Sample records for advice bureaux clients

  1. Advice-Implicative Interrogatives: Building "Client-Centered" Support in a Children's Helpline (United States)

    Butler, Carly W.; Potter, Jonathan; Danby, Susan; Emmison, Michael; Hepburn, Alexa


    Interactional research on advice giving has described advice as normative and asymmetric. In this paper we examine how these dimensions of advice are softened by counselors on a helpline for children and young people through the use of questions. Through what we term "advice-implicative interrogatives," counselors ask clients about the…

  2. Weight Management Advice for Clients with Overweight or Obesity: Allied Health Professional Survey

    Directory of Open Access Journals (Sweden)

    Suzanne J. Snodgrass


    Full Text Available The prevalence of obesity is increasing. The potential for allied health professionals to intervene through the provision of lifestyle advice is unknown. This study aimed to determine the knowledge, attitudes and practices of health professionals in the provision of dietary and physical activity advice for clients with overweight or obesity. Dietitians, exercise physiologists, nurses, occupational therapists, physiotherapists and psychologists (n = 296 working in New South Wales were surveyed using paper-based and online methods. The majority of health professionals (71% believed that providing weight management advice was within their scope of practice; 81% provided physical activity advice but only 57% provided dietary advice. Other than dietitians, few had received training in client weight management during their professional qualification (14% or continuing education (16%. Providing dietary advice was associated with: believing it was within their scope of practice (OR 3.9, 95% CI 1.9–7.9, p < 0.01, training during their entry-level qualification (OR 7.2, 3.2–16.4, p < 0.01 and having departmental guidelines (OR 4.7, 2.1–10.9, p < 0.01. Most health professionals are willing to provide lifestyle advice to clients with overweight or obesity but few have received required training. Developing guidelines and training for in client weight management may potentially impact on rising obesity levels.

  3. Personal features of children in client families who receive psychological advice

    Directory of Open Access Journals (Sweden)

    Sergey A. Kapustin


    Full Text Available The paper includes results of the research, where influence of main parenting styles on developing children’s personality and appearing child-parent problems were considered. It covers client families of psychological advice (with overprotection and over exactingness. It is indicated that the key factor emerging child-parent problems in this families is the abnormality of the parent personality identified through so-called existential criterion, which is displayed in their parenting styles. The parenting styles contribute to shaping child abnormal personality types, also identified through existential criteria are designated as “directed at external assistance”, “directed at complying with the requirements of other people” and “directed at protesting against compliance with the requirements of other people”. Children of such personality types have problems communicating with others as communication is addressed to children with normal personal development and is not relevant for abnormal personal abilities. As the problems mentioned above are connected with maladjustment to social environment requirements they can be classified as problems of social adaptation. There is a connection of a personality type “directed at complying with the requirements of other people” with abnormal personality predisposed to various life problems and mental disorders mentioned in the works of E. Fromm, S. Freud, A. Adler, С. Jung, C. Rogers, and V. Frankl. It suggests the understanding of the personality of this type to be regarded as a classical type of personality which the authors mentioned above were dealing with in their psychotherapeutic practice at different times.

  4. Advising in austerity reflections on challenging times for advice agencies

    CERN Document Server

    Kirwan, Samuel


    Advising in austerity provides a lively and thought-provoking account of the conditions, consequences and challenges of advice work in the UK. It examines how advisors negotiate the private troubles of those who come to Citizens Advice Bureaux (CAB) and construct ways forward.



    Véronique Malleret


    International audience; Cette communication examine les liens qui peuvent exister entre l'organisation spatiale des bureaux et la performance des entreprises. Elle propose un cadre d'analyse articulant les différentes variables du problème et l'illustre ensuite par une étude de cas.

  6. Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success

    Directory of Open Access Journals (Sweden)

    Lisanna Lamb


    Full Text Available Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no established way of assessing these. Therefore, the aim of this study was to develop an instrument for coding factors likely to impinge on pet owner adherence to behavior advice and validate its utility through the identification of the factors appearing to relate most closely to a successful treatment outcome in a sample population from our clinic. Potential factors affecting adherence were identified from human health and animal behavior studies, and a survey instrument developed with items matched to these factors. Forty-two dog owners who had attended the University of Lincoln Animal Behavior Clinic over a 2-year period provided data used in the analysis. The assessment of treatment outcome success by clients and clinicians was correlated, but clinicians tended to overestimate success by half a point on a 5-point scale. Eleven items relating to adherence were found to correlate with client ratings of treatment success in a univariate analysis, with three of these remaining in an ordinal logistic regression model. These three related to trust in the advice given by the clinician, concern over distress caused to the pet in the longer term and the perceived recommendation of treatment measures that had failed. By further examining the relationship between all of these factors in a hierarchical cluster analysis, we were able to postulate ways in which we might be able to improve client adherence and thus treatment success. This provides a model for the

  7. Advice to give advice. (United States)

    Zheng, Patricia Z; Smuck, Matthew


    Matthew L. Stevens, Chung-Wei C. Lin, Flavia A. de Carvalho, Kevin Phan, Bart Koes, Chris G. Maher. Advice for acute low back pain: A comparison of what research supports and what guidelines recommend. The Spine Journal, In Press. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Financial Advice: Who Pays (United States)

    Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.


    Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

  9. Advice dilemmas: Managing advice against the competing public ...

    African Journals Online (AJOL)

    Key to resolving this issue is an acknowledgement that, whether as counsellor or health adviser, persuasion and influence are central features of the VCT interaction. Clear practice guidelines and tools are required to assist counsellors to distinguish between advice, suggestion or mere confirmation of an intended client ...

  10. Professional advice

    DEFF Research Database (Denmark)

    Ottaviani, Marco; Sørensen, Peter Norman


    on the basis of the advice given and the realized state of the world. In equilibrium of this reputational cheap-talk game, no more than two messages are effectively reported. The model is extended to consider sequential communication by experts with conditionally independent signals. In the long run, learning...... is incomplete and herd behavior arises...

  11. Client Perspective

    International Nuclear Information System (INIS)

    Cohen, M.; Oleksiak, T.A.


    Training Sections can best serve the needs of their clients by encouraging them to recognize that self-determination and overall training program ownership are the key ingredients of a successful program. In a support role, Training Sections should provide excellent lesson plans and instructors, good record keeping, and feedback vehicles. Most importantly, Training Sections should communicate closely with their clients and provide maximum flexibility to support overall client responsibilities

  12. Nutrition Advice and Recipes (United States)

    ... Sign-Up Home Patient Information Nutrition Advice & Recipes Nutrition Advice & Recipes This is a very important section ... information on all aspects of daily life, including nutrition, medical treatments, pain management, and practical tips. For ...

  13. Regulating household financial advice

    Directory of Open Access Journals (Sweden)

    Benjamin F. Cummings


    Full Text Available This paper reviews economic theory related to investment advice. This theory explains 1 why financial advisors need to be carefully regulated for the benefit of both the investment advice industry and for consumers, 2 why principles-based regulation (e.g., a fiduciary standard is more efficient than rules-based regulation, 3 why dual regulation of financial professionals providing investment or insurance advice is inefficient and inequitable policy, and 4 why the application of a universal and uniform fiduciary standard will be difficult to implement.

  14. An Evaluation of an Occupational Health Advice Service (United States)

    Shearn, P.; Ford, Norma J.; Murphy, R. G.


    Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…

  15. Client training vital for NFP. (United States)

    Keller, S; Finger, W R


    Clients need both skill and motivation to effectively use natural family planning (NFP). Thus, NFP services must provide adequate counseling and training to clients. A good teacher of NFP does not need formal health care training but she/must have good communication skills. A teacher usually needs to meet with a client four times over a period of several months to teach NFP. Fertility awareness comprises the first step in NFP training. This involves helping couples to understand the reproductive system, menstrual cycles, and fertile periods. The NFP Training and Medical Services Center in Nairobi, Kenya, provides clients, many of whom live in slums and are illiterate, with an exercise book with small squares that they color so they can track their fertility signs. They tend to use the cervical mucus method rather than the basal temperature method which requires a thermometer. In Los Angeles, California, clients of one NFP program attend group sessions and individual counseling sessions to learn about the menstrual cycle, fertile period, and rules of NFP and how to apply them. The Twin Cities NFP Center in Minnesota found that individual counseling was 50% more expensive than group sessions and it affected changes in neither the pregnancy nor NFP continuation rates. Group training here involved more men. Catholic groups in Bangladesh, India, Kenya, South Korea, and the US conducted a study of NFP programs and found that client's willingness or ability to discuss NFP were not associated with socioeconomic status, previous family planning experiences, and education. Another study of the same users did find an association between higher education and lower unplanned pregnancy rate. The same was true for previous family planning use. Since limited resources prevent some family planning programs from training staff in NFP, the programs can refer clients to existing NFP services, sending one staff member to be trained in NFP, or having one staff member providing NFP

  16. clientes surdos

    Directory of Open Access Journals (Sweden)

    Wiliam César Alves Machado


    Full Text Available Objetivo: identificar cómo profesionales de la unidad municipal de rehabilitación física se comunican con personas sordas que buscan atención especializada. Métodos: estudio exploratorio, descriptivo, de enfoque cualitativo, realizado con 32 profesionales que trabajan en rehabilitación física a través de instrumento auto aplicable. Resultados: del análisis de datos, surgieron dos categorías temáticas: Usando el Lenguaje Brasileño de Signos; Improvisación de Estrategias de comunicación para interactuar con clientes sordos. Improvisación de estrategias utilizadas por los profesionales para comunicarse con personas sordas pueden causar barreras que inciden negativamente en la calidad de los servicios prestados a esta población. Conclusión: la comunicación es deficiente, e iniciativas eficaces centradas en la cualificación de los profesionales que trabajan en el ámbito de la rehabilitación, pueden contribuir para que puedan dominar el Lenguaje Brasileño de Signos, garantizándose a los clientes sordos la atención adecuada, conforme a lo dispuestos para personas sin discapacidad auditiva.

  17. Combining Expert Advice Efficiently

    NARCIS (Netherlands)

    W.M. Koolen-Wijkstra (Wouter); S. de Rooij (Steven)


    htmlabstractWe show how models for prediction with expert advice can be defined concisely and clearly using hidden Markov models (HMMs); standard HMM algorithms can then be used to efficiently calculate, among other things, how the expert predictions should be weighted according to the model. We

  18. What client?

    DEFF Research Database (Denmark)

    Unterrainer, Walter


    Urbanization is growing exponentially, global streams of refugees are at an all-time high, 10 million people found their homes destroyed by one typhoon on the Philippines, 2,000,000,000 people have no access to basic sanitation. The building sector produces a gigantic 60% of global waste. 40...... has been a popular art and that the clients were the rich and powerful, documented by a legacy of palaces, churches, villas, office blocs and alienated ´property developments´. Slum dwellers, climate victims, war refugees, the urban poor but also endangered species as well as tormented spaces cannot......% of (non-renewable) energy is consumed by buildings (without calculating energy used in construction). Growing amounts of buildings become abandoned and derelict, infrastructural failures and junk spaces surge and whole urban quarters decline socially and physically. Any more challenges needed? Looking...

  19. Safety advice sheets

    CERN Multimedia

    HSE Unit


    You never know when you might be faced with questions such as: when/how should I dispose of a gas canister? Where can I find an inspection report? How should I handle/store/dispose of a chemical substance…?   The SI section of the DGS/SEE Group is primarily responsible for safety inspections, evaluating the safety conditions of equipment items, premises and facilities. On top of this core task, it also regularly issues “Safety Advice Sheets” on various topics, designed to be of assistance to users but also to recall and reinforce safety rules and procedures. These clear and concise sheets, complete with illustrations, are easy to display in the appropriate areas. The following safety advice sheets have been issued so far: Other sheets will be published shortly. Suggestions are welcome and should be sent to the SI section of the DGS/SEE Group. Please send enquiries to

  20. The Financial Coaching Advice Model: An Exploration into how it Satisfies Expectations of Quality Advice

    Directory of Open Access Journals (Sweden)

    Julie Knutsen


    Full Text Available For 20 years, the financial planning sector in Australia has been transitioning from a sales-orientated force to aprofession of qualified and skilled practitioners. Today, the potential for professional financial planning adviceto benefit Australians financially, economically and psychologically is recognised by government. Financially,these benefits include increased savings, less interest expense through faster debt reduction, higher investmentreturns and appropriate levels of insurance. Economically, a more financially literate society has the potentialfor less reliance on an already burdened social security system. Psychologically, the benefits include the peaceof mind that comes from an individual being confident in financial matters. However, despite this level ofrecognition and development, national surveys have reported that only a small percentage of the populationactually seek professional financial advice. The factors attributing to these low percentages included the gapsin financial literacy limiting an individual’s engagement in financial matters and consumer’s current mistrust ofthe financial advice business models that remain dominated by commission-driven product sales. Thesedeficiencies have led some financial planning firms to break from financial product sales as the primary advicemodel and focus on financial coaching. Exploratory interviews with the practitioners and clients of a selectedfinancial planning firm have generated insightful discussion into how a financial coaching advice model isachieving the financial, economic and psychological benefits recognised by government as the potentialoutcomes of professional financial advice. The aim of this paper is to present the findings from that discussionand demonstrate the opportunities embedded within a financial coaching advice model. It is argued that thisdiscussion offers a foundation for future research direction in an area currently under researched in

  1. Implicit normativity in scientific advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter


    This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using...... nutritional science as an example, we identify three such implicit normative issues. The first concerns the aim of scientific advice: whether it is about avoiding harm or promoting good. The second concerns the intended beneficiaries of the advice: whether advice should be framed to benefit the society...... as a whole or with special concern for the most vulnerable members of the population. The third consideration involves scientific advisers' attempts to balance the strengths of the scientific evidence with the expected consequences of scientific advice. We hope to promote more explicit discussion...

  2. Implicit normativity in scientific advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter


    This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using nutritio...

  3. Dietary advice in family medicine.

    NARCIS (Netherlands)

    Weel, C. van


    This article discusses the conceptual basis of dietary advice in family medicine. Given the large number of illnesses and diseases encountered in family practice for which diet and nutrition are relevant interventions, food-related advice is an important part of daily practice. To enhance the

  4. Young children heed advice selectively. (United States)

    Rakoczy, Hannes; Ehrling, Christoph; Harris, Paul L; Schultze, Thomas


    A rational strategy to update and revise one's uncertain beliefs is to take advice by other agents who are better informed. Adults routinely engage in such advice taking in systematic and selective ways depending on relevant characteristics such as reliability of advisors. The current study merged research in social and developmental psychology to examine whether children also adjust their initial judgment to varying degrees depending on the characteristics of their advisors. Participants aged 3 to 6 years played a game in which they made initial judgments, received advice, and subsequently made final judgments. They systematically revised their judgments in light of the advice, and they did so selectively as a function of advisor expertise. They made greater adjustments to their initial judgment when advised by an apparently knowledgeable informant. This suggests that the pattern of advice taking studied in social psychology has its roots in early development. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Advice concerning radiotherapy

    International Nuclear Information System (INIS)


    Dutch National cancer incidence figures were calculated by using the reliable data on cancer incidence in the Eindhoven area and population forecasts and information obtained from the Central Bureau of Statistics. Several radiotherapy departments suffer from under capacity (a lack of resources and understaffing). Data have also shown that 35% of cancer patients receive radiotherapy, instead of 50%. Calculations have been made by the committee on the present and future needs with regard to equipment and staff. In 1983, the number of megavoltage therapy units amounted to 38, but should have been 65. It should be 80 in 1990 and 90 in 2000. Since building and installing such equipment is a lengthy process a considerable effort is needed to make up for the arrears. The committee advocates the extension of the system of regional cooperation in cancer care (comprehensive cancer centres), in which radiotherapy departments play a crucial role. Working parties from the committee provided a comprehensive description of current radiotherapy practice with reference to physical, technical, clinical and management aspects. Another working party assessed the results of cancer treatment with regard to many different tumour sites. Recent and expected developments were analysed or indicated. The Radiotherapy Committee commissioned an external team to conduct a project to achieve a picture of future developments using methods different to those of the committee's. An interim advice has been added on this subject. (Auth.)

  6. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin


    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  7. Physician advice for smoking cessation. (United States)

    Stead, Lindsay F; Buitrago, Diana; Preciado, Nataly; Sanchez, Guillermo; Hartmann-Boyce, Jamie; Lancaster, Tim


    Healthcare professionals frequently advise people to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions. The aims of this review were to assess the effectiveness of advice from physicians in promoting smoking cessation; to compare minimal interventions by physicians with more intensive interventions; to assess the effectiveness of various aids to advice in promoting smoking cessation, and to determine the effect of anti-smoking advice on disease-specific and all-cause mortality. We searched the Cochrane Tobacco Addiction Group trials register in January 2013 for trials of interventions involving physicians. We also searched Latin American databases through BVS (Virtual Library in Health) in February 2013. Randomised trials of smoking cessation advice from a medical practitioner in which abstinence was assessed at least six months after advice was first provided. We extracted data in duplicate on the setting in which advice was given, type of advice given (minimal or intensive), and whether aids to advice were used, the outcome measures, method of randomisation and completeness of follow-up.The main outcome measure was abstinence from smoking after at least six months follow-up. We also considered the effect of advice on mortality where long-term follow-up data were available. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. People lost to follow-up were counted as smokers. Effects were expressed as relative risks. Where possible, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. We identified 42 trials, conducted between 1972 and 2012, including over 31,000 smokers. In some trials, participants were at risk of specified diseases (chest disease, diabetes, ischaemic heart disease), but most were from unselected populations. The most common setting for delivery of advice was primary care. Other settings included hospital

  8. Actions and advice in coli

    DEFF Research Database (Denmark)

    Knoche, Hendrik; Jamadagni, HS; Rao, PR Sheshagiri


    To improve their agricultural output, farmers require timely and contextualized information and advice. Relevant information and advice provided by trusted peers represents a promising approach. We present the considerations for the design of coli, an agricultural information network on touch...... screen equipped smart phones and results from its 10-month trial with 15 farmers in a village in India. Although some farmers avoided dispensing prescriptive advice in person due to fear of liability, they had no reservations about sharing their farming activities via a mobile phone application. Richer...

  9. Weight management including dietary and physical activity advice provided by Australian physiotherapists: a pilot cross-sectional survey. (United States)

    Snodgrass, Suzanne J; Carter, Amy E; Guest, Maya; Collins, Clare E; James, Carole; Kable, Ashley K; Ashby, Samantha E; Plotnikoff, Ronald C


    Physiotherapists may have an impact on obesity prevention and treatment by providing nutrition and physical activity advice to overweight or obese clients; yet little is known about physiotherapists' beliefs and practices related to client weight management. The aim of this pilot study was to determine the practices, beliefs, attitudes and knowledge of physiotherapists regarding the provision of weight management advice to overweight or obese clients. Physiotherapists (n = 65) working in multiple practice settings completed a self-administered questionnaire. Logistic regression determined factors associated with the provision of dietary and physical activity advice for weight management. The majority of physiotherapists (n = 53 [81.5%]) believed providing weight management advice was within their scope of practice, yet only a minority had received training during their professional entry level education (n = 13 [20%]) or through professional development (n = 7 [11%]). Most physiotherapists (n = 55 [84.6%]) provided physical activity advice for weight management, but a minority (n = 27 [41.5%]) provided dietary advice. Having received training in weight management during their professional entry level education was associated with providing dietary advice (Odds ratio 8.8, 95% confidence interval 2.0-38.9, p = 0.004). Training in weight management may increase the likelihood of physiotherapists providing dietary advice, improving physiotherapists' management of obesity.

  10. Sleep Deprivation and Advice Taking

    NARCIS (Netherlands)

    Hausser, J.A.; Leder, J.; Ketturat, C.; Dresler, M.; Faber, N.S.


    Judgements and decisions in many political, economic or medical contexts are often made while sleep deprived. Furthermore, in such contexts individuals are required to integrate information provided by - more or less qualified - advisors. We asked if sleep deprivation affects advice taking. We

  11. Client Centred Design

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Tweddell Levinsen, Karin


    Abstract In this paper the Human Computer Interaction (HCI) Research Group reports on the pre-phase of an e-learning project, which was carried out in collaboration with the client. The project involved an initial exploration of the problem spaces, possibilities and challenges for an online...... on existing resources and networks, suggesting a design, which also included end-users community needs and work-context. Our argument is that if a preparation phase both seeks to confirm knowledge and contemplate what is not yet known, giving attention to the context and need of the client (i.e. not only end......-users,) then it is possible to build on existing resources within the client organisation, leading to grounding of design decisions and a match between the e-learning environment designed and the capabilities of the client....

  12. Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

    Directory of Open Access Journals (Sweden)

    Abhishek Singh

    Full Text Available Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India.The District Level Household Survey (2007-08 was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice.A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients

  13. Financial Literacy, Confidence and Financial Advice Seeking

    NARCIS (Netherlands)

    Kramer, Marc M.


    We find that people with higher confidence in their own financial literacy are less likely to seek financial advice, but no relation between objective measures of literacy and advice seeking. The negative association between confidence and advice seeking is more pronounced among wealthy households.

  14. Categorizing clients with disabilities

    DEFF Research Database (Denmark)

    Kjeldsen, Lena; Amby, Finn

    than that of people without disabilities for more than a decade (Larsen & Høgelund 2015). An explanation of this difference could be the limited connection between these general goals, the employment laws and the actual implementation of the goals in the job centers (Amby 2015). Earlier Danish studies...... have by large focused on employment and disability at the stage where the client already has been categorized as having a disability (e.g. Møller & Stone 2013). This study offers new insight to the field in a Danish context by exploring the process in which people with disabilities are categorized...... during their first interactions with the job center by asking two interconnected questions: a) To what extent do job centers construct categories that capture client with disabilities? b) How do caseworkers identify whether (and to what extent) the client has lasting impairments that can be considered...

  15. Specific antismoking advice after stroke

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Brink-Kjær, Tove


    INTRODUCTION: Many stroke survivors would benefit from modification of their lifestyle in order to reduce their risk of recurrent stroke. We investigated if tailored smoking cessation advice would yield a higher smoking cessation rate and a higher rate with sustained abstinence in ex......-smokers in the intervention group than among controls. MATERIAL AND METHODS: Patients admitted with an acute stroke or a transient ischaemic attack were included in a randomised controlled trial focusing on control of lifestyle risk factors and hypertension. Here, we report the intervention focused on smoking cessation. We...

  16. La contrainte client

    Directory of Open Access Journals (Sweden)

    Guillaume Tiffon


    Full Text Available Cet article montre que le contact client a beau être ambivalent, dans la mesure où il est à la fois source de contrainte et de reconnaissance, dans certains cas, comme celui des caissières, il constitue avant tout une contrainte, en ce que les clients contrôlent le travail qui s’opère « sous leurs yeux », tandis que, dans d’autres cas, comme celui des kinésithérapeutes, il contribue avant tout à donner du sens au travail et, par là, à susciter l’engagement des travailleurs. L’article souligne ainsi combien la contrainte client revêt des modalités différentes selon la configuration, spatiale et temporelle, dans laquelle se déroule la relation de service, et le différentiel de compétences entre les protagonistes engagés dans cette relation.The client constraint. A comparative analysis of cashiers and physiotherapistsThis article shows that despite the ambivalence of client contact, insofar as it is both a source of constraint and recognition, in some cases, as the ones of cashiers, it isprimarily a constraint: clients control the work that takes place “before their eyes”, whereas in other cases – as in the ones of physiotherapists – it contributes to give meaning to work and, thereby, to arouse the commitment of workers. The article highlights how the client constraint takes on different forms depending on thespatial and temporal configuration where the service relation runs, and the skills differential between the protagonists involved in this relation.El apremio de los clientes. Análisis comparativo entre las cajeras de supermercado y los kinesiterapeutasEn este artículo se demuestra que aunque el contacto con los clientes puede ser percibido como agradable, en realidad en la mayoría de los casos el cliente es percibido como un peso puesto que estos « controlan » visualmente el trabajo de las cajeras mientras que en otras profesiones como es el caso de los kinesiterapeutas la presencia del paciente

  17. Quality is client oriented. (United States)

    Diaz, S


    Successful growth greatly depends upon the quality of care received at each stage of one's development. As such, all family planning activities should be centered around the clients' perspective. Clients, however, are highly diverse and individual in terms of value systems, degrees of knowledge and awareness, sexes, sexualities, biomedical characteristics, lifestyles, psychosocial and economic conditions, community settings, and other factors. These influences and characteristics are also dynamic, changing over time. Each individual, regardless of his or her own particular characteristics and circumstances, still must make reproductive and sex behavioral decisions. Care providers need to be aware of such diversity and accept clients as unique individuals with individual needs, feelings, and ideas. The author considers quality of care in family planning services from the perspective of the humans involved and the opportunities for growth which each can find in the process of receiving or providing services. Understanding the needs of clients, the value of face-to-face communication, improving the attitudes and skills of providers, and the crucial role of managers are discussed.

  18. Counseling Bisexual Clients. (United States)

    Smiley, Elizabeth B.


    Provides a brief conceptual statement about bisexuality. Offers a review of existing research studies, and suggests issues to consider when counseling bisexual clients. Defines bisexuality and discusses prevalence studies, identity development, and implications for counseling. Claims that bisexuality challenges traditional rules about sexual…

  19. Psychotherapy for Suicidal Clients. (United States)

    Lester, David


    Reviews various systems of psychotherapy for suitability for suicidal clients. Discusses psychoanalysis, cognitive therapy, primal therapy, transactional analysis, Gestalt therapy, reality therapy, person-centered therapy, existential analysis, and Jungian analysis in light of available treatment options. Includes 36 citations. (Author/CRR)

  20. Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias. (United States)

    Zaleskiewicz, Tomasz; Gasiorowska, Agata; Stasiuk, Katarzyna; Maksymiuk, Renata; Bar-Tal, Yoram


    The goal of this experimental project was to investigate lay peoples' perceptions of epistemic authority (EA) in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts) or confirm clients' expectations (in the case of politicians). However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and - particularly - 3 suggested that this bias might also be due to clients' desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients' own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client's positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo , but this effect is limited by confirmation bias: when the client's a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this sense, results presented in the

  1. Facilitating client-centred practice: insights from clients. (United States)

    Sumsion, Thelma


    This paper adds to the established importance of client-centred practice in mental health programs by reporting on the outcome of client interviews in one community setting in England. The purpose of these interviews was to determine the opportunities for, and barriers to, the application of a definition of client-centred practice. Purposive sampling was used to obtain 9 clients who participated in structured interviews. A combination of methods, including template analysis and the editing approach, were employed to determine themes and sub themes that are presented within the context of the clients'reasons for attending these programs. These themes included initiating client-centred practice with the sub themes of providing information to enable choice, participate in negotiating goals, overcoming fear and the severity of illness. Other themes related to the therapist's response to the client's illness and the client's knowledge about client-centred practice. It was clear from these interviews that client-centred practice was important to this group of clients and there were both opportunities and barriers to be considered by therapists.

  2. Neural computations underpinning the strategic management of influence in advice giving. (United States)

    Hertz, Uri; Palminteri, Stefano; Brunetti, Silvia; Olesen, Cecilie; Frith, Chris D; Bahrami, Bahador


    Research on social influence has focused mainly on the target of influence (e.g., consumer and voter); thus, the cognitive and neurobiological underpinnings of the source of the influence (e.g., politicians and salesmen) remain unknown. Here, in a three-sided advice-giving game, two advisers competed to influence a client by modulating their own confidence in their advice about which lottery the client should choose. We report that advisers' strategy depends on their level of influence on the client and their merit relative to one another. Moreover, blood-oxygenation-level-dependent (BOLD) signal in the temporo-parietal junction is modulated by adviser's current level of influence on the client, and relative merit prediction error affects activity in medial-prefrontal cortex. Both types of social information modulate ventral striatum response. By demonstrating what happens in our mind and brain when we try to influence others, these results begin to explain the biological mechanisms that shape inter-individual differences in social conduct.

  3. Giving advice to agents with hidden goals

    CSIR Research Space (South Africa)

    Rosman, Benjamin S


    Full Text Available on an approximation of the trade-off in utility between potential benefits to the exploring agent and the costs incurred in giving this advice. This model is evaluated on a maze world domain by providing advice to different types of agents, and we show that this leads...

  4. Young Children's Trust in Overtly Misleading Advice (United States)

    Heyman, Gail D.; Sritanyaratana, Lalida; Vanderbilt, Kimberly E.


    The ability of 3- and 4-year-old children to disregard advice from an overtly misleading informant was investigated across five studies (total "n" =212). Previous studies have documented limitations in young children's ability to reject misleading advice. This study was designed to test the hypothesis that these limitations are primarily…

  5. Explaining customer experience of digital financial advice

    NARCIS (Netherlands)

    van Raaij, W.F.


    The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have

  6. 5 CFR 2635.107 - Ethics advice. (United States)


    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

  7. Client/server study (United States)

    Dezhgosha, Kamyar; Marcus, Robert; Brewster, Stephen


    The goal of this project is to find cost-effective and efficient strategies/solutions to integrate existing databases, manage network, and improve productivity of users in a move towards client/server and Integrated Desktop Environment (IDE) at NASA LeRC. The project consisted of two tasks as follows: (1) Data collection, and (2) Database Development/Integration. Under task 1, survey questionnaires and a database were developed. Also, an investigation on commercially available tools for automated data-collection and net-management was performed. As requirements evolved, the main focus has been task 2 which involved the following subtasks: (1) Data gathering/analysis of database user requirements, (2) Database analysis and design, making recommendations for modification of existing data structures into relational database or proposing a common interface to access heterogeneous databases(INFOMAN system, CCNS equipment list, CCNS software list, USERMAN, and other databases), (3) Establishment of a client/server test bed at Central State University (CSU), (4) Investigation of multi-database integration technologies/ products for IDE at NASA LeRC, and (5) Development of prototypes using CASE tools (Object/View) for representative scenarios accessing multi-databases and tables in a client/server environment. Both CSU and NASA LeRC have benefited from this project. CSU team investigated and prototyped cost-effective/practical solutions to facilitate NASA LeRC move to a more productive environment. CSU students utilized new products and gained skills that could be a great resource for future needs of NASA.

  8. [Client centered psychotherapy]. (United States)

    Werthmann, H V


    In the discussion concerning which psychotherapeutic methods should come under the auspices of the medical health system in West Germany, the question is raised regarding the client-centered therapy of Carl Rogers. Can it be considered a distinct psychotherapeutic method? A review of the scientific literature dealing with this method shows that it provides neither a theory of mental illness nor a theory of clinical application based on individual cases or specific neurotic disturbances, Therefore it should be categorized as a useful method of communication in the field of psychology and not as a therapeutic method for treating mental illness.

  9. Development and feasibility of falls prevention advice. (United States)

    van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth


    This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

  10. Family Stress and Coping From Hospitalization of Clients With Severe Alcohol Use Disorder in Korea. (United States)

    Park, Gyu-Hee; Choi, Yun-Jung

    The rate of relapse and involuntary hospitalization among clients with alcohol use disorder exceeds 40% in South Korea. As a result, family members of clients experience considerable stress and require the assistance of professional services. This empirical study investigates levels of perceived stress and stress coping styles among family members of clients with severe alcohol use disorder and examines the correlations among these variables. Data were collected from three inpatient alcohol rehabilitation centers and five psychiatric hospitals in South Korea. Family stress levels and stress coping styles for 133 respondents were evaluated using the Hospital Stress Rating Scale for Family Members and the Stress Coping Style Checklist. There were significant differences in stress levels according to whether participants had attended a family educational program in the past or were doing so presently. Furthermore, significant differences in stress were observed among participants who were using the stress coping style of easing strained emotions during the client's hospitalization but who had never attended an educational program. Among the subcategories, stress levels had especially strong relationships with easing strained emotions, seeking advice, and solving problems. The results showed that families with severe alcohol use disorder experience stress from the client's hospitalization and seek advice from neighbors to deal with worries, privacy concerns, and economic problems. Family interventions are needed to provide family members with strategies to cope with stress, which can support recovery of clients with severe alcohol use disorder.

  11. Opioid Overdose Prevention: Safety Advice for Patients & Family Members (United States)

    SAMHSA Opioid Overdose Prevention TOOLKIT: Safety Advice for Patients & Family Members TABLE OF CONTENTS Safety Advice for Patients & Family ... Advice for Patients & Family Members. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 What Are Opioids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Preventing Overdose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 If You Suspect an ...

  12. Client Resources: Client Characteristics, Coping Skills, and Compliance. (United States)

    Govaerts, Kathryn A.; Olson, Douglas H.

    Research on interpersonal influence within counseling psychology has focused primarily on the characteristics of the counselor. There is a need to study the role of client characteristics in resistance or noncompliance. A review of the literature indicates that most client characteristics associated with noncompliance in therapy can be narrowed…

  13. Age Differences among Female Sex Workers in the Philippines: Sexual Risk Negotiations and Perceived Manager Advice

    Directory of Open Access Journals (Sweden)

    Lianne A. Urada


    Full Text Available Consistent condom use among high risk groups such as female sex workers (FSWs remains low. Adolescent female sex workers are especially at higher risk for HIV/STI infections. However, few published studies have compared the sexual risk negotiations among adolescent, emerging adult, and older age groups or the extent a manager’s advice about condom use is associated with an FSW’s age. Of 1,388 female bar/spa workers surveyed in the southern Philippines, 791 FSW who traded sex in the past 6 months were included in multivariable logistic regression models. The oldest FSWs (aged 36–48 compared to adolescent FSWs (aged 14–17 were 3.3 times more likely to negotiate condoms when clients refused condom use. However, adolescent FSWs received more advice from their managers to convince clients to use condoms or else to refuse sex, compared to older FSWs. Both adolescent and the oldest FSWs had elevated sexually transmitted infections (STIs and inconsistent condom use compared to other groups. Having a condom rule at the establishment was positively associated with condom negotiation. Factors such as age, the advice managers give to their workers, and the influence of a condom use rule at the establishment need to be considered when delivering HIV/STI prevention interventions.

  14. Explaining customer experience of digital financial advice


    van Raaij, W.F.


    The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have been considered. It is found that experiential subjective system aspects are the most important. Surveys have been conducted in The United Kingdom and The Netherlands. In exploratory factor analys...

  15. Group Work with Transgender Clients (United States)

    Dickey, Lore M.; Loewy, Michael I.


    Drawing on the existing literature, the authors' research and clinical experiences, and the first author's personal journey as a member and leader of the transgender community, this article offers a brief history of group work with transgender clients followed by suggestions for group work with transgender clients from a social justice…

  16. A comparison of patient recall of smoking cessation advice with advice recorded in electronic medical records. (United States)

    Szatkowski, Lisa; McNeill, Ann; Lewis, Sarah; Coleman, Tim


    Brief cessation advice delivered to smokers during routine primary care consultations increases smoking cessation rates. However, in previous studies investigating recall of smoking cessation advice, smokers have reported more advice being received than is actually documented in their medical records. Recording of smoking cessation advice in UK primary care medical records has increased since the introduction of the Quality and Outcomes Framework (QOF) in 2004, and so we compare recall and recording of cessation advice since this time to assess whether or not agreement between these two data sources has improved. For each year from 2000 to 2009, the proportion of patients in The Health Improvement Network Database (THIN) with a recording of cessation advice in their notes in the last 12 months was calculated. In 2004, 2005 and 2008, these figures were compared to rates of patients recalling having received cessation advice in the last 12 months in the Primary Care Trust (PCT) Patient Surveys, with adjustment for age, sex and regional differences between the populations. In 2004 there was good agreement between the proportion of THIN patients who had cessation advice recorded in their medical records and the proportion recalling advice in the Patient Survey. However, in both 2005 and 2008, more patients had cessation advice recorded in their medical records than recalled receiving advice. Since the introduction of the QOF, the rate of recording of cessation advice in primary care medical records has exceeded that of patient recall. Whilst both data sources have limitations, our study suggests that, in recent years, the proportion of smokers being advised to quit by primary care health professionals may not have improved as much as the improved recording rates imply.

  17. Performance Consulting: Get CREDIT from Your Clients. (United States)

    Atkinson, Vicki; Chalmers, Nancy


    Discusses client satisfaction criteria relevant to human performance consultants and explains the CREDIT model that represents what clients consider most important. Examines CREDIT: Client needs, Relationships, demonstrating Expertise and experience, creating Deliverables, Interpersonal skills, and Tracking and project managing. (LRW)

  18. 4 CFR 28.8 - Informal procedural advice. (United States)


    ... 4 Accounts 1 2010-01-01 2010-01-01 false Informal procedural advice. 28.8 Section 28.8 Accounts... Procedures § 28.8 Informal procedural advice. (a) Persons may seek informal advice on all aspects of the..., General Counsel or the Clerk of the Board. (b) Informal procedural advice will be supplied within the...

  19. Vivrelec's summer comfort advice; Le conseil confort d'ete Vivrelec

    Energy Technology Data Exchange (ETDEWEB)



    After the 2003 heat wave and dryness, Electricite de France (EdF) has launched on May 17, 2004 the Vivrelec summer comfort advice in order to give help to its clients and to improve their thermal comfort during summer time. This document presents first the origins of discomfort, the heat supplies inside a dwelling and the way to limit the indoor temperature rise. Then, the use of suitable appliances is presented: fans, air cooling systems, air-conditioning systems. The different types of air-conditioning systems are presented in the appendix. (J.S.)

  20. Post-tonsillectomy dietary advice: systematic review. (United States)

    Millington, A J F; Gaunt, A C; Phillips, J S


    To determine if there is evidence that post-tonsillectomy dietary advice affects post-operative morbidity. A systematic review was conducted of Embase, Medline, the Cumulative Index to Nursing and Allied Health Literature and PsycInfo, to November 2014. Seventeen articles were included; their heterogeneous nature prevented meta-analysis. Of these, all three small, randomised studies showed no statistical difference in morbidity between restricted and non-restricted diets. Most post-tonsillectomy dietary advice is based on historical anecdotes and not rigorous scientific testing. The existing small-scale, randomised studies show no statistical difference in morbidity between non-restricted and restricted diets.

  1. Bringing the client back in

    DEFF Research Database (Denmark)

    Danneris, Sophie; Nielsen, Mathias Herup


    Categorizing the job readiness of unemployed clients is a task of the utmost importance for active labor market policies. Scholarly attention on the topic has mostly focused either on questions of political legitimacy or on how categories are practically negotiated in meetings between the welfare...... of the targeted individuals themselves to the analysis of political categorization, thereby avoiding the well‐known risk of reducing welfare clients to mere manipulable objects....

  2. Consider the source: adolescents and adults similarly follow older adult advice more than peer advice. (United States)

    Lourenco, Frederico S; Decker, Johannes H; Pedersen, Gloria A; Dellarco, Danielle V; Casey, B J; Hartley, Catherine A


    Individuals learn which of their actions are likely to be rewarded through trial and error. This form of learning is critical for adapting to new situations, which adolescents frequently encounter. Adolescents are also greatly influenced by their peers. The current study tested the extent to which adolescents rely on peer advice to guide their actions. Adolescent and young adult participants completed a probabilistic learning task in which they chose between four pairs of stimuli with different reinforcement probabilities, with one stimulus in each pair more frequently rewarded. Participants received advice about two of these pairs, once from a similarly aged peer and once from an older adult. Crucially, this advice was inaccurate, enabling the dissociation between experience-based and instruction-based learning. Adolescents and adults learned equally well from experience and no age group difference was evident in the overall influence of advice on choices. Surprisingly, when considering the source of advice, there was no evident influence of peer advice on adolescent choices. However, both adolescents and adults were biased toward choosing the stimulus recommended by the older adult. Contrary to conventional wisdom, these data suggest that adolescents may prioritize the advice of older adults over that of peers in certain decision-making contexts.

  3. [Pharmaceutical advice concerning different pharmaceutical dosage forms]. (United States)

    Szakonyi, Gergely; Zelkó, Romána


    The present paper summarizes the commonly applied types of drug uptake and the pharmacists' advice concerning a certain dosage form. The manuscript also deals with the modified release dosage forms and their abbreviations in the name of the marketing authorized products.

  4. Advice Complexity of the Online Search Problem

    DEFF Research Database (Denmark)

    Clemente, Jhoirene; Hromkovič, Juraj; Komm, Dennis


    The online search problem is a fundamental problem in finance. The numerous direct applications include searching for optimal prices for commodity trading and trading foreign currencies. In this paper, we analyze the advice complexity of this problem. In particular, we are interested in identifying...

  5. Generating personalized advice for schizophrenia patients

    NARCIS (Netherlands)

    Emerencia, A.; van der Krieke, Lian; Sytema, S.; Petkov, N.; Aiello, M.

    The results of routine patient assessments in psychiatric healthcare in the Northern Netherlands are primarily used to support clinicians. We developed Wegweis, a web-based advice platform, to make this data accessible and understandable for patients. Objective: We show that a fully automated

  6. Advice under uncertainty in the marine system

    DEFF Research Database (Denmark)

    Dankel, Dorothy J.; Aps, Robert; Padda, Gurpreet


    lacking. Fisheries science that gives advice to policy-making is plagued by uncertainties; the stakes of the policies are high and value-laden and need therefore to be treated as an example of “post-normal science” (PNS). To achieve robust governance, understanding of the characteristics and implications...

  7. A New Paradigm in Mortgage Loan Advice

    DEFF Research Database (Denmark)

    Otterstedt, Margrét Sesselja; Rasmussen, Kourosh Marjani; Kulahci, Murat


    The Danish mortgage market has undergone considerable changes during the last 15 years. New and more complex variations of loan products have been introduced. Nevertheless, mortgage loan advice has remained, by large, unchanged. This paper addresses a study where a number of new refinancing rules...

  8. Voting Advice Applications and electoral turnout

    NARCIS (Netherlands)

    Gemenis, Konstantinos; Rosema, Martin


    In the last two decades Voting Advice Applications (VAAs) have become popular tools among voters, especially in several countries with a multi-party system. In this paper we test if the use of VAAs stimulates electoral participation. We use survey data from the Netherlands, where such tools are

  9. Dietary advice in HFE-hemochromatosis

    NARCIS (Netherlands)

    Doorn, van G.M.; Gosselink, I.M.G.


    This report aims to provide dietary advice which is based on what is known so far about the effect of a diet, particularly on iron overload in HFE-hemochromatosis. The reason that the recommendations in principle apply only to the group of individuals with HFE-gene mutations and are focused on the

  10. 5 CFR 2641.105 - Advice. (United States)


    ... Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS POST-EMPLOYMENT CONFLICT OF INTEREST RESTRICTIONS General Provisions § 2641.105 Advice. (a) Agency ethics officials.Current or former employees or... designated agency ethics official or another agency ethics official. The agency in which an individual...

  11. Mortgage risks, debt literacy and financial advice

    NARCIS (Netherlands)

    van Ooijen, Raun; van Rooij, Maarten C.J.


    A limited understanding of mortgage contracts and the risks involved may have contributed to the outbreak of the 2007–2008 financial crisis. We developed a special questionnaire relating mortgage loan decisions to financial knowledge and financial advice. Our results demonstrate that homeowners

  12. Podemos fidelizar clientes inicialmente insatisfechos

    Directory of Open Access Journals (Sweden)

    Jesús Cambra-Fierro


    Full Text Available El paradigma relacional, dominante en el ámbito de la mercadotecnia, aboga por establecer y desarrollar relaciones duraderas con los clientes. Para ello es preciso conocer cuáles son sus necesidades y esforzarse por satisfacerlas. Los clientes quieren sentirse importantes y, por tanto, las empresas deberían preocuparse no sólo por vender, sino también por conocer su índice real de satisfacción/ insatisfacción. Por tanto, desde un punto de vista lógico este debería ser el patrón de comportamiento empresarial, los trabajos de Barroso (2008 y Coca (2008 así lo indican. Pero la realidad demuestra que esto no siempre es así. A pesar de que los clientes siempre desean sentirse atendidos, existen empresas que parecen olvidarse de esta premisa básica y, sin embargo, obtienen resultados positivos. Este trabajo tiene el objetivo de analizar la posible contribución de los procesos de recuperación de servicios en la fidelización de clientes/usuarios. Para ello tomamos como referencia el concepto de procesos de recuperación de servicio y estudiamos el contexto del sector de telefonía móvil en España.Através de un análisis de estadísticos descriptivos y de la técnica Partial Least Squares (PLS, concluimos que las empresas se comportan de manera opuesta a lo que esperan los clientes y no se preocupan realmente por reconquistar su satisfacción. Sin embargo, la opinión de los usuarios resulta muy reveladora y sugiere que es posible convertir un cliente inicialmente insatisfecho en un cliente fiel.

  13. Advice to young behavioral and cognitive scientists. (United States)

    Weisman, Ronald G


    Modeled on Medawar's Advice to a Young Scientist [Medawar, P.B., 1979. Advice to a Young Scientist. Basic Books, New York], this article provides advice to behavioral and cognitive scientists. An important guiding principle is that the study of comparative cognition and behavior are natural sciences tasked with explaining nature. The author advises young scientists to begin with a natural phenomenon and then bring it into the laboratory, rather than beginning in the laboratory and hoping for an application in nature. He suggests collaboration as a way to include research outside the scientist's normal competence. He then discusses several guides to good science. These guides include Tinbergen's [Tinbergen, N., 1963. On aims and methods of ethology. Zeitschrift für Tierpsychologie, 20, 410-433. This journal was renamed Ethology in 1986. Also reprinted in Anim. Biol. 55, 297-321, 2005] four "why" questions, Platt's [Platt, J.R., 1964. Strong inference. Science 146, 347-353, (] notion of strong inference using multiple alternative hypotheses, and the idea that positive controls help scientists to follow Popper's [Popper, K.R., 1959. The Logic of Scientific Discovery. Basic Books, New York, p. 41] advice about disproving hypotheses. The author also recommends Strunk and White's [Strunk, W., White, E.B., 1979. The Elements of Style, third ed. Macmillan, New York] rules for sound writing, and he provides his personal advice on how to use the anticipation of peer review to improve research and how to decode editors' and reviewers' comments about submitted articles.

  14. Working in Law’s Borderlands: Translation and the Work of an Advice Office

    Directory of Open Access Journals (Sweden)

    Morag McDermont


    Full Text Available Increasingly people in the UK are turning to voluntary sector advice organisations for help and support in dealing with everyday problems. Here we argue that advice organisations, who work in the borderlands of law, are nevertheless key players in legal arenas, focusing on local Citizens Advice offices supporting clients with employment problems. We look at the making of advisers as border-workers through programmes which turn volunteers into employment advisers; and the paid advisers who inhabit spaces on the edges of the profession. We examine the social practices of these advisers, the ways in which law-work becomes translation and advice-work becomes a process of co-production between adviser and client. In concluding, we consider how far into the legal arena it is possible to go with limited resources; and what happens when translating the technicalities of law no longer works. Translation comes to mean advisers turning to their activist-selves and adopting political tactics.Las autoras del artículo argumentamos que las organizaciones de asistencia, que operan en los límites de la legalidad, son no obstante actores claves en el campo jurídico. Nos centramos en las oficinas locales de Atención al Ciudadano, y nos fijamos en los asistentes como trabajadores en los límites, a través de programas que forman a los voluntarios para ser orientadores laborales; y los asesores pagados que habitan espacios en los márgenes de la profesión. Examinamos las prácticas sociales de estos asesores, las formas en que el trabajo jurídico se convierte en trabajo de interpretación y el trabajo de asesoramiento se convierte en un proceso de coproducción entre asesor y cliente. Para concluir, reflexionamos sobre cuán lejos se puede llegar en el campo jurídico con recursos limitados, y sobre qué sucede cuando ya no sirve la interpretación de los tecnicismos legales. La interpretación viene a significar que los asesores recurren a su papel de

  15. Determinants of Client-Professional Relationship Quality in the Financial Planning Setting

    Directory of Open Access Journals (Sweden)

    Katherine Hunt


    Full Text Available Advice provided by financial planners has the potential to impact the financial and emotional well being ofclients. Despite the outcomes of quality financial planning relationships, there is little direct evidence tosupport the importance of ‘relationship quality’ in financial planning. Previous research has emphasised theimportance of relationship quality in psychology, nursing, and business settings. This research investigatesdeterminants of client-professional relationship quality in financial planning, measured in a survey of clientsand financial planners regarding relationship factors of trust, engagement, empowerment, ownership, clientactivity and commitment. Ratings for relationship dimensions were compared between clients and financialplanners, with financial planners found to overestimate their clients’ levels of trust and commitment andunderestimate their client’s levels of empowerment. The relationship dimension of ‘trust’ was found to becritical for client-professional relationship quality.

  16. Leaping ''out of the doubt''- nutrition advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Sandøe, Peter


    This article deals with scientific advice to the public where the relevant science is subject to public attention and uncertainty of knowledge. It focuses on a tension in the management and presentation of scientific uncertainty between the uncertain nature of science and the expectation that sci......This article deals with scientific advice to the public where the relevant science is subject to public attention and uncertainty of knowledge. It focuses on a tension in the management and presentation of scientific uncertainty between the uncertain nature of science and the expectation....... The analysis is structured around the extremes of either total concealment or full openness regarding scientific uncertainty. The result of analysis is that scientific advisers should not simply ''feed'' scientific conclusions to the public. They should rather attempt to promote the ability and willingness...

  17. Anxiety in mammography: mammographers' and clients' perspectives

    International Nuclear Information System (INIS)

    Galletta, S.; Joel, N.; Maguire, R.; Weaver, K.; Poulos, A.


    The aim of this study was to identify causes of anxiety experienced by mammographers and clients during mammography and strategies to decrease the anxiety generated by the mammographic procedure. Two questionnaires were distributed: one to mammographers in public and private centres within NSW, the other to women (clients) who have experienced mammography. Mammographers' and clients' rankings of causes of clients' anxiety demonstrated many similarities indicating the mammographers' acknowledgement of factors contributing to client anxiety. Thematic analysis provided important qualitative data concerning anxiety experienced by both mammographers and clients and the influence of mammographer and client behaviour on that anxiety. The results of this study have provided important new knowledge for mammographic practice and mammography education. By understanding the causes of anxiety experienced by clients, mammographers can provide an informed, empathetic approach to the mammographic process. By acknowledging factors which increase their own anxiety mammographers can reduce the impact of this on themselves and on their clients. Copyright (2003) Australian Institute of Radiography

  18. Communication of Science Advice to Government. (United States)

    Hutchings, Jeffrey A; Stenseth, Nils Chr


    There are various ways to construct good processes for soliciting and understanding science. Our critique of advisory models finds that a well-supported chief science advisor (CSA) best ensures the provision of deliberative, informal, and emergency advice to government. Alternatively, bias, increasingly manifest as science-based advocacy, can hinder communication, diminish credibility, and distort scientific evidence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Agent Argumentation with Opinions and Advice (United States)

    Debenham, John; Sierra, Carles

    In argumentation-based negotiation the rhetorical illocutionary particles Appeals, Rewards and Threats have implications for the players that extend beyond a single negotiation and are concerned with building (business) relationships. This paper extends an agent's relationship-building argumentative repertoire with Opinions and Advice. A framework is described that enables agents to model their relationships and to use argumentative dialogue strategically both to achieve good negotiation outcomes and to build and sustain valuable relationships.

  20. Maintaining clinical governance when giving telephone advice. (United States)

    Alazawi, William; Agarwal, Kosh; Suddle, Abid; Aluvihare, Varuna; Heneghan, Michael A


    Delivering excellent healthcare depends on accurate communication between professionals who may be in different locations. Frequently, the first point of contact with the liver unit at King's College Hospital (KCH) is through a telephone call to a specialist registrar or liver fellow, for whom no case notes are available in which to record information. The aim of this study was to improve the clinical governance of telephone referrals and to generate contemporaneous records that could be easily retrieved and audited. An electronic database for telephone referrals and advice was designed and made securely available to registrars in our unit. Service development in a tertiary liver centre that receives referrals from across the UK and Europe. Demographic and clinical data were recorded prospectively and analysed retrospectively. Data from 350 calls were entered during 5 months. The information included the nature and origin of the call (200 from 75 different institutions), disease burden and severity of disease among the patients discussed with KCH, and outcome of the call. The majority of cases were discussed with consultants or arrangements were made for formal review at KCH. A telephone referrals and advice database provides clinical governance, serves as a quality indicator and forms a contemporaneous record at the referral centre. Activity data and knowledge of disease burden help to tailor services to the needs of referrers and commissioners. We recommend implementation of similar models in other centres that give extramural verbal advice.

  1. Regulations and classification advice: transport safety

    International Nuclear Information System (INIS)

    Davies, M.; Owen, K.


    The packaging of radioactive material for transport must conform with the regulations of the International Atomic Energy Agency (IAEA). These regulations are extensive and complex and require specialist interpretation. Packaging must be designed to contain the material, to limit radiation to safe levels, and to maintain the material in a safe state under both normal and accident conditions. British Nuclear Fuels Ltd. (BNFL) developed the TRANAID expert system to provide automated expert advice on the subject. It is used at BNFL and by other users internationally. The system was produced to meet an internal BNFL emphasis on accurate consistent and reliable interpretation of the complex IAEA regulations; and to provide a commercial product which would meet an external need. TRANAID provides reliable and consistent advice on safe transport procedures which reduce the workload on scarce skilled personnel, and allows them to concentrate on their primary task of packaging design. TRANAID also avoids overclassifying radioactive shipments, which would lead to the use of more expensive packaging than strictly is required. The IAEA regulations are applied internationally, and so there is a large potential worldwide market. The indications from the initial response are that future sales and use are expected to more than cover the investment. Other non-quantifiable benefits include the provision of consistent advice within a uniform approach, the safe-guarding of knowledge of the IAEA regulations, training and improvement in the expertise of users, improved management control, and enhancement of the professional image of BNFL. (author)

  2. Open client/server computing and middleware

    CERN Document Server

    Simon, Alan R


    Open Client/Server Computing and Middleware provides a tutorial-oriented overview of open client/server development environments and how client/server computing is being done.This book analyzes an in-depth set of case studies about two different open client/server development environments-Microsoft Windows and UNIX, describing the architectures, various product components, and how these environments interrelate. Topics include the open systems and client/server computing, next-generation client/server architectures, principles of middleware, and overview of ProtoGen+. The ViewPaint environment

  3. Content and Style of Advice in Iran and Canada (United States)

    Tavakoli, Mahin


    The content and nature of nonprofessional advice in Iran, a hierarchical and collectivist culture, was compared to the same type of advice in Canada, an egalitarian and individualist culture. A researcher developed a questionnaire that consisted of 10 letters, each describing a writer's problem and asking for advice. The responses of participants…

  4. The speech act of advice in Setswana educational contexts | Dlali ...

    African Journals Online (AJOL)

    The main purpose of this article is to examine the linguistic pragmatics of advice in Setswana. This article will attempt to present an account of the speech act of advice within the broad framework of Brown and Levinson's (1987) politeness theory and explore a range of features of advice in Setswana. The research ...

  5. Stepwise Advice Negotiation in Writing Center Peer Tutoring (United States)

    Park, Innhwa


    While the delivery and reception of advice is a practice integral to a wide range of settings, little attention has been given to the detailed practices of advice resistance and how it leads to advice negotiation. Based on 7 hours of videotaped tutoring interactions among 6 tutors and 11 tutees, this conversation analytic study examines the…

  6. 32 CFR 776.10 - Informal ethics advice. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

  7. Nutrition Education Needs Pantry Clients (United States)

    Wood, Dolores K.; Shultz, Jill Armstrong; Edlefsen, Miriam; Butkus, Sue N.


    Two food pantries were surveyed for nutrition education (NE) interests and experiences. One site provided nutrition education classes; the comparison site was utilized to assess client interest in class topics. "Fixing low cost meals," "fixing quick and easy recipes," and "stretching food and food dollars" were topics…

  8. Students: Customers, Clients or Pawns? (United States)

    Tight, Malcolm


    The metaphor of the student as a consumer or customer is widely used within contemporary higher education, and impacts on the ways in which students, academics and institutions behave. These, and a number of alternative metaphors for the student, are critically reviewed. The alternatives considered include both contemporary (student as client or…

  9. Smoking and its treatment in addiction services: clients' and staff behaviour and attitudes. (United States)

    Cookson, Camilla; Strang, John; Ratschen, Elena; Sutherland, Gay; Finch, Emily; McNeill, Ann


    High smoking prevalence has been observed among those misusing other substances. This study aimed to establish smoking behaviours and attitudes towards nicotine dependence treatment among clients and staff in substance abuse treatment settings. Cross-sectional questionnaire survey of staff and clients in a convenience sample of seven community and residential addiction services in, or with links to, Europe's largest provider of mental health care, the South London and Maudsley NHS Foundation Trust. Survey items assessed smoking behaviour, motivation to quit, receipt of and attitudes towards nicotine dependence treatment. Eighty five percent (n = 163) and 97% (n = 145) response rates of clients and staff were achieved. A high smoking prevalence was observed in clients (88%) and staff (45%); of current smokers, nearly all clients were daily smokers, while 42% of staff were occasional smokers. Despite 79% of clients who smoked expressing a desire to quit and 46% interested in receiving advice, only 15% had been offered support to stop smoking during their current treatment episode with 56% reported never having been offered support. Staff rated smoking treatment significantly less important than treatment of other substances (p < 0.001), and only 29% of staff thought it should be addressed early in a client's primary addiction treatment, compared with 48% of clients. A large unmet clinical need is evident with a widespread failure to deliver smoking cessation interventions to an extraordinarily high prevalence population of smokers in addiction services. This is despite the majority of smokers reporting motivation to quit. Staff smoking and attitudes may be a contributory factor in these findings.

  10. Client Contacts Improve Quality of Copywriting. (United States)

    McCann, Guy


    Discusses the advantages of using real-life clients for class assignments in copywriting courses. Presents suggestions for client sources and identifies possible problems which may be encountered. (MM)

  11. Client Involvement in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Henriksen, Nina; Kjær, Lone


    Client involvement’ has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how ‘client involvement’ is practised in home-care services. The aim of this article is to analyse ‘client involvement’ in practise seen...

  12. Negotiating the Client-Based Capstone Experience (United States)

    Reifenberg, Steve; Long, Sean


    Many graduate programs for professionals (public policy, public administration, business, international affairs, and others) use client-based experiential learning projects, often termed "capstones," in which students combine theory and practice to benefit an outside client. Increasingly, undergraduate programs use client-based capstones…

  13. Client-Side Monitoring for Web Mining. (United States)

    Fenstermacher, Kurt D.; Ginsburg, Mark


    Discusses mining Web data to draw conclusions about Web users and proposes a client-side monitoring system that supports flexible data collection and encompasses client-side applications beyond the Web browser to incorporate standard office productivity tools. Highlights include goals for client-side monitoring; framework for user monitoring,…

  14. Client Introversion and Counseling Session Impact. (United States)

    Nocita, Andrew; Stiles, William B.


    Examined impact of counseling sessions as a function of clients' personality characteristics. Results indicated introverted clients rated their sessions as uncomfortable, unpleasant, tense, rough, and difficult and rated their postsession mood as relatively unfriendly, uncertain, sad, angry, and afraid. Conversely, extroverted clients rated their…

  15. Advice on Writing a Scientific Paper (United States)

    Sterken, C.


    What makes one author a good communicator and another a poor one? What turns out one manuscript a swift editorial task, and another an editorial nightmare? Based on direct experience from the manuscripts of the lectures and papers presented during this school, advice is given on what to do and on what to avoid when writing a scientific paper. Some feedback recommendation is also provided on how to prepare manuscripts, handle copyright and permissions to reproduce, how to anticipate plagiarism, how to deal with editors and referees, and how to avoid common errors. A few illustrations of English grammar and style for the foreign author are given.

  16. Client and Therapist Variability in Clients' Perceptions of Their Therapists' Multicultural Competencies (United States)

    Owen, Jesse; Leach, Mark M.; Wampold, Bruce; Rodolfa, Emil


    This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated…

  17. Call center. Centrados en el cliente


    Leal-Alonso-de-Castañeda, José Enrique


    La empresa actual ha de estar preparada para responder al Cliente tal y como éste espera, porque no se busca un cliente puntual, sino un cliente fiel. La globalización de la economía y del acceso a los mercados exige que la empresa sea capaz de atraer al cliente no sólo con un servicio de calidad, sino además con una atención de calidad. La implantación de un Call Center (Centro de Atención al Cliente, Centro de Atención de Llamadas) constituye por todo ello una estrategia de negocio qu...

  18. Let Me Give You a Piece of Advice: Empirical Papers about Advice Taking in Marketing

    NARCIS (Netherlands)

    S.C. Tzioti (Stefanie)


    textabstractUsing advice in decision making is widespread for all sorts of important personal and professional decisions. Yet, traditional research on individual decision making has failed to systematically study the impact that social interactions about a decision problem can have on the decision

  19. Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States


    Vaccaro, Joan A; Feaster, Daniel J; Lobar, Sandra L; Baum, Marianna K; Magnus, Marcia; Huffman, Fatma G


    Abstract Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes se...

  20. Advice from working women with retired partners. (United States)

    Cooley, Eileen L; Adorno, Gail


    in the 21st century, as more women are employed full-time and couples increasingly share egalitarian values, more women continue employment after their partners have voluntarily retired. However, we know very little about the experiences of this growing population of women. We asked working women with retired partners to share their advice for other women who may face this developmental transition. Open-ended responses from 97 women were analyzed to identify pertinent issues and themes. Four primary content areas were identified: time management, division of household labor, financial planning, and communication. Communication between partners was both a topic of concern as well as the solution suggested to resolve conflicts or differences that may arise when women live with a retired partner. It is expected that future changes in the workforce and improvements in the gender balance within relationships will continue to impact experiences for working women with retired partners.

  1. Client perspectives on occupational therapy practice: are we truly client-centred? (United States)

    Rebeiro, K L


    In Canada, the guidelines for the practice of occupational therapy are named and framed as client-centred. Two in-depth interviews were conducted with clients of mental health services about their experiences with a hospital-based occupational therapy service. These occupational therapy clients described their experiences as prescriptive, and as less than client-centred. With the publication of Enabling occupation: A Canadian occupational therapy perspective (Canadian Association of Occupational Therapists [CAOT], 1997) and an increasingly refined focus on being client-centred, these interviews highlight the challenges of a client-centred practice within the current health care environment. These occupational therapy clients raise issues of importance for occupational therapy. The participants stated that the prescription of 'activity', a lack of choice, and a focus upon the illness as opposed to the individual, served to diminish any collaborative partnership with the client and eliminate the client from any decision-making process. This distancing from the client, in their opinion, served to greatly diminish any therapeutic value of occupation. The participants recommended a greater focus upon occupational choice, consideration of the individual within the client, providing accepting, supportive environments, and using professional expertise on occupation to guide the client towards participation in meaningful occupation. These recommendations are strikingly similar to the most recent guidelines for the client-centred practice of occupational therapy in Canada. A discussion of the implications of these findings for the client-centred practice of occupational therapy is offered.

  2. Home visits for dietary advice reduce caries. (United States)

    John, Jeyanthi


    This was a randomised field trial using block randomisation. A control group received routine assistance from their paediatricians in the health service, with research assessment usually within 1 month of the child's 6- and 12-month anniversary, then dietary advice by a fieldworker after the 12-month research assessment. The intervention group received home visits to advise the mother about healthy breastfeeding and weaning within 10 days of the child's birth, then monthly up to 6 months, then at 8, 10 and 12 months. This group also received the 6-month and 12-month research assessment and routine assistance from their paediatricians. Outcome measures were early childhood caries (ECC), defined as one or more caries surface of a tooth, duration of breastfeeding and dietary behaviours. Of the intervention group, 10.2% (16 out of 157) babies had caries compared with 18.3% (40 out of 219) babies in the control group. The odds of dental caries was 48% lower for the intervention group than for the controls (odds ratio, 0.52; 95% confidence interval, 0.27-0.97), after adjustment for the confounding effect of number of teeth. The intervention group had a longer mean duration of exclusive breastfeeding (X(2) P 0.000), later introduction of sugar (X(2) P 0.005) and a lower probability of their baby ever having eaten honey (X(2) P 0.003), chocolate or sweets (X(2) P 0.001), soft drinks (X(2) P 0.020), biscuits (X(2) P 0.000) and fromage frais cheese (X(2) P 0.001). Home visits for dietary advice appear to help reduce dental caries in infants. Greater efforts are needed to tackle cariogenic dietary behaviours, however, and further studies are required to examine any longer-term effect.

  3. Exploring the health visiting service from the view of South Asian clients in England: a grounded theory study. (United States)

    Abdu, Lena; Stenner, Karen; Vydelingum, Vasso


    The fact that health inequalities disproportionately affect the minority ethnic population is not new and projections are that the minority ethnic population will continue to increase. The importance of early intervention and the key role that health visitors can play in attempting to reduce health inequalities is well documented as is the requirement for health providers to establish culturally sensitive services. To date, much of the research has focused on the perspectives of healthcare professionals caring for minority ethnic clients in hospital-based settings and little is known about the perspectives of minority ethnic clients regarding the health visiting service (HVS). The aim of this study was to explore the perspectives of South Asians regarding their experiences with the HVS. The study was conducted in a small town in the South of England between March and June 2013. A qualitative study using a grounded theory approach was used to capture the perspectives of this group regarding their interactions with the HVS. The sample consisted of 15 participants and data were collected through audio-recorded semi-structured interviews and analysed using constant comparative approach. Three key categories were identified: 'understanding the health visitor's role', 'sensitivity of services' and 'the significance of family'. While clients valued one-to-one support from health visitors, there was some evidence of poor communication and ethnocentric tendencies within the service. It was found that South Asian clients distinguish between health and parenting advice, being more likely to accept health advice from their health visitor and more likely to accept parenting advice from their family. The findings, although limited in their generalisability, offer important insights into how South Asians perceive the service and will equip health visitors with a better understanding of how best to improve the experience of South Asian clients accessing the health visiting.

  4. Lay Evaluation of Financial Experts: The Action Advice Effect and Confirmation Bias

    Directory of Open Access Journals (Sweden)

    Tomasz Zaleskiewicz


    Full Text Available The goal of this experimental project was to investigate lay peoples’ perceptions of epistemic authority (EA in the field of finance. EA is defined as the extent to which a source of information is treated as evidence for judgments independently of its objective expertise and based on subjective beliefs. Previous research suggested that EA evaluations are biased and that lay people tend to ascribe higher EA to experts who advise action (in the case of medical experts or confirm clients’ expectations (in the case of politicians. However, there has been no research into biases in lay evaluations of financial experts and this project is aimed to fill this gap. Experiment 1 showed that lay people tended to ascribe greater authority to financial consultants who gave more active advice to clients considering taking out a mortgage. Experiment 2 confirmed the action advice effect found in Experiment 1. However, the outcomes of Experiments 2 and – particularly – 3 suggested that this bias might also be due to clients’ desire to confirm their own opinions. Experiment 2 showed that the action advice effect was moderated by clients’ own opinions on taking loans. Lay people ascribed the greatest EA to the advisor in the scenario in which he advised taking action and where this coincided with the client’s positive opinion on the advisability of taking out a loan. In Experiment 3 only participants with a positive opinion on the financial product ascribed greater authority to experts who recommended it; participants whose opinion was negative tended to rate consultants who advised rejecting the product more highly. To conclude, these three experiments revealed that lay people ascribe higher EA to financial consultants who advise action rather than maintenance of the status quo, but this effect is limited by confirmation bias: when the client’s a priori opinion is salient, greater authority is ascribed to experts whose advice confirms it. In this

  5. Do client fees help or hurt? (United States)

    Barnett, B


    This article discusses the impact of client fees for family planning (FP) services on cost recovery and level of user services in developing countries. The UN Population Fund reports that developing country governments currently pay 75% of the costs of FP programs. Donors contribute 15%, and clients pay 10%. Current pressures are on FP services to broaden and improve their scope, while user demand is increasing. Program managers should consider the program's need for funds and the clients' willingness to pay. Clients are willing to pay about 1% of their income for contraception. A study of sterilization acceptance in Mexico finds that the average monthly case load declined by 10% after the 1st price increase from $43 to $55 and declined by 58% after the 2nd price increase to $60. Fewer low-income clients requested sterilization. A CEMOPLAF study in Ecuador finds that in three price increase situations the number of clients seeking services declined, but the economic mix of clients remained about the same. The decline was 20% in the group with a 20% price increase and 26% in the 40% increase group. In setting fees, the first need is to determine unit costs. The Futures Group International recommends considering political, regulatory, and institutional constraints for charging fees; priorities for revenue use; protection for poor clients; and monitoring of money collection and expenditure. Management Sciences for Health emphasizes consideration of the reasons for collection of fees, client affordability, and client perception of quality issues. Sliding scales can be used to protect poor clients. Charging fees for laboratory services can subsidize poor clients. A Bangladesh program operated a restaurant and catering service in order to subsidize FP services. Colombia's PROFAMILIA sells medical and surgical services and a social marketing program in order to expand clinics.

  6. Preconceptions in the nurse-client relationship. (United States)

    Forchuk, C


    Nursing theorist, Hildegard Peplau (1952) has identified the concept of preconceptions as critical in the development of the therapeutic nurse-client relationship. Although stereotypes exist for both nurses and chronic psychiatric clients, very little research has been reported on the preconceptions nurses and psychiatric clients have of each other. This investigation utilized non-probability, purposive sampling of 20 newly formed nurse-client dyads within programmes serving a chronically mentally ill population in Canada. Subjects were asked to give descriptions of each other. Semantic differentials based on this feedback were then developed and administered to 124 nurse-client dyads. Clients' statements generally evaluated their nurses positively. The generally positive views expressed by nurses and clients did not reflect public stereotypes for either group. The preconceptions the clients had of their nurses, and nurses had of their clients were related to both the quality of the emerging relationship (task, bond and goals) and the duration of the orientation phase. The preconceptions were virtually unchanged over the initial 6 months of the relationship.

  7. Pre-travel advice: an overview. (United States)

    Sanford, Christopher


    The message of the pre-travel provider is necessarily paradoxic. First the provider lists a score of causes of illness and premature demise, and then states, "But it sounds like a great trip and I think you'll have fun." Pre-travel providers need to walk a fine line: they must encourage patients to be cautious but not paranoid, optimistic but realistic. This discussion is complicated further by the fact that risk reduction is not the only consideration; if it were, practitioners would advise patients to remain in the developed world and foray from their homes only to visit health clubs and the fruit-and-vegetable section of grocery stores. A tacit assumption in travel medicine is that some degree of acceptance of heightened risk is tolerated for the benefit of improved quality of life offered by travel abroad. The amount of risk that is reasonable to accept for a given benefit in quality of life yielded by travel cannot be quantified, however. Providers must render judgments on what is "reasonable" and what is not, and this complex decision is based on equal parts medical knowledge and intuition. At one extreme, mountaineers in Nepal have been found to have a 2.4% mortality rate per expedition [83,84]. The travel provider might make the reasonable decision to counsel these travelers to avoid that activity. These travelers most likely will ignore that advice, at which point the provider must endeavor to reduce risk to the extent possible. Other situations in which the provider should advise a change in itinerary or activities include counseling parents who plan to take an infant to high altitude or a pregnant woman who plans to scuba dive. If travelers remain cloistered in their hotel rooms, eating all meals from room service and watching CNN, then it could be suggested that they are overly risk-adverse and might consider foraying out of the hotel, despite the potential associated increased risks to health. Conversely, if travelers find themselves on motorcycles

  8. What Makes Proteges Take Mentors' Advice in Formal Mentoring Relationships? (United States)

    Son, SuJin; Kim, Do-Yeong


    This study examines the factors affecting a protege's willingness to take a mentor's advice. The sample for this study consisted of 183 proteges from two different South Korean organizations who were part of formal mentoring programs. We found protege commitment to be the principal factor that predisposes a protege to take advice from mentors and…

  9. 5 CFR 1304.4607 - Advice to former Government employees. (United States)


    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Advice to former Government employees. 1304.4607 Section 1304.4607 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES POST EMPLOYMENT CONFLICT OF INTEREST § 1304.4607 Advice to former Government employees. The Office...

  10. 29 CFR 1400.735-3 - Advice and counseling service. (United States)


    ... 29 Labor 4 2010-07-01 2010-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

  11. Emotions in Advice Taking: The Roles of Agency and Valence

    NARCIS (Netherlands)

    Hooge, de I.E.; Verlegh, P.W.J.; Tzioti, S.C.


    Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

  12. Emotions in advice taking: the roles of agency and valence

    NARCIS (Netherlands)

    de Hooge, I.E.; Verlegh, P.W.J.; Tzioti, S.C.


    Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

  13. Antimalarial measures - type, sources of advice and compliance ...

    African Journals Online (AJOL)


    Jun 1, 1994 ... basis from which to document further changes in prophylactic advice and usage. The results are being ... as posing a higher risk from malaria than the KBNR's more southerly regions. The diversity of accommodation ... Compliance, drug type and sources of advice were documented. Use of personal barrier ...

  14. Discharge against medical advice amongst orthopaedic patients in ...

    African Journals Online (AJOL)

    Background: Discharge Against Medical Advice (DAMA) is a term used when patients opt to leave a hospital against the advice of the doctor. Trauma patients account for a significant percentage of these. This study was aimed at determining the prevalence of and reasons for DAMA amongst Orthopaedic and trauma ...

  15. Discharge from hospital against medical advice among paediatric ...

    African Journals Online (AJOL)

    Background: The reasons underlying discharge against medical advice by Paediatric patients varies from place to place. Discharge against medical advice is frustrating to the medical personnel and deprives the patient of adequate medical care. This study aims to determine the prevalence and factors associated with ...


    Directory of Open Access Journals (Sweden)

    Richki Hardi


    Full Text Available The era of globalization is included era where the komputer virus has been growing rapidly, not only of mere academic research but has become a common problem for komputer users in the world. The effect of this loss is increasingly becoming the widespread use of the Internet as a global communication line between komputer users around the world, based on the results of the survey CSI / FB. Along with the progress, komputer viruses undergo some evolution in shape, characteristics and distribution medium such as Worms, Spyware Trojan horse and program Malcodelain. Through the development of server-based antivirus clien then the user can easily determine the behavior of viruses and worms, knowing what part of an operating system that is being attacked by viruses and worms, making itself a development of network-based antivirus client server and can also be relied upon as an engine fast and reliable scanner to recognize the virus and saving in memory management.

  17. The Influence of Client Fees on Evaluations By Clients of Counseling Outcome. (United States)

    Shipton, Brian; Spain, Armelle


    Psychoanalytic theory and cognitive dissonance theory predict that clients who pay a fee for counseling benefit more than clients who do not pay. Results of this study suggest that paying a fee does not significantly influence counseling outcome as measured by client evaluations of counselors. (Author)

  18. Collecting Multidimensional Client Data Using Repeated Measures: Experiences of Clients and Counselors Using the CCAPS-34 (United States)

    Martin, Jessica L.; Hess, Timothy R.; Ain, Stacie C.; Nelson, Dana L.; Locke, Benjamin D.


    Many college counseling centers do not collect client data at each session because of perceived burdens. This study explored 55 clients' and 16 doctoral counselor trainees' experiences collecting and using data on client distress at each session over the course of counseling at a large public university's counseling center. Results indicated that…

  19. The Impact of Client Expertise, Client Gender and Auditor Gender on Auditors' Judgments

    NARCIS (Netherlands)

    A.H. Gold-Nöteberg (Anna); J.E. Hunton (James); M.I. Gomaa (Mohamed)


    textabstractThe purpose of the current study is to assess the extent to which auditors’ judgments are affected by client expertise, client gender and auditor gender. Prior audit research suggests that auditors place more weight on evidence received from clients who possess higher, relative to

  20. Lawyer Secondary Consultations: improving access to justice and human rights: reaching clients otherwise excluded through professional support in a multi-disciplinary practice’

    Directory of Open Access Journals (Sweden)

    Liz Sara Curran


    Full Text Available Under international law there are moral obligations on Nation States to ensure, protect and adhere to certain human rights standards. The difficulty is that if people do not know they have rights, do not have the confidence to assert their human rights or do not know the pathways to gain access to legal support and advice to action their human rights, then those human rights become unrealisable. It is now empirically established that unresolved legal problems result in poorer health and social outcomes. This article argues that the use of secondary consultations where a lawyer gives advice in a timely and approachable way to non-legal professionals (‘trusted intermediaries’ likely to have contact with the most vulnerable and disadvantaged clients, then this is an effective way of reaching clients who would otherwise not gain help or advice. The thesis for this article is that legal secondary consultations build capacity and confidence in professionals to both identify legal or human rights so they either support a client or, where appropriate, refer clients who would otherwise not get help because of a range of inhibitors. Legal secondary consultations enable people to identify their human rights and action them where otherwise they would be overlooked. The author draws on personal practical experience and initial findings from recent research in urban, outer urban and rural settings in Australia.

  1. Family Systems and the Single Client. (United States)

    Baldwin, Cynthia


    Describes how a counselor used a combination of systemic family counseling techniques with a divorced middle-aged male client. The counselor states that it proved to be an efficient and honoring combination that helped the client move differently, with more freedom and self-assurance, toward his goals. (MKA)

  2. Client's Constraining Factors to Construction Project Management

    African Journals Online (AJOL)

    other factors include bribery and corruption of clients' representatives especially in public project monitoring .... bribery and corruption of client's representatives and the selection of competent design team. Private Sector .... The significant importance of this sector is evidenced in the fact that every business or services of ...

  3. Experiential Interventions for Clients with Genital Herpes. (United States)

    Cummings, Anne L.


    Explores potential benefits of incorporating concepts and interventions from experimental therapy to help clients with psychosocial difficulties in learning to live with genital herpes. Recommends experimental counseling of two-chair dialog, empty chair, and metaphor for helping clients with emotional sequelae of genital herpes. Presents case…

  4. YASGUI: Not Just Another SPARQL Client

    NARCIS (Netherlands)

    Rietveld, L.; Hoekstra, R.


    This paper introduces YASGUI, a user-friendly SPARQL client. We compare YASGUI with other SPARQL clients, and show the added value and ease of integrating Web APIs, services, and new technologies such as HTML5. Finally, we discuss some of the challenges we encountered in using these technologies for

  5. YASGUI: not just another SPARQL client

    NARCIS (Netherlands)

    Rietveld, L.; Hoekstra, R.


    This paper introduces YASGUI, a user-friendly SPARQL client. We compare YASGUI with other SPARQL clients, and show the added value and ease of integrating Web APIs, services, and new technologies such as HTML5. Finally, we discuss some of the challenges we encountered in using these technologies for

  6. Client's constraining factors to construction project management ...

    African Journals Online (AJOL)

    This study analyzed client's related factors that constrain project management success of public and private sector construction in Nigeria. Issues that concern clients in any project can not be undermined as they are the owners and the initiators of project proposals. It is assumed that success, failure or abandonment of ...

  7. Can retail banking clients' attrition be managed?

    Directory of Open Access Journals (Sweden)

    Agaliotis Konstantinos


    Full Text Available The rurrο_e of all banks across the universe is to satisfy their clients' necessities. One of the predominant impacts of the last few years' financial crisis in Europe was the way in which customers interact with their banks. The theory of 'main bank' is not any more the case as clients' trust toward banks fades away together with their loyalty. Nowadays, it is necessary for banks to segment their clientele data base, and target the most profitable clients. The retention strategy of each financial institution becomes more and more important as the value of each retained customer is disproportional to the cost of acquiring a new one. The main findings of the subject retail banking clients' retention policy analysis prove that clients of different lifetime value have different propensity to defect. At the same time, the ability of a bank to retain a potential defector does not depend directly on satisfying the defection reason. Many of the various bank counter offers which do not directly satisfy the reason that a client refers to as the 'defection' one, are enough in order to retain a client. Equally important to the identification of clients' behavioural patterns is the use of the subject findings on behalf of the retail oriented banks in order to predict accurately the cost of future defection, as well as, to incorporate one more measurable parameter in their credit risk scorecards i.e. the intention to increase credit exposure.

  8. What Abortion Counselors Want from Their Clients. (United States)

    Joffe, Carole


    The moral dilemmas of abortion counseling are exacerbated by client attitudes which do not conform to counselors' needs and expectations. Studies show that counselors expect sobermindedness, are intolerant of cynicism, detest repeat aborters, and expect clients to adopt values and courses of action based on counselor beliefs. (Author/WI)

  9. Racing toward client-server solutions. (United States)

    Cupito, M C


    If mainframe computing is like driving a reliable sedan, some experts say client-server computing is like driving a fast, maneuverable sports car. But until you understand and fine-tune a client-server system, performance can be disappointing.

  10. Chaperone-client complexes: A dynamic liaison (United States)

    Hiller, Sebastian; Burmann, Björn M.


    Living cells contain molecular chaperones that are organized in intricate networks to surveil protein homeostasis by avoiding polypeptide misfolding, aggregation, and the generation of toxic species. In addition, cellular chaperones also fulfill a multitude of alternative functionalities: transport of clients towards a target location, help them fold, unfold misfolded species, resolve aggregates, or deliver clients towards proteolysis machineries. Until recently, the only available source of atomic resolution information for virtually all chaperones were crystal structures of their client-free, apo-forms. These structures were unable to explain details of the functional mechanisms underlying chaperone-client interactions. The difficulties to crystallize chaperones in complexes with clients arise from their highly dynamic nature, making solution NMR spectroscopy the method of choice for their study. With the advent of advanced solution NMR techniques, in the past few years a substantial number of structural and functional studies on chaperone-client complexes have been resolved, allowing unique insight into the chaperone-client interaction. This review summarizes the recent insights provided by advanced high-resolution NMR-spectroscopy to understand chaperone-client interaction mechanisms at the atomic scale.

  11. Training Therapists about Client Expectations of Psychotherapy. (United States)

    Soley, Georgia; Marshall, Renee; Chambliss, Catherine

    Research has indicated that premature termination of therapy is sometimes due to a conflict in goal and outcome expectations between therapists and family members of clients. The present study requested both therapists and parents of child clients to complete questionnaires to determine if there is congruence between therapist and parental…

  12. Client-server Sistem Informasi Ulam Bebantenan

    Directory of Open Access Journals (Sweden)

    A.A. Gede Brampramana Putra


    Full Text Available Sistem Informasi ulam bebantenan adalah sistem informasi yangmelangsungkan hubungan antaraclientdanserverdalam proses perpindahana data informasi. Ulam bebantenan adalah sarana pelengkap yang digunakan pada beberapa jenis banten. Informasi yang disajikan dalam sistem adalah berupa deksripsi ulam hingga pada proses pengolahannya. Aplikasi client dibangun pada perangkat mobile dengan sistem operasi Android.Aplikasi client memberikan informasi terkait teks deskripsi, gambar, serta video mengenai Ulam Bebantenan di Bali.Sisi server dibangun dengan berbasiskan web.Server memiliki peran dalam mengelola data master pada basis data sistem. Hubungan yang terjadi pada client-server ini berperan dalam agar pada sisi client dapat mengakses data pada basis data sistem yang terdapat pada sisi server secara berkala.   Kata kunci: Client-server, Informasi, Ulam Bebantenan, Android.

  13. Advice for running a successful research team. (United States)

    Stanley, David; Anderson, Judith


    To explore what is meant by a 'research team' and offer practical suggestions for supporting an effective and productive, collaborative research team. Collaborative research has become one of the main objectives of most higher education institutions and running effective research teams is central to achieving this aim. However, there is limited guidance in the literature about how to run or steer a research team. Search engines/databases used: CINAHL, Nursing and Allied Health Source, Primo search, Google search and Health Collection to access research articles and publications to support this topic. Literature search was extended to the end of 2014. Publications were reviewed for relevance to the topic via standard literature search. Research teams vary in size and composition, however they all require effective collaboration if they are to establish successful and flexible working relationships and produce useful and trustworthy research outputs. This article offers guidance for establishing and managing successful collaborative research relationships, building trust and a positive research team culture, clarifying team member roles, setting the teams' research agenda and managing the teams' functions so that team members feel able to contribute fully to the research goals and build a culture of support and apply 'emotional intelligence' throughout the process of building and running a successful research team. Collaboration is a central component of establishing successful research teams and enabling productive research outputs. This article offers guidance for research teams to help them to function more effectively and allow all members to contribute fully to each team's goals. Research teams that have established trust and a positive team culture will result in more efficient working relationships and potentially greater productivity. The advice offered reinforces the value of having research teams with diverse members from different disciplines

  14. Career Advice for Young Allergy Patients. (United States)

    Radon, Katja; Nowak, Dennis; Vogelberg, Christian; Ruëff, Franziska


    One-third of all young persons entering the work force have a history of atopic disease. Occupationally induced allergy and asthma generally arise in the first few months on the job, while pre-existing symptoms tend to worsen. Young persons with a history of an atopic disease should receive evidence-based advice before choosing a career. We systematically searched PubMed for cohort studies investigating the new onset of asthma, rhinitis, or hand eczema among job trainees from before the start of training and onward into the first few years on the job. The search revealed 514 articles; we read their abstracts and selected 85 full-text articles for further analysis. 24 of these met the inclusion criteria. According to present evidence, atopy and a history of allergic disease (allergic rhinitis, atopic dermatitis) are the main risk factors for occupationally induced disease. The predictive value of a personal history of allergic diseases for the later development of an occupationally induced disease varies from 9% to 64% in the studies we analyzed. It follows that only young people with severe asthma or severe atopic eczema should be advised against choosing a job that is associated with a high risk of allergy, e.g., hairdressing or working with laboratory animals. Young people with a history of other atopic diseases should be counseled about their individual risk profile. In view of the relatively poor predictive value of pre-existing atopic disease, secondary prevention is particularly important. This includes frequent medical follow-up of the course of symptoms over the first few years on the job. If sensitization or allergic symptoms arise, it should be carefully considered whether exposure reduction will enable the apprentice to stay on the job.

  15. An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

    Directory of Open Access Journals (Sweden)

    Ujuju C


    Full Text Available Chinazo Ujuju,1 Samson B Adebayo,2 Jennifer Anyanti,3 Obi Oluigbo,3 Fatima Muhammad,4 Augustine Ankomah5 1Research and Evaluation Division, Society for Family Health, Abuja, Nigeria; 2Planning, Research and Statistics Directorate, National Agency for Food and Drug Administration and Control, Abuja, Nigeria; 3Technical Services Directorate, Society for Family Health, Abuja, Nigeria; 4Family Planning Directorate, Society for Family Health, Abuja, Nigeria; 5Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana Introduction: In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs. This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. Method: This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills; user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. Results: A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go

  16. Xerostomia among older home care clients. (United States)

    Viljakainen, Sari; Nykänen, Irma; Ahonen, Riitta; Komulainen, Kaija; Suominen, Anna Liisa; Hartikainen, Sirpa; Tiihonen, Miia


    The purpose of this study was to examine drug use and other factors associated with xerostomia in home care clients aged 75 years or older. The study sample included 270 home care clients aged ≥75 years living in Eastern and Central Finland. The home care clients underwent in-home interviews carried out by trained home care nurses, nutritionists, dental hygienists and pharmacists. The collected data contained information on sociodemographic factors, health and oral health status, drug use, depressive symptoms (GDS-15), cognitive functioning (MMSE), functional ability (Barthel Index, IADL) and nutrition (MNA). The primary outcome was xerostomia status (never, occasionally or continuously). Among the home care clients, 56% (n = 150) suffered from xerostomia. Persons with continuous xerostomia used more drugs and had more depressive symptoms and a higher number of comorbidities than other home care clients. In multivariate analyses, excessive polypharmacy (OR = 1.83, 95% Cl 1.08-3.10) and depressive symptoms (OR = 1.12, 95% Cl 1.03-1.22) were associated with xerostomia. Xerostomia is a common problem among old home care clients. Excessive polypharmacy, use of particular drug groups and depressive symptoms were associated with xerostomia. The findings support the importance of a multidisciplinary approach in the care of older home care clients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Team-client Relationships And Extreme Programming

    Directory of Open Access Journals (Sweden)

    John Karn


    Full Text Available This paper describes a study that examined the relationship between software engineering teams who adhered to the extreme programming (XP methodology and their project clients. The study involved observing teams working on projects for clients who had commissioned a piece of software to be used in the real world. Interviews were conducted during and at the end of the project to get client opinion on how the project had progressed. Of interest to the researchers were opinions on frequency of feedback, how the team captured requirements, whether or not the iterative approach of XP proved to be helpful, and the level of contextual and software engineering knowledge the client had at the start of the project. In theory, fidelity to XP should result in enhanced communication, reduce expectation gaps, and lead to greater client satisfaction. Our results suggest that this depends heavily on the communication skills of the team and of the client, the expectations of the client, and the nature of the project.

  18. Occupational Exposure to HIV: Advice for Health Care Workers (United States)

    ... Prevention and Wellness Staying Healthy Healthy Living Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets ... PoisoningAcute Bronchitis Home Prevention and Wellness Staying Healthy Occupational Health Occupational Exposure to HIV: Advice for Health Care ...

  19. An Expert's Advice: What To Do If You Have Psoriasis (United States)

    ... on. Feature: Living with Psoriasis An Expert's Advice: What To Do If You Have Psoriasis Past Issues / ... the Dermatology Foundation, and the American Skin Association. What is psoriasis? Psoriasis is a chronic (long-term) ...

  20. Clients' ratings of counselor multicultural competency. (United States)

    Fuertes, Jairo N; Brobst, Karen


    Differences in perceptions between Euro American and ethnic minority respondents were examined to compare the role of counselor multicultural competency in multicultural versus traditional counseling. Results showed a strong positive correlation between clients' ratings of counselors' multicultural competencies and clients' ratings of counselors' general competency and empathy. However, when comparisons were made between Euro American and ethnic minority clients' on satisfaction, counselor multicultural competency explained a large and significant amount of variance for the ethnic minority sample only, above and beyond counselor general competency and empathy. Results are discussed in the context of relevant literature and suggestions for future research.

  1. Client-Oriented Approach: Forming the System of Management of the Bank Relations with Clients

    Directory of Open Access Journals (Sweden)

    Zavadska Diana V.


    Full Text Available The aim of the article is to develop the theoretical principles of forming the bank relations with clients as part of the client-oriented strategy implementation. As a result of the conducted research there has been presented the definition of client-orientation, mechanism and system of management. The system of management of the bank relations with clients, the purpose and objectives of its formation have been substantiated. The hierarchy of subjects of forming and managing the process of the bank relations with client has been presented. The ways of implementing in practice the functions of the mechanism of managing relations with clients have been revealed. It has been proved that for implementation of the client-oriented approach the banking institution should have a comprehensive view of its clients’ behavior, which detailed understanding will allow for a more accurate segmentation and building individualized partnership relations. Implementing the principle of totality of client relationships level and comprehensive knowledge, development of employee behavior techniques and special techniques for working with the most valuable clients, the use of analytics and forecasting tools will provide targeting of marketing campaigns and lead to minimization of additional costs, satisfaction of every client, loyalty, increase in the market share, growth of sales volume, increase in profits of the banking institution.

  2. Clients' collaboration in therapy: Self-perceptions and relationships with client psychological functioning, interpersonal relations, and motivation. (United States)

    Bachelor, Alexandra; Laverdière, Olivier; Gamache, Dominick; Bordeleau, Vincent


    To gain a closer understanding of client collaboration and its determinants, the first goal of this study involved the investigation of clients' perceptions of collaboration using a discovery-oriented methodology. Content analysis of 30 clients' written descriptions revealed three different modes of client collaboration, labeled active, mutual, and therapist-dependent, which emphasized client initiative and active participation, joint participation, and reliance on therapists' contributions to the work and change process, respectively. The majority of clients valued the therapist's active involvement and also emphasized the helpfulness of their collaborative experiences. In general, the therapist actions and attitudes involved in clients' views of good collaboration varied among clients. A second goal was to examine the relationships between client psychological functioning, quality of interpersonal relationships, and motivation, and clients' collaborative contributions, as rated by clients and therapists. Of these, only motivation was significantly associated with client collaboration, particularly in the perceptions of therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  3. IPME and External Clients: Enhancing Performance by Offloading Simulation Workload to External Clients; Explaining and Simplifying the Process

    National Research Council Canada - National Science Library

    Haar, ter, Phil; Cain, Brad


    ...) to an external client using the external client architecture that accompanies IPME. This client communicates with IPME using TCP/IP network protocol, exchanging values of common variables over the network...

  4. GYNOTEL: telephone advice to gynaecological surgical patients after discharge. (United States)

    Caljouw, Monique A A; Hogendorf-Burgers, Marja E H J


    To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address this problem. To our knowledge, postdischarge health problems and the value of telephone advice have not been investigated among gynaecological patients. Randomised controlled trial. Gynaecological patients expected to stay in the ward longer than 24 hour were invited to participate. A pilot study showed that wound healing, pain, mobility, urination, defecation and vaginal bleeding were the most common health problems postdischarge. Based on that information, guidelines were formulated that were used by trained nurses to give telephone advice to the intervention group (n=235), in addition to the usual care. The control group of gynaecological patients (n=233) received usual care only. Of all 468 participants, about 50% were operated for general gynaecology. At discharge, wound pain (56%), mobility problems (54%) and constipation (27%) were the most frequently mentioned problems in both groups. Participants who completely followed the advice with regard to wound healing (p=0.02), pain (p=0.01), vaginal bleeding (p=0.03) and mobility (p=0.04) experienced greater improvement than participants who did not follow, or only partly followed, the advice. The telephone advice appears to make a significant contribution to help gynaecological surgical patients to solve or reduce their postdischarge health problems. The positive effect of such advice can be interpreted as an improvement in the quality of life of the postoperative gynaecological patient. © 2010 Blackwell Publishing Ltd.

  5. An investigation into whether clients and/or their respective clinicians are aware of pending service exit in the first two months of treatment admission. (United States)

    Pulford, Justin; Adams, Peter; Sheridan, Janie


    When a client exits an alcohol and other drug (AOD) treatment service against clinical advice, they and their service may incur significant disadvantage. The extent of awareness by both clients and clinicians that treatment would not continue has not been examined. Accordingly, this paper presents findings from a study that sought to identify whether clients and/or their respective clinicians were aware of pending service exit that occurred within the first 2 months of treatment admission. The study was set in an outpatient AOD treatment service located in Auckland, New Zealand. Data were obtained by structured questionnaire and were reported for a group of clients (n = 49), clinicians (n = 46) and matched client/clinician pairs (n = 36). Overall, clients and clinicians were no more likely to accurately identify pending service exit at a rate greater than would be expected by chance alone. However, clinicians were significantly more likely to identify pending service exit as compared with their respective clients (47% vs. 25%), although a large proportion of both groups expected treatment to continue beyond what proved to be the final treatment appointment (44% and 52%, respectively). These findings suggest that service exit that occurs within the first 2 months of treatment admission may be largely unpredictable and that, as a result of this unpredictability, the opportunities for a targeted response may be limited.

  6. Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots

    NARCIS (Netherlands)

    van Thiel, D.; van Raaij, W.F.


    The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily

  7. Caring for Clients and Families With Anxiety

    Directory of Open Access Journals (Sweden)

    Noriko Yamamoto-Mitani


    Full Text Available This study elucidated Japanese home care nurses’ experiences of supporting clients and families with anxiety. We interviewed 10 registered nurses working in home care agencies and analyzed the data using grounded theory to derive categories pertaining to the nurses’ experiences of providing care. We conceptualized nurses’ approaches to caring for anxiety into three categories: First, they attempted to reach out for anxiety even when the client/family did not make it explicit; second, they tried to alter the outlook of the situation; and third, they created comfort in the lives of the client/family. The conceptualizations of nurses’ strategies to alleviate client/family anxiety may reflect Japanese/Eastern cultural characteristics in communication and their view of the person and social care system, but these conceptualizations may also inform the practice of Western nurses by increasing awareness of skills they may also have and use.

  8. Client-server modes of GTVGIS (United States)

    Faust, Nickolas L.; Ribarsky, Bill; Jiang, Frank T. Y.


    The capabilities of the Georgia Tech Virtual Geographic Information System (GTVGIS) have been extended recently to fake full advantage of the internal client-server internal structure that we have used in our stand-alone visualization capabilities. Research is underway in the creation of 2 additional client-server modes that will allow GTVGIS capabilities to be accessed by laptop client systems with high quality rendering capability and by very inexpensive lightweight client laptop and possibly hand held computing platforms that need only to support standard web browsers. Interface to large, remote, databases is over IP protocols is necessary for these new GTVGIS modes. This paper describes each mode of GTVGIS and the capabilities and requirements for hardware and software for each of the modes.

  9. Toward Healthy Family Breathing: client survey

    National Research Council Canada - National Science Library

    Kaloti, Jiti; Naylor, P.J


    .... A secondary purpose was to measure clients behaviours and attitudes to add to the knowledge about how different types of perinatal workers can best assist pregnant and parenting women who smoke...

  10. Eros-based Confined Capability Client

    National Research Council Canada - National Science Library

    Shapiro, Jonathan S


    Objective of EROS-Based Confined Capability Client Project is to demonstrate that systems constructed using capability-based protection can be organized in a way that makes it defensible from hostile internet content...

  11. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    Directory of Open Access Journals (Sweden)

    Hulshof Carel


    Full Text Available Abstract Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65% of all professional advice was not in line with the research literature. In 18 cases (24% professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17% than advice that had not mentioned the literature as a source (65% (difference 48%, 95% Confidence Interval from 27% to 69%. Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice.

  12. The good client: How architect-client dynamics mediate attention to users


    Van der Linden, Valerie; Dong, Hua; Heylighen, Ann


    Due to the increasing complexity of architectural practice, gaining insight into future users’ perspectives presents a particular challenge for architects. Architects’ main reference point to obtain information about users is often the client. Moreover, architects indicate that a ‘good’ client is key to the project’s success. Yet, architect-client relationships can be highly diverse, depending on the project type, procedure and phase. This paper sets out to study how different architect-clien...

  13. The Client's Perspective on Voluntary Stuttering. (United States)

    Byrd, Courtney T; Gkalitsiou, Zoi; Donaher, Joe; Stergiou, Erin


    Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering. The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use. A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment. To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.

  14. Depression: an emotional obstacle to seeking medical advice for infertility. (United States)

    Herbert, Danielle L; Lucke, Jayne C; Dobson, Annette J


    To investigate the mental and general health of infertile women who had not sought medical advice for their recognized infertility and were therefore not represented in clinical populations. Longitudinal cohort study. Population based. Participants in the Australian Longitudinal Study on Women's Health aged 28-33 years in 2006 who had ever tried to conceive or had been pregnant (n = 5,936). None. Infertility, not seeking medical advice. Compared with fertile women (n = 4,905), infertile women (n = 1,031) had higher odds of self-reported depression (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.01-1.43), endometriosis (5.43, 4.01-7.36), polycystic ovary syndrome (9.52, 7.30-12.41), irregular periods (1.99, 1.68-2.36), type II diabetes (4.70, 1.79-12.37), or gestational diabetes (1.66, 1.12-2.46). Compared with infertile women who sought medical advice (n = 728), those who had not sought medical advice (n = 303) had higher odds of self-reported depression (1.67, 1.18-2.37), other mental health problems (3.14, 1.14-8.64), urinary tract infections (1.67, 1.12-2.49), heavy periods (1.63, 1.16-2.29), or a cancer diagnosis (11.33, 2.57-49.89). Infertile women who had or had not sought medical advice had similar odds of reporting an anxiety disorder or anxiety-related symptoms. Women with self-reported depression were unlikely to have sought medical advice for infertility. Depression and depressive symptoms may be barriers to seeking medical advice for infertility. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

    Directory of Open Access Journals (Sweden)

    Vaccaro Joan A


    Full Text Available Abstract Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH] who participated in the National Health and Nutrition Examination Survey (NHANES 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical

  16. Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States. (United States)

    Vaccaro, Joan A; Feaster, Daniel J; Lobar, Sandra L; Baum, Marianna K; Magnus, Marcia; Huffman, Fatma G


    Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who

  17. Client Engagement Characteristics Associated with Problem Gambling Treatment Outcomes (United States)

    Dowling, Nicki A.; Cosic, Sanja


    Previous research examining the factors associated with problem gambling treatment outcomes has examined client factors and to date, treatment characteristics, therapist factors, and client-therapist interactions have essentially remained unexplored. This study aimed to investigate how client engagement variables (client-rated therapeutic…

  18. A Survey of Clients and Ethical Perspectives of Voluntary Tubal ...

    African Journals Online (AJOL)

    There was a statistically significant association between having a voluntary sterilization done on clients and having counseled client on benefits of the procedure (P - 0.01), having sterilization done based on both client and her husband's decision (P - 0.05), and clients voluntarily accepting sterilization (P - 0.02). Conclusion: ...

  19. The travel advice as an inhibiting factor of tourist movement

    Directory of Open Access Journals (Sweden)

    Mylonopoulos Dimitrios


    Full Text Available Tourism is significantly affected by unpredictable and uncertain factors such as the occurrence of a terrorist attack, an epidemic outbreak or a natural disaster, etc. The impact of these phenomena on the tourist movement of the country or the place where the event occurred is aggravated by the way it is presented by the media both locally and internationally. The adverse climate gets worse by the issuance of travel advice that usually accompanies such phenomena and has the effect of limiting or even halting tourist flows. In order to identify and study the different types of travel advice that have been issued during international tourism crisis incidents, an internet search was carried out using keywords. Moreover, a study on the travel advice issued by major tourists' origin states, as the USA, Australia, Canada, Germany, the United Kingdom, etc. was carried out. Incidents (terrorist attacks, epidemics, natural disasters which had a great impact on tourism were then selected. In addition, the issuance of travel advice, their different issuing authorities, the classification level and the impact on the tourism of the country or the place in question were examined. An analysis of the reaction and the instructions of major international organizations (World Health Organization, World Tourism Organization concerning the management of such crises, directly or indirectly affecting tourism, were also analyzed. The study of the relevant websites, the international literature and the recorded incidents shows that the issuing of travel advice has negative effects on many sectors of tourism activity and is a bottleneck for tourism development. In fact, in many cases, travel advice is used by countries to exert pressure on other countries in order to achieve a desired result. Due to the enormous economic and social effects when issuing travel advice, the states proper management is necessary in order to minimize the negative consequences and avoid

  20. Client satisfaction determinants in four Kenyan slums. (United States)

    Wambua, Jonesmus Mutua; Mbayaki, Regina; Munyao, Paul Musya; Kabue, Mark Mugo; Mulindi, Rose; Change, Patrick Mose; Ikamati, Rudia; Jahonga, Ruth; Ambalu, Rachel; Maranga, Wamae; Mudany, Mildred


    In Kenya, gaps exist in health service provision to slum residents, especially service availability and access to quality care. There is also little information on the health status of people living in slums other than in Nairobi. The purpose of this paper is to generate evidence for use in designing interventions to improve health services in four mid-sized slums in Embu, Nyeri and Thika, Kenya. A cross-sectional survey of clients receiving services in health facilities was conducted in the targeted slums. Data were collected through face-to-face interviews. Factor scores were generated using the Rasch model; simple and multivariate logistic regression analyses were done using the R statistical software. Overall, 81 per cent of the 203 participants reported being satisfied with health services. Most clients (89 per cent) reported that health facility staff greeted them warmly; 82 per cent said their consultation was private. The facility type, waiting time and client experience with service providers determined their satisfaction (pmodelling to compute client satisfaction scores, which were dichotomised into two categories and fitted into a logistic regression model to identify factors that influence client satisfaction. Health facility clients in the four slums are satisfied with services and have confidence the providers will serve them in a friendly and professional manner that promotes respect and quality care. The paper recommend healthcare managers in similar settings carry out client flow analysis and institute remedial measures to address long waiting times. Qualitative studies are recommended to determine the reasons behind the high satisfaction levels reported in this study.

  1. Young tertiary students and help-seeking for health advice. (United States)

    Batten, Lesley; Dutton, Jane


    Help-seeking is an active process used by people of all ages to obtain assistance to solve problems. This research sought to investigate a component of help-seeking related to health concerns. A health related help-seeking model, was adapted to frame questions for an anonymous, self-administered questionnaire. Seventy-five students aged between 16 and 24 years responded and data were analysed using content and descriptive statistical techniques. Findings indicated that young people perceived the need to seek advice when unwell, needing support or information, are resourceful, and were motivated to seek help from a variety of sources. Parents and whānau formed one usual source of advice, but young people reported one of the best sources of advice as General Practice nurses and doctors. Barriers to seeking advice included distrusting sources, and concerns about confidentiality. Unsurprisingly, many respondents used the Internet for health information, although some mistrusted that information. Nurses need to be aware of the sources of health advice and support that young people choose to use. Motivations for selecting services, providers, or sources clearly replicated what young people hold as important--sources with which they feel comfortable, have a relationship, trust, and which they perceived as maintaining confidentiality.

  2. The illusion of client-centred practice. (United States)

    Gupta, Jyothi; Taff, Steven D


    A critical analysis of occupational therapy practice in the corporate health care culture in a free market economy was undertaken to demonstrate incongruence with the profession's philosophical basis and espoused commitment to client-centred practice. The current practice of occupational therapy in the reimbursement-driven practice arena in the United States is incongruent with the profession's espoused philosophy and values of client-centred practice. Occupational therapy differentiates itself from medicine's expert model aimed at curing disease and remediating impairment, by its claim to client-centred practice focused on restoring health through occupational enablement. Practice focused on impairment and function is at odds with the profession's core tenet, occupation, and minimizes the lasting impact of interventions on health and well-being. The profession cannot unleash the therapeutic power of human occupation in settings where body systems and body functions are not occupation-ready at the requisite levels for occupational participation. Client-centred practice is best embodied by occupation-focused interventions in the natural environment of everyday living. Providing services that are impairment-focused in unfamiliar settings is not a good fit for client-centred practice, which is the unique, authentic, and sustainable orientation for the profession.


    Directory of Open Access Journals (Sweden)

    Mohammad Hefni


    Full Text Available Abstrac This article traces patron-client relationship of Madurese both from socio-historical point of view and its contemporary progress. As an imbalance social-exchange relationship, in terms of patron-client relationship, second side (client much highly depends upon the first side (patron. This had been experienced in Madurese social history during the native governmental period of time. The government was classified into two major classes; ruler class (patron and farmer class (client. The former is fully in authority to take control either economic or politic potencies, however, the later transacts labors to the first side. Both side is connected by a bribe (upeti systems—percaton, apanage and daleman. In current progress this relationship becomes more acquaintance, it covers economic and politic relationship. The success of Trunojoyo, the king of Sumenep's inherit, against the Mataram domination had been supported by Madurese people that had previously tightened to the system. Today,  patron-client relationship in Madura is reflected in the relationship between the head of village, as the owner of percaton,  and the staff as well as people, as the percaton manager. The other is well-described in the relationship of ship owner and pandega (fisher in fishing. Once the relationship is set up, it directs to diadik relation, a two in one relation which is more personal and long lasting one. Kata-kata kunci Patron-klien, percaton, apanage, panembahan, rakyat, daleman, kepala desa, juragan, pandega, dan diadik.

  4. Red meats: time for a paradigm shift in dietary advice. (United States)

    Binnie, Mary Ann; Barlow, Karine; Johnson, Valerie; Harrison, Carol


    Recent evidence suggests dietary advice to limit red meat is unnecessarily restrictive and may have unintended health consequences. As nutrient-rich high quality protein foods, red meats can play an important role in helping people meet their essential nutrient needs. Yet dietary advice to limit red meat remains standard in many developed countries, even though red meat intakes appear to be within current guidelines. Meanwhile, energy intakes from processed foods have increased dramatically at the expense of nutrient-rich foods, such as red meat. Research suggests these food trends are associated with the growing burden of obesity and associated diseases in recent decades. It is time for dietary advice that emphasizes the value of unprocessed red meat as part of a healthy balanced diet. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Board advice following publication of the 1990 Recommendations of ICRP

    CERN Document Server

    United Kingdom. At. Energy Res. Establ. Nat. Radiolog. Protect. Board. Harwell


    The International Commission on Radiological Protection (ICRP) has published new Recommendations and the board has a statutory duty to advise Government and those with responsibilities for radiation protection on the acceptability to and the applicability in the UK of those Recommendations. The Board wishes to consult widely before finalising the advice which is proposed in this document. In general, the Board endorses the conceptual framework for radiological protection recommended by ICRP. In particular, the distinction between practices and intervention is useful and is consistent with the way in which the Board has presented its recent advice. A major new concept is that of a constraint. The Board believes that the introduction of constraints provides a powerful method for improving protection against ionising radiation. The advice in this consultative document is for maximum generic values of dose constraints for both workers and the public. Finally the Board proposes to endorse the use of the radiologic...

  6. Board advice following publication of the 1990 Recommendations of ICRP

    International Nuclear Information System (INIS)


    The International Commission on Radiological Protection (ICRP) has published new Recommendations and the Board has a statutory duty to advise Government and those with responsibilities for radiation protection on the acceptability to and the applicability in the UK of those Recommendations. The Board wishes to consult widely before finalising the advice which is proposed in this document. In general, the Board endorses the conceptual framework for radiological protection recommended by ICRP. In particular, the distinction between practices and intervention is useful and is consistent with the way in which the Board has presented its recent advice. A major new concept is that of a constraint. The Board believes that the introduction of constraints provides a powerful method for improving protection against ionising radiation. The advice in this consultative document is for maximum generic values of dose constraints for both workers and the public. Finally the Board proposes to endorse the use of the radiological quantities recommended by ICRP. (author)

  7. Telematics-based online client-server/client collaborative environment for radiotherapy planning simulations. (United States)

    Kum, Oyeon


    Customized cancer radiation treatment planning for each patient is very useful for both a patient and a doctor because it provides the ability to deliver higher doses to a more accurately defined tumor and at the same time lower doses to organs at risk and normal tissues. This can be realized by building an accurate planning simulation system to provide better treatment strategies based on each patient's tomographic data such as CT, MRI, PET, or SPECT. In this study, we develop a real-time online client-server/client collaborative environment between the client (health care professionals or hospitals) and the server/client under a secure network using telematics (the integrated use of telecommunications and medical informatics). The implementation is based on a point-to-point communication scheme between client and server/client following the WYSIWIS (what you see is what I see) paradigm. After uploading the patient tomographic data, the client is able to collaborate with the server/client for treatment planning. Consequently, the level of health care services can be improved, specifically for small radiotherapy clinics in rural/remote-country areas that do not possess much experience or equipment such as a treatment planning simulator. The telematics service of the system can also be used to provide continued medical education in radiotherapy. Moreover, the system is easy to use. A client can use the system if s/he is familiar with the Windows(TM) operating system because it is designed and built based on a user-friendly concept. This system does not require the client to continue hardware and software maintenance and updates. These are performed automatically by the server.

  8. Communication management between architects and clients (United States)

    Taleb, Hala; Ismail, Syuhaida; Wahab, Mohammad Hussaini; Rani, Wan Nurul Mardiah Wan Mohd.


    Architectural projects are initiated with the designing phase, that tends to translate and materialize the client's requirements and needs. This phase is highly and directly affected by the exchanged information and communication between architects with their clients. Nevertheless, despite of its importance, studies have proven that communication management, being a significant field of project management, is distinctly overlooked by architects in the architectural industry. Thus, this paper highlights the current practices and attributes of communication management in the context of architectural design phase. It outlines the different aspects' definitions of communication, as well as communication management standards and practices. By the end of this paper, the findings are expected to increase the communication management knowledge amongst architects to achieve success in projects by promoting the relationships between them and their clients. Finally, this paper uncover the architects' need for significant improvement of communication management as an insistent matter to ultimately fulfill project success.

  9. Efficient Mobile Client Caching Supporting Transaction Semantics

    Directory of Open Access Journals (Sweden)

    IlYoung Chung


    Full Text Available In mobile client-server database systems, caching of frequently accessed data is an important technique that will reduce the contention on the narrow bandwidth wireless channel. As the server in mobile environments may not have any information about the state of its clients' cache(stateless server, using broadcasting approach to transmit the updated data lists to numerous concurrent mobile clients is an attractive approach. In this paper, a caching policy is proposed to maintain cache consistency for mobile computers. The proposed protocol adopts asynchronous(non-periodic broadcasting as the cache invalidation scheme, and supports transaction semantics in mobile environments. With the asynchronous broadcasting approach, the proposed protocol can improve the throughput by reducing the abortion of transactions with low communication costs. We study the performance of the protocol by means of simulation experiments.

  10. Outsource the Clients Management? A Study about the Impact of the Facilities Management Activity Outsourcing in the Satisfaction of Organizational Clients

    Directory of Open Access Journals (Sweden)

    Hellio Calian Martins


    Full Text Available Satisfaction is the subject of several studies because of the managerial implications related to customer loyalty and business sustainability. This study aims to assess the satisfaction of organizational clients of Shopping Centers (SC with the technical and environmental services that provide the necessary conditions for the retail practice denominated facilities management (FM. FM involves a wide range of services to retailers to ensure normal operation (HR and finance management, real estate and Legal advice, IT repairs .... The services can be managed and/or performed by internal or external staff. FM activities are quite subject to contractual and environmental problems. Although most of the time they are invisible to consumers attending the SC, when they are poorly performed, the effects can be devastating, causing dissatisfaction among consumers and retailers. Data collected at two big SC in Rio de Janeiro were statistically analyzed. Results show evidence that this management option has significant relevance in customer satisfaction and there is also evidence that the shopkeeper satisfaction is lower when the FM is outsourced. This work aims to contribute to retail management, specifically SC management, by analyzing the satisfaction of organizational clients with services of FM and may provide more information for better decision making.

  11. Managing Client Values in Construction Design

    DEFF Research Database (Denmark)

    Thyssen, Mikael Hygum; Emmitt, Stephen; Bonke, Sten


    In construction projects the client will comprise both owner, end-users, and the wider society, representatives of which may have conflicting goals and values; and these may not be fully realized by the stakeholders themselves. Therefore it is a great challenge to capture and manage the values....... The management challenge is further complicated by the fact that the delivery team, who are to understand and deliver client value, consists of even more different parties. To address this a Danish engineering consultancy company has, together with a major contractor, developed a value-based workshop method...

  12. Indoor Location Fingerprinting with Heterogeneous Clients

    DEFF Research Database (Denmark)

    Kjærgaard, Mikkel Baun


    Heterogeneous wireless clients measure signal strength differently. This is a fundamental problem for indoor location fingerprinting, and it has a high impact on the positioning accuracy. Mapping-based solutions have been presented that require manual and error-prone calibration for each new client....... This article presents hyperbolic location fingerprinting, which records fingerprints as signal strength ratios between pairs of base stations instead of absolute signal strength values. This article also presents an automatic mapping-based method that avoids calibration by learning from online measurements...

  13. Client-centred practice in occupational therapy: critical reflections. (United States)

    Hammell, Karen R Whalley


    The occupational therapy profession has long proclaimed its commitment to a client-centred philosophy of practice and the assumption that occupational therapists consistently practice in a client-centred manner has become central to the profession's self-image and public rhetoric. However, client-centred practice has been subjected to little critical reflection within the occupational therapy profession. The aim of this paper is to foster critical reflection concerning the authenticity and veracity of the profession's commitment to client-centred practices. Client-centred practice is defined without evident reference to clients' perspectives. Few occupational therapy researchers have sought clients' perceptions of the client-centred nature of their occupational therapy services. Occupational therapy research is neither consistently undertaken in a collaborative manner, nor are the profession's theories developed through explicit reference to a diversity of clients' perspectives. Professional practices and service evaluations do not consistently seek clients' viewpoints. Client-centred rhetoric is politically expedient and may be a professionalizing strategy employed to increase status and entrench power. Although exemplary client-centred occupational therapy practices exist, evidence suggests that the profession does not adhere consistently to its espoused client-centred principle in all its practices. The client-centred practice of occupational therapy should be subjected to assiduous critical reflection.

  14. Availability and provision of misoprostol and other medicines for menstrual regulation among pharmacies in Bangladesh via mystery client survey. (United States)

    Huda, Fauzia A; Ngo, Thoai D; Ahmed, Anisuddin; Alam, Anadil; Reichenbach, Laura


    To explore the availability and provision of misoprostol and other medicines for menstrual regulation (MR) among pharmacies in Bangladesh. Between March and November 2011, a cross-sectional study using mystery client visits was conducted among pharmacy workers in Dhaka and Gazipur Districts, Bangladesh. Mystery clients were trained to present 1 of 4 pre-developed situations to pharmacy workers to elicit information on the regimen, adverse effects, and complications of misoprostol use. Mystery clients visited 331 pharmacies. Among the 331 pharmacy workers, 45.8% offered the mystery clients misoprostol and/or other medicines for MR; 25.7% referred them to private clinics or hospitals. Only 7% recommended an effective regimen of misoprostol for MR; 65% suggested administering vaginal and oral misoprostol together. Overall, 72.4% did not provide any advice on complications; the remainder suggested visiting trained providers for complications. Counseling on excessive bleeding as a danger sign was provided by 46% of pharmacy workers. Most (94%) did not provide or refer for post-MR family planning. Pharmacy workers in urban Bangladesh are providing ineffective drugs and regimens for MR. A training package is needed to strengthen service delivery by providing accurate information, high-quality products, and referral mechanisms for women seeking MR through pharmacies. © 2013.

  15. Sexuality and Romance in Advice Books for the Elderly. (United States)

    Arluke, Arnold; And Others


    Analyzed 65 advice books for the elderly to assess their romantic and sexual content. Results indicated that sexual activity is encouraged now more than in the past for the elderly, suggesting a trend which stresses activity rather than disengagement. However, little support for remarriage and dating was found. (Author/JAC)

  16. Use and preference of advice on small children's food

    DEFF Research Database (Denmark)

    Nielsen, Annemette Ljungdalh; Krasnik, Allan; Vassard, Ditte


    with ethnic minority status were more likely to find the advice obtained in this way incompatible with their family eating habits. Although existing dietary health communication strategies delivered by public health nurses appear to work well in all household types, parents from minority households seem...

  17. Sense about Sex: Media, Sex Advice, Education and Learning (United States)

    Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin


    The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

  18. factors associated with discharge against medical advice among ...

    African Journals Online (AJOL)

    OBJECTIVE: the main objective of this study was to investigate factors associated with discharge against medical advice among patients ... current situation compared to other hospitals, UCTH receives the most ... Emilia James Oyira, Department of Nursing Science, University of Calabar, Calabar, Cross River State, Nigeria.

  19. Productive ward 2: practical advice to facilitators implementing the programme. (United States)

    Allsopp, Pete; Faruqi, Joe; Gascoigne, Laura; Tennyson, Rachel

    This is the second in a two-part series looking at the implementation of Productive Ward. Part one looked at roll-out of the initiative across a hospital This part offers advice to facilitators involved in implementing the programme.

  20. Advice for Writing a Thesis (Based on What Examiners Do) (United States)

    Golding, Clinton


    In the article, "What examiners do: What thesis students should know", we identified 11 things that thesis examiners do as they read and judge a thesis. But, we left a gap in the research: knowing this, What should thesis students do to write for their examiners? In this article, I fill the gap. The advice for thesis students is: first,…

  1. Advice to Graduate Students: From Application to Career. (United States)

    ADE Bulletin, 1998


    Offers advice to graduate students studying English and those studying foreign languages, covering issues relevant to candidates for master's degrees or doctorates. Suggests questions to ask when selecting a graduate program, including those related to investigating the program and inquiring about employment and financial assistance, teaching…

  2. Advice to White Allies: Insights from Faculty of Color (United States)

    Boutte, Gloria S.; Jackson, Tambra O.


    This article interweaves discussions of successes and tensions surrounding cross-racial collaborative social justice efforts in teacher education. It addresses frustrations that often occur for faculty of Color when working with White allies in P-12 settings and schools of education at Predominantly White Institutions. Advice is offered with the…

  3. Essay-Writing: Do Study Manuals Give Relevant Advice? (United States)

    Mahalski, Pauline A.


    A study of the writing of 28 geography students at Otago University (New Zealand) compared aspects of the essays with grading and rater comments. It is concluded that, although study manuals for essay-writing can help some students, their advice may not be useful to all; other methods may be more helpful. (Author/MSE)

  4. Web accessibility practical advice for the library and information professional

    CERN Document Server

    Craven, Jenny


    Offers an introduction to web accessibility and usability for information professionals, offering advice on the concerns relevant to library and information organizations. This book can be used as a resource for developing staff training and awareness activities. It will also be of value to website managers involved in web design and development.

  5. 75 FR 9360 - Investment Advice-Participants and Beneficiaries (United States)


    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 29 CFR 2550 RIN 1210-AB35 Investment... Security Act, and parallel provisions of the Internal Revenue Code of 1986, relating to the provision of investment advice to participants and beneficiaries in individual account plans, such as 401(k) plans, and...

  6. Personalized nutrition advice : an everyday-life perspective

    NARCIS (Netherlands)

    Bouwman, L.I.


    This thesis presents societal preconditions for Personalized Nutrition Advice (PNA) that result from an everyday-life perspective on this innovative approach. Generally, PNA is regarded as promising, because it provides users with highly specific information on individual health risks and benefits

  7. Discharge against medical advice: Ethico-legal implications from an ...

    African Journals Online (AJOL)

    Background. Discharge against medical advice (DAMA) is a problematic issue for physicians worldwide, which can disrupt the physicianpatient relationship, have adverse medical outcomes and increase healthcare costs. This review aims to highlight the ethical and legal aspects of the issue from the perspective of ...

  8. A Career Advice Helpline: A Case Study from South Africa (United States)

    Flederman, Patricia


    This case study presents the new career guidance helpline managed by the South African Qualifications Authority in South Africa, a middle-income country. The National Qualifications Framework and Career Advice Helpline represent a national equity-driven initiative using technology to expand access. The model has drawn on contemporary international…

  9. Factors associated with discharge against medical advice among ...

    African Journals Online (AJOL)

    Objective: the main objective of this study was to investigate factors associated with discharge against medical advice among patients in UCTH. To achieve the aim of this study, the following hypotheses were formulated to direct the study. There is no significant relationship between patients' factors associated with ...

  10. Discharge against medical advice (Dama) in children's ward the ...

    African Journals Online (AJOL)

    Background: Until recovery, discharge against medical advice (DAMA) is a rare thing that does happen when one is admitted in a Health facility, but these days it appears to be a common occurrence due to some factors. Objective: To evaluate the factors responsible for DAMA in children's ward of Amaku general hospital ...

  11. Advice on protection against ultraviolet radiation. Consultation document

    International Nuclear Information System (INIS)

    McKinlay, A.; Driscoll, C.; Meara, J.


    The National Radiological Protection Board (NRPB) has a statutory responsibility to provide advice and information on standards of protection for exposure to non-ionising radiation. This includes the health effects and hazards associated with exposure to ultraviolet radiation (UVR). The Board discharges its responsibility to review and summarise the relevant scientific evidence in part through its independent Advisory Group on Non-ionising Radiation (AGNIR) which has a remit: 'to review work on the biological effects of non-ionising radiation relevant to human health and to advise on research priorities'. In its seventh report AGNIR (2002) updated its previous review of the health effects of exposure to UVR (AGNIR, 1995) and provided general guidance on methods of protection against exposure. In this consultation document, NRPB gives advice on limiting exposure to UVR. Both quantitative limits on exposure that will prevent short-term adverse effects on health and cautionary measures to reduce exposure and the risk of long-term adverse effects are provided. It also presents practical guidance on protection against UVR exposure from the sun and from artificial sources and aims to increase awareness of these effects. This advice applies to members of the public and to those who are occupationally exposed. This advice does not apply to exposures arising as a result of diagnostic or treatment procedures carried out under the supervision of a qualified medical practitioner. (author)

  12. Lebanese medical students' intention to deliver smoking cessation advice. (United States)

    Jradi, Hoda; Wewers, Mary Ellen; Pirie, Phyllis P; Binkley, Philip F; Ferketich, Amy K


    Objectives of this study were to examine the constructs of the Theory of Planned Behavior and determine how they predict Lebanese medical students' behavioral intention to advise patients to quit smoking. This was a cross-sectional study conducted among 191 medical students from six medical schools in Lebanon. The instrument contained scales that measured attitudes toward the behavior, behavioral beliefs, subjective norms, and perceived behavioral control. Psychometric properties of the scale were examined. Item to total scale score correlations were determined and linear regression was conducted to predict the intention to advise smokers to quit. Respondents had a positive, but not very high, intention to deliver smoking cessation advice. Students reported a positive attitude toward advising patients to quit cigarette smoking and a strong belief in the physician's obligations in smoking cessation advising. The majority reported lack of time to provide smoking cessation advice, insufficient knowledge of pharmacological aids, and the lack of openness of the patient to receive the advice. The attitude scale was the only variable that yielded a significant prediction of the intended behavior. The construct of attitude toward the behavior appeared to be the most predictive of the intention to deliver advice to quit smoking among Lebanese medical students. Focusing training efforts on this construct could improve the rate of delivery of brief cessation counseling. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  13. Client/Server Architecture Promises Radical Changes. (United States)

    Freeman, Grey; York, Jerry


    This article discusses the emergence of the client/server paradigm for the delivery of computer applications, its emergence in response to the proliferation of microcomputers and local area networks, the applicability of the model in academic institutions, and its implications for college campus information technology organizations. (Author/DB)

  14. Considering Thin Client Computing for Higher Education. (United States)

    Sheehan, Mark


    In response to concerns about the cost of keeping up with individual desktop computing technology, several new solutions have emerged. Referred to as "thin clients," or network-centric computers, they include two types of desktop device: the network computer and the Windows terminal. Purchase cost, life span, support costs, and overall total cost…

  15. Client/server power attracts healthcare markets. (United States)

    Kellerhals, S; Wheeler, M F; Dunbar, C; Lee, S


    Client/server architecture has become the darling of I/S professionals. The intelligence is spread among several processors, creating enormous flexibility. But are C/S systems easier, cheaper and faster than the good old mainframe? Not quite yet.

  16. Selling Energy Design to the Client (United States)

    Kays, Von


    The architect, as a trained, experienced professional, must galvanize others, persuading them of the ultimate importance of reducing energy consumption. The interview process, the actual contract, and writing of the program are phases during which the architect can begin to engender in the client a high priority valuation of energy. (Author/MLF)

  17. Architect-School Client Conflicts: Project Construction. (United States)

    Day, C. William


    Five major sources of construction disputes between architects and school clients are (1) errors, defects, or omissions in the contract documents; (2) cost-related problems; (3) changed conditions; (4) consumer reaction; and (5) interpersonal relationships. A clear understanding of each party's role is necessary to eliminate these conflicts. (MLF)

  18. Maximizing Vocational Opportunities for Handicapped Clients. (United States)

    Dahl, Peter R.


    Systematically identifies: (1) occupations across the broad employment spectrum in which severely handicapped persons are employed; (2) services available to handicapped persons through a variety of agencies; and (3) major classes of barriers to employment and means for overcoming them. Offers suggestions for counselors assisting disabled clients.…

  19. Prediagnostic Commentary in Veterinarian-Client Interaction. (United States)

    Stivers, Tanya


    A study investigated the form of diagnostic talk occurring between veterinarian and client before or during the physical examination and before the clinical diagnosis. Data are from six cases from a corpus of veterinary consultations. Analysis focuses on use of qualifiers, hedges, and evidential mitigators in communicating both good news and bad…

  20. Three-Dimensional Audio Client Library (United States)

    Rizzi, Stephen A.


    The Three-Dimensional Audio Client Library (3DAudio library) is a group of software routines written to facilitate development of both stand-alone (audio only) and immersive virtual-reality application programs that utilize three-dimensional audio displays. The library is intended to enable the development of three-dimensional audio client application programs by use of a code base common to multiple audio server computers. The 3DAudio library calls vendor-specific audio client libraries and currently supports the AuSIM Gold-Server and Lake Huron audio servers. 3DAudio library routines contain common functions for (1) initiation and termination of a client/audio server session, (2) configuration-file input, (3) positioning functions, (4) coordinate transformations, (5) audio transport functions, (6) rendering functions, (7) debugging functions, and (8) event-list-sequencing functions. The 3DAudio software is written in the C++ programming language and currently operates under the Linux, IRIX, and Windows operating systems.

  1. Enhancing Student Learning through Scaffolded Client Projects (United States)

    Tomlinson, Elizabeth


    This article reports on the current status of client projects (CPs) in business communication courses, provides a scaffolded model for implementing CP, and assesses student learning in CPs. Using a longitudinal mixed method research design, survey data and qualitative materials from six semesters are presented. The instructor survey indicated need…

  2. Smoking cessation advice for people with serious mental illness. (United States)

    Khanna, Priya; Clifton, Andrew V; Banks, David; Tosh, Graeme E


    People with a serious mental illness are more likely to smoke more and to be more dependent smokers than the general population. This may be due to a wide range of factors that could include a common aetiology to both smoking and the illness, self medication, smoking to alleviate adverse effects of medications, boredom in the existing environment, or a combination of these factors. It is important to undertake this review to facilitate improvements in both the health and safety of people with serious mental illness who smoke, and to reduce the overall burden of costs (both financial and health) to the smoker and, eventually, to the taxpayer. To review the effects of smoking cessation advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group Specialized Trials Register up to 2 April 2015, which is based on regular searches of CENTRAL, BIOSIS, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and trial registries. We also undertook unsystematic searches of a sample of the component databases (BNI, CINHAL, EMBASE, MEDLINE, and PsycINFO), up to 2 April 2015, and searched references of all identified studies We planned to include all randomised controlled trials (RCTs) that focussed on smoking cessation advice versus standard care or comparing smoking cessation advice with other more focussed methods of delivering care or information. The review authors (PK, AC, and DB) independently screened search results but did not identify any trials that fulfilled the inclusion criteria of this review. We did not identify any RCTs that evaluated advice regarding smoking cessation for people with serious mental illness. The excluded studies illustrate that randomisation of packages of care relevant to smokers with serious mental illness is possible. People with serious mental illness are more likely to smoke than the general population. Yet we could not find any high quality evidence to guide the smoking cessation advice healthcare professionals pass onto

  3. Dietary advice on prescription: experiences with a weight reduction programme. (United States)

    Bräutigam-Ewe, Marie; Lydell, Marie; Månsson, Jörgen; Johansson, Gunnar; Hildingh, Cathrine


    To describe overweight persons' experiences with weight reduction and participation in the dietary advice on prescription. Approximately 20% of overweight individuals are able to successfully lose weight. Experiences from earlier weight reduction programmes indicate that those who succeed typically manage to avoid overeating to handle stress and have high motivation to lose weight. Those who fail have low self-control and engage in negative health behaviours such as eating when experiencing negative emotions and stress. The study used a descriptive qualitative design and was conducted at a Primary Health Care Centre in south-west Sweden. The first nineteen study participants who completed the weight reduction programme in two years responded in writing to five open questions about their experiences with the programme. Data were analysed using inductive content analysis. The participants appreciated the face-to-face meetings with the nurse because they felt seen and listened to during these sessions. They also felt their life situations and self-discipline had an impact on how well they were able to follow the programme. Dietary advice on prescription advice was considered to be helpful for achieving behavioural changes and losing weight. People who succeeded in sustainably losing weight described the importance of support from partners or close friends. To achieve sustainable weight reduction, it is important to individualise the programme in order to address each person's life situation and the unique difficulties they may encounter. Motivational interviewing appears to be a good technique for developing a successful relationship between the nurse and the patient. The dietary advice on prescription advice was perceived to be a good way to improve food habits and can easily be used at many Primary Health Care Centres. Patient's partners should also be offered the opportunity to participate in the programme. © 2016 John Wiley & Sons Ltd.

  4. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice. (United States)

    Kanji, Noureen; Coe, Jason B; Adams, Cindy L; Shaw, Jane R


    To explore the relationship between veterinarian-client-patient interactions and client adherence to dental and surgery recommendations and to test the a priori hypotheses that appointment-specific client satisfaction and relationship-centered care are positively associated with client adherence. Cross-sectional study. A subsample of 19 companion-animal veterinarians and 83 clients from a larger observational study consisting of 20 randomly recruited veterinarians and a convenience sample of 350 clients from eastern Ontario. Videotaped veterinarian-client-patient interactions containing a dentistry recommendation, surgery recommendation, or both were selected for inclusion from the larger sample of interactions coded with the Roter interaction analysis system. Client adherence was measured by evaluating each patient's medical record approximately 6 months after the videotaped interaction. The clarity of the recommendation, appointment-specific client-satisfaction score, and relationship-centered care score were compared between adhering and nonadhering clients. Among the 83 veterinarian-client-patient interactions, 25 (30%) clients adhered to a dentistry recommendation, surgery recommendation, or both. The odds for adherence were 7 times as great for clients who received a clear recommendation, compared with clients who received an ambiguous recommendation from their veterinarian. Moreover, adhering clients were significantly more satisfied as measured after the interview. Interactions resulting in client adherence also had higher scores for relationship-centered care than did interactions leading to nonadherence. Veterinarian use of a relationship-centered care approach, characterized as a collaborative partnership between a veterinarian and a client with provision of clear recommendations and effective communication of the rationale for the recommendations, has positive implications for client adherence.

  5. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    NARCIS (Netherlands)

    Schaafsma, Frederieke; Verbeek, Jos; Hulshof, Carel; van Dijk, Frank


    Background: Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based

  6. Multiprofessional collaboration promoting home care clients' personal resources: perspectives of older clients. (United States)

    Eloranta, Sini; Arve, Seija; Routasalo, Pirkko


    Home care can be decisive in supporting older people in the home environment. However, one professional in home care cannot take the whole responsibility for promotion alone; on the contrary multiprofessional collaboration is needed. The aim of the study is to describe the experiences of multiprofessional collaboration in promoting personal resources among older home care clients (75+ years) in Finland. The data were collected by unstructured interviews with 21 older home care clients. Their mean age was 83.5 years, ranging from 75 to 91, with 17 female and four male participants. Inductive content analysis was used to analyze the data. The interviewees described the work of professionals from four perspectives: expertise, communication, decision-making and responsibility. Multiprofessional collaboration promoted the personal resources of interviewees with physical, psychological and social support. This study showed that the professionals worked as being expert-oriented: in the multiprofessional collaboration, each expert took care of his/her own part of the client's situation. This included the risk,, that the client's overall situations remained uncharted. However, the client's overall situation is a very important aspect when professionals suppport older people living in their own homes as long as possible. This study revealed the need for developing collaboration skills between social and health care professionals so that the staffs serve the needs of aged clients better together. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

  7. Asymmetry of Responsiveness in Client-Centered Therapy (United States)

    Shapiro, David A.


    Each utterance of a psychotherapy session conducted by Carl Rogers was transcribed on a separate card. Fifteen undergraduate subjects reconstituted client-therapist sequences more accurately than therapist-client sequences. (Author)

  8. 49 CFR 1103.23 - Confidences of a client. (United States)


    ... the disclosure or use of a client's confidences without knowledge and consent of the client even... when he discovers that this obligation presents a conflict in his duty between the former and the new...

  9. Gender Dysphoria: The Therapist's Dilemma--The Client's Choice. (United States)

    Sherebrin, Hannah


    Therapist's role and dilemmas faced in treating a gender dysphoric client are discussed. Examines ethical and moral issues relating to transsexualism and discusses the appropriateness of art therapy as a treatment for transsexual clients. (SNR)

  10. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice. (United States)

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L


    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  11. Evaluating the effectiveness of a healthy lifestyle clinician in addressing the chronic disease risk behaviours of community mental health clients: study protocol for a randomised controlled trial. (United States)

    Fehily, Caitlin; Bartlem, Kate; Wiggers, John; Wye, Paula; Clancy, Richard; Castle, David; Wutzke, Sonia; Rissel, Chris; Wilson, Andrew; McCombie, Paul; Murphy, Fionna; Bowman, Jenny


    People with a mental illness experience a greater morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of modifiable health risk behaviours such as smoking, poor nutrition, physical inactivity and harmful alcohol consumption contribute substantially to this disparity. Despite clinical practice guidelines recommending that mental health services routinely provide care to address these risk behaviours, the provision of such care is consistently reported to be low internationally and in Australia. This protocol describes a randomised controlled trial that aims to assess the effectiveness of allocating a clinician within a community mental health service to the specific role of providing assessment, advice and referral for clients' chronic disease risk behaviours. Approximately 540 clients of one community mental health service will be randomised to receive either usual care for chronic disease risks provided in routine consultations or usual care plus an additional face-to-face consultation and follow-up telephone call with a 'healthy lifestyle clinician'. The clinician will assess clients' chronic disease risk behaviours, provide advice to change behaviours, and refer at-risk clients to free telephone coaching services (New South Wales (NSW) Quitline and NSW Get Healthy Information and Coaching Service) for specialist behaviour change care. The primary outcomes, regarding referral to and client uptake of the telephone services, will be obtained from the respective services. Telephone interviews of clients at baseline and at 1 and 6 months post baseline follow-ups will assess secondary outcomes: receipt of any assessment, advice and referral from the mental health service; satisfaction with the receipt of such care; satisfaction with the receipt of any care provided by the telephone services; interest and confidence in and perceived importance of changing risk behaviours; and risk behaviour status. This study will add

  12. 32 CFR 776.4 - Attorney-client relationships. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Attorney-client relationships. 776.4 Section 776... General § 776.4 Attorney-client relationships. (a) The executive agency to which assigned (DON in most... will not establish attorney-client relationships with any individual unless detailed, assigned, or...

  13. Can Knowledge of Client Birth Order Bias Clinical Judgment? (United States)

    Stewart, Allan E.


    Clinicians (N = 308) responded to identical counseling vignettes of a male client that differed only in the client's stated birth order. Clinicians developed different impressions about the client and his family experiences that corresponded with the prototypical descriptions of persons from 1 of 4 birth orders (i.e., first, middle, youngest, and…

  14. Clients' knowledge, perception and satisfaction with quality of ...

    African Journals Online (AJOL)

    Clients' knowledge, perception and satisfaction with quality of maternal health care services at the primary health care level in Nnewi, Nigeria. ... Furthermore cost, local language used, staff attitude and interaction with clients was acceptable and may be the reason for high level of satisfaction reported. Key words: Clients' ...

  15. Involvement of the Client in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Kjær, Lone; Præstegaard, Jeanette

    Background: Through the last 35 years, ‘client involvement’ has been a mantra within health policies, education curriculums and health care institutions, yet very little is known about how ‘client involvement’ is practiced in the meetings with clients and health professionals. Aim: To analyse...

  16. What Business Students Should Know about Attorney-Client Privilege (United States)

    Draba, Robert; Marshall, Brent


    The case law on attorney-client privilege is extensive and can be somewhat complex. Over seven hundred articles in Westlaw, for example, have the phrase "attorney-client privilege" in the title; in the last three years alone, there have been over 3700 federal cases in which the phrase "attorney-client privilege" appears at least once. However,…

  17. 32 CFR 776.33 - Client under a disability. (United States)


    ... 32 National Defense 5 2010-07-01 2010-07-01 false Client under a disability. 776.33 Section 776.33... of Professional Conduct § 776.33 Client under a disability. (a) Client under a disability: (1) When a... impaired, whether because of minority, mental disability, or for some other reason, the covered attorney...

  18. Laser Surgeon, Client Education, and Satisfaction with Tattoo Removal

    DEFF Research Database (Denmark)

    Hutton Carlsen, Katrina; Esmann, Jørgen; Serup, Jørgen


    Studies of satisfaction with tattoo removal outcomes by laser, rated by clients themselves, including qualitative aspects, are sparse. We studied long-term results and client satisfaction with tattoo removal by Q-switched YAG laser. Client satisfaction is influenced by numerous factors...

  19. Corruption of Client Advocacy in a Community Mental Health System. (United States)

    Denner, Bruce

    This speech discusses client advocacy, a paraprofessional service offered in many community mental health centers to help bridge the gap between therapist and client. While having an advocate on the mental health team is an attractive idea, these client advocates are quite susceptible to "corruption." The author discusses two major causes of this…

  20. Efficient Client Puzzle Schemes to Mitigate DoS Attacks

    NARCIS (Netherlands)

    Tang, Qiang; Jeckmans, Arjan


    A (computational) client puzzle scheme enables a client to prove to a server that a certain amount of computing resources (CPU cycles and/or Memory look-ups) has been dedicated to solve a puzzle. In a number of different scenarios, researchers have applied client puzzle schemes to mitigate DoS

  1. Client Retention in Residential Drug Treatment for Latinos (United States)

    Amodeo, Maryann; Chassler, Deborah; Oettinger, Catherine; Labiosa, Wilfred; Lundgren, Lena M.


    Client drop out from treatment is of great concern to the substance abuse field. Completion rates across modalities vary from low to moderate, not ideal since length of stay has been positively and consistently associated with better client outcomes. The study explored whether client characteristics shown to be related to retention were associated…

  2. No Effect of Writing Advice on Reading Comprehension

    DEFF Research Database (Denmark)

    Balling, Laura Winther


    This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences...... instead of nominalizations. These recommended and problem constructions and two other contrasts were investigated in an eye-tracking experiment where 27 students read four authentic texts where the target constructions had been manipulated. A mixed-effects regression analysis showed no difference between...... recommended and problem constructions, while several control variables were significant. This result indicates that the linguistic manipulations are not in themselves crucial to text comprehension, and it is hypothesized that the central aspect for text comprehension is how the linguistic manipulations...

  3. Nutritional advice for community patients: insights from a panel discussion. (United States)

    Thomas, Linda V; Jenkins, Gill; Belton, Julie; Clements, Suzie; Jacob, Ciara; Johnson, Naomi; Joy, Deirdre; Low, Jennifer; Munson, Eileen; Sheppard, Jessica


    This article describes the conclusions of an expert panel that discussed four case studies; these were examples of patients typically encountered by nurses working in the community. The panel considered the nutritional and lifestyle advice that could be given by nurses relating to conditions such as irritable bowel syndrome (IBS), depression, chronic fatigue syndrome, vulnerability to common infections, elderly care, recurrent urinary tract infection, antibiotic use, and risk of type 2 diabetes. A general conclusion was the importance of motivational interviewing techniques in achieving full understanding of patients' concerns and to determine the best health strategy. As well as specific guidance appropriate for each disorder, a range of information sources for both health professionals and patients are listed in the paper. The panel noted that, although general nutritional advice can be given by nurses working at GP surgeries and in the community, patients should always be referred to registered dietitians or nutritionists if significant dietary changes are considered.

  4. Nutrigenomics-based personalised nutritional advice: in search of a business model?

    NARCIS (Netherlands)

    Ronteltap, A.; Trijp, van J.C.M.; Berezowska, A.; Goossens, Jo


    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts

  5. Advice on the accelerated market implementation of advanced biofuels

    International Nuclear Information System (INIS)


    The Platform for Sustainable Mobility aims to promote the accelerated market introduction of more sustainable motor fuels and vehicle technology. The Platform distinguishes four transition paths: hybridization of the fleet of cars; implementation of biofuels; hydrogen-fuelled driving (driving on natural gas and biogas); intelligent transport systems (ITS). This advice involves part of the transition path for the implementation of biofuels, i.e. accelerated market introduction of advances biofuels. [mk] [nl

  6. Millennials at Work: The Advice of Great Leaders (United States)


    on leadership will “bring out the best” from the millennial generation and benefit every generation. Millennials are fluent in technology , possess... Millennials at Work The Advice of Great Leaders Carol Axten Axten has more than 30 years of experience in Defense Department engineering, program...million members of the millennial generation will enter the workforce and by 2030 will make up 75 percent of all working professionals. As managers in the

  7. Getting started on your research: practical advice for medical educators. (United States)

    Markert, Ronald J


    Guidance and mentorship benefit faculty who having little or no background conducting research in medical education. From his experience the author suggests three characteristics that distinguish medical educators who are especially productive in their scholarly activities: intrinsic rather than extrinsic motivation, collaboration with colleagues, and the personal qualities of patience and organization. He then expands on these characteristics by offering practical advice in the form of eight tips for faculty seeking to acquire or improve their medical education research skills.

  8. Do British travel agents provide adequate health advice for travellers? (United States)

    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D


    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised.

  9. Do British travel agents provide adequate health advice for travellers?


    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D


    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised.

  10. Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions.


    Dickson, Jane; Hoggart, Lesley; Newton, Victoria Louise


    A common problem with etonogestrel contraceptive implants is irregular bleeding, for which women are often unprepared despite adequate pre-insertion advice. Dickson et al.’s commentary is a useful summary of management options. It will refresh readers’ ability to deal with this problem and it's a reminder to avoid ‘watchful waiting’, which risks women losing confidence in this highly effective contraceptive method.

  11. Advice from creative consumers: a study of online hotel reviews


    Lee, LW


    This study explores what creative consumers are compelled to say about hotels through online reviews. Online reviews are highly influential, with consumers preferring the advice of other consumers over industry experts or information provided by the marketer. Over 7,000 online hotel reviews posted on TripAdvisor were examined, using Leximancer, a content analysis tool. This study provides insights on the factors contributing to guest satisfaction and dissatisfaction in luxury hotels and moder...

  12. Attending physician and patient in radiotherapeutic treatment: practical advices

    International Nuclear Information System (INIS)


    This brochure is devoted to external radiotherapy and provides some pieces of practical advices for each stage of the patient's treatment: before, during and after radiotherapy. The monitoring and management of short-, medium- and long-term side-effects represent a major stake. Such side-effects and their treatments are presented in tables for each affected part of the body or affected organ. (J.S.)

  13. Nurses' perceptions of providing advice via a telephone care line. (United States)

    Ström, Mayvor; Marklund, Bertil; Hildingh, Cathrine

    The provision of advice over the telephone in the health service has become more common in the Western world and in Sweden this task is allocated to nurses. There are several million calls a year to the medical care telephone helpline. Nurses answer the calls, provide advice and direct the flow of patients to the most appropriate treatment level. The aim of this study was to describe how nurses perceive their job of providing telephone advice to patients. Interviews with 12 nurses were analyzed using a phenomenographic approach. The nurses perceived their work as stimulating, autonomous and challenging. They also felt exposed because extensive knowledge is required and there is a risk of being criticized, as they are in a front-line position. Nurses who are responsive, determined and not anxious about their prestige can carry out the work well, provided they have a good level of self-awareness. Personal qualities and the confidence of superiors make even an exposed position with considerable requirements manageable.

  14. Against professional advice: treatment attrition among pregnant methamphetamine users

    Directory of Open Access Journals (Sweden)

    Terplan M


    Full Text Available Brianna Lindsay1, Jennifer Albrecht1, Mishka Terplan1,21Department of Epidemiology and Public Health, University of Maryland, 2Department of Obstetrics, Gynecology, and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Pregnant methamphetamine users who leave substance use treatment against professional advice may be at risk of poorer health outcomes. To examine the hypothesis that methamphetamine use during pregnancy may be associated with leaving substance use treatment against professional advice, the 2006 Treatment Episode Data Set was analyzed. A logistic regression adjusting for age, race, service setting, prior substance abuse treatment, criminal justice referral, and education was conducted. Inclusion criteria were met by 18,688 pregnant admissions; 26.4% identified methamphetamines as their primary substance of use. Frequency of use was identified as an effect modifier, therefore results were stratified by less than weekly use and weekly or more use. Methamphetamine use was significantly associated with leaving treatment against professional advice regardless of usage level. However, the odds of leaving treatment were greater among women using methamphetamine less than weekly. Further investigation into this association may be warranted due to the complications that may result from methamphetamine use during pregnancy.Keywords: pregnancy, methamphetamines, treatment, attrition

  15. Diversity in action: Interpersonal networks and the distribution of advice. (United States)

    Vargas, Nicholas; Schafer, Markus H


    Does diversity beget the active dissemination of social support in the form of advice to others? Previous research by Robert Putnam suggests that individuals in compositionally diverse geographical areas become closed off from their social ties and less trusting of others, which are both antithetical to social support exchange. We argue, however, that studies of compositional diversity are ill-suited to reflect diversity as it is actually lived and experienced in social life. Drawing from the first nationally representative study with comprehensive indicators of interactional diversity in social life, we analyze self-reports of advice-giving across a variety of social roles. Results of regression analysis are consistent: greater interactional diversity is positively associated with advice-giving, whether the target is stranger, neighbor, close friend, or family member. These findings hold independent of important covariates such as reciprocity, sociability, and homophily. This research contributes to a growing literature set on identifying the unanticipated benefits of diversity in modern society. In sum, we call future research to consider not only diversity in structure, but also diversity in action. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Reinforcement learning agents providing advice in complex video games (United States)

    Taylor, Matthew E.; Carboni, Nicholas; Fachantidis, Anestis; Vlahavas, Ioannis; Torrey, Lisa


    This article introduces a teacher-student framework for reinforcement learning, synthesising and extending material that appeared in conference proceedings [Torrey, L., & Taylor, M. E. (2013)]. Teaching on a budget: Agents advising agents in reinforcement learning. {Proceedings of the international conference on autonomous agents and multiagent systems}] and in a non-archival workshop paper [Carboni, N., &Taylor, M. E. (2013, May)]. Preliminary results for 1 vs. 1 tactics in StarCraft. {Proceedings of the adaptive and learning agents workshop (at AAMAS-13)}]. In this framework, a teacher agent instructs a student agent by suggesting actions the student should take as it learns. However, the teacher may only give such advice a limited number of times. We present several novel algorithms that teachers can use to budget their advice effectively, and we evaluate them in two complex video games: StarCraft and Pac-Man. Our results show that the same amount of advice, given at different moments, can have different effects on student learning, and that teachers can significantly affect student learning even when students use different learning methods and state representations.

  17. Potential Clients' View of Language in Therapy


    Hendrick, Stefani P.


    Potential Clients' View of Language in Therapy Stefani P. Hendrick (ABSTRACT) This study compares the counselor credibility of therapists who use problem-focused with those who use solution-focused language. Participants from two undergraduate classes at a southeastern state university were assigned to one of two eight-minute videotapes of a role-played family therapy session: problem-focused or solution-focused. This study is a posttest only quasi-experimental design. On...


    Directory of Open Access Journals (Sweden)

    Ângela Cristina Bueno Vieira


    Full Text Available Em nossa vivência e atuação na Clínica Médica do Hospital das Clínicas da Universidade Federal de Goiás (HC/UFG, observamos que apesar da maioria dos pacientes internados receberem orientação sobre sua patologia, geralmente não cumprem as orientações realizadas pela equipe multidisciplinar. Para a promoção contínua do autocuidado, foi implantado o projeto de extensão “Cliente Cidadão”, com intuito de contribuir no resgate da cidadania do paciente, orientando e reforçando seus direitos e deveres enquanto portador de uma patologia. Relato de experiência discutido por meio de uma abordagem qualitativa junto a um grupo de pacientes internados na Clínica Médica do HC/UFG que deambulam, seus familiares e os que participaram do projeto Cliente Cidadão durante sua internação no ano de 2003. Nos encontros realizados foram ministradas palestras, oficinas e grupos de vivência por uma equipe multiprofissional e coordenados por uma enfermeira. Os assuntos foram diversos, abordando algumas patologias e seus cuidados, assistência espiritual e social. A participação do cliente na sua recuperação é de extrema importância e, para que isso ocorra, é necessária a educação em saúde compreendida em sua forma ampliada, reconhecendoa realidade do cliente, do seu dia a dia, proporcionando mecanismos para torna-lo sujeito ativo e com autonomia para agir em prol da sua saúde.

  19. Client-side Skype forensics: an overview (United States)

    Meißner, Tina; Kröger, Knut; Creutzburg, Reiner


    IT security and computer forensics are important components in the information technology. In the present study, a client-side Skype forensics is performed. It is designed to explain which kind of user data are stored on a computer and which tools allow the extraction of those data for a forensic investigation. There are described both methods - a manual analysis and an analysis with (mainly) open source tools, respectively.

  20. Implementing a secure client/server application

    Energy Technology Data Exchange (ETDEWEB)

    Kissinger, B.A.


    There is an increasing rise in attacks and security breaches on computer systems. Particularly vulnerable are systems that exchange user names and passwords directly across a network without encryption. These kinds of systems include many commercial-off-the-shelf client/server applications. A secure technique for authenticating computer users and transmitting passwords through the use of a trusted {open_quotes}broker{close_quotes} and public/private keys is described in this paper.

  1. Perceptions towards IT Security in Online Banking: Croatian Clients vs. Clients of Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Nedim Makarevic


    Full Text Available This study has been completed with a purpose to analyze and compare perceptions of clients of Bosnia and Herzegovina and those of Croatian clients about IT security in online banking, to provide insight into similarities and differences of their view points and to create important set of information for all subjects active in banking industry. Once the survey based on six variables and specific questions assigned to each one of those variables was prepared, results regarding both countries were collected and concluded. Survey was completed in both Bosnia and Herzegovina and Croatia at high response rates. Even 207 respondents replied from Bosnia and Herzegovina, while 203 respondents completed survey from Croatia. Results were analyzed and presented using descriptive statistics. Results indicated that Croatian e-banking users trust to banks when it comes to IT security of online banking much more compared to clients of Bosnia and Herzegovina. It is important to mention that clients of Croatia perceive tangible features as highly significant while Bosnian clients do not perceive tangible features that much important. This proved that Croatian clients are aware of potential security threats and they know their part of responsibility when it comes to handling money online. On the other hand, results from Bosnia and Herzegovina indicated that Bosnian clients have lack of trust in online banking, and lack of awareness about personal tangible aspects that can improve security of personal online banking experience. The main limitation of this study is relatively small sample and too generic approach. Therefore, this study may be perceived as a pilot study for future researchers. The study’s results may be of interest to marketers and managers of banks operating in Bosnia and Herzegovina and Croatia to learn more about their clients’ perceptions towards their e-banking services.

  2. Hsp90: Friends, clients and natural foes. (United States)

    Verma, Sharad; Goyal, Sukriti; Jamal, Salma; Singh, Aditi; Grover, Abhinav


    Hsp90, a homodimeric ATPase, is responsible for the correct folding of a number of newly synthesized polypeptides in addition to the correct folding of denatured/misfolded client proteins. It requires several co-chaperones and other partner proteins for chaperone activity. Due to the involvement of Hsp90-dependent client proteins in a variety of oncogenic signaling pathways, Hsp90 inhibition has emerged as one of the leading strategies for anticancer chemotherapeutics. Most of Hsp90 inhibitors blocks the N terminal ATP binding pocket and prevents the conformational changes which are essential for the loading of co-chaperones and client proteins. Several other inhibitors have also been reported which disrupt chaperone cycle in ways other than binding to N terminal ATP binding pocket. The Hsp90 inhibition is associated with heat shock response, mediated by HSF-1, to overcome the loss of Hsp90 and sustain cell survival. This review is an attempt to give an over view of all the important players of chaperone cycle. Copyright © 2016 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  3. The Effects of Psychotherapist's and Clients' Interpersonal Behaviors during a First Simulated Session: A Lab Study Investigating Client Satisfaction

    Directory of Open Access Journals (Sweden)

    François Moors


    Full Text Available The purpose of this study was to examine the effects of psychotherapists' behaviors during a first simulated therapy session on clients' satisfaction, including their intention to pursue or drop out from therapy. The importance of psychotherapists' warmth on clients' satisfaction was examined to check previous findings stressing this determining factor. Examining the role of warm behaviors is however insufficient according to the interpersonal perspective. We therefore tested the role of the psychotherapist's agentic behaviors since only a few studies provide contradictory results about the role of this interpersonal dimension on clients' satisfaction and how it is influenced by matching up client and therapist's profiles. To test our hypotheses and control for alternative therapy-related explanatory variables, we used different videos as experimental conditions manipulating the therapist's behaviors. Seventy-five participants had to imagine themselves as potential clients arriving for a first therapy session. They successively watched a role-playing therapist behaving according to five randomized interpersonal profiles. Results confirmed that warmth was a major dimension predicting client satisfaction. They revealed that agency was also a determinant of client satisfaction and that its effects depended on the client's own interpersonal agentic profile. Dominant clients were found to be more satisfied with the dominant psychotherapist than the submissive one while submissive clients preferred only the warm psychotherapist. These findings are discussed and suggest that therapists may need to be flexible and adapt their behaviors according to their client's interpersonal profile to increase their client satisfaction and decrease drop outs.

  4. What Really Drives Advice Seeking Behaviour? Looking Beyond the Subject of Legal Disputes

    Directory of Open Access Journals (Sweden)

    Stian Reimers


    Full Text Available When faced with a broad range of justiciable problems, people seek advice for around half of them, and advice from lawyers on around 13% of occasions. Various factors have been found to link to advice seeking behaviour, but it is commonly recognized that problem type ‘swamps’ other factors. This study draws on an Internet survey of 1,031 respondents, aged between 16 and 66, in which respondents were presented with a range of problem scenarios and asked to place them on a severity scale, characterize them (as legal or otherwise and suggest an appropriate source of advice. The study assesses the impact of problem severity and legal characterization on the likelihood of identifying legal advice, advice sector advice or other advice as being appropriate. Even having controlled for problem type, both problem severity and characterization have a highly significant impact on adviser choice. As severity increases, so does the likelihood of suggesting legal advice is appropriate. Where problems are characterized as legal, there is a significant increase in the likelihood of suggesting a lawyer across problem types. However, choice of advice sector advice was relatively unaffected by characterization. The findings move us beyond problem type being the primary explanation of advice seeking behaviour, and are discussed in the context of legal service delivery as well as with reference to Felstiner et al’s model of disputing behaviour.DOWNLOAD THIS PAPER FROM SSRN:

  5. 77 FR 48169 - The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1... (United States)


    ... Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1; The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 2 AGENCY: United States... Technology Agreement: Advice and Information on the Proposed Expansion: Part 1, and investigation No. 332-536...

  6. Choice, access, information are among clients' rights. (United States)

    Finger, W R


    This general discussion of the importance of respecting client's rights and access to a choice of methods relies on the statements of researchers and family planners from a variety of international and private organizations which reiterate the features of successful programs. The emphasis on client's rights is a change for many programs. The example is given of a clinic in Niger that posts the list of client rights to accessibility, information, education, communication, and freedom of choice. Pressure from international groups focuses on promoting client's informed and voluntary choice of family planning (FP) method, because it assures continuation. Quality of care is directly related to continuation of care. The quality of care framework of Judith Bruce, from the Population Council, identifies the first and most fundamental element in assuring quality of service to be choice of method. The UN assures that contraceptive choice is a basic human right. The International Planned Parenthood (IPPF) Medical and Service Delivery Guidelines proposes 10 client rights; this list of rights has been widely distributed as a poster. IPPF's African director states that contraceptive prevalence is low because of a lack of quality care. Women's rights have been integrated into FP and promoted in the Safe Motherhood Initiative and in the focus of the International Decade for Women, 1975-85. The International Women's Health Coalition, which is an alliance of over 100 women's organizations from 50 countries, has released a "Women's Declaration on Population Policies" at UN headquarters, which calls for provision of reproductive health care, not just technology, for fertility management by women. Policy makers and planners are urged to provide access to wide contraceptive choices, pregnancy care, safe abortion, prevention of sexually transmitted diseases (STDs), development of new technology for protection against STDs, and encouragement of men to take responsibility for sexual

  7. Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots


    van Thiel, D.; van Raaij, W.F.


    The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily focus on externally observed demographics or economic criteria such as profession, age, income, or wealth, post-hoc psychographic segmentation further supports personalization in the digital adviso...

  8. Client Education: Communicative Interaction between Physiotherapists and Clients with Subacute Low Back Pain in Private Practice. (United States)

    Harman, Katherine; Bassett, Raewyn; Fenety, Anne; Hoens, Alison M


    To explore, through focus-group interviews, client education provided by physiotherapists in private practice who treat injured workers with subacute low back pain (SA-LBP). Six focus-group interviews were held in the fall of 2006 to explore treatment practices of physiotherapists for this population. Each of the 44 physiotherapists who volunteered attended one of six regional sessions. Three overarching themes emerged: the critical importance of education; education: a multidimensional concept; and the physiotherapist-client relationship. In this study, we found that education provides continuity by tying together the separate tasks occurring during one treatment session. Our participants said that time is of the essence in private practice and described how they provide education seamlessly, making this type of delivery efficient. Education is a highly valued aspect of practice for physiotherapists. Verbal, tactile, and visual information obtained from the client as assessment and treatment progress is explored, expanded, and contextualized in conversation with the client. In a communicative, interactive process, client fears, other contextual information, and physiotherapist information about procedures and techniques, exercises, and anatomy are collaboratively interrelated.

  9. Client-centeredness in supported employment: specialist and supervisor perspectives. (United States)

    Kostick, Kristin M; Whitley, Rob; Bush, Philip W


    This article examines the notion of client-centeredness from the perspective of supported employment specialists and supervisors, identifying barriers and facilitators to implementation in the field. Though by definition client-centered practices give precedence to clients' wishes, in a realistic setting client-centeredness is adapted to account for negotiations among clients, specialists, employers, and mental health service agencies. Qualitative interviews (n = 22) were conducted with employment specialists and supervisors to elicit facilitators and barriers to successful supported employment outcomes. Data were analyzed inductively using ATLAS.ti 5.0 software. Principal factors influencing implementation of client-centeredness include (1) clients' anxieties about their interests and abilities, (2) difficulties interpreting and negotiating clients' preferences in realistic contexts, (3) quality of supervision and guidance in implementing client-centered practices and upholding morale when facing challenges in the field, and (4) managing discrepancies across resource-sharing agencies in what it means to be "client-centered". These factors suggest the need for (1) focused training among employment specialists to better understand and negotiate clients' wishes, (2) more integration and communication between members of the treatment team, (3) hiring supervisors with first-hand supported employment experience, and (4) spreading awareness of the IPS model across resource-sharing agencies.

  10. Evaluating the Influence of the Client Behavior in Cloud Computing. (United States)

    Souza Pardo, Mário Henrique; Centurion, Adriana Molina; Franco Eustáquio, Paulo Sérgio; Carlucci Santana, Regina Helena; Bruschi, Sarita Mazzini; Santana, Marcos José


    This paper proposes a novel approach for the implementation of simulation scenarios, providing a client entity for cloud computing systems. The client entity allows the creation of scenarios in which the client behavior has an influence on the simulation, making the results more realistic. The proposed client entity is based on several characteristics that affect the performance of a cloud computing system, including different modes of submission and their behavior when the waiting time between requests (think time) is considered. The proposed characterization of the client enables the sending of either individual requests or group of Web services to scenarios where the workload takes the form of bursts. The client entity is included in the CloudSim, a framework for modelling and simulation of cloud computing. Experimental results show the influence of the client behavior on the performance of the services executed in a cloud computing system.

  11. Health problems and help-seeking activities of methadone maintenance clients at Auckland Methadone Service (AMS): potential for community pharmacy service expansion? (United States)

    Sheridan, Janie; Wheeler, Amanda; Walters, Carina


    Background In general the health of methadone clients has been found to be poorer than that of the general population. In New Zealand specialist drug services are not funded to provide primary healthcare services. Many health conditions could potentially be managed by community pharmacists who have frequent contact with this client group. This study sought to explore the health problems suffered by methadone clients, who they sought help from, and the potential for greater involvement of pharmacists. Methods Self-completion questionnaire of methadone maintenance clients managed in specialist care in Auckland, New Zealand. Results The most common health problem experienced by these clients in the past three months was sweating (70.0%), and more than half of the respondents also reported experiencing headache, fatigue and depression. The least frequently experienced conditions were hay fever (12.9%) and abscesses (12.1%). Respondents indicated that the top three choices from whom they would seek help were GP (56.7%), the client's partner (31.6%) and community pharmacists (27.9%). Barriers to seeking help from pharmacists included issues around cost, perceptions of pharmacist knowledge and skills, privacy and confidentiality. Conclusion Methadone clients in this study indicated that they suffered a number of general health problems, and in many cases were likely to seek help from a GP or their own partner, before seeking help from pharmacists. However, for over one quarter of respondents the pharmacist was in the top three from whom they would seek advice. Any barriers towards consulting pharmacists, in the main seem to be resolvable. PMID:16283944

  12. A quantitative analysis of the quality and content of the health advice in popular Australian magazines. (United States)

    Wilson, Amanda; Smith, David; Peel, Roseanne; Robertson, Jane; Kypri, Kypros


    To examine how health advice is provided in popular magazines and the quality of that advice. A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Consumers need to be aware of this when making health choices. © 2016 Public Health Association of Australia.

  13. Following celebrities’ medical advice: meta-narrative analysis (United States)

    Tan, Charlie


    Objective To synthesise what is known about how celebrities influence people’s decisions on health. Design Meta-narrative analysis of economics, marketing, psychology, and sociology literatures. Data sources Systematic searches of electronic databases: BusinessSource Complete (1886-), Communication & Mass Media Complete (1915-), Humanities Abstracts (1984-), ProQuest Political Science (1985-), PsycINFO (1806-), PubMed (1966-), and Sociology Abstracts (1952-). Inclusion criteria Studies discussing mechanisms of celebrities’ influence on people in any context. Results Economics literature shows that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour. Marketing studies show that celebrities transfer their desirable attributes to products and use their success to boost their perceived credibility. Psychology shows that people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not, and are influenced by congruencies with their self conceptions. Sociology helps explain the spread of celebrity medical advice as a contagion that diffuses through social networks and people’s desire to acquire celebrities’ social capital. Conclusions The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices.

  14. Client/consultant model services agreement

    CERN Document Server

    International Federation of Consulting Engineers


    The terms of the Client Consultant Model Services agreement (The White Book) have been prepared by the Fédération Internationale des Ingénieurs-Conseils (FIDIC) and are recommended for general use for the purposes of pre-investment and feasibility studies, designs and administration of construction and project management, where proposals for such services are invited on an international basis. They are equally adaptable for domestic agreements. - See more at:

  15. A client/server approach to telemedicine. (United States)

    Vaughan, B J; Torok, K E; Kelly, L M; Ewing, D J; Andrews, L T


    This paper describes the Medical College of Ohio's efforts in developing a client/server telemedicine system. Telemedicine vastly improves the ability of a medical center physician or specialist to interactively consult with a physician at a remote health care facility. The patient receives attention more quickly, he and his family do not need to travel long distances to obtain specialists' services, and the primary care physician can be involved in diagnosis and developing a treatment program [1, 2]. Telemedicine consultations are designed to improve access to health services in underserved urban and rural communities and reduce isolation of rural practitioners [3].

  16. Client-server technology for merging practices. (United States)

    Blonsley, G


    Mergers, acquisitions and multiple care sites have made day-to-day management of information a logistical nightmare for medical group managers. As medical groups consolidate, each care site, typically, joins the new organization using stand-alone billing, accounting and scheduling packages. These legacy systems offer no automated way to transfer information between care sites and a central office. Rather than replacing established operating systems, medical group managers can use rules-based, decision support software and host-based, or client/server, technology. This type of connectivity allows medical groups to collect, process and redistribute key information.

  17. Characterizing fentanyl use in methadone-maintained clients. (United States)

    Arfken, Cynthia L; Suchanek, Jessica; Greenwald, Mark K


    Deaths attributed to fentanyl have increased in the United States. However, little is known about fentanyl use among substance abuse treatment clients. To fill this gap, we assessed prevalence of fentanyl exposure, characteristics of clients testing positive for fentanyl, other substances detected concurrently or simultaneously with fentanyl, and clients' perception of how many people are actively seeking to use fentanyl. A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan. Urine drug screens (UDS) including fentanyl (and its metabolite norfentanyl) were conducted clinically. To obtain additional data, 113 clients in this clinic subsequently completed an anonymous survey. Of 368 unique clients with UDS, 38.0% had at least one and 26.1% had ≥2 fentanyl-positive UDS results. None had a fentanyl prescription. Clients ever testing positive for fentanyl were significantly (pFentanyl-positive UDS results coincided most commonly with metabolites of cocaine- and heroin-positive UDS results. Of the anonymously surveyed clients, most (67.3%) reported they did not know anyone seeking fentanyl, a proportion significantly higher than for heroin, cocaine, alprazolam, hydrocodone and morphine. Fentanyl was commonly detected during this period with some clients having multiple fentanyl-positive UDS. Most clients did not know anyone seeking to obtain fentanyl. Regardless, the high exposure underscores that naloxone training and distribution is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. A flexible approach to client-server computing. (United States)

    van Mulligen, E M


    The number of standards for client-server computing almost equals the number of client-server applications. Although there are some standardization efforts, there is hardly any experience with applying these solutions to (medical) practice. The layering approach of the integration architecture HERMES anticipates the inclusion of commercial standards (when available and evaluated); it currently supports already the development of client-server applications. The toolkit provides support for the development of the communication between client and server through a callback mechanism. Stubs created with the HERMES toolkit contain a number of built-in callbacks that manage sessions between clients and services. An important feature of HERMES is the ability to include existing legacy systems as if they are true open services. In this way, the growth path from stand-alone to client-server computing can be shortened and the implementation of the client-server architecture can begin immediately. Moreover, the existing legacy systems remain available as a stand-alone solution for daily practice. Clients and services are connected through the HERMES kernel. This kernel uses a database to find the best server match for a request from a client. Moreover, it completes requests with mandatory data and tries to optimize performance. Special features are included to minimize the memory burden of the session-oriented client-server model. Currently, a system for the outpatient clinic cardiology, occupational health care, and clinical data analysis is available.

  19. More about software requirements thorny issues and practical advice

    CERN Document Server

    Wiegers, Karl E


    No matter how much instruction you've had on managing software requirements, there's no substitute for experience. Too often, lessons about requirements engineering processes lack the no-nonsense guidance that supports real-world solutions. Complementing the best practices presented in his book, Software Requirements, Second Edition, requirements engineering authority Karl Wiegers tackles even more of the real issues head-on in this book. With straightforward, professional advice and practical solutions based on actual project experiences, this book answers many of the tough questions rais

  20. Understanding the innovation adoption process of construction clients, Clients driving Innovation

    NARCIS (Netherlands)

    Hartmann, Andreas; Dewulf, Geert P.M.R.; Reymen, Isabelle; Adams, L.; Guest, K.


    Although the role of clients in stimulating construction innovation seems to be controversial, little has been known about their innovation adoption behaviour. This paper presents first results of an ongoing research project the aim of which is to shed more light on the adoption processes of

  1. Client emotional productivity-optimal client in-session emotional processing in experiential therapy. (United States)

    Auszra, Lars; Greenberg, Leslie S; Herrmann, Imke


    The goal of this investigation was to examine the predictive validity of Client Emotional Productivity (CEP), an operationalization of optimal client in-session emotional processing, possessing seven features: Attending, symbolization, congruence, acceptance, regulation, agency and differentiation. CEP was related to improvement in depressive and general symptoms, in 74 clients (66% female, 34% male) who received experiential therapy of depression and this was compared to the relationship between client high expressed emotional (CHEEA) arousal and the working alliance (WAI) and outcome. Hierarchical regression analyses revealed that working phase CEP predicted significant reduction of depressive and general symptoms over and above that predicted by beginning phase CEP, the working alliance and working phase CHEEA. Working phase CEP emerged as the sole, independent predictor of outcome for both depressive and general symptoms. Productive emotional processing, thus, mediates the relationship between the alliance and outcome and seems to go beyond mere activation and expression of emotional experience. It rather seems to involve an increase in the ability to process activated primary emotion in a productive manner specified by CEP.

  2. Spiritual Pain in Meals on Wheels’ Clients

    Directory of Open Access Journals (Sweden)

    Lisa Boss


    Full Text Available Background: Meals on Wheels’ clients are at risk for spiritual pain due to advanced age, social isolation, and failing health. They are also prone to stress, depression, and loneliness, placing them at risk for adverse biological disruptions and health outcomes. The purpose of the study was to examine associations of spiritual pain with psychosocial factors (stress, depression, loneliness, religious coping and salivary biomarkers of stress and inflammation (cortisol, IL-1β in Meals on Wheels’ clients. Methods: Data were collected cross-sectionally from 88 elderly (mean age 75.4. Spiritual pain, stress, depression, loneliness, and religious coping were measured with standardized instruments, and salivary biomarkers were assessed with enzyme immunoassays. Results: Spiritual pain was significantly and positively correlated with stress (r = 0.35, p ≤ 0.001, depression (r = 0.27, p = 0.01, and negative religious coping (r = 0.27, p = 0.01. Correlations with loneliness, positive religious coping, and salivary biomarkers were non-significant. Conclusion: Spiritual pain is an important concept in this population. Research should be expanded to understand the significance of spiritual pain in conjunction with psychosocial and biological variables and its potential impact on physical, mental, and cognitive health outcomes in the elderly.

  3. Hardened Client Platforms for Secure Internet Banking (United States)

    Ronchi, C.; Zakhidov, S.

    We review the security of e-banking platforms with particular attention to the exploitable attack vectors of three main attack categories: Man-in-the-Middle, Man-in-the-PC and Man-in-the-Browser. It will be shown that the most serious threats come from combination attacks capable of hacking any transaction without the need to control the authentication process. Using this approach, the security of any authentication system can be bypassed, including those using SecureID Tokens, OTP Tokens, Biometric Sensors and Smart Cards. We will describe and compare two recently proposed e-banking platforms, the ZTIC and the USPD, both of which are based on the use of dedicated client devices, but with diverging approaches with respect to the need of hardening the Web client application. It will be shown that the use of a Hardened Browser (or H-Browser) component is critical to force attackers to employ complex and expensive techniques and to reduce the strength and variety of social engineering attacks down to physiological fraud levels.

  4. Therapist influence on client language during motivational interviewing sessions. (United States)

    Moyers, Theresa B; Martin, Tim


    Client language in favor of change is hypothesized to be a causal mechanism for motivational interviewing (MI), and specific therapist behaviors are prescribed to elicit such speech. This project examined 38 motivational enhancement therapy sessions from Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), using a sequential behavioral coding system to investigate the relationship between therapist behaviors and client speech. Conditional probabilities were calculated between MI-consistent (MICO) therapist behaviors, MI-inconsistent (MIIN) therapist behaviors, and immediately subsequent client speech. MICO behaviors were more likely to be followed by self-motivational statements, whereas MIIN behaviors were more likely to be followed by client resistance. These results lend support to the importance of therapist behaviors in shaping client speech during MI sessions.

  5. Client contribution in negotiations on employability – categories revised?

    DEFF Research Database (Denmark)

    Eskelinen, L.; Olesen, Søren Peter; Caswell, D.


    In this article, we explore how the institutional category ‘unemployed’ is specified in everyday practice when implementing an active employment policy. We illustrate the process of categorisation as an aspect of the in situ positioning and self-representation of the client by examining one social...... worker–client talk: how the category unemployed is shaped and ‘translated’ when the client negotiates her situation with the social worker. Two types of category revisions are identified. First, the employability of the client, rather than her unemployment situation, is the issue under negotiation....... Second, the client introduces new categories that are compatible with the demands of the employment system. She contributes by drawing on discursive resources related to the category of ‘active job seeker’ but does this with an own agenda of looking for a suitable job. The analysis elucidates the client...

  6. Use of an anecdotal client feedback note in family therapy. (United States)

    Haber, Russell; Carlson, Ryan G; Braga, Cristina


    To attain information about divergent agendas in family therapy, as well as incorporate client feedback, we present the Client Feedback Note (CFN). The CFN elicits information about each family member's feelings, learning, dislikes, and wishes for each session. Anecdotal feedback after each session may help the therapist have better insight into the clients' perceptions and experience of the therapy and the therapist. Sensitivity to information generated by the CFN can help both therapist and client work to coconstruct a therapeutic process that is relevant to the diverse needs of the client system. This manuscript will (a) discuss literature supporting the use of client feedback in therapy; (b) present the CFN and rationale for its development; (c) discuss our experiences utilizing the CFN along with case examples that illustrate its use; and (d) identify practical applications, limitations, and potential research with using the CFN in systemic therapy. © 2014 FPI, Inc.

  7. Empathy from the client's perspective: A grounded theory analysis. (United States)

    MacFarlane, Peter; Anderson, Timothy; McClintock, Andrew S


    Although empathy is one of most robust predictors of client outcome, there is little consensus about how best to conceptualize this construct. The aim of the present research was to investigate clients' perceptions and in-session experiences of empathy. Semi-structured, video-assisted interpersonal process recall interviews were used to collect data from nine clients receiving individual psychotherapy at a university psychology clinic. Grounded theory analysis yielded a model consisting of three clusters: (1) relational context of empathy (i.e., personal relationship and professional relationship), (2) types of empathy (i.e., psychotherapists' cognitive empathy, psychotherapists' emotional empathy, and client attunement to psychotherapist), and (3) utility of empathy (i.e., process-related benefits and client-related benefits). These results suggest that empathy is a multi-dimensional, interactional process that affects-and is affected by-the broader relationship between client and psychotherapist.

  8. A framework of strategies for client-centred practice. (United States)

    Restall, Gayle; Ripat, Jacquie; Stern, Marlene


    Implementing strategies to overcome barriers to client-centred practice is a challenge encountered by many occupational therapists in their daily practice. The Client-centred Strategies Framework is proposed as a tool to assist occupational therapists to consider barriers and implement strategies from a variety of perspectives. The framework consists of five categories: personal reflection, client-centred processes, practice settings, community organizing, and coalition advocacy and political action. Within each category are a number of actions that can be taken to facilitate client-centred practice. This paper describes the framework with elaboration of each of the five categories. A case example is used to illustrate how a therapist can use the framework to address client-centred practice issues. This framework will assist therapists and students to problem-solve ways to enhance the use of client-centred processes within their own practice environments.

  9. Delivering effective science communication: advice from a professional science communicator. (United States)

    Illingworth, Sam


    Science communication is becoming ever more prevalent, with more and more scientists expected to not only communicate their research to a wider public, but to do so in an innovative and engaging manner. Given the other commitments that researchers and academics are required to fulfil as part of their workload models, it is unfair to be expect them to also instantly produce effective science communication events and activities. However, by thinking carefully about what it is that needs to be communicated, and why this is being done, it is possible to develop high-quality activities that are of benefit to both the audience and the communicator(s). In this paper, I present some practical advice for developing, delivering and evaluating effective science communication initiatives, based on over a decade of experience as being a professional science communicator. I provide advice regarding event logistics, suggestions on how to successfully market and advertise your science communication initiatives, and recommendations for establishing effective branding and legacy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  10. ADVICE for a healthier life: Adult Vaccination Campaign in Europe. (United States)

    Ozisik, Lale; Tanriover, Mine Durusu; Rigby, Shirley; Unal, Serhat


    Immunization is one of the most effective public health measures to prevent disease. Despite relatively good vaccination rates in childhood in many parts of the world, vaccines to prevent diseases are underused in the adult population and adult vaccination rates are still far below the target. The European Federation of Internal Medicine (EFIM), declared that 'internal medicine must focus on better care for individuals, better health care for populations and lower costs'. Adult vaccination is a good example of a public health initiative aimed at reducing morbidity and mortality, but awareness of the need for adult vaccination and uptake of the programs across Europe is variable. The Adult Vaccination Campaign in Europe (ADVICE) was developed with an aim to raise awareness for adult vaccination and to understand the dynamics of the vaccination practices and the possible barriers against achieving targeted vaccination rates in Europe. In order to reach vaccination targets, we need evidence based, up to date guidelines; recommendations at national and international levels; surveillance for vaccination rates; and opportunities to provide vaccines more readily. Leadership at a European level and a firm research and action agenda are crucial. The European Federation of Internal Medicine can take the lead as it declared its interest on 'better care for individuals, better health care for populations'. Hence, we consider ADVICE a very timely and very valuable initiative to draw a roadmap to improve adult vaccination rates in Europe. Copyright © 2016. Published by Elsevier B.V.

  11. Breastfeeding, co-sleeping and dental health advice. (United States)

    Wert, Katie M Lapps; Lindemeyer, Rochelle; Spatz, Diane L


    To identify dental health advice offered by healthcare providers (HCPs) to mothers that cosleep and breastfeed at night. Mothers were recruited via local contacts, e-mail, and support groups. In-person, digitally recorded interviews were conducted with 14 cosleeping, breastfeeding mothers with children from 6 months to 2 years. Interviews included seven open-ended questions about cosleeping patterns, night breastfeeding patterns, and dental health advice offered by HCPs. These HCPs included pediatricians, family medicine physicians, midwives, and obstetricians. Interviews were transcribed verbatim and qualitative descriptive analysis was done. The majority of women reported keeping their child in bed with them for most, if not all, of the night. All of the mothers reported breastfeeding on demand. Approximately half of the mothers did not disclose their sleeping patterns to their HCP. Mothers reported few HCPs initiated a discussion on cosleeping or oral hygiene for their child. Mothers did not readily share their cosleeping, nor did most HCPs initiate a conversation about cosleeping and dental hygiene. This qualitative study identifies the need for education on anticipatory guidance of oral hygiene discussions from HCPs. As HCPs, it is our responsibility to initiate the conversation with the mother because this study demonstrates that mothers will be unlikely to do so.

  12. Unrealistic optimism in advice taking: A computational account. (United States)

    Leong, Yuan Chang; Zaki, Jamil


    Expert advisors often make surprisingly inaccurate predictions about the future, yet people heed their suggestions nonetheless. Here we provide a novel, computational account of this unrealistic optimism in advice taking. Across 3 studies, participants observed as advisors predicted the performance of a stock. Advisors varied in their accuracy, performing reliably above, at, or below chance. Despite repeated feedback, participants exhibited inflated perceptions of advisors' accuracy, and reliably "bet" on advisors' predictions more than their performance warranted. Participants' decisions tightly tracked a computational model that makes 2 assumptions: (a) people hold optimistic initial expectations about advisors, and (b) people preferentially incorporate information that adheres to their expectations when learning about advisors. Consistent with model predictions, explicitly manipulating participants' initial expectations altered their optimism bias and subsequent advice-taking. With well-calibrated initial expectations, participants no longer exhibited an optimism bias. We then explored crowdsourced ratings as a strategy to curb unrealistic optimism in advisors. Star ratings for each advisor were collected from an initial group of participants, which were then shown to a second group of participants. Instead of calibrating expectations, these ratings propagated and exaggerated the unrealistic optimism. Our results provide a computational account of the cognitive processes underlying inflated perceptions of expertise, and explore the boundary conditions under which they occur. We discuss the adaptive value of this optimism bias, and how our account can be extended to explain unrealistic optimism in other domains. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Patients who leave the emergency department against medical advice. (United States)

    Lee, Choung Ah; Cho, Joon Pil; Choi, Sang Cheon; Kim, Hyuk Hoon; Park, Ju Ok


    Discharge against medical advice (DAMA) from the emergency department (ED) accounts for 0.1% to 2.7% of all ED discharges. DAMA carries a risk of increased mortality and readmissions. Our aim was to investigate the general characteristics of DAMA patients and the differences between them and non-DAMA patients. We reviewed data collected by the National Emergency Medical Center between 2010 and 2011. Subjects were categorized into 2 groups, namely, the DAMA group and the non-DAMA group. We compared these groups with respect to age, gender, trauma or non-trauma status, type of hospital, health insurance, level of consciousness on admission, and diagnosis. Of 8,000,529 patients, 222,389 (2.78%) left against medical advice. The risk factors for DAMA across all age groups were as follows: no medical insurance (odds ratio [OR], 1.993), initial response to voice (OR, 2.753) or pain (OR, 2.101), trauma admission (OR, 1.126), admission to a local emergency medical center (OR, 1.215), and increased age. A high risk of DAMA was observed among patients with immune, endocrine, psychiatric, neurological, circulatory diseases, and external causes of morbidity and mortality. Although DAMA cases account for only a small percentage of hospital discharges, they are important because DAMA patients have high readmission and mortality rates. It is therefore important to understand the general characteristics and predictors of DAMA in order to improve patient outcome and minimize the economic burden on the healthcare system.

  14. Advice taking from humans and machines: an fMRI and effective connectivity study

    Directory of Open Access Journals (Sweden)

    Kimberly Goodyear


    Full Text Available With new technological advances, advice can come from different sources such as machines or humans, but how individuals respond to such advice and the neural correlates involved need to be better understood. We combined functional MRI and multivariate Granger causality analysis with an X-ray luggage-screening task to investigate the neural basis and corresponding effective connectivity involved with advice utilization from agents framed as experts. Participants were asked to accept or reject good or bad advice from a human or machine agent with low reliability (high false alarm rate. We showed that unreliable advice decreased performance overall and participants interacting with the human agent had a greater depreciation of advice utilization during bad advice compared to the machine agent. These differences in advice utilization can be perceivably due to reevaluation of expectations arising from association of dispositional credibility for each agent. We demonstrated that differences in advice utilization engaged brain regions that may be associated with evaluation of personal characteristics and traits (precuneus, posterior cingulate cortex, temporoparietal junction and interoception (posterior insula. We found that the right posterior insula and left precuneus were the drivers of the advice utilization network that were reciprocally connected to each other and also projected to all other regions. Our behavioral and neuroimaging results have significant implications for society because of progressions in technology and increased interactions with machines.

  15. Drug abuse staff and clients smoking together: A shared addiction. (United States)

    Guydish, Joseph; Le, Thao; Campbell, Barbara; Yip, Deborah; Ji, Suzhe; Delucchi, Kevin


    Smoking is endemic in drug abuse treatment populations, and smoking prevalence in this population appears unresponsive to existing tobacco control strategies. Clinical and policy guidelines encourage programs to address smoking among clients, and research has identified key barriers to doing so. This report explores the practice of staff and clients smoking together in drug treatment programs, and how this practice is associated with other tobacco-related measures. Clients (N=1113) were surveyed and program directors were interviewed in a national sample of 24 drug abuse treatment programs affiliated with the NIDA Clinical Trials Network. Clients were asked whether they observed staff and clients smoking together in their program and, using program as the unit of analysis, this measure was tested for its association with client-level and program-level tobacco-related outcomes. Higher rates of staff and client smoking together were associated with higher staff smoking prevalence (p=0.006), lower rates of client thoughts about quitting in the next 30days (p=0.027), more negative client attitudes toward quitting smoking (p=0.004), and with clients receiving fewer tobacco-related services (p=0.024). These findings illuminate an actionable, low cost policy intervention to address smoking in drug abuse treatment, which is to prohibit the practice of staff smoking together with clients. In the interest of the health of clients whom they serve, counselors, program directors, state regulatory agencies, and federal funding agencies should act to end this practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Experimental Blind Quantum Computing for a Classical Client. (United States)

    Huang, He-Liang; Zhao, Qi; Ma, Xiongfeng; Liu, Chang; Su, Zu-En; Wang, Xi-Lin; Li, Li; Liu, Nai-Le; Sanders, Barry C; Lu, Chao-Yang; Pan, Jian-Wei


    To date, blind quantum computing demonstrations require clients to have weak quantum devices. Here we implement a proof-of-principle experiment for completely classical clients. Via classically interacting with two quantum servers that share entanglement, the client accomplishes the task of having the number 15 factorized by servers who are denied information about the computation itself. This concealment is accompanied by a verification protocol that tests servers' honesty and correctness. Our demonstration shows the feasibility of completely classical clients and thus is a key milestone towards secure cloud quantum computing.

  17. Client-centred occupational therapy with children: A critical perspective. (United States)

    Phoenix, Michelle; Vanderkaay, Sandra


    Client-centredness is a central theme within occupational therapy; however, its application within clinical practice has not been thoroughly examined within the literature. The aim of this practice reflection is to provide a critical perspective on client-centredness in occupational therapy practice with children. Two action points of the Canadian Practice Process Framework (CPPF): Set the Stage and Agree on Objectives and Plan are applied to examine the concept of client-centred practice using a common practice example. There are multiple benefits to using a client-centred approach to goal setting and developing a therapy plan. Practical challenges to client-centred practice include a lack of time, organizational support, and professional autonomy. Therapists may exert power over clients by enforcing institutional policies that prioritize the client diagnosis and organizational processes. The authors support a client-centred approach to occupational therapy practice with children but suggest that therapists may feel conflicted in trying to apply these principles within the current context of rehabilitation for children. Occupational therapists are encouraged to identify opportunities where they can advocate for a client-centred approach to services.

  18. Improvement of AMGA Python Client Library for Belle II Experiment (United States)

    Kwak, Jae-Hyuck; Park, Geunchul; Huh, Taesang; Hwang, Soonwook


    This paper describes the recent improvement of the AMGA (ARDA Metadata Grid Application) python client library for the Belle II Experiment. We were drawn to the action items related to library improvement after in-depth discussions with the developer of the Belle II distributed computing system. The improvement includes client-side metadata federation support in python, DIRAC SSL library support as well as API refinement for synchronous operation. Some of the improvements have already been applied to the AMGA python client library as bundled with the Belle II distributed computing software. The recent mass Monte- Carlo (MC) production campaign shows that the AMGA python client library is reliably stable.

  19. Mutual construction and reconstruction in client-consultant interaction

    DEFF Research Database (Denmark)

    Smith, Irene Skovgaard

    Based on preliminary interviews with client representatives and a pilot case study, the pa-per explores collaboration and mutual construction in client-consultant relationships. Both consultants and client actors take part in an active construction and reconstruction of knowledge that involve...... struggles over position, power and control. In the context of client-consultant interaction, it is thus not only ideas and solutions that are contested but also the power to define. Attention is paid to how ideas are brought into play and negotiated in the interaction between actors. The empirical material...

  20. How do incentives lead to deception in advisors-client interactions? Explicit and implicit strategies of self-interested deception.

    Directory of Open Access Journals (Sweden)

    Barbara eMackinger


    Full Text Available When confronted with important questions we like to rely on the advice of experts. However, uncertainty can occur regarding advisors’ motivation to pursue self-interest and deceive the client. This can especially occur when the advisor has the possibility to receive an incentive by recommending a certain alternative. We investigated how the possibility to pursue self-interest led to explicit strategic behavior (bias in recommendation and transfer of information and to implicit strategic behavior (bias in information processing: evaluation and memory. In Study 1 explicit strategic behavior could be identified: Self-interested advisors recommended more often the self-serving alternative and transferred more self-interested biased information to their client compared to the advisor without specific interest. Also deception through implicit strategic behavior was identified: Self-interested advisors biased the evaluation of information less in favor of the client compared to the control group. Self-interested advisors also remembered conflicting information regarding their self-interest worse compared to advisors without self-interest. In Study 2 beside self-interest we assessed accountability which interacted with self-interest and increased the bias: When accountability was high advisor’s self-interest led to higher explicit strategic behavior (less transfer of conflicting information, and to higher implicit strategic behavior (devaluated and remembered less conflicting information. Both studies identified implicit strategic behavior as mediator which can explain the relation between self-interest and explicit strategic behavior. Results of both studies suggest that self-interested advisors use explicit and implicit strategic behavior to receive an incentive. Thus, advisors do not only consciously inform their clients self-interested, but they are influenced unconsciously by biased information processing—a tendency which even increased with

  1. Parents’ professional sources of advice regarding child discipline and their use of corporal punishment (United States)

    Taylor, Catherine A.; Moeller, William; Hamvas, Lauren; Rice, Janet C.


    Parents (n=500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents that sought advice from religious leaders (vs. pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported they were more likely to follow the advice of pediatricians than any other professional; however, Black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents. PMID:23185082

  2. Parents' professional sources of advice regarding child discipline and their use of corporal punishment. (United States)

    Taylor, Catherine A; Moeller, William; Hamvas, Lauren; Rice, Janet C


    Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.

  3. Prostitution in Galicia: Clients and Feminine Imaginary

    Directory of Open Access Journals (Sweden)

    Agueda Gómes Suárez


    Full Text Available Today, the prostitution in our society turns out to be an indicator of the dominant “sexual culture” in the patriarchal and capitalist societies. This article tries to contribute with another approach to the analysis of the sexual industry in our country, adjusting, principally, to the experiences of the men involved in the phenomenon of the prostitution in Galicia. The dramatic quality in which the women in prostitution live their reality and the levity and idleness, in which the clients enjoy themselves, show the controversial and worrying face of this reality. The analysis of the clients’ speech across the “Frame Analysis”, and the study of the feminine dominant imaginary among them are portrayed in this text, together with the speech of the women in prostitution and of the men who occupy masculinized spaces. This article tries to be a contribution to the complex study of the phenomenon of the prostitution in our country.

  4. Client Experiences of Emergency Assistance Services

    Directory of Open Access Journals (Sweden)

    Ian Goodwin-Smith


    Full Text Available More people are requiring emergency assistance on a regular basis, placing a significant burden on service providers. However, there is little literature on client perceptions of emergency assistance, and whether their needs are being met. This study aimed to address this gap by interviewing people who had recently sought emergency assistance in South Australia. Sixteen people (nine women aged between 27 and 55 participated in this study. Participants reported that they were seeking assistance (mainly food due to bills, particularly relating to electricity, but also telephone, gas and car registration. Most people had their needs met to some extent, but many said that they had received insufficient or inappropriate food. Recommendations were provided around establishing compulsory service standards and partnerships, and reviewing the types of assistance provided (e.g. providing vouchers and healthy food parcels. Keywords: emergency assistance, emergency relief, social services, wrap around services, social inclusion

  5. Client Abuse to Public Welfare Workers

    DEFF Research Database (Denmark)

    Strøbæk, Pernille Solveig; Korczynski, Marek


    We analyse a case study of workers’ experience of client abuse in a Danish public welfare organisation. We make an original contribution by putting forward two different theoretical expectations of the case. One expectation is that the case follows a pattern of customer abuse processes in a social...... market economy – in which workers are accorded power and resources, in which workers tend to frame the abuse as the outcome of a co-citizen caught in system failure and in which workers demonstrate some resilience to abuse. Another expectation is that New Public Management reforms push the case to follow...... patterns of customer abuse associated with a liberal market economy – in which the customer is treated as sovereign against the relatively powerless worker, and in which workers bear heavy emotional costs of abuse. Our findings show a greater match to the social processes of abuse within a social market...

  6. Diagnostic medical exposures: advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)



    The NRPB offers advice on exposure to ionizing radiation during pregnancy, based on data published since 1985. In providing this advice the Board has considered risks to the developing embryo and fetus of death, malformation, mental impairment, cancer (solid tumours and leukaemias) and genetic damage from irradiation after the first missed menstrual period. The possible risks from irradiation of the early (up to 3-4 weeks) conceptus and from gonodal irradiation of patients is also covered in the present advice. (Author)

  7. Patient responses to inhaler advice given by community pharmacies

    DEFF Research Database (Denmark)

    Kaae, Susanne; Aarup, Kristine Hallberg Friis; Sporrong, Sofia Kälvemark


    BACKGROUND: The value of counseling in community pharmacy depends on its ability to help patients improve their use of medicine and thereby health status, by their adherence to recommendations. Studies showing how patients respond to daily pharmacy counseling are, however, scarce. The aim...... of this study was therefore to investigate how patients respond to medical advice given by pharmacy staff. METHODS: A heterogeneous sample of patients who received the 'Inhaler Technique Assessment Service' (ITAS) in Denmark were interviewed, using a semi-structured schedule. Meaning condensation...... proposed by pharmacy staff. CONCLUSIONS: ITAS recommendations seemed important to adhere with for patients despite experiencing difficulties when doing so and secondly not feeling an immediate improvement of health. Reasons for this appear to be connected with the concept of meaningfulness. Hence...

  8. Sport participation and Ramadan observance: Advice for the athlete

    Directory of Open Access Journals (Sweden)

    Roy J. Shephard


    Full Text Available Introduction: A growing number of Muslim athletes now engage in international competition. This raises the question of the advice they should be given if a major event occurs during the month of Ramadan. Methods: A narrative review has been based upon books and extensive reviews completed by the author and other investigators. Results: Practical considerations hamper assessment of the effects of Ramadan upon physical performance, but there seem small decreases in muscular strength and both anaerobic and aerobic capacity.  Nevertheless, athletes who wish to observe Ramadan can reduce such effects by prior adjustment of diet and training plans, minimizing sleep loss, and careful management of fluid and food intake during the period of intermittent fasting. Conclusion: Competitors in most events can observe Ramadan with a small loss of athletic performance. However, intermittent fasting can endanger health for individuals with type I diabetes mellitus, and for participants in ultra-endurance events (particularly under hot conditions.

  9. Advice and dissent: rating the corporate governance compact. (United States)

    Wharton, C R; Lorsch, J W; Hanson, L


    The July-August 1991 HBR presented "A New Compact for Owners and Directors," a set of principles for reconciling differences between owners and managers. In "Advice and Dissent: Rating the Corporate Governance Compact," a panel of three experts evaluates the Compact--and takes issue with its fundamental recommendation. Clifton R. Wharton, Jr., chairman and CEO of TIAA-CREF, describes how his organization brings delinquent managers and directors to task. Harvard Business School professor Jay W. Lorsch explains why strengthening the role of outside directors will develop more effective corporate control. And Lord Hanson, chairman of Hanson PLC, reaffirms the importance of maintaining a unitary board of directors and maximizing shareholder value.

  10. Telemedical advice to long-distance passenger ferries

    DEFF Research Database (Denmark)

    Jensen, Olaf C; Bo Bøggild, Niels; Kristensen, Søren


    BACKGROUND: Radio medical (RM) advice for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyze the data from consultations with passenger ferries to identify areas for possible improvements. METHODS......: Data from the journals for 1 year from Radio Medical Denmark consultations with the medical officers on passenger ferries were analyzed retrospectively. RESULTS: Two hundred fourteen RM records, 73% pertaining to passengers and 27% for crew members, were analyzed. Passenger patients were generally...... older and more seriously ill than patients among the crew. A high number of potential and life-threatening medical conditions such as angina pectoris was seen among the passengers, and nine of these patients were evacuated by helicopter. Sixty-three percent (n = 135) of the calls related to pain...

  11. The effects of civility on advice, leadership, and performance. (United States)

    Porath, Christine L; Gerbasi, Alexandra; Schorch, Sebastian L


    Workplace incivility is rampant and on the rise-with costs to individuals and organizations. Despite the increased need for civility, little is known about potential individual benefits of civility, defined as behavior involving politeness and regard for others in the workplace, within workplace norms for respect (Andersson & Pearson, 1999). Recent research has suggested that being civil may be hazardous to influence, power, and income (see Forni, 2002; Judge et al., 2012).Yet, throughout history, civil behavior has been extolled because it paid dividends to the person who behaved well. The focus of this research is whether that holds true in organizations. Using social exchange theory, we developed hypotheses about how civility benefits people, and investigated this in 2 studies. First, in a 2-wave social network study of a research and development department (n = 31) of a biotechnology firm, we found that people who perceived a colleague as civil would be more likely to seek that person out for work advice and to see that person as a leader. The more the individual was perceived as civil by others in his or her network, the better his or her performance. Being sought out for work advice and being viewed as a leader mediated this effect. In the second experiment (n = 162), we extended our understanding of what drove these benefits. We found that people who are civil were perceived as warm and competent, and these positive perceptions, in turn, helped to explain the benefits garnered. We discuss theoretical and practical implications. (c) 2015 APA, all rights reserved).

  12. Nutritional Advice for Patients with Melasma in Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Mahdis Mojtabaee


    Full Text Available Background Melasma (called Kalaf in Iranian traditional medicine is a common acquired hypermelanosis that affects sun-exposed areas of skin. Several factors including exposure to sunlight, pregnancy, and endocrine diseases increase the risk for Melasma. In traditional medicine, antecedent philosophers and physicians have tried to understand the nature and mechanisms of different systems of the human body for the diagnosis and management of Melasma; they have offered different solutions for it. This study is important since Melasma is a disease causing mental side effects in patients, due to darkness and opacity of the skin; therefore, the treatment of Melasma in terms of its psychological complications is of particular importance. In addition, texts of Iranian traditional medicine contain a wealth of nutritional advice for patients with Melasma. These texts have, until now, not yet been reviewed. The present study has considered the most important references of Iranian traditional medicine texts. Objectives The objective of this study was to extract and categorize the nutritional advice of Iranian traditional medicine texts for the treatment of Melasma. Results Dietary recommendations, not only for treatment but also for prevention of diseases and staying healthy, are very efficient. Conclusions Based on the traditional medicine texts, it is helpful to avoid Soda-producing food as well as to identify appropriate food in order to eliminate the accumulation of Soda or black bile from the blood. This study offers a set of analytical and clinical research on food, which in traditional medicine is called Soda-producing as well as Soda reducing.

  13. Science advice in the white house? Continuation of a debate. (United States)

    Skolnikoff, E B; Brooks, H


    Thus, we are skeptical of the commonly stated arguments for re-creation of a science office at the White House, but are ultimately convinced that such an office is justified. A three-man CST is a reasonable proposal, although the detailed structure is less critical than the mandate given to the office, and the general understanding within government of its functions and limitations and of its relationship to the President. To give it permanence, the office should be grounded in a science policy management and oversight function that is critically needed today. That kind of strong office could lead a president to use it as his personal science advisory staff, but the decision must be made anew by each president. The President does have other ways of obtaining scientific advice, although the right kind of science office would be a preferable route in our view. The importance of such an office being able to present its analyses and recommendations in policy terms useful to other policy-makers cannot be overestimated. This has important implications for the kind of competence required to staff and work with such a council; it also requires recognition of the fact that policy-relevant studies and advice can never be value-free, even when carried out by scientists and engineers. And finally, such a council could bring intensive and continuous attention to the international dimension of U.S. science policy, which seems to us to be particularly neglected. It is not yet clear whether there will be any structural changes in the new Administration. But it is not too soon to be clearer about the essential factors that should underlie a sensible proposal for this or the next Administration.

  14. From single-species advice to mixed-species management: taking the next step

    DEFF Research Database (Denmark)

    Vinther, Morten; Reeves, S.A.; Patterson, K.R.


    that accounts for mixed-fishery effects, but in the short term there is a need for approaches to resolve the conflicting management advice for different species within the same fishery, and to generate catch or effort advice that accounts for the mixed-species nature of the fishery. This paper documents...... a recent approach used to address these problems. The approach takes the single-species advice for each species in the fishery as a starting point, then attempts to resolve it into consistent catch or effort advice using fleet-disaggregated catch forecasts in combination with explicitly stated management...

  15. Dietary advice with or without oral nutritional supplements for disease-related malnutrition in adults. (United States)

    Baldwin, Christine; Weekes, Christine Elizabeth


    Disease-related malnutrition has been reported in 10% to 55% of people in hospital and the community. Dietary advice encouraging the use of energy- and nutrient-rich foods rather than oral nutritional supplements has been suggested as the initial approach for managing disease-related malnutrition. To examine evidence that dietary advice in adults with disease-related malnutrition improves survival, weight and anthropometry; to estimate the size of any additional effect of nutritional supplements combined with dietary advice and to compare the effects of dietary advice with oral nutritional supplements. Relevant publications were identified from comprehensive electronic database searches and handsearching.Last search: 14 February 2010. Randomised controlled trials of dietary advice with or without oral nutritional supplements in people with disease-related malnutrition in any health-care setting compared with no advice, oral nutritional supplements or dietary advice given alone. Two authors independently assessed trial eligibility, risk of bias and extracted data. Forty-five studies (3186 participants) met the inclusion criteria; (dietary advice compared with: no advice (1053 participants); with oral nutritional supplements (332 participants); with dietary advice and oral nutritional supplements (731 participants); and dietary advice plus oral nutritional supplements compared with no additional intervention (1070 participants). Follow-up ranged from 18 days to 24 months. No comparison showed a significant difference between groups for mortality or morbidity. There was a significant change in weight found between groups when comparing dietary advice to no advice for interventions lasting greater than 12 months, mean difference 3.75 kg (95% confidence interval 0.97 to 6.53), and when all studies were combined, mean difference 1.47 kg (95% confidence interval 0.32 to 2.61) although there was significant heterogeneity in the combined analysis (I(2) = 90%). Similar

  16. Group poetry therapy for clients recovering from anorexia: An interpretative phenomenological analysis of client experience


    Ramsey-Wade, C.


    Poetry therapy, also known as bibliotherapy or therapeutic creative writing, is an arts-based therapy which uses creative writing or published literature for therapeutic means. Like other art therapies, it may be a useful addition to the range of interventions that can be offered to clients recovering from anorexia in day patient or inpatient clinics, where there is a particular need for new treatments. In this qualitative study, participants who have had experience of a poetry therapy group ...

  17. Advice on health complaints with regard to CO2 storage in Barendrecht, Netherlands; Advies gezondheidsklachten naar aanleiding van CO2 opslag in Barendrecht

    Energy Technology Data Exchange (ETDEWEB)



    The CCS project organization wants to gain insight in the measures that can be taken to prevent and treat psychosomatic complaints resulting from the intended CO2 storage in Barendrecht. The advice should contain information on how governments and the initiator should act in their communications with residents in the practical set-up of their project. Moreover, the client asked for an assessment of the nature and number of complaints to be expected. [Dutch] De projectorganisatie CCS wil inzicht in maatregelen die kunnen worden genomen ter voorkoming en behandeling van psychosomatische klachten als gevolg van de voorgenomen CO2-opslag in Barendrecht. In een advies moet tot uitdrukking komen hoe overheden en initiatiefnemer bijvoorbeeld in hun communicatie met de bewoners, bij de praktische inrichting van hun project, het beste kunnen handelen. Verder vraagt de opdrachtgever om een inschatting van de aard en omvang van de te verwachten klachten.

  18. 45 CFR 1608.7 - Attorney-client relationship. (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Attorney-client relationship. 1608.7 Section 1608.7 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITED POLITICAL ACTIVITIES § 1608.7 Attorney-client relationship. Nothing in this part is intended to...

  19. Young Clients' Narratives of the Purpose and Outcome of Counselling (United States)

    Gibson, Kerry; Cartwright, Claire


    This study explores how adolescent clients construct the purpose and outcome of counselling. A narrative analysis was performed on interviews with 22 clients (aged 16--18) who had used a school-based counselling service. The aim was to identify the purpose and outcomes that participants attributed to their counselling experience. The analysis…

  20. Development of a nutrition education intervention for food bank clients (United States)

    The focus of this article is the development of a nutrition education intervention for food bank clients. Formative research using mixed-methods (qualitative and quantitative) and community-based participatory research principles was conducted to assess the nutrition education needs of clients obtai...

  1. The influence of clients' leadership in relation to construction health ...

    African Journals Online (AJOL)

    The South African Construction Regulations realise the contributions by each member of a project team to health and safety (H&S) improvement. These Regulations amplify the roles and contributions of clients to project realisation. The tenets of the Regulations conform with the observation that clients' H&S leadership and ...

  2. A Client-Centered Review of Rogers with Gloria (United States)

    Moon, Kathryn A.


    Carl Rogers's nondirective theory and his response style with Gloria (E. L. Shostrom, 1965) are discussed in reply to S. A. Wickman and C. Campbell's (2003) "An Analysis of How Carl Rogers Enacted Client-Centered Conversation With Gloria." Client-centered studies of C. Rogers's transcripts give context for reformulating S. A. Wickman and C.…

  3. Ulysses directives in The Netherlands: opinions of psychiatrists and clients

    NARCIS (Netherlands)

    Varekamp, I.


    In this article we present a study on the opinions of Dutch psychiatrists and clients on Ulysses directives. In-depth interviews were conducted with 18 clients and 17 psychiatrists. Most respondents were proponents of Ulysses directives. The most frequently mentioned objective of these directives

  4. Home-based rehabilitation: Physiotherapy student and client ...

    African Journals Online (AJOL)

    Background. Home-based rehabilitation (HBR) in under-resourced areas in a primary healthcare (PHC) context exposes students to the real-life situations of their clients. There is a scarcity of literature on student and client experiences of HBR in the physiotherapy context. Increased knowledge of HBR could result in an ...

  5. Characteristics of clients accessing HIV counseling and testing ...

    African Journals Online (AJOL)

    Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. Nevertheless, global coverage of HIV testing and counseling programs remains low. This study describes the characteristics of clients who accessed HIV counseling and testing (HCT) services in Olabisi Onabanjo ...

  6. Clients' knowledge, perception and satisfaction with quality of ...

    African Journals Online (AJOL)


    Apr 14, 2014 ... Background: Clients' knowledge, perception of and satisfaction with the quality of maternal health services (QMHS) enables maternal health programs to assess the impact of their services from the clients' perspective. Objective: The objective of this study is to assess the knowledge, perception of and ...

  7. Facet Analysis of the Client Needs Assessment Instrument. (United States)

    Dancer, L. Suzanne; Stanley, Lawrence R.

    The structure of the revised Client Needs Assessment Instrument (CNAI) is examined. In 1978-79, the Texas Department of Human Resources (DHR) developed the CNAI to provide an index of applicants' and clients' capacity for self-care by measuring the respondents' levels of functioning in: (1) physical health; (2) daily living activities; (3) mental…

  8. A study of valuation clients perception on mortgage valuation reliability

    African Journals Online (AJOL)

    This paper studies the perception of clients on reliability of mortgage valuation in Nigeria. A sample size of 50 lending institutions was randomly chosen representing 57.5% of the target population in Lagos State, the study area. The study used descriptive statistic to analyse the data. The study reveals that clients are of the ...

  9. Relationship of Therapist Attitudes at Intake to Client Premature Termination. (United States)

    Tryon, Georgiana Shick

    Most research on premature termination from therapy has focused on client attitudes. This study examined therapists' attitudes toward their own behavior and toward their clients at intake in relation to premature termination. Premature termination was studied after different numbers of sessions to determine the relationship of therapist attitudes…

  10. Women Empower Women: Volunteers and Their Clients in Community Service (United States)

    Kulik, Liat; Megidna, Hofit


    The study is aimed at examining the relationship between psychological empowerment of women volunteers and their clients in community volunteer projects in Israel. Based on an ecological approach, the study also aimed at examining whether the variables that explain empowerment of women who volunteer also explain empowerment of their clients. The…

  11. Client experiences of motivational interviewing: An interpersonal process recall study. (United States)

    Jones, Sarah A; Latchford, Gary; Tober, Gillian


    To explore clients' experience of the therapy process in motivational interviewing (MI) for alcohol abuse. A qualitative study using grounded theory. Interviews with nine clients were conducted using interpersonal process recall (IPR), a methodology which utilizes a video recording as a cue to aid memory recall. Clients watched a videotape of their MI session and were asked to identify and describe the important moments in the therapy session. The transcribed interviews were then analysed using grounded theory. A single session of MI is seen by the clients in this study as a complex interpersonal interaction between client and therapist, which impacts on the client's cognitive and affective intrapersonal processes. The themes which emerged partly confirm processes of MI previously hypothesized to be important, but also highlight the importance of factors common to all therapeutic approaches. The aspects of therapy which clients in this study felt were important are similar to those hypothesized to underlie the effectiveness of MI, including a non-confrontational approach, affirmation, and developing discrepancies between beliefs and behaviour. These were embedded in aspects common to all therapies, including the qualities of the therapist and the therapeutic relationship. Client's perspectives on therapeutic processes are an important area of research, and IPR is a particularly suitable method. © 2015 The British Psychological Society.

  12. Clients' satisfaction with immunisation services in the urban and ...

    African Journals Online (AJOL)

    The main reasons why the clients chose the primary health centres for immunisation services were because of their proximity to the health centres in the urban area (34.3%) and the availability of vaccines in the rural area (35.3%). The majority of clients in the urban (84.5%) and rural areas (94.3%) were truly satisfied with ...

  13. Client Experience in Psychotherapy: What Heals and What Harms?

    African Journals Online (AJOL)


    a place of light. Even though it was only one person there was some help there. I had this sense of lightness, being there and of light being present so there was a sense of hope. In the space of the client exposing deep layers of pain, clients want to experience the space as a completely sealed place free from intrusions. The.

  14. Do Organizational Culture and Climate Matter for Successful Client Outcomes? (United States)

    Silver Wolf, David A. Patterson; Dulmus, Catherine N.; Maguin, Eugene; Cristalli, Maria


    Objectives: The existing literature on the impact of workplace conditions on client care suggests that good cultures and climates provide the best outcomes for clients. The primary purpose of this study was to investigate the relationship between organizational culture and climate and the proportion of children and youth successfully discharged…

  15. Reading the Client: Nonverbal Communication as an Interviewing Tool. (United States)

    Willett, Tom H.

    The importance of effective communication skills between lawyers and clients is equalled only by the imperative need for sustained instruction in the development of communicative skills for the lawyer. Especially important are the nonverbal communication skills in "reading the client." The subtleties of intonation, posture, gesture, and eye…

  16. Client Views of TESOL Service: Expectations and Perceptions. (United States)

    Walker, John


    Used focus groups to explore TESOL (teaching of English to speakers of other languages) client expectations and perceptions of the service they received in New Zealand English language schools. Findings confirmed the key role of the teacher and the importance of the school's milieu and home stay, quality of client feedback systems, servicescape,…

  17. Factors Assisting Female Clients' Disclosure of Incest during Counseling. (United States)

    Josephson, Gilda S.; Fong-Beyette, Margaret L.


    Explored specific behaviors and characteristics of counselors that relate to adult, female clients' disclosure of incest during counseling. Suggests that factors related to initial disclosure and exploration of incest are client readiness, direct questioning by the counselor, specific counselor characteristics, and positive counselor reactions to…

  18. An Exploration of Supervisory and Therapeutic Relationships and Client Outcomes (United States)

    Bell, Hope; Hagedorn, W. Bryce; Robinson, E. H. Mike


    The authors explored the connection between the facilitative conditions present within the supervisory relationship, the therapeutic relationship, and client outcomes. A correlational research design was used with a sample of 55 counselors-in-training and 88 clients. Results indicated a significant positive relationship between the therapeutic…

  19. Factors Associated with Illegal Drug Use among Older Methadone Clients (United States)

    Rosen, Daniel


    Purpose. The overall aims of this study are to describe the life stressors of, exposure to illegal drug use of, and illegal drug use by older methadone clients. Design and Methods. The current study focuses on a sub-sample of the larger administrative data of a methadone clinic that is limited to African American and White clients over the age of…

  20. Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients (United States)

    American Psychologist, 2012


    The "Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients" provide psychologists with (a) a frame of reference for the treatment of lesbian, gay, and bisexual clients and (b) basic information and further references in the areas of assessment, intervention, identity, relationships, diversity, education, training, and…

  1. The Challenge of Prejudice: Counsellors' Talk about Challenging Clients' Prejudices (United States)

    Spong, Sheila J.


    This paper considers the implications for training and practice of counsellors' responses to the notion of challenging clients' prejudices. It explores tensions in counselling discourse between social responsibility, responsibility to the client and responsibility for one's self as counsellor. Three focus groups of counsellors were asked whether a…

  2. 42 CFR 483.420 - Condition of participation: Client protections. (United States)


    ... the employment of individuals with a conviction or prior employment history of child or client abuse... that all alleged violations are thoroughly investigated and must prevent further potential abuse while... psychological abuse or punishment; (6) Ensure that clients are free from unnecessary drugs and physical...

  3. Client-Controlled Case Information: A General System Theory Perspective (United States)

    Fitch, Dale


    The author proposes a model for client control of case information via the World Wide Web built on principles of general system theory. It incorporates the client into the design, resulting in an information structure that differs from traditional human services information-sharing practices. Referencing general system theory, the concepts of…

  4. Knowledge, Practices and Education of Clients on Cervical Cancer ...

    African Journals Online (AJOL)

    Background: Most patients with cancer of the cervix present late with poor prognosis. Health workers' knowledge and utilization of the screening services might influence their clients. The aim of this study was to determine the knowledge, practice and education of clients on cervical cancer and its screening among female ...

  5. Communicating Social Support to Grieving Clients: The Veterinarians' View (United States)

    Pilgram, Mary D.


    This exploratory study examines veterinarians' perceptions of how they offer social support to grieving clients. Because many clients cannot find the social support they would like from other sources when grieving the death of a pet, the role of the vet in offering support becomes increasingly important. The results indicate that vets perceive…

  6. Clients satisfaction with local design consultancy practices in Gaza ...

    African Journals Online (AJOL)

    The aim of this paper is to investigate the degree of public clients satisfaction with local consultancy practices in the Gaza strip. The paper deals with three types of clients: Local Ministries, Municipalities and other organizations such as Palestinian Water ity, United Nation Development Program, and the Palestinian ...

  7. Two Rebt Therapists and One Client: Windy Dryden Transcript


    Dryden, Windy


    In the summer of 1994, two of the most published authors in the field of Rational Emotive Behavior Therapy (REBT), Albert Ellis and Windy Dryden, each saw the same client. The transcript of Windy Dryden is presented with slight modifications to protect the confidentiality of the client and those in the client’s life.

  8. Experience of Client-centered Practice amongst Danish Occupational Therapists

    DEFF Research Database (Denmark)

    Larsen, Anette Enemark

    A client-centered approach is on the health care agenda in many European countries (1), and amongst these Denmark (2). It is described as the foundation for Occupational Therapy (OT) (3), a code of professional conduct (4,5), and defined as a partnership between client and therapist (3). The goal...

  9. E-mail security: mail clients must use encrypted protocols

    CERN Multimedia


    In the coming weeks, users of mail clients other than Outlook (e.g. Pine, Mozilla, Mac Mail, etc.) may receive an e-mail from with instructions to update the security settings of their mail client. The aim of this campaign is to enforce the use of encrypted and authenticated mail protocols in order to prevent the propagation of viruses and protect passwords from theft. As a first step, from 6 June 2006 onwards, access to mail servers from outside CERN will require a securely configured mail client as described in the help page On this page most users will also find tools that will update their mail client settings automatically. Note that Outlook clients and WebMail access are not affected. The Mail Team

  10. The impact of organizational stress and burnout on client engagement. (United States)

    Landrum, Brittany; Knight, Danica K; Flynn, Patrick M


    This article explores the impact of organizational attributes on client engagement within substance abuse treatment. Previous research has identified organizational features, including small size, accreditation, and workplace practices, that impact client engagement (K. M. Broome, P. M. Flynn, D. K. Knight, & D. D. Simpson, 2007). This study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the United States. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, whereas engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress but was not related to participation. Two additional organizational measures--workload and influence--moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Drug treatment clients and their community peers: how they differ. (United States)

    Bowser, Benjamin P; Lewis, David; Dogan, Derrick; Word, Carl


    Free-at-Last is a drug treatment program in East Palo Alto, California, a low-income predominantly African American community in Silicon Valley. In this research, a cohort of treatment clients was compared to a random sample of community residents. Both groups used drugs. Two-way analysis of variance was used to identify factors that predicted the number of drugs used, controlling for client or community sample status. Significant predictors turned out to be perception of race discrimination, ever selling drugs, contact with the police, the number of relatives who died suddenly as a juvenile, ever having thoughts of suicide, and marital status. Path analysis was used to show the relationship between predictors of the number of drugs used for treatment clients; a second path was done for community clients. By comparing each path analysis, we were able to show how treatment clients arrived at significantly higher drug use than peers in the community.

  12. Client-server multitask learning from distributed datasets. (United States)

    Dinuzzo, Francesco; Pillonetto, Gianluigi; De Nicolao, Giuseppe


    A client-server architecture to simultaneously solve multiple learning tasks from distributed datasets is described. In such architecture, each client corresponds to an individual learning task and the associated dataset of examples. The goal of the architecture is to perform information fusion from multiple datasets while preserving privacy of individual data. The role of the server is to collect data in real time from the clients and codify the information in a common database. Such information can be used by all the clients to solve their individual learning task, so that each client can exploit the information content of all the datasets without actually having access to private data of others. The proposed algorithmic framework, based on regularization and kernel methods, uses a suitable class of "mixed effect" kernels. The methodology is illustrated through a simulated recommendation system, as well as an experiment involving pharmacological data coming from a multicentric clinical trial.

  13. Mutual construction and reconstruction in client-consultant interaction

    DEFF Research Database (Denmark)

    Smith, Irene Skovgaard

    Based on preliminary interviews with client representatives and a pilot case study, the pa-per explores collaboration and mutual construction in client-consultant relationships. Both consultants and client actors take part in an active construction and reconstruction of knowledge that involve...... struggles over position, power and control. In the context of client-consultant interaction, it is thus not only ideas and solutions that are contested but also the power to define. Attention is paid to how ideas are brought into play and negotiated in the interaction between actors. The empirical material...... presented in the paper illustrates how consultancy projects evolve through processes of negotiation over whose interpretation should count and who should be in control. In the process, client actors with different posi-tions and interests play an active role in creating what become valid and what ideas...

  14. Internet provision of tailored advice on falls prevention activities for older people: a randomized controlled evaluation. (United States)

    Yardley, Lucy; Nyman, Samuel R


    Falls are very common in older persons and can result in substantial disability and distress. By undertaking strength and balance training (SBT) exercises, older people can reduce their risk of falling. The Internet offers a potentially cost-effective means of disseminating information about SBT to older people and their carers. A particular advantage of using the Internet for this purpose is that the advice given can be 'tailored' to the needs of the individual. This study used a randomized controlled design to evaluate an interactive web-based program that tailored advice about undertaking SBT activities. The participants were 280 people with an age range of 65-97 years recruited by advertising the website by email and the Internet. Those randomized to the tailored advice were presented with advice tailored to their personal self-rated balance capabilities, health problems and activity preferences. Those in the control group were presented with all the advice from which the tailored advice was selected. After reading the advice, those in the tailored advice group (n = 144) had more positive attitudes (p < 0.01) than those in the control group (n = 136), reporting greater perceived relevance of the SBT activities, greater confidence in the ability to carry them out, and hence stronger intentions to undertake the activities. This study provides an initial indication that an interactive website might offer a cost-effective way to provide personalized advice to some older people. Further research is required to determine whether website-based advice on falls prevention changes behavior as well as intentions and whether the advice needs to be supplemented by other forms of support.

  15. Realizing the Potential of Information Resources: Information, Technology, and Services. Track 3: Serving Clients with Client/Server. (United States)

    CAUSE, Boulder, CO.

    Eight papers are presented from the 1995 CAUSE conference track on client/server issues faced by managers of information technology at colleges and universities. The papers include: (1) "The Realities of Client/Server Development and Implementation" (Mary Ann Carr and Alan Hartwig), which examines Carnegie Mellon University's transition…

  16. United Kingdom Veterinarians' Perceptions of Clients' Internet Use and the Perceived Impact on the Client-Vet Relationship. (United States)

    Kogan, Lori R; Oxley, James A; Hellyer, Peter; Schoenfeld-Tacher, Regina


    The Internet is a commonly used resource for accessing health information. Despite the Internet's popularity in the human health field, little is known about the Internet's impact on veterinarians, their clients, and the veterinarian-client relationship. The aim of this study was to investigate the perception of veterinarians from the United Kingdom of clients' use of the Internet and the perceived impact on pet health and the veterinarian-client relationship. A survey was distributed between January 4 and March 3, 2017, via an online link. In total, 100 veterinarians completed the survey. This study found that most UK veterinarians feel their clients access the Internet to find pet health information, yet often do not understand what they read online. Importantly, 40% of veterinarians stated that the Internet has a negative impact on companion animal health. This small-scale study found mixed opinions regarding veterinarians' perceptions of their clients' use of the Internet and the potential impact it has on the client-veterinarian relationship. Research on clients' actual use of the Internet and their associated perceptions is a next logical step.

  17. Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service. (United States)

    Cockburn, Nicole; Gartner, Coral; Ford, Pauline J


    Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  18. Client/server approach to image capturing (United States)

    Tuijn, Chris; Stokes, Earle


    The diversity of the digital image capturing devices on the market today is quite astonishing and ranges from low-cost CCD scanners to digital cameras (for both action and stand-still scenes), mid-end CCD scanners for desktop publishing and pre- press applications and high-end CCD flatbed scanners and drum- scanners with photo multiplier technology. Each device and market segment has its own specific needs which explains the diversity of the associated scanner applications. What all those applications have in common is the need to communicate with a particular device to import the digital images; after the import, additional image processing might be needed as well as color management operations. Although the specific requirements for all of these applications might differ considerably, a number of image capturing and color management facilities as well as other services are needed which can be shared. In this paper, we propose a client/server architecture for scanning and image editing applications which can be used as a common component for all these applications. One of the principal components of the scan server is the input capturing module. The specification of the input jobs is based on a generic input device model. Through this model we make abstraction of the specific scanner parameters and define the scan job definitions by a number of absolute parameters. As a result, scan job definitions will be less dependent on a particular scanner and have a more universal meaning. In this context, we also elaborate on the interaction of the generic parameters and the color characterization (i.e., the ICC profile). Other topics that are covered are the scheduling and parallel processing capabilities of the server, the image processing facilities, the interaction with the ICC engine, the communication facilities (both in-memory and over the network) and the different client architectures (stand-alone applications, TWAIN servers, plug-ins, OLE or Apple-event driven

  19. Innovation and Patchwork Partnerships: Advice Services in Austere Times

    Directory of Open Access Journals (Sweden)

    Alice Forbess


    Full Text Available In the UK’s austerity regime, government spending has been slashed, while audit regimes tie up officers of charitable organisations in bureaucracy rather than leaving them free to attend to the substance of their jobs. These funding-cuts-masquerading-as-market-based-restructuring have drastically affected the provision of advice to welfare dependents. But advisers, and the organisations they work for, piece together new patchworks of funds, devise new forms of face-to-face advice, and rework the boundaries of the law. Local authority funds are invested to yield returns from centrally-funded sources. People are helped to honour their tax commitments while challenging debts incurred from the incorrect award and reclaim of benefits, and to pay their council tax and rent. For advisers, austerity is more a matter of seeking new resource flows, inventing novel interventions, and creating new spaces where justice may be sought and found, than of passively accepting funding cuts. En el Reino Unido, las políticas de recortes de fondos maquilladas como restructuraciones basadas en el mercado han afectado drásticamente la provisión a los dependientes de la asistencia social. Pero los asesores y las organizaciones para las que trabajan forman nuevos tejidos de fondos financieros, ingenian nuevas formas de ayudar en persona y reconfiguran los límites de la ley. Los fondos financieros de los gobiernos locales se invierten para obtener réditos de fuentes de financiación centralizada. Se ayuda a la gente a cumplir con sus obligaciones fiscales y, al mismo tiempo, a recortar las deudas generadas por una incorrecta concesión y reclamación de prestaciones, y a pagar sus tasas municipales y sus alquileres. Para los asesores, la austeridad es una cuestión de buscar nuevos flujos de recursos, idear nuevas formas de intervención y crear nuevos espacios en los que la justicia pueda ser buscada y hallada. DOWNLOAD THIS PAPER FROM SSRN: http

  20. [Pre-travel advice and patient education of Hungarian travellers]. (United States)

    Lengyel, Ingrid; Felkai, Péter


    According to international surveys, over half of the travellers face some kind of health issue when travelling. The overwhelming majority of travel-related illnesses can be prevented with pre-travel medical consultations, but the syllabus and content of the consultation have to match the travel habits and culture of the given society. This publication explores the specificities and travel habits of Hungarian travellers. One hundred participants of a travel exhibition completed a survey about their international travel. As the survey was not representative, the data could only be processed through simple statistical methods. However, since the exhibition was presumably attended by those wishing to travel, the conclusions drawn from the results are worth publishing, since no similar survey in Hungary has been published before. Based on the suitable classification of age groups in travel medicine, 11% of the participants were adolescents / young adults (aged 15-24), 81% adults (25-59) and 8% elderly (60-74). Twenty-eight percent of the participants travel multiple times a year, 40% yearly and 32% of them less frequently; 16% of the adults, 8% of the adolescents and 4% of the elderly age group travel multiple times a year. The travel destinations of Hungarian travellers have remained practically unchanged since a study was conducted 13 years ago: the vast majority (95%) travelled within Europe, 2% to the United States, and 11% of them elsewhere. Since Hungarians do not travel to endemic areas, only 5% consulted their general practitioners (GPs) prior to travelling, and 29% did when they had to be vaccinated. Forty-two percent of those wishing to travel never consult their GPs, even though 29% of them are aware of some chronic illness. Instead, 51% gather their health information from the internet and only 6% from their doctors. By the contradiction between the poor health status of the majority of Hungarian travellers and the negligence of seeking pre-travel advice

  1. Interactional patterns between staff and clients with borderline to mild intellectual disabilities

    NARCIS (Netherlands)

    Reuzel, E.; Embregts, P.J.C.M.; Bosman, A.M.T.; van Nieuwenhuizen, A.; Jahoda, A.


    Background Client-centred models of care imply that clients should have a collaborative relationship with staff providing support. This study investigates whether dialogues between staff and clients in naturally occurring contexts reflect this collaborative ideal. Methods Nineteen staff members

  2. Quality of Extension Advice: A Gendered Case Study from Ghana and Sri Lanka (United States)

    Lamontagne-Godwin, Julien; Williams, Frances; Bandara, Willoru Mudiyansele Palitha Thilakasiri; Appiah-Kubi, Ziporah


    Purpose: Women farmers have less access to extension services than male farmers, even though they make up almost half of the global agricultural workforce. Gender-focused international development programmes have focused on how ensuring women receive better access to advice. However, the quality of the technical advice and the service women…

  3. 75 FR 33824 - Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition... (United States)


    ... Intermediates, Fourth Review: Advice Concerning the Addition of Certain Products to the Pharmaceutical Appendix..., Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition of Certain...-zero initiative are conducting a fourth review to determine if products can be added to the initiative...

  4. The role of financial literacy and advice in fi nancial decision making ...

    African Journals Online (AJOL)

    A growing body of research is focused on determining to what extent fi nancial advice can act as a substitute for low levels of fi nancial literacy. To date, studies have found confl icting results. This study used data from a national survey of South Africans to determine whether advice could substitute for low levels of fi nancial ...

  5. Patients, evidence and genes: an exploration of GPs' perspectives on gene-based personalized nutrition advice

    NARCIS (Netherlands)

    Bouwman, L.I.; Molder, te H.F.M.; Hiddink, G.J.


    Background. Nutrigenomics science examines the response of individuals to food compounds using post-genomics technology. It is expected that in the future, personalized nutrition advice can be provided based on information about genetic make-up. Objectives. Gene-based personalized nutrition advice

  6. Empowering Girls through Sport? Sports Advice Books for Young Female Readers (United States)

    Heinecken, Dawn


    Advice books by female athletes are among the top selling sports books for young readers in the US. Though they have received little attention to date, sports advice books are important to examine because of how they function as a form of conduct manual instructing girls in specific understandings of female identity. Implying that girls face…

  7. An experimental study into the influence of works council advice on managerial decision-making

    NARCIS (Netherlands)

    Sapulete, S.; van Witteloostuijn, A.; Kaufmann, W.

    This paper experimentally studies the effect of works council advice on managerial decision-making, aiming to gain more insights into the fundamental mechanisms that may underlie the impact of works council advice. We conducted laboratory experiments in which subjects played a two-player Prisoner's

  8. Young People's Use of Friends and Family for Sex and Relationships Information and Advice (United States)

    Powell, Eryl


    With the recognition that improving access to advice and support on sex and relationships is vital in helping young people make positive healthy choices, the present paper explores how young people gain such information and advice. Drawing on the analysis of questionnaire and interview data collected for a local study of 401 young people from…

  9. Assessing drivers ability to carry out headway advice in motorway car driving

    NARCIS (Netherlands)

    Risto, Malte; Martens, Marieke Hendrikje; nb,


    In order to improve throughput on motorways, a headway advisory system is being developed. This system could enable drivers to choose their headway differently by providing in-vehicle advice. How well are drivers able to follow a time or a distance headway advice and what effect has vehicle speed

  10. Peer Tutoring in a Graduate Writing Centre: Identity, Expertise, and Advice Resisting (United States)

    Waring, Hansun Zhang


    Compared to research on the giving of advice (e.g. Hutchby 1995), relatively less work has been conducted on the receiving or resisting of advice, where the interactionally problematic nature of advising is crystallized (e.g. Heritage and Sefi 1992). Moreover, the notion of advising in education settings has predominantly concerned procedural…

  11. Who Leaves the Hospital Against Medical Advice in the Orthopaedic Setting?

    NARCIS (Netherlands)

    Menendez, Mariano E.; van Dijk, C. Niek; Ring, David


    Patients who leave the hospital against medical advice are at risk for readmission and for a variety of complications and are likely to consume more healthcare resources. However, little is known about which factors, if any, may be associated with self-discharge (discharge against medical advice)

  12. The binding study advice in medical education: a 2-year experience. (United States)

    Eijsvogels, Thijs M H; Goorden, Ronald; van den Bosch, Wil; Hopman, Maria T E


    To improve the effectiveness of higher education, Dutch universities implemented the binding study advice at medical faculties. Accordingly, medicine students of Radboud University need to gain ≥ 42 out of 60 European Credit Transfer System (ECTS) credits to obtain a positive binding study advice and to continue their study programme. In case of a negative advice, the student is obliged to terminate the study, and he/she cannot register for the same study programme in the Netherlands within the next three years. The purpose of this manuscript is to evaluate the effect of implementation of the binding study advice on study outcomes. First, the binding study advice did not impact on student performance, as the average ECTS credits were comparable before and after its introduction. Second, study progress improved 8 % with 93 % of the students obtaining access to the second year of the study programme after binding study advice implementation. Third, the binding study advice did not impact propaedeutic graduation rates. These data demonstrate that the implementation of the binding study advice in medical faculties has only a small impact on study outcomes. The high performance levels of medical students compared with peers at other faculties are likely to contribute to these findings and suggest a 'ceiling effect' in the potential improvement of study outcomes at medical faculties.

  13. The binding study advice in medical education: a 2-year experience.

    NARCIS (Netherlands)

    Eijsvogels, T.M.H.; Goorden, R.; Bosch, W.J.H.M. van den; Hopman, M.T.E.


    To improve the effectiveness of higher education, Dutch universities implemented the binding study advice at medical faculties. Accordingly, medicine students of Radboud University need to gain >/= 42 out of 60 European Credit Transfer System (ECTS) credits to obtain a positive binding study advice

  14. 19 CFR 181.99 - Issuance of NAFTA advance rulings or other advice. (United States)


    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Issuance of NAFTA advance rulings or other advice... Procedures § 181.99 Issuance of NAFTA advance rulings or other advice. (a) NAFTA advance ruling letters—(1... administration of the NAFTA provisions to do so. Otherwise, a request for an advance ruling will be answered by...

  15. Implementing a client-centred approach in rehabilitation: an autoethnography. (United States)

    Bright, Felicity A S; Boland, Pauline; Rutherford, Sandy J; Kayes, Nicola M; McPherson, Kathryn M


    Client-centred practice is widely considered a key element of rehabilitation. However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalized during a clinical trial of innovative goal-setting techniques. This study drew on principles of co-autoethnography. The personal experiences of three clinical researchers were explored to identify insights into client-centred practice, and seek understanding of this within the broader socio-cultural context. Data were collected through group discussions and written reflections. Thematic analysis and coding were used to identify the dominant themes from the data. The primary way that client-centred practice was operationalized was through listening in order to get to know, to uncover and to understand what was meaningful. Four strategies were identified: utilizing mindful listening, allowing time, supporting clients to prioritize what is meaningful and viewing the therapists' role differently. While technical competence in rehabilitation is important, our study suggested a starting point of 'being with' rather than 'doing to' may be beneficial for engaging people in their rehabilitation. We have highlighted a number of practical strategies that can be used to facilitate more client-centred practice. These approaches are consistent with what clients report they want and need from rehabilitation services.

  16. Protecting mental health clients' dignity - the importance of legal control. (United States)

    Kogstad, Ragnfrid Eline


    Protecting human beings' dignity is a fundamental value underlying the UN's Universal Declaration of Human Rights as well as several recommendations and conventions derived from this, among them the European Convention of Human Rights (ECHR), a declaration that also takes precedence over Norwegian legislation. Still, clients' stories inform us that their dignity is not always protected in the mental health service systems. The aim of the study has been to investigate violations of dignity considered from the clients' points of view, and to suggest actions that may ensure that practice is brought in line with human rights values. The method used has been a qualitative content analysis of 335 client narratives. The conclusion is that mental health clients experience infringements that cannot be explained without reference to their status as clients in a system which, based on judgments from medical experts, has a legitimate right to ignore clients' voices as well as their fundamental human rights. The main focus of this discussion is the role of the ECHR and the European Court of Human Rights as instruments for protecting mental health clients' human rights. To bring about changes, recommendations and practices should be harmonized with the new UN Convention on the Rights of Persons with Disabilities (2006). Under this convention, the European Court of Human Rights has support for the application of the ECHR without exemptions for special groups of people.

  17. Reflection as a means to foster client-centred practice. (United States)

    Duggan, Ruth


    Client-centred practice embraces important concepts about partnership and justice that promote client participation in meaningful occupations. It is important to understand how occupational therapists can engage in and continue to develop client-centred practice within the constraints of everyday settings. An action research study was undertaken by a group of four occupational therapists to describe insights gained, and to show the effectiveness of participation in reflective education to help foster client-centred practice. The six main insights generated by the group involve: congruence, understanding the potential, environmental factors, personal factors, expectations, and lifelong learning. Although actual change to daily practice was limited, group members felt the reflective group discussion provided them with a launch pad to start a journey toward more client-centred practice. This may be the key to moving beyond simply changing the face and language of occupational therapy practice toward a deeper understanding and implementation of client-centred practice to improve client outcomes. Suggestions are provided for implementing reflection to help continue to develop your own practice.

  18. Enhancing student occupational therapists' client-centred counselling skills. (United States)

    Wener, Pamela F; Bergen, Carolyn O; Diamond-Burchuk, Lisa G; Yamamoto, Cynthia M; Hosegood, Alana E; Staley, James D


    Client-centred practice is the cornerstone of the occupational therapy profession. However, there has been little focus on how to teach students to be client-centred practitioners while engaged in counselling. The purpose of this study was to examine the impact of the use of a client-completed rating scale on student occupational therapists' client-centred counselling skills. A time-series design was used to measure the changes in students' counselling skills over time. Demographic information was collected prior to time one. An online questionnaire was administered after study completion to explore students' experiences of using the Session Rating Scale. The impact of using the Session Rating Scale as a measure of students' client-centred counselling skills performance significantly improved over time. Most students valued using the rating scale and would recommend its use for future students. The process of supporting students to learn how to engage clients in providing timely feedback and using this feedback to design treatment sets the stage for integration and application of client-centred practice. © CAOT 2015.

  19. The therapy relationship with lesbian and gay clients. (United States)

    Kelley, Frances A


    This study investigated the role of therapy practices and the therapy relationship on lesbian and gay clients' feelings about their current therapist. Participants were 76 lesbian and 40 gay male clients ranging in age from 19 to 69 years. The real relationship was found to predict an additional 8% of variance in clients' positive feelings about their therapist above and beyond months in therapy, therapy practices, and the working alliance. However, therapy practices did not add significance in predicting lesbian and gay clients' feelings about their therapist beyond the working alliance and the real relationship. Fifty-three of the participants responded to a question about their current experiences in therapy, and the data were analyzed using consensual qualitative research-modified (CQR-M; Spangler, Liu, & Hill, 2012). Thirty percent of clients indicated a preference for a lesbian or gay therapist, or gay-friendly therapist. Only 25% found that their therapist lacked knowledge about lesbian and gay issues, but 21% indicated that their therapist was dismissive of and/or viewed their sexual orientation as a problem. More than two-thirds of the participants indicated they had a positive therapy relationship with their therapist. Results highlight the important role that therapy practices and the therapy relationship play in lesbian and gay clients perceptions' of their therapist. The findings also provide support for heterosexual therapists' ability to develop a positive therapy relationship and be effective with lesbian and gay clients. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  20. Negotiating exceptions to clients' problem discourse in consultative dialogue. (United States)

    Strong, Tom; Pyle, Nathan R


    The purpose of this qualitative study was to examine how consultants negotiated exceptions to clients problem or aspiration discourse in lifestyle consultations held for research purposes. Participants from a university campus (students and employees) were recruited for 1-hr lifestyle consultations with therapist consultants having graduate training and supervision in narrative and solution-focused therapy. The consultations were held with the expectation that consultants would, at least once, invite discussions of exceptions in client's problem or aspiration discourse. We wanted to understand how such discussions were initiated and brought to conclusion by examining client and consultants use of conversational practices. Twelve volunteer 'clients' participated in consultations with our six volunteering consultants. These consultations were videotaped then passages were selected where consultants initiated exception discussions with the clients involved. The 18 selected passages were discursively analyzed for general rhetorical features evident in those passages, and three passages were transcribed and analyzed using conversation analysis to make evident more specific rhetorical features of exception discussions, as they were engaged in by consultants and clients. Ten general features of exception discussions were highlighted and the more specific conversational analyses revealed a 'messiness' that was related to how exception discussions were introduced and negotiated as a novel discourse in the consultations. We discuss our findings in the context of therapists' use of exception questions and discussions in therapy and highlight particular conversational practices and sensitivities relevant to engaging clients in such exception discussions. ©2011 The British Psychological Society.

  1. Negotiating: experiences of community nurses when contracting with clients. (United States)

    Duiveman, Trudie; Bonner, Ann


    A community nurse is required to have excellent interpersonal, teaching, collaborative and clinical skills in order to develop effective individualised client care contracts. Using a descriptive qualitative design data was collected from two focus groups of fourteen community nurses to explore the issues surrounding negotiating and contracting client care contracts from the perspective of community nurses. Thematic analysis revealed three themes: 'assessment of needs', 'education towards enablement', and 'negotiation'. 'Assessment of needs' identified that community nurses assess both the client's requirements for health care as well as the ability of the nurse to provide that care. 'Education towards enablement' described that education of the client is a common strategy used by community nurses to establish realistic goals of health care as part of developing an ongoing care plan. The final theme, 'negotiation', involved an informed agreement between the client and the community nurse which forms the origin of the care contract that will direct the partnership between the client and the nurse. Of importance for community nurses is that development of successful person-centred care contracts requires skillful negotiation of care that strikes the balance between the needs of the client and the ability of the nurse to meet those needs.

  2. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    Directory of Open Access Journals (Sweden)

    Mark Brennan-Ing

    Full Text Available In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM, for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment. Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500. When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of

  3. Professional and Scholarly Writing: Advice for Information Professionals and Academics

    Directory of Open Access Journals (Sweden)

    Cox, Richard J.


    Full Text Available There has been an explosion of new research and writing about all aspects of the information disciplines. Nevertheless, both academics and practitioners often find it difficult to engage in successful writing strategies. Indeed, writing is hard work, and doing it in a way that leads to publication is an even harder task. Since reading is essential to good writing, the challenges of learning to write are obvious. In this essay, I am drawing on many years of experience in writing and publishing, as well as considerable reading of writers’ memoirs, advice books on writing, literary studies, and other perspectives on the experience of writing in order to offer a set of approaches that can be pursued over a lifetime of scholarship and practice. Writing is a craft or art to be learned, and learning demands paying attention to the audience, having clear objectives, being an avid reader, and possessing the ability to accept and learn from criticism. While information professionals and scholars incessantly write for each other, there are large segments of the public and other disciplines who they ignore. Fortunately, the tools and resources for improving one’s writing are both broad and deep; discipline and realistic strategies are all that are required to improve one’s writing and, ultimately, to achieve success in publishing.

  4. Top-selling childbirth advice books: a discourse analysis. (United States)

    Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda


    Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

  5. Whatever happens to trauma patients who leave against medical advice? (United States)

    Olufajo, Olubode A; Metcalfe, David; Yorkgitis, Brian K; Cooper, Zara; Askari, Reza; Havens, Joaquim M; Brat, Gabriel A; Haider, Adil H; Salim, Ali


    Although trauma patients are frequently discharged against medical advice (AMA), the fate of these patients remains mostly unknown. Patients with traumatic injuries were identified in the California State Inpatient Database, 2007 to 2011. Readmission characteristics of patients discharged AMA were compared with patients discharged home. There were 203,756 (75.65%) patients discharged home and 4,480 (1.66%) discharged AMA. Compared with those discharged home, patients discharged AMA had significantly higher 30-day readmission rates (17.12% vs 6.75%), rates of multiple readmissions (3.83% vs 1.12%), and likelihood of being readmitted at different hospitals (44.83% vs 33.82%) (all P < .001). The commonest reasons for readmission in patients discharged AMA were psychiatric conditions [adjusted odds ratio: 1.67 (1.21 to 2.27)]. Discharge AMA is associated with multiple readmissions and higher rates of readmissions at different hospitals. Early identification of vulnerable patients and improved modalities to prevent discharge AMA among these patients may reduce the negative outcomes associated with discharge AMA among trauma patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Advice concerning the early diagnosis of bronchial carcinoma

    International Nuclear Information System (INIS)


    Bronchial carcinoma is in the Netherlands for men the most frequent type of cancer; the incidence in women is rising. In the Netherlands nowadays, per year about 7100 persons die of this disease which therefore constitutes an important public health problem. The request of advice asks - among other things - whether in the future the periodical X-ray examination of the thorax for the detection of tuberculosis of persons over 40 years can be continued for presymptomatic cases of bronchial carcinoma. The available relevant literature does not yet give indications that periodical mass radiography has any influence on the morbidity and mortality of the disease. On the other hand, literature describing clinical experience shows that the prognosis of patients with bronchial carcinoma, detected in an early presymptomatic stage, is essentially better than in the case of patients with symptomatic disease. A critical analysis of the literature does not furnish epidemiological arguments to recommend periodical mass radiography for bronchial carcinoma. However, because lungcancer forms an extremely important public health problem and because the scarcity of randomized; controlled studies in this field, the committee advises - from a scientific point of view - to perform such a study in one or preferably two regions in the Netherlands. A number of conditions are mentioned which such a study at least should meet. (Auth.)

  7. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Directory of Open Access Journals (Sweden)

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  8. When hearing clients work with a deaf therapist. (United States)

    Jampel, Julie B


    Not being able to hear can present significant challenges for the therapist and for the deaf therapist/hearing client dyad. It can also create opportunities. Although the literature indicates that most culturally Deaf therapists work with Deaf clients due to their mutual use of American Sign Language, I describe (a) the background of an audiologically deaf therapist who relies on speech reading rather than sign language, and (b) this therapist's clinical work with hearing clients. Some of the relational dynamics of these treatments are identified, and I conclude by noting how attention to communication can benefit the work of all psychotherapists. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  9. An experimental study of client-side Spotify peering behaviour


    Ellis, M.; Strowes, S.; Perkins, C.


    Spotify is a popular music-streaming service which has seen widespread use across Europe. While Spotify’s server-side behaviour has previously been studied, little is known about the client-side behaviour. In this paper, we describe an experimental study where we collect packet headers for Spotify traffic over multiple 24-hour time frames at a client host. Two distinct types of behaviour are observed, when tracks are being downloaded, and when the client is only serving requests from other pe...

  10. Examining motivational interviewing from a client agency perspective. (United States)

    Faris, Alexander S; Cavell, Timothy A; Fishburne, John W; Britton, Peter C


    Although empirical investigations strongly support the use of motivational interviewing (MI), there is no theory to clearly explain how or why MI works. The authors propose that MI is efficacious because it mobilizes clients' inherent resources for motivation, learning, creativity, problem solving, and goal-driven activity. Examining MI from a client agency perspective reveals new ways of conceptualizing several critical issues, including MI's fundamental "spirit," the function of resolving ambivalence, the importance of change talk, MI's ability to combine well with other approaches, and the success of brief MI interventions. Implications for the science and practice of MI are discussed from the standpoint that clients are primarily responsible for driving therapeutic gains.

  11. UNIX based client/server hospital information system. (United States)

    Nakamura, S; Sakurai, K; Uchiyama, M; Yoshii, Y; Tachibana, N


    SMILE (St. Luke's Medical Center Information Linkage Environment) is a HIS which is a client/server system using a UNIX workstation under an open network, LAN(FDDI&10BASE-T). It provides a multivendor environment, high performance with low cost and a user-friendly GUI. However, the client/server architecture with a UNIX workstation does not have the same OLTP environment (ex. TP monor) as the mainframe. So, our system problems and the steps used to solve them were reviewed. Several points that are necessary for a client/server system with a UNIX workstation in the future are presented.

  12. The AROW Health Link experience with client-based system design. (United States)

    Hambleton, Joshua


    This article outlines the experience of the Arnprior Region & Ottawa West (AROW) Health Link using a multi-dimensional engagement framework in the co-development of systems change with client representatives. The article outlines patient, organizational, and societal factors influencing client engagement. The key learning that has allowed the joint Client Engagement Committee to evolve has been the core of client leadership. Client-led tables and workgroups have fueled client-to-client engagement, which has shifted clients from being a part of the change to driving the change. © 2016 The Canadian College of Health Leaders.

  13. Toward evidence-based, client-centred nutrition education guidelines: dietitian and consumer survey results. (United States)

    MacLellan, Deborah; Morley, Catherine; Traviss, Karol; Cividin, Theresa


    Dietitian and consumer perspectives on nutrition education needs and preferences were explored, as these relate to health status Phases 1 and 2 of a three-phase, mixed-methods study are reported. Phase 1 was a national online survey of dietitians, which was designed to inform the development of a consumer survey (Phase 2). Consumers responded to an online survey about their demographics, medical conditions, and nutrition education needs (what they wanted to learn) and preferences (how they wanted to learn). Phase 3 involved teleconferenced discussion groups with dietitians across Canada to develop guidelines for nutrition education. Dietitian respondents (n=441) perceived that consumer health status was important in predicting needs and preferences for nutrition education; emotional support was considered most important for consumers with life-altering medical conditions. Consumers (n=680) expressed interest in an array of nutrition education approaches; cooking tips, recipes, and supplement advice were the most popular. Respondents with and without medical conditions had similar nutrition education needs and preferences. Because of the complexity of nutrition education and consumers' preference for a spectrum of approaches and delivery methods, evidence-based nutrition education guidelines are important to inform dietetics training for the provision of client-centred nutrition education.

  14. GenExp: an interactive web-based genomic DAS client with client-side data rendering.

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    Bernat Gel Moreno

    Full Text Available BACKGROUND: The Distributed Annotation System (DAS offers a standard protocol for sharing and integrating annotations on biological sequences. There are more than 1000 DAS sources available and the number is steadily increasing. Clients are an essential part of the DAS system and integrate data from several independent sources in order to create a useful representation to the user. While web-based DAS clients exist, most of them do not have direct interaction capabilities such as dragging and zooming with the mouse. RESULTS: Here we present GenExp, a web based and fully interactive visual DAS client. GenExp is a genome oriented DAS client capable of creating informative representations of genomic data zooming out from base level to complete chromosomes. It proposes a novel approach to genomic data rendering and uses the latest HTML5 web technologies to create the data representation inside the client browser. Thanks to client-side rendering most position changes do not need a network request to the server and so responses to zooming and panning are almost immediate. In GenExp it is possible to explore the genome intuitively moving it with the mouse just like geographical map applications. Additionally, in GenExp it is possible to have more than one data viewer at the same time and to save the current state of the application to revisit it later on. CONCLUSIONS: GenExp is a new interactive web-based client for DAS and addresses some of the short-comings of the existing clients. It uses client-side data rendering techniques resulting in easier genome browsing and exploration. GenExp is open source under the GPL license and it is freely available at

  15. The tripartite efficacy framework in client-therapist rehabilitation interactions: implications for relationship quality and client engagement. (United States)

    Jackson, Ben; Dimmock, James A; Taylor, Ian M; Hagger, Martin S


    Within supervised rehabilitation programs, Lent and Lopez (2002) proposed that clients and therapists develop a "tripartite" network of efficacy beliefs, comprising their confidence in their own ability, their confidence in the other person's ability, and their estimation of the other person's confidence in them. To date, researchers have yet to explore the potential relational outcomes associated with this model in rehabilitation contexts. In Study 1, we recruited 170 exercise clients (Mage = 63.73, SD = 6.46) who were enrolled in a one-to-one aerobic exercise program with a therapist as a result of a lower-limb musculoskeletal disorder. Clients reported their tripartite efficacy beliefs and perceptions about the quality of their relationship with their therapist, and respective therapists rated each client's engagement in his or her exercise program. In Study 2, we recruited 68 separate exercise clients (Mage = 65.93, SD = 5.80) along with their therapists (n = 68, Mage = 31.89, SD = 4.79) from the same program, to examine whether individuals' efficacy perceptions were related to their own and/or the other person's relationship quality perceptions. In Study 1, each of the tripartite efficacy constructs displayed positive direct effects with respect to clients' relationship quality appraisals, as well as indirect effects in relation to program engagement. Actor-partner interdependence modeling in Study 2 demonstrated that clients and therapists reported more adaptive relationship perceptions when they themselves held strong tripartite efficacy beliefs (i.e., actor effects), and that clients viewed their relationship in a more positive light when their therapist was highly confident in the client's ability (i.e., partner effect). These findings underscore the potential utility of the tripartite efficacy framework in relation to motivational and relational processes within supervised exercise programs. PsycINFO Database Record (c) 2012 APA, all rights reserved

  16. Does the "script" need a rewrite? Is medication advice in television medical dramas appropriate? (United States)

    Cowley, M; Naunton, M; Thomas, J; Waddington, F; Peterson, G M


    Television medical dramas depict the healthcare industry and draw considerable interest from the public, while pharmacists play an integral part in providing medication-related advice to the public and other health practitioners in real life. The main objective of this retrospective, observational study was to assess the appropriateness of medication advice given in televised medical dramas and how frequently pharmacists were involved in providing the medication advice. Show selection was based on fictional series with a medical drama theme and having the highest viewership. Approximately 100 randomly selected hours of five medical television dramas (House, Grey's Anatomy, Nurse Jackie, Doc Martin and Royal Pains) were assessed for the appropriateness of advice given based on the medication indicated, number of safety checks performed, and the level of adherence to standard clinical guidelines. The appropriateness of medication advice was assessed as appropriate, mostly appropriate, partially appropriate and inappropriate using a piloted, 0-6 point scale. Other parameters recorded included patient demographics, health professionals involved, and the categories of medicines. Medications were mentioned on 424 occasions (on average four times per hour), including 239 occasions where medication advice was given. A pharmacist was involved in giving medication advice only 16 times (7%). Using the assessment tool, overall, medication advice was deemed to be appropriate 24% of the time, mostly appropriate 34%, partially appropriate 13% and inappropriate 7%. Although the medication advice given was often for the correct indication and the advice somewhat followed clinical guidelines, it frequently omitted adequate safety checks. Doc Martin had the highest mean appropriateness score, whereas House and Grey's Anatomy had the lowest. Medication was often used for the correct indication in television medical dramas; however, key safety checks were frequently omitted and other

  17. Client Centeredness and Health Reform: Key Issues for Occupational Therapy (United States)

    Pitonyak, Jennifer S.; Fogelberg, Donald; Leland, Natalie E.


    Health reform promotes the delivery of patient-centered care. Occupational therapy’s rich history of client-centered theory and practice provides an opportunity for the profession to participate in the evolving discussion about how best to provide care that is truly patient centered. However, the growing emphasis on patient-centered care also poses challenges to occupational therapy’s perspectives on client-centered care. We compare the conceptualizations of client-centered and patient-centered care and describe the current state of measurement of client-centered and patient-centered care. We then discuss implications for occupational therapy’s research agenda, practice, and education within the context of patient-centered care, and propose next steps for the profession. PMID:26356651

  18. Ulysses directives in The Netherlands: opinions of psychiatrists and clients. (United States)

    Varekamp, I


    In this article we present a study on the opinions of Dutch psychiatrists and clients on Ulysses directives. In-depth interviews were conducted with 18 clients and 17 psychiatrists. Most respondents were proponents of Ulysses directives. The most frequently mentioned objective of these directives was to secure timely admission to hospital, although a large minority was mainly interested in giving patients influence on treatment decisions. Psychiatrists differed on how much autonomy they preferred with regard to decisions about the moment of admission and kind of treatment. Clients also differed in this respect. Pressure from others to execute a Ulysses directive, and premature admission to the hospital were mentioned as risks of Ulysses directives. Crisis cards were seen as an alternative by many psychiatrists and some clients. Recommendations are made for a good functioning of Ulysses directives, and the appropriateness of crisis cards as an alternative for a number of patients is discussed.

  19. Reflections on the Development of Patron-Client Relationships. (United States)

    Melick-Barthelmess, Karin


    The development of the institution of clientage is traced from ancient Rome to modern times. The patron-client relationships in the hierarchical nature of society and institutions in Spain and Latin America are specifically examined. (RM)

  20. Knowledge, Practices and Education of Clients Regarding Breast ...

    African Journals Online (AJOL)

    depth knowledge regarding breast cancer and BSE among the respondents. The practice of BSE did not proportionately translate to education of clients. In-service educational programs should target PHC workers who will transfer the knowledge ...

  1. Investigation of Social Influence Theory's Conception of Client Resistance. (United States)

    Ruppel, George; Kaul, Theodore J.


    Investigated the predictions of social influence theory with respect to client resistance to counselor influence. Data offered support for the social influence theory in that subjects' expectations of others' instrumental behavior were lower for those who viewed illegitimate counselors. (Author)

  2. Client Mobile Software Design Principles for Mobile Learning Systems

    Directory of Open Access Journals (Sweden)

    Qing Tan


    Full Text Available In a client-server mobile learning system, client mobile software must run on the mobile phone to acquire, package, and send student’s interaction data via the mobile communications network to the connected mobile application server. The server will receive and process the client data in order to offer appropriate content and learning activities. To develop the mobile learning systems there are a number of very important issues that must be addressed. Mobile phones have scarce computing resources. They consist of heterogeneous devices and use various mobile operating systems, they have limitations with their user/device interaction capabilities, high data communications cost, and must provide for device mobility and portability. In this paper we propose five principles for designing Client mobile learning software. A location-based adaptive mobile learning system is presented as a proof of concept to demonstrate the applicability of these design principles.

  3. The association between client type and condom use with steady ...

    African Journals Online (AJOL)

    The association between client type and condom use with steady and unsteady partners among persons seeking HIV testing and counseling services in Kenya. Elizabeth Broel, Larissa Brunner Huber, Jan Warren-Findlow, Elizabeth Racine ...

  4. Client - server programs analysis in the EPOCA environment (United States)

    Donatelli, Susanna; Mazzocca, Nicola; Russo, Stefano


    Client - server processing is a popular paradigm for distributed computing. In the development of client - server programs, the designer has first to ensure that the implementation behaves correctly, in particular that it is deadlock free. Second, he has to guarantee that the program meets predefined performance requirements. This paper addresses the issues in the analysis of client - server programs in EPOCA. EPOCA is a computer-aided software engeneering (CASE) support system that allows the automated construction and analysis of generalized stochastic Petri net (GSPN) models of concurrent applications. The paper describes, on the basis of a realistic case study, how client - server systems are modelled in EPOCA, and the kind of qualitative and quantitative analysis supported by its tools.

  5. Client-centred occupational therapy in Canada: refocusing on core values. (United States)

    Hammell, Karen R Whalley


    The Canadian occupational therapy profession has proclaimed its allegiance to client-centred practice for three decades. However, official definitions of client-centred practice have been inconsistent, and its defining features, underlying assumptions, and power relations have been subjected to little critical reflection. The aim was to reflect critically on Canadian conceptions of client-centred practice and its core values. Definitions of client-centred practice have evolved and changed, suggesting that the occupational therapy profession in Canada may have abandoned those values that originally underpinned its vision of client-centred practice by electing to focus on the enabling skills of therapists. However, evidence suggests that clients value those qualities of client-centred practice that underpinned the profession's original vision. This paper proposes a renewed focus on respect-respect for clients; respect for clients' strengths, experience, and knowledge; respect for clients' moral right to make choices concerning their lives-and on fostering respectful, supportive relationships with clients.

  6. Identifying clients who might benefit from genetic services and information. (United States)

    Gaff, Clara L

    This article is the first in a series of seven which examine competence standards for nurses, midwives and health visitors in relation to genetics. The author indicates who might benefit from a genetic consultation and describes the use of a family history--in the form of a family tree--to identify these clients. Client expectations of a genetic consultation and managing these are also discussed.

  7. QUIP: Understanding Clients Through In-Depth Interviews




    QUIP (Qualitative in-depth individual impact assessment protocol) is a practical method to help managers of microfinance institutions (MFIs) better understand their clients through market research or impact assessment. Most managers would like to know who is benefiting and who is losing out from their services, and why this might be. This is vital information if they wish to design services that are effective and useful for clients.

  8. Visualization Software for VisIT Java Client

    Energy Technology Data Exchange (ETDEWEB)


    The VisIT Java Client (JVC) library is a lightweight thin client that is designed and written purely in the native language of Java (the Python & JavaScript versions of the library use the same concept) and communicates with any new unmodified standalone version of VisIT, a high performance computing parallel visualization toolkit, over traditional or web sockets and dynamically determines capabilities of the running VisIT instance whether local or remote.

  9. Therapist and Client Awareness of Client’s Rights

    Directory of Open Access Journals (Sweden)

    Seyyed Ali Hosseini


    Full Text Available Objective: Although considerable research has been conducted on awareness of and respect for patients' rights in the country, few have been implemented in the rehabilitation field. The aim of this study was to investigate about the awareness rate of rehabilitation clients and therapists, about the “patients' rights charter" in the phase of treatment. Materials & Methods: This descriptive-analytic study was conducted at two university-affiliated centers of the University of Welfare and Rehabilitation Sciences, in 1389-90. 103 clients and 28 therapists were recruited by convenient sampling. Data collection was carried out using 2 forms of questionnaires: that of therapists and of clients, the reliability and validity of which were confirmed. Data were analyzed using Pearson’s correlation coefficient. Results: 44 female and 59 male clients as well as 20 female and 8 male therapists participated in this study. Awareness level of the clients about the "patients' rights charter" was: 47/6% poor, 16/5% moderate and 35/9% good. There was no significant relationship between clients' awareness with age, sex, and setting. However, significant relationship was found between the level of awareness and the education level, number of visits, and the rehabilitation unit (P<0/05. Awareness level of the therapists about the "patients' rights charter" was: 32/1% poor, 14/3% moderate and 53/6% good. There was no significant relationship between therapists' awareness with age, sex, degree level, and field of expertise. However, significant relationship was found between level of awareness and work location (P<0/01. Conclusion: Considering the fact that rehabilitation clients are one of the most vulnerable groups, with special needs and low awareness of their rights, improving rehabilitation performance and patient satisfaction requires improvement in public awareness about rehabilitation services and client rights. as well as research on and development of

  10. Participatory citizenship: critical perspectives on client-centred occupational therapy


    Fransen, Hetty; Pollard, Nicholas; Kantartzis, Sarah; Viana-Moldes, Ines


    Background/aims: This article aims to discuss client-centred practice, the current dominant approach within occupational\\ud therapy, in relation to participatory citizenship. Occupational therapists work within structures and policies that set boundaries on their engagement with clients, while working with complex, multidimensional social realities. Methods: The authors present a critical discussion shaped by their research, including a survey, discussions at workshops at international confer...

  11. The Client Server Design of the Gemini Data Handling System (United States)

    Hill, Norman; Gaudet, Séverin; Dunn, Jennifer; Jaeger, Shannon; Cockayne, Steve

    The Gemini Telescopes Data Handling System (DHS) developed by the Canadian Astronomy Data Centre (CADC) has diverse requirements to support the operation of the Gemini telescopes. The DHS is implemented as a group of servers, where each performs separate functions. The servers use a client server model to communicate between themselves and with other Gemini software systems. This paper describes the client server model of the Gemini Data Handling System.

  12. Advice for salt, sugar and fat intake habits among adults: a national-based study

    Directory of Open Access Journals (Sweden)

    Suele Manjourany Silva


    Full Text Available INTRODUCTION : A healthy diet is recognized as an important strategy for promoting health as an essential part of non-pharmacological therapy of various health problems. OBJECTIVE : To analyze the reported advice for the intake of salt, sugar and fat for the Brazilian adults living in urban areas. METHODOLOGY : National-based cross-sectional study with 12,402 adults interviewed in 100 Brazilian cities. RESULTS : The most prevalent advice was to low fat intake (38%, followed by the advice to low salt and sugar intake (36% and sugar (29%. The percentage of receiving different advice was similar and more common among women, older people, those with a partner, higher economic class, former smokers, active and in person with physician diagnoses of hypertension, diabetes and overweight. People with white skin color received more advice to eat healthy food, except for the orientation to low salt intake. CONCLUSION : The results show a low prevalence of advice, which configures a missed opportunity to prevent health problems. Although dietary counseling should not be understood only as the transmission of advice regarding some nutrients, it is important to develop actions in order to qualify services and health professionals, allowing the population to have access to qualified information about the benefits of having healthy lifestyles.

  13. Pretravel health advice among international travelers visiting Cuzco, Peru. (United States)

    Cabada, Miguel M; Maldonado, Fernando; Quispe, Wanda; Serrano, Edson; Mozo, Karen; Gonzales, Elsa; Seas, Carlos; Verdonck, Kristien; Echevarria, Juan I; Gotuzzo, Eduardo


    Cuzco, a Peruvian city of historical interest located 3,326 m above sea level, is a frequent destination for tourists. We conducted a descriptive study to assess the extent and sources of pretravel health advice received by international travelers before their arrival to Cuzco. Data were collected as part of a health survey among travelers. Between August and November 2002, travelers between 15 and 65 years old were invited to fill out a questionnaire in the departing area of Cuzco's international airport. A total of 5,988 travelers participated. The mean age was 35.4 years (SD 11.4 yr); 50.6% were female and 50.8% were single. Tourism was the reason for traveling in 90.2% of the participants, and 89.3% of them were traveling with companions. Pretravel health information was received by 93.6%. The median number of information sources was two, with books (41.5%), travel medicine clinics (38.8%), the Internet (23.3%), and general practitioners (22.7%) as the main sources. Most frequently received recommendations were about safe food and water consumption (85%), use of insect repellents (66.0%), sunburn protection (64.4%), and condom use (22%). Only 16.5% took medication to prevent altitude sickness, and 14.2% took medication to prevent traveler's diarrhea. Variables independently associated with receiving pretravel health information from a health care professional were female gender, country of residence other than the United States, length of stay in Cuzco > 7 days, length of stay in other Peruvian cities > 7 days, tourism as the main reason for visiting Cuzco, traveling with companions, and consulting of more than one source of information. Most travelers arriving to Cuzco had received pretravel health information, and the majority obtained it from more than one source. Recommendations addressed for specific health risks, such as altitude sickness prophylaxis, were received by few travelers.

  14. Communicating curriculum reform to students: Advice in hindsight.....

    Directory of Open Access Journals (Sweden)

    McLean Michelle M


    Full Text Available Abstract Backgound In view of the changing health care needs of communities, curriculum reform of traditional curricula is inevitable. In order to allay the apprehension that may accompany such change, curriculum development and implementation should be an inclusive process, with both staff and students being well informed of the planned reform. In 2001, the Nelson R. Mandela School of Medicine implemented Year 1 of a problem-based learning curriculum. During the design phase, students and staff were invited to take part in the development and were kept abreast of developments through meetings and newsletters. Method A survey of Years 1–5 students of the last intake into the traditional curriculum was undertaken a few months prior to the implementation of the new programme. Results Students were generally well informed about the impending change, having heard about it from fellow students and staff. The more senior the students, the less the perceived impact of the reform. Although most of what students had heard was correct, some, however, had misconceptions that were generally extreme views (e.g. all self-directed learning; no Anatomy about the new programme. Others expressed valid concerns (e.g. underpreparedness of students from disadvantaged schools; overcrowding in hospitals. Conclusions Advice offered to institutions considering curriculum reform include using various methods to inform internal and external affected parties, ensuring that the student representative body and staff is well informed, reiterating the need for the change, confirming that the new programme meets recognised standards and that the students most affected are reassured about their future studies.

  15. Healthcare Providers' Knowledge of Diets and Dietary Advice. (United States)

    Arora, Sonali; Atreya, Auras R; Bernstein, Adam M; Kleppel, Reva; Friderici, Jennifer; Schramm, Sarah; Lagu, Tara; Rothberg, Michael B


    Little is known about healthcare providers' knowledge of dietary evidence or about what dietary advice providers offer to patients. The objective of our study was to determine which diets providers recommended to patients and providers' beliefs about the evidence behind those recommendations. This was a 22-question cross-sectional survey conducted between February 2013 and September 2013, in 45 ambulatory practices within two health systems. Attending physicians, housestaff, and advanced practitioners in internal medicine, medicine-pediatrics, family medicine, cardiology, and endocrinology practices were audited. Providers' attitudes, perceptions, and beliefs about diet modification were collected. Knowledge scores were constructed based on the number of correct responses to specific questions. Of 343 provider responses, largely from primary care specialties (n = 3027, 90%), the top dietary recommendations were low-salt diet (71%) for hypertension, low-carbohydrate diet (64%) for uncontrolled diabetes mellitus, low saturated fat diet (73%) for dyslipidemia, low-calorie diet (72%) for obesity, and low saturated fat diet (63%) for coronary heart disease. Providers believed that 51% of diet recommendations were supported by randomized trial evidence when they were not. Respondents' overall knowledge of randomized trial evidence for dietary interventions was low (mean [standard deviation] knowledge score 44.3% [22.4%], range 0.0%-100.0%). The survey study from two health systems, using a nonvalidated survey tool limits external and internal validity. Providers report recommending different diets depending on specific risk factors and generally believe that their recommendations are evidence based. Substantial gaps between their knowledge and the randomized trial evidence regarding diet for disease prevention remain.

  16. Examining challenging behaviors of clients with borderline personality disorder. (United States)

    Chalker, Samantha A; Carmel, Adam; Atkins, David C; Landes, Sara J; Kerbrat, Amanda H; Comtois, Katherine Anne


    Few studies have examined effects of challenging behaviors of clients with borderline personality disorder (BPD) on psychotherapy outcomes. Dialectical behavior therapy (DBT) is an evidence-based treatment designed to treat chronic suicidality, self-directed violence (SDV), and emotion dysregulation, while targeting challenging behaviors. DBT has been shown to be effective with clients with BPD. We evaluated whether therapist reported challenging behaviors, such as high volume phone contacts or violating the therapist's limits, during DBT would be associated with dropping out of DBT, severity and frequency of SDV, emotion regulation deficits, psychological symptom severity and client's and therapist's satisfaction of treatment. The current study examined challenging behaviors reported by therapists in a sample of 63 psychiatrically disabled outpatient DBT clients diagnosed with BPD (73% women, average age 37 years). More frequent phone contacts were associated with a decrease in dropout and psychological symptoms, and an increase in client and therapist satisfaction. More avoidance/disengagement behavior was associated with more than twice the risk of SDV and a decrease in therapist satisfaction. Findings suggest that the phone coaching might serve to maximize client satisfaction and reduce the likelihood of dropout. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Assessment of ART centres in India: client perspectives. (United States)

    Sogarwal, Ruchi; Bachani, Damodar


    Drug adherence and quality of antiretroviral therapy (ART) services are the keys for the successful ART programme. Hence, an attempt has been made to assess ART centres in India from client perspectives that are receiving services from the centres. Data were gathered through exit interviews with 1366 clients from 27 ART centres that were selected on the basis of drug adherence and client load. Analyses revealed that more than 80 per cent of the clients reported overall satisfaction with the services availed from the centre and 60 per cent reported that the quality of life has improved to a great extent after getting ART. Most of the clients strongly demanded to open ART centre in each district for better access as that will increase drug adherence and eventually control the HIV progression. It has been found that as many as 14% of respondents, ever been on ART, reported non-adherence and 70% of them cited distance and economic factors as the reasons for non-adherence. Study concludes that while majority of the clients were satisfied with ART services, shortage of staff, high level of non-drug adherence, long distances and poor referring system are the weak areas requiring attention.

  18. Client knowledge, attitudes and practices regarding zoonoses: a metropolitan experience. (United States)

    Steele, S G; Mor, S M


    To assess knowledge, attitudes and practices in relation to zoonoses among pet owners. Questionnaire completed by 81 clients attending a small animal practice in Sydney, Australia. Most (64.5%) clients reported that they were not concerned about contracting a disease from their pet, but 7.9% and 3.9% of clients were a little or very concerned, respectively; 23.7% of clients stated that they had not considered the possibility. Although respondents indicated that they had heard of a number of zoonoses, knowledge of animal sources and exposure pathways was generally low, particularly for the more important zoonoses in Australia such as toxoplasmosis, psittacosis and Q fever. Only 37.0%, 12.3% and 11.1%, respectively, of clients had heard of these diseases. Most respondents (84.1%) indicated that they viewed veterinarians as having the primary responsibility for providing information about zoonoses, yet less than half (48.1%) recalled ever getting information from their veterinarian. Likewise, many respondents (48.1%) indicated that medical professionals played a role in providing information about zoonoses, yet less than one-quarter (23.5%) recalled ever getting information from their doctor. The low level of knowledge among pet owners about sources and exposure pathways indicates a need to strengthen communication between veterinarians, doctors and their clients around the possible risks of zoonoses and appropriate prevention strategies. © 2015 Australian Veterinary Association.

  19. The ARAC client system: network-based access to ARAC

    International Nuclear Information System (INIS)

    Leach, M J; Sumikawa, D; Webster, C


    The ARAC Client System allows users (such as emergency managers and first responders) with commonly available desktop and laptop computers to utilize the central ARAC system over the Internet or any other communications link using Internet protocols. Providing cost-effective fast access to the central ARAC system greatly expands the availability of the ARAC capability. The ARAC Client system consists of (1) local client applications running on the remote user's computer, and (2) ''site servers'' that provide secure access to selected central ARAC system capabilities and run on a scalable number of dedicated workstations residing at the central facility. The remote client applications allow users to describe a real or potential them-bio event, electronically sends this information to the central ARAC system which performs model calculations, and quickly receive and visualize the resulting graphical products. The site servers will support simultaneous access to ARAC capabilities by multiple users. The ARAC Client system is based on object-oriented client/server and distributed computing technologies using CORBA and Java, and consists of a large number of interacting components

  20. Weight and body mass index among female contraceptive clients. (United States)

    Kohn, Julia E; Lopez, Priscilla M; Simons, Hannah R


    As obesity may affect the efficacy of some contraceptives, we examined weight, body mass index (BMI) and prevalence of obesity among female contraceptive clients at 231 U.S. health centers. A secondary aim was to analyze differences in contraceptive method use by obesity status. Cross-sectional study using de-identified electronic health record data from family planning centers. We analyzed contraceptive visits made by 147,336 females aged 15-44 years in 2013. A total of 46.1% of clients had BMI ≥25. Mean body weight was 154.4 lb (S.D.=41.9); mean BMI was 26.1 (S.D.=6.6). A total of 40% had BMI ≥26, when levonorgestrel emergency contraception may become less effective. Obese clients had higher odds of using a tier 1 or tier 3 contraceptive method and had lower odds of using a tier 2 or hormonal method than non-obese clients. About half of contraceptive clients would be categorized as overweight or obese. Contraceptive method choices differed by obesity status. About half of contraceptive clients in this study population were overweight or obese. Contraceptive method choices differed by obesity status. All women - regardless of body size - should receive unbiased, evidence-based counseling on the full range of contraceptive options so that they can make informed choices. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Client-centred ADL intervention after stroke: Occupational therapists' experiences. (United States)

    Ranner, Maria; von Koch, Lena; Guidetti, Susanne; Tham, Kerstin


    This study was conducted in the context of a randomized controlled trial evaluating the effect of a client-centred activities in daily living intervention (CADL). The aim of the CADL was to enable agency in daily activities and participation in everyday life among persons with stroke. This qualitative, longitudinal study aimed to describe how occupational therapists (OTs) applied the CADL in their clinical practice by studying their experiences and reflections concerning their interaction with the clients with stroke. Six OTs who conducted the CADL were followed through interviews and observations on four separate occasions over one year. Data were analysed using a grounded theory approach. Sharing was the core category showing how the OTs helped their clients to achieve agency in daily activities. Through sharing the situation the OTs strove to obtain an empathetic understanding of the clients' lived experience throughout the whole intervention process in order to enable the clients' ownership of their daily activities. The continuity of sharing seems to be the key for a gradual increase in agency. The approach of sharing should preferably be applied by all members of the interprofessional team, including the client and significant others.

  2. Diagnostic medical exposures. Advice on exposure to ionising radiation during pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Sharp, C.; Shrimpton, J.; Bury, R


    The main objective of NRPB advice concerning in utero exposures to ionising radiations is 'to prevent unnecessary exposure of the fetus when medical diagnostic procedures involving ionising radiations are indicated during pregnancy'. In addition, advice is meant to help to avoid unnecessary concern or action if an exposure does occur. NRPB issued ASP8 (Exposure to ionising radiation of pregnant women: advice on the diagnostic exposure of women who are, or who may be, pregnant) in 1985. This advice suggested that there would be no risks to the concepts following irradiation during the first 10 days of the menstrual cycle and that subsequent risks in the remainder of the first 4 week period would be likely to be so small that no special limitation on exposure was required - sometimes known as 'the 28-day rule'. In 1993, NRPB published further advice to replace ASP8 in the Documents of the NRPB series, in Volume 4, No 4 - henceforth referred to as Doc NRPB 4(4){sup 2} - which drew upon data published since 1985. The more recent data suggest that risks in the interval between 10 days and the date at which the next menstrual period is due, although still small for most diagnostic procedures, may be significant for higher dose procedures. Consequently, it is considered there is a need to operate a modified policy for such higher dose procedures. This pocket publication has been produced to present in a concise and user-friendly format the basis of the most recent NRPB advice and to provide a guide for the implementation of that advice in the everyday practice of diagnostic radiology. The opportunity has also been taken to provide the most up to date data on doses in the UK. This publication is split into three parts: an introduction to the terms used in the document, a practical guide to implementation of the advice, and the scientific background to the advice.

  3. Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey. (United States)

    Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C


    Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.

  4. Utilisation of Business Advice in Small Innovative Firms: the Role of Trust and Tacit Knowledge

    Directory of Open Access Journals (Sweden)

    Katarzyna Łobacz


    Full Text Available Objective: The aim of this paper is to expand the understanding of the influence of trust relationship, as well as tacit knowledge on the process of business advice utilisation in small innovative firms. Research Design & Methods: The  analysis  is  based  on  empirical  research  conducted with the use of the explorative approach. The multiple case study methodology was used. Findings: Trust relationships as well as tacit knowledge were identified as factors essential to the process of utilisation of business advice in small innovative firms. It was recognised that the significance of both factors is related not only to the process of advice, but also as a purpose of activities happening prior to advice. They are referred to as the initial phase. Implications & Recommendations: The  findings  provide  implications  for  further  research of the structure of the process of business advice utilisation. It is related to the inclusion of the “initial phase”, as well as to the  necessity to include both factors in further research. The paper also provides implicationsrelated to the measurement of business advice output, and recommendations on the construction of public policy instruments. Contribution & Value Added: The originality of this work lies in using the process perspective and qualitative methodology in the field of the utilisation of business advice. It extends our understanding of the processes of business advice with regard to trust, as well as the use of tacit knowledge. The original contribution is to add the “initial phase” to the description of the business advice process.

  5. Diagnostic medical exposures. Advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)

    Sharp, C.; Shrimpton, J.; Bury, R.


    The main objective of NRPB advice concerning in utero exposures to ionising radiations is 'to prevent unnecessary exposure of the fetus when medical diagnostic procedures involving ionising radiations are indicated during pregnancy'. In addition, advice is meant to help to avoid unnecessary concern or action if an exposure does occur. NRPB issued ASP8 (Exposure to ionising radiation of pregnant women: advice on the diagnostic exposure of women who are, or who may be, pregnant) in 1985. This advice suggested that there would be no risks to the concepts following irradiation during the first 10 days of the menstrual cycle and that subsequent risks in the remainder of the first 4 week period would be likely to be so small that no special limitation on exposure was required - sometimes known as 'the 28-day rule'. In 1993, NRPB published further advice to replace ASP8 in the Documents of the NRPB series, in Volume 4, No 4 - henceforth referred to as Doc NRPB 4(4) 2 - which drew upon data published since 1985. The more recent data suggest that risks in the interval between 10 days and the date at which the next menstrual period is due, although still small for most diagnostic procedures, may be significant for higher dose procedures. Consequently, it is considered there is a need to operate a modified policy for such higher dose procedures. This pocket publication has been produced to present in a concise and user-friendly format the basis of the most recent NRPB advice and to provide a guide for the implementation of that advice in the everyday practice of diagnostic radiology. The opportunity has also been taken to provide the most up to date data on doses in the UK. This publication is split into three parts: an introduction to the terms used in the document, a practical guide to implementation of the advice, and the scientific background to the advice

  6. Sexual Orientation Differences in Adolescent Health Care Access and Health-Promoting Physician Advice. (United States)

    Luk, Jeremy W; Gilman, Stephen E; Haynie, Denise L; Simons-Morton, Bruce G


    Physician screening and advice on health-related behaviors are an integral part of adolescent health care. Sexual minority adolescents encounter more barriers to health services; yet, no prior research has examined whether they also experience disparity in physician screening and advice. We examined possible sexual orientation disparities in health care access, physician screening, and advice on six health-related behaviors. Data were from a national sample of U.S. adolescents who participated in wave 2 of the NEXT Generation Health Study (n = 2023). Poisson regressions were conducted separately for males and females to estimate sexual orientation differences in health care access and health-related screening and advice. Compared with heterosexual males, sexual minority males were more likely to report unmet medical needs in the past year (adjusted relative risk [ARR] = 2.23) but did not differ with respect to receiving physician advice concerning health-related behaviors. Compared with heterosexual females, sexual minority females were more likely to report no routine physical checkup in the past year (ARR = 1.67) but were more likely to receive physician advice to reduce or stop drinking, smoking, drug use, increase physical activity, and improve diet (ARRs = 1.56-1.99), even after controlling for corresponding health-related behaviors. Sexual minority females were also more likely to receive advice about risk associated with sexual behavior (ARR = 1.35) and advice to avoid sexually transmitted diseases (ARR = 1.49). Both sexual minority males and females experienced disparities in some aspects of health care access. Improved health-promoting advice would better serve sexual minority males. Published by Elsevier Inc.

  7. Increased risk of mortality and readmission among patients discharged against medical advice. (United States)

    Southern, William N; Nahvi, Shadi; Arnsten, Julia H


    Approximately 500,000 patients are discharged from US hospitals against medical advice annually, but the associated risks are unknown. We examined 148,810 discharges from an urban, academic health system between July 1, 2002 and June 30, 2008. Of these, 3544 (2.4%) were discharged against medical advice, and 80,536 (54.1%) were discharged home. We excluded inpatient deaths, transfers to other hospitals or nursing facilities or discharges with home care. Using adjusted and propensity score-matched analyses, we compared 30-day mortality, 30-day readmission, and length of stay between discharges against medical advice and planned discharges. Discharge against medical advice was associated with higher mortality than planned discharge, after adjustment (odds ratio [OR](adj) 2.05; 95% confidence interval [CI], 1.48-2.86), and in propensity-matched analysis (OR(matched) 2.46; 95% CI, 1.29-4.68). Discharge against medical advice also was associated with higher 30-day readmission after adjustment (OR(adj) 1.84; 95% CI, 1.69-2.01), and in propensity-matched analysis (OR(matched) 1.65; 95% CI, 1.46-1.87). Finally, discharges against medical advice had shorter lengths of stay than matched planned discharges (3.37 vs 4.16 days, P medical advice is associated with increased risk for mortality and readmission. In addition, discharges against medical advice have shorter lengths of stay than matched planned discharges, suggesting that the increased risks associated with discharge against medical advice are attributable to premature discharge. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Attorney-client trust among convicted criminal defendants: preliminary examination of the attorney-client trust scale. (United States)

    Boccaccini, Marcus T; Brodsky, Stanley L


    The current study describes the development of the Attorney-Client Trust Scale (ACTS), a measure designed to assess a client's trust in his or her attorney. A sample of 307 male inmates completed the ACTS and provided information about their most recent case and attorney. Low ACTS scores were associated with having a court-appointed attorney, going to trial, and receiving a lengthy prison sentence. High ACTS scores were related to satisfaction with sentences and attorneys. In addition, findings suggest that perceptions about attorneys' interpersonal skills were as important as perceptions about legal skills in forming opinions about overall lawyering ability. It is recommended that attorneys employ a well rounded assortment of interpersonal skills to foster their clients' trust and to make better use of the limited amount of time they have to spend with clients. Copyright 2002 John Wiley & Sons, Ltd.

  9. Seeking health advice from social networks in low-income urban neighborhoods. (United States)

    Cook-Craig, Patricia; Ely, Gretchen; Flaherty, Chris; Dignan, Mark; White, Carol R


    To examine how individuals residing in low-income neighborhoods use their social networks for health advice. Secondary data analysis of 363 individuals living in low-income neighborhoods was conducted using social network analysis and logistic regression techniques. Findings suggest that residents typically seek health advice from one or 2 friends and family members rather than a health professional. Age and family history of illness increased the likelihood that one would seek support whereas the combination of anxiety and depression decreased advice seeking. Findings support the need for multidisciplinary strategies for disseminating health information through informal social networks.

  10. On Advice Complexity of the k-server Problem under Sparse Metrics

    DEFF Research Database (Denmark)

    Gupta, S.; Kamali, S.; López-Ortiz, A.


    We consider the k-Server problem under the advice model of computation when the underlying metric space is sparse. On one side, we introduce Θ (1)-competitive algorithms for a wide range of sparse graphs, which require advice of (almost) linear size. Namely, we show that for graphs of size N...... for the 2-server problem on a path metric of size N ≥ 5. Through another lower bound argument, we show that at least n/2 (log α - 1.22) bits of advice is required to obtain an optimal solution for metric spaces of treewidth α, where 4 ≤ α

  11. Acerca de los clientes de las organizaciones de salud pública On the clients of public health organizations

    Directory of Open Access Journals (Sweden)

    Júlia Duran


    Full Text Available Los servicios públicos han de responder y satisfacer a una diversidad de agentes: sus usuarios, los ciudadanos que pagan impuestos que los financian, los políticos, y el personal que trabaja en ellos. Para conseguir unos servicios públicos que pongan al ciudadano-usuario en el vértice de su funcionamiento habrá que conocer al cliente, sus expectativas, preferencias, quejas y satisfacción. Este manuscrito presenta el proceso de reflexión interna realizado en nuestra organización acerca de sus clientes, cuya naturaleza es muy distinta de los de una empresa industrial o comercial. Se plantea una tipología y el proceso que ha llevado a confeccionar un listado de clientes, y se plantean acciones que hay que realizar para mejorar los servicios desde su perspectiva.Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.

  12. 77 FR 47880 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Canada and Mexico: Advice on the... (United States)


    ....S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on Probable Economic... Partnership Free Trade Agreement Including Canada and Mexico: Advice on the Probable Economic Effect of... Mexico: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES...

  13. Maximising health literacy and client recall of clinical information: An exploratory study of clients and speech-language pathologists

    Directory of Open Access Journals (Sweden)

    Friderike Schmidt von Wûhlisch


    Full Text Available Limited research has been carried out in the field of speech-language pathology with regard to ways of maximising health literacy and client recall. However, speech-language pathologists (SLPs frequently provide vast amounts of information that clients need to understand, apply and review in order to manage their (or their child’s health. This exploratory study aimed to contribute information about ways in which SLPs can overcome low health literacy and poor client recall so that treatment effectiveness is improved. A case-study design was used with specific focus on four clients receiving treatment for dysphagia, voice disorders (including laryngectomies and cleft lip and/or palate management in Cape Town. Strategies which may be able to maximise health literacy and client recall of clinical information were trialled and evaluated by clients and their SLPs, using semi-structured interviews. The researchers proposed a combination of high-tech strategies which assisted in all the cases. No single solution or universal tool was found that would be appropriate for all. There is a need to evaluate the long-term effectiveness of the combined strategies across a wider population, at different stages of rehabilitation and in diverse contexts. Implications and suggestions for future related research are presented.

  14. Meeting the Needs of Clients with Dissociative Identity Disorder: Considerations for Psychotherapy (United States)

    Ringrose, Jo L.


    Psychotherapy for clients with Dissociative Identity Disorder (DID) is different to therapy with most clients because these clients are multiple, comprising one or more host, and one or more alter personalities. The necessary components to be addressed in order that clients can live successfully either as a multiple or as an integrated person are…

  15. Counselor-Client Diagnostic Agreement and Perceived Outcomes of Counseling: A Progress Report. (United States)

    Hurst, James C.; And Others

    This study was designed to investigate the effect of congruity of counselor and client diagnoses upon client-perceived success in counseling. The Missouri Diagnostic Classification Plan (MDCP) was used as the basic diagnostic method. Agreement in the 15 categories was related to client-perceived success of counseling. Subjects, all clients at the…

  16. 77 FR 24685 - Proposed Information Collection; Comment Request; Client Focus Groups and Qualitative Interviews (United States)


    ... Request; Client Focus Groups and Qualitative Interviews AGENCY: International Trade Administration (ITA... through Quality Assurance Surveys, the CS uses client focus groups as a mechanism to obtain further client feedback and substantiate customer service trends seen in the Surveys. Qualitative client focus group data...

  17. The Interactive Effects of Counselor Gender, Physical Attractiveness and Status on Client Self-Disclosure. (United States)

    Kunin, Carla C.; Rodin, Miriam J.


    Investigated client self-disclosure and client perception of counselors. Subjects rated counselors on intelligence and empathy, and while role-playing clients in therapy. Clients disclosed more to male counselors when counselors were high in status or attractiveness. Suggests the effect of counselor gender depends on an interaction with other…

  18. The Contribution of the Counselor-Client Working Alliance to Career Exploration (United States)

    Elad-Strenger, Julia; Littman-Ovadia, Hadassah


    This longitudinal study examines the effects of Israeli counselors' and clients' ratings of their working alliance on clients' career exploration (CE), using a sample of 94 three-session career counseling processes. Results reveal that both clients' and counselors' working alliance ratings increased over time; yet, clients' ratings remained…

  19. Rheumatology telephone advice line – Experience of a Portuguese department

    Directory of Open Access Journals (Sweden)

    Ricardo Ferreira


    Full Text Available Background: Telephone helplines for patients are tool for information and advice. They can contribute to patient’s satisfaction with care and to the effectiveness and safety of treatments. In order to achieve this, they need to be adequately adapted to the target populations, as to incorporate their abilities and expectations. Aims: a Evaluate the adherence of patients to a telephone helpline managed by nurses in a Portuguese Rheumatology Department, b Analyse the profile of users and their major needs, c Analyse the management of calls by the nurses. Material/Methods: The target population of this phone service are the patients treated at Day Care Hospital and Early Arthritis Clinic of our department. Nurses answered phone calls immediately between 8am and 4pm of working days. In the remaining hours messages were recorded on voice mail and answered as soon as possible. Details of the calls were registered in a dedicated sheet and patients were requested permission to use data to improve the service, with respect for their rights of confidentiality, anonymity and freedom of decision. Results: In 18 months 173 calls were made by 79 patients, with a mean age of 47.9 years (sd=9.13. Considering the proportions of men and women in the target population, it was found that men called more frequently (M= 32.7% vs F= 20.4%, p=.016. The reasons for these calls can be divided into three categories: instrumental help, such as the request for results of complementary tests or rescheduling appointments (43.9% of calls; counselling on side effects or worsening of the disease/pain (31.2 %; counselling on therapy management (24.9%. Neither sex nor patient age were significantly related to these reasons for calling. Nurses resolved autonomously half (50.3% of the calls and in 79.8% of the cases there was no need for patient referral to other health services. Conclusions: About a quarter of patients adhered to the telephone helpline.. Patients called to obtain

  20. 32 CFR 719.151 - Furnishing of advice and counsel to accused placed in pretrial confinement. (United States)


    ... with advice as to the confinee's right to consult with lawyer counsel and his right to prepare for trial. Lawyer counsel may be either a civilian lawyer provided by the confinee at his own expense or a...

  1. Advice to health professionals: Use of lignocaine as a diluent to ...

    African Journals Online (AJOL)

    Advice to health professionals: Use of lignocaine as a diluent to reduce the pain associated with the administration of benzathine penicillin G. Geoffrey Madeira, Ana Olga Mocumbi, Bongani M Mayosi ...

  2. Discharge against medical advice: Factors and patients′ characteristics in Abuth, Zaria

    Directory of Open Access Journals (Sweden)

    T Dahiru


    Conclusion: Discharge against medical advice is prevalent in ABUTH and factors significantly influence DAMA include young age, male gender, admission through ER, involvement in road accident, surgical as well as OBGYdiagnoses.

  3. Advice to the high school teacher in the conduct of its work teachers

    Directory of Open Access Journals (Sweden)

    Carlos Rosales López


    Full Text Available This paper analyzes the characteristics of advice to high school teacher for the realization of their basic teaching duties. We beging to identify current features of this stage as openness to multiple choice and the consequent need of guidance, the increase in enrollment in it, the decline in academic performance, diversification of its students, the increase in disruptive and violent behavior and the introduction of new technologies. It is emphasized that the high school teacher needs advice on a variety of tasks such as planning ac- cording to various perspectives, diverse and cooperative teaching and learning assessment. This advice can be external or internal to the school, can be performed by different professionals and according to different modalities. It is a task of the support and help to optimize your professional intervention and in this sense is con- sidered to constitute a component of teacher training. advice; secondary education; teaching duties; planning; methodology; evaluation. 

  4. Destination image and crime in Mexico: An analysis of foreign government travel advice

    Directory of Open Access Journals (Sweden)

    J. Carlos Monterrubio


    Full Text Available Destination image has been recognised as an influential component of travel decision processes. Although organic sources of information play an important role in shaping destination image, researchers have often ignored the types of sources and the information they deliver. In particular, official websites where government travel advice is given, especially in relation to crime, have been widely excluded from scholarly research. This paper analyses the relationship between crime-related travel advice given by foreign governments and Mexico’s destination image. Qualitative content analysis of official websites from the US, Canada, the UK and Spain reveals that the travel advice given relates largely to the violence and insecurity that Mexico is currently experiencing. “No advisory in effect”, “Exercise caution” and “Defer non-essential travel” are messages commonly found in the governments’ travel advice about Mexico.

  5. Smoking cessation advice in consultations with health problems not related to smoking?

    DEFF Research Database (Denmark)

    Guassora, Ann Dorrit Kristiane; Baarts, Charlotte


    Objective. To identify frames of interaction that allow smoking cessation advice in general practice consultations. Design . Qualitative study based on individual in-depth interviews with GPs and their patients. Each of the GPs’ consultations were observed during a three-day period. Interviews...... consultations by relevance criteria. Relevance criteria served the purpose of limiting the number of issues in individual consultations. Issues could be included if they connected to something already communicated in a consultation. Smoking cessation advice was subject to these relevance criteria...... and was primarily discussed if it posed a particular risk to a particular patient. Smoking cessation advice also occurred in conversations addressing the patient ’ s well-being. If occurring without any other readable frame, smoking cessation advice was apt to be perceived by patients as part of a public campaign...

  6. Request queues for interactive clients in a shared file system of a parallel computing system (United States)

    Bent, John M.; Faibish, Sorin


    Interactive requests are processed from users of log-in nodes. A metadata server node is provided for use in a file system shared by one or more interactive nodes and one or more batch nodes. The interactive nodes comprise interactive clients to execute interactive tasks and the batch nodes execute batch jobs for one or more batch clients. The metadata server node comprises a virtual machine monitor; an interactive client proxy to store metadata requests from the interactive clients in an interactive client queue; a batch client proxy to store metadata requests from the batch clients in a batch client queue; and a metadata server to store the metadata requests from the interactive client queue and the batch client queue in a metadata queue based on an allocation of resources by the virtual machine monitor. The metadata requests can be prioritized, for example, based on one or more of a predefined policy and predefined rules.

  7. Hospital admission for schizophrenia and discharge against medical advice in the United States. (United States)

    Sclar, David A; Robison, Linda M


    Hospital discharge against medical advice may leave a patient at risk for adverse health outcomes and/or readmission, yet little is known regarding its occurrence, especially among patients with mental illness. The objective of this study was to discern the prevalence of, and predictive factors for, being discharged against medical advice among hospitalized patients with a primary diagnosis of schizophrenia. The 2004 US Healthcare Cost and Utilization Project Nationwide Inpatient Sample was used to discern demographic predictors, length of stay, and costs for discharge against medical advice relative to discharge with medical approval. Inpatient discharges from US community hospitals for patients of all ages with The International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes 295.0-295.9 were included. Conditional logistic regression was used to discern factors predictive of discharge against medical advice, and least squares mean analysis was used to examine differences in length of stay and mean cost per day relative to discharge with medical approval. Least squares means were adjusted for age (continuous), sex, race, region, payer, hospital setting, and bed size. Within the study population, 1.6% of patients admitted for schizophrenia were discharged against medical advice (n = 3,382/210,722). Patients discharged against medical advice were significantly more likely to be younger (OR = 0.985, 95% CI, 0.982-0.987) and male (OR = 1.421, 95% CI, 1.321-1.529). Race was not a significant factor. Mean +/- SE length of stay for discharge against medical advice was 5.0 +/- 0.24 days, as compared to 8.7 +/- 0.06 days for patients discharged with medical approval (P medical advice ($1,886.02 +/- 49.67 vs $1,565.79 +/- 13.42, P medical advice was small, the numeric magnitude on a nationwide basis was substantial. The adjusted mean length of stay for discharge against medical advice was significantly reduced, while cost per day was

  8. Association of Provider Advice and Pregnancy Weight Gain in a Predominantly Hispanic Population. (United States)

    Liu, Jihong; Whitaker, Kara M; Yu, Stella M; Chao, Shin M; Lu, Michael C


    This study sought to determine whether women's report of gestational weight gain (GWG) advice from a health care provider is consistent with the Institute of Medicine (IOM) guidelines and the association between provider advice and women's weight gain during pregnancy. Data came from the 2007 Los Angeles Mommy and Baby study (n = 3,402). The 1990 IOM GWG guidelines were used to define whether the provider's advice on weight gain and women's weight gain were below, within, or above the guidelines. Approximately 4 months after delivery, 18.8% of the women reported having not discussed weight gain with any health care providers during pregnancy. Among those who reported such discussions, 42% reported receiving weight gain advice from a health care provider within IOM guidelines, 16.5% below guidelines, and 10% above. An additional 13.5% reported the discussion but did not report the recommended weight gain amount. Compared with women who reported provider advice on weight gain within guidelines, women who reported advice below guidelines were 1.7 times (95% confidence interval [CI], 1.3-2.2) more likely to gain less than the IOM recommended amount. Women who reported provider advice above IOM guidelines were 2.0 times (95% CI, 1.4-2.9) more likely to exceed guidelines. There is a need for more women to receive advice consistent with the IOM GWG guidelines from their prenatal care providers. Intervention strategies are needed to educate providers about IOM guidelines and how to counsel on GWG. Copyright © 2016 Jacobs Institute of Women's Health. All rights reserved.

  9. Nutrigenomics-based personalised nutritional advice: in search of a business model?


    Ronteltap, Amber; van Trijp, Hans; Berezowska, Aleksandra; Goossens, Jo


    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts can take on many forms, but these have in common that they can only be effective if they are supported by a viable business model. The present paper takes an inventory of approaches to personalise...

  10. Midwives' Role in Providing Nutrition Advice during Pregnancy: Meeting the Challenges? A Qualitative Study


    Arrish, Jamila; Yeatman, Heather; Williamson, Moira


    This study explored the Australian midwives' role in the provision of nutrition advice. Little is known about their perceptions of this role, the influence of the model of care, and the barriers and facilitators that may influence them providing quality nutrition advice to pregnant women. Semistructured telephone interviews were undertaken with a subsample (n = 16) of the members of the Australian College of Midwives who participated in an online survey about midwives' nutrition knowledge, at...

  11. Psychological effects of prescriptive vs general lifestyle advice for weight loss in young women. (United States)

    Lim, Siew S; Norman, Robert J; Clifton, Peter M; Noakes, Manny


    This study aimed to investigate the effects of prescriptive lifestyle advice with quantifiable dietary and physical goals compared to general lifestyle advice on weight and psychological outcomes in young women with overweight or obesity. A total of 203 women (body mass index 33.3+/-0.3, age 28+/-0.3 years) received either prescriptive or general lifestyle advice for weight loss over 12 weeks. Linear mixed models found that the prescriptive lifestyle advice group had significantly greater weight loss (4.2+/-0.4 kg vs 0.6+/-0.2 kg, Pself-esteem (3.2+/-0.8 vs -0.04+/-0.04, Pself-esteem remained significantly different between groups after correcting for weight loss. Food cravings decreased significantly over time without group differences (P0.05). Drop-outs had greater baseline psychological distress (15.1+/-0.7 vs 12.5+/-0.4, P<0.01) and higher food cravings (2.42+/-0.07 vs 2.24+/-0.05, P=0.049) compared to completers. In conclusion, a prescriptive approach is associated with greater weight loss and greater improvements in psychological outcomes in young women compared to general lifestyle advice. However, these quantitative targets should be accompanied with qualitative advice on how they could be met in a variety of circumstances.

  12. Nutrigenomics-based personalised nutritional advice: in search of a business model? (United States)

    Ronteltap, Amber; van Trijp, Hans; Berezowska, Aleksandra; Goossens, Jo


    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts can take on many forms, but these have in common that they can only be effective if they are supported by a viable business model. The present paper takes an inventory of approaches to personalised nutrition currently available in the market place as its starting point to arrive at an identification of their underlying business models. This analysis is presented as a unifying framework against which the potential of nutrigenomics-based personalised advice can be assessed. It has uncovered nine archetypical approaches to personalised nutrition advice in terms of their dominant underlying business models. Differentiating features among such business models are the type of information that is used as a basis for personalisation, the definition of the target group, the communication channels that are being adopted, and the partnerships that are built as a part of the business model. Future research should explore the consumer responses to the diversity of "archetypical" business models for personalised nutrition advice as a source of market information on which the delivery of nutrigenomics-based personalised nutrition advice may further build.

  13. The implementation of ergonomics advice and the stage of change approach. (United States)

    Rothmore, Paul; Aylward, Paul; Karnon, Jonathan


    This paper investigates the implementation of injury prevention advice tailored according to the Stage of Change (SOC) approach. The managers of 25 workgroups, drawn from medium to large companies across a wide range of occupational sectors were allocated to receive either standard ergonomics advice or ergonomics advice tailored according to the workgroup SOC. Twelve months after the advice was provided, semi-structured interviews were conducted with each manager. In a multivariate model, managers who had received tailored advice were found to have implemented significantly more of the recommended changes (IRR = 1.68, 95% CI 1.07-2.63) and more "additional" changes (IRR = 1.90, 95% CI 1.12-3.20). Qualitative analysis identified that the key barriers and facilitators to the implementation of changes were largely related to worker resistance to change and the attitudes of senior managers towards health and safety. The findings from this study suggest that the implementation of ergonomics recommendations may be improved by the tailoring of advice according to SOC principles. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  14. A survey of exercise advice and recommendations in United Kingdom paediatric cardiac clinics. (United States)

    Williams, Craig A; Gowing, Lucy; Horn, Richard; Stuart, Alan Graham


    Physical activity and exercise have important health benefits for children and adolescents with CHD. The objective of this study was to survey the provision of advice and recommendations in United Kingdom paediatric CHD clinics. A three-page questionnaire was sent out to paediatric cardiac consultants in the United Kingdom, paediatric consultants with expertise in cardiology, and nursing staff (Paediatricians with Expertise in Cardiology Special Interest Group), as well as all members of the British Congenital Cardiovascular Association. The aim of this questionnaire was to determine the extent and scope of current information provision and to assess the importance that clinicians place on this advice. There were 68 responses in total, and the data showed that, of these, 24 (36%) clinicians had never provided paediatric CHD patients with written advice about exercise. Only 27 (39%) clinicians provided physical activity advice at every appointment. Lack of time during consultation (n=39, 56.9%), lack of training (n=38, 55.2%), and uncertainty about appropriate recommendations (n=38, 55.2%) were identified as the main factors preventing clinicians from providing patients with advice about physical activity. Although healthcare providers consider physical activity to be very important, the provision of clear, specific advice and recommendations is underutilised; therefore, more education and provision of resources to support the promotion of exercise need to be provided to clinicians and their support teams.

  15. Linked analysis for definition of nurse advice line syndrome groups, and comparison to encounters. (United States)

    Magruder, Steven F; Henry, J; Snyde, M


    Nurse advice call centers are a potentially important source of data for syndromic surveillance purposes. For this reason, researchers at Johns Hopkins University Applied Physics Laboratory and Kaiser Permanente of the Mid-Atlantic States (KPMAS) have been collaborating to develop methods to use this data within the ESSENCE II Syndromic Surveillance System in the National Capital Region. The objective of this report is to present a general method for finding syndrome groups in data sources that can be linked to physician encounters and to determine effective advice call syndrome groups for use with KPMAS advice data. Advice calls are linked to physician encounters and stratified by patient age. They are placed in groups according to a maximum positive predictive value criterion. The groups are evaluated by correlating the resulting syndrome time series against physician encounter data. Potentially useful advice syndrome groups are found for respiratory, lower gastrointestinal (GI), and total GI syndromes for each age stratum. The time series of the advice data for respiratory, lower GI, and upper GI syndromes accurately predict the physician encounter time series for the corresponding syndromes for each age stratum.

  16. Client Satisfaction with Telehealth in Assisted Living and Homecare. (United States)

    Grant, Leslie A; Rockwood, Todd; Stennes, Leif


    The Evangelical Lutheran Good Samaritan Society launched LivingWell@Home (LW@H) to provide telehealth services to clients in assisted living and home healthcare. LW@H assures client safety through remote monitoring of physiological parameters and assessment of nonbiometric parameters. Public policies increasingly support aging in place by allowing older adults with greater levels of impairment avoid or delay nursing home placement through alternative services offered in assisted living facilities and home healthcare agencies. Provider organizations face challenges caring for frail seniors with complex medical needs. Telehealth services may be helpful in supporting frail seniors living at home. Seniors were recruited into a randomized trial. Telehealth services were provided to 820 experimental subjects. Control subjects (n=762) received usual care. Clients rated their satisfaction at three points in time postimplementation: baseline, 6 months, and 12 months. Fisher's exact test compared client ratings at each measurement interval. No statistically significant differences were found between experimental and control subjects at baseline. Statistically significant differences emerged at follow-up. Experimental subjects in home healthcare agencies reported higher levels of satisfaction relative to controls, whereas experimental subjects in assisted living facilities reported lower levels of satisfaction. Telehealth services increased the probability that clients will be more satisfied compared with those without telehealth in homecare agencies. The opposite effect resulted among assisted living residents. Value propositions among community-dwelling older adults may influence their satisfaction with telehealth services postimplementation. More research is needed to examine the clinical efficacy and cost-effectiveness of these services.

  17. Retención de clientes en agencias de eventos

    Directory of Open Access Journals (Sweden)

    Claudia Gómez-Ramírez


    Full Text Available Como componente de la mezcla de comunicación efectiva para las marcas se encuentran los "Eventos", que hoy en día exigen una gestión estratégica. Resulta clave, para las organizaciones especializadas en la prestación de este servicio, aplicar herramientas que les permitan ser competitivas a largo plazo gracias a la diferenciación. Para ello, el CESA ha estudiado la relación cliente-agencia de comunicación de marketing, fundamentalmente respecto a la importancia de la retención de clientes en relaciones B2B, como las que se llevan a cabo entre agencias de eventos y sus clientes. En el presente artículo se exponen los principales hallazgos de una investigación de tipo exploratorio acerca del tema de retención de clientes, que incluye perfiles, elementos claves para la satisfacción y factores relevantes de la relación clienteagencia de eventos como elementos fundamentales de la gestión empresarial. Al tener un mayor conocimiento del perfil de los clientes, las agencias podrán ser más productivas y competitivas, pues estarán en capacidad de ofrecer iniciativas de servicios con características particulares.

  18. Critical reflexivity in client-centred therapeutic relationships. (United States)

    McCorquodale, Lisa; Kinsella, Elizabeth Anne


    This paper explores how a particular form of reflection--critical reflexivity--can support clinicians in developing a more nuanced understanding of therapeutic relationships, and work to advance the goal of client-centred practice. A critical autobiographical narrative was written, and critical reflexivity adopted, as methods to critically examine the therapeutic relationship. Critically reflexive stories have the potential to advance client-centred therapeutic relationships by inspiring the (re-)consideration of practices, and by interrogating interpretive systems. Understandings and practices that potentially limit the extent to which therapeutic relationships are client centred include (i) Dichotomous thinking, (ii) Objectification, (iii) The economic imperative, and (iv) Knowledge generation. The critical autobiographical account points to ways in which critical reflexivity on the therapeutic relationship has the potential to foster critical questioning, interrogate interpretive systems, attune to subjectivities, contribute to practice-based knowledge, resist violation, foster compassionate practice, and develop new understandings of relevance to client-centred practice. This critical examination of the therapeutic relationship supports occupational therapists in more fully realizing the profession's core value of client-centred practice.

  19. Participatory citizenship: Critical perspectives on client-centred occupational therapy. (United States)

    Fransen, Hetty; Pollard, Nick; Kantartzis, Sarah; Viana-Moldes, Inés


    This article aims to discuss client-centred practice, the current dominant approach within occupational therapy, in relation to participatory citizenship. Occupational therapists work within structures and policies that set boundaries on their engagement with clients, while working with complex, multidimensional social realities. The authors present a critical discussion shaped by their research, including a survey, discussions at workshops at international conferences, and critical engagement with the literature on occupational therapy, occupation, and citizenship. A focus on citizenship suggests reframing professional development based on the participation in public life of people as citizens of their society. While occupational therapists often refer to clients in the context of communities, groups, families, and wider society, the term client-centred practice typically represents a particular view of the individual and may sometimes be too limited in application for a more systemic and societal approach. The authors question the individual focus which has, until recently, been typical of client-centred occupational therapy. Placing citizenship at the core of intervention is a transformative process that assumes all people are citizens and conceives of health as a collective issue, influencing the way we educate, do research, and practise.

  20. Client-centred occupational therapy: the importance of critical perspectives. (United States)

    Whalley Hammell, Karen R


    The occupational therapy profession has proclaimed itself to be client-centred for over 30 years, but until recently this assertion remained largely unchallenged. Critical thinkers, who have begun to explore client-centred practice in occupational therapy, highlight the necessity for further critical reflection. This paper aims to define what constitutes "critical" thinking; and to persuade occupational therapists of the importance of employing critical perspectives towards the profession's assumptions and assertions regarding occupational therapy's "client-centred" practices. Critical thinking is not solely a process of carefully and thoughtfully weighing various arguments or evidence, but of additionally appraising the ideological and structural contexts in which these positions or evidence have arisen. Critical perspectives towards occupational therapy's client-centred practices identify the ways in which power is exercised by the profession, and culturally specific and disabling ideologies are perpetuated. Critical thinking enables occupational therapists to reflect on their own inequitable access to privilege and power, and reduces the potential for the profession to re-inscribe dominant ideologies that devalue disabled people and justify their inequitable opportunities. Because critical thinking demands a readiness to restructure one's thinking, and decreases the risk of acting on faulty assumptions, it is an essential component of client-centred practice.

  1. Associations of HSP90 client proteins in human breast cancer. (United States)

    Shipp, Christopher; Watson, Kenneth; Jones, Graham Lloyd


    HSP90 has been studied intensively as a therapeutic target, however little is known regarding specific interactions of the large number of HSP90 client proteins. Therefore, this study investigated HSP90 client proteins sensitive to the HSP90 inhibitor geldanamycin in tumour and healthy breast tissue. Co-immunoprecipitation and SDS-PAGE were used to investigate protein interactions. Western blotting and LC-MS were used to infer protein identities. HSP90 client proteins were observed in 7 out of 11 breast cancer patients. Further experiments inferred HSP40, -56/FKBP52, -60, -70, -105 and lumican to associate with HSP90 and to belong to this group of geldanamycin-sensitive proteins. In one patient, a cancer-specific group of proteins was identified. In all experiments geldanamycin resistance was observed. HSP90 differentially associated with client proteins and this was patient dependent. Geldanamycin resistance and lack of HSP90 client protein expression may limit clinical applications of HSP90 inhibitors.

  2. Maximizing health literacy and client recall in a developing context: speech-language therapist and client perspectives. (United States)

    von Wühlisch, Friderike Schmidt; Pascoe, Michelle


    In the field of speech-language therapy, limited research has been conducted with regards to health literacy and client recall. However, speech-language therapists frequently provide a considerable amount of information for clients to understand, apply and review in order to manage their (or their child's) health. This study aimed to investigate (1) issues around clients' health literacy and recall of information; and (2) how these issues can be overcome in speech-language therapy in a developing context. An exploratory study was undertaken with specific focus on speech-language therapists and their clients who had previously received treatment for dysphagia, voice disorders (including laryngectomies), and cleft lip and/or palate management. They were recruited at public tertiary hospitals and primary healthcare clinics in Cape Town, South Africa. Data were gathered through focus group discussions and qualitatively analysed using a content-driven immersion/crystallization style. Five themes and 13 subthemes were identified. Speech-language therapists currently use mostly low-technology strategies to manage issues of health literacy and client recall, and frequently view poor outcomes as being related to clients themselves and a lack of compliance. An understanding of context, intercultural health literacy and client-provider concordance are important factors that should inform the clinical practice of speech-language therapy. There is a need to develop effective strategies for information provision and review post-consultation. Speech-language therapists have an important mediating role in cross-cultural communication. © 2011 Royal College of Speech & Language Therapists.

  3. Lifestyle advice and lifestyle change: to what degree does lifestyle advice of healthcare professionals reach the population, focusing on gender, age and education? (United States)

    Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine


    Health promotion practice in health care has a high priority in the endeavour to achieve equal opportunities for health and diversity in health among the population. The purpose of the study was to investigate whether there is any connection between the lifestyle advice given by healthcare professionals and the lifestyle change of the population, focusing on age, gender and education level. The study is based on the data from a national population survey in Sweden in which 52 595 patients who had attended health care were interviewed by phone. The participants were asked whether healthcare professionals had raised the subject of lifestyle during the visit and whether the advice they gave had contributed to a lifestyle change. The results indicated that lifestyle issues were raised with 32.2% of those who attended health care, particularly among men, younger patients and those with a high education level. When lifestyle issues were raised, the advice contributed to 39.2% of patients making a lifestyle change, to a higher extent among men, older patients and those with a low education level. The study shows that lifestyle advice given by healthcare professionals, during both emergency and outpatient healthcare visits, is an important contributor to patients' lifestyle change. © 2014 Nordic College of Caring Science.

  4. Does Motivational Interviewing (MI) Work with Nonaddicted Clients? A Controlled Study Measuring the Effects of a Brief Training in MI on Client Outcomes (United States)

    Young, Tabitha L.; Gutierrez, Daniel; Hagedorn, W. Bryce


    This study investigated the relationships between motivational interviewing (MI) and client symptoms, attendance, and satisfaction. Seventy-nine clients attending a university-based counseling center were purposefully assigned to treatment or control conditions. Statistical analyses revealed client symptoms in both groups improved. However,…

  5. Cultural humility: measuring openness to culturally diverse clients. (United States)

    Hook, Joshua N; Davis, Don E; Owen, Jesse; Worthington, Everett L; Utsey, Shawn O


    Building on recent theory stressing multicultural orientation, as well as the development of virtues and dispositions associated with multicultural values, we introduce the construct of cultural humility, defined as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individual's cultural background and experience. In 4 studies, we provide evidence for the estimated reliability and construct validity of a client-rated measure of a therapist's cultural humility, and we demonstrate that client perceptions of their therapist's cultural humility are positively associated with developing a strong working alliance. Furthermore, client perceptions of their therapist's cultural humility were positively associated with improvement in therapy, and this relationship was mediated by a strong working alliance. We consider implications for research, practice, and training. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  6. Designing e-learning solutions with a client centred approach

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin


      This paper claims that the strategies applied in designing e-learning solutions tend to focus on how to proceed after the precondition, e.g., learners requirements, pedagogical choice, etc., have been decided upon. Investigating the HCI research field, we find that the methodological approaches...... as the organisation that has initiated the e-learning project and needs to manage the e-learning system after its development. Through the Client Centred Design and in close collaboration with the client, three strategic issues are uncovered and strategic models are presented for each. These models are complementary...... perspectives in a Client Centred framework that is useable as the starting point for others in developing large scale e-learning projects....

  7. Client satisfaction with prenatal care and pregnancy outcomes. (United States)

    Lowry, L W; Saeger, J; Barnett, S


    Client satisfaction and pregnancy outcomes of two groups of low socioeconomic women were compared. One group received prenatal care from a public health clinic, the other from a prototype tertiary multidisciplinary clinic. Sixty-two women from each clinic completed the Risser Patient Satisfaction instrument, after no less than three clinic visits. Clients from the multidisciplinary clinic were significantly more satisfied on three variables related to nursing care (technical skills, teaching, and interpersonal relationships), and one variable related to setting. Postdelivery log reviews revealed that infant birth weights, Apgar scores, and gestational ages were not significantly different between the two groups. Nurse case managed care and removal of barriers contributed to more satisfied consumers. Continuity of prenatal care was associated with healthy infants regardless of client perceptions of satisfaction.

  8. Provider-client interactions and quantity of health care use. (United States)

    Lien, Hsien-Ming; Albert Ma, Ching-To; McGuire, Thomas G


    This paper considers three types of provider-client interactions that influence quantity of health care use: rationing, effort, and persuasion. By rationing, we refer to a quantity limit set by a provider; effort, the productive inputs supplied by a provider to increase a client's demand; persuasion, the unproductive inputs used by a provider to induce a client's demand. We construct a theoretical model incorporating all three mechanisms as special cases. When the general model is specialized into one of three mechanisms, a set of empirical implications emerges. We test for the presence of each mechanism using data of patients receiving outpatient treatment for alcohol abuse in the Maine Addiction Treatment System. We find evidence for rationing and persuasion, but not effort.

  9. Acculturation and polysubstance abuse in Arab-American treatment clients. (United States)

    Arfken, Cynthia L; Kubiak, Sheryl P; Farrag, Mohamed


    Acculturation to U.S. culture by Latinos and Asian Americans has been associated with increased prevalence of substance abuse. However, little is known about the association between acculturation and substance use among Arab Americans, or more specifically, among Arab-American treatment clients. In 156 Arab-American male treatment clients, we found that higher levels of U.S. acculturation were positively associated with increased prevalence of polysubstance abuse. This first report on a large series of Arab-American clients also found considerable within-group variability. These results can be used to develop treatment plans and work-force training on the importance of U.S. acculturation and variability within Arab Americans.

  10. A Hybrid Brain-Computer Interface-Based Mail Client

    Directory of Open Access Journals (Sweden)

    Tianyou Yu


    Full Text Available Brain-computer interface-based communication plays an important role in brain-computer interface (BCI applications; electronic mail is one of the most common communication tools. In this study, we propose a hybrid BCI-based mail client that implements electronic mail communication by means of real-time classification of multimodal features extracted from scalp electroencephalography (EEG. With this BCI mail client, users can receive, read, write, and attach files to their mail. Using a BCI mouse that utilizes hybrid brain signals, that is, motor imagery and P300 potential, the user can select and activate the function keys and links on the mail client graphical user interface (GUI. An adaptive P300 speller is employed for text input. The system has been tested with 6 subjects, and the experimental results validate the efficacy of the proposed method.

  11. A hybrid brain-computer interface-based mail client. (United States)

    Yu, Tianyou; Li, Yuanqing; Long, Jinyi; Li, Feng


    Brain-computer interface-based communication plays an important role in brain-computer interface (BCI) applications; electronic mail is one of the most common communication tools. In this study, we propose a hybrid BCI-based mail client that implements electronic mail communication by means of real-time classification of multimodal features extracted from scalp electroencephalography (EEG). With this BCI mail client, users can receive, read, write, and attach files to their mail. Using a BCI mouse that utilizes hybrid brain signals, that is, motor imagery and P300 potential, the user can select and activate the function keys and links on the mail client graphical user interface (GUI). An adaptive P300 speller is employed for text input. The system has been tested with 6 subjects, and the experimental results validate the efficacy of the proposed method.

  12. Dietary advice for muscularity, leanness and weight control in Men's Health magazine: a content analysis. (United States)

    Cook, Toni M; Russell, Jean M; Barker, Margo E


    The dietary content of advice in men's lifestyle magazines has not been closely scrutinised. We carried out an analysis of such content in all 2009 issues (n = 11) of Men's Health (MH) focusing on muscularity, leanness and weight control. Promotion of a mesomorphic body image underpinned advice to affect muscle building and control weight. Diet advice was underpinned by a strong pseudo-scientific discourse, with citation of expert sources widely used to legitimise the information. Frequently multiple dietary components were advocated within one article e.g. fat, omega-3 fatty acids, thiamine, zinc and high-glycaemic index foods. Furthermore advice would cover numerous nutritional effects, e.g. strengthening bones, reducing stress and boosting testosterone, with little contextualisation. The emphasis on attainment of a mesomorphic body image permitted promotion of slimming diets.Advice to increase calorie and protein intake to augment muscle mass was frequent (183 and 262 references, respectively). Such an anabolic diet was advised in various ways, including consumption of traditional protein foods (217 references) and sports foods (107 references), thereby replicating muscle magazines' support for nutritional supplements. Although advice to increase consumption of red meat was common (52 references), fish and non-flesh sources of protein (eggs, nuts & pulses, and soy products) together exceeded red meat in number of recommendations (206 references). Advice widely asserted micronutrients and phytochemicals from plant food (161 references) as being important in muscle building. This emphasis diverges from stereotypical gender-based food consumption patterns.Dietary advice for control of body weight largely replicated that of muscularity, with strong endorsement to consume fruits and vegetables (59 references), diets rich in nuts and pulses and fish (66 references), as well as specific micronutrients and phytochemicals (62 references). Notably there was emphasis on

  13. Structural Characterization of Clusterin-Chaperone Client Protein Complexes* (United States)

    Wyatt, Amy R.; Yerbury, Justin J.; Wilson, Mark R.


    Clusterin (CLU) is a potent extracellular chaperone that inhibits protein aggregation and precipitation otherwise caused by physical or chemical stresses (e.g. heat, reduction). This action involves CLU forming soluble high molecular weight (HMW) complexes with the client protein. Other than their unquantified large size, the physical characteristics of these complexes were previously unknown. In this study, HMW CLU-citrate synthase (CS), HMW CLU-fibrinogen (FGN), and HMW CLU-glutathione S-transferase (GST) complexes were generated in vitro, and their structures studied using size exclusion chromatography (SEC), ELISA, SDS-PAGE, dynamic light scattering (DLS), bisANS fluorescence, and circular dichroism spectrophotometry (CD). Densitometry of Coomassie Blue-stained SDS-PAGE gels indicated that all three HMW CLU-client protein complexes had an approximate mass ratio of 1:2 (CLU:client protein). SEC indicated that all three clients formed complexes with CLU ≥ 4 × 107 Da; however, DLS estimated HMW CLU-FGN to have a diameter of 108.57 ± 18.09 nm, while HMW CLU-CS and HMW CLU-GST were smaller with estimated diameters of 51.06 ± 6.87 nm and 52.61 ± 7.71 nm, respectively. Measurements of bisANS fluorescence suggest that the chaperone action of CLU involves preventing the exposure to aqueous solvent of hydrophobic regions that are normally exposed by the client protein during heat-induced unfolding. CD analysis indicated that, depending on the individual client protein, CLU may interact with a variety of intermediates on protein unfolding pathways with different amounts of native secondary structure. In vivo, soluble complexes like those studied here are likely to serve as vehicles to dispose of otherwise dangerous aggregation-prone misfolded extracellular proteins. PMID:19535339

  14. Prevalence and risk factors of frailty among home care clients. (United States)

    Miettinen, Minna; Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma


    Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. NCT02214758 .

  15. Control in chronic condition self-care management: how it occurs in the health worker-client relationship and implications for client empowerment. (United States)

    Lawn, Sharon; Delany, Toni; Sweet, Linda; Battersby, Malcolm; Skinner, Timothy C


    To examine health worker-client interactions during care planning to understand processes that foster client empowerment and disempowerment. It is unclear how health worker-client exchanges and information sharing through chronic condition care planning currently operate in primary health care. Moreover, it is unclear how control in these exchanges either enhances collaborative decision-making, partnership and client empowerment, or works to create client disempowerment and dependency on workers and health services. Critical discourse analysis of qualitative data from ethnographic observations and audio-taped worker-client consultations. Multidisciplinary teams in two Australian community-based primary healthcare sites participated. This included nurses, general practitioners and allied health workers and their clients who had a chronic condition care plan. Nineteen worker-client consultations were observed/recorded in 2011. Control was expressed through multiple processes inherent in the worker role and in their interactions with clients. When workers exercised disproportionate control and clients relinquished their own control, client disempowerment and dependency were evident. Clients' attempts to gain control and workers' attempts to relinquish control alleviated clients' disempowerment and dependency. However, structural features of information sharing systems and workers' care planning behaviours diminished such efforts. Worker awareness of their communication style and the power of their role must improve for client chronic condition self-care management to be achieved. Training on the impacts of control in worker communication and systems where they work must be provided if unbeneficial forms of client dependency are to be overcome and true self-care management is to be realized. © 2013 John Wiley & Sons Ltd.

  16. Leaving the Hospital Against Medical Advice Among People Who Use Illicit Drugs: A Systematic Review (United States)

    Ti, Lianlian


    Background. Leaving the hospital against medical advice is an increasing problem in acute care settings and is associated with an array of negative health consequences that may lead to readmission for a worsened health outcome or mortality. Leaving the hospital against medical advice is particularly common among people who use illicit drugs (PWUD) and has been linked to a number of complex issues; however, few studies have focused specifically on this population beyond identifying them as being at an increased risk of leaving the hospital prematurely. Furthermore, programs and interventions for reducing the rate of leaving the hospital against medical advice among PWUD in acute care settings have not been well studied. Objectives. We systematically assessed the literature examining hospital discharge against medical advice from acute care among this population and identified potential methods to minimize the occurrence of this phenomenon. Search methods. We searched 5 electronic databases (from database inception to August 2014) and article reference lists for articles investigating hospital discharge from acute care against medical advice among PWUD. Search terms consistent across databases included “patient discharge,” “hospital discharge,” “against medical advice,” “drug user,” “substance-related disorders,” and “intravenous substance abuse.” Selection criteria. Studies were eligible for inclusion if they were published in a peer-reviewed journal as an original research article in English. We excluded gray literature, case reports, case series, reviews, and editorials. We retained original studies that reported illicit drug use as a predictor of leaving the hospital against medical advice and studies of discharge against medical advice that included PWUD as a population of interest, and we assessed significance through appropriate statistical tests. We excluded studies that reported patients leaving the hospital against medical advice

  17. Leaving the Hospital Against Medical Advice Among People Who Use Illicit Drugs: A Systematic Review. (United States)

    Ti, Lianping; Ti, Lianlian


    Leaving the hospital against medical advice is an increasing problem in acute care settings and is associated with an array of negative health consequences that may lead to readmission for a worsened health outcome or mortality. Leaving the hospital against medical advice is particularly common among people who use illicit drugs (PWUD) and has been linked to a number of complex issues; however, few studies have focused specifically on this population beyond identifying them as being at an increased risk of leaving the hospital prematurely. Furthermore, programs and interventions for reducing the rate of leaving the hospital against medical advice among PWUD in acute care settings have not been well studied. We systematically assessed the literature examining hospital discharge against medical advice from acute care among this population and identified potential methods to minimize the occurrence of this phenomenon. We searched 5 electronic databases (from database inception to August 2014) and article reference lists for articles investigating hospital discharge from acute care against medical advice among PWUD. Search terms consistent across databases included "patient discharge," "hospital discharge," "against medical advice," "drug user," "substance-related disorders," and "intravenous substance abuse." Studies were eligible for inclusion if they were published in a peer-reviewed journal as an original research article in English. We excluded gray literature, case reports, case series, reviews, and editorials. We retained original studies that reported illicit drug use as a predictor of leaving the hospital against medical advice and studies of discharge against medical advice that included PWUD as a population of interest, and we assessed significance through appropriate statistical tests. We excluded studies that reported patients leaving the hospital against medical advice from psychiatric hospitals, drug treatment centers and emergency departments, and

  18. A sociological approach to counseling homosexual clients and their families. (United States)

    Hammersmith, S K


    Stigma lies at the root of many problems typically experienced by homosexual clients and their families. Sociological theory and research shed light on the dynamics of stigma and its consequences, both for the stigmatized population and for their heterosexual families and associates. This article summarizes key sociological research on the nature and development of sexual orientation. It considers the dynamics of homophobia and its implications for homosexual youngsters and their families. It offers practical tips for helping clients to understand their own or a family member's homosexual orientation, for coping with stigma, for reconciling issues of religion and morality, and for determining lifestyle. Suggestions for therapist office materials are also included.

  19. WORKING WITH HOMOSEXUAL CLIENTS: Application of Solution-Focused Therapy

    Directory of Open Access Journals (Sweden)

    Husmiati Husmiati


    Full Text Available This article discusses the psychosocial problems dealt by gay, lesbian, and bisexual clients. Gay is an individual who has sex orientation to male, whereas lesbian is to female. Bisexual has both sex orientation towards male and female. This article also points out one approach called Solution-Focused Therapy (SFT which can be applied in clinical practice. Working with SFT technique to homoerotic individual or group is significantly different to common people. Mental health experts such as social workers and clinical psychologists should have this understanding. Keywords: Homosexuality, client, clinical practice, therapy, solution focused

  20. Characteristics of patients with cirrhosis who are discharged from the hospital against medical advice. (United States)

    Myers, Robert P; Shaheen, Abdel Aziz M; Hubbard, James N; Kaplan, Gilaad G


    Patients discharged from hospital against medical advice are at risk of adverse health outcomes. The frequency and predictors of self-discharge in cirrhotic patients have not been examined. By using the 1993-2005 US Nationwide Inpatient Sample, we identified 581,380 cirrhotic patients who had been admitted to hospitals. The proportion discharged against medical advice and predictors of self-discharge were analyzed by using regression models with adjustments for clinical factors, including illness severity. Of the patients with cirrhosis identified, 2.8% left their hospital against medical advice. Self-discharge was most common in patients with alcoholic cirrhosis (4.2%) and hepatitis B or C ( approximately 3%) and least common among those with chronic cholestasis (0.4%). Independent predictors of self-discharge included male sex, younger age, non-private insurance, and admission to urban, nonteaching hospitals. Patients undergoing surgery and those with more comorbidities were less likely to leave against medical advice, whereas those with human immunodeficiency virus, drug and alcohol abuse, or psychosis were more likely to leave against medical advice. Self-discharge was less common among patients with hepatic decompensation (odds ratio [OR], 0.79; 95% confidence interval [CI], 0.76-0.82), primary liver cancer (OR, 0.49; 95% CI, 0.41-0.59), or prior transplantation (OR, 0.37; 95% CI, 0.25-0.55). Length of stay and hospital charges were lower in patients discharged against medical advice (P medical advice. Self-discharge is most common among patients with alcoholic cirrhosis, lower socioeconomic status, psychiatric disorders, substance abuse, and less severe liver disease. These findings might assist in the prevention of self-discharge and, ultimately, improve health outcomes in patients with cirrhosis.

  1. Contraceptive counselling for women with multiple unintended pregnancies: the abortion client's perspective. (United States)

    Loeber, Olga E; Muntinga, Maaike E


    Some women have multiple unintended pregnancies. Appropriate interventions could prevent some of the abortions that follow. This article presents the opinions of some abortion clients about their contraception and the counselling they received. It also formulates suggestions for counselling strategies of health care providers (HCPs) and other interventions that can support effective contraceptive behaviour. A mixed method approach was used. A quantitative survey was carried out in one clinic in the Netherlands (N = 201), assessing topics related to contraceptive use and counselling. Semi-structured interviews (n = 11) were conducted with women who had had at least three unintended pregnancies. Interview topics included the type of contraceptive counselling, experience with contraceptive counselling and preferences regarding access to contraceptive information. Women who had had multiple abortions were more likely to express a need for contraceptive counselling and more often discussed contraception with their HCP compared with women who had had one abortion. Several themes emerged from the semi-structured interviews that had partially contributed to further unplanned pregnancies: experience with counselling, acceptability of the contraceptive method, sources of information and cultural influences. Many women with multiple unintended pregnancies could not find suitable advice and stated preferences for future decision making. This study offers insight into the motives for contraceptive use of women with multiple unintended pregnancies. Contraceptive efficacy could be improved by implementing counselling that is adapted to individual needs. The respondents stated that they would appreciate other sources of information, such as support through other forms of communication. The formation of a working group would be helpful in developing these services.

  2. The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition. (United States)

    Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia


    Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.

  3. Genetic test feedback with weight control advice: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Meisel Susanne F


    Full Text Available Abstract Background Genetic testing for risk of weight gain is already available over the internet despite uncertain benefits and concerns about adverse emotional or behavioral effects. Few studies have assessed the effect of adding genetic test feedback to weight control advice, even though one of the proposed applications of genetic testing is to stimulate preventive action. This study will investigate the motivational effect of adding genetic test feedback to simple weight control advice in a situation where weight gain is relatively common. Methods/design First-year university students (n = 800 will be randomized to receive either 1 their personal genetic test result for a gene (FTO related to weight gain susceptibility in addition to a leaflet with simple weight control advice (‘Feedback + Advice’ group, FA, or 2 only the leaflet containing simple weight control advice (‘Advice Only’ group, AO. Motivation to avoid weight gain and active use of weight control strategies will be assessed one month after receipt of the leaflet with or without genetic test feedback. Weight and body fat will be measured at baseline and eight months follow-up. We will also assess short-term psychological reactions to the genetic test result. In addition, we will explore interactions between feedback condition and gene test status. Discussion We hope to provide a first indication of the clinical utility of weight-related genetic test feedback in the prevention context. Trial registration Current controlled trials ISRCTN91178663

  4. Advice networks in teams: the role of transformational leadership and members' core self-evaluations. (United States)

    Zhang, Zhen; Peterson, Suzanne J


    This article examines the team-level factors promoting advice exchange networks in teams. Drawing upon theory and research on transformational leadership, team diversity, and social networks, we hypothesized that transformational leadership positively influences advice network density in teams and that advice network density serves as a mediating mechanism linking transformational leadership to team performance. We further hypothesized a 3-way interaction in which members' mean core self-evaluation (CSE) and diversity in CSE jointly moderate the transformational leadership-advice network density relationship, such that the relationship is positive and stronger for teams with low diversity in CSE and high mean CSE. In addition, we expected that advice network centralization attenuates the positive influence of network density on team performance. Results based on multisource data from 79 business unit management teams showed support for these hypotheses. The results highlight the pivotal role played by transformational leadership and team members' CSEs in enhancing team social networks and, ultimately, team effectiveness. PsycINFO Database Record (c) 2011 APA, all rights reserved

  5. Friends with Benefits, but without the Sex: Straight Women and Gay Men Exchange Trustworthy Mating Advice

    Directory of Open Access Journals (Sweden)

    Eric M. Russell


    Full Text Available Although research has made progress in elucidating the benefits exchanged within same- and opposite-sex friendships formed between heterosexual men and women, it is less clear why straight women and gay men form close relationships with one another. The current experiments begin to address this question by exploring a potential benefit hypothesized to be uniquely available to straight women and gay men in the context of these friendships: trustworthy mating advice. Experiment 1 revealed that straight women perceive mating-relevant advice from a gay man to be more trustworthy than similar advice offered by a straight man or woman. Experiment 2 demonstrated that gay men perceive mating advice offered by a straight woman to be more trustworthy than advice offered by a lesbian woman or another gay man. Overall, the results provide initial experimental evidence that relationships between gay men and straight women may be characterized by a mutual exchange of mating-relevant benefits in the absence of sexual interest or competition.

  6. Evidence-based first aid advice for paediatric burns in the United Kingdom. (United States)

    Varley, Alice; Sarginson, Julia; Young, Amber


    Burn and scald injuries are common in children. First aid advice for paediatric burns is offered by a range of health organisations and charities in the UK. Despite this, children still present to emergency departments and burn services having received little or inadequate first aid. A survey was undertaken regarding the content and consistency of the advice given by a cross-section of UK health organisations involved in first aid prevention and education. The advice was subsequently examined to determine if it was evidence-based. Our study has demonstrated inconsistencies in the content of the first aid advice provided by the 21 organisations included in the study. Seventy-one percent of the information was only available online. The temperature, method and duration of cooling varied substantially, as did the advice recommended for the removal of clothing and jewellery and methods for covering the burn immediately after injury. Results from the literature review concluded the following based on available evidence; cool the burn with running tap water for 20min, remove clothing and jewellery and cover the burn with cling film or a clean non-adhesive dressing. This study highlights the lack of consistency between first aid guidance provided by health organisations and charities in the UK. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  7. Developing leaflets to give dental health advice to Aboriginal families with young children. (United States)

    Blinkhorn, Fiona; Wallace, Janet; Smith, Leanne; Blinkhorn, Anthony S


    Dental caries (decay) is a serious problem for young Aboriginal children, causing pain and stress. Treatment often involves extraction of teeth under a general anaesthetic. However, dental caries can be prevented by reducing the frequency of sugar consumption and brushing teeth twice a day with fluoride toothpaste. Such straightforward advice could be given to families by Aboriginal Health Workers who are trusted by their communities and have an existing advisory role. This paper reports on the development of dental health advice leaflets for use in Aboriginal communities. An Aboriginal reference panel was recruited to comment on dental health advice leaflets prepared by an Aboriginal graphic designer. The panel was asked to consider the design, cultural appropriateness and practicality of the leaflets. Comments were collected through email and face-to-face discussions, which were collated and the leaflets altered accordingly. The advice from the panel resulted in greater use of pictures. For example large green ticks and red crosses highlighted healthy and unhealthy behaviours, respectively. The tooth brushing leaflet was amended to emphasise the safe storage of toothpaste in order to keep it out of reach of young children. The panel stated that all leaflets should incorporate the Aboriginal flag, and proposed that fridge magnets might be beneficial as all family members would benefit from seeing the messages every day. The consultation process refined dental advice leaflets to reflect the views of an Aboriginal Reference Panel, in terms of design, cultural competence and practicality. © 2014 FDI World Dental Federation.

  8. Friends with benefits, but without the sex: straight women and gay men exchange trustworthy mating advice. (United States)

    Russell, Eric M; DelPriore, Danielle J; Butterfield, Max E; Hill, Sarah E


    Although research has made progress in elucidating the benefits exchanged within same- and opposite-sex friendships formed between heterosexual men and women, it is less clear why straight women and gay men form close relationships with one another. The current experiments begin to address this question by exploring a potential benefit hypothesized to be uniquely available to straight women and gay men in the context of these friendships: trustworthy mating advice. Experiment 1 revealed that straight women perceive mating-relevant advice from a gay man to be more trustworthy than similar advice offered by a straight man or woman. Experiment 2 demonstrated that gay men perceive mating advice offered by a straight woman to be more trustworthy than advice offered by a lesbian woman or another gay man. Overall, the results provide initial experimental evidence that relationships between gay men and straight women may be characterized by a mutual exchange of mating-relevant benefits in the absence of sexual interest or competition.

  9. [Scientific advice by the national and European approval authorities concerning advanced therapy medicinal products]. (United States)

    Jost, Nils; Schüssler-Lenz, Martina; Ziegele, Bettina; Reinhardt, Jens


    The aim of scientific advice is to support pharmaceutical developers in regulatory and scientific questions, thus facilitating the development of safe and efficacious new medicinal products. Recent years have shown that the development of advanced therapy medicinal products (ATMPs) in particular needs a high degree of regulatory support. On one hand, this is related to the complexity and heterogeneity of this group of medicinal products and on the other hand due to the fact that mainly academic research institutions and small- and medium-sized enterprises (SMEs) are developing ATMPs. These often have limited regulatory experience and resources. In 2009 the Paul-Ehrlich-Institut (PEI) initiated the Innovation Office as a contact point for applicants developing ATMPs. The mandate of the Innovation Office is to provide support on regulatory questions and to coordinate national scientific advice meetings concerning ATMPs for every phase in drug development and especially with view to the preparation of clinical trial applications. On the European level, the Scientific Advice Working Party (SAWP) of the Committee for Medicinal Products for Human Use (CHMP) of the European Medicinal Agency (EMA) offers scientific advice. This article describes the concepts of national and EMA scientific advice concerning ATMPs and summarizes the experience of the last six years.

  10. Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar


    INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized to a stru......INTRODUCTION AND HYPOTHESIS: We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program. METHODS: This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized...... to a structured lifestyle advice program with or without PFMT. Both groups received similar lifestyle advice in six separate group sessions. The combined group performed group PFMT after an individual assessment. Primary outcome was a global improvement scale at six-month follow-up. Secondary outcomes were...... %) completed six-month follow-up. At both follow-ups, significantly more women in the combined group reported improvement in the global scale. At the three-month follow-up, the combined group only had significant improvement of POP symptoms while only the lifestyle advice group had significant improvement...

  11. Patients leaving against medical advice: an inpatient psychiatric hospital-based study. (United States)

    Hayat, Aalia Akhtar; Ahmed, Muhammad Munir; Minhas, Fareed Aslam


    To determine the frequency of patients leaving against medical advice (LAMA) in an inpatient psychiatric facility in Rawalpindi, Pakistan. Descriptive cross-sectional study. Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, from August 2010 to February 2011. Patients who got admitted during study period irrespective of duration of illness and mode of admission were recruited through non-probability consecutive sampling and followed till discharge to determine their mode of leaving hospital. A thirteen-item proforma was developed and information was obtained on demographic, socioeconomic, patient related and disease related variables. Descriptive statistics were calculated on SPSS 14. The total number (n) of participants was 246. Among the participants, 96 (39%) left against medical advice (LAMA) whereas 150 (61%) left on regular discharge on physician's advice. Frequency of patients who left against medical advice was found to be more in males (63.5%), younger age groups (21 - 30 years), lesser educated (more than half were under matric) and with the ICD-10 diagnosis of substance abuse (23.9%). About half of patients who LAMA had a prior history of psychiatric illness and a significant number (37.5%) had a history of previous psychiatric admission. Leaving against medical advice is a frequent problem in psychiatric inpatients and is a matter of great concern for the treating doctors.

  12. Patients discharged against medical advice from a psychiatric hospital in Iran: a prospective study. (United States)

    Sheikhmoonesi, Fatemeh; Khademloo, Mohammad; Pazhuheshgar, Samaneh


    Self- discharged patients are at high risk for readmission and ultimately higher cost for care.We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics. This prospective study of discharge against medical advice was conducted in psychiatric wards of Zare hospital in Iran, 2011. A psychologist recorded some information on a checklist based on the documented information about the patient who wanted to leave against medical advice. The psychologist interviewed these patients and recorded the reasons for discharge against medical advice. Descriptive statistics were calculated for the variables. The rate of premature discharge was 34.4%. Compared to patients with regular discharges, patients with premature discharge were significantly more likely to be male, self-employed, to have co morbid substance abuse and first admission and positive family history of psychiatric disorder. Disappearance of symptoms was the most frequent reason for premature discharge. The 34.4% rate of premature discharge observed in our study is higher than rate reported in other studies. One possible explanation is our teaching hospital serves a low-income urban area and most patients had low socioeconomic status. Further studies are needed to compare teaching and non-teaching hospital about the rate of premature discharge and the reasons of patients who want to leave against medical advice.

  13. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef


    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  14. Early Memories as a Guide to Client Movement through Life. (United States)

    Slavik, Steve


    Outlines the theory of the significance of early memories used as a projective tool by Adlerian psychologists. Describes a procedure for elicitation and interpretation of early memories and provides several examples of their use in an encouraging therapeutic context. Attempts to show effectiveness of this technique in assessing client issues and…

  15. Counselling the (Self?) Diagnosed Client: Generative and Reflective Conversations (United States)

    Strong, Tom; Ross, Karen H.; Sesma-Vazquez, Monica


    In this paper, we address the phenomenon of clients who present their concerns in the medicalised discourse of the "Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition" ("DSM-5"). We contextualise this phenomenon, highlighting how a "diagnose-and-treat" logic increasingly pervades everyday…

  16. Prevalence of malaria at booking among antenatal clients in a ...

    African Journals Online (AJOL)

    The prevalence of malaria parasitemia at booking was studied in 1,848 pregnant women in a secondary hospital in Ibadan, Nigeria. Main outcome variables were patent parasitemia and fever. 8.4% had patent malaria parasitaemia. Most clients (89%) with parasitemia were asymptomatic. Febrile subjects booked at an ...

  17. Data Cleaning Methods for Client and Proxy Logs

    NARCIS (Netherlands)

    Weinreich, H.; Obendorf, H.; Herder, E.; Edmonds, A.; Hawkey, K.; Kellar, M.; Turnbull, D.


    In this paper we present our experiences with the cleaning of Web client and proxy usage logs, based on a long-term browsing study with 25 participants. A detailed clickstream log, recorded using a Web intermediary, was combined with a second log of user interface actions, which was captured by a

  18. Experiences of Counselors-as-Clients in Counselor Education (United States)

    Osborn, Cynthia J.; West, Erin M.; Nance, William Z.


    Eight professional counselors who routinely role-play as clients in 1 counselor education program participated in a focus group investigating their portrayal experiences. Data were analyzed using interpretative phenomenological analysis, which resulted in 3 superordinate themes: missions, influential factors, and repercussions. Findings reinforce…

  19. Client-Centeredness of Family Planning Services in a Resource ...

    African Journals Online (AJOL)

    RESULTS: The average levels of perceived informed choice and client provider interaction were 70.0% and 67.6%, respectively. Perceived clinical competence of providers, perceived integration and coordination of care, perceived accessibility of services, perceived participation of families and friends in care delivery, ...

  20. Weight changes in clients on hormonal contraceptives in Zaria, Nigeria

    African Journals Online (AJOL)

    Misconceptions exist in Nigeria about the effects of hormonal contraceptives on weight, which may have negative effects on contraceptive use. Data from case notes of clients attending the reproductive health centre at the Ahmadu Bello University Teaching Hospital, Zaria, between 1993 and 1995, were analysed to ...

  1. Determinants of Referral Practices of Clients by Traditional Birth ...

    African Journals Online (AJOL)

    About 90%, whose source of skill acquisition was by inheritance did not refer their clients appropriately compared with 48% of those whose source of skill acquisition was through formal training (p<0.05). The more the numbers of trainings, the more appropriate the referral (p<0.05). Having supervisory visit by qualified ...

  2. Risk Factors for Suicidality among Clients with Schizophrenia. (United States)

    Schwartz, Robert C.; Cohen, Benjamin N.


    Investigates risk factors for current suicidality in clients diagnosed with schizophrenia (N=223). Results indicate that severity of depressive symptoms most strongly correlated with degree of suicidality. Younger age and recent traumatic stress each significantly predicted suicidality independent of depressive symptoms. Suggests that the…

  3. Clinical Assessment of Dissociative Identity Disorder among College Counseling Clients (United States)

    Levy, Benjamin; Swanson, Janine E.


    College counseling professionals address a wide range of complex student mental health concerns. Among these, accurately identifying client presentations of dissociative identity disorder (DID) can be especially challenging because students with DID sometimes present as if they are experiencing another problem, such as a mood, anxiety, or…

  4. Assessment of clients' satisfaction with the PMTCT counselling ...

    African Journals Online (AJOL)

    The PMTCT counselling service is an important entry point into the national programme for the prevention mother-to-child transmission of HIV (PMTCT). This study assessed clients' satisfaction with the PMTCT counselling service provided at health facilities in Benin City, Edo State. The study design was a descriptive ...

  5. Therapists' Experience of Working with Suicidal Clients | Rossouw ...

    African Journals Online (AJOL)

    The study sheds light on how the experiences of therapists whose clients have committed suicide can be understood. The findings show how mainstream prevention and intervention strategies result from the misrepresentation and misinterpretation of our traditional way of knowing what it means to be human.

  6. Nutrition education program for food bank clients: A pilot study (United States)

    Many low income families depend on foods from food banks. The objective of the study was to determine program content and examine feasibility of a pilot nutrition education program for food bank clients. Formative research was conducted with staff at a local food bank and its pantries and adult clie...

  7. Client Satisfaction and Trust in the South African Public Service ...

    African Journals Online (AJOL)

    This article discusses the relationship between service quality (as defined by the legislative framework) from the public service and client satisfaction from the point of view of citizens. The article will confine itself to organisational trust – that is, the experience and perception held by citizens of the commitment and ...

  8. New Commodity Services System increases gas bill for clients

    International Nuclear Information System (INIS)

    Koevoet, H.


    The Dutch company Gasunie Trade and Supply will replace the Commodity Services System (CDS, abbreviated in Dutch) January 1, 2004. This will result in a higher gas bill for almost all their clients that are expected to use more than 1 million m 3 natural gas per year. An overview is given of the principles of the old and the new pricing system [nl

  9. Clients\\' Satisfaction With Services For Prevention Of Mother-To ...

    African Journals Online (AJOL)

    Objective: The study was conducted to assess clients' satisfaction with PMTCT services on privacy, waiting time and counselling in PMTCT of HIV /AIDS in Dodoma Rural district. Methods: A cross sectional study was conducted to 208 women assessing Reproductive Child Health (RCH) and PMTCT of HIV services.

  10. Thin Client Architecture: The Promise and the Problems. (United States)

    Machovec, George S.


    Describes thin clients, a networking technology that allows organizations to provide software applications over networked workstations connected to a central server. Topics include corporate settings; major advantages, including cost effectiveness and increased computer security; problems; and possible applications for large public and academic…

  11. Effect of nutrition counselling on client perceptions and eating behaviour. (United States)

    Cook, Stephanie L; Nasser, Roseann; Comfort, Brenda L Webster; Larsen, Derrick K


    Demonstrating the effectiveness of nutrition counselling is imperative, not only to promote successful patient outcomes but also to secure funding. This study therefore assessed the value and effectiveness of nutrition counselling. To measure clients' perceptions of the value of inpatient counselling, the Clients' Perceptions about Nutrition Counselling (CPNC) instrument was administered to 164 clients one week after hospital discharge. To determine if inpatient nutrition counselling is effective in promoting changes in eating behaviours, the same clients were asked to complete the Health Habits and History Questionnaire (HHHQ) before counselling and then at three and six months following discharge. The majority of respondents who completed the CPNC indicated that the information provided by the dietitian was useful, that the dietitian was knowledgeable, and that they knew what to eat after speaking with the dietitian and had changed their diet according to the recommendations. From the HHHQ, respondents counselled for heart health diet modifications (n = 45) significantly lowered their intake of energy (p<0.002), fat, saturated fat, sodium, and cholesterol (all p<0.001) over time. These results suggest that inpatient nutrition counselling is perceived as valuable and results in positive dietary behaviours, the majority of which are sustained at six months.

  12. Clients' Preferences for Small Groups vs. Individual Testing. (United States)

    Backman, Margaret E.; And Others

    Test takers' preferences for group versus individual administration of the Micro-TOWER System of Vocational Evaluation are reported. The system was administered to 211 clients at a vocational rehabilitation center, and consisted of work samples measuring the following job skills: record checking, filing, lamp assembly, message-taking, zip coding,…

  13. Developments in the Market for Client-based Management Education. (United States)

    Prince, Christopher


    Interviews with 19 human resource managers, 6 consultants, and 11 business faculty investigated the effectiveness of client-based management education. Results suggested that strategic management education is a business imperative and many companies are developing partnerships with business schools to deliver training that supports business…

  14. The Effect of Client Case Complexity on Clinical Decision Making

    NARCIS (Netherlands)

    Groenier, M.; Pieters, J.M.; Witteman, C.L.M.; Lehmann, S.R.S.


    In mental health care, clinicians' treatment decisions are expected to be based on the formulation (i.e., exploration of the causing and maintaining mechanisms) of the client's problems. Previous research showed two things: clinicians' case formulations mainly contain descriptive information instead

  15. Does bank failure affect client firms? Micro evidence from Estonia

    Czech Academy of Sciences Publication Activity Database

    Joeveer, Karin

    -, č. 224 (2004), s. 1-29 ISSN 1211-3298 Institutional research plan: CEZ:AV0Z7085904 Keywords : bank failure * client firm performance * firm bank ruptcy Subject RIV: AH - Economics

  16. Bias in psychotherapist ratings of client transference and insight. (United States)

    Markin, Rayna D; Kivlighan, Dennis M


    The psychology literature at large considers rater bias to be a substantial source of error in observer ratings. Yet, it is typically ignored by psychotherapy researchers using participant (psychotherapist/client) ratings. In particular, interrater variability, or differences between raters' overall tendency to rate others favorably or unfavorably, has been a largely ignored source of error in studies that use psychotherapists and/or clients as raters. Ignoring rater bias can have serious consequences for statistical power and for interpretation of research findings. Rater bias may be a particular problem in psychotherapy research, as psychotherapists are often asked to rate subjective variables that require much rater inference. Consequently, we examined the extent to which rater bias is a factor in psychotherapist ratings of client transference and insight, by comparing psychotherapist variance from these ratings to psychotherapist variance in ratings of client-perceived emotional intelligence, using Hierarchical Linear Modeling. Results suggest that bias may be a substantial source of error in psychotherapist process and relationship ratings, accounting for, on average, 38% of the total variance in scores, and 30% after accounting for perceived emotional intelligence. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  17. Client application for automated management training system of NPP personnel

    International Nuclear Information System (INIS)

    Pribysh, P.I.; Poplavskij, I.A.; Karpej, A.L.


    This paper describes the client side of automated management training system. This system will optimize the speed of the organization and quality of the training plan; reduce the time of collecting the necessary documentation and facilitate the analysis of the results. (authors)

  18. Evaluation of a Continuing Education Training on Client Financial Capability (United States)

    Frey, Jodi Jacobson; Svoboda, Deborah; Sander, Rebecca L.; Osteen, Philip J.; Callahan, Christine; Elkinson, Audrey


    The researchers conducted an evaluation study assessing outcomes among 37 social workers who completed a continuing education course on financial capability and working with clients. Key constructs assessed included participants' attitudes about financial capability, self-efficacy to provide services, organizational barriers, and basic financial…

  19. Prevalence of malaria at booking among antenatal clients in a ...

    African Journals Online (AJOL)


    2Institute for Advanced medical Research and Training, College of Medicine, Ibadan, Nigeria. 3Department of Obstetrics ... MATERIALS AND METHODS. We used a cross sectional ... all part of routine care in the. Prevalence of malaria at booking among antenatal clients in a secondary health care facility in Ibadan, Nigeria ...

  20. Client Judgement of Therapist Characteristics: A Factor in Treatment Outcome. (United States)

    Chambers, Alycia A.; And Others

    This study, based on Strong's (1968) model of therapy as social influence, focused on the relationship between clients' judgments of therapists' characteristics and the outcomes of their treatment for generalized anxiety. Thirty subjects and 15 therapists met in 12 individual therapy sessions using Progressive Relaxation Training combined with…