factor for aggression and receive more attention by research on aggression and preventive efforts. © 2018 Wiley Periodicals, Inc.

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.

Pioglitazone use and heart failure in patients with type 2 diabetes and preexisting cardiovascular disease: data from the PROactive study (PROactive 08).

PubMed

Erdmann, Erland; Charbonnel, Bernard; Wilcox, Robert G; Skene, Allan M; Massi-Benedetti, Massimo; Yates, John; Tan, Meng; Spanheimer, Robert; Standl, Eberhard; Dormandy, John A

2007-11-01

PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive) enrolled patients with type 2 diabetes and preexisting cardiovascular disease. These patients were at high risk for heart failure, so any therapeutic benefit could potentially be offset by risk of associated heart failure mortality. We analyzed the heart failure cases to assess the effects of treatment on morbidity and mortality after reports of serious heart failure. PROactive was an outcome study in 5,238 patients randomized to pioglitazone or placebo. Patients with New York Heart Association Class II-IV heart failure at screening were excluded. A serious adverse event of heart failure was defined as heart failure that required hospitalization or prolonged a hospitalization stay, was fatal or life threatening, or resulted in persistent significant disability or incapacity. Heart failure risk was evaluated by multivariate regression. More pioglitazone (5.7%) than placebo patients (4.1%) had a serious heart failure event during the study (P = 0.007). However, mortality due to heart failure was similar (25 of 2,605 [0.96%] for pioglitazone vs. 22 of 2,633 [0.84%] for placebo; P = 0.639). Among patients with a serious heart failure event, subsequent all-cause mortality was proportionately lower with pioglitazone (40 of 149 [26.8%] vs. 37 of 108 [34.3%] with placebo; P = 0.1338). Proportionately fewer pioglitazone patients with serious heart failure went on to have an event in the primary (47.7% with pioglitazone vs. 57.4% with placebo; P = 0.0593) or main secondary end point (34.9% with pioglitazone vs. 47.2% with placebo; P = 0.025). Although the incidence of serious heart failure was increased with pioglitazone versus placebo in the total PROactive population of patients with type 2 diabetes and macrovascular disease, subsequent mortality or morbidity was not increased in patients with serious heart failure.

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.

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.

Decreases in collision risk and derailments attributed to changing at-risk behavior process at Union Pacific.

DOT National Transportation Integrated Search

2009-09-01

Changing At-Risk Behavior (CAB) is a safety process that is being conducted at Union Pacifics San Antonio Service Unit (SASU) with the aim of improving road and yard safety. CAB is an example of a proactive safety risk-reduction method, called Cle...

NASA Collaborative Approach Mitigates Environmentally-Driven Obsolescence

NASA Technical Reports Server (NTRS)

Greene, Brian; Leeney, Bob; Richards, Joni

2016-01-01

National Aeronautics and Space Administration (NASA) missions, like Department of Defense (DoD) organizations, require the rigorous testing and qualification of critical materials. Obsolescence supply risks created by environmental requirements can affect the cost, schedule and performance of NASA missions and the resilience of critical infrastructure. The NASA Technology Evaluation for Environmental Risk Mitigation (TEERM) Principal Center helps to identify obsolescence supply risks driven by environmental requirements and works proactively with NASA Centers and Programs, the DoD, the European Space Agency (ESA) and other agencies and partners to identify and evaluate environmentally friendly alternatives. TEERM tracks environmental regulations, identifies the potential loss of material availability and works with NASA programs and Centers to evaluate potential impacts through a risk assessment approach. TEERM collaborative projects identify, demonstrate and evaluate commercially viable alternative technologies and materials. A major focus during the Space Shuttle Program was the need to replace ozone depleting substances that were used in spray foam and cleaning applications. The potential obsolescence of coatings containing hexavalent chromium and the risks associated with lead free solder were also of concern for the Space Shuttle and present ongoing risks to new programs such as the Space Launch System. One current project teams NASA and ESA in the evaluation and testing of individual coatings and coating systems as replacements for hexavalent chromium coatings in aerospace applications. The proactive, collaborative approach used by TEERM helps reduce the cost burden on any one team partner, reduces duplication of effort, and enhances the technical quality and overall applicability of the testing and analysis.

Mission Risk Reduction Regulatory Change Management

NASA Technical Reports Server (NTRS)

Scroggins, Sharon

2007-01-01

NASA Headquarters Environmental Management Division supports NASA's mission to pioneer the future in space exploration, scientific discovery, and aeronautics research by integrating environmental considerations into programs and projects early-on, thereby proactively reducing NASA's exposure to institutional, programmatic and operational risk. As part of this effort, NASA established the Principal Center for Regulatory Risk Analysis and Communication (RRAC PC) as a resource for detecting, analyzing, and communicating environmental regulatory risks to the NASA stakeholder community. The RRAC PC focuses on detecting emerging environmental regulations and other operational change drivers that may pose risks to NASA programs and facilities, and effectively communicating the potential risks. For example, regulatory change may restrict how and where certain activities or operations may be conducted. Regulatory change can also directly affect the ability to use certain materials by mandating a production phase-out or restricting usage applications of certain materials. Regulatory change can result in significant adverse impacts to NASA programs and facilities due to NASA's stringent performance requirements for materials and components related to human-rated space vehicles. Even if a regulation does not directly affect NASA operations, U.S. and international regulations can pose program risks indirectly through requirements levied on manufacturers and vendors of components and materials. For example, manufacturers can change their formulations to comply with new regulatory requirements. Such changes can require time-consuming and costly requalification certification for use in human spaceflight programs. The RRAC PC has implemented a system for proactively managing regulatory change to minimize potential adverse impacts to NASA programs and facilities. This presentation highlights the process utilized by the RRACPC to communicate regulatory change and the associated potential risks within NASA, as well as the process for communicating and cooperating with other government agencies and industry partners, both domestic and international, to ensure mission success.

Personality and innate immune defenses in a wild bird: Evidence for the pace-of-life hypothesis.

PubMed

Jacques-Hamilton, Rowan; Hall, Michelle L; Buttemer, William A; Matson, Kevin D; Gonҫalves da Silva, Anders; Mulder, Raoul A; Peters, Anne

2017-02-01

We tested the two main evolutionary hypotheses for an association between immunity and personality. The risk-of-parasitism hypothesis predicts that more proactive (bold, exploratory, risk-taking) individuals have more vigorous immune defenses because of increased risk of parasite exposure. In contrast, the pace-of-life hypothesis argues that proactive behavioral styles are associated with shorter lifespans and reduced investment in immune function. Mechanistically, associations between immunity and personality can arise because personality differences are often associated with differences in condition and stress responsiveness, both of which are intricately linked with immunity. Here we investigate the association between personality (measured as proactive exploration of a novel environment) and three indices of innate immune function (the non-specific first line of defense against parasites) in wild superb fairy-wrens Malurus cyaneus. We also quantified body condition, hemoparasites (none detected), chronic stress (heterophil:lymphocyte ratio) and circulating corticosterone levels at the end of the behavioral test (CORT, in a subset of birds). We found that fast explorers had lower titers of natural antibodies. This result is consistent with the pace-of-life hypothesis, and with the previously documented higher mortality of fast explorers in this species. There was no interactive effect of exploration score and duration in captivity on immune indices. This suggests that personality-related differences in stress responsiveness did not underlie differences in immunity, even though behavioral style did modulate the effect of captivity on CORT. Taken together these results suggest reduced constitutive investment in innate immune function in more proactive individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

75 FR 81519 - Confirmation, Portfolio Reconciliation, and Portfolio Compression Requirements for Swap Dealers...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-28

... systemic risk, portfolio reconciliation should be a proactive process that delivers a consolidated view of... achieved by portfolio compression, in turn, may lessen systemic risk and enhance the overall stability of...

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.

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.

Proactive Motor Control Reduces Monetary Risk Taking in Gambling

PubMed Central

Adams, Rachel; Chambers, Christopher D.

2012-01-01

Less supervision by the executive system after disruption of the right prefrontal cortex leads to increased risk taking in gambling because superficially attractive—but risky—choices are not suppressed. Similarly, people might gamble more in multitask situations than in single-task situations because concurrent executive processes usually interfere with each other. In the study reported here, we used a novel monetary decision-making paradigm to investigate whether multitasking could reduce rather than increase risk taking in gambling. We found that performing a task that induced cautious motor responding reduced gambling in a multitask situation (Experiment 1). We then found that a short period of inhibitory training lessened risk taking in gambling at least 2 hr later (Experiments 2 and 3). Our findings indicate that proactive motor control strongly affects monetary risk taking in gambling. The link between control systems at different cognitive levels might be exploited to develop new methods for rehabilitation of addiction and impulse-control disorders. PMID:22692336

Modern monitoring with preventive role for a production capacity

NASA Astrophysics Data System (ADS)

Tomescu, Cristian; Lupu, Constantin; Szollosi-Mota, Andrei; Rădoi, Florin; Chiuzan, Emeric

2016-10-01

In the process of exploitation of coal, the appearance of the phenomenon of spontaneous combustion represents a risk factor identified by the subjective and objective the causes, which requires the development of appropriate prevention methods. In order to control the risk, shall be drawn up incipient intervention solutions with preventive function, which consist in the direct and indirect measurement of the working environment, of the temperature of the coal massif and of the concentrations of gases, O2, CO2, CO. Monitoring instruments which fall within the modern concept for proactively anticipation is represented by thermography applied in the exploitation of coal and by the gas chromatograph for the analysis of the air collected. The drawing up of thermal maps on the basis of the thermograms and analysis of the chromatograms resulted represents the binome for assessing and treatments of the spontaneous combustion risk, which will be discussed in this work.

Efficacy of a proactive health and safety risk management system in the fire service.

PubMed

Poplin, Gerald S; Griffin, Stephanie; Pollack Porter, Keshia; Mallett, Joshua; Hu, Chengcheng; Day-Nash, Virginia; Burgess, Jefferey L

2018-04-16

This study evaluated the efficacy of a fire department proactive risk management program aimed at reducing firefighter injuries and their associated costs. Injury data were collected for the intervention fire department and a contemporary control department. Workers' compensation claim frequency and costs were analyzed for the intervention fire department only. Total, exercise, patient transport, and fireground operations injury rates were calculated for both fire departments. There was a post-intervention average annual reduction in injuries (13%), workers' compensation injury claims (30%) and claims costs (21%). Median monthly injury rates comparing the post-intervention to the pre-intervention period did not show statistically significant changes in either the intervention or control fire department. Reduced workers' compensation claims and costs were observed following the risk management intervention, but changes in injury rates were not statistically significant.

Towards modelling flood protection investment as a coupled human and natural system

NASA Astrophysics Data System (ADS)

O'Connell, P. E.; O'Donnell, G.

2013-06-01

Due to a number of recent high profile flood events and the apparent threat from global warming, governments and their agencies are under pressure to make proactive investments to protect people living in floodplains. However, adopting a proactive approach as a universal strategy is not affordable. It has been argued that delaying expensive and essentially irreversible capital decisions could be a prudent strategy in situations with high future uncertainty. This paper firstly uses Monte Carlo simulation to explore the performance of proactive and reactive investment strategies using a rational cost-benefit approach in a natural system with varying levels of persistence/interannual variability in Annual Maximum Floods. It is found that, as persistence increases, there is a change in investment strategy optimality from proactive to reactive. This could have implications for investment strategies under the increasingly variable climate that is expected with global warming. As part of the emerging holistic approaches to flood risk management, there is increasing emphasis on stakeholder participation in determining where and when flood protection investments are made, and so flood risk management is becoming more people-centred. As a consequence, multiple actors are involved in the decision-making process, and the social sciences are assuming an increasingly important role in flood risk management. There is a need for modelling approaches which can couple the natural and human system elements. It is proposed that Coupled Human and Natural System (CHANS) modelling could play an important role in understanding the motivations, actions and influence of citizens and institutions and how these impact on the effective delivery of flood protection investment. A framework for using Agent Based Modelling of human activities leading to flood investments is outlined, and some of the challenges associated with implementation are discussed.

Towards modelling flood protection investment as a coupled human and natural system

NASA Astrophysics Data System (ADS)

O'Connell, P. E.; O'Donnell, G.

2014-01-01

Due to a number of recent high-profile flood events and the apparent threat from global warming, governments and their agencies are under pressure to make proactive investments to protect people living in floodplains. However, adopting a proactive approach as a universal strategy is not affordable. It has been argued that delaying expensive and essentially irreversible capital decisions could be a prudent strategy in situations with high future uncertainty. This paper firstly uses Monte Carlo simulation to explore the performance of proactive and reactive investment strategies using a rational cost-benefit approach in a natural system with varying levels of persistence/interannual variability in annual maximum floods. It is found that, as persistence increases, there is a change in investment strategy optimality from proactive to reactive. This could have implications for investment strategies under the increasingly variable climate that is expected with global warming. As part of the emerging holistic approaches to flood risk management, there is increasing emphasis on stakeholder participation in determining where and when flood protection investments are made, and so flood risk management is becoming more people-centred. As a consequence, multiple actors are involved in the decision-making process, and the social sciences are assuming an increasingly important role in flood risk management. There is a need for modelling approaches which can couple the natural and human system elements. It is proposed that coupled human and natural system (CHANS) modelling could play an important role in understanding the motivations, actions and influence of citizens and institutions and how these impact on the effective delivery of flood protection investment. A framework for using agent-based modelling of human activities leading to flood investments is outlined, and some of the challenges associated with implementation are discussed.

Perceived Risk and Efficacy Beliefs as Motivators of Change: Use of the Risk Perception Attitude (RPA) Framework To Understand Health Behaviors.

ERIC Educational Resources Information Center

Rimal, Rajiv N.; Real, Kevin

2003-01-01

Introduces the risk perception attitude (RPA) framework that categorizes individuals into one of four attitudinal groups: responsive, avoidance, proactive, and indifference. Conducts two studies using college students as subjects. Finds that when risk and efficacy are made salient, people's risk perception guides most of their subsequent actions,…

Adaptive Behavior in Adopted Children: Predictors from Early Risk, Collaboration in Relationships within the Adoptive Kinship Network, and Openness Arrangements.

ERIC Educational Resources Information Center

Grotevant, Harold D.; Ross, Nicole M.; Marchel, Mary Ann; McRoy, Ruth G.

1999-01-01

Examined links between early risk and problematic developmental outcomes in adopted children during middle childhood. Found no direct relation between prenatal, perinatal, or preplacement risk factors and problematic socioemotional adjustment. With 12 high-risk children, proactive cooperation among the child's adoptive and birth family members on…

Obsolescence Risk Assessment Process Best Practice

NASA Astrophysics Data System (ADS)

Romero Rojo, F. J.; Roy, R.; Kelly, S.

2012-05-01

A component becomes obsolete when it is no longer available from the original manufacturer to the original specification. In long-lifecycle projects, obsolescence has become a major problem as it prevents the maintenance of the system. This is the reason why obsolescence management is now an essential part of the product support activities in sectors such as defence, aerospace, nuclear and railway; where systems need to be supported for several decades. The obsolescence risk assessment for the bill of materials (BoM) is a paramount activity in order to manage obsolescence proactively and cost-effectively. This is the reason why it was necessary to undertake a benchmarking study to develop best practice in this process. A total of 22 obsolescence experts from 13 different organisations/projects from across UK and USA have participated in this study. Their current processes and experience have been taken into account in the development of the best practice process for obsolescence risk assessment. The key factors that have to be analysed in the risk assessment process for each component in the BoM are: number of manufacturers, years to end of life, stock available, consumption rate and operational impact criticality. For the very high risk components, a more detailed analysis is required to inform the decisions regarding the most suitable mitigation strategies. On the contrary, for the low risk components, a fully proactive approach is neither appropriate nor cost effective. Therefore, it is advised for these components that obsolescence issues are dealt with reactively. This process has been validated using case studies with several experts from industry and is currently being implemented by the UK Ministry of Defence as technical guidance within the JSP 886 Volume 7 Part 8.13 standards.

FMEA: a model for reducing medical errors.

PubMed

Chiozza, Maria Laura; Ponzetti, Clemente

2009-06-01

Patient safety is a management issue, in view of the fact that clinical risk management has become an important part of hospital management. Failure Mode and Effect Analysis (FMEA) is a proactive technique for error detection and reduction, firstly introduced within the aerospace industry in the 1960s. Early applications in the health care industry dating back to the 1990s included critical systems in the development and manufacture of drugs and in the prevention of medication errors in hospitals. In 2008, the Technical Committee of the International Organization for Standardization (ISO), licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. Here we describe the main steps of the FMEA process and review data available on the application of this technique to laboratory medicine. A significant reduction of the risk priority number (RPN) was obtained when applying FMEA to blood cross-matching, to clinical chemistry analytes, as well as to point-of-care testing (POCT).

Enhanced conditioned eyeblink response acquisition and proactive interference in anxiety vulnerable individuals

PubMed Central

Holloway, Jacqueline L.; Trivedi, Payal; Myers, Catherine E.; Servatius, Richard J.

2012-01-01

In classical conditioning, proactive interference may arise from experience with the conditioned stimulus (CS), the unconditional stimulus (US), or both, prior to their paired presentations. Interest in the application of proactive interference has extended to clinical populations as either a risk factor for disorders or as a secondary sign. Although the current literature is dense with comparisons of stimulus pre-exposure effects in animals, such comparisons are lacking in human subjects. As such, interpretation of proactive interference over studies as well as its generalization and utility in clinical research is limited. The present study was designed to assess eyeblink response acquisition after equal numbers of CS, US, and explicitly unpaired CS and US pre-exposures, as well as to evaluate how anxiety vulnerability might modulate proactive interference. In the current study, anxiety vulnerability was assessed using the State/Trait Anxiety Inventories as well as the adult and retrospective measures of behavioral inhibition (AMBI and RMBI, respectively). Participants were exposed to 1 of 4 possible pre-exposure contingencies: 30 CS, 30 US, 30 CS, and 30 US explicitly unpaired pre-exposures, or Context pre-exposure, immediately prior to standard delay training. Robust proactive interference was evident in all pre-exposure groups relative to Context pre-exposure, independent of anxiety classification, with CR acquisition attenuated at similar rates. In addition, trait anxious individuals were found to have enhanced overall acquisition as well as greater proactive interference relative to non-vulnerable individuals. The findings suggest that anxiety vulnerable individuals learn implicit associations faster, an effect which persists after the introduction of new stimulus contingencies. This effect is not due to enhanced sensitivity to the US. Such differences would have implications for the development of anxiety psychopathology within a learning framework. PMID:23162449

Enhanced conditioned eyeblink response acquisition and proactive interference in anxiety vulnerable individuals.

PubMed

Holloway, Jacqueline L; Trivedi, Payal; Myers, Catherine E; Servatius, Richard J

2012-01-01

In classical conditioning, proactive interference may arise from experience with the conditioned stimulus (CS), the unconditional stimulus (US), or both, prior to their paired presentations. Interest in the application of proactive interference has extended to clinical populations as either a risk factor for disorders or as a secondary sign. Although the current literature is dense with comparisons of stimulus pre-exposure effects in animals, such comparisons are lacking in human subjects. As such, interpretation of proactive interference over studies as well as its generalization and utility in clinical research is limited. The present study was designed to assess eyeblink response acquisition after equal numbers of CS, US, and explicitly unpaired CS and US pre-exposures, as well as to evaluate how anxiety vulnerability might modulate proactive interference. In the current study, anxiety vulnerability was assessed using the State/Trait Anxiety Inventories as well as the adult and retrospective measures of behavioral inhibition (AMBI and RMBI, respectively). Participants were exposed to 1 of 4 possible pre-exposure contingencies: 30 CS, 30 US, 30 CS, and 30 US explicitly unpaired pre-exposures, or Context pre-exposure, immediately prior to standard delay training. Robust proactive interference was evident in all pre-exposure groups relative to Context pre-exposure, independent of anxiety classification, with CR acquisition attenuated at similar rates. In addition, trait anxious individuals were found to have enhanced overall acquisition as well as greater proactive interference relative to non-vulnerable individuals. The findings suggest that anxiety vulnerable individuals learn implicit associations faster, an effect which persists after the introduction of new stimulus contingencies. This effect is not due to enhanced sensitivity to the US. Such differences would have implications for the development of anxiety psychopathology within a learning framework.

Managing security risks for inter-organisational information systems: a multiagent collaborative model

NASA Astrophysics Data System (ADS)

Feng, Nan; Wu, Harris; Li, Minqiang; Wu, Desheng; Chen, Fuzan; Tian, Jin

2016-09-01

Information sharing across organisations is critical to effectively managing the security risks of inter-organisational information systems. Nevertheless, few previous studies on information systems security have focused on inter-organisational information sharing, and none have studied the sharing of inferred beliefs versus factual observations. In this article, a multiagent collaborative model (MACM) is proposed as a practical solution to assess the risk level of each allied organisation's information system and support proactive security treatment by sharing beliefs on event probabilities as well as factual observations. In MACM, for each allied organisation's information system, we design four types of agents: inspection agent, analysis agent, control agent, and communication agent. By sharing soft findings (beliefs) in addition to hard findings (factual observations) among the organisations, each organisation's analysis agent is capable of dynamically predicting its security risk level using a Bayesian network. A real-world implementation illustrates how our model can be used to manage security risks in distributed information systems and that sharing soft findings leads to lower expected loss from security risks.

Working paper : estimating the potential safety benefits of intelligent transportation systems

DOT National Transportation Integrated Search

1998-05-15

The ODOT Abandoned Underground Mine Inventory and Risk Assessment process was conceived as a proactive response to the need to locate and assess the risk of all mapped or otherwise identified roadway sites beneath which abandoned underground mines ex...

Improved safety culture and labor-management relations attributed to changing at-risk behavior process at Union Pacific.

DOT National Transportation Integrated Search

2009-09-01

Changing At-Risk Behavior (CAB) is a safety process that is being conducted at Union Pacifics San Antonio Service Unit (SASU) with the aim of improving road and yard safety. CAB is an example of a proactive safety risk-reduction method called Clea...

Application of failure mode and effect analysis in a radiology department.

PubMed

Thornton, Eavan; Brook, Olga R; Mendiratta-Lala, Mishal; Hallett, Donna T; Kruskal, Jonathan B

2011-01-01

With increasing deployment, complexity, and sophistication of equipment and related processes within the clinical imaging environment, system failures are more likely to occur. These failures may have varying effects on the patient, ranging from no harm to devastating harm. Failure mode and effect analysis (FMEA) is a tool that permits the proactive identification of possible failures in complex processes and provides a basis for continuous improvement. This overview of the basic principles and methodology of FMEA provides an explanation of how FMEA can be applied to clinical operations in a radiology department to reduce, predict, or prevent errors. The six sequential steps in the FMEA process are explained, and clinical magnetic resonance imaging services are used as an example for which FMEA is particularly applicable. A modified version of traditional FMEA called Healthcare Failure Mode and Effect Analysis, which was introduced by the U.S. Department of Veterans Affairs National Center for Patient Safety, is briefly reviewed. In conclusion, FMEA is an effective and reliable method to proactively examine complex processes in the radiology department. FMEA can be used to highlight the high-risk subprocesses and allows these to be targeted to minimize the future occurrence of failures, thus improving patient safety and streamlining the efficiency of the radiology department. RSNA, 2010

Effectiveness of proactive telephone counselling for smoking cessation in parents: Study protocol of a randomized controlled trial

PubMed Central

2011-01-01

Background Smoking is the world's fourth most common risk factor for disease, the leading preventable cause of death, and it is associated with tremendous social costs. In the Netherlands, the smoking prevalence rate is high. A total of 27.7% of the population over age 15 years smokes. In addition to the direct advantages of smoking cessation for the smoker, parents who quit smoking may also decrease their children's risk of smoking initiation. Methods/Design A randomized controlled trial will be conducted to evaluate the effectiveness of proactive telephone counselling to increase smoking cessation rates among smoking parents. A total of 512 smoking parents will be proactively recruited through their children's primary schools and randomly assigned to either proactive telephone counselling or a control condition. Proactive telephone counselling will consist of up to seven counsellor-initiated telephone calls (based on cognitive-behavioural skill building and Motivational Interviewing), distributed over a period of three months. Three supplementary brochures will also be provided. In the control condition, parents will receive a standard brochure to aid smoking cessation. Assessments will take place at baseline, three months after start of the intervention (post-measurement), and twelve months after start of the intervention (follow-up measurement). Primary outcome measures will include sustained abstinence between post-measurement and follow-up measurement and 7-day point prevalence abstinence and 24-hours point prevalence abstinence at both post- and follow-up measurement. Several secondary outcome measures will also be included (e.g., smoking intensity, smoking policies at home). In addition, we will evaluate smoking-related cognitions (e.g., attitudes towards smoking, social norms, self-efficacy, intention to smoke) in 9-12 year old children of smoking parents. Discussion This study protocol describes the design of a randomized controlled trial to evaluate the effectiveness of proactive telephone counselling in smoking cessation. It is expected that, in the telephone counseling condition, parental smoking cessation rates will be higher and children's cognitions will be less favorable about smoking compared to the control condition. Trial registration The protocol for this study is registered with the Netherlands Trial Register NTR2707. PMID:21943207

Interrelatedness of Proactive Coping, Reactive Coping, and Learned Resourcefulness

ERIC Educational Resources Information Center

Moring, John; Fuhrman, Robert; Zauszniewski, Jaclene A.

2011-01-01

Research has identified that coping strategies used by individuals depend on temporal locations of stressors. Dispositional attributes are also identified as predictors of coping. The current study identified commonalities of proactive coping, reactive coping, and learned resourcefulness measures. The analysis yielded three factors reflective of…

[Neurobiological aspects of reactive and proactive violence in antisocial personality disorder and "psychopathy"].

PubMed

Roth, Gerhard; Strüber, Daniel

2009-01-01

Impulsive-reactive violent offenders show increased autonomic activity in response to negative emotional and threatening stimuli. A volume reduction and/or activity decrease of frontal brain structures associated with impulse control and the regulation of fear and anger are likewise found in combination with a fear-related hyperactivity of the amygdala. In addition, impulsive aggression is facilitated by variants of gene polymorphisms influencing the serotonergic system. Conversely, proactive-instrumental violent offender with psychopathy, who are characterized by a lack of empathy and remorse, demonstrate an autonomic hypo-responsivity as well as dysfunctions of the amygdala and of cortical regions related to empathic and social behavior. Developmentally, aggressive children exhibit temperamental differences from early childhood on that are characteristic of a developmental pathway towards either reactive or proactive violence later in life. Exposure to negative environmental factors like ineffective parenting or childhood maltreatment has been related to a heightened risk for developing reactive violence. A developmental trajectory of proactive violence, however, has been related to a mostly genetically determined callous unemotional temperament of the child that disrupts the parental socialization efforts during childhood.

Individual and Class Norms Differentially Predict Proactive and Reactive Aggression: A Functional Analysis

ERIC Educational Resources Information Center

Frey, Karin S.; Higheagle Strong, Zoe; Onyewuenyi, Adaurennaya C.

2017-01-01

Theory and research using a social-information processing framework indicate that reward-focused (proactive) aggression has different social consequences than defense-focused (reactive) aggression. Students use norms that identify expected and socially approved behaviors as guides to their own actions. Differences in social-cognitive processing…

Proactive assessment of accident risk to improve safety on a system of freeways.

DOT National Transportation Integrated Search

2012-05-01

This report describes the development and evaluation of real-time crash risk-assessment models for four freeway corridors: U.S. Route 101 NB (northbound) and SB (southbound) and Interstate 880 NB and SB. Crash data for these freeway segments for the ...

Medication Safety of Five Oral Chemotherapies: A Proactive Risk Assessment

PubMed Central

Weingart, Saul N.; Spencer, Justin; Buia, Stephanie; Duncombe, Deborah; Singh, Prabhjyot; Gadkari, Mrinalini; Connor, Maureen

2011-01-01

Purpose: Oral chemotherapies represent an emerging risk area in ambulatory oncology practice. To examine the hazards associated with five oral chemotherapies, we performed a proactive risk assessment. Methods: We convened interdisciplinary teams and conducted failure mode and effects analyses (FMEAs) for five oral chemotherapy agents: capecitabine, imatinib, temozolomide, 6-mercaptopurine, and an investigational agent. This involved the creation of process maps for each medication, identification of failure modes, selection of high-risk failure modes, and development of recommendations to mitigate these risks. We analyzed the number of steps and types of failure modes and compared this information across the study drugs. Results: Key vulnerabilities include patient education about drug handling and adverse effects, prescription writing, patient self-administration and medication adherence, and failure to monitor and manage toxicities. Many of these failure modes were common across the five oral chemotherapies, suggesting the presence of common targets for improvement. Streamlining the FMEA itself may promote the dissemination of this method. Conclusion: Each stage of the medication process poses risks to the safe use of oral chemotherapies. FMEAs may identify opportunities to improve medication safety and reduce the risk of patient harm. PMID:21532801

Prevention of accidental exposure in radiotherapy: the risk matrix approach.

PubMed

Vilaragut, J J; Duménigo, C; Delgado, J M; Morales, J; McDonnell, J D; Ferro, R; Ortiz López, P; Ramírez, M L; Pérez Mulas, A; Papadopulos, S; Gonçalves, M; López Morones, R; Sánchez Cayuela, C; Cascajo Castresana, A; Somoano, F; Álvarez, C; Guillén, A; Rodríguez, M; Pereira, P P; Nader, A

2013-02-01

Knowledge and lessons from past accidental exposures in radiotherapy are very helpful in finding safety provisions to prevent recurrence. Disseminating lessons is necessary but not sufficient. There may be additional latent risks for other accidental exposures, which have not been reported or have not occurred, but are possible and may occur in the future if not identified, analyzed, and prevented by safety provisions. Proactive methods are available for anticipating and quantifying risk from potential event sequences. In this work, proactive methods, successfully used in industry, have been adapted and used in radiotherapy. Risk matrix is a tool that can be used in individual hospitals to classify event sequences in levels of risk. As with any anticipative method, the risk matrix involves a systematic search for potential risks; that is, any situation that can cause an accidental exposure. The method contributes new insights: The application of the risk matrix approach has identified that another group of less catastrophic but still severe single-patient events may have a higher probability, resulting in higher risk. The use of the risk matrix approach for safety assessment in individual hospitals would provide an opportunity for self-evaluation and managing the safety measures that are most suitable to the hospital's own conditions.

Proactive prevention in occupational safety and health: how to identify tomorrow's prevention priorities and preventive measures.

PubMed

Hauke, Angelika; Flaspöler, Eva; Reinert, Dietmar

2018-04-17

Global trends such as digitalisation, globalisation and demographic change are changing workplaces, and accordingly occupational safety and health (OSH) needs. To better prepare for the future and to foster proactive prevention, the German Social Accident Insurance (DGUV) established an OSH risk observatory (RO OSH). The RO OSH relies on an online survey and calls upon the expertise of labour inspectors. 398 labour inspectors participated in the first RO OSH enquiry. They rated developments with regard to their sector-specific relevance for OSH in the near future. The RO OSH also provides ideas for preventive measures that can be implemented by the German Social Accident Insurance Institutions. Work intensity, demographic aspects, and digitalisation play a major role for most or all sectors. However, familiar OSH issues such as musculoskeletal strain and noise also continue to be of major importance and require further consideration and specific solutions in prevention. For the DGUV, training and consulting bear great potential for proactive prevention in the above priority areas, e.g. by fostering a prevention culture and supporting companies in (psychosocial) risk assessment (also for mobile work). For instance, concepts for increasing physical activity at sedentary workplaces, and data security require continued research.

Proactive telephone counseling for smoking cessation: meta-analyses by recruitment channel and methodological quality.

PubMed

Tzelepis, Flora; Paul, Christine L; Walsh, Raoul A; McElduff, Patrick; Knight, Jenny

2011-06-22

Systematic reviews demonstrated that proactive telephone counseling increases smoking cessation rates. However, these reviews did not differentiate studies by recruitment channel, did not adequately assess methodological quality, and combined different measures of abstinence. Twenty-four randomized controlled trials published before December 31, 2008, included seven of active recruitment, 16 of passive recruitment, and one of mixed recruitment. We rated methodological quality on selection bias, study design, confounders, blinding, data collection methods, withdrawals, and dropouts, according to the Quality Assessment Tool for Quantitative Studies. We conducted random effects meta-analysis to pool the results according to abstinence type and follow-up time for studies overall and segregated by recruitment channel, and methodological quality. The level of statistical heterogeneity was quantified by I(2). All statistical tests were two-sided. Methodological quality ratings indicated two strong, 10 moderate, and 12 weak studies. Overall, compared with self-help materials or no intervention control groups, proactive telephone counseling had a statistically significantly greater effect on point prevalence abstinence (nonsmoking at follow-up or abstinent for at least 24 hours, 7 days before follow-up) at 6-9 months (relative risk [RR] = 1.26, 95% confidence interval [CI] = 1.11 to 1.43, P < .001, I(2) = 21.4%) but not at 12-15 months after recruitment. This pattern also emerged when studies were segregated by recruitment channel (active, passive) or methodological quality (strong/moderate, weak). Overall, the positive effect on prolonged/continuous abstinence (abstinent for 3 months or longer before follow-up) was also statistically significantly greater at 6-9 months (RR = 1.58, CI = 1.26 to 1.98, P < .001, I(2) = 49.1%) and 12-18 months after recruitment (RR = 1.40, CI = 1.23 to 1.60, P < .001, I(2) = 18.5%). With the exception of point prevalence abstinence in the long term, these data support previous results showing that proactive telephone counseling has a positive impact on smoking cessation. Proactive telephone counseling increased prolonged/continuous abstinence long term for both actively and passively recruited smokers.

A proactive outreach intervention that decreases readmission after hepatectomy.

PubMed

Narula, Nisha; Kim, Bradford J; Davis, Catherine H; Dewhurst, Whitney L; Samp, Leigh A; Aloia, Thomas A

2018-04-01

After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge. Readmission rates were compared pre- and postintervention using standard statistics. Two hundred thirty-one patients met the inclusion criteria and major hepatectomy was performed in 45.5% of patients. Although the complication rate was similar (25.0% preintervention and 19.4% postintervention, P = .324), readmissions within 30 days of operation decreased from 14.5% pre- to 6.5% postintervention (P = .046). Approximately 30% of outreach interactions required outpatient intervention. Factors associated with readmission on univariate analysis included increased operative time (P = .007), major hepatectomy (P = .012), hemi or extended hepatectomy (P = .032), second stage operation (P = .031), bile leak (P = 0.022), and any complication/modified Accordion complication ≥ 3 within 30 days (P <.0001). On multivariate analysis, lack of post-discharge intervention (P = .012) and bile leak (P = .031) were independently associated with readmission. These data demonstrate the efficacy of a proactive communication intervention after discharge to decrease readmissions after hepatectomy. The additional work created by the intervention is likely offset by decreased inpatient care needs and costs. Identification of high-risk populations and application of technology are likely to lead to further improvements. Copyright © 2017 Elsevier Inc. All rights reserved.

Climatic and psychosocial risks of heat illness incidents on construction site.

PubMed

Jia, Yunyan Andrea; Rowlinson, Steve; Ciccarelli, Marina

2016-03-01

The study presented in this paper aims to identify prominent risks leading to heat illness in summer among construction workers that can be prioritised for developing effective interventions. Samples are 216 construction workers' cases at the individual level and 26 construction projects cases at the organisation level. A grounded theory is generated to define the climatic heat and psychosocial risks and the relationships between risks, timing and effectiveness of interventions. The theoretical framework is then used to guide content analysis of 36 individual onsite heat illness cases to identify prominent risks. The results suggest that heat stress risks on construction site are socially constructed and can be effectively managed through elimination at supply chain level, effective engineering control, proactive control of the risks through individual interventions and reactive control through mindful recognition and response to early symptoms. The role of management infrastructure as a base for effective interventions is discussed. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

A Human Factors Analysis of Proactive Support in Human-Robot Teaming

DTIC Science & Technology

2015-09-28

teammate is remotely controlling a robot while working with an intelligent robot teammate ‘Mary’. Our main result shows that the subjects generally...IEEE/RSJ Intl. Conference on Intelligent Robots and Systems Conference Date: September 28, 2015 A Human Factors Analysis of Proactive Support in Human...human teammate is remotely controlling a robot while working with an intelligent robot teammate ‘Mary’. Our main result shows that the subjects

Standards for gene therapy clinical trials based on pro-active risk assessment in a London NHS Teaching Hospital Trust.

PubMed

Bamford, K B; Wood, S; Shaw, R J

2005-02-01

Conducting gene therapy clinical trials with genetically modified organisms as the vectors presents unique safety and infection control issues. The area is governed by a range of legislation and guidelines, some unique to this field, as well as those pertinent to any area of clinical work. The relevant regulations covering gene therapy using genetically modified vectors are reviewed and illustrated with the approach taken by a large teaching hospital NHS Trust. Key elements were Trust-wide communication and involvement of staff in a pro-active approach to risk management, with specific emphasis on staff training and engagement, waste management, audit and record keeping. This process has led to the development of proposed standards for clinical trials involving genetically modified micro-organisms.

High Performance Proactive Digital Forensics

NASA Astrophysics Data System (ADS)

Alharbi, Soltan; Moa, Belaid; Weber-Jahnke, Jens; Traore, Issa

2012-10-01

With the increase in the number of digital crimes and in their sophistication, High Performance Computing (HPC) is becoming a must in Digital Forensics (DF). According to the FBI annual report, the size of data processed during the 2010 fiscal year reached 3,086 TB (compared to 2,334 TB in 2009) and the number of agencies that requested Regional Computer Forensics Laboratory assistance increasing from 689 in 2009 to 722 in 2010. Since most investigation tools are both I/O and CPU bound, the next-generation DF tools are required to be distributed and offer HPC capabilities. The need for HPC is even more evident in investigating crimes on clouds or when proactive DF analysis and on-site investigation, requiring semi-real time processing, are performed. Although overcoming the performance challenge is a major goal in DF, as far as we know, there is almost no research on HPC-DF except for few papers. As such, in this work, we extend our work on the need of a proactive system and present a high performance automated proactive digital forensic system. The most expensive phase of the system, namely proactive analysis and detection, uses a parallel extension of the iterative z algorithm. It also implements new parallel information-based outlier detection algorithms to proactively and forensically handle suspicious activities. To analyse a large number of targets and events and continuously do so (to capture the dynamics of the system), we rely on a multi-resolution approach to explore the digital forensic space. Data set from the Honeynet Forensic Challenge in 2001 is used to evaluate the system from DF and HPC perspectives.

Towards a Proactive Risk Mitigation Strategy at La Fossa Volcano, Vulcano Island

NASA Astrophysics Data System (ADS)

Biass, S.; Gregg, C. E.; Frischknecht, C.; Falcone, J. L.; Lestuzzi, P.; di Traglia, F.; Rosi, M.; Bonadonna, C.

2014-12-01

A comprehensive risk assessment framework was built to develop proactive risk reduction measures for Vulcano Island, Italy. This framework includes identification of eruption scenarios; probabilistic hazard assessment, quantification of hazard impacts on the built environment, accessibility assessment on the island and risk perception study. Vulcano, a 21 km2 island with two primary communities host to 900 permanent residents and up to 10,000 visitors during summer, shows a strong dependency on the mainland for basic needs (water, energy) and relies on a ~2 month tourism season for its economy. The recent stratigraphy reveals a dominance of vulcanian and subplinian eruptions, producing a range of hazards acting at different time scales. We developed new methods to probabilistically quantify the hazard related to ballistics, lahars and tephra for all eruption styles. We also elaborated field- and GIS- based methods to assess the physical vulnerability of the built environment and created dynamic models of accessibility. Results outline the difference of hazard between short and long-lasting eruptions. A subplinian eruption has a 50% probability of impacting ~30% of the buildings within days after the eruption, but the year-long damage resulting from a long-lasting vulcanian eruption is similar if tephra is not removed from rooftops. Similarly, a subplinian eruption results in a volume of 7x105 m3 of material potentially remobilized into lahars soon after the eruption. Similar volumes are expected for a vulcanian activity over years, increasing the hazard of small lahars. Preferential lahar paths affect critical infrastructures lacking redundancy, such as the road network, communications systems, the island's only gas station, and access to the island's two evacuation ports. Such results from hazard, physical and systemic vulnerability help establish proactive volcanic risk mitigation strategies and may be applicable in other island settings.

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

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...

The Promotion of Wellness in Children and Families: Challenges and Opportunities.

ERIC Educational Resources Information Center

Pedro-Carroll, JoAnne

This paper considers the effects of martial disruption on families and the associated risks to children. It discusses opportunities for reducing risk and fostering the psychological well-being of children and families, through research, carefully designed interventions, and proactive social policies. A theory of resilience as cumulative competence…

Development of the Adult Scale of Hostility and Aggression: Reactive-Proactive (A-SHARP)

ERIC Educational Resources Information Center

Matlock, Scott Thomas; Aman, Michael G.

2011-01-01

In this study, the authors developed the Adult Scale of Hostility and Aggression Reactive-Proactive (A-SHARP). Sixty-one caregivers rated 512 individuals with intellectual and developmental disabilities on the A-SHARP. Exploratory factor analysis revealed 5 factors on the Problem Scale: (a) Verbal Aggression, (b) Physical Aggression, (c) Hostile…

Development of the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP)

ERIC Educational Resources Information Center

Farmer, Cristan A.; Aman, Michael G.

2009-01-01

Whereas some scales exist for assessing aggression in typically developing children, they do not give a detailed analysis, and none is available for populations with developmental disabilities (DD). Parents of 365 children with DD completed the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP), which surveys the severity…

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

Treesearch

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

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...

Patient Safety in Complementary Medicine through the Application of Clinical Risk Management in the Public Health System

PubMed Central

Rossi, Elio G.; Picchi, Marco; Baccetti, Sonia; Monechi, Maria Valeria; Vuono, Catia; Sabatini, Federica; Traversi, Antonella; Di Stefano, Mariella; Firenzuoli, Fabio; Albolino, Sara; Tartaglia, Riccardo

2017-01-01

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM. PMID:29258191

Patient Safety in Complementary Medicine through the Application of Clinical Risk Management in the Public Health System.

PubMed

Rossi, Elio G; Bellandi, Tommaso; Picchi, Marco; Baccetti, Sonia; Monechi, Maria Valeria; Vuono, Catia; Sabatini, Federica; Traversi, Antonella; Di Stefano, Mariella; Firenzuoli, Fabio; Albolino, Sara; Tartaglia, Riccardo

2017-12-16

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM.

Individual differences in experiencing intrusive memories: the role of the ability to resist proactive interference.

PubMed

Verwoerd, Johan; Wessel, Ineke; de Jong, Peter J

2009-06-01

This study explored whether a relatively poor ability to resist or inhibit interference from irrelevant information in working memory is associated with experiencing undesirable intrusive memories. Non-selected participants (N=91) completed a self-report measure of intrusive memories, and carried out experimental tasks intended to measure two different types of inhibition: resistance to proactive interference and response inhibition (i.e., the ability to prevent automatically triggered responses). The results showed a significant relationship between inhibition at the cognitive level (i.e., resistance to proactive interference) and the frequency of intrusive memories (especially in the group of female participants) whereas no such relationship with measures of response inhibition emerged. These findings are consistent with the idea that deficient inhibitory control reflects a vulnerability factor for experiencing intrusive memories. Implications for research investigating risk factors for the development of posttraumatic stress disorder (PTSD) are discussed.

Interactions between callous unemotional behaviors and executive function in early childhood predict later socioemotional functioning

PubMed Central

Waller, Rebecca; Hyde, Luke W.; Baskin-Sommers, Arielle; Olson, Sheryl L.

2018-01-01

Callous unemotional (CU) behaviors are linked to aggression, behavior problems, and difficulties in peer relationships in children and adolescents. However, few studies have examined whether early childhood CU behaviors predict aggression or peer-rejection during late-childhood or potential moderation of this relationship by executive function. The current study examined whether the interaction of CU behaviors and executive function in early childhood predicted different forms of aggression in late-childhood, including proactive, reactive, and relational aggression, as well as how much children were liked by their peers. Data from cross-informant reports and multiple observational tasks were collected from a high-risk sample (N=240; female=118) at ages 3 and 10 years old. Parent reports of CU behaviors at age 3 predicted teacher reports of reactive, proactive, and relational aggression, as well as lower peer-liking at age 10. Moderation analysis showed that specifically at high levels of CU behaviors and low levels of observed executive function, children were reported by teachers as showing greater reactive and proactive aggression, and were less-liked by peers. Findings demonstrate that early childhood CU behaviors and executive function have unique main and interactive effects on both later aggression and lower peer-liking even when taking into account stability in behavior problems over time. By elucidating how CU behaviors and deficits in executive function potentiate each other during early childhood, we can better characterize the emergence of severe and persistent behavior and interpersonal difficulties across development. PMID:27418255

A Release from Proactive Interference Analysis of Gender Schema Encoding for Occupations in Adults and Children

ERIC Educational Resources Information Center

Kee, D.W.; Gregory-Domingue, A.; Rice, K.; Tone, K.

2005-01-01

The present study examined gender schema encoding (activation of gender stereotypes) in the absence deliberate purposes relating to people (stereotype application). A release from proactive interference short-term-memory task was used. College (Experiment 1) and sixth-grade (Experiment 2) participants were asked to retain item identity and…

Top 10 Campus Legal Issues for Boards

ERIC Educational Resources Information Center

White, Lawrence

2015-01-01

A principle responsibility of a board member is to understand the environment in which his or her institution operates. Today, that environment includes a host of legal risks that every institution of higher education must be prepared to assess and proactively address. Colleges and universities work to contain and manage those risks through such…

Proactive Approaches to Improving Outcomes for At-Risk Students.

ERIC Educational Resources Information Center

Freeman, G.; Gum, M.; Blackbourn, J. M.

This paper outlines two approaches for improving outcomes for students at risk for academic failure. Both take a systemic approach to the problem by focusing on how specific circumstances create a reality of failure for many students. One school analyzed factors related to retention/promotion decisions and determined that four factors directly…

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.

Cost-effectiveness of a motivational intervention for alcohol-involved youth in a hospital emergency department.

PubMed

Neighbors, Charles J; Barnett, Nancy P; Rohsenow, Damaris J; Colby, Suzanne M; Monti, Peter M

2010-05-01

Brief interventions in the emergency department targeting risk-taking youth show promise to reduce alcohol-related injury. This study models the cost-effectiveness of a motivational interviewing-based intervention relative to brief advice to stop alcohol-related risk behaviors (standard care). Average cost-effectiveness ratios were compared between conditions. In addition, a cost-utility analysis examined the incremental cost of motivational interviewing per quality-adjusted life year gained. Microcosting methods were used to estimate marginal costs of motivational interviewing and standard care as well as two methods of patient screening: standard emergency-department staff questioning and proactive outreach by counseling staff. Average cost-effectiveness ratios were computed for drinking and driving, injuries, vehicular citations, and negative social consequences. Using estimates of the marginal effect of motivational interviewing in reducing drinking and driving, estimates of traffic fatality risk from drinking-and-driving youth, and national life tables, the societal costs per quality-adjusted life year saved by motivational interviewing relative to standard care were also estimated. Alcohol-attributable traffic fatality risks were estimated using national databases. Intervention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening. The cost-effectiveness ratios for motivational interviewing were more favorable than standard care across all study outcomes and better for men than women. The societal cost per quality-adjusted life year of motivational interviewing was $8,795. Sensitivity analyses indicated that results were robust in terms of variability in parameter estimates. This brief intervention represents a good societal investment compared with other commonly adopted medical interventions.

Distilling Heterogeneity among Children with Disruptive Behavior: Associations between Symptom Patterns and Social Functioning.

PubMed

Aitken, Madison; Henry, Shanelle; Andrade, Brendan F

2017-10-16

Children with disruptive behavior (DB) are a heterogeneous group who exhibit several characteristics that may contribute to poor social functioning. The present study identified profiles of reactive aggression, proactive aggression, callous-unemotional (CU) traits, and prosocial behavior in a sample of children with DB. Associations with social functioning (social interaction, social status) were then examined, along with sex differences in profile membership. Parent ratings of 304 clinic-referred children ages 6-12 years with DB were analyzed using latent profile analysis. Five profiles were identified: 1) Moderate prosocial behavior, reactive aggression, and CU, and low proactive aggression (labelled Moderate); 2) Relatively high prosocial behavior and low reactive and proactive aggression and CU traits (Prosocial); 3) High prosocial behavior and reactive aggression, moderate proactive aggression, and low-moderate CU (Reactive-Prosocial); 4) Low prosocial behavior, high CU, high-moderate reactive aggression, and low-moderate proactive aggression (Reactive-CU); and 5) Low prosocial behavior and high reactive and proactive aggression and CU (Aggressive-CU). Profiles characterized by CU traits, reactive aggression, and low prosocial behavior were associated with the most problematic parent-rated social interaction and social status. The results highlight the need to differentiate profiles of psychopathology in children with DB to better address factors most associated with social functioning.

Proactive inhibitory control: A general biasing account☆

PubMed Central

Elchlepp, Heike; Lavric, Aureliu; Chambers, Christopher D.; Verbruggen, Frederick

2016-01-01

Flexible behavior requires a control system that can inhibit actions in response to changes in the environment. Recent studies suggest that people proactively adjust response parameters in anticipation of a stop signal. In three experiments, we tested the hypothesis that proactive inhibitory control involves adjusting both attentional and response settings, and we explored the relationship with other forms of proactive and anticipatory control. Subjects responded to the color of a stimulus. On some trials, an extra signal occurred. The response to this signal depended on the task context subjects were in: in the ‘ignore’ context, they ignored it; in the ‘stop’ context, they had to withhold their response; and in the ‘double-response’ context, they had to execute a secondary response. An analysis of event-related brain potentials for no-signal trials in the stop context revealed that proactive inhibitory control works by biasing the settings of lower-level systems that are involved in stimulus detection, action selection, and action execution. Furthermore, subjects made similar adjustments in the double-response and stop-signal contexts, indicating an overlap between various forms of proactive action control. The results of Experiment 1 also suggest an overlap between proactive inhibitory control and preparatory control in task-switching studies: both require reconfiguration of task-set parameters to bias or alter subordinate processes. We conclude that much of the top-down control in response inhibition tasks takes place before the inhibition signal is presented. PMID:26859519

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.

Feeling vital after a good night's sleep: The interplay of energetic resources and self-efficacy for daily proactivity.

PubMed

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

2017-10-01

This study aims to investigate the role of daily vitality as an energy-based mechanism through which sleep quantity and quality relate to proactive behavior. In addition, we propose that daily self-efficacy forms a contingency condition in that self-efficacy facilitates the translation of vitality into proactive behavior. We conducted a 7-day diary study based on a sample of 66 employees who completed surveys 3 times daily. We used multilevel regression analyses to test the hypotheses while controlling for the 1-day lagged measures of vitality and proactivity. The results provide evidence for a model of moderated mediation. Sleep quality but not quantity predicted an increase in daily vitality. Self-efficacy moderated the relationship between vitality and daily proactivity such that this relationship was stronger when self-efficacy was reported to be high rather than low. The conditional effect mediated by vitality was significant for sleep quality but not for sleep quantity and occurred at the within-person level of analysis. These results suggest that organizations aiming to boost daily proactivity in employees can benefit from increasing employees' self-efficacy and supporting them in developing strategies to ensure sufficient vitality. One such strategy is improving sleep quality. This study extends the literature on dynamics in proactive work behavior and its well-being-related antecedents by exploring both vitality as an underlying energetic mechanism and daily self-efficacy as a boundary condition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Proactive and Top-Down Approach to Managing Risk at NASA

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon

2010-01-01

Our ultimate goal is to manage risk in a holistic and coherent fashion across the Agency: a) The RIDM process is intended to risk-inform direction-setting decisions. c) The CRM process is intended to manage risk associated with the implementation of baseline performance requirements. Currently we are working on: a) Enhancements to the CRM process. b) Better integration of the RIDM and CRM processes. c) Better integration of institutional risk considerations into RM framework.

Risk-Informed Decision Making: Application to Technology Development Alternative Selection

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

2010-01-01

NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

Evaluating Partnerships to Enhance Disaster Risk Management using Multi-Criteria Analysis: An Application at the Pan-European Level

NASA Astrophysics Data System (ADS)

Hochrainer-Stigler, Stefan; Lorant, Anna

2018-01-01

Disaster risk is increasingly recognized as a major development challenge. Recent calls emphasize the need to proactively engage in disaster risk reduction, as well as to establish new partnerships between private and public sector entities in order to decrease current and future risks. Very often such potential partnerships have to meet different objectives reflecting on the priorities of stakeholders involved. Consequently, potential partnerships need to be assessed on multiple criteria to determine weakest links and greatest threats in collaboration. This paper takes a supranational multi-sector partnership perspective, and considers possible ways to enhance disaster risk management in the European Union by better coordination between the European Union Solidarity Fund, risk reduction efforts, and insurance mechanisms. Based on flood risk estimates we employ a risk-layer approach to determine set of options for new partnerships and test them in a high-level workshop via a novel cardinal ranking based multi-criteria approach. Whilst transformative changes receive good overall scores, we also find that the incorporation of risk into budget planning is an essential condition for successful partnerships.

Improving the effectiveness of health care innovation implementation: middle managers as change agents.

PubMed

Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J; Chin, Marshall H; Schaefer, Cynthia T

2013-02-01

The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers' commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers' commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers' influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected.

Improving the Effectiveness of Health Care Innovation Implementation: Middle Managers as Change Agents

PubMed Central

Birken, Sarah A.; Lee, Shoou-Yih Daniel; Weiner, Bryan J.; Chin, Marshall H.; Schaefer, Cynthia T.

2013-01-01

The rate of successful health care innovation implementation is dismal. Middle managers have a potentially important yet poorly understood role in health care innovation implementation. This study used self-administered surveys and interviews of middle managers in health centers that implemented an innovation to reduce health disparities to address the questions: Does middle managers’ commitment to health care innovation implementation influence implementation effectiveness? If so, in what ways does their commitment influence implementation effectiveness? Although quantitative survey data analysis results suggest a weak relationship, qualitative interview data analysis results indicate that middle managers’ commitment influences implementation effectiveness when middle managers are proactive. Scholars should account for middle managers’ influence in implementation research, and health care executives may promote implementation effectiveness by hiring proactive middle managers and creating climates in which proactivity is rewarded, supported, and expected. PMID:22930312

The Reactive–Proactive Aggression Questionnaire: Differential Correlates of Reactive and Proactive Aggression in Adolescent Boys

PubMed Central

Raine, Adrian; Dodge, Kenneth; Loeber, Rolf; Gatzke-Kopp, Lisa; Lynam, Don; Reynolds, Chandra; Stouthamer-Loeber, Magda; Liu, Jianghong

2009-01-01

This study reports the development of the Reactive–Proactive Aggression Questionnaire (RPQ), and the differential correlates of these two forms of aggression. Antisocial, psychosocial and personality measures were obtained at ages 7 and 16 years in schoolboys, while the RPQ was administered to 334 of the boys at age 16 years. Confirmatory factor analysis indicated a significant fit for a two-factor proactive–reactive model that replicated from one independent subsample to another. Proactive aggression was uniquely characterized at age 7 by initiation of fights, strong-arm tactics, delinquency, poor school motivation, poor peer relationships, single-parent status, psychosocial adversity, substance-abusing parents, and hyperactivity, and at age 16 by a psychopathic personality, blunted affect, delinquency, and serious violent offending. Reactive aggression was uniquely characterized at age 16 by impulsivity, hostility, social anxiety, lack of close friends, unusual perceptual experiences, and ideas of reference. Findings confirm and extend the differential correlates of proactive–reactive aggression, and demonstrate that this brief but reliable and valid self-report instrument can be used to assess proactive and reactive aggression in child and adolescent samples. PMID:20798781

Identification of fall predictors in the active elderly population from the routine medical records of general practitioners.

PubMed

Lastrucci, Vieri; Lorini, Chiara; Rinaldi, Giada; Bonaccorsi, Guglielmo

2018-03-01

Aim To evaluate the possibility of determining predictors of falls in the active community-dwelling elderly from the routine medical records of the general practitioners (GPs). Time constraints and competing demands in the clinical encounters frequently undermine fall-risk evaluation. In the context of proactive primary healthcare, quick, and efficient tools for a preliminary fall-risk assessment are needed in order to overcome these barriers. The study included 1220 subjects of 65 years of age or older. Data were extracted from the GPs' patient records. For each subject, the following variables were considered: age, gender, diseases, and pharmacotherapy. Univariate and multivariable analyses have been conducted to identify the independent predictors of falls. Findings The mean age of the study population was 77.8±8.7 years for women and 74.9±7.3 years for men. Of the sample, 11.6% had experienced one or more falls in the previous year. The risk of falling was found to increase significantly (P<0.05) with age (OR=1.03; 95% CI=1.01-1.05), generalized osteoarthritis (OR=2.01; 95% CI=1.23-3.30), tinnitus (OR=4.14; 95% CI=1.25-13.74), cognitive impairment (OR=4.12; 95% CI=2.18-7.80), and two or more co-existing diseases (OR=5.4; 95% CI=1.68-17.39). Results suggest that it is possible to identify patients at higher risk of falling by going through the current medical records, without adding extra workload on the health personnel. In the context of proactive primary healthcare, the analysis of fall predictors from routine medical records may allow the identification of which of the several known and hypothesized risk factors may be more relevant for developing quick and efficient tools for a preliminary fall-risk assessment.

The use of failure mode and effect analysis in a radiation oncology setting: the Cancer Treatment Centers of America experience.

PubMed

Denny, Diane S; Allen, Debra K; Worthington, Nicole; Gupta, Digant

2014-01-01

Delivering radiation therapy in an oncology setting is a high-risk process where system failures are more likely to occur because of increasing utilization, complexity, and sophistication of the equipment and related processes. Healthcare failure mode and effect analysis (FMEA) is a method used to proactively detect risks to the patient in a particular healthcare process and correct potential errors before adverse events occur. FMEA is a systematic, multidisciplinary team-based approach to error prevention and enhancing patient safety. We describe our experience of using FMEA as a prospective risk-management technique in radiation oncology at a national network of oncology hospitals in the United States, capitalizing not only on the use of a team-based tool but also creating momentum across a network of collaborative facilities seeking to learn from and share best practices with each other. The major steps of our analysis across 4 sites and collectively were: choosing the process and subprocesses to be studied, assembling a multidisciplinary team at each site responsible for conducting the hazard analysis, and developing and implementing actions related to our findings. We identified 5 areas of performance improvement for which risk-reducing actions were successfully implemented across our enterprise. © 2012 National Association for Healthcare Quality.

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/

Audience segmentation as a social-marketing tool in health promotion: use of the risk perception attitude framework in HIV prevention in Malawi.

PubMed

Rimal, Rajiv N; Brown, Jane; Mkandawire, Glory; Folda, Lisa; Böse, Kirsten; Creel, Alisha H

2009-12-01

We sought to determine whether individuals' risk perceptions and efficacy beliefs could be used to meaningfully segment audiences to assist interventions that seek to change HIV-related behaviors. A household-level survey of individuals (N=968) was conducted in 4 districts in Malawi. On the basis of responses about perceptions of risk and beliefs about personal efficacy, we used cluster analysis to create 4 groups within the risk perception attitude framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). We ran analysis of covariance models (controlling for known predictors) to determine how membership in the risk perception attitude framework groups would affect knowledge about HIV, HIV-testing uptake, and condom use. A significant association was found between membership in 1 or more of the 4 risk perception attitude framework groups and the 3 study variables of interest: knowledge about HIV (F8, 956=20.77; P<.001), HIV testing uptake (F8, 952=10.91; P<.001), and condom use (F8, 885=29.59; P<.001). The risk perception attitude framework can serve as a theoretically sound audience segmentation technique that can be used to determine whether messages should augment perceptions of risk, beliefs about personal efficacy, or both.

Audience Segmentation as a Social-Marketing Tool in Health Promotion: Use of the Risk Perception Attitude Framework in HIV Prevention in Malawi

PubMed Central

Brown, Jane; Mkandawire, Glory; Folda, Lisa; Böse, Kirsten; Creel, Alisha H.

2009-01-01

Objectives. We sought to determine whether individuals' risk perceptions and efficacy beliefs could be used to meaningfully segment audiences to assist interventions that seek to change HIV-related behaviors. Methods. A household-level survey of individuals (N = 968) was conducted in 4 districts in Malawi. On the basis of responses about perceptions of risk and beliefs about personal efficacy, we used cluster analysis to create 4 groups within the risk perception attitude framework: responsive (high risk, strong efficacy), avoidance (high risk, weak efficacy), proactive (low risk, strong efficacy), and indifference (low risk, weak efficacy). We ran analysis of covariance models (controlling for known predictors) to determine how membership in the risk perception attitude framework groups would affect knowledge about HIV, HIV-testing uptake, and condom use. Results. A significant association was found between membership in 1 or more of the 4 risk perception attitude framework groups and the 3 study variables of interest: knowledge about HIV (F8, 956 = 20.77; P < .001), HIV testing uptake (F8, 952 = 10.91; P < .001), and condom use (F8, 885 = 29.59; P < .001). Conclusions. The risk perception attitude framework can serve as a theoretically sound audience segmentation technique that can be used to determine whether messages should augment perceptions of risk, beliefs about personal efficacy, or both. PMID:19833992

On "black swans" and "perfect storms": risk analysis and management when statistics are not enough.

PubMed

Paté-Cornell, Elisabeth

2012-11-01

Two images, "black swans" and "perfect storms," have struck the public's imagination and are used--at times indiscriminately--to describe the unthinkable or the extremely unlikely. These metaphors have been used as excuses to wait for an accident to happen before taking risk management measures, both in industry and government. These two images represent two distinct types of uncertainties (epistemic and aleatory). Existing statistics are often insufficient to support risk management because the sample may be too small and the system may have changed. Rationality as defined by the von Neumann axioms leads to a combination of both types of uncertainties into a single probability measure--Bayesian probability--and accounts only for risk aversion. Yet, the decisionmaker may also want to be ambiguity averse. This article presents an engineering risk analysis perspective on the problem, using all available information in support of proactive risk management decisions and considering both types of uncertainty. These measures involve monitoring of signals, precursors, and near-misses, as well as reinforcement of the system and a thoughtful response strategy. It also involves careful examination of organizational factors such as the incentive system, which shape human performance and affect the risk of errors. In all cases, including rare events, risk quantification does not allow "prediction" of accidents and catastrophes. Instead, it is meant to support effective risk management rather than simply reacting to the latest events and headlines. © 2012 Society for Risk Analysis.

Prioritization of Managed Pork Supply Movements during a FMD Outbreak in the US.

PubMed

Patterson, Gilbert R; Mohr, Alicia H; Snider, Tim P; Lindsay, Thomas A; Davies, Peter R; Goldsmith, Tim J; Sampedro, Fernando

2016-01-01

In the event of a foot-and-mouth disease (FMD) outbreak in the United States, local, state, and federal authorities will implement a foreign animal disease emergency response plan restricting the pork supply chain movements and likely disrupting the continuity of the swine industry business. To minimize disruptions of the food supply while providing an effective response in an outbreak, it is necessary to have proactive measures in place to ensure minimal disease spread and maximum continuation of business. Therefore, it is critical to identify candidate movements for proactive risk assessments: those that are both most likely to contribute to disease spread and most necessary for business continuity. To do this, experts from production, harvest, retail, and allied pork industries assessed 30 common pork supply movements for risk of disease spread and industry criticality. The highest priority movements for conducting a risk assessment included the movement of weaned pigs originating from multiple sow farm sources to an off-site nursery or wean to finish facility, the movement of employees or commercial crews, the movement of vaccination crews, the movement of dedicated livestock hauling trucks, and the movement of commercial crews such as manure haulers and feed trucks onto, off, or between sites. These critical movements, along with several others identified in this study, will provide an initial guide for prioritization of risk management efforts and resources to be better prepared in the event of a FMD outbreak in the United States. By specifically and proactively targeting movements that experts agree are likely to spread the disease and are critical to the continuity of business operations, potentially catastrophic consequences in the event of an outbreak can be limited.

Prioritization of Managed Pork Supply Movements during a FMD Outbreak in the US

PubMed Central

Patterson, Gilbert R.; Mohr, Alicia H.; Snider, Tim P.; Lindsay, Thomas A.; Davies, Peter R.; Goldsmith, Tim J.; Sampedro, Fernando

2016-01-01

In the event of a foot-and-mouth disease (FMD) outbreak in the United States, local, state, and federal authorities will implement a foreign animal disease emergency response plan restricting the pork supply chain movements and likely disrupting the continuity of the swine industry business. To minimize disruptions of the food supply while providing an effective response in an outbreak, it is necessary to have proactive measures in place to ensure minimal disease spread and maximum continuation of business. Therefore, it is critical to identify candidate movements for proactive risk assessments: those that are both most likely to contribute to disease spread and most necessary for business continuity. To do this, experts from production, harvest, retail, and allied pork industries assessed 30 common pork supply movements for risk of disease spread and industry criticality. The highest priority movements for conducting a risk assessment included the movement of weaned pigs originating from multiple sow farm sources to an off-site nursery or wean to finish facility, the movement of employees or commercial crews, the movement of vaccination crews, the movement of dedicated livestock hauling trucks, and the movement of commercial crews such as manure haulers and feed trucks onto, off, or between sites. These critical movements, along with several others identified in this study, will provide an initial guide for prioritization of risk management efforts and resources to be better prepared in the event of a FMD outbreak in the United States. By specifically and proactively targeting movements that experts agree are likely to spread the disease and are critical to the continuity of business operations, potentially catastrophic consequences in the event of an outbreak can be limited. PMID:27843934

[Proactive screening for rehabilitation need in type 2 diabetics from an AOK Disease Management Programe: which patients will be identified?].

PubMed

Döbler, A; Pollmann, H; Raspe, H; Mittag, O

2014-02-01

Medical rehabilitation seems suitable for implementing multimodal interventions for the treatment of type 2 diabetes. Rehabilitation in Germany on principle requires that insurees file an application. Proactive screening for rehabilitation need has only been explored in pilot projects so far. It seems a promising attempt to assess rehab need by questionnaire especially in patients with type 2 diabetes. We do not know though how patients who have been screened positive for rehab need differ from other patients with type 2 diabetes as to their health and risk profiles. This could provide an indication of the validity of the proactive approach. Members of an Allgemeine Ortskrankenkasse (AOK) Disease Management Program (DMP) for type 2 diabetes were screened for rehab need by questionnaire. 13 diabetes-specific problem areas were assessed. Problems were assigned to 10 specific treatments (problem-treatment-pairs). Rehab need was presumed if patients needed 3 or more treatments. Patients were then compared to regular rehab patients as well as patients with type 2 diabetes from primary care medical offices. From 5500 DMP-patients 829 returned the questionnaire (return rate: 15.5%). From these 94% met the criteria for rehab need; of these 55% needed 6 or more treatments (complex problems). Patients who screened positive for rehab suffered from more health problems and had worse risk profiles as compared to patients from medical offices, and disease burden was comparable or worse as compared to regular rehab patients. This indicates that proactive screening for rehab need in patients with type 2 diabetes leads to reasonable (valid) results. The very low return rate suggests that the sample may be considerably biased, though. Possibly, mainly patients with greater impairment to health responded to the screening. © Georg Thieme Verlag KG Stuttgart · New York.

When Does a Good Working Memory Counteract Proactive Interference? Surprising Evidence from a Probe Recognition Task

ERIC Educational Resources Information Center

Cowan, Nelson; Saults, J. Scott

2013-01-01

It is often proposed that individuals with high working memory span overcome proactive interference (PI) from previous trials, saving working memory for task-relevant items. We examined this hypothesis in word-list probe recognition. We found no difference in PI related to span. Instead, ex-Gaussian analysis of reaction time showed speed…

Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct.

PubMed

Lee, Howard; Lee, Heechan; Baik, Jungmi; Kim, Hyunjung; Kim, Rachel

2017-01-01

Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. A total of 114 failure modes were identified with an RPN score ranging 3-378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes.

Comparative Effectiveness of Proactive Tobacco Treatment among Smokers with and without Chronic Lower Respiratory Disease.

PubMed

Melzer, Anne C; Clothier, Barbara A; Japuntich, Sandra J; Noorbaloochi, Siamak; Hammett, Patrick; Burgess, Diana J; Joseph, Anne M; Fu, Steven S

2018-03-01

Adults with chronic lower respiratory disease differ in their barriers to smoking cessation but also suffer from tobacco-related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without chronic lower respiratory disease. We examined the effectiveness of a proactive outreach program for cessation among smokers with and without chronic lower respiratory disease. Subgroup analysis of the Veterans Victory over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared with usual care. Smokers identified via the electronic medical record were proactively offered phone-based counseling and care coordination to receive medication from their Veterans Affairs providers or in-person care. We compared the response among those with and without an International Classification of Diseases, 9th Revision diagnosis of a chronic lower respiratory disease (chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma). We used stratification by propensity scores to adjust for imbalanced covariates between groups with and without chronic lower respiratory disease within each treatment arm, using complete case analysis accounting for the stratified sampling by site. The study participants were predominantly older, white, male smokers. Overall, 19.6% had chronic lower respiratory disease. A total of 3,307 had outcome data with the following assignments to the intervention: proactive care: n = 1,272 without chronic lower respiratory disease, n = 301 with chronic lower respiratory disease; usual care: n = 1,387 without chronic lower respiratory disease, n = 347 with chronic lower respiratory disease. A total of 1,888 had both complete baseline and outcome data and were included in the primary analysis. In unadjusted analyses (n = 3,307), among individuals with chronic lower respiratory disease, 13.1% in the proactive group reported 6-month prolonged abstinence compared with 8.7% of those in the usual care group (odds ratio, 1.57; 95% confidence interval, 0.93-2.65). Among individuals without chronic lower respiratory disease, 13.1% quit in the proactive group compared with 11.0% in the usual care group (odds ratio, 1.22; 95% confidence interval, 0.95-1.55). In adjusted analyses (n = 1,888), the association between treatment arm and quit rate varied by the presence of chronic lower respiratory disease, with a stronger association between allocation to the proactive group and quit rate among those with chronic lower respiratory disease (odds ratio, 3.45; 95% confidence interval, 1.59-7.47) than those without chronic lower respiratory disease (odds ratio, 1.34; 95% confidence interval, 0.95-1.88; P for interaction with chronic lower respiratory disease = 0.03). Smokers with chronic lower respiratory disease may be more likely to respond to a proactive outreach intervention for tobacco cessation treatment than those without chronic lower respiratory disease. Clinical trial registered with www.clinicaltrials.gov (NCT 00608426).

Development of the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP).

PubMed

Farmer, Cristan A; Aman, Michael G

2009-01-01

Whereas some scales exist for assessing aggression in typically developing children, they do not give a detailed analysis, and none is available for populations with developmental disabilities (DD). Parents of 365 children with DD completed the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP), which surveys the severity of aggressive and hostile behaviors (Problem Scale) in addition to their proactive or reactive qualities (the Provocation Scale). Factor analysis yielded a 5-factor solution: I. Verbal Aggression (12 items), II. Bullying (12 items), III. Covert Aggression (11 items), IV. Hostility (9 items), and V. Physical Aggression (8 items). Coefficient alpha ranged from moderate (0.74, Physical Aggression) to high (0.92, Verbal Aggression). General validity was supported by expected differences between age and gender groups. Preliminary normative data were presented. The C-SHARP appears to be a promising tool for assessing aggression and hostility in children with DD.

Method for detecting core malware sites related to biomedical information systems.

PubMed

Kim, Dohoon; Choi, Donghee; Jin, Jonghyun

2015-01-01

Most advanced persistent threat attacks target web users through malicious code within landing (exploit) or distribution sites. There is an urgent need to block the affected websites. Attacks on biomedical information systems are no exception to this issue. In this paper, we present a method for locating malicious websites that attempt to attack biomedical information systems. Our approach uses malicious code crawling to rearrange websites in the order of their risk index by analyzing the centrality between malware sites and proactively eliminates the root of these sites by finding the core-hub node, thereby reducing unnecessary security policies. In particular, we dynamically estimate the risk index of the affected websites by analyzing various centrality measures and converting them into a single quantified vector. On average, the proactive elimination of core malicious websites results in an average improvement in zero-day attack detection of more than 20%.

Method for Detecting Core Malware Sites Related to Biomedical Information Systems

PubMed Central

Kim, Dohoon; Choi, Donghee; Jin, Jonghyun

2015-01-01

Most advanced persistent threat attacks target web users through malicious code within landing (exploit) or distribution sites. There is an urgent need to block the affected websites. Attacks on biomedical information systems are no exception to this issue. In this paper, we present a method for locating malicious websites that attempt to attack biomedical information systems. Our approach uses malicious code crawling to rearrange websites in the order of their risk index by analyzing the centrality between malware sites and proactively eliminates the root of these sites by finding the core-hub node, thereby reducing unnecessary security policies. In particular, we dynamically estimate the risk index of the affected websites by analyzing various centrality measures and converting them into a single quantified vector. On average, the proactive elimination of core malicious websites results in an average improvement in zero-day attack detection of more than 20%. PMID:25821511

Impaired inhibition of proactive interference in abstinent individuals with alcoholism.

PubMed

Noël, Xavier; Billieux, Joël; Van der Linden, Martial; Dan, Bernard; Hanak, Catherine; de Bournonville, Stéphanie; Baurain, Céline; Verbanck, Paul

2009-01-01

Cognitive impairment has been associated with higher risk of alcoholism and relapse. Recent theoretical refinements have separated inhibition of dominant response and inhibition of proactive interference. We assessed the latter using a directed-forgetting procedure in 38 recently detoxified individuals with alcoholism and in 26 controls. On this task, memory performance of letter trigrams was compared when presented alone, followed by a second trigram to be recalled, then a second trigram to be forgotten (directed-forgetting condition). Individuals with alcoholism recalled more letters to be forgotten and performed worse than controls in the directed-forgetting condition, which significantly correlated with the duration of alcoholism.

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.

The role of delinquency, proactive aggression, psychopathy and behavioral school engagement in reported youth gang membership.

PubMed

Ang, Rebecca P; Huan, Vivien S; Chan, Wei Teng; Cheong, Siew Ann; Leaw, Jia Ning

2015-06-01

Given the robust positive association between gangs and crime, a better understanding of factors related to reported youth gang membership is critical and especially since youth in gangs are a universal concern. The present study investigated the role of delinquency, proactive aggression, psychopathy and behavioral school engagement in reported youth gang membership using a large sample of 1027 Singapore adolescents. Results from logistic regression showed that delinquency, proactive aggression, and behavioral school engagement were statistically significant risk factors for reported youth gang membership, and that psychopathy was not related to reported gang membership. Implications for prevention and intervention work with respect to youth gang membership were discussed. In particular, strengthening students' engagement with school and meaningful school-related activities and developing supportive teacher-student relationships are particularly important in working with young people with respect to prevention work. Additionally, the present study's theoretical and empirical contributions were also discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Interactions between Callous Unemotional Behaviors and Executive Function in Early Childhood Predict later Aggression and Lower Peer-liking in Late-childhood.

PubMed

Waller, Rebecca; Hyde, Luke W; Baskin-Sommers, Arielle R; Olson, Sheryl L

2017-04-01

Callous unemotional (CU) behaviors are linked to aggression, behavior problems, and difficulties in peer relationships in children and adolescents. However, few studies have examined whether early childhood CU behaviors predict aggression or peer-rejection during late-childhood or potential moderation of this relationship by executive function. The current study examined whether the interaction of CU behaviors and executive function in early childhood predicted different forms of aggression in late-childhood, including proactive, reactive, and relational aggression, as well as how much children were liked by their peers. Data from cross-informant reports and multiple observational tasks were collected from a high-risk sample (N = 240; female = 118) at ages 3 and 10 years old. Parent reports of CU behaviors at age 3 predicted teacher reports of reactive, proactive, and relational aggression, as well as lower peer-liking at age 10. Moderation analysis showed that specifically at high levels of CU behaviors and low levels of observed executive function, children were reported by teachers as showing greater reactive and proactive aggression, and were less-liked by peers. Findings demonstrate that early childhood CU behaviors and executive function have unique main and interactive effects on both later aggression and lower peer-liking even when taking into account stability in behavior problems over time. By elucidating how CU behaviors and deficits in executive function potentiate each other during early childhood, we can better characterize the emergence of severe and persistent behavior and interpersonal difficulties across development.

Interaction of healthcare staff's attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment.

PubMed

Regolisti, Giuseppe; Maggiore, Umberto; Sabatino, Alice; Gandolfini, Ilaria; Pioli, Sarah; Torino, Claudia; Aucella, Filippo; Cupisti, Adamasco; Pistolesi, Valentina; Capitanini, Alessandro; Caloro, Giorgia; Gregorini, Mariacristina; Battaglia, Yuri; Mandreoli, Marcora; Dani, Lucia; Mosconi, Giovanni; Bellizzi, Vincenzo; Di Iorio, Biagio Raffaele; Conti, Paolo; Fiaccadori, Enrico

2018-01-01

In hemodialysis patients, sedentarism is a potentially modifiable mortality risk factor. We explored whether healthcare staff's attitude towards exercise interacts with patient-perceived barriers in modifying the level of physical activity in this population. In this prospective, cross-sectional, multicenter study we recruited 608 adult patients and 330 members of the healthcare staff in 16 hemodialysis units in Italy. We assessed patient-perceived barriers to, and healthcare staff's attitude towards, exercise by specific questionnaires. We fitted multilevel linear models to analyze the relationships of either barriers or staff's attitude, and their interaction, with a measure of patient self-reported physical activity (the Human Activity Profile-Adjusted Activity Score [HAP-AAS]), adjusting for multiple confounders. We also employed latent class analysis to dichotomize patients into those endorsing or not endorsing barriers. Most barriers were negatively associated with the HAP-AAS (adjusted change attributable to a given barrier ranging between -5.1 ["Feeling too old", 95% Confidence Interval: -9.4 to -0.8] and -15.6 ["Ulcers on legs and feet", 95%CI: -24.8 to -6.5]. We found a significant interaction between staff's attitude and barriers (adjusted P values ranging between 0.03 ["I do not believe that it is physician's or nurse's role providing advice on exercise to patients on dialysis"] and 0.001 ["I do not often ask patients about exercise"]). A beneficial effect of a proactive staff's attitude was evident only in patients not endorsing barriers. Barriers and non-proactive staff's attitude reduce physical activity in hemodialysis patients. Patients not endorsing barriers benefit the most from a proactive staff's attitude.

Systematic detection of polyvascular disease combined with aggressive secondary prevention in patients presenting with severe coronary artery disease: The randomized AMERICA Study.

PubMed

Collet, Jean-Philippe; Cayla, Guillaume; Ennezat, Pierre-Vladimir; Leclercq, Florence; Cuisset, Thomas; Elhadad, Simon; Henry, Patrick; Belle, Loic; Cohen, Ariel; Silvain, Johanne; Barthelemy, Olivier; Beygui, Farzin; Diallo, Abdourahmane; Vicaut, Eric; Montalescot, Gilles

2018-03-01

The prevalence and associated-risk of asymptomatic multisite artery disease (MSAD) in high risk coronary patients are unknown. Whether systematic identification and aggressive management of asymptomatic MSAD is clinically relevant in high risk coronary patients has not been evaluated. We randomly assigned 521 high risk coronary patients defined by the presence of three-vessel coronary disease (n=304) or recent acute coronary syndrome beyond the age of 75years (n=215) to either a strategy of systematic detection of asymptomatic MSAD combined with an aggressive secondary prevention (n=263) or to a more conventional strategy based on treatment of coronary artery disease only with standard of care (n=258). The primary end point was the time to first occurrence of death, any organ failure or ischemic event leading to re-hospitalization through two years of follow-up. The pro-active strategy identified asymptomatic MSAD in 21.7% of patients with few revascularizations (3.6%); the pro-active pharmacological secondary prevention was obtained in >85% of patients and life-style changes in <60% of patients. At 2-year follow-up, the primary end point occurred in 44.9% of patients in the pro-active group and 43.0% of patients in the conventional group (HR 1.03; 95% confidence interval [CI], 0.80 to 1.34]. The rate of major bleeding did not differ significantly between groups (4.6% vs 5.0%; HR, 0.97; 95% CI, 0.40 to 1.91). In high risk coronary patients, there is no apparent benefit of a systematic detection of asymptomatic extra-coronary atherothrombotic disease and intensified treatment over a 2-year follow-up period. (Funded by the Academic Allies in Cardiovascular Trials Initiatives and Organized Networks and Institut de l'Athérothrombose; AMERICA ClinicalTrials.gov number, NCT00445835). Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Multi-hazard risk analysis for management strategies

NASA Astrophysics Data System (ADS)

Kappes, M.; Keiler, M.; Bell, R.; Glade, T.

2009-04-01

Risk management is very often operating in a reactive way, responding to an event, instead of proactive starting with risk analysis and building up the whole process of risk evaluation, prevention, event management and regeneration. Since damage and losses from natural hazards raise continuously more and more studies, concepts (e.g. Switzerland or South Tyrol-Bolozano) and software packages (e.g. ARMAGEDOM, HAZUS or RiskScape) are developed to guide, standardize and facilitate the risk analysis. But these approaches focus on different aspects and are mostly closely adapted to the situation (legislation, organization of the administration, specific processes etc.) of the specific country or region. We propose in this study the development of a flexible methodology for multi-hazard risk analysis, identifying the stakeholders and their needs, processes and their characteristics, modeling approaches as well as incoherencies occurring by combining all these different aspects. Based on this concept a flexible software package will be established consisting of ArcGIS as central base and being complemented by various modules for hazard modeling, vulnerability assessment and risk calculation. Not all modules will be developed newly but taken from the current state-of-the-art and connected or integrated into ArcGIS. For this purpose two study sites, Valtellina in Italy and Bacelonnette in France, were chosen and the hazards types debris flows, rockfalls, landslides, avalanches and floods are planned to be included in the tool for a regional multi-hazard risk analysis. Since the central idea of this tool is its flexibility this will only be a first step, in the future further processes and scales can be included and the instrument thus adapted to any study site.

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.

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…

Continuous Learning: Balancing Educational Excellence and Cultural Diversity for At-Risk. A Developing, Generalizing, Working Model.

ERIC Educational Resources Information Center

Demery, Marie

This proactive research and development model presents data of misfortune, reality, and hope for approximately 40 percent of American children labeled as "at-risk." The model was based on the premise that in spite of their past and an environment of failure, these children can learn successfully and continuously through the balancing of…

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…

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

Thurman, J.

Can operating companies cost-effectively manage environmental risks, meet compliance requirements and attain financial and market-oriented goals? Yes, if top management fully supports incorporating environmental-risk issues into the corporate management system. Using evaluation tools such as risk assessment and environmental audits, operators can fully define their environment condition and risk level. Working these results, HPI companies can take action to reduce the probability of environmental accidents and mitigate adverse event effects. Adopting this top-down, proactive outlook, organizations can evade environmental catastrophes, avoid negative public image and prevent ruined reputations.

Use of failure mode and effects analysis for proactive identification of communication and handoff failures from organ procurement to transplantation.

PubMed

Steinberger, Dina M; Douglas, Stephen V; Kirschbaum, Mark S

2009-09-01

A multidisciplinary team from the University of Wisconsin Hospital and Clinics transplant program used failure mode and effects analysis to proactively examine opportunities for communication and handoff failures across the continuum of care from organ procurement to transplantation. The team performed a modified failure mode and effects analysis that isolated the multiple linked, serial, and complex information exchanges occurring during the transplantation of one solid organ. Failure mode and effects analysis proved effective for engaging a diverse group of persons who had an investment in the outcome in analysis and discussion of opportunities to improve the system's resilience for avoiding errors during a time-pressured and complex process.

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.

Full Implementation of Screening for Nutritional Risk and Dysphagia in an Acute Stroke Unit: A Clinical Audit.

PubMed

Kampman, Margitta T; Eltoft, Agnethe; Karaliute, Migle; Børvik, Margrethe T; Nilssen, Hugo; Rasmussen, Ida; Johnsen, Stein H

2015-10-01

In patients with acute stroke, undernutrition and aspiration pneumonia are associated with increased mortality and length of hospital stay. Formal screening for nutritional risk and dysphagia helps to ensure optimal nutritional management in all patients with stroke and to reduce the risk of aspiration in patients with dysphagia. We developed a national guideline for nutritional and dysphagia screening in acute stroke, which was introduced in our stroke unit on June 1, 2012. The primary objective was to audit adherence to the guideline and to achieve full implementation. Second, we assessed the prevalence of nutritional risk and dysphagia. We performed a chart review to assess performance of screening for nutritional risk and dysphagia in all patients with stroke hospitalized for ≥48 hours between June 1, 2012, and May 31, 2013. Next we applied a "clinical microsystems approach" with rapid improvement cycles and audits over a 6-month period to achieve full implementation. The chart review showed that nutritional risk screening was performed in 65% and swallow testing in 91% of eligible patients (n = 185). Proactive implementation resulted in >95% patients screened (n = 79). The overall prevalence of nutritional risk was 29%, and 23% of the patients failed the initial swallow test. Proactive implementation is required to obtain high screening rates for nutritional risk and swallowing difficulties using validated screening tools. The proportion of patients at nutritional risk and the prevalence of dysphagia at initial swallow test were in the lower range of previous reports.

Assessment of horse creek conservation seeding

USDA-ARS?s Scientific Manuscript database

Millions of acres of big sagebrush (Artemisia tridentata)/bunchgrass communities have been invaded by the exotic and invasive annual, cheatgrass (Bromus tectorum) and require pro-active management to reduce the risk of catastrophic wildfires. The introduction of cheatgrass has increased the chance, ...

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.

Telephone counselling for smoking cessation.

PubMed

Stead, Lindsay F; Hartmann-Boyce, Jamie; Perera, Rafael; Lancaster, Tim

2013-08-12

Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. To evaluate the effect of proactive and reactive telephone support via helplines and in other settings to help smokers quit. We searched the Cochrane Tobacco Addiction Group Specialised Register for studies of telephone counselling, using search terms including 'hotlines' or 'quitline' or 'helpline'. Date of the most recent search: May 2013. randomized or quasi-randomised controlled trials in which proactive or reactive telephone counselling to assist smoking cessation was offered to smokers or recent quitters. One author identified and data extracted trials, and a second author checked them. The main outcome measure was the risk ratio for abstinence from smoking after at least six months follow-up. We selected the strictest measure of abstinence, using biochemically validated rates where available. We considered participants lost to follow-up to be continuing smokers. Where trials had more than one arm with a less intensive intervention we used only the most similar intervention without the telephone component as the control group in the primary analysis. We assessed statistical heterogeneity amongst subgroups of clinically comparable studies using the I² statistic. We considered trials recruiting callers to quitlines separately from studies recruiting in other settings. Where appropriate, we pooled studies using a fixed-effect model. We used a meta-regression to investigate the effect of differences in planned number of calls, selection for motivation, and the nature of the control condition (self help only, minimal intervention, pharmacotherapy) in the group of studies recruiting in non-quitline settings. Seventy-seven trials met the inclusion criteria. Some trials were judged to be at risk of bias in some domains but overall we did not judge the results to be at high risk of bias. Among smokers who contacted helplines, quit rates were higher for groups randomized to receive multiple sessions of proactive counselling (nine studies, > 24,000 participants, risk ratio (RR) for cessation at longest follow-up 1.37, 95% confidence interval (CI) 1.26 to 1.50). There was mixed evidence about whether increasing the number of calls altered quit rates but most trials used more than two calls. Three studies comparing different counselling approaches during a single quitline contact did not detect significant differences. Of three studies that tested the provision of access to a hotline two detected a significant benefit and one did not.Telephone counselling not initiated by calls to helplines also increased quitting (51 studies, > 30,000 participants, RR 1.27; 95% CI 1.20 to 1.36). In a meta-regression controlling for other factors the effect was estimated to be slightly larger if more calls were offered, and in trials that specifically recruited smokers motivated to try to quit. The relative extra benefit of counselling was smaller when it was provided in addition to pharmacotherapy (usually nicotine replacement therapy) than when the control group only received self-help material or a brief intervention.A further eight studies were too diverse to contribute to meta-analyses and are discussed separately. Two compared different intensities of counselling, both of which detected a dose response; one of these detected a benefit of multiple counselling sessions over a single call for people prescribed bupropion. The others tested a variety of interventions largely involving offering telephone counselling as part of a referral or systems change and none detected evidence of effect. Proactive telephone counselling aids smokers who seek help from quitlines. Telephone quitlines provide an important route of access to support for smokers, and call-back counselling enhances their usefulness. There is limited evidence about the optimal number of calls. Proactive telephone counselling also helps people who receive it in other settings. There is some evidence of a dose response; one or two brief calls are less likely to provide a measurable benefit. Three or more calls increase the chances of quitting compared to a minimal intervention such as providing standard self-help materials, or brief advice, or compared to pharmacotherapy alone.

Pleiotropic Contribution of MECOM and AVPR1A to Aggression and Subcortical Brain Volumes

PubMed Central

van Donkelaar, Marjolein M. J.; Hoogman, Martine; Pappa, Irene; Tiemeier, Henning; Buitelaar, Jan K.; Franke, Barbara; Bralten, Janita

2018-01-01

Reactive and proactive subtypes of aggression have been recognized to help parse etiological heterogeneity of this complex phenotype. With a heritability of about 50%, genetic factors play a role in the development of aggressive behavior. Imaging studies implicate brain structures related to social behavior in aggression etiology, most notably the amygdala and striatum. This study aimed to gain more insight into the pathways from genetic risk factors for aggression to aggression phenotypes. To this end, we conducted genome-wide gene-based cross-trait meta-analyses of aggression with the volumes of amygdala, nucleus accumbens and caudate nucleus to identify genes influencing both aggression and aggression-related brain volumes. We used data of large-scale genome-wide association studies (GWAS) of: (a) aggressive behavior in children and adolescents (EAGLE, N = 18,988); and (b) Magnetic Resonance Imaging (MRI)-based volume measures of aggression-relevant subcortical brain regions (ENIGMA2, N = 13,171). Second, the identified genes were further investigated in a sample of healthy adults (mean age (SD) = 25.28 (4.62) years; 43% male) who had genome-wide genotyping data and questionnaire data on aggression subtypes available (Brain Imaging Genetics, BIG, N = 501) to study their effect on reactive and proactive subtypes of aggression. Our meta-analysis identified two genes, MECOM and AVPR1A, significantly associated with both aggression risk and nucleus accumbens (MECOM) and amygdala (AVPR1A) brain volume. Subsequent in-depth analysis of these genes in healthy adults (BIG), including sex as an interaction term in the model, revealed no significant subtype-specific gene-wide associations. Using cross-trait meta-analysis of brain measures and psychiatric phenotypes, this study generated new hypotheses about specific links between genes, the brain and behavior. Results indicate that MECOM and AVPR1A may exert an effect on aggression through mechanisms involving nucleus accumbens and amygdala volumes, respectively. PMID:29666571

Risk Factors of Occupational Fraud: A Study of Member Institutions of the National Association of Independent Colleges and Universities

ERIC Educational Resources Information Center

Ten Napel, Karmen

2013-01-01

Available data indicate that colleges and universities have experienced an unexpected rise in occupational fraud over the past two decades. In order to mitigate the risk of fraud, these institutions must be proactive and have strong internal controls and policies. The purpose of this study was to examine the current controls in place at Midwest…

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.…

Insider Risk Evaluation and Audit

DTIC Science & Technology

2009-08-01

by security or other management personnel as proactive measures to minimize insider risk. The study recommends that this tool be used to assess an...burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense...VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to

Mediation of the relationship between callous-unemotional traits and proactive aggression by amygdala response to fear among children with conduct problems.

PubMed

Lozier, Leah M; Cardinale, Elise M; VanMeter, John W; Marsh, Abigail A

2014-06-01

Among youths with conduct problems, callous-unemotional (CU) traits are known to be an important determinant of symptom severity, prognosis, and treatment responsiveness. But positive correlations between conduct problems and CU traits result in suppressor effects that may mask important neurobiological distinctions among subgroups of children with conduct problems. To assess the unique neurobiological covariates of CU traits and externalizing behaviors in youths with conduct problems and determine whether neural dysfunction linked to CU traits mediates the link between callousness and proactive aggression. This cross-sectional case-control study involved behavioral testing and neuroimaging that were conducted at a university research institution. Neuroimaging was conducted using a 3-T Siemens magnetic resonance imaging scanner. It included 46 community-recruited male and female juveniles aged 10 to 17 years, including 16 healthy control participants and 30 youths with conduct problems with both low and high levels of CU traits. Blood oxygenation level-dependent signal as measured via functional magnetic resonance imaging during an implicit face-emotion processing task and analyzed using whole-brain and region of interest-based analysis of variance and multiple-regression analyses. Analysis of variance revealed no group differences in the amygdala. By contrast, consistent with the existence of suppressor effects, multiple-regression analysis found amygdala responses to fearful expressions to be negatively associated with CU traits (x = 26, y = 0, z = -12; k = 1) and positively associated with externalizing behavior (x = 24, y = 0, z = -14; k = 8) when both variables were modeled simultaneously. Reduced amygdala responses mediated the relationship between CU traits and proactive aggression. The results linked proactive aggression in youths with CU traits to hypoactive amygdala responses to emotional distress cues, consistent with theories that externalizing behaviors, particularly proactive aggression, in youths with these traits stem from deficient empathic responses to distress. Amygdala hypoactivity may represent an intermediate phenotype, offering new insights into effective treatment strategies for conduct problems.

The Aviation System Monitoring and Modeling (ASMM) Project: A Documentation of its History and Accomplishments: 1999-2005

NASA Technical Reports Server (NTRS)

Statler, Irving C. (Editor)

2007-01-01

The Aviation System Monitoring and Modeling (ASMM) Project was one of the projects within NASA s Aviation Safety Program from 1999 through 2005. The objective of the ASMM Project was to develop the technologies to enable the aviation industry to undertake a proactive approach to the management of its system-wide safety risks. The ASMM Project entailed four interdependent elements: (1) Data Analysis Tools Development - develop tools to convert numerical and textual data into information; (2) Intramural Monitoring - test and evaluate the data analysis tools in operational environments; (3) Extramural Monitoring - gain insight into the aviation system performance by surveying its front-line operators; and (4) Modeling and Simulations - provide reliable predictions of the system-wide hazards, their causal factors, and their operational risks that may result from the introduction of new technologies, new procedures, or new operational concepts. This report is a documentation of the history of this highly successful project and of its many accomplishments and contributions to improved safety of the aviation system.

Social engineering: mitigating a stealthy risk.

PubMed

Maas, Jos

2014-01-01

Can a Healthcare Facility (HCF) be victimized by Social Engineering (SE)? Yes, says the author If so, what can you do about it? This article explains what Social Engineering is; how it is used; and how to use proactive security to prevent such an attack.

Liquid Rocket Engine Testing

NASA Technical Reports Server (NTRS)

Rahman, Shamim

2005-01-01

Comprehensive Liquid Rocket Engine testing is essential to risk reduction for Space Flight. Test capability represents significant national investments in expertise and infrastructure. Historical experience underpins current test capabilities. Test facilities continually seek proactive alignment with national space development goals and objectives including government and commercial sectors.

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).

Failure mode and effects analysis drastically reduced potential risks in clinical trial conduct

PubMed Central

Baik, Jungmi; Kim, Hyunjung; Kim, Rachel

2017-01-01

Background Failure mode and effects analysis (FMEA) is a risk management tool to proactively identify and assess the causes and effects of potential failures in a system, thereby preventing them from happening. The objective of this study was to evaluate effectiveness of FMEA applied to an academic clinical trial center in a tertiary care setting. Methods A multidisciplinary FMEA focus group at the Seoul National University Hospital Clinical Trials Center selected 6 core clinical trial processes, for which potential failure modes were identified and their risk priority number (RPN) was assessed. Remedial action plans for high-risk failure modes (RPN >160) were devised and a follow-up RPN scoring was conducted a year later. Results A total of 114 failure modes were identified with an RPN score ranging 3–378, which was mainly driven by the severity score. Fourteen failure modes were of high risk, 11 of which were addressed by remedial actions. Rescoring showed a dramatic improvement attributed to reduction in the occurrence and detection scores by >3 and >2 points, respectively. Conclusions FMEA is a powerful tool to improve quality in clinical trials. The Seoul National University Hospital Clinical Trials Center is expanding its FMEA capability to other core clinical trial processes. PMID:29089745

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.

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.

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

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

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.

Risk Management for the International Space Station

NASA Technical Reports Server (NTRS)

Sebastian, J.; Brezovic, Philip

2002-01-01

The International Space Station (ISS) is an extremely complex system, both technically and programmatically. The Space Station must support a wide range of payloads and missions. It must be launched in numerous launch packages and be safely assembled and operated in the harsh environment of space. It is being designed and manufactured by many organizations, including the prime contractor, Boeing, the NASA institutions, and international partners and their contractors. Finally, the ISS has multiple customers, (e.g., the Administration, Congress, users, public, international partners, etc.) with contrasting needs and constraints. It is the ISS Risk Management Office strategy to proactively and systematically manages risks to help ensure ISS Program success. ISS program follows integrated risk management process (both quantitative and qualitative) and is integrated into ISS project management. The process and tools are simple and seamless and permeate to the lowest levels (at a level where effective management can be realized) and follows the continuous risk management methodology. The risk process assesses continually what could go wrong (risks), determine which risks need to be managed, implement strategies to deal with those risks, and measure effectiveness of the implemented strategies. The process integrates all facets of risk including cost, schedule and technical aspects. Support analysis risk tools like PRA are used to support programatic decisions and assist in analyzing risks.

Decision making for animal health and welfare: integrating risk-benefit analysis with prospect theory.

PubMed

Hansson, Helena; Lagerkvist, Carl Johan

2014-06-01

This study integrated risk-benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers' choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder-health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers' assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers' management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds. © 2013 Society for Risk Analysis.

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

Delayed breast cancer presentation: hospital data should inform proactive primary care

PubMed Central

Lunda, Samy; Fernandez, Leticia

2013-01-01

Abstract Background Breast (and cervical) cancer affects a growing proportion of women in South Africa. Although treatable, where health literacy is low, women typically seek medical attention only when their condition is at an advanced stage and difficult to contain. Objectives To understand the sociodemographic characteristics of women who present with advanced breast cancer in order to intervene proactively in primary care. Method A retrospective analysis of women with advanced breast cancer (Stage IIb and higher) at a Level 2 regional hospital in South Africa (2007–2010). Results The average age amongst the 103 women enrolled in this study was 59. One-third of the women had secondary education, 35% were unemployed and two-thirds were not married. Nearly 11% (n = 11) of the women had previously had cancer. Lumps (n = 87) were the most common reason for seeking healthcare and were, together with axillary lymph node abnormalities (84.5% and 19.4% respectively), the most common clinical symptoms. Symptoms were noticed by 52% (n = 54) of the women more than six months prior to their first consultation. A personal history of cancer increased threefold the odds of presenting within three months. Middle-aged women were twice as likely as those < 45 and > 65 to report within three to six months. Secondary education increased the odds of presenting within three to six months by 56%. Employment and marital status were not significant. Conclusion The women most at risk for delayed detection and treatment were those without a history of breast cancer, aged < 45 and > 65, with low education. They can best be reached through low-cost community-orientated primary care that proactively provides health education and promotes self- and clinical examination at the individual, family, clinic and general practitioner level.

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.

Six sigma tools for a patient safety-oriented, quality-checklist driven radiation medicine department.

PubMed

Kapur, Ajay; Potters, Louis

2012-01-01

The purpose of this work was to develop and implement six sigma practices toward the enhancement of patient safety in an electronic, quality checklist-driven, multicenter, paperless radiation medicine department. A quality checklist process map (QPM), stratified into consultation through treatment-completion stages was incorporated into an oncology information systems platform. A cross-functional quality management team conducted quality-function-deployment and define-measure-analyze-improve-control (DMAIC) six sigma exercises with a focus on patient safety. QPM procedures were Pareto-sorted in order of decreasing patient safety risk with failure mode and effects analysis (FMEA). Quantitative metrics for a grouped set of highest risk procedures were established. These included procedural delays, associated standard deviations and six sigma Z scores. Baseline performance of the QPM was established over the previous year of usage. Data-driven analysis led to simplification, standardization, and refinement of the QPM with standard deviation, slip-day reduction, and Z-score enhancement goals. A no-fly policy (NFP) for patient safety was introduced at the improve-control DMAIC phase, with a process map interlock imposed on treatment initiation in the event of FMEA-identified high-risk tasks being delayed or not completed. The NFP was introduced in a pilot phase with specific stopping rules and the same metrics used for performance assessments. A custom root-cause analysis database was deployed to monitor patient safety events. Relative to the baseline period, average slip days and standard deviations for the risk-enhanced QPM procedures improved by over threefold factors in the NFP period. The Z scores improved by approximately 20%. A trend for proactive delays instead of reactive hard stops was observed with no adverse effects of the NFP. The number of computed potential no-fly delays per month dropped from 60 to 20 over a total of 520 cases. The fraction of computed potential no-fly cases that were delayed in NFP compliance rose from 28% to 45%. Proactive delays rose to 80% of all delayed cases. For potential no-fly cases, event reporting rose from 18% to 50%, while for actually delayed cases, event reporting rose from 65% to 100%. With complex technologies, resource-compromised staff, and pressures to hasten treatment initiation, the use of the six sigma driven process interlocks may mitigate potential patient safety risks as demonstrated in this study. Copyright © 2012 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

NORTHEAST LOON STUDY WORKING GROUP PARTNERSHIP TO ASSESS ENVIRONMENTAL RISK

EPA Science Inventory

The Northeast Loon Study Working Group (NELSWG) was formed in 1994 to proactively identify threats to one of the Northeast's most popular waterbirds, the common loon, Gavia immer. Seventeen institutions have come together to identify strategy, coordinate the work load, and share ...

Risk intelligence: making profit from uncertainty in data processing system.

PubMed

Zheng, Si; Liao, Xiangke; Liu, Xiaodong

2014-01-01

In extreme scale data processing systems, fault tolerance is an essential and indispensable part. Proactive fault tolerance scheme (such as the speculative execution in MapReduce framework) is introduced to dramatically improve the response time of job executions when the failure becomes a norm rather than an exception. Efficient proactive fault tolerance schemes require precise knowledge on the task executions, which has been an open challenge for decades. To well address the issue, in this paper we design and implement RiskI, a profile-based prediction algorithm in conjunction with a riskaware task assignment algorithm, to accelerate task executions, taking the uncertainty nature of tasks into account. Our design demonstrates that the nature uncertainty brings not only great challenges, but also new opportunities. With a careful design, we can benefit from such uncertainties. We implement the idea in Hadoop 0.21.0 systems and the experimental results show that, compared with the traditional LATE algorithm, the response time can be improved by 46% with the same system throughput.

Risk Intelligence: Making Profit from Uncertainty in Data Processing System

PubMed Central

Liao, Xiangke; Liu, Xiaodong

2014-01-01

In extreme scale data processing systems, fault tolerance is an essential and indispensable part. Proactive fault tolerance scheme (such as the speculative execution in MapReduce framework) is introduced to dramatically improve the response time of job executions when the failure becomes a norm rather than an exception. Efficient proactive fault tolerance schemes require precise knowledge on the task executions, which has been an open challenge for decades. To well address the issue, in this paper we design and implement RiskI, a profile-based prediction algorithm in conjunction with a riskaware task assignment algorithm, to accelerate task executions, taking the uncertainty nature of tasks into account. Our design demonstrates that the nature uncertainty brings not only great challenges, but also new opportunities. With a careful design, we can benefit from such uncertainties. We implement the idea in Hadoop 0.21.0 systems and the experimental results show that, compared with the traditional LATE algorithm, the response time can be improved by 46% with the same system throughput. PMID:24883392

In-home behavioral health case management: an integrated model for high-risk populations.

PubMed

Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

2006-01-01

The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

Proactive human-computer collaboration for information discovery

NASA Astrophysics Data System (ADS)

DiBona, Phil; Shilliday, Andrew; Barry, Kevin

2016-05-01

Lockheed Martin Advanced Technology Laboratories (LM ATL) is researching methods, representations, and processes for human/autonomy collaboration to scale analysis and hypotheses substantiation for intelligence analysts. This research establishes a machinereadable hypothesis representation that is commonsensical to the human analyst. The representation unifies context between the human and computer, enabling autonomy in the form of analytic software, to support the analyst through proactively acquiring, assessing, and organizing high-value information that is needed to inform and substantiate hypotheses.

Social, Personal and Educational Constraints on Access to Employment among Groups at Risk of Social Exclusion: Contributions from an Employment Observatory

ERIC Educational Resources Information Center

Anuncibay, Raquel de la Fuente

2007-01-01

One of the challenges raised by proactive employment policies centres on redressing inequalities that are not solely of an economic nature, as others may also be added of a social and ethnic nature as well as personal, cultural and educational aspects. This article analyses the situation in which groups at risk of social exclusion find themselves…

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...

Mitigating Real or Perceived Risks: A Pro-Active Approach for Dealing with Naysayers and Critics

NASA Technical Reports Server (NTRS)

Schutte, Bart; Jones, Kevin

2010-01-01

This slide presentation reviews an approach to mitigating real or perceived risks from "Naysayers" and critics in developing and using the software tools available with web 2.0. Some of the issues are about the use of the tools, the ability of management to control the use of these tools, privacy issues and the time the people spend using these tools.

An Extensible Information Grid for Risk Management

NASA Technical Reports Server (NTRS)

Maluf, David A.; Bell, David G.

2003-01-01

This paper describes recent work on developing an extensible information grid for risk management at NASA - a RISK INFORMATION GRID. This grid is being developed by integrating information grid technology with risk management processes for a variety of risk related applications. To date, RISK GRID applications are being developed for three main NASA processes: risk management - a closed-loop iterative process for explicit risk management, program/project management - a proactive process that includes risk management, and mishap management - a feedback loop for learning from historical risks that escaped other processes. This is enabled through an architecture involving an extensible database, structuring information with XML, schemaless mapping of XML, and secure server-mediated communication using standard protocols.

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.

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…

POLLUTION FROM THE COMBINED ACTIVITIES, ACTIONS, AND BEHAVIORS OF THE PUBLIC: PHARMACEUTICALS AND PERSONAL CARE PRODUCTS

EPA Science Inventory

ORD's four-fold objectives in its efforts have been to: (i) Identify potential (future) environmental concerns (anticipatory research and identification of emerging issues, especially to identify pivotal sources of uncertainty that might affect risk estimates), (ii) Be proactive ...

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...

Minimizing liability risks under the ACMG recommendations for reporting incidental findings in clinical exome and genome sequencing.

PubMed

Evans, Barbara J

2013-12-01

Recent recommendations by the American College of Medical Genetics and Genomics (ACMG) for reporting incidental findings present novel ethical and legal issues. This article expresses no views on the ethical aspects of these recommendations and focuses strictly on liability risks and how to minimize them. The recommendations place labs and clinicians in a new liability environment that exposes them to intentional tort lawsuits as well to traditional suits for negligence. Intentional tort suits are especially troubling because of their potential to inflict ruinous personal financial losses on individual clinicians and laboratory personnel. This article surveys this new liability landscape and describes analytical approaches for minimizing tort liabilities. To a considerable degree, liability risks can be controlled by structuring activities in ways that make future lawsuits nonviable before the suits ever arise. Proactive liability analysis is an effective tool for minimizing tort liabilities in connection with the testing and reporting activities that the ACMG recommends.

Minimizing liability risks under the ACMG recommendations for reporting incidental findings in clinical exome and genome sequencing

PubMed Central

Evans, Barbara J.

2014-01-01

Recent recommendations by the American College of Medical Genetics and Genomics (ACMG) for reporting incidental findings present novel ethical and legal issues. This article expresses no views on the ethical aspects of these recommendations and focuses strictly on liability risks and how to minimize them. The recommendations place labs and clinicians in a new liability environment that exposes them to intentional tort lawsuits as well to traditional suits for negligence. Intentional tort suits are especially troubling because of their potential to inflict ruinous personal financial losses on individual clinicians and laboratory personnel. This article surveys this new liability landscape and describes analytical approaches for minimizing tort liabilities. To a considerable degree, liability risks can be controlled by structuring activities in ways that make future lawsuits nonviable before the suits ever arise. Proactive liability analysis is an effective tool for minimizing tort liabilities in connection with the testing and reporting activities that the ACMG recommends. PMID:24030435

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.

NASA Aerospace Flight Battery Program: Wet Life of Nickel-Hydrogen (Ni-H2) Batteries. Volume 2, Part 3; Appendices

NASA Technical Reports Server (NTRS)

Jung, David S,; Lee, Leonine S.; Manzo, Michelle A.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 3 - Volume II Appendices to Part 3 - Volume I.

NASA Aerospace Flight Battery Program: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements. Volume 2/Part 2

NASA Technical Reports Server (NTRS)

Jung, David S.; Manzo, Michelle A.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 2 - Volume II Appendix A to Part 2 - Volume I.

E-health interventions for suicide prevention.

PubMed

Christensen, Helen; Batterham, Philip J; O'Dea, Bridianne

2014-08-12

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals' posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain.

E-Health Interventions for Suicide Prevention

PubMed Central

Christensen, Helen; Batterham, Philip J.; O’Dea, Bridianne

2014-01-01

Many people at risk of suicide do not seek help before an attempt, and do not remain connected to health services following an attempt. E-health interventions are now being considered as a means to identify at-risk individuals, offer self-help through web interventions or to deliver proactive interventions in response to individuals’ posts on social media. In this article, we examine research studies which focus on these three aspects of suicide and the internet: the use of online screening for suicide, the effectiveness of e-health interventions aimed to manage suicidal thoughts, and newer studies which aim to proactively intervene when individuals at risk of suicide are identified by their social media postings. We conclude that online screening may have a role, although there is a need for additional robust controlled research to establish whether suicide screening can effectively reduce suicide-related outcomes, and in what settings online screening might be most effective. The effectiveness of Internet interventions may be increased if these interventions are designed to specifically target suicidal thoughts, rather than associated conditions such as depression. The evidence for the use of intervention practices using social media is possible, although validity, feasibility and implementation remains highly uncertain. PMID:25119698

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.

The Effect of Aging on the Dynamics of Reactive and Proactive Cognitive Control of Response Interference

PubMed Central

Xiang, Ling; Zhang, Baoqiang; Wang, Baoxi; Jiang, Jun; Zhang, Fenghua; Hu, Zhujing

2016-01-01

A prime-target interference task was used to investigate the effects of cognitive aging on reactive and proactive control after eliminating frequency confounds and feature repetitions from the cognitive control measures. We used distributional analyses to explore the dynamics of the two control functions by distinguishing the strength of incorrect response capture and the efficiency of suppression control. For reactive control, within-trial conflict control and between-trial conflict adaption were analyzed. The statistical analysis showed that there were no reliable between-trial conflict adaption effects for either young or older adults. For within-trial conflict control, the results revealed that older adults showed larger interference effects on mean RT and mean accuracy. Distributional analyses showed that the decline mainly stemmed from inefficient suppression rather than from stronger incorrect responses. For proactive control, older adults showed comparable proactive conflict resolution to young adults on mean RT and mean accuracy. Distributional analyses showed that older adults were as effective as younger adults in adjusting their responses based on congruency proportion information to minimize automatic response capture and actively suppress the direct response activation. The results suggest that older adults were less proficient at suppressing interference after conflict was detected but can anticipate and prevent inference in response to congruency proportion manipulation. These results challenge earlier views that older adults have selective deficits in proactive control but intact reactive control. PMID:27847482

The Effect of Aging on the Dynamics of Reactive and Proactive Cognitive Control of Response Interference.

PubMed

Xiang, Ling; Zhang, Baoqiang; Wang, Baoxi; Jiang, Jun; Zhang, Fenghua; Hu, Zhujing

2016-01-01

A prime-target interference task was used to investigate the effects of cognitive aging on reactive and proactive control after eliminating frequency confounds and feature repetitions from the cognitive control measures. We used distributional analyses to explore the dynamics of the two control functions by distinguishing the strength of incorrect response capture and the efficiency of suppression control. For reactive control, within-trial conflict control and between-trial conflict adaption were analyzed. The statistical analysis showed that there were no reliable between-trial conflict adaption effects for either young or older adults. For within-trial conflict control, the results revealed that older adults showed larger interference effects on mean RT and mean accuracy. Distributional analyses showed that the decline mainly stemmed from inefficient suppression rather than from stronger incorrect responses. For proactive control, older adults showed comparable proactive conflict resolution to young adults on mean RT and mean accuracy. Distributional analyses showed that older adults were as effective as younger adults in adjusting their responses based on congruency proportion information to minimize automatic response capture and actively suppress the direct response activation. The results suggest that older adults were less proficient at suppressing interference after conflict was detected but can anticipate and prevent inference in response to congruency proportion manipulation. These results challenge earlier views that older adults have selective deficits in proactive control but intact reactive control.

[Failure mode effect analysis applied to preparation of intravenous cytostatics].

PubMed

Santos-Rubio, M D; Marín-Gil, R; Muñoz-de la Corte, R; Velázquez-López, M D; Gil-Navarro, M V; Bautista-Paloma, F J

2016-01-01

To proactively identify risks in the preparation of intravenous cytostatic drugs, and to prioritise and establish measures to improve safety procedures. Failure Mode Effect Analysis methodology was used. A multidisciplinary team identified potential failure modes of the procedure through a brainstorming session. The impact associated with each failure mode was assessed with the Risk Priority Number (RPN), which involves three variables: occurrence, severity, and detectability. Improvement measures were established for all identified failure modes, with those with RPN>100 considered critical. The final RPN (theoretical) that would result from the proposed measures was also calculated and the process was redesigned. A total of 34 failure modes were identified. The initial accumulated RPN was 3022 (range: 3-252), and after recommended actions the final RPN was 1292 (range: 3-189). RPN scores >100 were obtained in 13 failure modes; only the dispensing sub-process was free of critical points (RPN>100). A final reduction of RPN>50% was achieved in 9 failure modes. This prospective risk analysis methodology allows the weaknesses of the procedure to be prioritised, optimize use of resources, and a substantial improvement in the safety of the preparation of cytostatic drugs through the introduction of double checking and intermediate product labelling. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Early and Late Recurrent Epistaxis Admissions: Patterns of Incidence and Risk Factors.

PubMed

Cohen, Oded; Shoffel-Havakuk, Hagit; Warman, Meir; Tzelnick, Sharon; Haimovich, Yaara; Kohlberg, Gavriel D; Halperin, Doron; Lahav, Yonatan

2017-09-01

Objective Epistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA). Study Design Case series with chart review. Settings Single academic center. Subjects and Methods The medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow-up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission. Logistic regression was used to identify potential predictors of REAs. Results A total of 653 patients were included. Eighty-six patients (14%) had REAs: 48 (7.5%) early and 38 (6.5%) late. Nonlinear incidence curve was demonstrated for both early and late REAs. Based on logistic regression, prior nasal surgery and anemia were independent risk factors for early REAs. According to multivariate analysis, thrombocytopenia was significantly associated with late REAs. Conclusion Early and late REAs demonstrate different risk predictors. Knowledge of such risk factors may help in risk stratification for this selected group of patients. All patients at risk should be advised on possible preventive measures. Patients at risk for early REA may benefit from a more proactive approach.

Pretreatment data is highly predictive of liver chemistry signals in clinical trials.

PubMed

Cai, Zhaohui; Bresell, Anders; Steinberg, Mark H; Silberg, Debra G; Furlong, Stephen T

2012-01-01

The goal of this retrospective analysis was to assess how well predictive models could determine which patients would develop liver chemistry signals during clinical trials based on their pretreatment (baseline) information. Based on data from 24 late-stage clinical trials, classification models were developed to predict liver chemistry outcomes using baseline information, which included demographics, medical history, concomitant medications, and baseline laboratory results. Predictive models using baseline data predicted which patients would develop liver signals during the trials with average validation accuracy around 80%. Baseline levels of individual liver chemistry tests were most important for predicting their own elevations during the trials. High bilirubin levels at baseline were not uncommon and were associated with a high risk of developing biochemical Hy's law cases. Baseline γ-glutamyltransferase (GGT) level appeared to have some predictive value, but did not increase predictability beyond using established liver chemistry tests. It is possible to predict which patients are at a higher risk of developing liver chemistry signals using pretreatment (baseline) data. Derived knowledge from such predictions may allow proactive and targeted risk management, and the type of analysis described here could help determine whether new biomarkers offer improved performance over established ones.

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

Wanted: A New Breed of School Administrator--The Professional Entrepreneur.

ERIC Educational Resources Information Center

Jupe, Stephen; Murphy, Peter James

1999-01-01

Establishes a professional entrepreneurship profile of six Canadian Sylvan Learning Center owners who possess the caring values of educators and the proactive skills of business people. All six possessed a pragmatic vision, empowered their staff, and stressed quality. They advocated customer care, risk taking, fairness, and instructional…

POLLUTION FROM THE COMBINED ACTIVITIES, ACTIONS ...

EPA Pesticide Factsheets

ORD's four-fold objectives in its efforts have been to: (i) Identify potential (future) environmental concerns (anticipatory research and identification of emerging issues, especially to identify pivotal sources of uncertainty that might affect risk estimates), (ii) Be proactive versus reactive (allowing for pollution prevention versus remediation/restoration; identify and foster investigation of

The EQUIP for Educators Program

ERIC Educational Resources Information Center

DiBiase, Ann-Marie; Potter, Granville Bud; Gibbs, John C.

2011-01-01

There is a need for proactive support and early intervention to meet the needs of behaviorally at-risk students. There is limited opportunity to intervene with effective results, given that stability of antisocial behavior increases dramatically over time. Moreover, if antisocial behavior patterns are not addressed early on, these children tend to…

Aggression and the Risk for Suicidal Behaviors among Children

ERIC Educational Resources Information Center

Greening, Leilani; Stoppelbein, Laura; Luebbe, Aaron; Fite, Paula J.

2010-01-01

Two subtypes of aggression--reactive and proactive--were examined to see how they relate to suicidal behaviors among young children admitted for acute psychiatric inpatient care. The children and their parents completed self-report questionnaires/interviews. Regression analyses revealed that depressed girls who scored higher on reactive aggression…

PROACTIVE DEFENSE FOR EVOLVING SUPPLY CHAIN COUNTERFEITING

DTIC Science & Technology

2015-12-01

Mohana . "DOD’s Current Infosec Strategy Is "Patch and Pray"" Newsgroup. October 1, 2015. Defense One. Rostami, Masoud, Farinaz Koushanfar, and...Managing Supply Chain Risk Effectively. Technical paper. RESIL. 17. Ravindranath, Mohana . "DOD’s Current Infosec Strategy Is "Patch and Pray

Increasing the use of preventative health services to promote healthy eating, physical activity and weight management: the acceptability and potential effectiveness of a proactive telemarketing approach

PubMed Central

2012-01-01

Background Telephone based interventions are effective in promoting health behaviours. The use of telephone based support services to promote healthy eating, activity or weight loss, however, are currently under-utilised. The aim of this study was to assess the acceptability and potential effectiveness of a telemarketing approach in increasing community use of proactive services to encourage healthy eating, physical activity and weight loss. Methods The study employed a cross sectional design. Eligible consenting participants completed a 15 minute telephone survey conducted by trained telephone interviewers using computer assisted telephone interviewing technology. Results Overall, 87% of participants considered it acceptable for a health service to contact people by telephone to offer assistance to help them lose weight, eat healthily or be more physically active. Among participants with inadequate fruit and vegetable intake, physical activity or who were overweight, 64%, 54% and 61% respectively reported that they would use one or more of the proactive support services offered. Females and those from non -English speaking households who did not eat sufficient serves were significantly more likely to report that they would use support services. Conclusions The findings suggest that proactive telemarketing of health services to facilitate healthy eating, physical activity or weight loss is considered highly acceptable and may be effective in encouraging service use by more than half of all adults with these behavioural risks. PMID:23134686

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.

Predictive teratology: teratogenic risk-hazard identification partnered in the discovery process.

PubMed

Augustine-Rauch, K A

2008-11-01

Unexpected teratogenicity is ranked as one of the most prevalent causes for toxicity-related attrition of drug candidates. Without proactive assessment, the liability tends to be identified relatively late in drug development, following significant investment in compound and engagement in pre clinical and clinical studies. When unexpected teratogenicity occurs in pre-clinical development, three principle questions arise: Can clinical trials that include women of child bearing populations be initiated? Will all compounds in this pharmacological class produce the same liability? Could this effect be related to the chemical structure resulting in undesirable off-target adverse effects? The first question is typically addressed at the time of the unexpected finding and involves considering the nature of the teratogenicity, whether or not maternal toxicity could have had a role in onset, human exposure margins and therapeutic indication. The latter two questions can be addressed proactively, earlier in the discovery process as drug target profiling and lead compound optimization is taking place. Such proactive approaches include thorough assessment of the literature for identification of potential liabilities and follow-up work that can be conducted on the level of target expression and functional characterization using molecular biology and developmental model systems. Developmental model systems can also be applied in the form of in vitro teratogenicity screens, and show potential for effective hazard identification or issue resolution on the level of characterizing teratogenic mechanism. This review discusses approaches that can be applied for proactive assessment of compounds for teratogenic liability.

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.

[Failure mode and effects analysis to improve quality in clinical trials].

PubMed

Mañes-Sevilla, M; Marzal-Alfaro, M B; Romero Jiménez, R; Herranz-Alonso, A; Sanchez Fresneda, M N; Benedi Gonzalez, J; Sanjurjo-Sáez, M

The failure mode and effects analysis (FMEA) has been used as a tool in risk management and quality improvement. The objective of this study is to identify the weaknesses in processes in the clinical trials area, of a Pharmacy Department (PD) with great research activity, in order to improve the safety of the usual procedures. A multidisciplinary team was created to analyse each of the critical points, identified as possible failure modes, in the development of clinical trial in the PD. For each failure mode, the possible cause and effect were identified, criticality was calculated using the risk priority number and the possible corrective actions were discussed. Six sub-processes were defined in the development of the clinical trials in PD. The FMEA identified 67 failure modes, being the dispensing and prescription/validation sub-processes the most likely to generate errors. All the improvement actions established in the AMFE were implemented in the Clinical Trials area. The FMEA is a useful tool in proactive risk management because it allows us to identify where we are making mistakes and analyze the causes that originate them, to prioritize and to adopt solutions to risk reduction. The FMEA improves process safety and quality in PD. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Safety analysis of occupational exposure of healthcare workers to residual contaminations of cytotoxic drugs using FMECA security approach.

PubMed

Le, Laetitia Minh Mai; Reitter, Delphine; He, Sophie; Bonle, Franck Té; Launois, Amélie; Martinez, Diane; Prognon, Patrice; Caudron, Eric

2017-12-01

Handling cytotoxic drugs is associated with chemical contamination of workplace surfaces. The potential mutagenic, teratogenic and oncogenic properties of those drugs create a risk of occupational exposure for healthcare workers, from reception of starting materials to the preparation and administration of cytotoxic therapies. The Security Failure Mode Effects and Criticality Analysis (FMECA) was used as a proactive method to assess the risks involved in the chemotherapy compounding process. FMECA was carried out by a multidisciplinary team from 2011 to 2016. Potential failure modes of the process were identified based on the Risk Priority Number (RPN) that prioritizes corrective actions. Twenty-five potential failure modes were identified. Based on RPN results, the corrective actions plan was revised annually to reduce the risk of exposure and improve practices. Since 2011, 16 specific measures were implemented successively. In six years, a cumulative RPN reduction of 626 was observed, with a decrease from 912 to 286 (-69%) despite an increase of cytotoxic compounding activity of around 23.2%. In order to anticipate and prevent occupational exposure, FMECA is a valuable tool to identify, prioritize and eliminate potential failure modes for operators involved in the cytotoxic drug preparation process before the failures occur. Copyright © 2017 Elsevier B.V. All rights reserved.

Aggressive behavior in children: the role of temperament and family socialization.

PubMed

González-Peña, Paloma; Egido, Begoña Delgado; Carrasco, Miguel Á; Tello, Francisco Pablo Holgado

2013-01-01

This study's objective is to analyze temperament and parenting variables as they relate to proactive and reactive aggression in children. To be specific, profiles based on these variables were analyzed in children with high levels of proactive versus reactive aggression. The sample was made up of two groups: 482 children (52.3% boys) between 1 and 3 years-old, and 422 children (42.42% boys) 3 to 6 years-old. Statistical analyses of the two age groups included: Pearson's correlations to explore the relationships among variables, Cluster Analysis to create groups with different levels of aggression, and finally discriminant analysis to determine which variables discriminate between groups. The results show that high levels of frustration/negative affect in the 1-3 year-old group and low effortful control in children 3 to 6 years old are the most relevant variables in differentiating between aggressive and non-aggressive subjects. Nevertheless, differential profiles of subjects with high levels of proactive versus reactive aggression were not observed. The implications of these different types of aggression in terms of development and prevention are discussed.

Consumer responses to communication about food risk management.

PubMed

van Dijk, Heleen; Houghton, Julie; van Kleef, Ellen; van der Lans, Ivo; Rowe, Gene; Frewer, Lynn

2008-01-01

Recent emphasis within policy circles has been on transparent communication with consumers about food risk management decisions and practices. As a consequence, it is important to develop best practice regarding communication with the public about how food risks are managed. In the current study, the provision of information about regulatory enforcement, proactive risk management, scientific uncertainty and risk variability were manipulated in an experiment designed to examine their impact on consumer perceptions of food risk management quality. In order to compare consumer reactions across different cases, three food hazards were selected (mycotoxins on organically grown food, pesticide residues, and a genetically modified potato). Data were collected from representative samples of consumers in Germany, Greece, Norway and the UK. Scores on the "perceived food risk management quality" scale were subjected to a repeated-measures mixed linear model. Analysis points to a number of important findings, including the existence of cultural variation regarding the impact of risk communication strategies-something which has obvious implications for pan-European risk communication approaches. For example, while communication of uncertainty had a positive impact in Germany, it had a negative impact in the UK and Norway. Results also indicate that food risk managers should inform the public about enforcement of safety laws when communicating scientific uncertainty associated with risks. This has implications for the coordination of risk communication strategies between risk assessment and risk management organizations.

Mediation of the Relationship Between Callous-Unemotional Traits and Proactive Aggression by Amygdala Response to Fear Among Children With Conduct Problems

PubMed Central

Lozier, Leah M.; Cardinale, Elise M.; VanMeter, John W.; Marsh, Abigail A.

2015-01-01

Importance Among youths with conduct problems, callous-unemotional (CU) traits are known to be an important determinant of symptom severity, prognosis, and treatment responsiveness. But positive correlations between conduct problems and CU traits result in suppressor effects that may mask important neurobiological distinctions among subgroups of children with conduct problems. Objective To assess the unique neurobiological covariates of CU traits and externalizing behaviors in youths with conduct problems and determine whether neural dysfunction linked to CU traits mediates the link between callousness and proactive aggression. Design, Setting, and Participants This cross-sectional case-control study involved behavioral testing and neuroimaging that were conducted at a university research institution. Neuroimaging was conducted using a 3-T Siemens magnetic resonance imaging scanner. It included 46 community-recruited male and female juveniles aged 10 to 17 years, including 16 healthy control participants and 30 youths with conduct problems with both low and high levels of CU traits. Main Outcomes and Measures Blood oxygenation level–dependent signal as measured via functional magnetic resonance imaging during an implicit face-emotion processing task and analyzed using whole-brain and region of interest–based analysis of variance and multiple-regression analyses. Results Analysis of variance revealed no group differences in the amygdala. By contrast, consistent with the existence of suppressor effects, multiple-regression analysis found amygdala responses to fearful expressions to be negatively associated with CU traits (x = 26, y = 0, z = −12; k = 1) and positively associated with externalizing behavior (x = 24, y = 0, z = −14; k = 8) when both variables were modeled simultaneously. Reduced amygdala responses mediated the relationship between CU traits and proactive aggression. Conclusions and Relevance The results linked proactive aggression in youths with CU traits to hypoactive amygdala responses to emotional distress cues, consistent with theories that externalizing behaviors, particularly proactive aggression, in youths with these traits stem from deficient empathic responses to distress. Amygdala hypoactivity may represent an intermediate phenotype, offering new insights into effective treatment strategies for conduct problems. PMID:24671141

Advanced National Seismic System—Current status, development opportunities, and priorities for 2017–2027

USGS Publications Warehouse

,

2017-05-25

SummaryEarthquakes pose a threat to the safety of over 143 million people living in the United States. Earthquake impacts can be significantly reduced if communities understand their risk and take proactive steps to mitigate that risk. The Advanced National Seismic System (ANSS) is a cooperative effort to collect and analyze seismic and geodetic data on earthquakes, issue timely and reliable notifications of their occurrence and impacts, and provide data for earthquake research and the hazard and risk assessments that are the foundation for creating an earthquakeresilient nation.

The application of risk management in sport.

PubMed

Fuller, Colin; Drawer, Scott

2004-01-01

The process of risk management can be implemented as part of a best practice management system within the sport and leisure sector. The process enables risk factors that might lead to injuries to be identified and the levels of risk associated with activities to be estimated and evaluated. This information can be utilised proactively by sports governing bodies and participants to identify preventive and therapeutic interventions in order to reduce the frequency of occurrence and/or severity of injuries within their sports. The acceptability of risk within specific sports, however, is dependent on the perceptions of the participants involved. Copyright 2004 Adis Data Information BV

Achieving a Risk-Informed Decision-Making Environment at NASA: The Emphasis of NASA's Risk Management Policy

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon

2010-01-01

This slide presentation reviews the evolution of risk management (RM) at NASA. The aim of the RM approach at NASA is to promote an approach that is heuristic, proactive, and coherent across all of NASA. Risk Informed Decision Making (RIDM) is a decision making process that uses a diverse set of performance measures along with other considerations within a deliberative process to inform decision making. RIDM is invoked for key decisions such as architecture and design decisions, make-buy decisions, and budget reallocation. The RIDM process and how it relates to the continuous Risk Management (CRM) process is reviewed.

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.

Use of failure mode effect analysis (FMEA) to improve medication management process.

PubMed

Jain, Khushboo

2017-03-13

Purpose Medication management is a complex process, at high risk of error with life threatening consequences. The focus should be on devising strategies to avoid errors and make the process self-reliable by ensuring prevention of errors and/or error detection at subsequent stages. The purpose of this paper is to use failure mode effect analysis (FMEA), a systematic proactive tool, to identify the likelihood and the causes for the process to fail at various steps and prioritise them to devise risk reduction strategies to improve patient safety. Design/methodology/approach The study was designed as an observational analytical study of medication management process in the inpatient area of a multi-speciality hospital in Gurgaon, Haryana, India. A team was made to study the complex process of medication management in the hospital. FMEA tool was used. Corrective actions were developed based on the prioritised failure modes which were implemented and monitored. Findings The percentage distribution of medication errors as per the observation made by the team was found to be maximum of transcription errors (37 per cent) followed by administration errors (29 per cent) indicating the need to identify the causes and effects of their occurrence. In all, 11 failure modes were identified out of which major five were prioritised based on the risk priority number (RPN). The process was repeated after corrective actions were taken which resulted in about 40 per cent (average) and around 60 per cent reduction in the RPN of prioritised failure modes. Research limitations/implications FMEA is a time consuming process and requires a multidisciplinary team which has good understanding of the process being analysed. FMEA only helps in identifying the possibilities of a process to fail, it does not eliminate them, additional efforts are required to develop action plans and implement them. Frank discussion and agreement among the team members is required not only for successfully conducing FMEA but also for implementing the corrective actions. Practical implications FMEA is an effective proactive risk-assessment tool and is a continuous process which can be continued in phases. The corrective actions taken resulted in reduction in RPN, subjected to further evaluation and usage by others depending on the facility type. Originality/value The application of the tool helped the hospital in identifying failures in medication management process, thereby prioritising and correcting them leading to improvement.

NASA Aerospace Flight Battery Program: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements. Volume 1, Part 2

NASA Technical Reports Server (NTRS)

Jung, David S.; Manzo, Michelle A.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 2 - Volume I: Recommendations for Technical Requirements for Inclusion in Aerospace Battery Procurements of the program's operations.

NASA Aerospace Flight Battery Program: Wet Life of Nickel-Hydrogen (Ni-H2) Batteries. Volume 1, Part 3

NASA Technical Reports Server (NTRS)

Jung, David S.; Lee, Leonine S.; Manzo, Michelle A.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 3 - Volume I: Wet Life of Nickel-Hydrogen (Ni-H2) Batteries of the program's operations.

Real-time hostile attribution measurement and aggression in children.

PubMed

Yaros, Anna; Lochman, John E; Rosenbaum, Jill; Jimenez-Camargo, Luis Alberto

2014-01-01

Hostile attributions are an important predictor of aggression in children, but few studies have measured hostile attributions as they occur in real-time. The current study uses an interactive video racing game to measure hostile attributions while children played against a presumed peer. A sample of 75 children, ages 10-13, used nonverbal and verbal procedures to respond to ambiguous provocation by their opponent. Hostile attributions were significantly positively related to parent-rated reactive aggression, when controlling for proactive aggression. Hostile attributions using a nonverbal response procedure were negatively related to proactive aggression, when controlling for reactive aggression. Results suggest hostile attributions in real-time occur quickly and simultaneously with social interaction, which differs from the deliberative, controlled appraisals measured with vignette-based instruments. The relation between real-time hostile attributions and reactive aggression could be accounted for by the impulsive response style that is characteristic of reactive aggression, whereas children exhibiting proactive aggression may be more deliberate and intentional in their responding, resulting in a negative relation with real-time hostile attributions. These findings can be used both to identify children at risk for aggression and to enhance preventive interventions. © 2014 Wiley Periodicals, Inc.

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).

Nutraceuticals: A paradigm of proactive medicine.

PubMed

Santini, Antonello; Tenore, Gian Carlo; Novellino, Ettore

2017-01-01

Nutraceuticals define a new category which shades the frontier between drugs and food. As per its definition, a nutraceutical is "a food or part of a food that provides benefits health in addition to its nutritional content". Active substances either way extracted from plants (phytocomplexes) or of animal origin, when extracted, concentrated and administered in a suitable pharmaceutical form, can create a very promising toolbox useful to prevent and/or support the therapy of some pathologic conditions given their proven clinical efficacy. It is worldwide recognized that diet and lifestyle are essential to promote and maintain well-being and nice-being condition, other than help to prevent diseases possible onset. Both non-correct dietary habits and lifestyle can in fact determine pathological conditions. The metabolic syndrome, a worldwide epidemic threat, can be named an outstanding example. This syndrome is characterized by a cascade of cardio metabolic risk factors which include obesity, insulin resistance, hypertension, and dyslipidemia. Prevention is the key strategy for an effective proactive medicine, in which efforts are addressed to prevention and, consequently, to lower the risk connected to some lifestyle related diseases reducing, at the same time, any National Health Systems cost needed to guarantee the proper therapeutic approach based on pharmaceuticals. Nutraceuticals use in prevention is a proactive reverse approach tool to pre-clinical health conditions. They can be effectively used, by including in the daily diet, in an area which shades in the range "beyond the diet, before drugs", since they combine both nutritional and beneficial healthy properties of food extracts with the healing properties of natural active compounds. Copyright © 2016 Elsevier B.V. All rights reserved.

DRD2 Schizophrenia-Risk Allele Is Associated With Impaired Striatal Functioning in Unaffected Siblings of Schizophrenia Patients

PubMed Central

Vink, Matthijs; de Leeuw, Max; Luykx, Jurjen J.; van Eijk, Kristel R.; van den Munkhof, Hanna E.; van Buuren, Mariët; Kahn, René S.

2016-01-01

A recent Genome-Wide Association Study showed that the rs2514218 single nucleotide polymorphism (SNP) in close proximity to dopamine receptor D2 is strongly associated with schizophrenia. Further, an in silico experiment showed that rs2514218 has a cis expression quantitative trait locus effect in the basal ganglia. To date, however, the functional consequence of this SNP is unknown. Here, we used functional Magnetic resonance imaging to investigate the impact of this risk allele on striatal activation during proactive and reactive response inhibition in 45 unaffected siblings of schizophrenia patients. We included siblings to circumvent the illness specific confounds affecting striatal functioning independent from gene effects. Behavioral analyses revealed no differences between the carriers (n = 21) and noncarriers (n = 24). Risk allele carriers showed a diminished striatal response to increasing proactive inhibitory control demands, whereas overall level of striatal activation in carriers was elevated compared to noncarriers. Finally, risk allele carriers showed a blunted striatal response during successful reactive inhibition compared to the noncarriers. These data are consistent with earlier reports showing similar deficits in schizophrenia patients, and point to a failure to flexibly engage the striatum in response to contextual cues. This is the first study to demonstrate an association between impaired striatal functioning and the rs2514218 polymorphism. We take our findings to indicate that striatal functioning is impaired in carriers of the DRD2 risk allele, likely due to dopamine dysregulation at the DRD2 location. PMID:26598739

Evaluating genotoxic risks in Brazilian public health agents occupationally exposed to pesticides: a multi-biomarker approach.

PubMed

Franco, Fernanda Craveiro; Alves, Alessandro Arruda; Godoy, Fernanda Ribeiro; Avelar, Juliana Boaventura; Rodrigues, Douglas Dantas; Pedroso, Thays Millena Alves; da Cruz, Aparecido Divino; Nomura, Fausto; de Melo E Silva, Daniela

2016-10-01

This is the first study demonstrating genotoxic effects and whole transcriptome analysis on community health agents (CHAs) occupationally exposed to pesticides in Central Brazil. For the transcriptome analysis, we found some genes related to Alzheimer's disease (LRP1), an insulin-like growth factor receptor (IGF2R), immunity genes (IGL family and IGJ), two genes related to inflammatory reaction (CXCL5 and CCL3), one gene related to maintenance of cellular morphology (NHS), one gene considered to be a strong apoptosis inductor (LGALS14), and several transcripts of the neuroblastoma breakpoint family (NBPF). Related to comet assay, we demonstrated a significant increase in DNA damage, measured by the olive tail moment (OTM), in the exposed group compared to the control group. Moreover, we also observed a statistically significant difference in OTM values depending on GSTM1 genotypes. Therefore, Brazilian epidemiological surveillance, an organization responsible for the assessment and management of health risks associated to pesticide exposure to CHA, needs to be more proactive and considers the implications of pesticide exposure for CHA procedures and processes.

The Impact of the Supplemental Instruction Leader on Student Performance in Introductory Accounting

ERIC Educational Resources Information Center

Jones, Jefferson P.

2013-01-01

This study explores the association between a supplemental instruction (SI) program and student performance in an introductory accounting course. SI is a proactive academic support program that is aimed at improving student learning in traditionally "high-risk" college courses by integrating learning and critical thinking strategies with…

Restructuring Board Committees : How to Effectively Create Change

ERIC Educational Resources Information Center

Hodge-Clark, Kristen; Johnston, Susan Whealler

2015-01-01

Governing boards of universities and colleges are facing an unprecedented tidal wave of change that is creating new opportunities, risks, innovations, and disruptions within and beyond the confines of their campuses. A board's ability to be both reactive to these changes and proactive in response will require that they not only have the right…

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)…

The Career Pathways of Young Adults in the Former USSR

ERIC Educational Resources Information Center

Roberts, Ken

2006-01-01

Market reforms in former communist countries are supposed to have liberated individuals and enterprises alike. Post-industrial, globalised contexts are said to create greater risks and to require flexibility of businesses and employees, and that the latter are therefore required to become reflexive, proactive, and to take charge of their own…

Fitness Promotion Strategies for K-12 Physical Education Programs

ERIC Educational Resources Information Center

Hill, Grant; Turner, Bud

2004-01-01

In recent years efforts have been made to emphasize the need for physical education by showing how physical activity helps students reduce the risk of cardiovascular disease; strengthen bones and muscles; supply energy, reduce stress, and help maintain a healthy body weight. This article describes a variety of proactive fitness strategies…

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…

Risk, Issues and Lessons Learned: Maximizing Risk Management in the DoD Ground Domain

DTIC Science & Technology

2011-09-01

mpor an r s s e ore ey urn n o ssues . - Carnegie Mellon University “Risk Management Overview for TACOM” Benefits of Risk Management include: • Risk...min 10 inch  length) • Ketchup (Heinz) •Mustard (yellow) • Onions (chopped) • Chili (no beans)      • Hot dog sub‐assy Unclassified How does FMEA work...risk early SAVES MONEY! ARE YOU USING FMEA?  CAN YOU AFFORD NOT TO? How can we use FMEA to our  benefit ? Use it proactively  to prevent failures Use it

The Essential Elements of a Risk Governance Framework for Current and Future Nanotechnologies.

PubMed

Stone, Vicki; Führ, Martin; Feindt, Peter H; Bouwmeester, Hans; Linkov, Igor; Sabella, Stefania; Murphy, Finbarr; Bizer, Kilian; Tran, Lang; Ågerstrand, Marlene; Fito, Carlos; Andersen, Torben; Anderson, Diana; Bergamaschi, Enrico; Cherrie, John W; Cowan, Sue; Dalemcourt, Jean-Francois; Faure, Michael; Gabbert, Silke; Gajewicz, Agnieszka; Fernandes, Teresa F; Hristozov, Danail; Johnston, Helinor J; Lansdown, Terry C; Linder, Stefan; Marvin, Hans J P; Mullins, Martin; Purnhagen, Kai; Puzyn, Tomasz; Sanchez Jimenez, Araceli; Scott-Fordsmand, Janeck J; Streftaris, George; van Tongeren, Martie; Voelcker, Nicolas H; Voyiatzis, George; Yannopoulos, Spyros N; Poortvliet, P Marijn

2017-12-14

Societies worldwide are investing considerable resources into the safe development and use of nanomaterials. Although each of these protective efforts is crucial for governing the risks of nanomaterials, they are insufficient in isolation. What is missing is a more integrative governance approach that goes beyond legislation. Development of this approach must be evidence based and involve key stakeholders to ensure acceptance by end users. The challenge is to develop a framework that coordinates the variety of actors involved in nanotechnology and civil society to facilitate consideration of the complex issues that occur in this rapidly evolving research and development area. Here, we propose three sets of essential elements required to generate an effective risk governance framework for nanomaterials. (1) Advanced tools to facilitate risk-based decision making, including an assessment of the needs of users regarding risk assessment, mitigation, and transfer. (2) An integrated model of predicted human behavior and decision making concerning nanomaterial risks. (3) Legal and other (nano-specific and general) regulatory requirements to ensure compliance and to stimulate proactive approaches to safety. The implementation of such an approach should facilitate and motivate good practice for the various stakeholders to allow the safe and sustainable future development of nanotechnology. © 2017 Society for Risk Analysis.

Applying the AcciMap methodology to investigate the tragic Sewol Ferry accident in South Korea.

PubMed

Lee, Samuel; Moh, Young Bo; Tabibzadeh, Maryam; Meshkati, Najmedin

2017-03-01

This study applies the AcciMap methodology, which was originally proposed by Professor Jens Rasmussen (1997), to the analysis of the tragic Sewol Ferry accident in South Korea on April 16, 2014, which killed 304 mostly young people and is considered as a national disaster in that country. This graphical representation, by incorporating associated socio-technical factors into an integrated framework, provides a big-picture to illustrate the context in which an accident occurred as well as the interactions between different levels of the studied system that resulted in that event. In general, analysis of past accidents within the stated framework can define the patterns of hazards within an industrial sector. Such analysis can lead to the definition of preconditions for safe operations, which is a main focus of proactive risk management systems. In the case of the Sewol Ferry accident, a lot of the blame has been placed on the Sewol's captain and its crewmembers. However, according to this study, which relied on analyzing all available sources published in English and Korean, the disaster is the result of a series of lapses and disregards for safety across different levels of government and regulatory bodies, Chonghaejin Company, and the Sewol's crewmembers. The primary layers of the AcciMap framework, which include the political environment and non-proactive governmental body; inadequate regulations and their lax oversight and enforcement; poor safety culture; inconsideration of human factors issues; and lack of and/or outdated standard operating and emergency procedures were not only limited to the maritime industry in South Korea, and the Sewol Ferry accident, but they could also subject any safety-sensitive industry anywhere in the world. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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.

Collecting and registering sexual health information in the context of HIV risk in the electronic medical record of general practitioners: a qualitative exploration of the preference of general practitioners in urban communities in Flanders (Belgium).

PubMed

Vos, Jolien; Pype, Peter; Deblonde, Jessika; Van den Eynde, Sandra; Aelbrecht, Karolien; Deveugele, Myriam; Avonts, Dirk

2016-07-01

Background and aim Current health-care delivery requires increasingly proactive and inter-professional work. Therefore, collecting patient information and knowledge management is of paramount importance. General practitioners (GPs) are well placed to lead these evolving models of care delivery. However, it is unclear how they are handling these changes. To gain an insight into this matter, the HIV epidemic was chosen as a test case. Data were collected and analysed from 13 semi-structured interviews with GPs, working in urban communities in Flanders. Findings GPs use various types of patient information to estimate patients' risk of HIV. The way in which sexual health information is collected and registered, depends on the type of information under discussion. General patient information and medical history data are often automatically collected and registered. Proactively collecting sexual health information is uncommon. Moreover, the registration of the latter is not obvious, mostly owing to insufficient space in the electronic medical record (EMR). GPs seem willing to systematically collect and register sexual health information, in particular about HIV-risk factors. They expressed a need for guidance together with practical adjustments of the EMR to adequately capture and share this information.

Failure to upregulate Agrp and Orexin in response to activity based anorexia in weight loss vulnerable rats characterized by passive stress coping and prenatal stress experience

PubMed Central

Boersma, Gretha J.; Liang, Nu-Chu; Lee, Richard S.; Albertz, Jennifer D.; Kastelein, Anneke; Moody, Laura A.; Aryal, Shivani; Moran, Timothy H.; Tamashiro, Kellie L.

2016-01-01

We hypothesize that Anorexia Nervosa (AN) poses a physiological stress. Therefore, the way an individual copes with stress may affect AN vulnerability. Since prenatal stress (PNS) exposure alters stress responsivity in offspring this may increase their risk of developing AN. We tested this hypothesis using the activity based anorexia (ABA) rat model in control and PNS rats that were characterized by either proactive or passive stress-coping behavior. We found that PNS passively coping rats ate less and lost more weight during the ABA paradigm. Exposure to ABA resulted in higher baseline corticosterone and lower insulin levels in all groups. However, leptin levels were only decreased in rats with a proactive stress-coping style. Similarly, ghrelin levels were increased only in proactively coping ABA rats. Neuropeptide Y (Npy) expression was increased and proopiomelanocortin (Pomc) expression was decreased in all rats exposed to ABA. In contrast, agouti-related peptide (Agrp) and orexin (Hctr) expression were increased in all but the PNS passively coping ABA rats. Furthermore, DNA methylation of the orexin gene was increased after ABA in proactive coping rats and not in passive coping rats. Overall our study suggests that passive PNS rats have innate impairments in leptin and ghrelin in responses to starvation combined with prenatal stress associated impairments in Agrp and orexin expression in response to starvation. These impairments may underlie decreased food intake and associated heightened body weight loss during ABA in the passively coping PNS rats. PMID:26907996

Failure to upregulate Agrp and Orexin in response to activity based anorexia in weight loss vulnerable rats characterized by passive stress coping and prenatal stress experience.

PubMed

Boersma, Gretha J; Liang, Nu-Chu; Lee, Richard S; Albertz, Jennifer D; Kastelein, Anneke; Moody, Laura A; Aryal, Shivani; Moran, Timothy H; Tamashiro, Kellie L

2016-05-01

We hypothesize that anorexia nervosa (AN) poses a physiological stress. Therefore, the way an individual copes with stress may affect AN vulnerability. Since prenatal stress (PNS) exposure alters stress responsivity in offspring this may increase their risk of developing AN. We tested this hypothesis using the activity based anorexia (ABA) rat model in control and PNS rats that were characterized by either proactive or passive stress-coping behavior. We found that PNS passively coping rats ate less and lost more weight during the ABA paradigm. Exposure to ABA resulted in higher baseline corticosterone and lower insulin levels in all groups. However, leptin levels were only decreased in rats with a proactive stress-coping style. Similarly, ghrelin levels were increased only in proactively coping ABA rats. Neuropeptide Y (Npy) expression was increased and proopiomelanocortin (Pomc) expression was decreased in all rats exposed to ABA. In contrast, agouti-related peptide (Agrp) and orexin (Hctr) expression were increased in all but the PNS passively coping ABA rats. Furthermore, DNA methylation of the orexin gene was increased after ABA in proactive coping rats and not in passive coping rats. Overall our study suggests that passive PNS rats have innate impairments in leptin and ghrelin in responses to starvation combined with prenatal stress associated impairments in Agrp and orexin expression in response to starvation. These impairments may underlie decreased food intake and associated heightened body weight loss during ABA in the passively coping PNS rats. Published by Elsevier Ltd.

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)…

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.

Transformation products in the water cycle and the unsolved problem of their proactive assessment: A combined in vitro/in silico approach.

PubMed

Menz, Jakob; Toolaram, Anju Priya; Rastogi, Tushar; Leder, Christoph; Olsson, Oliver; Kümmerer, Klaus; Schneider, Mandy

2017-01-01

Transformation products (TPs) emerging from incomplete degradation of micropollutants in aquatic systems can retain the biological activity of the parent compound, or may even possess new unexpected toxic properties. The chemical identities of these substances remain largely unknown, and consequently, the risks caused by their presence in the water cycle cannot be assessed thoroughly. In this study, a combined approach for the proactive identification of hazardous elements in the chemical structures of TPs, comprising analytical, bioanalytical and computational methods, was assessed by the example of the pharmaceutically active micropollutant propranolol (PPL). PPL was photo-transformed using ultraviolet (UV) irradiation and 115 newly formed TPs were monitored in the reaction mixtures by LC-MS analysis. The reaction mixtures were screened for emerging effects using a battery of in vitro bioassays and the occurrence of cytotoxic and mutagenic activities in bacteria was found to be significantly correlated with the occurrence of specific TPs during the treatment process. The follow-up analysis of structure-activity-relationships further illustrated that only small chemical transformations, such as the hydroxylation or the oxidative opening of an aromatic ring system, could substantially alter the biological effects of micropollutants in aquatic systems. In conclusion, more efforts should be made to prevent the occurrence and transformation of micropollutants in the water cycle and to identify the principal degradation pathways leading to their toxicological activation. With regard to the latter, the judicious combination of bioanalytical and computational tools represents an appealing approach that should be developed further. Copyright © 2016 Elsevier Ltd. All rights reserved.

Association of a Proactive Swallowing Rehabilitation Program With Feeding Tube Placement in Patients Treated for Pharyngeal Cancer.

PubMed

Ajmani, Gaurav S; Nocon, Cheryl C; Brockstein, Bruce E; Campbell, Nicholas P; Kelly, Amy B; Allison, Jamie; Bhayani, Mihir K

2018-04-19

A proactive speech and language pathology (SLP) program is an important component of the multidisciplinary care of patients with head and neck squamous cell carcinoma (HNSCC). Swallowing rehabilitation can reduce the rate of feeding tube placement, thereby significantly improving quality of life. To evaluate the initiation of a proactive SLP rehabilitation program at a single institution and its association with rates of feeding tube placement and dietary intake in patients with HNSCC. Cohort study at a tertiary care and referral center for patients with HNSCC serving the northern Chicago region. Patients were treated for squamous cell carcinomas of the hypopharynx, oropharynx, and nasopharynx from 2004 to 2015 with radiation or chemoradiation therapy in the definitive or adjuvant setting. Patients who received less than 5000 cGy radiation or underwent reirradiation were excluded. A proactive SLP program for patients with HNSCC was initiated in 2011. Study cohorts were divided into 2 groups: 2004 through 2010 and 2011 through 2015. Primary outcome variables were SLP referral placement and timing of the referral. Secondary outcomes were feeding tube placement and ability to tolerate any oral intake. A total of 254 patients met inclusion criteria (135 before and 119 after implementation of SLP program; median age, 60 years [range, 14-94 years]; 77% male). With the initiation of a proactive SLP program, pretreatment evaluations increased from 29 (21.5%) to 70 (58.8%; risk ratio [RR], 2.74; 95% CI, 1.92-3.91), and rate of referral overall at any time increased from 60.0% to 79.8% (RR, 1.33; 95% CI, 1.13-1.57). Feeding tube placement rates decreased from 45.9% (n = 62) to 29.4% (n = 35; RR, 0.64; 95% CI, 0.46-0.89). Among patients receiving a swallow evaluation, feeding tube requirements were less frequent for those receiving a pretreatment evaluation (31 of 99 [31%]) than for those referred during (11 of 18 [61%]) or after (38 of 59 [64%]) treatment. The rate of tolerating any oral intake at the end of treatment improved from 71.1% (n = 96) in the preimplementation period to 82.4% (n = 98; RR, 1.16; 95% CI, 1.01-1.33). A proactive SLP program can be successfully established as part of the multidisciplinary care of patients with HNSCC and improve patient quality of life.

The Effect of Parenthood Education on Self- Efficacy and Parent Effectiveness in an Alternative High School Student Population

ERIC Educational Resources Information Center

Meyer, Becky Weller; Jain, Sachin; Canfield-Davis, Kathy

2011-01-01

Adolescents defined as at-risk typically lack healthy models of parenting and receive no parenthood education prior to assuming the parenting role. Unless a proactive approach is implemented, the cyclic pattern of dysfunctional parenting-- including higher rates of teen pregnancy, increased childhood abuse, low educational attainment,…

Aligning smoke management with ecological and public health goals

Treesearch

Jonathan W. Long; Leland W. Tarnay; Malcolm P. North

2017-01-01

Past and current forest management affects wildland fire smoke impacts on downwind human populations. However, mismatches between the scale of benefits and risks make it difficult to proactively manage wildland fires to promote both ecological and public health. Building on recent literature and advances in modeling smoke and health effects, we outline a framework to...

A procedure for NEPA assessment of selenium hazards associated with mining

Treesearch

Dennis A. Lemly

2007-01-01

This paper gives step-by-step instructions for assessing aquatic selenium hazards associated with mining. The procedure was developed to provide the U.S. Forest Service with a proactive capability for determining the risk of selenium pollution when it reviews mine permit applications in accordance with the National Environmental Policy Act (NEPA). The procedural...

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…

Resistance among U.S. wheat Triticum aestivum cultivars to the wheat pathotype of Magnaporthe oryzae

USDA-ARS?s Scientific Manuscript database

Magnaporthe oryzae is the causal agent of blast on several graminaceous plants. The M. oryzae population causing wheat blast has not been found outside South America. U.S. wheat production is at risk to this pathogen if introduced and established. Proactive testing of US wheat cultivars for their re...

Helping Students with Disabilities Better Address Teasing and Bullying Situations: A MASNRN Study

ERIC Educational Resources Information Center

Vessey, Judith A.; O'Neill, Katherine M.

2011-01-01

Students with disabilities are more likely to be chronically teased or bullied and develop related psychosocial problems. Proactive interventions help these youths develop coping skills and become more resilient in handling such situations. The specific aims of this study were to (a) identify children with disabilities, who are at risk for being…

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…

Stress coping style does not determine social status, but influences the consequences of social subordination stress.

PubMed

Boersma, Gretha J; Smeltzer, Michael D; Scott, Karen A; Scheurink, Anton J; Tamashiro, Kellie L; Sakai, Randall R

2017-09-01

Chronic stress exposure may have negative consequences for health. One of the most common sources of chronic stress is stress associated with social interaction. In rodents, the effects of social stress can be studied in a naturalistic way using the visual burrow system (VBS). The way an individual copes with stress, their "stress coping style", may influence the consequences of social stress. In the current study we tested the hypothesis that stress coping style may modulate social status and influence the consequences of having a lower social status. We formed 7 VBS colonies, with 1 proactive coping male, 1 passive coping male, and 4 female rats per colony to assess whether a rat's coping style prior to colony formation could predict whether that individual is more likely to become socially dominant. The rats remained in their respective colonies for 14days and the physiological and behavioral consequences of social stress were assessed. Our study shows that stress coping style does not predict social status. However, stress coping style may influence the consequences of having a lower social status. Subordinate passive and proactive rats had distinctly different wound patterns; proactive rats had more wounds on the front of their bodies. Behavioral analysis confirmed that proactive subordinate rats engaged in more offensive interactions. Furthermore, subordinate rats with a proactive stress coping style had larger adrenals, and increased stress responsivity to a novel acute stressor (restraint stress) compared to passive subordinate rats or dominant rats, suggesting that the allostatic load may have been larger in this group. Copyright © 2017 Elsevier Inc. All rights reserved.

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project

PubMed Central

Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

2017-01-01

Background There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. Objective The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. Methodology An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Results Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. Conclusion The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges. PMID:28579793

Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project.

PubMed

Lydell, Marie; Hildingh, Cathrine; Söderbom, Arne; Ziegert, Kristina

2017-01-01

There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs. The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies. An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken. Three categories emerged from the analysis: "Balancing complex situations" clarified the complexity regarding senior employees; "Working with a proactive approach" indicated the need for working with a new proactive approach supporting sustainable health; and "Collaborate internally and externally" showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners. The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges.

Randomised controlled trial of a secondary prevention program for myocardial infarction patients ('ProActive Heart'): study protocol. Secondary prevention program for myocardial infarction patients.

PubMed

Hawkes, Anna L; Atherton, John; Taylor, C Barr; Scuffham, Paul; Eadie, Kathy; Miller, Nancy Houston; Oldenburg, Brian

2009-05-09

Coronary heart disease (CHD) is a significant cause of health and economic burden. Secondary prevention programs play a pivotal role in the treatment and management of those affected by CHD although participation rates are poor due to patient, provider, health system and societal-level barriers. As such, there is a need to develop innovative secondary prevention programs to address the treatment gap. Telephone-delivered care is convenient, flexible and has been shown to improve behavioural and clinical outcomes following myocardial infarction (MI). This paper presents the design of a randomised controlled trial to evaluate the efficacy of a six-month telephone-delivered secondary prevention program for MI patients (ProActive Heart). 550 adult MI patients have been recruited over a 14 month period (December 2007 to January 2009) through two Brisbane metropolitan hospitals, and randomised to an intervention or control group (n = 225 per group). The intervention commences within two weeks of hospital discharge delivered by study-trained health professionals ('health coaches') during up to 10 x 30 minute scripted telephone health coaching sessions. Participants also receive a ProActive Heart handbook and an educational resource to use during the health coaching sessions. The intervention focuses on appropriate modification of CHD risk factors, compliance with pharmacological management, and management of psychosocial issues. Data collection occurs at baseline or prior to commencement of the intervention (Time 1), six months follow-up or the completion of the intervention (Time 2), and at 12 months follow-up for longer term outcomes (Time 3). Primary outcome measures include quality of life (Short Form-36) and physical activity (Active Australia Survey). A cost-effective analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. The results of this study will provide valuable new information about an innovative telephone-delivered cost-effective secondary prevention program for MI patients.

Critical laboratory value notification: a failure mode effects and criticality analysis.

PubMed

Saxena, Sunita; Kempf, Raymond; Wilcox, Susan; Shulman, Ira A; Wong, Louise; Cunningham, Glenn; Vega, Elaine; Hall, Stephanie

2005-09-01

The Failure Mode Effects and Criticality Analysis (FMECA) was applied to improve the timeliness of reporting and the timeliness of receipt by the responsible licensed caregiver of critical laboratory values (CLVs) for outpatients and non-critical care inpatients. Through a risk prioritization process, the most important areas for improvement, including contacting the provider, assisting the provider in contacting the patient, and educating the provider in follow-up options available during off hours, were identified. A variety of systemic improvements were made; for example, the CLV notification process was centralized in the customer service center, with databases to help providers select options and make arrangements for follow-up care and an electronic abstract form to document the CLV notification process. Review of documentation and appropriateness of CLV follow-up care was integrated into the quality monitoring process to detect any variations or problems. The average CLV notification time for the month steadily declined during an eight-month period. Compliance was 100% for the "read-back" requirement and documentation in patient's health record. This proactive risk assessment project successfully modified the CLV notification program from a high- to a low-risk process, identified activities to further improve the process, and helped ensure compliance with a variety of requirements.

Pretreatment data is highly predictive of liver chemistry signals in clinical trials

PubMed Central

Cai, Zhaohui; Bresell, Anders; Steinberg, Mark H; Silberg, Debra G; Furlong, Stephen T

2012-01-01

Purpose The goal of this retrospective analysis was to assess how well predictive models could determine which patients would develop liver chemistry signals during clinical trials based on their pretreatment (baseline) information. Patients and methods Based on data from 24 late-stage clinical trials, classification models were developed to predict liver chemistry outcomes using baseline information, which included demographics, medical history, concomitant medications, and baseline laboratory results. Results Predictive models using baseline data predicted which patients would develop liver signals during the trials with average validation accuracy around 80%. Baseline levels of individual liver chemistry tests were most important for predicting their own elevations during the trials. High bilirubin levels at baseline were not uncommon and were associated with a high risk of developing biochemical Hy’s law cases. Baseline γ-glutamyltransferase (GGT) level appeared to have some predictive value, but did not increase predictability beyond using established liver chemistry tests. Conclusion It is possible to predict which patients are at a higher risk of developing liver chemistry signals using pretreatment (baseline) data. Derived knowledge from such predictions may allow proactive and targeted risk management, and the type of analysis described here could help determine whether new biomarkers offer improved performance over established ones. PMID:23226004

Integrating Statistical Machine Learning in a Semantic Sensor Web for Proactive Monitoring and Control.

PubMed

Adeleke, Jude Adekunle; Moodley, Deshendran; Rens, Gavin; Adewumi, Aderemi Oluyinka

2017-04-09

Proactive monitoring and control of our natural and built environments is important in various application scenarios. Semantic Sensor Web technologies have been well researched and used for environmental monitoring applications to expose sensor data for analysis in order to provide responsive actions in situations of interest. While these applications provide quick response to situations, to minimize their unwanted effects, research efforts are still necessary to provide techniques that can anticipate the future to support proactive control, such that unwanted situations can be averted altogether. This study integrates a statistical machine learning based predictive model in a Semantic Sensor Web using stream reasoning. The approach is evaluated in an indoor air quality monitoring case study. A sliding window approach that employs the Multilayer Perceptron model to predict short term PM 2 . 5 pollution situations is integrated into the proactive monitoring and control framework. Results show that the proposed approach can effectively predict short term PM 2 . 5 pollution situations: precision of up to 0.86 and sensitivity of up to 0.85 is achieved over half hour prediction horizons, making it possible for the system to warn occupants or even to autonomously avert the predicted pollution situations within the context of Semantic Sensor Web.

Integrating Statistical Machine Learning in a Semantic Sensor Web for Proactive Monitoring and Control

PubMed Central

Adeleke, Jude Adekunle; Moodley, Deshendran; Rens, Gavin; Adewumi, Aderemi Oluyinka

2017-01-01

Proactive monitoring and control of our natural and built environments is important in various application scenarios. Semantic Sensor Web technologies have been well researched and used for environmental monitoring applications to expose sensor data for analysis in order to provide responsive actions in situations of interest. While these applications provide quick response to situations, to minimize their unwanted effects, research efforts are still necessary to provide techniques that can anticipate the future to support proactive control, such that unwanted situations can be averted altogether. This study integrates a statistical machine learning based predictive model in a Semantic Sensor Web using stream reasoning. The approach is evaluated in an indoor air quality monitoring case study. A sliding window approach that employs the Multilayer Perceptron model to predict short term PM2.5 pollution situations is integrated into the proactive monitoring and control framework. Results show that the proposed approach can effectively predict short term PM2.5 pollution situations: precision of up to 0.86 and sensitivity of up to 0.85 is achieved over half hour prediction horizons, making it possible for the system to warn occupants or even to autonomously avert the predicted pollution situations within the context of Semantic Sensor Web. PMID:28397776

Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

PubMed

Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

2018-03-15

We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic risks well. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Maximizing retention with high risk participants in a clinical trial.

PubMed

Kim, Romina; Hickman, Norval; Gali, Kathleen; Orozco, Nicholas; Prochaska, Judith J

2014-01-01

To describe effective retention strategies in a clinical trial with a high risk, low-income, and vulnerable patient population with serious mental illness. Follow-up assessments were conducted for a randomized clinical tobacco treatment trial at 3, 6, and 12 months postbaseline. Initial follow-up rates of <40% at 3 months led to implementation of proactive retention strategies including obtaining extensive contact information; building relationships with case managers and social workers; contacting jails and prisons; text messaging, e-mailing, and messaging via social networking sites; identifying appointments via electronic medical record; and field outreach to treatment facilities, residences, and parks. Large urban public hospital. Participants were current smokers recruited from 100% smoke-free locked psychiatry units. Assessments covered demographics, substance use, and mental health functioning. Retention rates were plotted over time in relation to key retention strategies. Chi-square and t-tests were used to examine participant predictors of retention at each follow-up. At the 12-month follow-up, the retention strategies that most frequently led to assessment completion were identified. The sample (N = 100) was 65% male; age x = 39.5 years (SD = 11.3); 44% non-Hispanic white; 46% on Medicaid and 34% uninsured; 79% unemployed; and 48% unstably housed. Proactive retention strategies dramatically increased follow-up rates, concluding at 3 months = 82.65%, 6 months = 89.69%, and 12 months = 92.78%. Married and divorced/separated/widowed participants, those with higher income, and participants with alcohol or illicit drug problems had increased retention from 3- to 12-month follow-up. Follow-up rates improved as proactive methods to contact participants were implemented. Dedicated research staff, multiple methods, community networking, and outreach within drug treatment settings improved retention.

Anatomy of a Security Operations Center

NASA Technical Reports Server (NTRS)

Wang, John

2010-01-01

Many agencies and corporations are either contemplating or in the process of building a cyber Security Operations Center (SOC). Those Agencies that have established SOCs are most likely working on major revisions or enhancements to existing capabilities. As principle developers of the NASA SOC; this Presenters' goals are to provide the GFIRST community with examples of some of the key building blocks of an Agency scale cyber Security Operations Center. This presentation viII include the inputs and outputs, the facilities or shell, as well as the internal components and the processes necessary to maintain the SOC's subsistence - in other words, the anatomy of a SOC. Details to be presented include the SOC architecture and its key components: Tier 1 Call Center, data entry, and incident triage; Tier 2 monitoring, incident handling and tracking; Tier 3 computer forensics, malware analysis, and reverse engineering; Incident Management System; Threat Management System; SOC Portal; Log Aggregation and Security Incident Management (SIM) systems; flow monitoring; IDS; etc. Specific processes and methodologies discussed include Incident States and associated Work Elements; the Incident Management Workflow Process; Cyber Threat Risk Assessment methodology; and Incident Taxonomy. The Evolution of the Cyber Security Operations Center viII be discussed; starting from reactive, to proactive, and finally to proactive. Finally, the resources necessary to establish an Agency scale SOC as well as the lessons learned in the process of standing up a SOC viII be presented.

Support needs and experiences of family members of wounded, injured or sick UK service personnel.

PubMed

Verey, Anna; Keeling, M; Thandi, G; Stevelink, S; Fear, N

2017-12-01

When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach. 'Family member involvement' was the main theme under which four subthemes were situated: 'continuity of support', 'proactive signposting and initiating contact', 'psychoeducation and counselling' and 'higher risk groups'. Family members felt they might benefit from direct, consistent and continuous care regardless of the WIS person's injury or engagement type, and whether the WIS person was being treated in a hospital, rehabilitative centre or at home. The findings of this study suggest that family members of WIS personnel value proactive, direct and sustained communication from support service providers. We suggest that families of UK service personnel may benefit from family care coordinators, who could provide continuous and consistent care to family members of WIS personnel. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Application of failure mode and effects analysis to intracranial stereotactic radiation surgery by linear accelerator.

PubMed

Masini, Laura; Donis, Laura; Loi, Gianfranco; Mones, Eleonora; Molina, Elisa; Bolchini, Cesare; Krengli, Marco

2014-01-01

The aim of this study was to analyze the application of the failure modes and effects analysis (FMEA) to intracranial stereotactic radiation surgery (SRS) by linear accelerator in order to identify the potential failure modes in the process tree and adopt appropriate safety measures to prevent adverse events (AEs) and near-misses, thus improving the process quality. A working group was set up to perform FMEA for intracranial SRS in the framework of a quality assurance program. FMEA was performed in 4 consecutive tasks: (1) creation of a visual map of the process; (2) identification of possible failure modes; (3) assignment of a risk probability number (RPN) to each failure mode based on tabulated scores of severity, frequency of occurrence and detectability; and (4) identification of preventive measures to minimize the risk of occurrence. The whole SRS procedure was subdivided into 73 single steps; 116 total possible failure modes were identified and a score of severity, occurrence, and detectability was assigned to each. Based on these scores, RPN was calculated for each failure mode thus obtaining values from 1 to 180. In our analysis, 112/116 (96.6%) RPN values were <60, 2 (1.7%) between 60 and 125 (63, 70), and 2 (1.7%) >125 (135, 180). The 2 highest RPN scores were assigned to the risk of using the wrong collimator's size and incorrect coordinates on the laser target localizer frame. Failure modes and effects analysis is a simple and practical proactive tool for systematic analysis of risks in radiation therapy. In our experience of SRS, FMEA led to the adoption of major changes in various steps of the SRS procedure.

Decision Making for Animal Health and Welfare: Integrating Risk-Benefit Analysis with Prospect Theory

PubMed Central

Hansson, Helena; Lagerkvist, Carl Johan

2013-01-01

This study integrated risk-benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers’ choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder-health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers’ assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers’ management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds. PMID:24372180

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.

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

A Novel Approach to Proactive Primary Care-Based Case Finding and Multidisciplinary Management of Falls, Syncope, and Dizziness in a One-Stop Service: Preliminary Results.

PubMed

Parry, Steve W; Hill, Harry; Lawson, Joanna; Lawson, Nick; Green, David; Trundle, Heidi; McNaught, Judith; Strassheim, Victoria; Caldwell, Alma; Mayland, Richard; Earley, Phillip; McMeekin, Peter

2016-11-01

National and international evidence and guidelines on falls prevention and management in community-dwelling elderly adults recommend that falls services should be multifactorial and their interventions multicomponent. The way that individuals are identified as having had or being at risk of falls in order to take advantage of such services is far less clear. A novel multidisciplinary, multifactorial falls, syncope, and dizziness service model was designed with enhanced case ascertainment through proactive, primary care-based screening (of individual case notes of individuals aged ≥60) for individual fall risk factors. The service model identified 4,039 individuals, of whom 2,232 had significant gait and balance abnormalities according to senior physiotherapist assessment. Significant numbers of individuals with new diagnoses ranging from cognitive impairment to Parkinson's disease to urgent indications for a pacemaker were discovered. More than 600 individuals were found who were at high risk of osteoporosis according to World Health Association Fracture Risk Assessment Tool score, 179 with benign positional paroxysmal vertigo and 50 with atrial fibrillation. Through such screening and this approach, Comprehensive Geriatric Assessment Plus (Plus falls, syncope and dizziness expertise), unmet need was targeted on a scale far outside the numbers seen in clinical trials. Further work is needed to determine whether this approach translates into fewer falls and decreases in syncope and dizziness. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Positive symptoms, substance use, and psychopathic traits as predictors of aggression in persons with a schizophrenia disorder.

PubMed

van Dongen, Josanne D M; Buck, Nicole M L; van Marle, Hjalmar J C

2016-03-30

It is still not clear what the unique contribution of particular psychopathological factors is in explaining aggression in schizophrenia. The current study examined whether persecutory ideations, psychopathy and substance use are associated with different measures of aggressive behavior. We expected that persecutory ideations are associated with reactive aggression, and psychopathic traits are more associated with proactive aggression of inpatients. 59 inpatients with schizophrenia were included. Persecutory ideations we assessed using the Persecutory Ideation Questionnaire (PIQ), psychopathic traits with the revised version of Psychopathic Personality Inventory (PPI-R) and substance use was assessed using the Comprehensive Assessment of Symptoms and History (CASH). In addition, aggression was measured with the Reactive and Proactive Aggression Questionnaire (RPQ), in an experimental task using the Point Subtraction Aggression Paradigm (PSAP) and on the ward using the Social Dysfunction and Aggression Scale (SDAS). Results showed that psychopathy explains most of the variance in self-reported proactive and reactive aggression. In contrast, persecutory ideations explain most of the variance in observed aggression on the ward. Results implicate that it is important to acknowledge comorbid factors in patients with schizophrenia for more precise risk assessment and appropriate treatment for aggressive patients with schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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.

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.

Risk communication of vaccines: challenges in the post-trust environment.

PubMed

Bouder, Frederic

2015-01-01

Highly publicised vaccine scares and recent debates about the risks suggest that public trust in immunisation programmes is fragile. For instance, the recent outbreak of Measles in Wales was the direct result of almost fifteen years of distrust for the MMR vaccine in the UK. This article shows how the latest science on risk communication will help critical actors, especially policy-makers, to build trust when they communicate risks to citizens and patients. The article offers policy advice on risk communication based on the results of three vaccines case studies. Five procedural principles which were developed for the UK government - the so-called "five As" of public risk communication are used to structure the discussion. Conclusions and recommendations suggest ways to move forward and build a two-way proactive risk communication practice.

Toward a pro-active scientific advice on global volcanic activity within the multi-hazard framework of the EU Aristotle project

NASA Astrophysics Data System (ADS)

Barsotti, Sara; Duncan, Melanie; Loughlin, Susan; Gísladóttir, Bryndis; Roberts, Matthew; Karlsdóttir, Sigrún; Scollo, Simona; Salerno, Giuseppe; Corsaro, Rosa Anna; Charalampakis, Marinos; Papadopoulos, Gerassimos

2017-04-01

The demand for timely analysis and advice on global volcanic activity from scientists is growing. At the same time, decision-makers require more than an understanding of hazards; they need to know what impacts to expect from ongoing and future events. ARISTOTLE (All Risk Integrated System TOwards Trans-boundary hoListic Early-warning) is a two-year EC funded pilot project designed to do just that. The Emergency Response Coordination Centre (ERCC) works to support and coordinate response to disasters both inside and outside Europe using resources from the countries participating in the European Union Civil Protection Mechanism. Led by INGV and ZAMG, the ARISTOTLE consortium comprises 15 institutions across Europe and aims to deliver multi-hazard advice on natural events, including their potential interactions and impact, both inside and outside of Europe to the ERCC. Where possible, the ERCC would like a pro-active provision of scientific advice by the scientific group. Iceland Met Office leads the volcanic hazards work, with BGS, INGV and NOA comprising the volcano observatory team. At this stage, the volcanology component of the project comprises mainly volcanic ash and gas dispersal and potential impact on population and ground-based critical infrastructures. We approach it by relying upon available and official volcano monitoring institutions' reporting of activity, existing assessments and global databases of past events, modelling tools, remote-sensing observational systems and official VAAC advisories. We also make use of global assessments of volcanic hazards, country profiles, exposure and proxy indicators of threat to livelihoods, infrastructure and economic assets (e.g. Global Volcano Model outputs). Volcanic ash fall remains the only hazard modelled at the global scale. Volcanic risk assessments remain in their infancy, owing to challenges related to the multitude of hazards, data availability and model representation. We therefore face a number of challenges in delivering pro-active scientific advice to ARISTOTLE, in addition to the main challenge of working within a multi-hazard framework. Here we present our methods for analysis and advice, along with the challenges we face, and hope to stimulate interesting discussion and receive constructive feedback, as well as explore how the global community can address the demand for scientific advice at the international level. The role of international networks and collaboration is clear; as is the critical role of volcano observatories, which are embedded in local communities and connected to the international community. We aim to enhance our approaches through the Global Volcano Model network (including IAVCEI, WOVO, GVP and VHub) and directly with volcano observatories, VAACs and civil protection agencies.

Preliminary Recommendations for the Collection, Storage, and Analysis of UAS Safety Data

NASA Technical Reports Server (NTRS)

Enomoto, Francis; Bushnell, David; Denney, Ewen; Pai, Ganesh; Schumann, Johann

2013-01-01

Although the use of UASs in military and public service operations is proliferating, civilian use of UASs remains limited in the United States today. With efforts underway to accommodate and integrate UASs into the NAS, a proactive understanding of safety issues, i.e., the unique hazards and the corresponding risks that UASs pose not only through their operations for commercial purposes, but also to existing operations in the NAS, is especially important so as to (a) support the development of a sound regulatory basis, (b) regulate, design and properly equip UASs, and (c) effectively mitigate the risks posed. Data, especially about system and component failures, incidents, and accidents, provides valuable insight into how performance and operational capabilities/limitations contribute to hazards. Since the majority of UAS operations today take place in a context that is significantly different from the norm in civil aviation, i.e., with different operational goals and standards, identifying that which constitutes useful and sufficient data on UASs and their operations is a substantial research challenge.

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

PubMed

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

2014-10-01

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

Failure to Recover from Proactive Semantic Interference and Abnormal Limbic Connectivity in Asymptomatic, Middle-Aged Offspring of Patients with Late-Onset Alzheimer's Disease.

PubMed

Sánchez, Stella M; Abulafia, Carolina; Duarte-Abritta, Barbara; de Guevara, M Soledad Ladrón; Castro, Mariana N; Drucaroff, Lucas; Sevlever, Gustavo; Nemeroff, Charles B; Vigo, Daniel E; Loewenstein, David A; Villarreal, Mirta F; Guinjoan, Salvador M

2017-01-01

We have obtained previous evidence of limbic dysfunction in middle-aged, asymptomatic offspring of late-onset Alzheimer's disease (LOAD) patients, and failure to recover from proactive semantic interference has been shown to be a sensitive cognitive test in other groups at risk for LOAD. To assess the effects of specific proactive semantic interference deficits as they relate to functional magnetic resonance imaging (fMRI) neocortical and limbic functional connectivity in middle aged offspring of individuals with LOAD (O-LOAD) and age-equivalent controls. We examined 21 O-LOAD and 20 controls without family history of neurodegenerative disorders (CS) on traditional measures of cognitive functioning and the LASSI-L, a novel semantic interference test uniquely sensitive to the failure to recover from proactive interference (frPSI). Cognitive tests then were correlated to fMRI connectivity of seeds located in entorhinal cortex and anterodorsal thalamic nuclei among O-LOAD and CS participants. Relative to CS, O-LOAD participants evidenced lower connectivity between entorhinal cortex and orbitofrontal, anterior cingulate, and anterior temporal cortex. In the offspring of LOAD patients, LASSI-L measures of frPSI were inversely associated with connectivity between anterodorsal thalamus and contralateral posterior cingulate. Intrusions on the task related to frPSI were inversely correlated with a widespread connectivity network involving hippocampal, insular, posterior cingulate, and dorsolateral prefrontal cortices, along with precunei and anterior thalamus in this group. Different patterns of connectivity associated with frPSI were observed among controls. The present results suggest that both semantic interference deficits and connectivity abnormalities might reflect limbic circuit dysfunction as a very early clinical signature of LOAD pathology, as previously demonstrated for other limbic phenotypes, such as sleep and circadian alterations.

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.

The past, present and perhaps future of pharmacovigilance: homage to Folke Sjoqvist.

PubMed

Moore, Nicholas

2013-05-01

Over the years since 1961 and the identification of thalidomide as the common link in thousands of birth defects, daily pharmacovigilance activities and signal generation have evolved from the analysis of individual case reports and imputology, to case series and underreporting, to spontaneous report databases and disproportionality analyses, to data mining in population databases. Regulatory requirements have also changed from purely passive monitoring and reacting to alerts to a proactive approach that includes risk management plans and risk minimization, and from reporting only by healthcare professionals to patient reporting and exploration of social media. The emphasis only on risk assessment is changing towards assessment of the risk/benefit ratio and the exploration of real-life efficacy studies to complement the measure of real-life risk. The interactions between industry and regulators have been amplified and strengthened. However, most adverse reactions, including severe ones, are related to well-known and often pharmacological effects of the older drugs, possibly with genetic predispositions. Prevention is the next frontier for pharmacovigilance, beyond simply generating alerts, and it involves not only the removal of drugs from the market, but also promotion of proper drug prescribing by better trained physicians and the proper use of drugs by better informed patients.

Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.

PubMed

Scobie, Andrea

2011-04-01

To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. None. A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill. A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P < 0.01) for inclusion in a binary logistic regression model. The final regression model included eight risk factors for self-reported error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department. Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.

How to Perform a Security Audit: Is Your School's or District's Network Vulnerable?

ERIC Educational Resources Information Center

Dark, Melissa; Poftak, Amy

2004-01-01

In this article, the authors address the importance of taking a proactive approach to securing a school's network. To do this, it is first required to know the system's specific vulnerabilities and what steps to take to reduce them. The formal process for doing this is known as an information security risk assessment, or a security audit. What…

Reduced autobiographical memory specificity relates to weak resistance to proactive interference.

PubMed

Smets, Jorien; Wessel, Ineke; Raes, Filip

2014-06-01

Reduced autobiographical memory specificity (rAMS), experiencing intrusive memories, and rumination appear to be risk factors for depression and depressive relapse. The aim of the current study was to investigate whether a weak resistance to proactive interference (PI) might underlie this trio of cognitive risk factors. Resistance to PI refers to being able to ignore cognitive distracters that were previously relevant but became irrelevant for current task goals. Students (N = 65) and depressed patients (N = 37) completed tasks measuring resistance to PI and AMS, and completed questionnaires on intrusive memories and rumination. In both samples, weaker resistance to PI was associated with rAMS. There was no evidence for a relationship between resistance to PI and intrusive memories or rumination. As we did not assess other measures of executive functioning, we cannot conclude whether the observed relationship between rumination and PI is due to unique qualities of PI. Difficulties to deliberately recall specific, rather than general or categoric autobiographical memories appear to be related to more general problems with the inhibition of interference of mental distracters. The results are in line with the executive control account of rAMS. Copyright © 2013 Elsevier Ltd. All rights reserved.

Coping Style Modifies General and Affective Autonomic Reactions of Domestic Pigs in Different Behavioral Contexts

PubMed Central

Krause, Annika; Puppe, Birger; Langbein, Jan

2017-01-01

Based on individual adaptive strategies (coping), animals may react differently to environmental challenges in terms of behavior and physiology according to their emotional perception. Emotional valence as well as arousal may be derived by measuring vagal and sympathetic tone of the autonomic nervous system (ANS). We investigated the situation-dependent autonomic response of 16 domestic pigs with either a reactive or a proactive coping style, previously selected according to the backtest which is accepted in piglets to assess escape behavior. At 11 weeks of age, the pigs were equipped with an implantable telemetric device, and heart rate (HR), blood pressure (BP) and their respective variabilities (HRV, BPV) were recorded for 1 h daily over a time period of 10 days and analyzed in four behavioral contexts (resting, feeding, idling, handling). Additionally, the first minute of feeding and handling was used for a short-term analysis of these parameters in 10-s intervals. Data from day 1–3 (period 1) and day 8–10 (period 2) were grouped into two separate periods. Our results revealed general differences between the coping styles during feeding, resting and handling, with proactive pigs showing higher HR compared to reactive pigs. This elevated HR was based on either lower vagal (resting) or elevated sympathetic activation (feeding, handling). The short-term analysis of the autonomic activation during feeding revealed a physiological anticipation reaction in proactive pigs in period 1, whereas reactive pigs showed this reaction only in period 2. Food intake was characterized by sympathetic arousal with concurrent vagal withdrawal, which was more pronounced in proactive pigs. In contrast, neither coping style resulted in an anticipation reaction to handling. Vagal activation increased in reactive pigs during handling, while proactive pigs showed an increase in sympathetically driven arousal in period 2. Our findings confirm significant context-related differences in the general autonomic reaction of pigs with different coping styles. Additionally, the two coping styles differ in their affective appraisal over the time course of the experiment, underlining the importance of taking individual differences into account when studying affect and emotion in humans and animals. PMID:28611608

Coping Style Modifies General and Affective Autonomic Reactions of Domestic Pigs in Different Behavioral Contexts.

PubMed

Krause, Annika; Puppe, Birger; Langbein, Jan

2017-01-01

Based on individual adaptive strategies (coping), animals may react differently to environmental challenges in terms of behavior and physiology according to their emotional perception. Emotional valence as well as arousal may be derived by measuring vagal and sympathetic tone of the autonomic nervous system (ANS). We investigated the situation-dependent autonomic response of 16 domestic pigs with either a reactive or a proactive coping style, previously selected according to the backtest which is accepted in piglets to assess escape behavior. At 11 weeks of age, the pigs were equipped with an implantable telemetric device, and heart rate (HR), blood pressure (BP) and their respective variabilities (HRV, BPV) were recorded for 1 h daily over a time period of 10 days and analyzed in four behavioral contexts (resting, feeding, idling, handling). Additionally, the first minute of feeding and handling was used for a short-term analysis of these parameters in 10-s intervals. Data from day 1-3 (period 1) and day 8-10 (period 2) were grouped into two separate periods. Our results revealed general differences between the coping styles during feeding, resting and handling, with proactive pigs showing higher HR compared to reactive pigs. This elevated HR was based on either lower vagal (resting) or elevated sympathetic activation (feeding, handling). The short-term analysis of the autonomic activation during feeding revealed a physiological anticipation reaction in proactive pigs in period 1, whereas reactive pigs showed this reaction only in period 2. Food intake was characterized by sympathetic arousal with concurrent vagal withdrawal, which was more pronounced in proactive pigs. In contrast, neither coping style resulted in an anticipation reaction to handling. Vagal activation increased in reactive pigs during handling, while proactive pigs showed an increase in sympathetically driven arousal in period 2. Our findings confirm significant context-related differences in the general autonomic reaction of pigs with different coping styles. Additionally, the two coping styles differ in their affective appraisal over the time course of the experiment, underlining the importance of taking individual differences into account when studying affect and emotion in humans and animals.

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

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management.

PubMed

Jiménez-Rodríguez, Enrique; Feria-Domínguez, José Manuel; Sebastián-Lacave, Alonso

2018-03-30

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData ® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

PubMed Central

Jiménez-Rodríguez, Enrique; Sebastián-Lacave, Alonso

2018-01-01

Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls. PMID:29601529

Proactive life extension of pressure vessels

NASA Astrophysics Data System (ADS)

Mager, Lloyd

1998-03-01

For a company to maintain its competitive edge in today's global market every opportunity to gain an advantage must be exploited. Many companies are strategically focusing on improved utilization of existing equipment as well as regulatory compliance. Abbott Laboratories is no exception. Pharmaceutical companies such as Abbott Laboratories realize that reliability and availability of their production equipment is critical to be successful and competitive. Abbott Laboratories, like many of our competitors, is working to improve safety, minimize downtime and maximize the productivity and efficiency of key production equipment such as the pressure vessels utilized in our processes. The correct strategy in obtaining these objectives is to perform meaningful inspection with prioritization based on hazard analysis and risk. The inspection data gathered in Abbott Laboratories pressure vessel program allows informed decisions leading to improved process control. The results of the program are reduced risks to the corporation and employees when operating pressure retaining equipment. Accurate and meaningful inspection methods become the cornerstone of a program allowing proper preventative maintenance actions to occur. Successful preventative/predictive maintenance programs must utilize meaningful nondestructive evaluation techniques and inspection methods. Nondestructive examination methods require accurate useful tools that allow rapid inspection for the entire pressure vessel. Results from the examination must allow the owner to prove compliance of all applicable regulatory laws and codes. At Abbott Laboratories the use of advanced NDE techniques, primarily B-scan ultrasonics, has provided us with the proper tools allowing us to obtain our objectives. Abbott Laboratories uses B-scan ultrasonics utilizing a pulse echo pitch catch technique to provide essential data on our pressure vessels. Equipment downtime is reduced because the nondestructive examination usually takes place while our vessels are in service. As the inspection takes place we are able to view a real time image of detected discontinuities on a video monitor. The B-scan ultrasonic technique is allowing us to perform fast accurate examinations covering up to 95% of the surface area of each pressure vessel. Receiving data on 95% of a pressure vessel provides us with a lot of useful information. We use this data to determine the condition of each pressure vessel. Once the condition is known the vessels are classed by risk. The risk level is then managed by making decisions related to repair, operating parameters, accepting and monitoring or replacement of the equipment. Inspection schedules are set at maximum intervals and reinspection is minimized for the vessels that are not at risk. The remaining life of each pressure vessel is determined, mechanical integrity is proven and regulatory requirements are met. Abbott Laboratories is taking this proactive approach because we understand that our process equipment is a critical element for successful operation. A run to failure practice would never allow Abbott Laboratories to achieve the corporation's objective of being the world's leading health care company. Nondestructive state of the art technology and the understanding of its capabilities and limitations are key components of a proactive program for life extension of pressure vessels. 26

Meta-Prediction of MTHFR Gene Polymorphism Mutations and Associated Risk for Colorectal Cancer

PubMed Central

Yu, C. H.

2016-01-01

The methylenetetrahydrofolate reductase (MTHFR) gene is one of the most investigated of the genes associated with chronic human diseases because of its associations with hyperhomocysteinemia and toxicity. It has been proposed as a prototype gene for the prevention of colorectal cancer (CRC). The major objectives of this meta-analysis were to examine the polymorphism-mutation patterns of MTHFR and their associations with risk for CRC as well as potential contributing factors for mutations and disease risks. This analysis included 33,626 CRC cases and 48,688 controls across 92 studies for MTHFR 677 and 16,367 cases and 24,874 controls across 54 studies for MTHFR 1298, comprising data for various racial and ethnic groups, both genders, and multiple cancer sites. MTHFR 677 homozygous TT genotype was protective (p < .05) for CRC for all included populations; however, with heterogeneity across various racial–ethnic groups and opposing findings, it was a risk genotype for the subgroup of Hispanics (p < .01). Additional countries for which subgroup analyses resulted in 677 TT as a risk genotype included Turkey, Romania, Croatia, Hungary, Portugal, Mexico, Brazil, U.S. Hawai’i, Taiwan, India, and Egypt. Countries with the highest mutation rates and risks for both MTHFR 677 and 1298 genotypes are presented using global maps to visualize the grouping patterns. Meta-predictive analyses revealed that air pollution levels were associated with gene polymorphisms for both genotypes. Future nursing research should be conducted to develop proactive measures to protect populations in cities where air pollution causes more deaths. PMID:26858257

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).

NASA Aerospace Flight Battery Program: Generic Safety, Handling and Qualification Guidelines for Lithium-Ion (Li-Ion) Batteries; Availability of Source Materials for Lithium-Ion (Li-Ion) Batteries; Maintaining Technical Communications Related to Aerospace Batteries (NASA Aerospace Battery Workshop). Volume 2, Part 1

NASA Technical Reports Server (NTRS)

Manzo, Michelle A.; Brewer, Jeffrey C.; Bugga, Ratnakumar V.; Darcy, Eric C.; Jeevarajan, Judith A.; McKissock, Barbara I.; Schmitz, Paul C.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This report contains the Appendices to the findings from the first year of the program's operations.

Effect of a patient engagement tool on positive airway pressure adherence: analysis of a German healthcare provider database.

PubMed

Woehrle, Holger; Arzt, Michael; Graml, Andrea; Fietze, Ingo; Young, Peter; Teschler, Helmut; Ficker, Joachim H

2018-01-01

This study investigated the addition of a real-time feedback patient engagement tool on positive airway pressure (PAP) adherence when added to a proactive telemedicine strategy. Data from a German healthcare provider (ResMed Healthcare Germany) were retrospectively analyzed. Patients who first started PAP therapy between 1 September 2009 and 30 April 2014, and were managed using telemedicine (AirView™; proactive care) or telemedicine + patient engagement tool (AirView™ + myAir™; patient engagement) were eligible. Patient demographics, therapy start date, sleep-disordered breathing indices, device usage hours, and therapy termination rate were obtained and compared between the two groups. The first 500 patients managed by telemedicine-guided care and a patient engagement tool were matched with 500 patients managed by telemedicine-guided care only. The proportion of nights with device usage ≥4 h was 77 ± 25% in the patient engagement group versus 63 ± 32% in the proactive care group (p < 0.001). Therapy termination occurred less often in the patient engagement group (p < 0.001). The apnea-hypopnea index was similar in the two groups, but leak was significantly lower in the patient engagement versus proactive care group (2.7 ± 4.0 vs 4.1 ± 5.3 L/min; p < 0.001). Addition of a patient engagement tool to telemonitoring-guided proactive care was associated with higher device usage and lower leak. This suggests that addition of an engagement tool may help improve PAP therapy adherence and reduce mask leak. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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…

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

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.

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).

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.

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.

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.

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.

When does a good working memory counteract proactive interference? Surprising evidence from a probe recognition task.

PubMed

Cowan, Nelson; Saults, J Scott

2013-02-01

It is often proposed that individuals with high working memory span overcome proactive interference (PI) from previous trials, saving working memory for task-relevant items. We examined this hypothesis in word-list probe recognition. We found no difference in PI related to span. Instead, ex-gaussian analysis of reaction time showed speed advantages for high spans specific to short lists (3 or 4 items) but absent from longer lists (6 or 8 items). We suggest that high-span advantages in reaction time are based on finesse during easy trials, not on overcoming PI. 2013 APA, all rights reserved

How to develop a proactive formulary system.

PubMed

Crane, V S; Gonzalez, E R; Hull, B L

1994-10-01

To develop a quality formulary system, a proactive approach is necessary. This approach incorporates a prospective product and concurrent product analyses. A prospective product analysis, in turn, involves a review of current formulary agents, those likely to enter the marketplace shortly, and the formation of an expert review panel. This panel's tasks are to examine therapeutic, economic, and humanistic aspects of therapy and to set initial parameters for appropriate and cost-effective use of accepted products. Keys to a successful formulary system are to continuously monitor drug use and compliance with criteria and to work collaboratively with all institutional professionals in the development, implementation, and monitoring of the system.

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

The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease

PubMed Central

Gimeno-Santos, Elena; Raste, Yogini; Demeyer, Heleen; Louvaris, Zafeiris; de Jong, Corina; Rabinovich, Roberto A.; Hopkinson, Nicholas S.; Polkey, Michael I.; Vogiatzis, Ioannis; Tabberer, Maggie; Dobbels, Fabienne; Ivanoff, Nathalie; de Boer, Willem I.; van der Molen, Thys; Kulich, Karoly; Serra, Ignasi; Basagaña, Xavier; Troosters, Thierry; Puhan, Milo A.; Karlsson, Niklas

2015-01-01

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD. Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts. 236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled “amount” and “difficulty”. After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test–retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity. Daily and clinical visit “PROactive physical activity in COPD” instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients. PMID:26022965

Family context and externalizing correlates of childhood animal cruelty in adjudicated delinquents.

PubMed

Walters, Glenn D; Noon, Alexandria

2015-05-01

The purpose of this study was to determine whether childhood animal cruelty is primarily a feature of family context or of externalizing behavior. Twenty measures of family context and proactive (fearlessness) and reactive (disinhibition) externalizing behavior were correlated with the retrospective accounts of childhood animal cruelty provided by 1,354 adjudicated delinquents. A cross-sectional analysis revealed that all 20 family context, proactive externalizing, and reactive externalizing variables correlated significantly with animal cruelty. Prospective analyses showed that when the animal cruelty variable was included in a regression equation with the 10 family context variables (parental arguing and fighting, parental drug use, parental hostility, and parental knowledge and monitoring of offspring behavior) or in a regression equation with the five reactive externalizing variables (interpersonal hostility, secondary psychopathy, weak impulse control, weak suppression of aggression, and short time horizon), it continued to predict future violent and income (property + drug) offending. The animal cruelty variable no longer predicted offending, however, when included in a regression equation with the five proactive externalizing variables (early onset behavioral problems, primary psychopathy, moral disengagement, positive outcome expectancies for crime, and lack of consideration for others). These findings suggest that while animal cruelty correlates with a wide range of family context and externalizing variables, it may serve as a marker of violent and nonviolent offending by virtue of its position on the proactive subdimension of the externalizing spectrum. © The Author(s) 2014.

Testing complex animal cognition: Concept learning, proactive interference, and list memory.

PubMed

Wright, Anthony A

2018-01-01

This article describes an approach for assessing and comparing complex cognition in rhesus monkeys and pigeons by training them in a sequence of synergistic tasks, each yielding a whole function for enhanced comparisons. These species were trained in similar same/different tasks with expanding training sets (8, 16, 32, 64, 128 … 1024 pictures) followed by novel-stimulus transfer eventually resulting in full abstract-concept learning. Concept-learning functions revealed better rhesus transfer throughout and full concept learning at the 128 set, versus pigeons at the 256 set. They were then tested in delayed same/different tasks for proactive interference by inserting occasional tests within trial-unique sessions where the test stimulus matched a previous sample stimulus (1, 2, 4, 8, 16 trials prior). Proactive-interference functions revealed time-based interference for pigeons (1, 10 s delays), but event-based interference for rhesus (no effect of 1, 10, 20 s delays). They were then tested in list-memory tasks by expanding the sample to four samples in trial-unique sessions (minimizing proactive interference). The four-item, list-memory functions revealed strong recency memory at short delays, gradually changing to strong primacy memory at long delays over 30 s for rhesus, and 10 s for pigeons. Other species comparisons and future directions are discussed. © 2018 Society for the Experimental Analysis of Behavior.

Lack of correspondence between the reactive proactive questionnaire and the impulsive premeditated aggression scale among forensic psychiatric outpatients.

PubMed

Smeijers, Danique; Brugman, Suzanne; von Borries, Katinka; Verkes, Robbert-Jan; Bulten, Erik

2018-05-15

The most studied bimodal classifications of aggressive behavior are the impulsive/premeditated distinction measured with the Impulsive Premeditated Aggression Scale and the reactive/proactive distinction measured with the Reactive Proactive Questionnaire. The terms of these classifications are often used interchangeably, assuming that reactive aggression is equivalent to impulsive aggression and that proactive aggressive behavior is the same as premeditated aggression. The correspondence or discrepancy between both aggression classifications/questionnaires, however, is understudied. Therefore, the current study investigated the correspondence between the RPQ and IPAS in a sample of 161 forensic psychiatric outpatients (FPOs) with severe aggressive behavior. Correlation analysis revealed a limited correspondence between the RPQ and IPAS. Cluster analyses derived three clusters from the RPQ as well as the IPAS: these clusters did not match in 60.3% of the cases. Furthermore, the notion that the RPQ measures trait aggression whereas the IPAS assesses state aggression could not be verified. The present study indicates that aggression subtypes as measured by use of the RPQ and IPAS correspond only partially and should not be used interchangeably. Furthermore, it was suggested that RPQ focuses more on actual aggressive behavior and the IPAS more on emotions and their regulation. Future research is needed to elucidate the applicability of both questionnaires in further detail. © 2018 Wiley Periodicals, Inc.

The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease.

PubMed

Gimeno-Santos, Elena; Raste, Yogini; Demeyer, Heleen; Louvaris, Zafeiris; de Jong, Corina; Rabinovich, Roberto A; Hopkinson, Nicholas S; Polkey, Michael I; Vogiatzis, Ioannis; Tabberer, Maggie; Dobbels, Fabienne; Ivanoff, Nathalie; de Boer, Willem I; van der Molen, Thys; Kulich, Karoly; Serra, Ignasi; Basagaña, Xavier; Troosters, Thierry; Puhan, Milo A; Karlsson, Niklas; Garcia-Aymerich, Judith

2015-10-01

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD.Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts.236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled "amount" and "difficulty". After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test-retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity.Daily and clinical visit "PROactive physical activity in COPD" instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients. Copyright ©ERS 2015.

The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention.

PubMed

Schneider, Francine; Schulz, Daniela N; Pouwels, Loes H L; de Vries, Hein; van Osch, Liesbeth A D M

2013-08-05

The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants' characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive dissemination strategy succeeded in ensuring relatively high levels of reach. Reach among at-risk individuals (e.g. low socioeconomic status and unhealthy lifestyle) was modest. It is therefore essential to further optimize reach by putting additional effort into increasing interest in the lifestyle intervention among at-risk individuals and to encourage them to actually use the intervention. Dutch Trial Register (NTR1786) and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016).

The use of a proactive dissemination strategy to optimize reach of an internet-delivered computer tailored lifestyle intervention

PubMed Central

2013-01-01

Background The use of reactive strategies to disseminate effective Internet-delivered lifestyle interventions restricts their level of reach within the target population. This stresses the need to invest in proactive strategies to offer these interventions to the target population. The present study used a proactive strategy to increase reach of an Internet-delivered multi component computer tailored intervention, by embedding the intervention in an existing online health monitoring system of the Regional Public Health Services in the Netherlands. Methods The research population consisted of Dutch adults who were invited to participate in the Adult Health Monitor (N = 96,388) offered by the Regional Public Health Services. This Monitor consisted of an online or a written questionnaire. A prospective design was used to determine levels of reach, by focusing on actual participation in the lifestyle intervention. Furthermore, adequacy of reach among the target group was assessed by composing detailed profiles of intervention users. Participants’ characteristics, like demographics, behavioral and mental health status and quality of life, were included in the model as predictors. Results A total of 41,155 (43%) people participated in the Adult Health Monitor, of which 41% (n = 16,940) filled out the online version. More than half of the online participants indicated their interest (n = 9169; 54%) in the computer tailored intervention and 5168 participants (31%) actually participated in the Internet-delivered computer tailored intervention. Males, older respondents and individuals with a higher educational degree were significantly more likely to participate in the intervention. Furthermore, results indicated that especially participants with a relatively healthier lifestyle and a healthy BMI were likely to participate. Conclusions With one out of three online Adult Health Monitor participants actually participating in the computer tailored lifestyle intervention, the employed proactive dissemination strategy succeeded in ensuring relatively high levels of reach. Reach among at-risk individuals (e.g. low socioeconomic status and unhealthy lifestyle) was modest. It is therefore essential to further optimize reach by putting additional effort into increasing interest in the lifestyle intervention among at-risk individuals and to encourage them to actually use the intervention. Trial registration Dutch Trial Register (NTR1786) and Medical Ethics Committee of Maastricht University and the University Hospital Maastricht (NL2723506809/MEC0903016). PMID:23914991

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.

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.

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

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.

Exploring the interactions between forecast accuracy, risk perception and perceived forecast reliability in reservoir operator's decision to use forecast

NASA Astrophysics Data System (ADS)

Shafiee-Jood, M.; Cai, X.

2017-12-01

Advances in streamflow forecasts at different time scales offer a promise for proactive flood management and improved risk management. Despite the huge potential, previous studies have found that water resources managers are often not willing to incorporate streamflow forecasts information in decisions making, particularly in risky situations. While low accuracy of forecasts information is often cited as the main reason, some studies have found that implementation of streamflow forecasts sometimes is impeded by institutional obstacles and behavioral factors (e.g., risk perception). In fact, a seminal study by O'Connor et al. (2005) found that risk perception is the strongest determinant of forecast use while managers' perception about forecast reliability is not significant. In this study, we aim to address this issue again. However, instead of using survey data and regression analysis, we develop a theoretical framework to assess the user-perceived value of streamflow forecasts. The framework includes a novel behavioral component which incorporates both risk perception and perceived forecast reliability. The framework is then used in a hypothetical problem where reservoir operator should react to probabilistic flood forecasts with different reliabilities. The framework will allow us to explore the interactions among risk perception and perceived forecast reliability, and among the behavioral components and information accuracy. The findings will provide insights to improve the usability of flood forecasts information through better communication and education.

Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

PubMed Central

Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

2015-01-01

Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination. PMID:26501109

Soil and salinity mobilization and transport in the Colorado River Basin

Treesearch

Cole Green Rossi; Mark A. Weitz; Kossi Nouwakpo; Ken McGwire

2016-01-01

Federally, the evaluated potential of soil loss risk in national reports in the past and ways to adapt to be proactive in preventing accelerated soil loss on rangelands has been incomplete. The areas where it is difficult to measure due to the complexities of multiple interactions (splash, sheet and rill formation, landscape dominated by wind and water processes,...

Team Proactivity as a Linking Mechanism between Team Creative Efficacy, Transformational Leadership, and Risk-Taking Norms and Team Creative Performance

ERIC Educational Resources Information Center

Shin, Yuhyung; Eom, Chanyoung

2014-01-01

Despite the growing body of research on creativity in team contexts, very few attempts have been made to explore the team-level antecedents and the mediating processes of team creative performance on the basis of a theoretical framework. To address this gap, drawing on Paulus and Dzindolet's (2008) group creativity model, this study proposed team…

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)

The Relations Among Inhibition and Interference Control Functions: A Latent-Variable Analysis

ERIC Educational Resources Information Center

Friedman, Naomi P.; Miyake, Akira

2004-01-01

This study used data from 220 adults to examine the relations among 3 inhibition-related functions. Confirmatory factor analysis suggested that Prepotent Response Inhibition and Resistance to Distractor Interference were closely related, but both were unrelated to Resistance to Proactive Interference. Structural equation modeling, which combined…

Psychological predictors of injury occurrence: a prospective investigation of professional Swedish soccer players.

PubMed

Ivarsson, Andreas; Johnson, Urban; Podlog, Leslie

2013-02-01

Athletes participating in sport are exposed to a high injury risk. Previous research has found a great number of risk factors (both physiological and psychological) that could increase injury risk. One limitation in previous studies is that few have considered the complex interaction between psychological factors in their research design. To study whether personality, stress, and coping predicted injury occurrence in an elite soccer population based on a hypothesized model. Prospective. 56 (n = 38 male, n = 18 female) Swedish Premiere League soccer players were selected based on convenience sampling. Participants completed 4 questionnaires including the Swedish Universities Scales of Personality, Life Events Survey for Collegiate Athletes, and Brief COPE during the initial questionnaire administration. Subsequent to the first meeting, participants also completed the Hassle and Uplift Scale5 once per wk for a 13-wk period throughout the competitive season. A path analysis was conducted examining the influence of personality traits (ie, trait anxiety), state-level stressors (ie, negative-life-event stress and daily hassles), and coping on injury frequency. Results of the path analysis indicated that trait anxiety, negative-life-event stress, and daily hassle were significant predictors of injury among professional soccer players, accounting for 24% of the variance. The findings highlight the need for athletes, coaches, and medical practitioners to attempt to reduce state-level stressors, especially daily hassles, in minimizing injury risk. Educating and training athletes and coaches in proactive stress-management techniques appears warranted.

SAMCO: Society Adaptation for coping with Mountain risks in a global change COntext

NASA Astrophysics Data System (ADS)

Grandjean, Gilles; Bernardie, Severine; Malet, Jean-Philippe; Puissant, Anne; Houet, Thomas; Berger, Frederic; Fort, Monique; Pierre, Daniel

2013-04-01

The SAMCO project aims to develop a proactive resilience framework enhancing the overall resilience of societies on the impacts of mountain risks. The project aims to elaborate methodological tools to characterize and measure ecosystem and societal resilience from an operative perspective on three mountain representative case studies. To achieve this objective, the methodology is split in several points with (1) the definition of the potential impacts of global environmental changes (climate system, ecosystem e.g. land use, socio-economic system) on landslide hazards, (2) the analysis of these consequences in terms of vulnerability (e.g. changes in the location and characteristics of the impacted areas and level of their perturbation) and (3) the implementation of a methodology for quantitatively investigating and mapping indicators of mountain slope vulnerability exposed to several hazard types, and the development of a GIS-based demonstration platform. The strength and originality of the SAMCO project will be to combine different techniques, methodologies and models (multi-hazard assessment, risk evolution in time, vulnerability functional analysis, and governance strategies) and to gather various interdisciplinary expertises in earth sciences, environmental sciences, and social sciences. The multidisciplinary background of the members could potentially lead to the development of new concepts and emerging strategies for mountain hazard/risk adaptation. Research areas, characterized by a variety of environmental, economical and social settings, are severely affected by landslides, and have experienced significant land use modifications (reforestation, abandonment of traditional agricultural practices) and human interferences (urban expansion, ski resorts construction) over the last century.

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.

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.

Alcohol Words Elicit Reactive Cognitive Control in Low Sensitivity Drinkers

PubMed Central

Bailey, Kira; Bartholow, Bruce D.

2016-01-01

Previous event-related potential (ERP) studies shown support for the idea that alcohol-related stimuli are particularly salient to individuals who report low sensitivity to alcohol's effects (LS; a known risk factor for alcohol-related problems), leading such stimuli to spontaneously capture their attention and interfere with self-regulatory goal pursuit. The current study investigated LS individuals’ use of reactive and proactive cognitive control in response to alcohol-related stimuli. Participants performed an alcohol Stroop task in which they indicated the font color of alcohol- and nonalcohol-related words while ERPs were recorded. The probability of alcohol and nonalcohol words was manipulated to test predictions derived from Dual Mechanisms of Control theory. Among LS individuals, infrequent alcohol-related words elicited slower responses and larger N2 amplitude, consistent with these stimuli eliciting enhanced reactive control responses. Amplitude of the frontal slow wave (FSW) component, associated with proactive control, was marginally larger among LS individuals when alcohol words were more frequent, but response accuracy was lower. These findings demonstrate that LS individuals experience conflict when presented with task-irrelevant alcohol-related stimuli, even in a context where conflict arguably should not be present. Findings further suggest that LS individuals can effectively implement reactive control to deal with this conflict when it is infrequent, but have difficulty implementing proactive control in the context of more frequent conflict. PMID:27545019

Detection of medical errors in kidney transplantation: a pilot study comparing proactive clinician debriefings to a hospital-wide incident reporting system.

PubMed

McElroy, Lisa M; Daud, Amna; Lapin, Brittany; Ross, Olivia; Woods, Donna M; Skaro, Anton I; Holl, Jane L; Ladner, Daniela P

2014-11-01

Rates of medical errors and adverse events remain high for patients who undergo kidney transplantation; they are particularly vulnerable because of the complexity of their disease and the kidney transplantation procedure. Although institutional incident-reporting systems are used in hospitals around the country, they often fail to capture a substantial proportion of medical errors. The goal of this study was to assess the ability of a proactive, web-based clinician safety debriefing to augment the information about medical errors and adverse events obtained via traditional incident reporting systems. Debriefings were sent to all individuals listed on operating room personnel reports for kidney transplantation surgeries between April 2010 and April 2011, and incident reports were collected for the same time period. The World Health Organization International Classification for Patient Safety was used to classify all issues reported. A total of 270 debriefings reported 334 patient safety issues (179 safety incidents, 155 contributing factors), and 57 incident reports reported 92 patient safety issues (56 safety incidents, 36 contributing factors). Compared with incident reports, more attending physicians completed the debriefings (32.0 vs 3.5%). The use of a proactive, web-based debriefing to augment an incident reporting system in assessing safety risks in kidney transplantation demonstrated increased information, more perspectives of a single safety issue, and increased breadth of participants. Copyright © 2014 Elsevier Inc. All rights reserved.

Refining the Value of Secretory Phospholipase A2 as a Predictor of Acute Chest Syndrome in Sickle Cell Disease: Results of a Feasibility Study (PROACTIVE)

PubMed Central

Styles, Lori; Wager, Carrie G.; Labotka, Richard J.; Smith-Whitley, Kim; Thompson, Alexis A.; Lane, Peter A.; McMahon, Lillian E.C; Miller, Robin; Roseff, Susan; Iyer, Rathi; Hsu, Lewis L.; Castro, Oswaldo; Ataga, Kenneth; Onyekwere, Onyinye; Okam, Maureen; Bellevue, Rita; Miller, Scott T.

2012-01-01

Acute chest syndrome (ACS) is defined as fever, respiratory symptoms and a new pulmonary infiltrate in an individual with sickle cell disease (SCD). Nearly half of ACS episodes occur in SCD patients already hospitalized, potentially permitting pre-emptive therapy in high-risk patients. Simple transfusion of red blood cells may abort ACS if given to patients hospitalized for pain who develop fever and elevated levels of secretory phospholipase A2 (sPLA2). In a feasibility study (PROACTIVE; ClinicalTrials.gov NCT00951808), patients hospitalized for pain who developed fever and elevated sPLA2 were eligible for randomization to transfusion or observation; all others were enrolled in an observational arm. Of 237 enrolled, only 10 were randomized; one of the four to receive transfusion had delayed treatment. Of 233 subjects receiving standard care, 22 developed ACS. A threshold level of sPLA2 ≥ 48 ng/ml gave optimal sensitivity (73%), specificity (71%) and accuracy (71%), but a positive predictive value of only 24%. The predictive value of sPLA2 was improved in adults and patients with chest or back pain, lower haemoglobin concentration and higher white blood cell counts; and those receiving less than two-thirds maintenance fluids. The hurdles identified in PROACTIVE should facilitate design of a larger, definitive, phase 3 randomized controlled trial. PMID:22463614

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.

Methodology for safety optimization of highway cross-sections for horizontal curves with restricted sight distance.

PubMed

Ibrahim, Shewkar E; Sayed, Tarek; Ismail, Karim

2012-11-01

Several earlier studies have noted the shortcomings with existing geometric design guides which provide deterministic standards. In these standards the safety margin of the design output is generally unknown and there is little knowledge of the safety implications of deviating from the standards. To mitigate these shortcomings, probabilistic geometric design has been advocated where reliability analysis can be used to account for the uncertainty in the design parameters and to provide a mechanism for risk measurement to evaluate the safety impact of deviations from design standards. This paper applies reliability analysis for optimizing the safety of highway cross-sections. The paper presents an original methodology to select a suitable combination of cross-section elements with restricted sight distance to result in reduced collisions and consistent risk levels. The purpose of this optimization method is to provide designers with a proactive approach to the design of cross-section elements in order to (i) minimize the risk associated with restricted sight distance, (ii) balance the risk across the two carriageways of the highway, and (iii) reduce the expected collision frequency. A case study involving nine cross-sections that are parts of two major highway developments in British Columbia, Canada, was presented. The results showed that an additional reduction in collisions can be realized by incorporating the reliability component, P(nc) (denoting the probability of non-compliance), in the optimization process. The proposed approach results in reduced and consistent risk levels for both travel directions in addition to further collision reductions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Towards a Framework for Managing Risk Associated with Technology-Induced Error.

PubMed

Borycki, Elizabeth M; Kushniruk, Andre W

2017-01-01

Health information technologies (HIT) promised to streamline and modernize healthcare processes. However, a growing body of research has indicated that if such technologies are not designed, implemented or maintained properly this may lead to an increased incidence of new types of errors which the authors have referred to as "technology-induced errors". In this paper, framework is presented that can be used to manage HIT risk. The framework considers the reduction of technology-induced errors at different stages by managing risks associated with the implementation of HIT. Frameworks that allow health information technology managers to employ proactive and preventative approaches that can be used to manage the risks associated with technology-induced errors are critical to improving HIT safety and managing risk associated with implementing new technologies.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

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.

Predictors of patterns of pain, fatigue and insomnia during the first year following a cancer diagnosis in the elderly

PubMed Central

Bandeen-Roche, Karen

2008-01-01

Pain, fatigue and insomnia (PFI) are among the most prevalent, distressing, and under managed symptoms experienced by cancer patients. Research has demonstrated that PFI co-occur; what remains unclear are the patterning and stability of PFI patterns, and the patient, disease and treatment characteristics that predict PFI patterns over time. This secondary analysis used a dataset comprised of 867 elders (46% female) who were newly diagnosed with breast, colorectal, lung or prostate cancer and followed at four points during the year following diagnosis. The university's IRB approved this study. Descriptive statistics and multi-state transition models using multinomial logistic regression were employed. The typical participant was 72.6 years, reported 7.9 symptoms and 2.7 comorbidities. Prior PFI pattern was consistently associated with significantly increased risks for subsequent PFI pattern. At observations 1-3, lung cancer, treatment, higher comorbidity with breast cancer, and late stage colorectal cancer were significantly associated with increased risks for PFI patterns. Advancing age was not significantly associated with increased risks for PFI patterns. PFI co-occurrence declined over time, but was associated with significantly increased risks for death or loss to follow-up and increased reports of other symptoms. PFI co-occurrence is associated with adverse outcomes and should be proactively targeted for intervention. PMID:18772657

Privacy-Assured Aggregation Protocol for Smart Metering: A Proactive Fault-Tolerant Approach [Proactive Fault-Tolerant Aggregation Protocol for Privacy-Assured Smart Metering

DOE PAGES

Won, Jongho; Ma, Chris Y. T.; Yau, David K. Y.; ...

2016-06-01

Smart meters are integral to demand response in emerging smart grids, by reporting the electricity consumption of users to serve application needs. But reporting real-time usage information for individual households raises privacy concerns. Existing techniques to guarantee differential privacy (DP) of smart meter users either are not fault tolerant or achieve (possibly partial) fault tolerance at high communication overheads. In this paper, we propose a fault-tolerant protocol for smart metering that can handle general communication failures while ensuring DP with significantly improved efficiency and lower errors compared with the state of the art. Our protocol handles fail-stop faults proactively bymore » using a novel design of future ciphertexts, and distributes trust among the smart meters by sharing secret keys among them. We prove the DP properties of our protocol and analyze its advantages in fault tolerance, accuracy, and communication efficiency relative to competing techniques. We illustrate our analysis by simulations driven by real-world traces of electricity consumption.« less

Privacy-Assured Aggregation Protocol for Smart Metering: A Proactive Fault-Tolerant Approach [Proactive Fault-Tolerant Aggregation Protocol for Privacy-Assured Smart Metering

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

Won, Jongho; Ma, Chris Y. T.; Yau, David K. Y.

Smart meters are integral to demand response in emerging smart grids, by reporting the electricity consumption of users to serve application needs. But reporting real-time usage information for individual households raises privacy concerns. Existing techniques to guarantee differential privacy (DP) of smart meter users either are not fault tolerant or achieve (possibly partial) fault tolerance at high communication overheads. In this paper, we propose a fault-tolerant protocol for smart metering that can handle general communication failures while ensuring DP with significantly improved efficiency and lower errors compared with the state of the art. Our protocol handles fail-stop faults proactively bymore » using a novel design of future ciphertexts, and distributes trust among the smart meters by sharing secret keys among them. We prove the DP properties of our protocol and analyze its advantages in fault tolerance, accuracy, and communication efficiency relative to competing techniques. We illustrate our analysis by simulations driven by real-world traces of electricity consumption.« less

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

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.

Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice.

PubMed

Mathews, Rahel; Zachariah, Rachel

2008-07-01

Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.

Towards integrative risk management and more resilient societies

NASA Astrophysics Data System (ADS)

Al-Khudhairy, D.; Axhausen, K.; Bishop, S.; Herrmann, H.; Hu, B.; Kröger, W.; Lewis, T.; MacIntosh, J.; Nowak, A.; Pickl, S.; Stauffacher, D.; Tan, E.

2012-11-01

Society depends decisively on the availability of infrastructure systems such as energy, telecommunication, transportation, banking and finance, health care and governmental and public administration. Even selective damages of one of these infrastructures may result in disruptions of governmental, industrial or public functions. Vulnerability of infrastructures therefore provides spectacular leverage for natural disasters as well as criminal and terrorist actions. Threats and risks are part of the technological, economical, and societal development. This article focuses on the development and characterization of an integrative risk-management which, from the perspective of "resilient systems", can be seen as an innovative and pro-active crisis management approach dealing with the increasing amount of complexity in societies in a comprehensive, agile and adaptive way.

How youth-serving organizations enable acquaintance molesters.

PubMed

Boyle, Patrick

2014-10-01

In recent years, some of the country's most prominent institutions have been ensnared in child sex abuse scandals. While each abuse incident features its own particular circumstances, institutions that have been the subject of these scandals have displayed similar patterns of organizational behavior that allowed molesting to occur and molesters to escape accountability. We can learn from those patterns to better understand and combat acquaintance molestation in youth-serving organizations. Although sex abuse is an inherent risk in youth work, American youth-serving organizations have responded to this risk largely on a case-by-case basis after abuse incidents have been revealed, rather than through proactive strategies to reduce the risk of abuse and to respond effectively to allegations. An examination of abuse scandals reveals common patterns of behavior among paid and volunteer staff in organizations that did not enact comprehensive, proactive strategies: Faith in the organiation blinded staff to the liklihood of abuse; organizations kept workers ignorant about the extent of the abuse problem; when abuse accusations arose, staff gave the benefit of the doubt to the adult; when abuse accusations were confirmed, staffers did not know how to respond; and not knowing how to resopnd, staff prioritized the protection of the organization. As a result, child molesters have been falsely exonerated or not held accountable, abused children have been disbelieved, and abuse has continued. These organizations inadvertently achieved the opposite of their missions: They enabled child molesters at the expense of children. © The Author(s) 2014.

Genetically engineered plants in the product development pipeline in India.

PubMed

Warrier, Ranjini; Pande, Hem

2016-01-02

In order to proactively identify emerging issues that may impact the risk assessment and risk management functions of the Indian biosafety regulatory system, the Ministry of Environment, Forests and Climate Change sought to understand the nature and diversity of genetically engineered crops that may move to product commercialization within the next 10 y. This paper describes the findings from a questionnaire designed to solicit information about public and private sector research and development (R&D) activities in plant biotechnology. It is the first comprehensive overview of the R&D pipeline for GE crops in India.

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,…

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…

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…

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

Communicating food risks in an era of growing public distrust: three case studies.

PubMed

Lofstedt, Ragnar

2013-02-01

The communication and regulation of risk has changed significantly over the past 30 years in Europe and to a noticeable but lesser extent in the United States. In Europe, this is partly due to a series of regulatory mishaps, ranging from mad cow disease in the United Kingdom to contamination of the blood supply in France. In the United States, general public confidence in the American government has been gradually declining for more than three decades, driven by a mix of cultural and political conflicts like negative political advertising, a corrosive news media, and cuts in regulatory budgets. While the former approach is based on an objective assessment of the risk, the latter is driven more by the perception of the risk, consumer sentiment, political will, and sectoral advocacy. In this article, the author examines three U.S.-based food case studies (acrylamide, bisphenol A, and artificial food colorings) where regulations at the local and state levels are increasingly being based on perceived risk advocacy rather than on the most effective response to the risk, be it to food safety or public health, as defined by regulatory interpretation of existing data. In the final section, the author puts forward a series of recommendations for how U.S.-based regulators can best handle those situations where the perceived risk is markedly different from the fact-based risk, such as strengthening the communication departments of food regulatory agencies, training officials in risk communication, and working more proactively with neutral third-party experts. © 2011 Society for Risk Analysis.

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

Digital technology to facilitate Proactive Assessment of Obesity Risk during Infancy (ProAsk): a feasibility study

PubMed Central

Rose, Jennie; Ablewhite, Joanne; Swift, Judy Anne; Nathan, Dilip; Atkinson, Pippa; Watson, Vicki; McMaster, Fiona

2017-01-01

Objective To assess the feasibility and acceptability of using digital technology for Proactive Assessment of Obesity Risk during Infancy (ProAsk) with the UK health visitors (HVs) and parents. Design Multicentre, pre- and post-intervention feasibility study with process evaluation. Setting Rural and urban deprived settings, UK community care. Participants 66 parents of infants and 22 HVs. Intervention ProAsk was delivered on a tablet device. It comprises a validated risk prediction tool to quantify overweight risk status and a therapeutic wheel detailing motivational strategies for preventive parental behaviour. Parents were encouraged to agree goals for behaviour change with HVs who received motivational interviewing training. Outcome measures We assessed recruitment, response and attrition rates. Demographic details were collected, and overweight risk status. The proposed primary outcome measure was weight-for-age z-score. The proposed secondary outcomes were parenting self-efficacy, maternal feeding style, infant diet and exposure to physical activity/sedentary behaviour. Qualitative interviews ascertained the acceptability of study processes and intervention fidelity. Results HVs screened 324/589 infants for inclusion in the study and 66/226 (29%) eligible infants were recruited. Assessment of overweight risk was completed on 53 infants and 40% of these were identified as above population risk. Weight-for-age z-score (SD) between the infants at population risk and those above population risk differed significantly at baseline (−0.67 SD vs 0.32 SD). HVs were able to collect data and calculate overweight risk for the infants. Protocol adherence and intervention fidelity was a challenge. HVs and parents found the information provided in the therapeutic wheel appropriate and acceptable. Conclusion Study recruitment and protocol adherence were problematic. ProAsk was acceptable to most parents and HVs, but intervention fidelity was low. There was limited evidence to support the feasibility of implementing ProAsk without significant additional resources. A future study could evaluate ProAsk as a HV-supported, parent-led intervention. Trial registration number NCT02314494 (Feasibility Study Results) PMID:28882926

Addressing the Barriers to Agile Development in the Department of Defense: Program Structure, Requirements, and Contracting

DTIC Science & Technology

2015-04-30

approach directly contrast with the traditional DoD acquisition model designed for a single big-bang waterfall approach (Broadus, 2013). Currently...progress, reduce technical and programmatic risk, and respond to feedback and changes more quickly than traditional waterfall methods (Modigliani...requirements, and contracting. The DoD can address these barriers by utilizing a proactively tailored Agile acquisition model , implementing an IT Box

Combating the Insider Cyber Threat

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

Greitzer, Frank L.; Moore, Andrew P.; Cappelli, Dawn M.

This article represents a collaboration between PNNL, CERT/CMU, and AFRL that describes needs and related efforts by these institutions to develop technologies and approaches to counter cyber threats by insiders to informatin systems. The main focus of this article is on the need for effective training on insider threat to raise staff awareness and encourage organizations to adopt a more effective approach to identifying potential risks and take proactive steps to mitigate them.

The Army Priority List of At-Risk Species: 2009-2010 Status Update

DTIC Science & Technology

2010-09-01

moved three species closer to formal TES status. Results of this work should help target proactive actions, such as participation in conservation ... Conservation Branch, Installation Services, OACSIM. The work was completed by the Ecological Process Branch (CN-N) of the Installations Division (CN...for the conservation of threatened and endangered plants and animals and the habitats in which they are found (USEPA 2009). The ESA regulates Feder

Proactive routing mutation against stealthy Distributed Denial of Service attacks: metrics, modeling, and analysis

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

Duan, Qi; Al-Shaer, Ehab; Chatterjee, Samrat

The Infrastructure Distributed Denial of Service (IDDoS) attacks continue to be one of the most devastating challenges facing cyber systems. The new generation of IDDoS attacks exploit the inherent weakness of cyber infrastructure including deterministic nature of routes, skew distribution of flows, and Internet ossification to discover the network critical links and launch highly stealthy flooding attacks that are not observable at the victim end. In this paper, first, we propose a new metric to quantitatively measure the potential susceptibility of any arbitrary target server or domain to stealthy IDDoS attacks, and es- timate the impact of such susceptibility onmore » enterprises. Second, we develop a proactive route mutation technique to minimize the susceptibility to these attacks by dynamically changing the flow paths periodically to invalidate the adversary knowledge about the network and avoid targeted critical links. Our proposed approach actively changes these network paths while satisfying security and qualify of service requirements. We present an integrated approach of proactive route mutation that combines both infrastructure-based mutation that is based on reconfiguration of switches and routers, and middle-box approach that uses an overlay of end-point proxies to construct a virtual network path free of critical links to reach a destination. We implemented the proactive path mutation technique on a Software Defined Network using the OpendDaylight controller to demonstrate a feasible deployment of this approach. Our evaluation validates the correctness, effectiveness, and scalability of the proposed approaches.« less

Evaluation of the expect respect support group program: A violence prevention strategy for youth exposed to violence.

PubMed

Reidy, Dennis E; Holland, Kristin M; Cortina, Kai; Ball, Barbara; Rosenbluth, Barri

2017-07-01

In the present study, we assess the effects of the Expect Respect Support Groups (ERSG) on frequency of teen dating violence (TDV) and general youth violence. ERSG is a school-based violence prevention program for youth who have been exposed to violence in their home, school, or community. Boys and girls (N=1,678, M age =14.3, S.D.=1.7, Range=11-17) from 36 schools in Texas participated in this accelerated longitudinal (7-year trajectory) study beginning in 2011. Latent growth curve analyses were conducted using three waves of data from three cross-sectional cohorts of adolescents. Among boys, the number of ERSG sessions attended related to incremental declines in psychological TDV perpetration and victimization, physical TDV victimization, sexual TDV perpetration and victimization, reactive aggression, and proactive aggression. Girls attending ERSG demonstrated reductions in reactive and proactive aggression. The present findings suggest ERSG may be an effective cross-cutting strategy to reduce TDV and other forms of violence among high-risk boys and possibly girls. This information provides valuable understanding of TDV and youth violence in high-risk populations and may be useful in tailoring future prevention efforts to different groups of teens. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The quality assurance-risk management interface.

PubMed

Little, N

1992-08-01

Involvement with both risk management and quality assurance programs has led many authors to the conclusion that the fundamental differences between these activities are, in fact, very small. "At the point of overlap, it is almost impossible to distinguish the purposes and methods of both functions from one another." "Good risk management includes real improvement in patient care through organized quality assurance activities." The interface between a proactive risk management program and a quality assurance program is dynamic and can serve the legitimate interests of both. There is little to be gained by thinking of them as separate entities and much to be gained by sharing the lessons of both. If one thinks of risk management in terms of "risk" to quality patient care, and that "assuring quality" is the most productive type of risk management, then there is no practical reason to separate one from the other.

Predicting all-cause risk of 30-day hospital readmission using artificial neural networks.

PubMed

Jamei, Mehdi; Nisnevich, Aleksandr; Wetchler, Everett; Sudat, Sylvia; Liu, Eric

2017-01-01

Avoidable hospital readmissions not only contribute to the high costs of healthcare in the US, but also have an impact on the quality of care for patients. Large scale adoption of Electronic Health Records (EHR) has created the opportunity to proactively identify patients with high risk of hospital readmission, and apply effective interventions to mitigate that risk. To that end, in the past, numerous machine-learning models have been employed to predict the risk of 30-day hospital readmission. However, the need for an accurate and real-time predictive model, suitable for hospital setting applications still exists. Here, using data from more than 300,000 hospital stays in California from Sutter Health's EHR system, we built and tested an artificial neural network (NN) model based on Google's TensorFlow library. Through comparison with other traditional and non-traditional models, we demonstrated that neural networks are great candidates to capture the complexity and interdependency of various data fields in EHRs. LACE, the current industry standard, showed a precision (PPV) of 0.20 in identifying high-risk patients in our database. In contrast, our NN model yielded a PPV of 0.24, which is a 20% improvement over LACE. Additionally, we discussed the predictive power of Social Determinants of Health (SDoH) data, and presented a simple cost analysis to assist hospitalists in implementing helpful and cost-effective post-discharge interventions.

Predicting all-cause risk of 30-day hospital readmission using artificial neural networks

PubMed Central

2017-01-01

Avoidable hospital readmissions not only contribute to the high costs of healthcare in the US, but also have an impact on the quality of care for patients. Large scale adoption of Electronic Health Records (EHR) has created the opportunity to proactively identify patients with high risk of hospital readmission, and apply effective interventions to mitigate that risk. To that end, in the past, numerous machine-learning models have been employed to predict the risk of 30-day hospital readmission. However, the need for an accurate and real-time predictive model, suitable for hospital setting applications still exists. Here, using data from more than 300,000 hospital stays in California from Sutter Health’s EHR system, we built and tested an artificial neural network (NN) model based on Google’s TensorFlow library. Through comparison with other traditional and non-traditional models, we demonstrated that neural networks are great candidates to capture the complexity and interdependency of various data fields in EHRs. LACE, the current industry standard, showed a precision (PPV) of 0.20 in identifying high-risk patients in our database. In contrast, our NN model yielded a PPV of 0.24, which is a 20% improvement over LACE. Additionally, we discussed the predictive power of Social Determinants of Health (SDoH) data, and presented a simple cost analysis to assist hospitalists in implementing helpful and cost-effective post-discharge interventions. PMID:28708848

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.

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.

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.

A Study of Gaps in Attack Analysis

DTIC Science & Technology

2016-10-12

2014. [86] Shobha Venkataraman , David Brumley, Subhabrata Sen, and Oliver Spatscheck. Automati- cally Inferring the Evolution of Malicious Activity on...Shobha Venkataraman , Subhabrata Sen, Oliver Spatscheck, Patrick Haffner, and Dawn Song. Exploiting Network Structure for Proactive Spam Mitigation. In

Managing risks in the fisheries supply chain using House of Risk Framework (HOR) and Interpretive Structural Modeling (ISM)

NASA Astrophysics Data System (ADS)

Nguyen, T. L. T.; Tran, T. T.; Huynh, T. P.; Ho, T. K. D.; Le, A. T.; Do, T. K. H.

2018-04-01

One of the sectors which contributes importantly to the development of Vietnam economy is fishery industry. However, during recent year, it has been witnessed many difficulties on managing the performance of the fishery supply chain operations as a whole. In this paper, a framework for supply chain risk management (SCRM) is proposed. Initially, all the activities are mapped by using Supply Chain Operations Reference (SCOR) model. Next, the risk ranking is analyzed in House of Risk. Furthermore, interpretive structural modeling (ISM) is used to identify inter-relationships among supply chain risks and to visualize the risks according to their levels. For illustration, the model has been tested in several case studies with fishery companies in Can Tho, Mekong Delta. This study identifies 22 risk events and 20 risk agents through the supply chain. Also, the risk priority could be used for further House of Risk with proactive actions in future studies.

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…

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.…

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…

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…

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…

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

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.

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.

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.

Mediators of disability and hope for people with spinal cord injury.

PubMed

Phillips, Brian N; Smedema, Susan M; Fleming, Allison R; Sung, Connie; Allen, Michael G

2016-08-01

To test potential strength-based mediators of functional disability and hope in adults with spinal cord injury. Two hundred and forty-two participants with spinal cord injury were recruited for this study. The mean age of participants was 44.6 years (standard deviation = 13.2), and 66.1% were men. Participants completed a survey containing a demographic questionnaire, as well as measures of functional disability, hope, self-esteem, proactive coping, perceived social support and disability acceptance. Mediation analysis was conducted using a bootstrap test for multiple mediators. Proactive coping, self-esteem and perceived social support significantly mediated the relationship between functional disability and hope, while disability acceptance did not. The combination of mediators resulted in functional disability no longer being a significant predictor of hope. The strength-based constructs of proactive coping, self-esteem and social support appear effective in predicting hope regardless of severity of spinal cord injury. Functional disability was no longer predictive of hope after controlling for these strength-based constructs. Disability acceptance did not significantly add to the mediation model. These results provide further evidence for strength-based interventions in rehabilitation. Implications for Rehabilitation Strength-based constructs of proactive coping, self-esteem and social support are important factors for addressing hope following spinal cord injury, regardless of level of severity. Rehabilitation services providers should focus efforts on supporting clients in the accurate appraisal of predictable stressors and then generate means for addressing them as a form of proactive coping. Rehabilitation services providers must be cautious when addressing self-esteem to focus on perceived competence and learning processes rather than self-esteem directly or through the accomplishment of goals that may not be achieved. Knowing that social supports are related to hope post-spinal cord injury, it is important for rehabilitation services providers to recognize potential social supports early in the rehabilitation process and involve those social supports in the rehabilitation process when possible.

Agricultural biosecurity.

PubMed

Waage, J K; Mumford, J D

2008-02-27

The prevention and control of new pest and disease introductions is an agricultural challenge which is attracting growing public interest. This interest is in part driven by an impression that the threat is increasing, but there has been little analysis of the changing rates of biosecurity threat, and existing evidence is equivocal. Traditional biosecurity systems for animals and plants differ substantially but are beginning to converge. Bio-economic modelling of risk will be a valuable tool in guiding the allocation of limited resources for biosecurity. The future of prevention and management systems will be strongly influenced by new technology and the growing role of the private sector. Overall, today's biosecurity systems are challenged by changing national priorities regarding trade, by new concerns about environmental effects of biological invasions and by the question 'who pays?'. Tomorrow's systems may need to be quite different to be effective. We suggest three changes: an integration of plant and animal biosecurity around a common, proactive, risk-based approach; a greater focus on international cooperation to deal with threats at source; and a commitment to refocus biosecurity on building resilience to invasion into agroecosystems rather than building walls around them.

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.

Evidence-Based Practice Guideline: Fall Prevention for Older Adults.

PubMed

Kruschke, Cheryl; Butcher, Howard K

2017-11-01

Falls are a major cause of injury and death annually for millions of individuals 65 and older. Older adults are at risk for falls for a variety of reasons regardless of where they live. Falls are defined as any sudden drop from one surface to a lower surface. The purpose of this fall prevention evidence-based practice guideline is to describe strategies that can identify individuals at risk for falls. A 10-step protocol including screening for falls, comprehensive fall assessment, gait and balance screening when necessary, and an individualized fall intervention program addressing specific fall risks is presented. Reassessing fall risk and fall prevention programs will ensure a proactive approach to reducing falls in the aging population. [Journal of Gerontological Nursing, 43(11), 15-21.]. Copyright 2017, SLACK Incorporated.

Nanotechnology Risk Communication Past and Prologue

PubMed Central

Bostrom, Ann; Löfstedt, Ragnar E.

2013-01-01

Nanotechnologies operate at atomic, molecular, and macromolecular scales, at scales where matter behaves differently than at larger scales and quantum effects can dominate. Nanotechnologies have captured the imagination of science fiction writers as science, engineering, and industry have leapt to the challenge of harnessing them. Applications are proliferating. In contrast, despite recent progress the regulatory landscape is not yet coherent, and public awareness of nanotechnology remains low. This has led risk researchers and critics of current nanotechnology risk communication efforts to call for proactive strategies that do more than address facts, that include and go beyond the public participation stipulated by some government acts. A redoubling of nanotechnology risk communication efforts could enable consumer choice and informed public discourse about regulation and public investments in science and safety. PMID:21039707

Scorched earth: will environmental risks in China overwhelm its opportunities?

PubMed

Economy, Elizabeth; Lieberthal, Kenneth

2007-06-01

Of all the risks of doing business in China, the greatest is the threat posed by environmental degradation. And yet it's barely discussed in corporate boardrooms. This is a serious mistake. Multinationals may be more concerned with intellectual property rights violations, corruption, and potential political instability, but the Chinese government, NGOs, and the Chinese press have been focused squarely on the country's energy shortages, soil erosion, lack of water, and pollution problems, which are so severe they might constrain GDP growth. What's more, the Chinese expect the international community to take the lead in environmental protection. If that doesn't happen, multinationals face clear risks to their operations, their workers' health, and their reputations. In factoring environmental issues into their China strategies, foreign firms need to be both defensive, taking steps to reduce harm, and proactive, investing in environmental protection efforts. Coca-Cola, for example, installed state-of-the-art bottling plants in China that operate with no net loss of water resources. Mattel increased the safety of its Barbie-manufacturing process to protect workers' health. With its efforts to reduce greenhouse gas emissions, GE is shrinking its environmental footprint in China; more proactively, GE is working closely with the Chinese government and scientists to develop clean coal, water purification, and water reuse technologies. In considering the value of such efforts, companies can not only factor in reduced risk but also increased opportunity, as they use innovations designed for the Chinese market in the rest of the world. The bottom line: How well multinationals address environmental issues in China will affect their fortunes in one of the most important economies in the world.

Urban Flood Risk Insurance Models as a Strategy for Proactive Water Management Policies

NASA Astrophysics Data System (ADS)

Graciosa, M. C.; Mendiondo, E. M.

2006-12-01

To improve the water management through hydrological sciences, novel integration strategies could be underpinned to bridge up both engineering and economics. This is especially significant in developing nations where hydrologic extremes are expressive while the financial resources to mitigate that variability are scarce. One example of this problem is related to floods and their global and regional consequences. Floods mainly cause disasters in terms of human and material losses. In 2002, more than 30% of extreme climatic events occurred worldwide were floods, representing 42% of fatalities and 66% of material losses, mostly related to reactive policies. Throughout the last century, hydrological variability and rapidly growing of urban areas have developed new environmental problems in Brazilian cities, such as inundation occurrences on non-planned river basins. One of the causes of flood impacts is that public funds (national, state or municipal) have barely introduced wise proactive polices to follow up rapidly growing urban areas. Inexistent flood-risk-transfer mechanisms have caused the so-called `flood poverty cycle' due to reactive polices that have been increasing flood losses and, sometimes, became flood disasters. Flood risk management (FRM) is part of pro-active policies to mitigate inundation losses, in order to sustain environmental, social and economic aspects. Concepts and principles of FRM are part of a process that encompasses three phases: (1) preparedness stage, that consists in structural and non-structural actions to prevent and protect potential risk areas, such as early warning systems and scenarios development; (2) control stage, that refers to help actions and protection facilities during the event, and (3) restoration stage, that is related to rebuild affected areas, restore the river dynamics and transfer the socio-economic risks through flood insurances. Flood risk insurances agree to the goals of losses mitigation programs. Their use is more common in basins affected by alluvial floods. However, most of losses occur in urban areas, as a consequence of flash floods. Quantification of losses is an important basis of flood mitigation programs. It is also a complex task, which involves setting values on not easily quantifiable goods and determining risk and damage curves. This work proposes a flood insurance risk model coupled with a hydrological model as an incentive-based mechanism for achieving economically efficient flood management to be applied in Brazilian urban basins. It consists of integrating an insurance model and hydrological modeling of peak discharge warnings. It sets up curves, such as: water level versus discharge, water level versus inundation areas, and inundation area versus damage. It considers the prediction of future scenarios in order to evaluate the behavior of the insurance fund under climate variability. By using different probability distribution is compared the solvency and efficiency of the flood insurance fund for each premium-covered situation. The methodology is outlined to provide resources for the FRM restoration phase. Results are depicted from an experimental river basin sited on a rapid growing urban area, with some lessons learned valid to approach in other urban basins. This example is envisaged to foster resilience in the integration of hydrological science with policy and economic approaches. KEY WORDS: Flood risks management; flood insurance; hydrological modeling.

Proactive Interference in Short-Term Recognition and Recall Memory

ERIC Educational Resources Information Center

Dillon, Richard F.; Petrusic, William M.

1972-01-01

Purpose of study was to (a) compare the rate of increase of proactive interference over the first few trials under recall and recognition memory test conditions, (2) determine the effects of two types of distractors on short-term recognition, and (3) test memory after proactive interference had reached a stable level under each of three test…

Proactive Personality and the Successful Job Search : A Field Investigation with College Graduates

ERIC Educational Resources Information Center

Brown, Douglas J.; Cober, Richard T.; Kane, Kevin; Levy, Paul E.; Shalhoop, Jarrett

2006-01-01

The current article tests a model of proactive personality and job search success with a sample of 180 graduating college students. Using structural equation modeling, the authors tested a theoretical model that specified the relations among proactive personality, job search self-efficacy, job search behaviors, job search effort, and job search…

Peer Relations and Peer Deviance as Predictors of Reactive and Proactive Aggression among High School Girls

ERIC Educational Resources Information Center

Uz Bas, Asli; Öz Soysal, Fatma Selda

2016-01-01

This study aimed to investigate associations between reactive and proactive aggression and peer relations and peer deviance among high school girls. A total of 442 high school students participated in this study. Reactive-Proactive Aggression Questionnaire, the Peer Relations Scale, and the Peer Deviance Scale were used to collect data. Results…

Proactive Personality and Training Motivation among Older Workers: A Mediational Model of Goal Orientation

ERIC Educational Resources Information Center

Setti, Ilaria; Dordoni, Paola; Piccoli, Beatrice; Bellotto, Massimo; Argentero, Piergiorgio

2015-01-01

Purpose: This paper aims at examining the relationship between proactive personality and training motivation among older workers (aged over 55 years) in a context characterized by the growing ageing of the global population. First, the authors hypothesized that proactive personality predicts the motivation to learn among older workers and that…

Does Verbal Labeling Influence Age Differences in Proactive and Reactive Cognitive Control?

ERIC Educational Resources Information Center

Kray, Jutta; Schmitt, Hannah; Heintz, Sonja; Blaye, Agnès

2015-01-01

The main goal of this study was to examine whether different types of verbal labeling can influence age-related changes in the dynamic control of behavior by inducing either a proactive or reactive mode of control. Proactive control is characterized by a strong engagement in maintaining task-relevant information to be optimally prepared while…

Observational, Physiological, and Self-Report Measures of Children's Anger: Relations to Reactive versus Proactive Aggression.

ERIC Educational Resources Information Center

Hubbard, Julie A.; Smithmyer, Catherine M.; Ramsden, Sally R.; Parker, Elizabeth H.; Flanagan, Kelly D.; Dearing, Karen F.; Relyea, Nicole; Simons, Robert F.

2002-01-01

This study examined relations of reactive versus proactive aggression to second-graders' anger after losing in a board game to a cheating confederate. Found that reactive aggression, but not proactive aggression, was positively related to skin conductance reactivity and observed angry nonverbal behaviors, both at an aggregated level and in terms…

Using structured decision making to manage disease risk for Montana wildlife

USGS Publications Warehouse

Mitchell, Michael S.; Gude, Justin A.; Anderson, Neil J.; Ramsey, Jennifer M.; Thompson, Michael J.; Sullivan, Mark G.; Edwards, Victoria L.; Gower, Claire N.; Cochrane, Jean Fitts; Irwin, Elise R.; Walshe, Terry

2013-01-01

We used structured decision-making to develop a 2-part framework to assist managers in the proactive management of disease outbreaks in Montana, USA. The first part of the framework is a model to estimate the probability of disease outbreak given field observations available to managers. The second part of the framework is decision analysis that evaluates likely outcomes of management alternatives based on the estimated probability of disease outbreak, and applies managers' values for different objectives to indicate a preferred management strategy. We used pneumonia in bighorn sheep (Ovis canadensis) as a case study for our approach, applying it to 2 populations in Montana that differed in their likelihood of a pneumonia outbreak. The framework provided credible predictions of both probability of disease outbreaks, as well as biological and monetary consequences of management actions. The structured decision-making approach to this problem was valuable for defining the challenges of disease management in a decentralized agency where decisions are generally made at the local level in cooperation with stakeholders. Our approach provides local managers with the ability to tailor management planning for disease outbreaks to local conditions. Further work is needed to refine our disease risk models and decision analysis, including robust prediction of disease outbreaks and improved assessment of management alternatives.

The proactive management of rumor and gossip.

PubMed

Ribeiro, V E; Blakeley, J A

1995-06-01

Gossip and rumor are common forms of communication in the workplace. Consequently, nursing administrators are challenged to find ways to manage these grapevine activities. The authors present an analysis of gossip and rumor and discuss strategies for their prevention and control.

Modeling traffic accidents at signalized intersections in the city of Norfolk, VA.

DOT National Transportation Integrated Search

2010-12-31

This study was an attempt to apply a proactive approach using traffic pattern and signalized intersection characteristics to predict accident rates at signalized intersections in a citys arterial network. An earlier analysis of accident data at se...

Modeling risk of pneumonia epizootics in bighorn sheep

USGS Publications Warehouse

Sells, Sarah N.; Mitchell, Michael S.; Nowak, J. Joshua; Lukacs, Paul M.; Anderson, Neil J.; Ramsey, Jennifer M.; Gude, Justin A.; Krausman, Paul R.

2015-01-01

Pneumonia epizootics are a major challenge for management of bighorn sheep (Ovis canadensis) affecting persistence of herds, satisfaction of stakeholders, and allocations of resources by management agencies. Risk factors associated with the disease are poorly understood, making pneumonia epizootics hard to predict; such epizootics are thus managed reactively rather than proactively. We developed a model for herds in Montana that identifies risk factors and addresses biological questions about risk. Using Bayesian logistic regression with repeated measures, we found that private land, weed control using domestic sheep or goats, pneumonia history, and herd density were positively associated with risk of pneumonia epizootics in 43 herds that experienced 22 epizootics out of 637 herd-years from 1979–2013. We defined an area of high risk for pathogen exposure as the area of each herd distribution plus a 14.5-km buffer from that boundary. Within this area, the odds of a pneumonia epizootic increased by >1.5 times per additional unit of private land (unit is the standardized % of private land where global  = 25.58% and SD = 14.53%). Odds were >3.3 times greater if domestic sheep or goats were used for weed control in a herd's area of high risk. If a herd or its neighbors within the area of high risk had a history of a pneumonia epizootic, odds of a subsequent pneumonia epizootic were >10 times greater. Risk greatly increased when herds were at high density, with nearly 15 times greater odds of a pneumonia epizootic compared to when herds were at low density. Odds of a pneumonia epizootic also appeared to decrease following increased spring precipitation (odds = 0.41 per unit increase, global  = 100.18% and SD = 26.97%). Risk was not associated with number of federal sheep and goat allotments, proximity to nearest herds of bighorn sheep, ratio of rams to ewes, percentage of average winter precipitation, or whether herds were of native versus mixed or reintroduced origin. We conclude that factors associated with risk of pneumonia epizootics are complex and may not always be from the most obvious sources. The ability to identify high-risk herds will help biologists and managers determine where to focus management efforts and the risk factors that most affect each herd, facilitating more effective, proactive management. 

Healthcare for Military Retirees Task Group. Recommendations Regarding Improvements to the Military Health Systems and Specifically Healthcare of Military Retirees.

DTIC Science & Technology

2005-12-01

Business Board Utilize specially trained care managers to proactively attend to/assist high-risk population. Customize a comprehensive...ADDRESS(ES) Defense Business Board,1155 Defense Pentagon,Washington,DC,20301-1155 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING...c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Defense Business Board HEALTHCARE FOR MILITARY RETIREES

Correlation of Risk Factors With Caries Prevalence Among U.S. Military Recruits

DTIC Science & Technology

2012-06-01

the incidence of dental caries in individuals has been a topic of research in the dental community for a long time. If an accurate caries predictive...before the occurrence of a patient’s first caries lesion), it may allow for the truly proactive delivery of preventive dental therapies. The...Epidemiologic research suggests that 60% of dental caries occurs in 20% of the population. Compared to the general population, U.S. military

Impaired Midline Theta Power and Connectivity During Proactive Cognitive Control in Schizophrenia.

PubMed

Ryman, Sephira G; Cavanagh, James F; Wertz, Christopher J; Shaff, Nicholas A; Dodd, Andrew B; Stevens, Brigitte; Ling, Josef; Yeo, Ronald A; Hanlon, Faith M; Bustillo, Juan; Stromberg, Shannon F; Lin, Denise S; Abrams, Swala; Mayer, Andrew R

2018-05-25

Disrupted proactive cognitive control, a form of early selection and active goal maintenance, is hypothesized to underlie the broad cognitive deficits observed in patients with schizophrenia (SPs). Current research suggests that the disrupted activation within and connectivity between regions of the cognitive control network contribute to disrupted proactive cognitive control; however, no study has examined these mechanisms using an AX Continuous Performance Test task in schizophrenia. Twenty-six SPs (17 male subjects; mean age 34.46 ± 8.77 years) and 28 healthy control participants (HCs; 16 male subjects; mean age 31.43 ± 7.23 years) underwent an electroencephalogram while performing the AX Continuous Performance Test. To examine the extent of activation and level of connectivity within the cognitive control network, power, intertrial phase clustering, and intersite phase clustering metrics were calculated and analyzed. SPs exhibited expected general decrements in behavioral performance relative to HCs and a more selective deficit in conditions requiring proactive cognitive control. Additionally, SPs exhibited deficits in midline theta power and connectivity during proactive cognitive control trials. Specifically, HCs exhibited significantly greater theta power for B cues relative to A cues, whereas SPs exhibited no significant differences between A- and B-cue theta power. Additionally, differential theta connectivity patterns were observed in SPs and HCs. Behavioral measures of proactive cognitive control predicted functional outcomes in SPs. This study suggests that low-frequency midline theta activity is selectively disrupted during proactive cognitive control in SPs. The disrupted midline theta activity may reflect a failure of SPs to proactively recruit cognitive control processes. Copyright © 2018 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Update on the prevention of local recurrence and peritoneal metastases in patients with colorectal cancer.

PubMed

Sugarbaker, Paul H

2014-07-28

The prevention of a disease process has always been superior to the treatment of the same disease throughout the history of medicine and surgery. Local recurrence and peritoneal metastases occur in approximately 8% of colon cancer patients and 25% of rectal cancer patients and should be prevented. Strategies to prevent colon or rectal cancer local recurrence and peritoneal metastases include cytoreductive surgery and hyperthermic perioperative chemotherapy (HIPEC). These strategies can be used at the time of primary colon or rectal cancer resection if the HIPEC is available. At institutions where HIPEC is not available with the treatment of primary malignancy, a proactive second-look surgery is recommended. Several phase II studies strongly support the proactive approach. If peritoneal metastases were treated along with the primary colon resection, 5-year survival was seen and these results were superior to the results of treatment after peritoneal metastases had developed as recurrence. Also, prophylactic HIPEC improved survival with T3/T4 mucinous or signet ring colon cancers. A second-look has been shown to be effective in two published manuscripts. Unpublished data from MedStar Washington Cancer Institute also produced favorable date. Rectal cancer with peritoneal metastases may not be so effectively treated. There are both credits and debits of this proactive approach. Selection factors should be reviewed by the multidisciplinary team for individualized management of patients with or at high risk for peritoneal metastases.

Proactive coping and gambling disorder among young men.

PubMed

Sleczka, Pawel; Braun, Barbara; Grüne, Bettina; Bühringer, Gerhard; Kraus, Ludwig

2016-12-01

Objectives Male sex, young age, and frequent gambling are considered as risk factors for gambling disorder (GD) and stress might be one of the triggers of gambling behavior among problem gamblers. Conversely, well-developed coping with stress might counteract gambling problems. The Proactive Coping Theory provides a promising approach for the further development of preventive and treatment measures. The objective of the study was to investigate different facets of proactive coping (PC) in young male gamblers. Methods Young men from Bavaria were recruited via the Munich citizens' registry (n = 2,588) and Facebook invitations (n = 105). In total, 173 out of 398 individuals were positively screened for frequent gambling and/or signs of related problems and completed the baseline questionnaire of the Munich Leisure-time Study. Factors investigated include gambling problems, PC, impulsiveness, social support, and psychological distress. Results Gambling problems were associated with lower levels of preventive coping as well as of adaptive reaction delay. The associations were also significant when controlled for impulsiveness and general psychological distress. Preventive coping moderated the association between social support and gambling problems. Discussion and conclusions Young men with gambling problems less frequently prevent the occurrence of stressors and more often react hasty when these occur. While the investigated group reported good social support, this factor was negatively associated with GD only among individuals with good preventive coping. Preventive coping poses a useful construct for selective prevention and treatment as it can be modified in professional interventions.

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.

Evaluation of the "Lose Your Excuse" public service advertising campaign for tweens to save energy.

PubMed

Bertrand, Jane T; Goldman, Patty; Zhivan, Natalia; Agyeman, Yaw; Barber, Erin

2011-10-01

This study evaluates the 2008-2009 "Lose your Excuse" public service advertising (PSA) campaign on energy efficiency targeting 8- to 12-year-olds, intended to increase knowledge, foster proactive attitudes, and change energy usage behaviors. Baseline and two follow-up surveys were conducted with online samples representative of the national population of households with kids with online access. Almost half (47%) of the tweens recognized at least one ad from the campaign. Ad recognition was positively associated with knowledge, proactive attitudes, and energy-saving behavior. Propensity score analysis confirmed a small but measurable and statistically significant effect on energy-saving behavior. The discussion section compares these results to public health campaigns in terms of ghost awareness, reach, and effect size.

What it takes to get proactive: An integrative multilevel model of the antecedents of personal initiative.

PubMed

Hong, Ying; Liao, Hui; Raub, Steffen; Han, Joo Hun

2016-05-01

Building upon and extending Parker, Bindl, and Strauss's (2010) theory of proactive motivation, we develop an integrated, multilevel model to examine how contextual factors shape employees' proactive motivational states and, through these proactive motivational states, influence their personal initiative behavior. Using data from a sample of hotels collected from 3 sources and over 2 time periods, we show that establishment-level initiative-enhancing human resource management (HRM) systems were positively related to departmental initiative climate, which was positively related to employee personal initiative through employee role-breadth self-efficacy. Further, department-level empowering leadership was positively related to initiative climate only when initiative-enhancing HRM systems were low. These findings offer interesting implications for research on personal initiative and for the management of employee proactivity in organizations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Does Affective Theory of Mind Contribute to Proactive Aggression in Boys with Conduct Problems and Psychopathic Tendencies?

PubMed

Gillespie, Steven M; Kongerslev, Mickey T; Sharp, Carla; Bo, Sune; Abu-Akel, Ahmad M

2018-04-27

Adolescent psychopathic tendencies are associated with phenotypic increases in proactive aggression. However, the extent to which an understanding of others' affective mental states, or affective theory of mind (ToM), contributes to proactive aggression remains unknown. We examined how performance on a well-known test of affective ToM, based on cropped images of the eye region, contributes to reactive and proactive types of aggression in a mixed ethnicity sample of 80 incarcerated adolescent boys. A hierarchical regression model showed that affective ToM predicted proactive aggression over and above the influence of clinically rated psychopathic tendencies. Importantly, affective ToM was unrelated to reactive aggression. Our results suggest that being able to recognize others' affective mental states may be an important factor in aggressing against others for personal gain. These findings have implications for interventions designed to enhance ToM in youth with conduct problems.

Relations of Proactive and Reactive Dimensions of Aggression to Overt and Covert Narcissism in Nonclinical Adolescents

PubMed Central

Fossati, Andrea; Borroni, Serena; Eisenberg, Nancy; Maffei, Cesare

2009-01-01

In recent years, there has been increasing acknowledgement of the multidimensionality of narcissism and that different types of narcissism may relate differently to other domains of functioning. Similarly, aggression—a frequently discussed correlate of narcissism--is a heterogeneous construct. In the present study, the relations of proactive and reactive aggression with overt and covert manifestations of narcissism were examined in a sample of 674 Italian high school students (mean age = 15.5 years, SD = 2.1 years). Overt narcissism was positively related to both proactive and reactive subtypes of aggression, whereas covert narcissism related only to reactive aggression. Vanity, Authority, Exhibitionism, and Exploitativeness were the components of overt narcissism related to Proactive Aggression (all remained unique correlates when controlling for Reactive Aggression), whereas Reactive Aggression was associated with the Exhibitionism, Superiority, and Entitlement subscales (only the latter was uniquely related when controlling for Proactive Aggression). PMID:19918915

Proactive sustainability strategy and corporate sustainability performance: The mediating effect of sustainability control systems.

PubMed

Wijethilake, Chaminda

2017-07-01

This study examines to what extent corporations use sustainability control systems (SCS) to translate proactive sustainability strategy into corporate sustainability performance. The study investigates the mediating effect of SCS on the relationship between proactive sustainability strategy and corporate sustainability performance. Survey data were collected from top managers in 175 multinational and local corporations operating in Sri Lanka and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). SCS were observed to only partially mediate the relationship between proactive sustainability strategy and corporate sustainability performance. The mediating effect of SCS is further examined under three sustainability strategies; environmental and social strategies reveal a partial mediation, while the economic strategy exhibits no mediation. The study also finds that (i) a proactive sustainability strategy is positively associated with SCS and corporate sustainability performance and (ii) SCS are positively associated with corporate sustainability performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of parenting on the associations between child aggression subtypes and oppositional defiant disorder symptoms.

PubMed

Pederson, Casey A; Fite, Paula J

2014-12-01

The current study evaluated parenting behaviors (i.e., parental monitoring, inconsistent discipline, parental involvement, positive parenting, and corporal punishment) as moderators of the link between proactive and reactive aggression and oppositional defiant disorder (ODD) symptoms in a community sample of 89 children ranging from 9 to 12 years of age (M = 10.44, SD = 1.14; 56 % male). Reactive, but not proactive, aggression was uniquely positively associated with ODD symptoms. Additionally, inconsistent discipline moderated the association between proactive, but not reactive, aggression and ODD symptoms, such that proactive aggression was associated with ODD symptoms only when levels of inconsistent discipline were high. Findings appear to suggest that associations between these aggression subtypes and ODD symptoms are influenced by different factors, with inconsistent discipline indicated in the association between proactively aggressive behavior and ODD symptoms. Implications for intervention are discussed.

Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit

PubMed Central

Li, Xixi; He, Mei; Wang, Haiyan

2017-01-01

Abstract In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit. The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures. Failure modes with risk priority number (RPN) ≥100 (top 10 RPN scores) were deemed as high-priority-risks, meaning that they needed immediate corrective action. After modifications were put, the resulting RPN was compared with the previous one. A centralized nursing care system was designed. A total of 25 failure modes were identified. High-priority risks were “Unqualified medical device sterilization” (RPN, 337), “leukopenia, very low immunity” (RPN, 222), and “Poor hand hygiene Basic diseases” (RPN, 160). The corrective measures that we took allowed a decrease in the RPNs, especially for the high-priority risks. The maximum reduction was approximately 80%, as observed for the failure mode “Not creating the maximal barrier for patient.” The averaged incidence of CRBSIs was reduced from 5.19% to 1.45%, with 3 months of 0 infection rate. The FMEA can effectively reduce incidence of CRBSIs, improve the security of central venous catheterization technology, decrease overall medical expenses, and improve nursing quality. PMID:29390515

The SAMCO Web-platform for resilience assessment in mountainous valleys impacted by landslide risks.

NASA Astrophysics Data System (ADS)

Grandjean, Gilles; Thomas, Loic; Bernardie, Severine

2016-04-01

The ANR-SAMCO project aims to develop a proactive resilience framework enhancing the overall resilience of societies on the impacts of mountain risks. The project aims to elaborate methodological tools to characterize and measure ecosystem and societal resilience from an operative perspective on three mountain representative case studies. To achieve this objective, the methodology is split in several points: (1) the definition of the potential impacts of global environmental changes (climate system, ecosystem e.g. land use, socio-economic system) on landslide hazards, (2) the analysis of these consequences in terms of vulnerability (e.g. changes in the location and characteristics of the impacted areas and level of their perturbation) and (3) the implementation of a methodology for quantitatively investigating and mapping indicators of mountain slope vulnerability exposed to several hazard types, and the development of a GIS-based demonstration platform available on the web. The strength and originality of the SAMCO project lies in the combination of different techniques, methodologies and models (multi-hazard assessment, risk evolution in time, vulnerability functional analysis, and governance strategies) that are implemented in a user-oriented web-platform, currently in development. We present the first results of this development task, architecture and functions of the web-tools, the case studies database showing the multi-hazard maps and the stakes at risks. Risk assessment over several area of interest in Alpine or Pyrenean valleys are still in progress, but the first analyses are presented for current and future periods for which climate change and land-use (economical, geographical and social aspects) scenarios are taken into account. This tool, dedicated to stakeholders, should be finally used to evaluate resilience of mountainous regions since multiple scenarios can be tested and compared.

Risk factors associated with academic difficulty in an Australian regionally located medical school.

PubMed

Malau-Aduli, Bunmi S; O'Connor, Teresa; Ray, Robin A; van der Kruk, Yolanda; Bellingan, Michelle; Teague, Peta-Ann

2017-12-28

Despite the highly selective admission processes utilised by medical schools, a significant cohort of medical students still face academic difficulties and are at a higher risk of delayed graduation or outright dismissal. This study used survival analysis to identify the non-academic and academic risk factors (and their relative risks) associated with academic difficulty at a regionally located medical school. Retrospective non-academic and academic entry data for all medical students who were enrolled at the time of the study (2009-2014) were collated and analysed. Non-academic variables included age at commencement of studies, gender, Indigenous status, origin, first in family to go to University (FIF), non-English speaking background (NESB), socio-economic status (SES) and rurality expressed as Australian Standard Geographical Classification-Remoteness Area (ASGC-RA). Academic variables included tertiary entrance exam score expressed as overall position (OP) and interview score. In addition, post-entry mid- and end-of-year summative assessment data in the first and second years of study were collated. The results of the survival analysis indicated that FIF, Indigenous and very remote backgrounds, as well as low post-entry Year 1 (final) and Year 2 (mid-year and final) examination scores were strong risk factors associated with academic difficulty. A high proportion of the FIF students who experienced academic difficulty eventually failed and exited the medical program. Further exploratory research will be required to identify the specific needs of this group of students in order to develop appropriate and targeted academic support programs for them. This study has highlighted the need for medical schools to be proactive in establishing support interventions/strategies earlier rather than later, for students experiencing academic difficulty because, the earlier such students can be flagged, the more likely they are able to obtain positive academic outcomes.

Validity and Reliability of the Reactive-Proactive Aggression Questionnaire in Turkish Adolescents

ERIC Educational Resources Information Center

Cenkseven-Önder, Fulya; Avci, Rasit; Çolakkadioglu, Oguzhan

2016-01-01

The aim of this study was to adapt the Reactive-Proactive Aggression Questionnaire (RPQ), developed to measure two dimensions of aggression which are reactive and proactive, to Turkish and test the validity and reliability of the Turkish form. The study group consisted of 278 students in four junior high schools in Adana, Turkey, and 485 students…

Proactive Goal Generation and Innovative Work Behavior: The Moderating Role of Affective Commitment, Production Ownership and Leader Support for Innovation

ERIC Educational Resources Information Center

Montani, Francesco; Battistelli, Adalgisa; Odoardi, Carlo

2017-01-01

Building on goal-regulation theory, we develop and test the hypothesis that proactive goal generation fosters individual innovative work behavior. Consistent with a resource-based perspective, we further examine two-three-way interactions to assess whether the link between proactive goal generation and innovative behavior is jointly moderated by…

Language Proficiency and Executive Control in Proactive Interference: Evidence from Monolingual and Bilingual Children and Adults

ERIC Educational Resources Information Center

Bialystok, Ellen; Feng, Xiaojia

2009-01-01

Two studies are reported in which monolingual and bilingual children (Study 1) and adults (Study 2) completed a memory task involving proactive interference. In both cases, the bilinguals attained lower scores on a vocabulary test than monolinguals but performed the same on the proactive interference task. For the children, bilinguals made fewer…

Investigating the optimality of proactive management of an invasive forest pest

Treesearch

Craig A. Bond; Patricia Champ; James Meldrum; Anna Schoettle

2011-01-01

This paper offers a preliminary investigation into the conditions under which it might be optimal to engage in proactive management of a non-timber forest resource in the presence of an invasive species whose spread is unaffected by management action. Proactive management is defined as treating an uninfected area to encourage healthy ecosystem function, given that the...

Proactive or reactive? Optimal management of an invasive forest pest in a spatial framework

Treesearch

Craig A. Bond; Patricia Champ; James Meldrum; Anna Schoettle

2010-01-01

This paper offers a preliminary investigation into the conditions under which it might be optimal to engage in proactive management of a non-timber forest resource in the presence of an invasive species whose spread is unaffected by management action. Proactive management is defined as treating an uninfected area in order to encourage healthy ecosystem...

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)…

Barriers to Mathematics Achievement in Brunei Secondary School Students: Insights into the Roles of Mathematics Anxiety, Self-Esteem, Proactive Coping, and Test Stress

ERIC Educational Resources Information Center

Hamid, Malai Hayati Sheikh; Shahrill, Masitah; Matzin, Rohani; Mahalle, Salwa; Mundia, Lawrence

2013-01-01

The cross-sectional field survey examined the roles of mathematics anxiety, self-esteem, proactive coping, and test stress in mathematics achievement among 204 (151 females) randomly selected Year 8-10 Brunei secondary school students. The negative dimensions of mathematics anxiety, self-esteem, and proactive coping correlated negatively with…

Brain cortisol receptor expression differs in Arctic charr displaying opposite coping styles.

PubMed

Vindas, Marco A; Magnhagen, Carin; Brännäs, Eva; Øverli, Øyvind; Winberg, Svante; Nilsson, Jan; Backström, Tobias

2017-08-01

Individually consistent behavioral and physiological responses to stressful situations (often referred to as coping styles) has been reported in many animal species. Differences in hypothalamic-pituitary axis reactivity characterize individuals, and it has been proposed that the glucocorticoid (gr) and mineralocorticoid (mr) receptors are fundamental in regulating coping styles. We sorted individuals into reactive and proactive coping styles by collapsing behavioral outputs from net restraint and confinement stress tests in a principal component analysis. We then analyzed plasma cortisol levels, serotonin neurochemistry and the relative mRNA expression of gr1 and mr in stressed individuals per coping style. Proactive fish were characterized as having a lower serotonergic activity and being more active under stress. In addition, proactive fish had higher hypothalamic gr1 and mr abundance and a higher mr/gr1 ratio, compared to reactive fish. We found no significant differences in cortisol or telencephalic mRNA, gr1 and mr expression, or their ratio. Brain MR and GR have been proven to have an important role in the appraisal, coping and adaptation to stressful stimuli, so that a higher expression of these receptors in proactive fish suggests increased tolerance and performance under stress, compared to reactive individuals. We present evidence of a conserved neuroendocrine mechanism associated with coping styles in a fish species which is ecologically very diverse and considered to be the most cold-adapted fish in freshwater. We propose that this may be a first step into exploiting this model in order to better understand climate-change related effects in sub populations and ecophenotypes. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Neural correlates of proactive and reactive aggression in adolescent twins.

PubMed

Yang, Yaling; Joshi, Shantanu H; Jahanshad, Neda; Thompson, Paul M; Baker, Laura A

2017-05-01

Verbal and physical aggression begin early in life and steadily decline thereafter in normal development. As a result, elevated aggressive behavior in adolescence may signal atypical development and greater vulnerability for negative mental and health outcomes. Converging evidence suggests that brain disturbances in regions involved in impulse control, emotional regulation, and sensation seeking may contribute to heightened aggression. However, little is known regarding the neural mechanisms underlying subtypes of aggression (i.e., proactive and reactive aggression) and whether they differ between males and females. Using a sample of 106 14-year-old adolescent twins, this study found that striatal enlargement was associated with both proactive and reactive aggression. We also found that volumetric alterations in several frontal regions including smaller middle frontal and larger orbitofrontal cortex were correlated with higher levels of aggression in adolescent twins. In addition, cortical thickness analysis showed that thickness alterations in many overlapping regions including middle frontal, superior frontal, and anterior cingulate cortex and temporal regions were associated with aggression in adolescent twins. Results support the involvement of fronto-limbic-striatal circuit in the etiology of aggression during adolescence. Aggr. Behav. 43:230-240, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Psychometric properties of the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP).

PubMed

Farmer, Cristan A; Aman, Michael G

2010-01-01

Although often lacking "malice", aggression is fairly common in children with intellectual or developmental disability (I/DD). Despite this, there are no scales available that are appropriate for an in-depth analysis of aggressive behavior in this population. Such scales are needed for the study of aggressive behavior, which is a common target symptom in clinical trials. We assessed the reliability and validity of the Children's Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP), a new aggression scale created for children with I/DD. Data are presented from a survey of 365 children with I/DD aged 3-21 years. Interrater reliability was very high for the Problem Scale, which characterizes type of aggression. Reliability was lower but largely acceptable for the Provocation Scale, which assesses motivation. Validity of the Problem Scale was supported by expected differences in children with autism, Down syndrome, comorbid disruptive behavior disorders (DBDs) and ADHD. The Provocation Scale, which categorizes behavior as proactive or reactive, showed expected differences in children with DBD, but was less effective in those with ADHD. The C-SHARP appears to have fundamentally sound psychometric characteristics, although more research is needed.

Tobacco users' perceptions of a brief tobacco cessation intervention in community pharmacies.

PubMed

Patwardhan, Pallavi D; Chewning, Betty A

2010-01-01

To explore factors affecting tobacco users' perceived appropriateness of a brief and proactive tobacco cessation counseling program, ask, advise, and refer (AAR), at community pharmacies. Inductive thematic analysis. Southern Wisconsin during fall 2008. 24 tobacco users who had recently received brief and proactive tobacco cessation counseling at a community pharmacy. Semistructured telephone interviews conducted by primary author. Perceptions of a brief and proactive tobacco cessation counseling program conducted at community pharmacies. In conducting the thematic analysis, eight distinct themes were identified. Display of information and resources at pharmacies for use by tobacco users as needed was identified as the most predominant theme and was found to be most helpful by many respondents. Other themes identified in decreasing order of prevalence were: tobacco users' perceptions of the role of pharmacists in health care, tobacco users' belief that smoking could interact with a current medication or health condition, tobacco users' sensitivity toward their tobacco use behavior or being told what to do, nonconfrontational and friendly approach of pharmacists, tobacco users' readiness to quit at the time of AAR counseling, tobacco user initiation of tobacco use discussion, and tobacco users' belief that tobacco use is bad. Overall, this qualitative investigation suggests that several factors might influence tobacco users' perceived appropriateness of AAR counseling at community pharmacies. AAR might be well received by tobacco users and pharmacy patrons as long as it is done in a professional and respectful manner.

Integrated corridor management (ICM) initiative : ICM surveillance and detection needs analysis for the transit data gap.

DOT National Transportation Integrated Search

2008-11-01

The primary objective of the ICM Initiative is to demonstrate how Intelligent Transportation System (ITS) technologies can efficiently and proactively facilitate the movement of people and goods through major transportation corridors that comprise a ...

System Dynamics Modeling for Proactive Intelligence

DTIC Science & Technology

2010-01-01

5  4. Modeling Resources as Part of an Integrated Multi- Methodology System .................. 16  5. Formalizing Pro-Active...Observable Data With and Without Simulation Analysis ............................... 15  Figure 13. Summary of Probe Methodology and Results...Strategy ............................................................................. 22  Figure 22. Overview of Methodology

Integrated corridor management (ICM) initiative : ICM surveillance and detection requirements needs analysis for the arterial data gap.

DOT National Transportation Integrated Search

2008-11-01

The primary objective of the ICM Initiative is to demonstrate how Intelligent Transportation System (ITS) technologies can efficiently and proactively facilitate the movement of people and goods through major transportation corridors that comprise a ...

Aggression Can be Contagious: Longitudinal Associations between Proactive Aggression and Reactive Aggression Among Young Twins

PubMed Central

Dickson, Daniel J.; Richmond, Ashley; Brendgen, Mara; Vitaro, Frank; Laursen, Brett; Dionne, Ginette; Boivin, Michel

2015-01-01

The present study examined sibling influence over reactive and proactive aggression in a sample of 452 same-sex twins (113 male dyads, 113 female dyads). Between and within siblings influence processes were examined as a function of relative levels of parental coercion and hostility to test the hypothesis that aggression contagion between twins occurs only among dyads who experience parental coerciveness. Teacher reports of reactive and proactive aggression were collected for each twin in kindergarten (M = 6.04 years; SD = 0.27) and in first grade (M = 7.08 years; SD = 0.27). Families were divided into relatively low, average, and relatively high parental coercion-hostility groups on the basis of maternal reports collected when the children were 5 years old. In families with relatively high levels of parental coercion-hostility, there was evidence of between-sibling influence, such that one twin’s reactive aggression at age 6 predicted increases in the other twin’s reactive aggression from ages 6 to 7, and one twin’s proactive aggression at age 6 predicted increases in the other twin’s proactive aggression from ages 6 to 7. There was also evidence of within-sibling influence such that a child’s level of reactive aggression at age 6 predicted increases in the same child’s proactive aggression at age 7, regardless of parental coercion-hostility. The findings provide new information about the etiology of reactive and proactive aggression and individual differences in their developmental interplay. PMID:25683448

Emotional facial recognition in proactive and reactive violent offenders.

PubMed

Philipp-Wiegmann, Florence; Rösler, Michael; Retz-Junginger, Petra; Retz, Wolfgang

2017-10-01

The purpose of this study is to analyse individual differences in the ability of emotional facial recognition in violent offenders, who were characterised as either reactive or proactive in relation to their offending. In accordance with findings of our previous study, we expected higher impairments in facial recognition in reactive than proactive violent offenders. To assess the ability to recognize facial expressions, the computer-based Facial Emotional Expression Labeling Test (FEEL) was performed. Group allocation of reactive und proactive violent offenders and assessment of psychopathic traits were performed by an independent forensic expert using rating scales (PROREA, PCL-SV). Compared to proactive violent offenders and controls, the performance of emotion recognition in the reactive offender group was significantly lower, both in total and especially in recognition of negative emotions such as anxiety (d = -1.29), sadness (d = -1.54), and disgust (d = -1.11). Furthermore, reactive violent offenders showed a tendency to interpret non-anger emotions as anger. In contrast, proactive violent offenders performed as well as controls. General and specific deficits in reactive violent offenders are in line with the results of our previous study and correspond to predictions of the Integrated Emotion System (IES, 7) and the hostile attribution processes (21). Due to the different error pattern in the FEEL test, the theoretical distinction between proactive and reactive aggression can be supported based on emotion recognition, even though aggression itself is always a heterogeneous act rather than a distinct one-dimensional concept.

Aggression can be contagious: Longitudinal associations between proactive aggression and reactive aggression among young twins.

PubMed

Dickson, Daniel J; Richmond, Ashley D; Brendgen, Mara; Vitaro, Frank; Laursen, Brett; Dionne, Ginette; Boivin, Michel

2015-01-01

The present study examined sibling influence over reactive and proactive aggression in a sample of 452 same-sex twins (113 male dyads, 113 female dyads). Between and within siblings influence processes were examined as a function of relative levels of parental coercion and hostility to test the hypothesis that aggression contagion between twins occurs only among dyads who experience parental coerciveness. Teacher reports of reactive and proactive aggression were collected for each twin in kindergarten (M = 6.04 years; SD = 0.27) and in first grade (M = 7.08 years; SD = 0.27). Families were divided into relatively low, average, and relatively high parental coercion-hostility groups on the basis of maternal reports collected when the children were 5 years old. In families with relatively high levels of parental coercion-hostility, there was evidence of between-sibling influence, such that one twin's reactive aggression at age 6 predicted increases in the other twin's reactive aggression from ages 6 to 7, and one twin's proactive aggression at age 6 predicted increases in the other twin's proactive aggression from ages 6 to 7. There was also evidence of within-sibling influence such that a child's level of reactive aggression at age 6 predicted increases in the same child's proactive aggression at age 7, regardless of parental coercion-hostility. The findings provide new information about the etiology of reactive and proactive aggression and individual differences in their developmental interplay. © 2015 Wiley Periodicals, Inc.

Temporal Dynamics of Proactive and Reactive Motor Inhibition

PubMed Central

Liebrand, Matthias; Pein, Inga; Tzvi, Elinor; Krämer, Ulrike M.

2017-01-01

Proactive motor inhibition refers to endogenous preparatory mechanisms facilitating action inhibition, whereas reactive motor inhibition is considered to be a sudden stopping process triggered by external signals. Previous studies were inconclusive about the temporal dynamics of involved neurocognitive processes during proactive and reactive motor control. Using electroencephalography (EEG), we investigated the time-course of proactive and reactive inhibition, measuring event-related oscillations and event-related potentials (ERPs). Participants performed in a cued go/nogo paradigm with cues indicating whether the motor response might or might not have to be inhibited. Based on the dual mechanisms of control (DMC) framework by Braver, we investigated the role of attentional effects, motor preparation in the sensorimotor cortex and prefrontal cognitive control mechanisms, separating effects before and after target onset. In the cue-target interval, proactive motor inhibition was associated with increased attention, reflected in reduced visual alpha power and an increased contingent negative variation (CNV). At the same time, motor inhibition was modulated by reduced sensorimotor beta power. After target onset, proactive inhibition resulted in an increased N1, indicating allocation of attention towards relevant stimuli, increased prefrontal beta power and a modulation of sensorimotor mu activity. As in previous studies, reactive stopping of motor actions was associated with increased prefrontal beta power and increased sensorimotor beta activity. The results stress the relevance of attentional mechanisms for proactive inhibition and speak for different neurocognitive mechanisms being involved in the early preparation for and in later implementation of motor inhibition. PMID:28496405

Risk mitigation of shared electronic records system in campus institutions: medical social work practice in singapore.

PubMed

Ow Yong, Lai Meng; Tan, Amanda Wei Li; Loo, Cecilia Lay Keng; Lim, Esther Li Ping

2014-10-01

In 2013, the Singapore General Hospital (SGH) Campus initiated a shared electronic system where patient records and documentations were standardized and shared across institutions within the Campus. The project was initiated to enhance quality of health care, improve accessibility, and ensure integrated (as opposed to fragmented) care for best outcomes in our patients. In mitigating the risks of ICT, it was found that familiarity with guiding ethical principles, and ensuring adherence to regulatory and technical competencies in medical social work were important. The need to negotiate and maneuver in a large environment within the Campus to ensure proactive integrative process helped.

The promotion of wellness in children and families challenges and opportunities.

PubMed

Pedro-Carroll, J

2001-11-01

This article considers the effects of marital disruption on children and families, using a risk and resilience perspective. The challenges that parental divorce poses for children are widely recognized; however, less attention has been given to strategies for promoting children's resilience and healthy developmental trajectories. The purpose of this article is to redress that imbalance by highlighting the importance of understanding pathways toward risk and resilience in children in the aftermath of divorce and the ways in which this research can be integrated into effective, evidence-based preventive interventions and proactive social policies that foster supportive parent-child relationships and psychological wellness in children and families.

The sexual double standard in African American adolescent women's sexual risk reduction socialization.

PubMed

Fasula, Amy M; Miller, Kim S; Wiener, Jeffrey

2007-01-01

This study explored the sexual double standard (SDS) (in which males are afforded more freedom and power than females in heterosexual interactions) in African American mothers' sexual messages to sons and daughters. We used a convenience sample of 129 African American adolescents, aged 14 to 17 years, and their mothers who reported SDS attitudes. Qualitative analyses revealed gender differences based on an SDS in mothers' sexual risk reduction socialization. Mothers typically took a proactive approach with sons and a neutral or prohibitive approach with daughters. Findings provide directions for socially relevant programs for African American parents, schools, and communities.

Proactive Approach for Safe Use of Antimicrobial Coatings in Healthcare Settings: Opinion of the COST Action Network AMiCI

PubMed Central

Ahonen, Merja; Kahru, Anne; Ivask, Angela; Kasemets, Kaja; Kõljalg, Siiri; Mantecca, Paride; Vinković Vrček, Ivana; Keinänen-Toivola, Minna M.; Crijns, Francy

2017-01-01

Infections and infectious diseases are considered a major challenge to human health in healthcare units worldwide. This opinion paper was initiated by EU COST Action network AMiCI (AntiMicrobial Coating Innovations) and focuses on scientific information essential for weighing the risks and benefits of antimicrobial surfaces in healthcare settings. Particular attention is drawn on nanomaterial-based antimicrobial surfaces in frequently-touched areas in healthcare settings and the potential of these nano-enabled coatings to induce (eco)toxicological hazard and antimicrobial resistance. Possibilities to minimize those risks e.g., at the level of safe-by-design are demonstrated. PMID:28362344

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.

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

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

The Role of Long-Term Memory in a Test of Visual Working Memory: Proactive Facilitation but No Proactive Interference

ERIC Educational Resources Information Center

Oberauer, Klaus; Awh, Edward; Sutterer, David W.

2017-01-01

We report 4 experiments examining whether associations in visual working memory are subject to proactive interference from long-term memory (LTM). Following a long-term learning phase in which participants learned the colors of 120 unique objects, a working memory (WM) test was administered in which participants recalled the precise colors of 3…

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…

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…

A new multi-disciplinary model for the assessment and reduction of volcanic risk: the example of the island of Vulcano, Italy

NASA Astrophysics Data System (ADS)

Simicevic, Aleksandra; Bonadonna, Costanza; di Traglia, Federico; Rosi, Mauro

2010-05-01

Volcanic eruptions are accompanied by numerous hazards which pose short- and long-term threats to people and property. Recent experiences have shown that successful responses to hazard events correlate strongly with the degree to which proactive policies of risk reduction are already in place before an eruption occurs. Effective proactive risk-reduction strategies require contributions from numerous disciplines. A volcanic eruption is not a hazard, per se, but rather an event capable of producing a variety of hazards (e.g. earthquakes, pyroclastic density currents, lava flows, tephra fall, lahars, landslides, gas release, and tsunamis) that can affect the built environment in a variety of ways, over different time scales and with different degrees of intensity. Our proposed model for the assessment and mitigation of exposure-based volcanic risk is mainly based on the compilation of three types of maps: hazard maps, hazard-specific vulnerability maps and exposure-based risk maps. Hazard maps identify the spatial distribution of individual volcanic hazard and it includes both event analysis and impact analysis. Hazard-specific vulnerability maps represent the systematic evaluation of physical vulnerability of the built environment to a range of volcanic phenomena, i.e. spatial distribution of buildings vulnerable to a given hazard based on the analysis of selected building elements. Buildings are classified on the basis of their major components that are relevant for different volcanic hazards, their strength, their construction materials and are defined taking into account the potential damage that each group of building elements (e.g. walls, roof, load-bearing structure) will suffer under a volcanic hazard. All those factors are enumerated in a checklist and are used for the building survey. Hazard-specific vulnerability maps are then overlapped with hazard maps in order to compile exposure-based risk maps and so quantify the potential damage. Such quantification is the starting point of the identification of suitable mitigation measures which will be analyzed through a cost-benefit analysis to assess their financial feasibility. Information about public networks is also recorded in order to give an overall idea of the built environment condition of the island. The vulnerability assessment of the technical systems describes the potential damages that could stress systems like electricity supply, water distribution, communication networks or transport systems. These damages can also be described as function disruption of the system. The important aspect is not only the physical capacity of a system to resist, but also its capacity to continue functioning. The model will be tested on the island of Vulcano in southern Italy. Vulcano is characterized by clear signs of volcanic unrest and is the type locality for a deadly style of eruption. The main active system of Vulcano Island (La Fossa cone) is known to produce a variety of eruption styles and intensities, each posing their own hazards and threats. Six different hazard scenarios have been identified based on a detailed stratigraphic work. The urbanization on Vulcano took place in the 1980s with no real planning and its population mostly subsists on tourism. Our preliminary results show that Vulcano is not characterized by a great variability of architectural typologies and construction materials. Three main types of buildings are present (masonry with concrete frame, masonry with manufactured stone units, masonry with hollow clay bricks) and no statistically significant trends were found between physical and morphological characteristics. The recent signs of volcanic unrest combined with a complex vulnerability of the island due to an uncontrolled urban development and a significant seasonal variation of the exposed population in summer months result in a high volcanic risk. As a result, Vulcano represents the ideal environment to test a multi-hazard based risk model and to study the transition between micro (building) and macro (urban environment) scale of analysis, which is still an unexplored field in the study of volcanic risk. Different levels of vulnerability need to be analyzed in order to increase the level of preparedness, plan a potential evacuation, manage a potential volcanic crisis and assess the best mitigation measures to put in place and reduce the volcanic risk.

Heritability of Boldness and Hypoxia Avoidance in European Seabass, Dicentrarchus labrax.

PubMed

Ferrari, Sébastien; Horri, Khaled; Allal, François; Vergnet, Alain; Benhaim, David; Vandeputte, Marc; Chatain, Béatrice; Bégout, Marie-Laure

2016-01-01

To understand the genetic basis of coping style in European seabass, fish from a full factorial mating (10 females x 50 males) were reared in common garden and individually tagged. Individuals coping style was characterized through behavior tests at four different ages, categorizing fish into proactive or reactive: a hypoxia avoidance test (at 255 days post hatching, dph) and 3 risk-taking tests (at 276, 286 and 304 dph). We observed significant heritability of the coping style, higher for the average of risk-taking scores (h2 = 0.45 ± 0.14) than for the hypoxia avoidance test (h2 = 0.19 ± 0.10). The genetic correlations between the three risk-taking scores were very high (rA = 0.96-0.99) showing that although their repeatability was moderately high (rP = 0.64-0.72), successive risk-taking tests evaluated the same genetic variation. A mild genetic correlation between the results of the hypoxia avoidance test and the average of risk-taking scores (0.45 ± 0.27) suggested that hypoxia avoidance and risk-taking tests do not address exactly the same behavioral and physiological responses. Genetic correlations between weight and risk taking traits showed negative values whatever the test used in our population i.e. reactive individual weights were larger. The results of this quantitative genetic analysis suggest a potential for the development of selection programs based on coping styles that could increase seabass welfare without altering growth performances. Overall, it also contributes to a better understanding of the origin and the significance of individual behavioral differences.

Applying the lessons of high risk industries to health care.

PubMed

Hudson, P

2003-12-01

High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks.

[Methodology for Identification of Inverse Drug Distribution, Spain].

PubMed

López Pérez, M Arantzazu; Muñoz Arias, Mariano; Vázquez Mourelle, Raquel

2016-04-04

The phenomenon of reverse drug trafficking in the legal supply chain is an unlawful practice to serious risks to public health. The aims was to identify proactively pharmacies that carry out these illegal activities. An analysis was performed through the crossing billing data to SAS of 52 million packs of medicines for the 496 pharmacies in the province over a period of 29 months with the drug packaging data supplied by the distribution entities of the province with the implementation of specific indicator defined called 'percentage overbought' allows us to detect those pharmacies at high risk of being involved in this illicit trade. It was tested in two pharmacies one rural and other urban a detour of 5.130 medicine containers and an illicit profit obtained from € 9,591.78 for the first and 9.982 packaging and € 26,885.11 for the second; they had gone unnoticed in previous inspections. The methodology implemented to define a profile of infringing pharmacies high risk in these illicit practices, identify new ones that had not been sanctioned, weigh the drugs for illegal trade and to identify new drugs subject to diversion; also added as a challenge, it helps to adjust accurately and effectively calculate the illicit profit obtained.

Risk of obesity in the neutered cat.

PubMed

Larsen, Jennifer A

2017-08-01

Surgical neutering is one of the most common procedures performed on pets in the USA among other countries. There are known effects of neutering on the physiology and behavior of the cat that predispose to obesity, which is the most significant sequela from a nutritional perspective. Increased food intake is the most likely factor influencing weight gain in the neutered cat. Proactively addressing these changes with nutritional management strategies can help prevent weight gain and associated negative consequences.

Child-to-parent violence: emotional and behavioral predictors.

PubMed

Calvete, Esther; Orue, Izaskun; Gámez-Guadix, Manuel

2013-03-01

Child-to-parent violence (CPV) includes acts committed by a child to intentionally cause physical, psychological, or financial pain to a parent. Available data indicate increasing rates of CPV in Spain, which have been attributed to a tendency toward more permissive parenting styles and changes in the power cycles within the families. The primary aim of this study was to assess the predictive role of some behavioral and emotional characteristics of adolescents who perpetrate CPV. A total of 1,072 adolescents (601 girls) filled out measures of CPV, proactive and reactive aggression, depressive symptoms, and substance abuse at Time 1, and measures of CPV 6 months later. The results showed that CPV was predicted by proactive, but not by reactive, aggression. This finding supports an instrumental role for CPV, which should be understood in the context of permissibility and lack of limits within the family. Depression and substance abuse also predicted the increase of CPV over time. Moreover, there were no sex differences in the prevalence of physical CPV, but verbal CPV was more predominant among girls. Although there were sex differences in some of the risk factors for CPV, the predictive model linking these risks to CPV was similar for boys and girls. Findings of this study suggest a psychological profile that combines internalizing problems and an instrumental use of violence in adolescents who perpetrate CPV. These characteristics are important for interventions.

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…

Motivational Antecedents of Preventive Proactivity in Late Life: Linking Future Orientation and Exercise1

PubMed Central

Kahana, Eva; Kahana, Boaz; Zhang, Jianping

2007-01-01

Future orientation is considered as a motivational antecedent of late-life proactivity. In a panel study of 453 old-old adults, we linked future orientation to exercise, a key component of late-life proactivity. Findings based on hierarchical linear modeling reveal that future orientation at baseline predicts changes in exercise during the subsequent four years. Whereas exercise behavior generally declined over time, future orientation and female gender were associated with smaller decline. These results suggest that future-oriented thinking has a lasting impact on health promotion behavior. Future orientation thus represents a dispositional antecedent of preventive proactivity as proposed in our successful aging model. PMID:18080009

Relationship between parenting and proactive versus reactive aggression among Chinese preschool children.

PubMed

Jia, Shoumei; Wang, Ling; Shi, Yingjuan

2014-04-01

This study examines the relationship between parenting and proactive versus reactive aggression among preschool children in China. Children (1164) from 10 kindergartens in Shanghai were rated by their parents and teachers using the Parent Behavior Inventory (PBI) and the Aggressive Behavior-Teacher's Checklist. Children had higher levels of reactive than proactive aggression, and older children and boys had higher levels of both proactive and reactive aggression. Hostile/coercive parenting style and low father education were significantly linked to aggression in children. These findings suggest that parenting style and type of aggression should be addressed when considering prevention and intervention. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Facilitating and debilitating trait anxiety, situational anxiety, and coping with an anticipated stressor: a process analysis.

PubMed

Raffety, B D; Smith, R E; Ptacek, J T

1997-04-01

Participants completed anxiety and coping diaries during 10 periods that began 7 days before an academic stressor and continued through the evening after the stressor. Profile analysis was used to examine the anxiety and coping processes in relation to 2 trait anxiety grouping variables: debilitating and facilitating test anxiety (D-TA and F-TA). Anxiety and coping changed over time, and high and low levels of D-TA and F-TA were associated with different daily patterns of anxiety and coping. Participants with a debilitative, as opposed to facilitative, trait anxiety style had lower examination scores, higher anxiety, and less problem-solving coping. Covarying F-TA, high D-TA was associated with a pattern of higher levels of tension, worry, distraction, and avoidant coping, as well as lower levels of proactive coping. Covarying D-TA, high F-TA was associated with higher levels of tension (but not worry or distraction), support seeking, proactive and problem-solving coping.

Are precues effective in proactively controlling taboo interference during speech production?

PubMed

White, Katherine K; Abrams, Lise; Hsi, Lisa R; Watkins, Emily C

2018-02-07

This research investigated whether precues engage proactive control to reduce emotional interference during speech production. A picture-word interference task required participants to name target pictures accompanied by taboo, negative, or neutral distractors. Proactive control was manipulated by presenting precues that signalled the type of distractor that would appear on the next trial. Experiment 1 included one block of trials with precues and one without, whereas Experiment 2 mixed precued and uncued trials. Consistent with previous research, picture naming was slowed in both experiments when distractors were taboo or negative compared to neutral, with the greatest slowing effect when distractors were taboo. Evidence that precues engaged proactive control to reduce interference from taboo (but not negative) distractors was found in Experiment 1. In contrast, mixing precued trials in Experiment 2 resulted in no taboo cueing benefit. These results suggest that item-level proactive control can be engaged under certain conditions to reduce taboo interference during speech production, findings that help to refine a role for cognitive control of distraction during speech production.

Electrophysiological correlates of proactive interference in the 'Recent Probes' verbal working memory task.

PubMed

Zhang, John X; Wu, Renhua; Kong, Lingyue; Weng, Xuchu; Du, Yingchun

2010-06-01

Using event-related potentials (ERPs), the present study examined the temporal dynamics of proactive interference in working memory using a recent probes task. Participants memorized and retained a target set of four letters over a short retention interval. They then responded to a recognition probe by judging whether it was from the memory set. ERP waveforms elicited by positive probes compared to those from negative probes showed positive shifts in a fronto-central early N2 component and a parietal late positive component (LPC). The LPC was identified as the electrophysiological signature of proactive interference, as it differentiated between two types of negative probes defined based on whether they were recently encountered. These results indicate that the proactive interference we observed arises from a mismatch between familiarity and contextual information during recognition memory. When considered together with related studies in the literature, the results also suggest that there are different forms of proactive interference associated with different neural correlates. Copyright 2010 Elsevier Ltd. All rights reserved.

Costs and benefits linked to developments in cognitive control.

PubMed

Blackwell, Katharine A; Munakata, Yuko

2014-03-01

Developing cognitive control over one's thoughts, emotions, and actions is a fundamental process that predicts important life outcomes. Such control begins in infancy, and shifts during development from a predominantly reactive form (e.g. retrieving task-relevant information when needed) to an increasingly proactive form (e.g. maintaining task-relevant information in anticipation of needing it). While such developments are generally viewed as adaptive, cognitive abilities can also involve trade-offs, such that the benefits of developing increasingly proactive control may come with associated costs. In two experiments, we test for such cognitive trade-offs in children who are transitioning to proactive control. We find that proactive control predicts expected benefits in children's working memory, but is also associated with predicted costs in disproportionately slowing children under conditions of distraction. These findings highlight unique advantages and disadvantages of proactive and reactive control, and suggest caution in attempting to alter their balance during development. © 2013 John Wiley & Sons Ltd.

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

Proactive and reactive control depends on emotional valence: a Stroop study with emotional expressions and words.

PubMed

Kar, Bhoomika Rastogi; Srinivasan, Narayanan; Nehabala, Yagyima; Nigam, Richa

2018-03-01

We examined proactive and reactive control effects in the context of task-relevant happy, sad, and angry facial expressions on a face-word Stroop task. Participants identified the emotion expressed by a face that contained a congruent or incongruent emotional word (happy/sad/angry). Proactive control effects were measured in terms of the reduction in Stroop interference (difference between incongruent and congruent trials) as a function of previous trial emotion and previous trial congruence. Reactive control effects were measured in terms of the reduction in Stroop interference as a function of current trial emotion and previous trial congruence. Previous trial negative emotions exert greater influence on proactive control than the positive emotion. Sad faces in the previous trial resulted in greater reduction in the Stroop interference for happy faces in the current trial. However, current trial angry faces showed stronger adaptation effects compared to happy faces. Thus, both proactive and reactive control mechanisms are dependent on emotional valence of task-relevant stimuli.

Neural mechanisms of proactive interference-resolution.

PubMed

Nee, Derek Evan; Jonides, John; Berman, Marc G

2007-12-01

The ability to mitigate interference from information that was previously relevant, but is no longer relevant, is central to successful cognition. Several studies have implicated left ventrolateral prefrontal cortex (VLPFC) as a region tied to this ability, but it is unclear whether this result generalizes across different tasks. In addition, it has been suggested that left anterior prefrontal cortex (APFC) also plays a role in proactive interference-resolution although support for this claim has been limited. The present study used event-related functional magnetic resonance imaging (fMRI) to investigate the role of these regions in resolving proactive-interference across two different tasks performed on the same subjects. Results indicate that both left VLPFC and left APFC are involved in the resolution of proactive interference across tasks. However, different functional networks related to each region suggest dissociable roles for the two regions. Additionally, regions of the posterior cingulate gyrus demonstrated unique involvement in facilitation when short- and long-term memory converged. This pattern of results serves to further specify models of proactive interference-resolution.

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.

Variability in emotional responsiveness and coping style during active avoidance as a window onto psychological vulnerability to stress.

PubMed

Gorka, Adam X; LaBar, Kevin S; Hariri, Ahmad R

2016-05-01

Individual differences in coping styles are associated with psychological vulnerability to stress. Recent animal research suggests that coping styles reflect trade-offs between proactive and reactive threat responses during active avoidance paradigms, with proactive responses associated with better stress tolerance. Based on these preclinical findings, we developed a novel instructed active avoidance paradigm to characterize patterns of proactive and reactive responses using behavioral, motoric, and autonomic measures in humans. Analyses revealed significant inter-individual variability not only in the magnitude of general emotional responsiveness but also the likelihood to specifically express proactive or reactive responses. In men but not women, individual differences in general emotional responsiveness were linked to increased trait anxiety while proactive coping style was linked to increased trait aggression. These patterns are consistent with preclinical findings and suggest that instructed active avoidance paradigms may be useful in assessing psychological vulnerability to stress using objective behavioral measures. Copyright © 2016. Published by Elsevier Inc.

Proactive Aggression: Teaching Self-Control to Children Who Use Aggression to Get Their Needs Met. Boys Town National Family Home Program Informational Series, Volume No. 105.

ERIC Educational Resources Information Center

Dowd, Thomas P.

This Boys' Town guide for parents focuses on proactive aggression, how to recognize it, and how to deal with it. The guide differentiates proactive and reactive aggression, describes potential causes, and presents suggestions for eliminating inappropriate behavior. One parent-child scenario is described in which unwitting parents with the best of…

Research and Development for Advanced Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices

DTIC Science & Technology

2009-09-01

Tele-maintenance Capability with Remote Serial Console Access and Proactive Monitoring of Medical Devices PRINCIPAL INVESTIGATOR...Remote Serial Console Access and Proactive Monitoring of Medical Devices 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...ORGANIZATION REPORT NUMBER Concepteers LLC 880 Bergen Avenue, Suite 403 Jersey City, NJ 07306 9. SPONSORING / MONITORING

Proactive Fault Tolerance Using Preemptive Migration

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

Engelmann, Christian; Vallee, Geoffroy R; Naughton, III, Thomas J

2009-01-01

Proactive fault tolerance (FT) in high-performance computing is a concept that prevents compute node failures from impacting running parallel applications by preemptively migrating application parts away from nodes that are about to fail. This paper provides a foundation for proactive FT by defining its architecture and classifying implementation options. This paper further relates prior work to the presented architecture and classification, and discusses the challenges ahead for needed supporting technologies.

Approach and avoidance towards aggressive stimuli and its relation to reactive and proactive aggression.

PubMed

Lobbestael, Jill; Cousijn, Janna; Brugman, Suzanne; Wiers, Reinout W

2016-06-30

This study assessed the association between indirectly measured behavioural approach- and avoidance-related tendencies on the one hand, and reactive versus proactive aggression on the other hand. Reactive aggression (i.e. the impulsive, anger-driven aggression expressed in response to threatening stimuli) was differentiated from proactive aggression (i.e. the more controlled aggression motivated towards obtaining specific goals). A mixed sample of 118 patients and healthy controls filled out a self-report measure to assess their degree of reactive and proactive aggression, and then performed an Approach Avoidance Task in which they were asked to pull or push a joystick in response to a format-feature of a series of pictures, irrespective of their contents. The pictorial stimuli used in this task included attack-related scenes and angry faces, along with neutral, positive and negative control stimuli. The results were controlled for the level of personality disorder pathology, gender, and age. The findings indicated that reactive but not proactive aggression was related to the relative behavioural tendency to approach attack-related scenes, along with positive stimuli. These findings reflect the hyper-reactivity of the approach-related reward system in reactive aggression, and further our knowledge into the distinct correlates and precursors of reactive and proactive aggression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of ageing on problem size and proactive interference in arithmetic facts solving.

PubMed

Archambeau, Kim; De Visscher, Alice; Noël, Marie-Pascale; Gevers, Wim

2018-02-01

Arithmetic facts (AFs) are required when solving problems such as "3 × 4" and refer to calculations for which the correct answer is retrieved from memory. Currently, two important effects that modulate the performance in AFs have been highlighted: the problem size effect and the proactive interference effect. The aim of this study is to investigate possible age-related changes of the problem size effect and the proactive interference effect in AF solving. To this end, the performance of young and older adults was compared in a multiplication production task. Furthermore, an independent measure of proactive interference was assessed to further define the architecture underlying this effect in multiplication solving. The results indicate that both young and older adults were sensitive to the effects of interference and of the problem size. That is, both interference and problem size affected performance negatively: the time needed to solve a multiplication problem increases as the level of interference and the size of the problem increase. Regarding the effect of ageing, the problem size effect remains constant with age, indicating a preserved AF network in older adults. Interestingly, sensitivity to proactive interference in multiplication solving was less pronounced in older than in younger adults suggesting that part of the proactive interference has been overcome with age.

Free nicotine patches plus proactive telephone peer support to help low-income women stop smoking.

PubMed

Solomon, L J; Scharoun, G M; Flynn, B S; Secker-Walker, R H; Sepinwall, D

2000-07-01

This study tested the impact of free nicotine patches plus proactive telephone peer support to help low-income women stop smoking. A total of 214 Medicaid-eligible women smokers of childbearing age were randomized to receive free nicotine patches through the mail or free nicotine patches through the mail plus the provision of proactive support by telephone from a woman ex-smoker for up to 3 months. Assessments were conducted by telephone at baseline, 10 days, and 3 and 6 months after enrollment. At the 3-month follow-up, significantly more women in the patch plus proactive telephone support condition were abstinent (42%) compared to the patch only condition (28%) (P = 0.03). Similarly, more women in the experimental condition were abstinent at both the 10-day and 3-month assessments (32 v 19%, P = 0.02). However, differences were not found at the 6-month follow-up, suggesting that the addition of proactive telephone peer support enhanced short-term, but not long-term cessation. This is the first study to demonstrate a beneficial effect for the addition of proactive telephone support as an adjunct to free nicotine replacement in a low-income population. Copyright 2000 American Health Foundation and Academic Press.

Risk management systems for health care and safety development on transplantation: a review and a proposal.

PubMed

Pretagostini, R; Gabbrielli, F; Fiaschetti, P; Oliveti, A; Cenci, S; Peritore, D; Stabile, D

2010-05-01

Starting from the report on medical errors published in 1999 by the US Institute of Medicine, a number of different approaches to risk management have been developed for maximum risk reduction in health care activities. The health care authorities in many countries have focused attention on patient safety, employing action research programs that are based on quite different principles. We performed a systematic Medline research of the literature since 1999. The following key words were used, also combining boolean operators and medical subheading terms: "adverse event," "risk management," "error," and "governance." Studies published in the last 5 years were particularly classified in various groups: risk management in health care systems; safety in specific hospital activities; and health care institutions' official documents. Methods of action researches have been analysed and their characteristics compared. Their suitability for safety development in donation, retrieval, and transplantation processes were discussed in the reality of the Italian transplant network. Some action researches and studies were dedicated to entire national healthcare systems, whereas others focused on specific risks. Many research programs have undergone critical review in the literature. Retrospective analysis has centered on so-called sentinel events to particularly analyze only a minor portion of the organizational phenomena, which can be the origin of an adverse event, an incident, or an error. Sentinel events give useful information if they are studied in highly engineered and standardized organizations like laboratories or tissue establishments, but they show several limits in the analysis of organ donation, retrieval, and transplantation processes, which are characterized by prevailing human factors, with high intrinsic risk and variability. Thus, they are poorly effective to deliver sure elements to base safety management improvement programs, especially regarding multidisciplinary systems with high complexity. In organ transplantation, the possibility to increase safety seems greater using proactive research, mainly centred on organizational processes together with retrospective analyses but not limited to sentinel event reports. Copyright (c) 2010. Published by Elsevier Inc.

Neural and behavioral mechanisms of proactive and reactive inhibition

PubMed Central

Meyer, Heidi C.

2016-01-01

Response inhibition is an important component of adaptive behavior. Substantial prior research has focused on reactive inhibition, which refers to the cessation of a motor response that is already in progress. More recently, a growing number of studies have begun to examine mechanisms underlying proactive inhibition, whereby preparatory processes result in a response being withheld before it is initiated. It has become apparent that proactive inhibition is an essential component of the overall ability to regulate behavior and has implications for the success of reactive inhibition. Moreover, successful inhibition relies on learning the meaning of specific environmental cues that signal when a behavioral response should be withheld. Proactive inhibitory control is mediated by stopping goals, which reflect the desired outcome of inhibition and include information about how and when inhibition should be implemented. However, little is known about the circuits and cellular processes that encode and represent features in the environment that indicate the necessity for proactive inhibition or how these representations are implemented in response inhibition. In this article, we will review the brain circuits and systems involved in implementing inhibitory control through both reactive and proactive mechanisms. We also comment on possible cellular mechanisms that may contribute to inhibitory control processes, noting that substantial further research is necessary in this regard. Furthermore, we will outline a number of ways in which the temporal dynamics underlying the generation of the proactive inhibitory signal may be particularly important for parsing out the neurobiological correlates that contribute to the learning processes underlying various aspects of inhibitory control. PMID:27634142

[Juvenile criminality: general strain theory and the reactive-proactive aggression trait].

PubMed

Greco, Romy; Curci, Antonietta; Grattagliano, Ignazio

2009-01-01

The aims of the present study are to test General Strain Theory's (GST) assumptions, and to integrate the model including the proactive-reactive aggression trait. GST hypothesizes crime to be enacted in response to extra-personal stimuli (strain) and their subsequent negative emotions, especially anger. However, there exist also internally-driven manifestations of crime (instrumental or proactive), motivated by stimuli that are of an intrapersonal origin. Further, individuals differ to each other in the tendency to commit reactive or proactive or both manifestations of crime. With the goal to gain a more comprehensive model, GST variables and the reactive-proactive aggression trait are together tested as to their ability to predict criminal behaviour. Participants in the present research are 68 adolescent males with age ranging from 14 to 19 (M = 16.94, SD = 0.95). Half of the participants were jailed adolescents at the Fornelli Juvenile Detention Centre in Bari, while the remaining were adolescents with no criminal record, matched for age and level of education with the former group. An interview was administered to assess the experienced strain events, anger, and crime committed by the participants in the three months preceding the interview and also before. The reactive-proactive aggression trait was additionally measured. Results of the present study supported GST's assumptions, and confirmed the utility of integrating the model to include the proactive-reactive aggression trait. Strain events experienced in three-month time were found to influence property and violent offences committed by participants in the same time-interval as well as over this time. Furthermore,jailed participants were more likely to react with anger, and violence to strain events than non-jailed individuals, although the number of events experienced by both groups in the preceding months is similar. Finally, the results of the present study showed that proactive aggression is a strong predictor of criminal behaviour.

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)

Adapting an ambient monitoring program to the challenge of managing emerging pollutants in the San Francisco Estuary.

PubMed

Hoenicke, Rainer; Oros, Daniel R; Oram, John J; Taberski, Karen M

2007-09-01

While over seven million organic and inorganic compounds that have been indexed by the American Chemical Society's Chemical Abstracts Service in their CAS Registry are commercially available, most pollution monitoring programs focus only on those chemical stressors for which regulatory benchmarks exist, and have been traditionally considered responsible for the most significant human and environmental health risks. Until the late 1990s, the San Francisco Estuary Regional Monitoring Program was no exception in that regard. After a thorough external review, the monitoring program responded to the need for developing a pro-active surveillance approach for emerging pollutants in recognition of the fact that the potential for the growing list of widely used chemical compounds to alter the integrity of water is high. We describe (1) the scientific and analytical bases underlying a new surveillance monitoring approach; (2) summarize approaches used and results obtained from a forensic retrospective; (3) present the growing data set on emerging pollutants from surveillance monitoring and related efforts in the San Francisco Bay Area to characterize newly targeted compounds in wastewater streams, sediment, storm water runoff, and biota; and (4) suggest next steps in monitoring program development and applied research that could move beyond traditional approaches of pollutant characterization. Based on the forensic analysis of archived chromatograms and chemical and toxicological properties of candidate compounds, we quantified a variety of synthetic organic compounds which had previously not been targeted for analysis. Flame retardant compounds, pesticides and insecticide synergists, insect repellents, pharmaceuticals, personal care product ingredients, plasticizers, non-ionic surfactants, and other manufacturing ingredients were detected in water, sediment, and/or biological tissue samples. Several of these compounds, especially polybrominated diphenyl ether flame retardants, exhibited concentrations of environmental concern. We also describe environmental management challenges associated with emerging pollutants and how pro-active surveillance monitoring might assist in implementing a more holistic approach to pollution prevention and control before emerging pollutants become a burden on future generations.

The implications of autonomy: Viewed in the light of efforts to uphold patients dignity and integrity

PubMed Central

Delmar, Charlotte; Alenius-Karlsson, Nanny; Mikkelsen, Anette Højer

2011-01-01

This article focuses on Danish patients’ experience of autonomy and its interplay with dignity and integrity in their meeting with health professionals. The aim is to chart the meanings and implications of autonomy for persons whose illness places them in a vulnerable life situation. The interplay between autonomy and personal dignity in the meeting with health care staff are central concepts in the framework. Data collection and findings are based on eight qualitative semi-structured interviews with patients. Patients with acute, chronic, and life threatening diseases were represented including surgical as well as medical patients. The values associated with autonomy are in many ways vitalising, but may become so dominant, autonomy seeking, and pervasive that the patient's dignity is affected. Three types of patient behaviour were identified. (1) The proactive patient: Patients feel that they assume responsibility for their own situation, but it may be a responsibility that they find hard to bear. (2) The rejected patient: proactive patients take responsibility on many occasions but very active patients are at risk of being rejected with consequences for their dignity. (3) The knowledgeable patient: when patients are health care professionals, the patient's right of self-determination was managed in a variety of ways, sometimes the patient's right of autonomy was treated in a dignified way but the opposite was also evident. In one way, patients are active and willing to take responsibility for themselves, and at the same time they are “forced” to do so by health care staff. Patients would like health professionals to be more attentive and proactive. PMID:21695070

Differential development of retroactive and proactive interference during post-learning wakefulness.

PubMed

Brawn, Timothy P; Nusbaum, Howard C; Margoliash, Daniel

2018-07-01

Newly encoded, labile memories are prone to disruption during post-learning wakefulness. Here we examine the contributions of retroactive and proactive interference to daytime forgetting on an auditory classification task in a songbird. While both types of interference impair performance, they do not develop concurrently. The retroactive interference of task-B on task-A developed during the learning of task-B, whereas the proactive interference of task-A on task-B emerged during subsequent waking retention. These different time courses indicate an asymmetry in the emergence of retroactive and proactive interference and suggest a mechanistic framework for how different types of interference between new memories develop. © 2018 Brawn et al.; Published by Cold Spring Harbor Laboratory Press.

Proactive interference effects on sentence production

PubMed Central

FERREIRA, VICTOR S.; FIRATO, CARLA E.

2007-01-01

Proactive interference refers to recall difficulties caused by prior similar memory-related processing. Information-processing approaches to sentence production predict that retrievability affects sentence form: Speakers may word sentences so that material that is difficult to retrieve is spoken later. In this experiment, speakers produced sentence structures that could include an optional that, thereby delaying the mention of a subsequent noun phrase. This subsequent noun phrase was either (1) conceptually similar to three previous noun phrases in the same sentence, leading to greater proactive interference, or (2) conceptually dissimilar, leading to less proactive interference. Speakers produced more thats (and were more disfluencies) before conceptually similar noun phrases, suggesting that retrieval difficulties during sentence production affect the syntactic structures of sentences that speakers produce. PMID:12613685

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.

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.

Efficacy of proactive long-term maintenance therapy of canine atopic dermatitis with 0.0584% hydrocortisone aceponate spray: a double-blind placebo controlled pilot study.

PubMed

Lourenço, Ana M; Schmidt, Vanessa; São Braz, Berta; Nóbrega, Diana; Nunes, Telmo; Duarte-Correia, José H; Matias, Daniela; Maruhashi, Emi; Rème, Christophe A; Nuttall, Tim

2016-04-01

Long-term remission between flares of canine atopic dermatitis (CAD) can be difficult to achieve. Therefore, additional strategic forms of treatment are needed in order to target flare prevention. The concept of proactive therapy is recommended in the European guidelines for the treatment of human atopic eczema. To evaluate the efficacy of a proactive treatment regimen with a 0.0584% hydrocortisone aceponate (HCA) spray for CAD. Client-owned dogs with spontaneous atopic dermatitis (AD) (n = 41). This pilot study was conducted as a randomised, placebo-controlled, double-blinded clinical trial with an end-point of treatment failure. Dogs were treated once daily to remission, then randomly assigned to receive either the HCA spray (n = 21) or a placebo (n = 20) spray on two consecutive days each week. All dogs were on appropriate flea control. No topical or systemic anti-inflammatory or antimicrobial agents were permitted. Intention-to-treat analysis was used. At Day 0, all the dogs were in remission or had mild AD based on their Canine Atopic Dermatitis Extent and Severity Index, version 3 (CADESI-03) scores. The time to relapse was significantly higher in the HCA group (median 115 d; range 31-260 d) compared to the placebo group (median 33 d; range 15-61 d) (P < 0.0001). No adverse events were attributable to the HCA spray. Four dogs were lost to follow-up and four were withdrawn after receiving prohibited medication. These results indicate that proactive long-term therapy of CAD with an HCA spray administered on two consecutive days each week is effective and well-tolerated. © 2016 ESVD and ACVD.

Why Don't They Just Give Us Money? Project Cost Estimating and Cost Reporting

NASA Technical Reports Server (NTRS)

Comstock, Douglas A.; Van Wychen, Kristin; Zimmerman, Mary Beth

2015-01-01

Successful projects require an integrated approach to managing cost, schedule, and risk. This is especially true for complex, multi-year projects involving multiple organizations. To explore solutions and leverage valuable lessons learned, NASA's Virtual Project Management Challenge will kick off a three-part series examining some of the challenges faced by project and program managers when it comes to managing these important elements. In this first session of the series, we will look at cost management, with an emphasis on the critical roles of cost estimating and cost reporting. By taking a proactive approach to both of these activities, project managers can better control life cycle costs, maintain stakeholder confidence, and protect other current and future projects in the organization's portfolio. Speakers will be Doug Comstock, Director of NASA's Cost Analysis Division, Kristin Van Wychen, Senior Analyst in the GAO Acquisition and Sourcing Management Team, and Mary Beth Zimmerman, Branch Chief for NASA's Portfolio Analysis Branch, Strategic Investments Division. Moderator Ramien Pierre is from NASA's Academy for Program/Project and Engineering Leadership (APPEL).

Scale-dependent approaches to modeling spatial epidemiology of chronic wasting disease.

USGS Publications Warehouse

Conner, Mary M.; Gross, John E.; Cross, Paul C.; Ebinger, Michael R.; Gillies, Robert; Samuel, Michael D.; Miller, Michael W.

2007-01-01

For each scale, we presented a focal approach that would be useful for understanding the spatial pattern and epidemiology of CWD, as well as being a useful tool for CWD management. The focal approaches include risk analysis and micromaps for the regional scale, cluster analysis for the landscape scale, and individual based modeling for the fine scale of within population. For each of these methods, we used simulated data and walked through the method step by step to fully illustrate the “how to”, with specifics about what is input and output, as well as what questions the method addresses. We also provided a summary table to, at a glance, describe the scale, questions that can be addressed, and general data required for each method described in this e-book. We hope that this review will be helpful to biologists and managers by increasing the utility of their surveillance data, and ultimately be useful for increasing our understanding of CWD and allowing wildlife biologists and managers to move beyond retroactive fire-fighting to proactive preventative action.

Local Food Systems Food Safety Concerns.

PubMed

Chapman, Benjamin; Gunter, Chris

2018-04-01

Foodborne disease causes an estimated 48 million illnesses and 3,000 deaths annually (Scallan E, et al., Emerg Infect Dis 17:7-15, 2011), with U.S. economic costs estimated at $152 billion to $1.4 trillion annually (Roberts T, Am J Agric Econ 89:1183-1188, 2007; Scharff RL, http://www.pewtrusts.org/en/research-and-analysis/reports/0001/01/01/healthrelated-costs-from-foodborne-illness-in-the-united-states, 2010). An increasing number of these illnesses are associated with fresh fruits and vegetables. An analysis of outbreaks from 1990 to 2003 found that 12% of outbreaks and 20% of outbreak-related illnesses were associated with produce (Klein S, Smith DeWaal CS, Center for Science in the Public Interest, https://cspinet.org/sites/default/files/attachment/ddreport.pdf, June 2008; Lynch M, Tauxe R, Hedberg C, Epidemiol Infect 137:307-315, 2009). These food safety problems have resulted in various stakeholders recommending the shift to a more preventative and risk-based food safety system. A modern risk-based food safety system takes a farm-to-fork preventative approach to food safety and relies on the proactive collection and analysis of data to better understand potential hazards and risk factors, to design and evaluate interventions, and to prioritize prevention efforts. Such a system focuses limited resources at the points in the food system with the likelihood of having greatest benefit to public health. As shared kitchens, food hubs, and local food systems such as community supported agriculture are becoming more prevalent throughout the United States, so are foodborne illness outbreaks at these locations. At these locations, many with limited resources, food safety methods of prevention are rarely the main focus. This lack of focus on food safety knowledge is why a growing number of foodborne illness outbreaks are occurring at these locations.

Defining the impact of the use of granulocyte colony stimulating factors on the incidence of chemotherapy-induced neutropenia in patients with gynecologic malignancies.

PubMed

Julius, Justin M; Hammerstrom, Aimee; Wei, Caimiao; Rajesh, Raeshmma; Bodurka, Diane C; Kurian, Shiney; Smith, Judith A

2017-03-01

Purpose The objectives of this study were to characterize the incidence of chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) with specific chemotherapy agents commonly used in the treatment of gynecologic malignancies, as well as defining the impact of granulocyte colony stimulating factors (G-CSF) on the prevention of CIN and FN in this patient population. Methods This retrospective analysis was conducted from a database of 635 gynecologic cancer patients who received chemotherapy between 1 September 2007 and 31 August 2008. A logistic regression analysis was conducted to determine the impact of potential covariates on the overall incidence of CIN. Results Overall, 28.3% of patients experienced CIN with one or more cycles chemotherapy, and 13.1% had treatment delays or dose reduction associated with CIN. The use of G-CSF prior to administration of chemotherapy resulted in a decrease in the incidence of CIN from 29.8% to 19.6% compared to no G-CSF use. No difference was observed in number of treatment delays or dose reductions in the 46 (7.2%) of gynecologic cancer patients that received G-CSF prophylaxis. Multivariate analysis found that both age and the number of current cycles jointly may predict risk of CIN. Conclusions Patients with gynecologic malignancies appear to be at a higher risk of development of neutropenia when treated with chemotherapy. The proactive use of G-CSF did decrease the risk of CIN by over 30%. Prospective study is warranted to determine the impact of G-CSF to reduce CIN in patients with gynecologic malignancies receiving chemotherapy.

Fishing for ecosystem services.

PubMed

Pope, Kevin L; Pegg, Mark A; Cole, Nicholas W; Siddons, Stephen F; Fedele, Alexis D; Harmon, Brian S; Ruskamp, Ryan L; Turner, Dylan R; Uerling, Caleb C

2016-12-01

Ecosystems are commonly exploited and manipulated to maximize certain human benefits. Such changes can degrade systems, leading to cascading negative effects that may be initially undetected, yet ultimately result in a reduction, or complete loss, of certain valuable ecosystem services. Ecosystem-based management is intended to maintain ecosystem quality and minimize the risk of irreversible change to natural assemblages of species and to ecosystem processes while obtaining and maintaining long-term socioeconomic benefits. We discuss policy decisions in fishery management related to commonly manipulated environments with a focus on influences to ecosystem services. By focusing on broader scales, managing for ecosystem services, and taking a more proactive approach, we expect sustainable, quality fisheries that are resilient to future disturbances. To that end, we contend that: (1) management always involves tradeoffs; (2) explicit management of fisheries for ecosystem services could facilitate a transition from reactive to proactive management; and (3) adaptive co-management is a process that could enhance management for ecosystem services. We propose adaptive co-management with an ecosystem service framework where actions are implemented within ecosystem boundaries, rather than political boundaries, through strong interjurisdictional relationships. Published by Elsevier Ltd.

Fishing for ecosystem services

USGS Publications Warehouse

Pope, Kevin L.; Pegg, Mark A.; Cole, Nicholas W.; Siddons, Stephen F.; Fedele, Alexis D.; Harmon, Brian S.; Ruskamp, Ryan L.; Turner, Dylan R.; Uerling, Caleb C.

2016-01-01

Ecosystems are commonly exploited and manipulated to maximize certain human benefits. Such changes can degrade systems, leading to cascading negative effects that may be initially undetected, yet ultimately result in a reduction, or complete loss, of certain valuable ecosystem services. Ecosystem-based management is intended to maintain ecosystem quality and minimize the risk of irreversible change to natural assemblages of species and to ecosystem processes while obtaining and maintaining long-term socioeconomic benefits. We discuss policy decisions in fishery management related to commonly manipulated environments with a focus on influences to ecosystem services. By focusing on broader scales, managing for ecosystem services, and taking a more proactive approach, we expect sustainable, quality fisheries that are resilient to future disturbances. To that end, we contend that: (1) management always involves tradeoffs; (2) explicit management of fisheries for ecosystem services could facilitate a transition from reactive to proactive management; and (3) adaptive co-management is a process that could enhance management for ecosystem services. We propose adaptive co-management with an ecosystem service framework where actions are implemented within ecosystem boundaries, rather than political boundaries, through strong interjurisdictional relationships.

NASA Aerospace Flight Battery Program: Generic Safety, Handling and Qualification Guidelines for Lithium-Ion (Li-Ion) Batteries; Availability of Source Materials for Lithium-Ion (Li-Ion) Batteries; Maintaining Technical Communications Related to Aerospace Batteries (NASA Aerospace Battery Workshop). Volume 1, Part 1

NASA Technical Reports Server (NTRS)

Manzo, Michelle A.; Brewer, Jeffrey C.; Bugga, Ratnakumar V.; Darcy, Eric C.; Jeevarajan, Judith A.; McKissock, Barbara I.; Schmitz, Paul C.

2010-01-01

This NASA Aerospace Flight Battery Systems Working Group was chartered within the NASA Engineering and Safety Center (NESC). The Battery Working Group was tasked to complete tasks and to propose proactive work to address battery related, agency-wide issues on an annual basis. In its first year of operation, this proactive program addressed various aspects of the validation and verification of aerospace battery systems for NASA missions. Studies were performed, issues were discussed and in many cases, test programs were executed to generate recommendations and guidelines to reduce risk associated with various aspects of implementing battery technology in the aerospace industry. This document contains Part 1 - Volume I: Generic Safety, Handling and Qualification Guidelines for Lithium-Ion (Li-Ion) Batteries, Availability of Source Materials for Lithium-Ion (Li-Ion) Batteries, and Maintaining Technical Communications Related to Aerospace Batteries (NASA Aerospace Battery Workshop).

Proactive conservation management of an island-endemic bird species in the face of global change

USGS Publications Warehouse

Morrison, S.A.; Sillett, T. Scott; Ghalambor, Cameron K.; Fitzpatrick, J.W.; Graber, D.M.; Bakker, V.J.; Bowman, R.; Collins, C.T.; Collins, P.W.; Delaney, K.S.; Doak, D.F.; Koenig, Walter D.; Laughrin, L.; Lieberman, A.A.; Marzluff, J.M.; Reynolds, M.D.; Scott, J.M.; Stallcup, J.A.; Vickers, W.; Boyce, W.M.

2011-01-01

Biodiversity conservation in an era of global change and scarce funding benefits from approaches that simultaneously solve multiple problems. Here, we discuss conservation management of the island scrub-jay (Aphelocoma insularis), the only island-endemic passerine species in the continental United States, which is currently restricted to 250-square-kilometer Santa Cruz Island, California. Although the species is not listed as threatened by state or federal agencies, its viability is nonetheless threatened on multiple fronts. We discuss management actions that could reduce extinction risk, including vaccination, captive propagation, biosecurity measures, and establishing a second free-living population on a neighboring island. Establishing a second population on Santa Rosa Island may have the added benefit of accelerating the restoration and enhancing the resilience of that island's currently highly degraded ecosystem. The proactive management framework for island scrub-jays presented here illustrates how strategies for species protection, ecosystem restoration, and adaptation to and mitigation of climate change can converge into an integrated solution. ?? 2011 by American Institute of Biological Sciences. All rights reserved.

Social and Economic Aspects of the Transmission of Pathogenic Bacteria between Wildlife and Food Animals: A Thematic Analysis of Published Research Knowledge.

PubMed

Fournier, A; Young, I; Rajić, A; Greig, J; LeJeune, J

2015-09-01

Wildlife is a known reservoir of pathogenic bacteria, including Mycobacterium bovis and Brucella spp. Transmission of these pathogens between wildlife and food animals can lead to damaging impacts on the agri-food industry and public health. Several international case studies have highlighted the complex and cross-sectoral challenges involved in preventing and managing these potential transmission risks. The objective of our study was to develop a better understanding of the socio-economic aspects of the transmission of pathogenic bacteria between wildlife and food animals to support more effective and sustainable risk mitigation strategies. We conducted qualitative thematic analysis on a purposive sample of 30/141 articles identified in a complementary scoping review of the literature in this area and identified two key themes. The first related to the framing of this issue as a 'wicked problem' that depends on a complex interaction of social factors and risk perceptions, governance and public policy, and economic implications. The second theme consisted of promising approaches and strategies to prevent and mitigate the potential risks from transmission of pathogenic bacteria between wildlife and food animals. These included participatory, collaborative and multidisciplinary decision-making approaches and the proactive incorporation of credible scientific evidence and local contextual factors into solutions. The integration of these approaches to address 'wicked problems' in this field may assist stakeholders and decision-makers in improving the acceptability and sustainability of future strategies to reduce the transmission of pathogenic bacteria between wildlife and food animals. © 2015 Zoonoses and Public Health © 2015 Her Majesty the Queen in Right of Canada Reproduced with the permission of the Minister of the Public Health Agency of Canada.

Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit.

PubMed

Li, Xixi; He, Mei; Wang, Haiyan

2017-12-01

In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit.The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures. Failure modes with risk priority number (RPN) ≥100 (top 10 RPN scores) were deemed as high-priority-risks, meaning that they needed immediate corrective action. After modifications were put, the resulting RPN was compared with the previous one. A centralized nursing care system was designed.A total of 25 failure modes were identified. High-priority risks were "Unqualified medical device sterilization" (RPN, 337), "leukopenia, very low immunity" (RPN, 222), and "Poor hand hygiene Basic diseases" (RPN, 160). The corrective measures that we took allowed a decrease in the RPNs, especially for the high-priority risks. The maximum reduction was approximately 80%, as observed for the failure mode "Not creating the maximal barrier for patient." The averaged incidence of CRBSIs was reduced from 5.19% to 1.45%, with 3 months of 0 infection rate.The FMEA can effectively reduce incidence of CRBSIs, improve the security of central venous catheterization technology, decrease overall medical expenses, and improve nursing quality. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Defending the Homeland: The Case for Integrating National Guard Intelligence Personnel into the State Fusion Centers

DTIC Science & Technology

2011-02-15

already robust lineup of 57 National Guard Combat Support Teams (CSTs) and 17 CBRNE Enhanced Response Force Packages (CERFPs) to increase the existing...analysis of disparate data sources, identification of intelligence gaps, and proactive collection of intelligence against those gaps which could

Categorical Coding of Manual & English Alphabet Characters by Beginning Students of American Sign Language.

ERIC Educational Resources Information Center

Hoemann, Harry W.; Koenig, Teresa J.

1990-01-01

Analysis of the performance of beginning American Sign Language students, who had only recently learned the manual alphabet, on a task in which proactive interference would build up rapidly on successive trials, supported the view that different languages have separate memory stores. (Author/CB)

[The relationship between reactive/proactive aggression, callous/unemotional traits and behavioural problems in Hungarian adolescents].

PubMed

Bozsik, Csilla; Körmendi, Attila; Inántsy-Pap, Judit; Pataky, Nóra; Gádoros, Júlia; Halász, József

2013-01-01

The relationship between the type of physical aggressive behavior, callous/unemotional traits and behavioral problems was extensively studied in the literature, but no similar data exist in Hungarian adolescents. In the present study, the type of aggressive behavior was assessed in adolescents on a normative sample to study its relationship with callous/unemotional traits and behavioral problems. 223 students were participated in the study after informed consent (girls, n=106, age: 14.2±1.5 years; boys, n=117, age: 13.9±1.6 years) from primary and secondary schools in Miskolc and adjacent areas. The Reactive/Proactive Aggression Questionnaire was used to assess the level of aggressive behavior, the Inventory of Callous Unemotional Traits was used to measure callous/unemotional traits, while behavioral problems were established by the means of the Strengths and Difficulties Questionnaire. In the present non-clinical sample, the level of reactive aggression was higher than the level of proactive aggressive behavior. In boys, proactive and total aggression measures were significantly higher compared to girls. In both genders, reactive aggression was specifically associated with emotional and peer-related problems. Proactive aggression was correlated positively with callous traits in both genders, while self-reported prosocial behavior had an inverse correlation with proactive aggressive behavior in boys. Self reported conduct- and hyperactivity problems were positively correlated with both types of aggressive behavior in both genders. The strongest positive correlation was observed between self-reported conduct symptoms and both types of aggressive behavior. Callous/unemotional traits were related with proactive forms of aggression, similar to literature data. Reactive aggressive behavior was related to peer-related and emotional problems, thus our data outlined the importance of the distinction between the two main types of aggression.

The Enterprise 2.0 Concept: Challenges on Data and Information Security

NASA Astrophysics Data System (ADS)

Silva, Ana; Moreira, Fernando; Varajão, João

The Web 2.0 wave has "hit" businesses all over the world, with companies taking advantage of the 2.0 concept and new applications stimulating collaboration between employees, and also with external partners (suppliers, contractors, universities, R&D organizations and others). However, the use of Web 2.0 applications inside organizations has created additional security challenges, especially regarding data and information security. Companies need to be aware of these risks when deploying the 2.0 concept and take a proactive approach on security. In this paper are identified and discussed some of the challenges and risks of the use of Web 2.0 tools, namely when it comes to securing companies' intellectual property.