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Sample records for increase client engagement

  1. Women-focused treatment agencies and process improvement: Strategies to increase client engagement

    Science.gov (United States)

    Wisdom, Jennifer P.; Hoffman, Kim; Rechberger, Elke; Seim, Kay; Owens, Betta

    2009-01-01

    Behavioral health treatment agencies often struggle to keep clients engaged in treatment. Women clients often have additional factors such as family responsibilities, financial difficulties, or abuse histories that provide extra challenges to remaining in care. As part of a national initiative, four women-focused drug treatment agencies used process improvement to address treatment engagement. Interviews and focus groups with staff assessed the nature and extent of interventions. Women-focused drug treatment agencies selected relational-based interventions to engage clients in treatment and improved four-week treatment retention from 66% to 76%. Process improvement interventions in women-focused treatment may be useful to improve engagement. PMID:20046914

  2. The Impact of Organizational Stress and Burnout on Client Engagement

    Science.gov (United States)

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

    2011-01-01

    This paper 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 (Broome, Flynn, Knight, & Simpson, 2007). The current study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the U.S. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, while 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. PMID:22154029

  3. Predicting initial client engagement with community mental health services by routinely measured data

    NARCIS (Netherlands)

    Roeg, D.P.K.; van de Goor, L.A.M.; Garretsen, H.F.L.

    2015-01-01

    Engagement is a determinant of how well a person will respond to professional input. This study investigates whether, in practice, routinely measured data predict initial client engagement with community mental health services. Engagement, problem severity, client characteristics, and duration

  4. Client and family engagement in rehabilitation research: a framework for health care organizations.

    Science.gov (United States)

    Anderson, James; Williams, Laura; Karmali, Amir; Beesley, Lori; Tanel, Nadia; Doyle-Thomas, Krissy; Sheps, Gideon; Chau, Tom

    2018-04-01

    To describe the development and implementation of an organizational framework for client and family-centered research. Case report. While patient-centered care is now well established, patient-centered research remains underdeveloped. This is particularly true at the organizational level (e.g., hospital based research institutes). In this paper we describe the development of an organizational framework for client and family centered research at Holland Bloorview Kids Rehabilitation Hospital in Toronto, Canada. It is our hope that, by sharing our framework other research institutions can learn from our experience and develop their own research patient/client/family engagement programs. Implications for rehabilitation Family engagement in rehabilitation research •Rehabilitation research is crucial to the development and improvement of rehabilitative care. •The relevance, appropriateness, and accountability of research to patients, clients and families could be improved. •Engaging clients and families as partners in all aspects of the research process is one way to address this problem. •In this paper, we describe a framework for engaging clients and families in research at the organizational level.

  5. Relating Therapist Characteristics to Client Engagement and the Therapeutic Alliance in an Adolescent Custodial Group Substance Misuse Treatment Program.

    Science.gov (United States)

    Daniels, Rachael Anne; Holdsworth, Emma; Tramontano, Carlo

    2017-07-29

    Client engagement in substance misuse treatment programs is directly associated with positive treatment outcomes. The nature of these programs means there are often difficulties engaging and retaining clients, but authors have consistently found a strong therapeutic alliance is associated with client engagement. While research has focused on the association between the alliance and engagement, the factors that influence the therapeutic alliance have received less attention. To examine therapists' characteristics, namely therapists' stress and empathy levels, as potential predictors of client engagement and the therapeutic alliance, within an adolescent substance misuse group treatment program. The sample included 84 adolescent clients and 14 therapists from a Secure Training Centre in England. Client engagement in the treatment program was observed, while self-reporting measures assessed the therapeutic alliance (client and therapist-rated), and therapists' stress and empathy levels. Multiple regression analysis revealed that therapists' stress levels negatively influenced the therapeutic alliance and had a curvilinear relationship with client engagement, indicating that stress is not exclusively negatively related to engagement. Although stress was found to negatively impact both cognitive and affective empathy, neither cognitive nor affective empathy were significantly related to client engagement or the therapeutic alliance. This study demonstrates the importance of therapist characteristics on client engagement and the therapeutic alliance. Within practice stress can have a positive impact on clients' engagement. Nevertheless, therapists may need additional support to deal with stress effectively. Therapists' empathy may too be fundamental to client engagement, but only it if is perceived by clients.

  6. The Client Risk and The Audit Planning: Influence of Acceptance of Audit Engagement

    Directory of Open Access Journals (Sweden)

    Deby Suryani

    2018-03-01

    Full Text Available This study briefly aims to extend the relationship between client risks with the audit planning by proposes the acceptance of audit engagement as a mediate variable to fill a gap research, furthermore to determine the effect of client risk toward the audit planning in Public Accounting Firm in Jakarta, Indonesia. This research is a quantitative causal with primary data obtained by questionnaires. The population of this study is the auditors of Public Accounting Firm registered in the Directory Indonesian Institute of Accountants (Certified 2016 in Jakarta and to obtain the sample used purposive sampling technique and obtained samples of 197 respondents from 45 Public Accounting Firms spread in Jakarta. The analysis of data is using Structural Equation Modeling. The results of this research shows; (1. The Client risks directly may affect the audit planning in a positive but not significantly, (2. The Client risk directly affects the acceptance of audit positively and significantly, (3. The acceptance of audit engagement has positively and significantly influence on audit planning. Therefore the acceptance of audit engagement perfectly can act as mediate variable between client's risks with the audit planning, whereas the acceptance of audit engagement indicated by Time Budget Pressure, Audit Fee. Letter of Auditing and all indicator have a high loading factor.

  7. The roles of effective communication and client engagement in delivering culturally sensitive care to immigrant parents of children with disabilities.

    Science.gov (United States)

    King, Gillian; Desmarais, Chantal; Lindsay, Sally; Piérart, Geneviève; Tétreault, Sylvie

    2015-01-01

    Delivering pediatric rehabilitation services to immigrant parents of children with disabilities requires the practice of culturally sensitive care. Few studies have examined the specific nature of culturally sensitive care in pediatric rehabilitation, especially the notions of effective communication and client engagement. Interviews were held with 42 therapists (10 social workers, 16 occupational therapists and 16 speech language pathologists) from two locations in Canada (Toronto and Quebec City). Data were analyzed using an inductive content analysis approach. Study themes included the importance and nature of effective communication and client engagement in service delivery involving immigrant parents. Participants discussed using four main types of strategies to engage immigrant parents, including understanding the family situation, building a collaborative relationship, tailoring practice to the client's situation and ensuring parents' understanding of therapy procedures. The findings illuminate the importance of effective, two-way communication in providing the mutual understanding needed by therapists to engage parents in the intervention process. The findings also richly describe the engagement strategies used by therapists. Clinical implications include recommendations for strategies for therapists to employ to engage this group of parents. Furthermore, the findings are applicable to service provision in general, as engaging families in a collaborative relationship through attention to their specific situation is a general principle of good quality, family-centered care. Implications for Rehabilitation Effective communication permeates the delivery of culturally sensitive care and provides mutual understanding, which is fundamental to client engagement. The findings illuminate the nature of "partnership" by indicating the role of collaborative therapist strategies in facilitating engagement. Four main strategies facilitate effective communication and

  8. Working with Clients Who Engage in Self-Harming Behaviour: Experiences of a Group of Counsellors

    Science.gov (United States)

    Fox, Claudine

    2011-01-01

    This study aimed to explore the experiences of a group of counsellors regarding working with clients who engage in self-harming behaviour, in order to gain an understanding of what it is like to work with this client group. A series of six individual, semi-structured qualitative interviews were carried out, which were then transcribed and analysed…

  9. Increasing student engagement and retention using immersive interfaces virtual worlds, gaming and simulation

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    Wankel, Charles

    2012-01-01

    Increasing Student Engagement and Retention Using Immersive Interfaces: Virtual Worlds, Gaming, and Simulation uses case studies, surveys, and literature reviews to critically examine how gaming, simulation, and virtualization are being used to improve teamwork and leadership skills in students, create engaging communities of practice, and as experiential learning tools to create inter-cultural, multi-perspective, and global experiences. Chapters include how to increase learner engagement using serious games, using game features for classroom engagement, using client-based peer assessment in multi-role, whole-enterprise simulations, using virtual worlds to develop teacher candidate skills, enhancing leadership skills through virtual simulation, using online video simulation for educational leadership, using augmented reality in education, using open source software in education, using educational robotics laboratories to enhance active learning, and utilizing the virtual learning environment to encourage facu...

  10. 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

  11. ANALISIS PERSEPSI AUDITOR MENGENAI FAKTOR PENENTU AUDIT FEE BERDASARKAN CLIENT ATTRIBUTES, AUDITOR ATTRIBUTES, DAN ENGAGEMENT ATRTRIBUTES

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    Aman Faturachman

    2013-04-01

    Full Text Available This research purposes to know how perception auditors about determining factors of audit fee based on Client Attributes, Auditor Attributes, and Engagement Attributes at The Public Accountant Firm residing in Bandung. In this research, the indicator that is used to characterize the Client Attributes are size, complexity, inherent risk, profitability, leverage and liquidity, and industry. While the indicator to characterize the Auditor Attributes are auditor’s specialization, audit tenure, and location. And the indicators to characterize the Engagement Attributes are audit problems, audit report lag, busy season, and number of reports. The Method that is used in this research is a descriptive method. The population in this research is a public accountant in Bandung. Based on sampling techniques that saturated and qualified then it take about 11 offices of public accountant. SmartPLS ver 2.0 M3 are used as a Statistical analysis. The result of this research with count the loading factor and bootstrapping method are, the first one that the perception of the auditor based on client attributes of audit fee determinants from which is very important to not important is size, complexity, profitability, inherent risk,  industry, and leverage & liquidty, the second states that perception based on auditor attributes audit fee determinants from which is very important to not important is audit tenure, location, and specialization. And the third states that the perception of auditor engagement attributes based determinants of audit fee which is very important to not important audit report lag, busy season, audit problems and number of reports.

  12. Practical Liability Issues of Information Technology Education: Internship and Consulting Engagements

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    Daniel A. Peak

    1998-01-01

    Full Text Available This article examines university liability created by internship and consulting relationships. Business clients participating in outreach relationships formulate performance expectations based on perceptions of experience and / or qualifications. Clients assign tasks accordingly, and the university incurs liability that is conditioned by business clients’ expectations. Substantial liability is related to unusually large and rare unfavorable outcomes in the outreach engagement, known as tail events. Tail events can significantly and negatively impact the client. Both the liability for and the probability of tail events increase as universities continue to expand business outreach activities. As internship and consulting engagements increase, the probability of a tail event also increases. The responsibilities of IT intern engagements and potential liability of the sponsoring university are analyzed. The university is the primary insurer for the client and indemnifies its representatives. All internship engagements should be formalized by written contract. An example contract is attached.

  13. 34 CFR 377.1 - What is the Demonstration Projects to Increase Client Choice Program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Demonstration Projects to Increase Client... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM General § 377.1 What is the Demonstration Projects to Increase Client Choice Program? The Demonstration Projects to Increase Client Choice Program is designed to...

  14. Relative efficacy of cash versus vouchers in engaging opioid substitution treatment clients in survey-based research.

    Science.gov (United States)

    Topp, Libby; Islam, M Mofizul; Day, Carolyn Ann

    2013-04-01

    Concerns that cash payments to people who inject drugs (PWID) to reimburse research participation will facilitate illicit drug purchases have led some ethical authorities to mandate department store/supermarket vouchers as research reimbursement. To examine the relative efficacy of the two forms of reimbursement in engaging PWID in research, clients of two public opioid substitution therapy clinics were invited to participate in a 20-30 min, anonymous and confidential interview about alcohol consumption on two separate occasions, 4 months apart. Under the crossover design, at Time 1, clients of Clinic 1 were offered $A20 cash as reimbursement, while clients of Clinic 2 were offered an $A20 voucher; at Time 2, the form of reimbursement was reversed. Using clinic records to determine the denominator (number of clients dosed), we found that compared with clients offered a voucher, a significantly higher proportion of clients who were offered cash participated in the survey (58% (139/241) vs 74% (186/252); χ(2)=14.27; p=0.0002). At first participation, respondents most commonly reported planning to purchase food/drinks/groceries (68%), cigarettes (21%) and transport/fuel (11%) with their payments, with those reimbursed in cash more likely to report planning to fund transport/fuel (19% vs 1%; ppayment. Results demonstrate that modest cash payments enhanced recruitment of this group, an important consideration given the challenges of delineating the parameters of a population defined by illegal activity, seemingly without promoting excessive additional drug use.

  15. Client Perceptions of the Mental Health Engagement Network: A Secondary Analysis of an Intervention Using Smartphones and Desktop Devices for Individuals Experiencing Mood or Psychotic Disorders in Canada

    OpenAIRE

    Forchuk, Cheryl; Donelle, Lorie; Ethridge, Paige; Warner, Laura

    2015-01-01

    Background The use of innovative technologies in mental health care has the potential to improve system efficiency, enhance quality of care, and increase patient engagement. The Mental Health Engagement Network (MHEN) project developed, delivered, and evaluated an interactive Web-based personal health record, the Lawson SMART Record (LSR), to assist mental health clients in managing their care and connecting with their care providers. This paper presents a secondary analysis of data collected...

  16. The Lifestyle Engagement Activity Program (LEAP): Implementing Social and Recreational Activity into Case-Managed Home Care.

    Science.gov (United States)

    Low, Lee-Fay; Baker, Jessica Rose; Harrison, Fleur; Jeon, Yun-Hee; Haertsch, Maggie; Camp, Cameron; Skropeta, Margaret

    2015-12-01

    The Lifestyle Engagement Activity Program (LEAP) incorporates social support and recreational activities into case-managed home care. This study's aim was to evaluate the effect of LEAP on engagement, mood, and behavior of home care clients, and on case managers and care workers. Quasi-experimental. Five Australian aged home care providers, including 2 specializing in care for ethnic minorities. Clients (n = 189) from 5 home care providers participated. The 12-month program had 3 components: (1) engaging support of management and staff; (2) a champion to drive practice change; (3) staff training. Case managers were trained to set meaningful social and/or recreational goals during care planning. Care workers were trained in good communication, to promote client independence and choice, and in techniques such as Montessori activities, reminiscence, music, physical activity, and humor. Data were collected 6 months before program commencement, at baseline, and 6 and 12 months. The Homecare Measure of Engagement Staff report and Client-Family interview were primary outcomes. Secondary outcomes were the Cohen-Mansfield Agitation Inventory; apathy, dysphoria, and agitation subscales of the Neuropsychiatric Inventory-Clinician Rating; the geriatric depression scale; UCLA loneliness scale; and home care satisfaction scale. Staff provided information on confidence in engaging clients and the Utrecht Work Engagement Scale. Twelve months after program commencement, clients showed a significant increase in self- or family-reported client engagement (b = 5.39, t[113.09] = 3.93, P recreationally engage clients (b = 0.52, t(21.33) = 2.80, P = .011, b = 0.29, t(198.69) = 2.58, P = .011, respectively). There were no significant changes in care worker-rated client engagement or client or family self-complete measures of depression or loneliness (P > .05). Client and family self-rated apathy increased over 12 months (b = 0.04, t(43.36) = 3.06, P = .004; b = 3.63, t(34.70) = 2.20, P

  17. Client and parent feedback on a Youth Mental Health Service: The importance of family inclusive practice and working with client preferences.

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    Coates, Dominiek

    2016-12-01

    In mental health settings, feedback from clients and carers is central to service evaluation, development and delivery. Increasingly, client and carer feedback is considered an integral part of service planning, and recognized as a critical element of the provision of recovery oriented service. This paper outlines the findings of a qualitative evaluation of a Youth Mental Health (YMH) service from the perspective of discharged clients and their parents. The service researcher conducted telephone interviews with 39 parents of discharged clients, and 17 young people themselves. Participants reported positive or mixed experiences with the service. In addition to more generic positive statements about the service, analysis identified two key themes: the importance of 'family inclusive practice' and the importance of 'working with client preferences'. Young people and their parents want to be actively engaged in treatment and have their treatment preferences considered in treatment planning. Participants expressed the importance of "a good fit" between the client and the worker in terms of the clinician's gender, personality and treatment style/modality. While for some participants these themes were raised in the context of service strengths, others identified them as limitations or opportunities for service improvement. The extent to which clients and their parents felt engaged and heard by their allocated clinician is critical to their satisfaction or dissatisfaction with the service, depending on their unique experience. As an outcome of this evaluation, a range of service improvement strategies have been recommended. © 2016 Australian College of Mental Health Nurses Inc.

  18. Montessori-based training makes a difference for home health workers & their clients.

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    Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

    2003-01-01

    Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.

  19. Facilitating neurorehabilitation through principles of engagement.

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    Danzl, Megan M; Etter, Nicole M; Andreatta, Richard D; Kitzman, Patrick H

    2012-01-01

    A primary goal of neurorehabilitation is to guide recovery of functional skills after injury through evidence-based interventions that operate to manipulate the sensorimotor environment of the client. While choice of intervention is an important decision for clinicians, we contend it is only one part of producing optimal activity-dependent neuroplastic changes. A key variable in the rehabilitation equation is engagement. Applying principles of engagement may yield greater neuroplastic changes and functional outcomes for clients. We review the principles of neuroplasticity and engagement and their potential linkage through concepts of attention and motivation and strategies such as mental practice and enriched environments. Clinical applications and challenges for enhancing engagement during rehabilitation are presented. Engagement strategies, such as building trust and rapport, motivational interviewing, enhancing the client education process, and interventions that empower clients, are reviewed. Well-controlled research is needed to test our theoretical framework and suggested outcomes. Clinicians may enhance engagement by investing time and energy in the growth and development of the therapeutic relationship with clients, as this is paramount to maintaining clients' investment in continuing therapy and also may act as a driver of neuroplastic changes.

  20. La contrainte client

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    Guillaume Tiffon

    2011-04-01

    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

  1. Social work - client relationship practice: exploring social worker perspectives

    OpenAIRE

    WENDY ELIZABETH ROLLINS

    2018-01-01

    This thesis explores, using qualitative methodology, the significance of social worker – client relationships for achieving client outcomes in the field of child and family welfare. The study found that social worker – client relationships are critical for achieving outcomes. It is a distinct practice method, informed by relational views about ‘the self’, human development and healing. The social worker, as Relationship Building Agent, is heavily focused on client engagement and building t...

  2. HIV susceptibility among clients of female sex workers in Indonesia: a qualitative inquiry.

    Science.gov (United States)

    Mwanri, Lillian; Fauk, Nelsensius Klau; Kustanti, Christina Yeni; Ambarwati, Atik; Merry, Maria Silvia

    2018-02-15

    Background: The spread of HIV infection among men in Indonesia continues to increase every year. Clients of female sex workers (FSWs) are a group at higher risk of acquiring HIV infection due to their frequent engagement in sexual acts with sex workers. This study aimed to identify factors of susceptibility to HIV infection among clients of FSWs. Methods: A qualitative inquiry using one-on-one in-depth interviews was conducted in the Belu and Malaka districts of Indonesia from January to April 2017. The study participants (n =42) were the clients of FSWs recruited using the snowball sampling technique. The inclusion criteria were: being a client of FSWs and being aged 18 years or more. Data were analysed using a framework analysis. Results: Findings were grouped into two main emerging themes that included behavioural and socioeconomic factors. Behavioural factors that mediated HIV susceptibility among clients of FSWs were: frequent engagement in unsafe sex with multiple sex workers; low perceptions of the relevance of available HIV and AIDS services and limited access to these services; and HIV stigma or fear of being labelled as HIV positive. Socioeconomic factors included: participants' economic situation; and individuals' household responsibility and ability to afford FSWs services. Conclusions: The study results indicate the need to reformulate and improve HIV and AIDS-related services, including increasing the level of availability of HIV service points and the dissemination of knowledge and information about HIV and AIDS and condom use and making them accessible to both FSWs and their clients in Belu and Malaka districts.

  3. RELATIONSHIPS AMONG COMPONENTS OF ENGAGEMENT RISK

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    EVREN DILEK SENGUR

    2012-01-01

    Full Text Available Accounting scandals exploded at the beginning of 2000s and the collapse of Arthur Andersen highlighted the importance of implementing engagement risk management strategies in audit firms. Engagement risk refers the overall risk associated with an audit engagement and it consists of three components: client's business risk, auditor's business risk, and audit risk. The main purpose of this study is to describe each components of engagement risk and explain relations among them. Additionally, the paper points out the importance of engagement risk management throughout the audit and demonstrates engagement risk management strategies at client acceptance/ continuance, planning and completion of audit.

  4. Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record.

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    Forchuk, Cheryl; Reiss, Jeffrey P; O'Regan, Tony; Ethridge, Paige; Donelle, Lorie; Rudnick, Abraham

    2015-10-14

    Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here. Individuals living in the community with a mood or psychotic disorder (n = 394) were provided with a smartphone and access to an electronic personal health record, the Lawson SMART Record, for 12 to 18 months to manage their mental health. This study employed a delayed-implementation design and obtained both quantitative and qualitative data through individual interviews and focus group sessions. Participants had the opportunity to participate in voluntary focus group sessions at three points throughout the study to discuss their perceptions of the technologies. Qualitative data from 95 focus group participants were analysed using a thematic analysis. Four overarching themes emerged from focus group discussions: 1) Versatile functionality of the Lawson SMART Record and smartphone facilitated use; 2) Aspects of the technologies as barriers to use; 3) Use of the Mental health Engagement Network technologies resulted in perceived positive outcomes; 4) Future enhancement of the Lawson SMART Record and intervention is recommended. These qualitative data provide a valuable contribution to the understanding of how smarttechnologies can be integrated into usual mental health care. Smartphones are extremely portable andcommonplace in society. Therefore, clients can use these devices to manage and track mental

  5. Empowering staff and clients: comparing preferences for management models by the professional degrees held by organization administrators.

    Science.gov (United States)

    Hardina, Donna; Montana, Salvador

    2011-07-01

    In this article, findings from a national survey of social service managers are described. Respondents were asked to identify theories and models of management that influenced their administrative activities. The results indicate that many of the respondents used an empowerment-oriented approach to management. Respondents were more likely to engage in management activities that focused on empowering staffthan in activities intended to increase client involvement in the political process or organizational decision making. However, when the responses of participants with MSW degrees were compared with those of non-social workers, findings indicate that social workers are more likely to engage in workplace activities that facilitate the political empowerment of clients.

  6. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers

    Science.gov (United States)

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-01-01

    Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%). Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission

  7. Drivers and obstacles for employee-driven innovation in large client project organisations

    DEFF Research Database (Denmark)

    Sørensen, Henrik; Wandahl, Søren

    2012-01-01

    of employees’ spoken and tacit knowledge in development of new tools and structures to optimise the construction project management processes is a relatively new approach to engage innovation. In this broad perspective the aim is to map the boundary conditions for an EDI approach in a client project......, and in sequence increased revenue, this study suggests that the key source for innovation is the employees. Employee-driven innovation (EDI) is often seen in a greater innovation context, in which it is often de-emphasised contrary to product and process innovation. Hence a methodology to take advantage...... a literature review to clarify the most potential methodologies and tools. Based on this review a framework of tools and methods is derived from related development theories to engage EDI in client project organisa-tions, where product and process knowledge often are closely related to, and irregular driven by...

  8. Is Student Pathology Really Increasing? Seven Measures of the Acuity of Counseling Center Clients, 1992-2007

    Science.gov (United States)

    Schwartz, Allan J.

    2015-01-01

    Since 1992, an overwhelming consensus among counseling center directors has asserted that, year after year, the severity or psychopathology of counseling center clients has been increasing. In contrast to this perceptual consensus, the search for confirming evidence using client self-report measures has been frustrating. These studies have…

  9. Exploring Lawyer-Client Interaction: A Qualitative Study of Positive Lawyer Characteristics.

    Science.gov (United States)

    Elbers, Nieke A; van Wees, Kiliaan A P C; Akkermans, Arno J; Cuijpers, Pim; Bruinvels, David J

    2012-03-01

    Personal injury victims involved in compensation processes have a worse recovery than those not involved in compensation processes. One predictor for worse recovery is lawyer engagement. As some people argue that this negative relation between lawyer engagement and recovery may be explained by lawyers' attitude and communications to clients, it seems important to investigate lawyer-client interaction. Although procedural justice and therapeutic jurisprudence had previously discussed aspects relevant for lawyer-client interaction, the client's perspective has been rather ignored and only few empirical studies have been conducted. In this qualitative study, 21 traffic accident victims were interviewed about their experiences with their lawyer. Five desirable characteristics for lawyers were identified: communication, empathy, decisiveness, independence, and expertise. Communication and empathy corresponded with aspects already discussed in literature, whereas decisiveness, independence and expertise had been addressed only marginally. Further qualitative and quantitative research is necessary to establish preferable lawyer characteristics and to investigate what would improve the well-being of personal injury victims during the claims settlement process.

  10. What client?

    DEFF Research Database (Denmark)

    Unterrainer, Walter

    2015-01-01

    rising pressure for new approaches towards space, urbanization, environmental challenges, technological inventions, transformation of cities and buildings on one hand and the decline in impact, reputation, self-esteem and economy of ´conventional´architectural profession on the other hand. In Asia like...... engage architects, no matter how urgent the problems are. It is the architects who must reverse their understanding of ´clients´, for the sake of these challenges as well as for their own professional future. This started happen very much in contrast to predominant architectural education models: Young...

  11. A qualitative analysis of staff-client interactions within a breast cancer assessment clinic

    International Nuclear Information System (INIS)

    Nightingale, J.M.; Murphy, F.; Eaton, C.; Borgen, R.

    2017-01-01

    Objectives: Breast screening clients recalled to an assessment clinic experience high levels of anxiety. The culture of the assessment clinic may impact upon client experience, which may influence their future re-engagement in screening. This study aimed to explore the culture of staff-client interactions within a breast cancer assessment clinic. Materials and methods: Following an ethnographic approach, twenty-three client journeys were observed, followed by semi-structured interviews with the clients. The observation and interview data were analysed to produce research themes, which were then explored within two focus groups to add a practitioner perspective. Results: Multiple staff-client interaction events were observed over a period of several weeks. Client interview feedback was overwhelmingly positive. Three recurrent and sequential themes emerged: breaking down barriers, preparing the ground and sign-posting. These themes outline the changing focus of staff-client interactions during the client's clinic journey, encompassing how anxieties were expressed by clients, and responded to by practitioners. Conclusion: This study was the first to explore in depth the staff-client interaction culture within a breast assessment clinic using an ethnographic approach. A new perspective on professional values and behaviours has been demonstrated via a model of staff-client interaction. The model documents the process of guiding the client from initial confusion and distress to an enhanced clarity of understanding. A recommendation most likely to have a positive impact on the client experience is the introduction of a client navigator role to guide the clients through what is often a lengthy, stressful and confusing process. - Highlights: • This study was the first to explore staff-client interaction within breast assessment clinics. • Assessment clinic culture may affect client perceptions and future re-engagement in screening. • An ethnographic approach

  12. Fostering engagement during termination: Applying attachment theory and research.

    Science.gov (United States)

    Marmarosh, Cheri L

    2017-03-01

    Therapists often struggle to determine the most important things to focus on during termination. Reviewing the treatment, identifying plans for the future, summarizing positive gains, and saying goodbye receive the most attention. Despite our best intentions, termination can end up becoming intellectualized. Attachment theory and recent developments in neuroscience offer us a road map for facilitating endings that address client's underlying relational needs, direct us to foster engagement, and help us facilitate new relational experience that can be transformative for clients. We argue that endings in therapy activate client's and therapist's attachments and these endings trigger emotion regulating strategies that can elicit client's engagement or more defensiveness. The current paper will highlight through de-identified case examples how clients automatically respond termination and how therapists can foster rich relational experiences in the here-and-now that clients can take with them. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Risk-Coping through Sexual Networks: Evidence from Client Transfers in Kenya

    Science.gov (United States)

    Robinson, Jonathan; Yeh, Ethan

    2012-01-01

    Why do women engage in transactional sex? While much of the explanation is that sex-for-money pays more than other jobs, we use a unique panel data set constructed from 192 self-reported diaries of sex workers in Western Kenya to show that women who supply transactional sex develop relationships with regular clients, and that these clients send…

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

    Directory of Open Access Journals (Sweden)

    Zavadska Diana V.

    2015-03-01

    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.

  15. Do client fees help or hurt?

    Science.gov (United States)

    Barnett, B

    1998-01-01

    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.

  16. Workplace Responses and Psychologists' Needs Following Client Suicide.

    Science.gov (United States)

    Finlayson, Melissa; Simmonds, Janette

    2017-01-01

    This research aimed to explore the role of workplace responses in psychologists' adaptation to client suicides. Participants were 178 psychologists who completed an online self-report questionnaire which included both open and closed questions yielding qualitative and quantitative data. Fifty-six (31.5%) participants reported one or more client suicides. Mixed results were found in terms of perceived support from the workplace following a client suicide. Psychologists reported a need for more open communication in the workplace, peer supports, space to grieve, as well as opportunities to engage in a learning process. The findings have important implications for research and for understanding the role of the workplace postvention. It also raises the need for external support to be accessible for psychologists working in private practice.

  17. Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists' Observable Behaviors.

    Science.gov (United States)

    Sotero, Luciana; Cunha, Diana; da Silva, José Tomás; Escudero, Valentín; Relvas, Ana Paula

    2017-12-01

    This study aimed to compare therapists' observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists' contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients' engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists' alliance-building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research. © 2016 Family Process Institute.

  18. Increasing Student Engagement in Online Educational Leadership Courses

    Science.gov (United States)

    Deschaine, Mark E.; Whale, David E.

    2017-01-01

    Utilization of online instruction continues to increase at universities, placing more emphasis on the exploration of issues related to adult graduate student engagement. This reflective case study reviews nontraditional student engagement in online courses. The goals of the study are to enhance student focus, attention, and interaction. Findings…

  19. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps.To evaluate the effect of SCE interventions on health worker motivation and experiences with clients.The study is a cluster randomized trial involving health workers in private (n = 38 and public (n = 26 primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72% were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation.Intrinsic (non-financial work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were

  20. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

    2016-01-01

    Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked

  1. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

    2016-01-01

    Background Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. Purpose To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. Methods The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Results Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while

  2. Client Perceptions of the Mental Health Engagement Network: A Secondary Analysis of an Intervention Using Smartphones and Desktop Devices for Individuals Experiencing Mood or Psychotic Disorders in Canada.

    Science.gov (United States)

    Forchuk, Cheryl; Donelle, Lorie; Ethridge, Paige; Warner, Laura

    2015-01-01

    The use of innovative technologies in mental health care has the potential to improve system efficiency, enhance quality of care, and increase patient engagement. The Mental Health Engagement Network (MHEN) project developed, delivered, and evaluated an interactive Web-based personal health record, the Lawson SMART Record (LSR), to assist mental health clients in managing their care and connecting with their care providers. This paper presents a secondary analysis of data collected in the MHEN project regarding clients' perceptions of technology and the use of these technologies in their care. We aimed to answer six questions: (1) What is the level of comfort with technology within a sample of individuals experiencing mood or psychotic disorders? (2) How easy to use and helpful are the MHEN technologies from the perspective of individuals experiencing a mental illness? (3) Are there differences in how helpful or useful individuals find the smartphone compared to the LSR? (4) Are there specific functions of MHEN technologies (eg, reminders for medications or appointments) that are more valued than others? (5) What are the other ways that individuals are using MHEN technologies in their daily lives? (6) How likely are individuals to be able to retain and maintain their smartphone? Mental health clients aged 18-80 (N=400) and diagnosed with a mood or psychotic disorder were provided with a smartphone (iPhone 4S) and participating care providers (n=52) were provided with a tablet (iPad) in order to access and engage with the LSR. A delayed implementation design with mixed methods was used. Survey and interview data were collected over the course of 18 months through semistructured interviews conducted by experienced research assistants every 6 months post-implementation of the intervention. Paired t tests were used to determine differences between 6 and 12-month data for perceptions of the MHEN technologies. A paired t test was used to examine whether differences

  3. Empowerment and occupational engagement among people with psychiatric disabilities.

    Science.gov (United States)

    Hultqvist, Jenny; Eklund, Mona; Leufstadius, Christel

    2015-01-01

    Empowerment is essential in the rehabilitation process for people with psychiatric disabilities and knowledge about factors that may play a key role within this process would be valuable for further development of the day centre services. The present study investigates day centre attendees' perceptions of empowerment. The aim was to investigate which factors show the strongest relationships to empowerment when considering occupational engagement, client satisfaction with day centres, and health-related and socio-demographic factors as correlates. 123 Swedish day centre attendees participated in a cross-sectional study by completing questionnaires regarding empowerment and the targeted correlates. Data were analysed with non-parametric statistics. Empowerment was shown to be significantly correlated with occupational engagement and client satisfaction and also with self-rated health and symptoms rated by a research assistant. The strongest indicator for belonging to the group with the highest ratings on empowerment was self-rated health, followed by occupational engagement and symptom severity. Occupational engagement added to the beneficial influence of self-rated health on empowerment. Enabling occupational engagement in meaningful activities and providing occupations that can generate client satisfaction is an important focus for day centres in order to assist the attendees' rehabilitation process so that it promotes empowerment.

  4. Perspective-Taking Increases Willingness to Engage in Intergroup Contact

    OpenAIRE

    Wang, Cynthia S.; Kenneth, Tai; Ku, Gillian; Galinsky, Adam D.

    2014-01-01

    The current research explored whether perspective-taking increases willingness to engage in contact with stereotyped outgroup members. Across three studies, we find that perspective-taking increases willingness to engage in contact with negatively-stereotyped targets. In Study 1, perspective-takers sat closer to, whereas stereotype suppressors sat further from, a hooligan compared to control participants. In Study 2, individual differences in perspective-taking tendencies predicted individual...

  5. Addressing clients' racism and racial prejudice in individual psychotherapy: Therapeutic considerations.

    Science.gov (United States)

    Bartoli, Eleonora; Pyati, Aarti

    2009-06-01

    Psychotherapists lack clear guidelines regarding how to address clients' racist and prejudicial comments in clinical work. The authors explore the contributions of multicultural, social justice, feminist, and ethical theories to the field of psychotherapy and apply these theories to 2 clinical vignettes in which clients made racially charged statements. These clinical examples highlight the importance of using racial, in addition to traditional, theories to decipher the clinical meanings of racial comments and dynamics in clinical work. The article provides therapeutic conceptualizations regarding how to address clients' racist and prejudicial comments in psychotherapy and elaborates on the complex meanings that might arise from engaging in racially charged discussions with clients depending on the racial composition of the therapeutic dyad. In addition to highlighting how social justice, multicultural, and feminist lenses are necessary to fully understand the meaning of clients' comments, the argument is made that addressing clients' racist and prejudicial comments is at once a clinical and a social justice issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  6. Negotiating the Client-Based Capstone Experience

    Science.gov (United States)

    Reifenberg, Steve; Long, Sean

    2017-01-01

    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…

  7. Collaborating with Your Clients Using Social Media & Mobile Communications

    Science.gov (United States)

    Typhina, Eli; Bardon, Robert E.; Gharis, Laurie W.

    2015-01-01

    Many Extension educators are still learning how to effectively integrate social media into their programs. By using the right social media platforms and mobile applications to create engaged, online communities, Extension educators can collaborate with clients to produce and to share information expanding and enhancing their social media and…

  8. Increasing Student Engagement through Paired Technologies

    Science.gov (United States)

    Basko, Lynn; Hartman, Jillian

    2017-01-01

    This article highlights efficient ways to combine tech tools, such as Remind and video conferencing, to increase student engagement and faculty/student communication. Using Remind is a great way to provide information to students outside of LoudCloud, and video conferencing is a tool for having synchronous meetings and conferences with students.…

  9. Teaching the Importance and Use of Web-Based Services to Assist Clients in Obtaining Public Benefits

    Science.gov (United States)

    Eamon, Mary Keegan; Wu, Chi-Fang; Moroney, Gabriela; Cundari, Melissa

    2013-01-01

    Research suggests that social work students and practitioners are not particularly sensitive to assessing clients' economic hardship, nor when needed to assist clients in accessing relevant resources such as public benefits. To enhance students' understanding of the importance of engaging in these activities, this article provides…

  10. Perspective-taking increases willingness to engage in intergroup contact.

    Science.gov (United States)

    Wang, Cynthia S; Kenneth, Tai; Ku, Gillian; Galinsky, Adam D

    2014-01-01

    The current research explored whether perspective-taking increases willingness to engage in contact with stereotyped outgroup members. Across three studies, we find that perspective-taking increases willingness to engage in contact with negatively-stereotyped targets. In Study 1, perspective-takers sat closer to, whereas stereotype suppressors sat further from, a hooligan compared to control participants. In Study 2, individual differences in perspective-taking tendencies predicted individuals' willingness to engage in contact with a hooligan, having effects above and beyond those of empathic concern. Finally, Study 3 demonstrated that perspective-taking's effects on intergroup contact extend to the target's group (i.e., another homeless man), but not to other outgroups (i.e., a man of African descent). Consistent with other perspective-taking research, our findings show that perspective-taking facilitates the creation of social bonds by increasing contact with stereotyped outgroup members.

  11. Perspective-Taking Increases Willingness to Engage in Intergroup Contact

    Science.gov (United States)

    Wang, Cynthia S.; Kenneth, Tai; Ku, Gillian; Galinsky, Adam D.

    2014-01-01

    The current research explored whether perspective-taking increases willingness to engage in contact with stereotyped outgroup members. Across three studies, we find that perspective-taking increases willingness to engage in contact with negatively-stereotyped targets. In Study 1, perspective-takers sat closer to, whereas stereotype suppressors sat further from, a hooligan compared to control participants. In Study 2, individual differences in perspective-taking tendencies predicted individuals' willingness to engage in contact with a hooligan, having effects above and beyond those of empathic concern. Finally, Study 3 demonstrated that perspective-taking's effects on intergroup contact extend to the target's group (i.e., another homeless man), but not to other outgroups (i.e., a man of African descent). Consistent with other perspective-taking research, our findings show that perspective-taking facilitates the creation of social bonds by increasing contact with stereotyped outgroup members. PMID:24465648

  12. Patterns of client behavior with their most recent male escort: an application of latent class analysis.

    Science.gov (United States)

    Grov, Christian; Starks, Tyrel J; Wolff, Margaret; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

    2015-05-01

    Research examining interactions between male escorts and clients has relied heavily on data from escorts, men working on the street, and behavioral data aggregated over time. In the current study, 495 clients of male escorts answered questions about sexual behavior with their last hire. Latent class analysis identified four client sets based on these variables. The largest (n = 200, 40.4 %, labeled Typical Escort Encounter) included men endorsing behavior prior research found typical of paid encounters (e.g., oral sex and kissing). The second largest class (n = 157, 31.7 %, Typical Escort Encounter + Erotic Touching) included men reporting similar behaviors, but with greater variety along a spectrum of touching (e.g., mutual masturbation and body worship). Those classed BD/SM and Kink (n = 76, 15.4 %) reported activity along the kink spectrum (BD/SM and role play). Finally, men classed Erotic Massage Encounters (n = 58, 11.7 %) primarily engaged in erotic touch. Clients reporting condomless anal sex were in the minority (12.2 % overall). Escorts who engage in anal sex with clients might be appropriate to train in HIV prevention and other harm reduction practices-adopting the perspective of "sex workers as sex educators."

  13. Does gamification increase engagement with online programs? A systematic review.

    Directory of Open Access Journals (Sweden)

    Jemma Looyestyn

    Full Text Available Engagement in online programs is difficult to maintain. Gamification is the recent trend that offers to increase engagement through the inclusion of game-like features like points and badges, in non-game contexts. This review will answer the following question, 'Are gamification strategies effective in increasing engagement in online programs?'Eight databases (Web of Science, PsycINFO, Medline, INSPEC, ERIC, Cochrane Library, Business Source Complete and ACM Digital Library were searched from 2010 to the 28th of October 2015 using a comprehensive search strategy. Eligibility criteria was based on the PICOS format, where "population" included adults, "intervention" involved an online program or smart phone application that included at least one gamification feature. "Comparator" was a control group, "outcomes" included engagement and "downstream" outcomes which occurred as a result of engagement; and "study design" included experimental studies from peer-reviewed sources. Effect sizes (Cohens d and 95% confidence intervals were also calculated.1017 studies were identified from database searches following the removal of duplicates, of which 15 met the inclusion criteria. The studies involved a total of 10,499 participants, and were commonly undertaken in tertiary education contexts. Engagement metrics included time spent (n = 5, volume of contributions (n = 11 and occasions visited to the software (n = 4; as well as downstream behaviours such as performance (n = 4 and healthy behaviours (n = 1. Effect sizes typically ranged from medium to large in direct engagement and downstream behaviours, with 12 out of 15 studies finding positive significant effects in favour of gamification.Gamification is effective in increasing engagement in online programs. Key recommendations for future research into gamification are provided. In particular, rigorous study designs are required to fully examine gamification's effects and determine how to best achieve

  14. Does gamification increase engagement with online programs? A systematic review.

    Science.gov (United States)

    Looyestyn, Jemma; Kernot, Jocelyn; Boshoff, Kobie; Ryan, Jillian; Edney, Sarah; Maher, Carol

    2017-01-01

    Engagement in online programs is difficult to maintain. Gamification is the recent trend that offers to increase engagement through the inclusion of game-like features like points and badges, in non-game contexts. This review will answer the following question, 'Are gamification strategies effective in increasing engagement in online programs?' Eight databases (Web of Science, PsycINFO, Medline, INSPEC, ERIC, Cochrane Library, Business Source Complete and ACM Digital Library) were searched from 2010 to the 28th of October 2015 using a comprehensive search strategy. Eligibility criteria was based on the PICOS format, where "population" included adults, "intervention" involved an online program or smart phone application that included at least one gamification feature. "Comparator" was a control group, "outcomes" included engagement and "downstream" outcomes which occurred as a result of engagement; and "study design" included experimental studies from peer-reviewed sources. Effect sizes (Cohens d and 95% confidence intervals) were also calculated. 1017 studies were identified from database searches following the removal of duplicates, of which 15 met the inclusion criteria. The studies involved a total of 10,499 participants, and were commonly undertaken in tertiary education contexts. Engagement metrics included time spent (n = 5), volume of contributions (n = 11) and occasions visited to the software (n = 4); as well as downstream behaviours such as performance (n = 4) and healthy behaviours (n = 1). Effect sizes typically ranged from medium to large in direct engagement and downstream behaviours, with 12 out of 15 studies finding positive significant effects in favour of gamification. Gamification is effective in increasing engagement in online programs. Key recommendations for future research into gamification are provided. In particular, rigorous study designs are required to fully examine gamification's effects and determine how to best achieve sustained

  15. Perspective-taking increases willingness to engage in intergroup contact.

    Directory of Open Access Journals (Sweden)

    Cynthia S Wang

    Full Text Available The current research explored whether perspective-taking increases willingness to engage in contact with stereotyped outgroup members. Across three studies, we find that perspective-taking increases willingness to engage in contact with negatively-stereotyped targets. In Study 1, perspective-takers sat closer to, whereas stereotype suppressors sat further from, a hooligan compared to control participants. In Study 2, individual differences in perspective-taking tendencies predicted individuals' willingness to engage in contact with a hooligan, having effects above and beyond those of empathic concern. Finally, Study 3 demonstrated that perspective-taking's effects on intergroup contact extend to the target's group (i.e., another homeless man, but not to other outgroups (i.e., a man of African descent. Consistent with other perspective-taking research, our findings show that perspective-taking facilitates the creation of social bonds by increasing contact with stereotyped outgroup members.

  16. Engaging with Assessment: Increasing Student Engagement through Continuous Assessment

    Science.gov (United States)

    Holmes, Naomi

    2018-01-01

    Student engagement is intrinsically linked to two important metrics in learning: student satisfaction and the quality of the student experience. One of the ways that engagement can be influenced is through careful curriculum design. Using the knowledge that many students are "assessment-driven," a low-stakes continuous weekly summative…

  17. Gardening with Huntington's disease clients--creating a programme of winter activities.

    Science.gov (United States)

    Spring, Josephine Anne; Baker, Mark; Dauya, Loreane; Ewemade, Ivie; Marsh, Nicola; Patel, Prina; Scott, Adrienne; Stoy, Nicholas; Turner, Hannah; Viera, Marc; Will, Diana

    2011-01-01

    A programme of garden-related indoor activities was developed to sustain a gardening group for people with mid to late stage Huntington's disease during the winter. The activities were devised by the horticulturist, working empirically, involving the services occupational therapist, physiotherapist, occupational therapy art technician, computer room, recreation and leisure staff. The programme was strongly supported by the nursing and care staff. Feedback on the effectiveness of the activities was sought from the clients, team members and unit staff. The clients' interest in gardening was sustained by a multidisciplinary programme of indoor growing and using plant products in creative activities, computing and group projects. The clients enjoyed all activities except one that they said lacked contact with plants. The inexpensive programme of activities enabled creativity and self-expression, stimulated social contact and helped with therapeutic goals of the clients. In addition, it engaged the multi-disciplinary team and the unit staff, was practical and enhanced the environment.

  18. Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

    Science.gov (United States)

    MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

    2017-11-28

    Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

  19. Romancing the boundary: client masculinities in the Chinese sex industry.

    Science.gov (United States)

    Kong, Travis S K

    2015-01-01

    This paper draws on 24 in-depth interviews and 2 focus-group discussions conducted since 2012 with Hong Kong heterosexual men who buy sex in order to examine men's level of physical and emotional engagement with sex workers under two dominant sexual scripts in contemporary Hong Kong. Torn between companionate sexuality, with its companionate model of relationships, and recreational sexuality, with its promiscuous model of sexual pleasure, Hong Kong male clients seek to satisfy their sexual and affective needs through commercial sexual relationships. The term (meaning 'chicken worm', connoting a 'McSex' form of masculinity) refers to those men who seek impersonal sexual release with as many women as they wish, while the term (meaning 'sunken boat' and connoting a 'Titanic' form of masculinity) refers to those men who seek an intense level of emotional intimacy with sex workers. Between these two contrasting types, the majority of respondents fall into a form of 'bounded' masculinity characteristic of men who emphasise control and balance by seeking emotionally responsive women in a time-bound romance. By comparing clients' variations in the level of physical and emotional engagement with sex workers, this paper seeks to understand individual differences in client types and offers a new understanding of Chinese male sexuality and relationship formation, and the corresponding health risks (e.g., sexual, emotional) associated with each type.

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

    Directory of Open Access Journals (Sweden)

    Katherine Hunt

    2011-06-01

    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.

  1. Engagement and avoidance in support staff working with people with intellectual disability and challenging behavior : A multiple-case study

    NARCIS (Netherlands)

    Zijlmans, L.J.M.; Bosman, A.M.T.; Gerits, L.; Derksen, J.; Embregts, P.J.C.M.

    2014-01-01

    Background Challenging behaviour of clients influences emotional wellbeing of staff; this in turn affects levels of staff engagement and avoidance within interactions with clients. The main goal of this study was to investigate to what extent levels of staff engagement and staff avoidance are

  2. New Commodity Services System increases gas bill for clients

    International Nuclear Information System (INIS)

    Koevoet, H.

    2003-01-01

    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

  3. Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

    Science.gov (United States)

    Lloyd, Belinda; Zahnow, Renee; Barratt, Monica J; Best, David; Lubman, Dan I; Ferris, Jason

    2017-11-01

    Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2003-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    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 http://gralggen.lsi.upc.edu/recerca/genexp.

  6. Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.

    Science.gov (United States)

    Danilovich, Margaret K; Diaz, Laura; Saberbein, Gustavo; Healey, William E; Huber, Gail; Corcos, Daniel M

    2017-01-01

    We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.

  7. Declining Inconsistent Condom Use but Increasing HIV and Syphilis Prevalence Among Older Male Clients of Female Sex Workers: Analysis From Sentinel Surveillance Sites (2010-2015), Guangxi, China.

    Science.gov (United States)

    Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua

    2016-05-01

    Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%).Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission.

  8. Predicting treatment noncompliance among criminal justice-mandated clients: a theoretical and empirical exploration.

    Science.gov (United States)

    Sung, Hung-En; Belenko, Steven; Feng, Li; Tabachnick, Carrie

    2004-01-01

    Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.

  9. Increasing Social Media Engagement through a Digital Marketing Plan. Case: Plootu

    OpenAIRE

    Koskinen, Saku

    2016-01-01

    The importance of mastering digital marketing in companies’ marketing mix is increasing and expertise in the field is still developing. Digital marketing provides tools to facilitate more targeted and cost-efficient marketing. Not only can marketing teams reach customers all over the world but they can also communicate, interact and engage with them. The objective of this project-based thesis was to increase social media engagement, brand awareness and reach new audiences in social media ...

  10. A physician role typology: colleague and client dependence in an HMO.

    Science.gov (United States)

    Barr, J K; Steinberg, M K

    1985-01-01

    This paper reports on physicians' role definitions in one prepaid group practice, a health maintenance organization (HMO). Colleague and client dependence are reviewed and analyzed as separable dimensions of physician role definitions. Data are derived from documents, interviews, and staff questionnaires collected in 1979-1980. The evidence reported suggests widespread colleague dependence in the HMO. Physicians consulted with one another about patient care and engaged in informal referral and review, developing practice standards; and some of these physicians relied on colleagues for handling their patient visits when needed. In relation to their patients, some physicians viewed themselves as bureaucratic officials relatively dependent on client approval in carrying out their health care activities, while others saw themselves as trusted medical experts in a setting free of nonmedical constraints in patient care. The relationship of organizational structure to these different role definitions is discussed. Classifying these HMO physicians according to a fourfold typology of professional dependence shows that most are Organizational Physicians (Type I), who are both colleague and client dependent. Collegial Physicians (Type II) are colleague dependent and, at the same time, do not perceive clients as demanding. Implications for quality of care and physician satisfaction and turnover are considered.

  11. Know Your Client and Know Your Team: A Complexity Inspired Approach to Understanding Safe Transitions in Care

    Directory of Open Access Journals (Sweden)

    Deborah Tregunno

    2013-01-01

    Full Text Available Background. Transitions in care are one of the most important and challenging client safety issues in healthcare. This project was undertaken to gain insight into the practice setting realities for nurses and other health care providers as they manage increasingly complex care transitions across multiple settings. Methods. The Appreciative Inquiry approach was used to guide interviews with sixty-six healthcare providers from a variety of practice settings. Data was collected on participants’ experience of exceptional care transitions and opportunities for improving care transitions. Results. Nurses and other healthcare providers need to know three things to ensure safe care transitions: (1 know your client; (2 know your team on both sides of the transfer; and (3 know the resources your client needs and how to get them. Three themes describe successful care transitions, including flexible structures; independence and teamwork; and client and provider focus. Conclusion. Nurses often operate at the margins of acceptable performance, and flexibility with regulation and standards is often required in complex sociotechnical work like care transitions. Priority needs to be given to creating conditions where nurses and other healthcare providers are free to creatively engage and respond in ways that will optimize safe care transitions.

  12. 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

    2017-10-01

    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.

  13. Client Perspective

    International Nuclear Information System (INIS)

    Cohen, M.; Oleksiak, T.A.

    1991-01-01

    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

  14. Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20-29 in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available Zimbabwe aims to increase circumcision coverage to 80% among 13- to 29-year-olds. However, implementation data suggest that high coverage among men ages 20 and older may not be achievable without efforts specifically targeted to these men, incurring additional costs per circumcision. Scale-up scenarios were created based on trends in implementation data in Zimbabwe, and the cost-effectiveness of increasing efforts to recruit clients ages 20-29 was examined.Zimbabwe voluntary medical male circumcision (VMMC program data were used to project trends in male circumcision coverage by age into the future. The projection informed a base scenario in which, by 2018, the country achieves 80% circumcision coverage among males ages 10-19 and lower levels of coverage among men above age 20. The Zimbabwe DMPPT 2.0 model was used to project costs and impacts, assuming a US$109 VMMC unit cost in the base scenario and a 3% discount rate. Two other scenarios assumed that the program could increase coverage among clients ages 20-29 with a corresponding increase in unit cost for these age groups.When circumcision coverage among men ages 20-29 is increased compared with a base scenario reflecting current implementation trends, fewer VMMCs are required to avert one infection. If more than 50% additional effort (reflected as multiplying the unit cost by >1.5 is required to double the increase in coverage among this age group compared with the base scenario, the cost per HIV infection averted is higher than in the base scenario.Although increased investment in recruiting VMMC clients ages 20-29 may lead to greater overall impact if recruitment efforts are successful, it may also lead to lower cost-effectiveness, depending on the cost of increasing recruitment. Programs should measure the relationship between increased effort and increased ability to attract this age group.

  15. Workplace violence among female sex workers who use drugs in Vancouver, Canada: does client-targeted policing increase safety?

    Science.gov (United States)

    Prangnell, Amy; Shannon, Kate; Nosova, Ekaterina; DeBeck, Kora; Milloy, M-J; Kerr, Thomas; Hayashi, Kanna

    2018-02-01

    Workplace violence, by clients or predators, poses serious negative health consequences for sex workers. In 2013, the Vancouver (British Columbia), Canada Police Department changed their guidelines with the goal of increasing safety for sex workers by focusing law enforcement on clients and third parties, but not sex workers. We sought to examine the trends and correlates of workplace violence among female sex workers (FSW) before and after the guideline change, using data collected from prospective cohorts of persons who use illicit drugs in Vancouver, Canada. Among 259 FSW, 21.0% reported workplace violence at least once during the study period between 2008 and 2014. There was no statistically significant change in rates of workplace violence after the guideline change. In our multivariable analysis, daily heroin use was independently associated with workplace violence. The 2013 policing guideline change did not appear to have resulted in decreased reports of workplace violence. Increased access to opioid agonist therapies may reduce workplace violence among drug-using FSW.

  16. Characterizing fentanyl use in methadone-maintained clients.

    Science.gov (United States)

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

    2017-04-01

    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.

  17. Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

    Science.gov (United States)

    2013-01-01

    Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process

  18. Client and clinician-rated characteristics of problem gamblers with and without history of gambling-related illegal behaviors.

    Science.gov (United States)

    Ellis, Jennifer D; Lister, Jamey J; Struble, Cara A; Cairncross, Molly; Carr, Meagan M; Ledgerwood, David M

    2018-03-12

    Individuals with gambling disorder are at an elevated risk for engaging in gambling-related illegal behaviors. The present study examined client (N = 88) and clinician ratings (N = 30) of client characteristics associated with a history of gambling-related illegal behaviors. We also examined client characteristics associated with history of arrest for a gambling-related crime. Gambling-related illegal behaviors and arrest were common (57.3% and 23.9%, respectively) in the present sample. Clients of younger age, and those with greater gambling-related financial consequences, lifetime alcohol problems, impulsivity, mood symptoms, and daily living role difficulties were more likely to report gambling-related illegal behaviors. Clients who had been arrested for a gambling-related crime were more likely to report daily living and role functioning difficulties and lifetime alcohol problems. Clinicians rated clients with a history of gambling-related illegal behaviors and/or gambling-related arrests as more impulsive, and clinicians also endorsed higher rates of treatment failure among these clients. Both client and clinician report suggested that clients with a history of illegal behaviors may have a variety of comorbid problems that may be a focus of clinical intervention. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

    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....

  20. Clinical educators' experiences of facilitating learning when speaking a different language from both the student and client.

    Science.gov (United States)

    Keeton, Nicola; Kathard, Harsha; Singh, Shajila

    2017-11-02

    Worldwide there is an increasing responsibility for clinical educators to help students from different language backgrounds to develop the necessary skills to provide health care services to a linguistically diverse client base. This study describes the experiences of clinical educators who facilitate learning in contexts where they are not familiar with the language spoken between students and their clients. A part of the qualitative component of a larger mixed methods study is the focus of this paper. Semi-structured interviews were conducted with eight participants recruited from all audiology university programmes in South Africa. Thematic analysis allowed for an in depth exploration of the research question. Member checking was used to enhance credibility. It is hoped that the findings will inform training programmes and in so doing, optimize the learning of diverse students who may better be able to provide appropriate services to the linguistically diverse population they serve. Participants experienced challenges with fair assessment of students and with ensuring appropriate client care when they were unable to speak the language shared between the client and the student. In the absence of formal guidelines, clinical educators developed unique coping strategies that they used on a case-by-case basis to assess students and ensure adequate client management when they experienced such language barriers while supervising. Coping strategies included engaging other students as interpreters, having students role-play parts of a session in English in advance and requesting real-time translations from the student during the session. They expressed concern about the fairness and efficacy of the coping strategies used. While clinical educators use unique strategies to assess students and to ensure suitable client care, dilemmas remain regarding the fairness of assessment and the ability to ensure the quality of client care.

  1. An exploration of mammographers' attitudes towards the use of social media for providing breast screening information to clients.

    Science.gov (United States)

    Scragg, B; Shaikh, S; Shires, G; Stein Hodgins, J; Mercer, C; Robinson, L; Wray, J

    2017-08-01

    Increasingly patients and clients of health services are using social media to locate information about medical procedures and outcomes. There is increasing pressure for health professionals to engage in on-line spaces to provide clear and accurate information to their patient community. Research suggests there are some anxieties on the part of practitioners to do this. This study aimed to explore the attitudes of the NHS breast screening programme workforce towards engaging in online discussions with clients about breast screening. 78 practitioners, representing a range of professional roles within the NHS Breast Screening Programme, attended one of 4 workshops. We used a Nominal Group Technique to identify and rank responses to the question: "What are the challenges that practitioners face in using SoME as part of their role?" Responses were categorised into themes. Participants were also asked to identify solutions to these challenges. Challenges: We identified two overarching themes: (1) Working within boundaries: which was further categorised into (a) Professional/legal accountability; (b) Information accuracy and (c)Time as a boundary, and (2) Support: further categorised into (a) Employer and (b) Manager. Solutions: These included: training in technical and interactional aspects of on-line communication and a responsibility to better understand employer and professional body SoMe policies. The study participants appeared willing and motivated to engage in SoMe. However, in keeping with the literature from other disciplines, a number of challenges need to be overcome for its use to be adopted more widely by breast screening professionals. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  2. The Contribution of the Counselor-Client Working Alliance to Career Exploration

    Science.gov (United States)

    Elad-Strenger, Julia; Littman-Ovadia, Hadassah

    2012-01-01

    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…

  3. Creating integrative work: a qualitative study of how massage therapists work with existing clients.

    Science.gov (United States)

    Fortune, Luann Drolc; Hymel, Glenn M

    2015-01-01

    As one of the most often used complementary treatments, massage is increasingly positioned as an essential component of integrative medicine. Recent studies evaluate the clinical efficacy of massage therapy, but few studies explore how massage therapists (MTs) execute their work and exercise clinical reasoning in natural settings. To gain foundational knowledge about clinical reasoning and applied knowledge, this study examined how 10 MTs executed an entire session with established clients. Results support translational research design and inform educators. Ethnomethodology and phenomenology informed the qualitative design. Data were collected by videotaping actual sessions and interviewing the participants immediately afterward while viewing the videos. Computer-aided analysis identified data patterns for thematic interpretation. The MTs shared tacit knowledge that directed their work: a) maintaining a primarily biomechanical focus, b) prerequisite safe touch, c) multitasking not allowed, d) MTs assume physical risk, and e) the work affects multiple bodily systems. The MTs sensed effectiveness experientially by adopting common tactics: a) visualizing the manual engagement points, b) assuming the client controlled the physiological release, and c) educating the client. Within these commonalities, they operationalized their work in complex and singular ways, with the particular client relationship critical to structuring the session and evaluating the outcome. MTs viewed their work primarily as a biomechanical intervention, but understood therapeutic massage as serving multiple functions. Process-oriented clinical reasoning mirrored models found in psychotherapy and was informed by experience, intuition, and training, which resulted in an intentionally holistic approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site.

    Science.gov (United States)

    Higashi, Robin T; Craddock Lee, Simon J; Leonard, Tammy; Cuate, Erica L; Cole, Jay; Pruitt, Sandi L

    2015-10-01

    Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population. © 2015 Wiley Periodicals, Inc.

  5. Using Patient Portals to Increase Engagement in Patients with Cancer.

    Science.gov (United States)

    Rodriguez, Elizabeth S

    2018-04-03

    To review patient portals which serve as a tool for patient engagement by increasing access to electronic health care information and expanding ways to communicate with health care providers. Reviews of the literature and first-hand experience. Meaningful Use requirements propelled the design and development of patient portals in recent years. Patient engagement in oncology can improve quality of life and outcomes. Oncology nurses facilitate patient adoption of patient portals and support usage. Patient education helps manage communication expectations and understanding of online medical information. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Do drug treatment facilities increase clients' exposure to potential neighborhood-level triggers for relapse? A small-area assessment of a large, public treatment system.

    Science.gov (United States)

    Jacobson, Jerry O

    2006-03-01

    Research on drug treatment facility locations has focused narrowly on the issue of geographic proximity to clients. We argue that neighborhood conditions should also enter into the facility location decision and illustrate a formal assessment of neighborhood conditions at facilities in a large, metropolitan area, taking into account conditions clients already face at home. We discuss choice and construction of small-area measures relevant to the drug treatment context, including drug activity, disadvantage, and violence as well as statistical comparisons of clients' home and treatment locations with respect to these measures. Analysis of 22,707 clients discharged from 494 community-based outpatient and residential treatment facilities that received public funds during 1998-2000 in Los Angeles County revealed no significant mean differences between home and treatment neighborhoods. However, up to 20% of clients are exposed to markedly higher levels of disadvantage, violence, or drug activity where they attend treatment than where they live, suggesting that it is not uncommon for treatment locations to increase clients' exposure to potential environmental triggers for relapse. Whereas on average both home and treatment locations exhibit higher levels of these measures than the household locations of the general population, substantial variability in public treatment clients' home neighborhoods calls into question the notion that they hail exclusively from poor, high drug activity areas. Shortcomings of measures available for neighborhood assessment of treatment locations and implications of the findings for other areas of treatment research are also discussed.

  7. Qualitative insights into implementation, processes, and outcomes of a randomized trial on peer support and HIV care engagement in Rakai, Uganda.

    Science.gov (United States)

    Monroe, April; Nakigozi, Gertrude; Ddaaki, William; Bazaale, Jeremiah Mulamba; Gray, Ronald H; Wawer, Maria J; Reynolds, Steven J; Kennedy, Caitlin E; Chang, Larry W

    2017-01-10

    People living with human immunodeficiency virus (HIV) who have not yet initiated antiretroviral therapy (ART) can benefit from being engaged in care and utilizing preventive interventions. Community-based peer support may be an effective approach to promote these important HIV services. After conducting a randomized trial of the impact of peer support on pre-ART outcomes, we conducted a qualitative evaluation to better understand trial implementation, processes, and results. Overall, 75 participants, including trial participants (clients), peer supporters, and clinic staff, participated in 41 in-depth interviews and 6 focus group discussions. A situated Information Motivation, and Behavioral skills model of behavior change was used to develop semi-structured interview and focus group guides. Transcripts were coded and thematically synthesized. We found that participant narratives were generally consistent with the theoretical model, indicating that peer support improved information, motivation, and behavioral skills, leading to increased engagement in pre-ART care. Clients described how peer supporters reinforced health messages and helped them better understand complicated health information. Peer supporters also helped clients navigate the health system, develop support networks, and identify strategies for remembering medication and clinic appointments. Some peer supporters adopted roles beyond visiting patients, serving as a bridge between the client and his or her family, community, and health system. Qualitative results demonstrated plausible processes by which peer support improved client engagement in care, cotrimoxazole use, and safe water vessel use. Challenges identified included insufficient messaging surrounding ART initiation, lack of care continuity after ART initiation, rare breaches in confidentiality, and structural challenges. The evaluation found largely positive perceptions of the peer intervention across stakeholders and provided valuable

  8. Can retail banking clients' attrition be managed?

    Directory of Open Access Journals (Sweden)

    Agaliotis Konstantinos

    2015-01-01

    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.

  9. A "client perspective" helps improve services.

    Science.gov (United States)

    1998-01-01

    Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.

  10. Client interpersonal impacts as mediators of long-term outcome in cognitive-behavioral therapy integrated with motivational interviewing for generalized anxiety disorder.

    Science.gov (United States)

    Constantino, Michael J; Romano, Felicia M; Coyne, Alice E; Westra, Henny A; Antony, Martin M

    2017-03-24

    A recent trial of generalized anxiety disorder treatment (Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating Motivational Interviewing With Cognitive-Behavioral Therapy for Severe Generalized Anxiety Disorder: An Allegiance-Controlled Randomized Clinical Trial. Journal of Consulting and Clinical Psychology, 84, 768-782. doi: 10.1037/ccp0000098 ) revealed that cognitive-behavioral therapy (CBT) integrated with motivational interviewing (MI) outperformed CBT alone across a 12-month follow up. The present study examined whether this treatment effect was mediated by MI-CBT clients engaging over time in during-session interpersonal behaviors reflecting more friendly dominance, or agentic actions, and less friendly submissiveness (FS), or trustingly compliant actions both theory-specific MI mechanisms. Clients received 15 sessions of MI-CBT (n = 42) or CBT alone (n = 43). Therapists rated client interpersonal behavior following five sessions, and clients rated their worry at baseline, each session, and 6- and 12-month follow up. Mediator and outcome variables were derived from multilevel models. Mediation was tested using a bootstrapping procedure. There was a significant indirect effect for FS. As expected, CBT clients evidenced greater increases in FS than MI-CBT clients, which in turn, though unexpectedly, related to lower 12-month worry. However, long-term CBT outcomes remained inferior to MI-CBT outcomes even with CBT clients'greater increase in FS. Results suggest that CBT outcomes are more positive when clients trustingly comply; however, MI-CBT remained superior, but for as yet unexplained reasons. Clinical or methodological significance of this article: The findings highlight the clinical importance of GAD clients becoming more friendly dominant in the therapy relationship irrespective of whether they received CBT or integrative MI-CBT. Moreover, it seems clinically indicated to incorporate MI spirit and techniques into CBT when

  11. Evaluating healing for cancer in a community setting from the perspective of clients and healers: a pilot study.

    Science.gov (United States)

    Vaghela, C; Robinson, N; Gore, J; Peace, B; Lorenc, A

    2007-11-01

    The real-life practice of 'healing' for cancer in the community as perceived by clients and healers was investigated in a multi-method pilot study. Fifteen clients received six weekly healing sessions. Pre- and post-changes in perception towards well-being and client experience were assessed by EuroQol (EQ-5D), measure yourself concerns and well-being (MYCaW) and a client satisfaction tool. Qualitative methods, including focus groups, explored the perceived effects of healing in more depth and the participants' experience of taking part in research. The study was not designed to test the effect of healing on disease. Quantitative data showed perceived significant improvements in 'concerns/problems' for which clients wanted help (pquantitative improvements to healing itself. Despite some concerns, healers and clients engaged fully with the research process, and were enthusiastic about the importance of research into healing. Our study suggests that, while there are some confounding issues and study limitations to address, clients and healers perceive healing to have a range of benefits, particularly in terms of coping with cancer, and regard it as a useful approach that can be applied in a community setting alongside conventional medicine.

  12. Data exploration of social client relationship management (CRM 2.0) adoption in the Nigerian construction business.

    Science.gov (United States)

    Ojelabi, Rapheal A; Afolabi, Adedeji O; Oyeyipo, Opeyemi O; Tunji-Olayeni, Patience F; Adewale, Bukola A

    2018-06-01

    Integrating social client relationship management (CRM 2.0) in the built environment can enhance the relationship between construction organizations and client towards sustaining a long and lasting collaboration. The data exploration analyzed the e-readiness of contracting and consulting construction firms in the uptake of CRM 2.0 and the barriers encountered in the adoption of the modern business tool. The targeted organizations consist of seventy five (75) construction businesses operating in Lagos State which were selected from a pool of registered contracting and consulting construction firms using random sampling technique. Descriptive statistics of the e-readiness of contracting and consulting construction firms for CRM 2.0 adoption and barriers limiting its uptake were analyzed. Also, inferential analysis using Mann-Whitney U statistical and independent sample t-test was performed on the dataset obtained. The data generated will support construction firms on the necessity to engage in client social relationship management in ensuring sustainable client relationship management in the built environment.

  13. Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada—a qualitative study

    Science.gov (United States)

    Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

    2014-01-01

    Objectives To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers’ working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Design Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Setting Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers’ safety over arrest, while continuing to target clients. Participants 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Outcome measures Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers’ working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January–November 2013). Results Sex workers’ narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants’ accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. Conclusions These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in

  14. 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...... is to empower a client to fulfil his/her occupational roles in a variety of environments, leading to an increase in intervention efficacy and client perception of intervention quality (3). However, it is known to be challenging (1,3). Given the importance of this approach, there has been limited exploration...

  15. Stakeholder Engagement: Achieving Sustainability in the Construction Sector

    Directory of Open Access Journals (Sweden)

    Damian Fearon

    2013-02-01

    Full Text Available Achieving sustainability-related targets in construction projects is increasingly becoming a key performance driver. Yet sustainability is a complex concept in projects and there are many diverse stakeholders. Some stakeholders are generally recognized as important, i.e., the client and main contractor, yet there are others not always perceived as such and whose absence from the decision-making processes may result in a failure to address sustainability issues. Hence there is a need for a systematic approach to engage with stakeholders with high salience in relation to sustainability. This paper reports the results of an exploratory study involving interviews with construction project practitioners that are involved in sustainability in some way. Data were collected from the practitioners in terms of the processes for engaging with stakeholders to deliver sustainability. The data suggests six steps to a stakeholder engagement process: (i identification; (ii relating stakeholders to different sustainability-related targets; (iii prioritization; (iv managing; (v measuring performance; and (vi putting targets into action. The results suggest that understanding the different sustainability agendas of stakeholders and measuring their performance using key performance indicators are important stages to be emphasized in any stakeholder engagement process to achieve sustainability-related goals.

  16. Client reflections on confirmation and disconfirmation of expectations in cognitive behavioral therapy for generalized anxiety disorder with and without motivational interviewing.

    Science.gov (United States)

    Button, Melissa L; Norouzian, Nikoo; Westra, Henny A; Constantino, Michael J; Antony, Martin M

    2018-01-22

    Addressing methodological shortcomings of prior work on process expectations, this study examined client process expectations both prospectively and retrospectively following treatment. Differences between clients receiving cognitive behavioral therapy (CBT) versus motivational interviewing integrated with CBT (MI-CBT) were also examined. Grounded theory analysis was used to study narratives of 10 participants (N = 5 CBT, 5 MI-CBT) who completed treatment for severe generalized anxiety disorder as part of a larger randomized controlled trial. Clients in both groups reported and elaborated expectancy disconfirmations more than expectancy confirmations. Compared to CBT clients, MI-CBT clients reported experiencing greater agency in the treatment process than expected (e.g., that they did most of the work) and that therapy provided a corrective experience. Despite nearly all clients achieving recovery status, CBT clients described therapy as not working in some ways (i.e., tasks did not fit, lack of improvement) and that they overcame initial skepticism regarding treatment. Largely converging with MI theory, findings highlight the role of key therapist behaviors (e.g., encouraging client autonomy, validating) in facilitating client experiences of the self as an agentic individual who is actively engaged in the therapy process and capable of effecting change.

  17. Evaluation of a liaison librarian program: client and liaison perspectives.

    Science.gov (United States)

    Tennant, Michele R; Cataldo, Tara Tobin; Sherwill-Navarro, Pamela; Jesano, Rae

    2006-10-01

    This paper describes a survey-based evaluation of the five-year old Liaison Librarian Program at the University of Florida. Liaison librarians, faculty, students, staff, residents, and post-doctoral associates were queried via Web-based surveys. Questions addressed client and liaison perspectives on a variety of issues, including program and service awareness and usage, client-library relations and communication, client support for the program, and liaison workload. Approximately 43% of the 323 client respondents were aware of liaison services; 72% (n = 163) of these clients had had contact with their liaison. Ninety-five percent (n = 101) of faculty and students who reported contact with their liaison supported the continuation of the program. Liaison services were used by a greater percentage of faculty than students, although they had similar patterns of usage and reported the same "traditional" services to be most important. Liaisons indicated that communications with clients had increased, the reputation of the library was enhanced, and their workloads had increased as a result of the Liaison Librarian Program. Survey results suggest that the Liaison Librarian Program has a core set of clients who use and highly value the services provided by liaisons. Recommendations addressing workload, training, marketing, and administrative support are provided.

  18. Antecedent control in the treatment of brain-injured clients.

    Science.gov (United States)

    Zencius, A H; Wesolowski, M D; Burke, W H; McQuade, P

    1989-01-01

    Three brain-injured clients failed to respond significantly to consequence management programmes designed to increase attendance, use of a cane, and to reduce unauthorized breaks. When antecedent stimulus control procedures were applied, attendance and use of a cane increased and unauthorized breaks decreased. The study shows that antecedent control may be the treatment of choice when treating brain-injured clients with memory loss.

  19. A theory led narrative review of one-to-one health interventions: the influence of attachment style and client-provider relationship on client adherence.

    Science.gov (United States)

    Nanjappa, S; Chambers, S; Marcenes, W; Richards, D; Freeman, R

    2014-10-01

    A theory-led narrative approach was used to unpack the complexities of the factors that enable successful client adherence following one-to-one health interventions. Understanding this could prepare the provider to anticipate different adherence behaviours by clients, allowing them to tailor their interventions to increase the likelihood of adherence. The review was done in two stages. A theoretical formulation was proposed to explore factors which influence the effectiveness of one-to-one interventions to result in client adherence. The second stage tested this theory using a narrative synthesis approach. Eleven studies across the health care arena were included in the synthesis and explored the interplay between client attachment style, client-provider interaction and client adherence with health interventions. It emerged that adherence results substantially because of the relationship that the client has with the provider, which is amplified or diminished by the client's own attachment style. This occurs because the client's attachment style shapes how they perceive and behave in relationships with the health-care providers, who become the 'secure base' from which the client accepts, assimilates and adheres with the recommended health intervention. The pathway from one-to-one interventions to adherence is explained using moderated mediation and mediated moderation models. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. Homebased rehabilitation: Physiotherapy student and client perspectives

    Directory of Open Access Journals (Sweden)

    Dianne Parris

    2016-05-01

    Full Text Available 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 enhanced experience for both student and client. This study sought to discover the perceptions of final-year physiotherapy students and their clients relating to their experiences of HBR during a PHC placement in a resource-constrained setting. Objectives. To explore the experiences and perceptions of physiotherapy students and their clients regarding HBR as part of clinical training in resource-constrained settings. To discover the barriers to and facilitators of effective HBR. Methods. An exploratory case study was performed. A qualitative phenomenological research design in the interpretivist paradigm was used. Semistructured interviews were conducted with clients (n=7 living in an under-resourced setting, who had received HBR from physiotherapy students. Paired interviews were conducted with final-year physiotherapy students (n=6 after their HBR placement. Results. Clients appreciated the students’ services; however, data revealed communication barriers and unmet expectations. Students reported struggling to adapt to the context, resulting in interventions not being sufficiently client-centred. They voiced a need for language competency and earlier exposure to such contexts. Conclusion. Exposure to real-life situations in under-resourced settings in HBR provides valuable situated and authentic learning opportunities for physiotherapy students. The experience can be useful in preparing graduates to address the needs of the populations they serve during community service.

  1. Caring for Clients and Families With Anxiety

    Directory of Open Access Journals (Sweden)

    Noriko Yamamoto-Mitani

    2016-08-01

    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.

  2. Counselor Responsiveness to Client Religiousness.

    Science.gov (United States)

    Kelly, Eugene W., Jr.

    1990-01-01

    Presents eight categories of client attitudes toward religion and suggests opportunities for religiously oriented counselor responses. Uses four categories to describes how religion may be associated with specific client issues. Contends that an informed appreciation of clients' religiousness and the religious dimensions of many client issues can…

  3. 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)

    2006-01-01

    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

  4. Assessment of ART centres in India: client perspectives.

    Science.gov (United States)

    Sogarwal, Ruchi; Bachani, Damodar

    2009-05-01

    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.

  5. "The Adopted Children of ART": expert clients and role tensions in ART provision in Uganda.

    Science.gov (United States)

    Kyakuwa, Margaret; Hardon, Anita; Goldstein, Zoe

    2012-01-01

    The implementation of the greater involvement of people living with HIV (GIPA) principle in Ugandan AIDS care is described by focusing on the engagement of expert clients in two rural health centers during a time of antiretroviral therapy (ART) scale-up. We contrast how the expert clients help overburdened nurses to manage the well-attended ART programs in the public and in the nongovernmental organization clinic. They are unpaid, but acquire preferential status in the ART program because of their knowledge of AIDS medicines (and its adverse effects) and because of the compassionate care that they provide. Despite the assistance provided, nurses in the public facility felt threatened in their professional status by these expert clients, who were seen to overstep the boundaries of their role. We pay particular attention to the double burden for HIV-positive nurses, who fear stigma, and (unlike the expert patients) keep their HIV status secret.

  6. Increasing Resilience Through Engagement In Sea Level Rise Community Science Initiatives.

    Science.gov (United States)

    Chilton, L. A.; Rindge, H.

    2017-12-01

    Science literate and engaged members of the public, including students, are critical to building climate resilient communities. USC Sea Grant facilitates programs that work to build and strengthen these connections. The Urban Tides Community Science Initiative (Urban Tides) and the Youth Exploring Sea Level Rise Science Program (YESS) engage communities across the boundaries of public engagement, K-12 education, and informal education. YESS is an experiential sea level rise education program that combines classroom learning, field investigations and public presentations. Students explore sea level rise using a new curricula, collect their own data on sea level rise, develop communication products, and present their findings to city governments, researchers, and others. Urban Tides engages community members, informal education centers, K-12 students, and local government leaders in a citizen science program photo- documenting extreme high tides, erosion and coastal flooding in Southern California. Images provide critical information to help calibrate scientific models used to identify locations vulnerable to damage from future sea level rise. These tools and information enable community leaders and local governments to set priorities, guidelines, and update policies as they plan strategies that will help the region adapt. The program includes a mobile app for data collection, an open database to view photos, a lesson plan, and community beach walks. Urban Tides has led to an increase in data and data-gathering capacity for regional scientists, an increase in public participation in science, and an increase in ocean and climate literacy among initiative participants. Both of these programs bring informed and diverse voices into the discussion of how to adapt and build climate resilient communities. USC Sea Grant will share impacts and lessons learned from these two unique programs.

  7. 34 CFR 377.31 - What information must a grantee provide to eligible clients?

    Science.gov (United States)

    2010-07-01

    ... clients? 377.31 Section 377.31 Education Regulations of the Offices of the Department of Education... PROJECTS TO INCREASE CLIENT CHOICE PROGRAM What Post-Award Conditions Must Be Met by a Grantee? § 377.31 What information must a grantee provide to eligible clients? Each grantee shall advise all clients and...

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

    OpenAIRE

    Zavadska Diana V.

    2015-01-01

    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...

  9. Integrating Reiki and community-engaged scholarship: an interdisciplinary educational innovation.

    Science.gov (United States)

    Bremner, Marie N; Bennett, David N; Chambers, Donna

    2014-09-01

    To provide students with a meaningful holistic care experience while integrating community-engaged scholarship, students partnered with a Reiki-prepared faculty member within a nurse-managed community clinic to offer Reiki to the clients and participate in the evaluation of the effectiveness of the modality. This article describes how students and faculty integrated holistic care, scholarship, and community engagement. This experience provided the students with an opportunity to embrace the art and science of holistic nursing while obtaining experience in measuring outcomes.

  10. Increasing First-Semester Student Engagement: A Residential Community Retention Study

    Science.gov (United States)

    Briggs, Ronald

    2012-01-01

    The purpose of this study was to increase first year residential student engagement and participation in residence hall programs during the 2011 fall semester at the Downtown Phoenix Campus of Arizona State University. Six upperclassmen (Taylor Place Leaders) residing in a residence hall (Taylor Place) were matched by academic major with 17 first…

  11. A positive risk approach when clients choose to live at risk: a palliative case discussion.

    Science.gov (United States)

    De Bono, Christopher E; Henry, Blair

    2016-09-01

    The article discusses recent approaches in the literature about clients who chose to live at risk in their homes. It argues for a positive risk-based approach and a tool to help manage risk in the home, and applies these to a hypothetical end-of-life scenario. Historically, safety plans to consider risk management involved a culture of risk aversion supported by sometimes paternalistic motives intended to protect vulnerable clients. New findings in the literature engage in a process that respects the ethical principles underlying harm reduction philosophies. The literature also argues for a perspective that moves away from viewing risk as only harmful, to one that supports a positive understanding of risk as part of a client's informed choice. A risk support management plan, based on a positive approach, can provide a way to both support a client's choice to live at risk, anticipate for expected complications, and inform the creation of a contingency plan to address concerns as they may arise. The added value of a structured approach like the one proposed here for risk support management plans is that it provides adequate due diligence and informed decision-making when planning for risk-taking in complex situations.

  12. Open client/server computing and middleware

    CERN Document Server

    Simon, Alan R

    2014-01-01

    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

  13. Counselors' attachment anxiety and avoidance and the congruence in clients' and therapists' working alliance ratings.

    Science.gov (United States)

    Kivlighan, Dennis M; Marmarosh, Cheri L

    2018-07-01

    To determine how counselors' attachment anxiety and avoidance related to congruence between counselors' and clients' Working alliance (WA) ratings. Congruence strength was defined as the regression coefficient for clients' WA ratings predicting counselors' WA ratings. Directional bias was defined as the difference in level between counselors' and clients' WA ratings. Twenty-seven graduate student counselors completed an attachment measure and they and their 64 clients completed a measure of WA early in therapy. The truth-and-bias analysis was adapted to analyze the data. As hypothesized counselors' WA ratings were significantly and positively related to clients' WA ratings. Also as hypothesized, counselors' WA ratings were significantly lower than their clients' WA ratings (directional bias). Increasing counselor attachment anxiety was related to increasing negative directional bias; as counselors' attachment anxiety increased the difference between counselors and clients WA ratings became more negative. There was a significant interaction between counselor attachment anxiety and congruence strength in predicting counselor WA ratings. There was a stronger relationship between client WA ratings and counselor WA ratings for counselors low versus high in attachment anxiety. Counselors' attachment anxiety is realted to their ability to accurately percieve their clients' WA.

  14. Seeking what matters: determinants of clients' satisfaction in obstetric care services in Pakistan.

    Science.gov (United States)

    Ali, Moazzam; Qazi, Muhammad Suleman; Seuc, Armando

    2014-01-01

    Aim of this study was to determine the dimensions of the service quality in the public hospitals and evaluate the determinants of client satisfaction in obstetric health in the context of Pakistan. The present research evaluates the application of an integrated client satisfaction model that draws mainly from the original SERVQUAL framework in obstetric health services. We conducted a cross-sectional study, in four public district hospitals in Pakistan, enrolling 1101 clients attending obstetric health care services. Measures of service quality and determinants of client satisfaction were factor-analysed and multiple regression analysis was used to test the hypothesis. The client satisfaction increased significantly with increases in respondent's age, number of children, number of visits and with decrease in educational status. Factor analysis revealed five service quality dimensions; and multiple regression analysis showed that all five dimensions of service quality in obstetric care were significant in explaining client satisfaction. The most powerful predictor for client satisfaction was provider communication with clients, followed by responsiveness and discipline. Interventions aimed at improving client provider interaction would not only advance the clinical provision of services, butwould also result in greater patient satisfaction with the services provided, leading to higher levels of facility utilization and continuity of care. Better client provider interaction can be accomplished at hospital's level through focused training of all cadre of service providers sensitizing them on clients' needs. Results also showed that the proposed framework is a valid and flexible instrument in assessing and monitoring service quality and enabling staff to identify where improvements are needed, from the clients' perspective.

  15. An exploratory study of engagement in a technology-supported substance abuse intervention

    Directory of Open Access Journals (Sweden)

    VanDeMark Nancy R

    2010-06-01

    Full Text Available Abstract Background The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings. Methods This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed. Results The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community. Conclusions The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions

  16. A Study on the Effects of Client Company Information on the On-Site Logistics and Processes in a Supply Chain: A New Design Approach using Quality Function Deployment

    Directory of Open Access Journals (Sweden)

    Masamitsu KIUCHI

    2016-04-01

    Full Text Available Recently, manufacturing companies have to construct supply chains considering the contingencies of global clients. In order to meet global demand, companies are required to quickly grasp the information which is disseminated in the supply chain. This study focuses on business to business (B to B manufacturing model in a supply chain. Generally, manufacturing companies which supply the products to client companies engaged in B to B structures deliver the products according to the client companies’ order. Manufacturing companies subsequently deliver the product depending on the order specifications that determine the delivery time, the order quantity, the order quality and so on. Therefore, the orders requisitioned by client companies might cause some impacts on the operations in the companies engaged in B to B structures in the supply chain. We suggest a new approach to solving the operation problems using Quality Function Deployment (QFD. QFD is a powerful methodology and is effective in organizing manufacturing information and setting the quality of design. A case study is given to show the implementation of the proposed methodology.

  17. Communication management between architects and clients

    Science.gov (United States)

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

    2017-10-01

    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.

  18. Examining challenging behaviors of clients with borderline personality disorder.

    Science.gov (United States)

    Chalker, Samantha A; Carmel, Adam; Atkins, David C; Landes, Sara J; Kerbrat, Amanda H; Comtois, Katherine Anne

    2015-12-01

    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.

  19. Connecting Music, Art, and Science for Increased Creativity and Topic Engagement

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    Tamara L. McNealy

    2013-08-01

    Full Text Available ‘Attention spans have shortened,’ is a common phrase often used in reference to today’s college students. As faculty and instructors, we need to address this issue through the utilization of innovative and creative techniques that aid in making our subjects accessible to our students. Connecting a serious topic such as microbiology with a ‘fun’ activity can increase student engagement and learning. Ideas to maintain student attention on a subject include providing information in 15- to 20-minute blocks, giving one- to two-minute assignments, and providing an active learning activity at least once per hour. But what if we could also increase their engagement with science by connecting it to things they already think of outside of class, and, in addition, make science thinking interdisciplinary? I have recently introduced exercises that connect music and art to various microbiology topics in my class. The creative processes in art and science have much in common. Albert Einstein recognized that both science and art delve into the mysterious by stating, “The most beautiful thing we can experience is the mysterious. It is the source of all true art and all science” (1. Connecting these subjects in the minds of our students will help them realize the importance of technology, industry, and progress in science and simultaneously emphasize the importance of art, music, and the humanities. The tools presented here will encourage students to connect new science information through the music and art they already know and, therefore, provide increased engagement and retention of the new knowledge. These techniques used in a microbiology class increased the amount of time spent thinking about new information, increased engagement with the information being presented, and encouraged critical thinking of microbiology topics. These tools were used in an upper level microbiology course, but the techniques can be easily incorporated into any course

  20. Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients

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    Ekundayo A. Sodeke-Gregson

    2013-12-01

    Full Text Available Background: Therapists who work with trauma clients are impacted both positively and negatively. However, most studies have tended to focus on the negative impact of the work, the quantitative evidence has been inconsistent, and the research has primarily been conducted outside the United Kingdom. Objectives: This study aimed to assess the prevalence of, and identify predictor variables for, compassion satisfaction, burnout, and secondary traumatic stress in a group of UK therapists (N=253 working with adult trauma clients. Method: An online questionnaire was developed which used The Professional Quality of Life Scale (Version 5 to assess compassion satisfaction, burnout, and secondary traumatic stress and collect demographics and other pertinent information. Results: Whilst the majority of therapists scored within the average range for compassion satisfaction and burnout, 70% of scores indicated that therapists were at high risk of secondary traumatic stress. Maturity, time spent engaging in research and development activities, a higher perceived supportiveness of management, and supervision predicted higher potential for compassion satisfaction. Youth and a lower perceived supportiveness of management predicted higher risk of burnout. A higher risk of secondary traumatic stress was predicted in therapists engaging in more individual supervision and self-care activities, as well as those who had a personal trauma history. Conclusions: UK therapists working with trauma clients are at high risk of being negatively impacted by their work, obtaining scores which suggest a risk of developing secondary traumatic stress. Of particular note was that exposure to trauma stories did not significantly predict secondary traumatic stress scores as suggested by theory. However, the negative impact of working with trauma clients was balanced by the potential for a positive outcome from trauma work as a majority indicated an average potential for compassion

  1. Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients.

    Science.gov (United States)

    Sodeke-Gregson, Ekundayo A; Holttum, Sue; Billings, Jo

    2013-01-01

    Therapists who work with trauma clients are impacted both positively and negatively. However, most studies have tended to focus on the negative impact of the work, the quantitative evidence has been inconsistent, and the research has primarily been conducted outside the United Kingdom. This study aimed to assess the prevalence of, and identify predictor variables for, compassion satisfaction, burnout, and secondary traumatic stress in a group of UK therapists (N=253) working with adult trauma clients. An online questionnaire was developed which used The Professional Quality of Life Scale (Version 5) to assess compassion satisfaction, burnout, and secondary traumatic stress and collect demographics and other pertinent information. Whilst the majority of therapists scored within the average range for compassion satisfaction and burnout, 70% of scores indicated that therapists were at high risk of secondary traumatic stress. Maturity, time spent engaging in research and development activities, a higher perceived supportiveness of management, and supervision predicted higher potential for compassion satisfaction. Youth and a lower perceived supportiveness of management predicted higher risk of burnout. A higher risk of secondary traumatic stress was predicted in therapists engaging in more individual supervision and self-care activities, as well as those who had a personal trauma history. UK therapists working with trauma clients are at high risk of being negatively impacted by their work, obtaining scores which suggest a risk of developing secondary traumatic stress. Of particular note was that exposure to trauma stories did not significantly predict secondary traumatic stress scores as suggested by theory. However, the negative impact of working with trauma clients was balanced by the potential for a positive outcome from trauma work as a majority indicated an average potential for compassion satisfaction.

  2. The flipped classroom: A learning model to increase student engagement not academic achievement

    Directory of Open Access Journals (Sweden)

    Masha Smallhorn

    2017-07-01

    Full Text Available A decrease in student attendance at lectures both nationally and internationally, has prompted educators to re-evaluate their teaching methods and investigate strategies which promote student engagement. The flipped classroom model, grounded in active learning pedagogy, transforms the face-to-face classroom. Students prepare for the flipped classroom in their own time by watching short online videos and completing readings. Face-to-face time is used to apply learning through problem-solving with peers. To improve the engagement and learning outcomes of our second year cohort, lectures were replaced with short online videos and face-to-face time was spent in a flipped classroom. The impact of the flipped classroom was analysed through surveys, attendance records, learning analytics and exam data before and after the implementation of the flipped classroom. Results suggest an increase in student engagement and a positive attitude towards the learning method. However, there were no measurable increases in student learning outcomes.

  3. Mindfulness and flow in occupational engagement: presence in doing.

    Science.gov (United States)

    Reid, Denise

    2011-02-01

    Flow is a psychological state that might be viewed as desirable, and it occurs when a person is aware of his or her actions but is not being aware of his or her awareness. Mindfulness is viewed not as the achievement of any particular state, but as intentional awareness of what is, being aware of awareness. To examine theoretical perspectives and empirical research on flow and mindfulness, and offer suggestions about the relevance of these concepts to occupational engagement. Both flow and mindfulness involve being present, actively engaged, and attentive. The experience and practice of flow and mindfulness are relevant to the experience of occupational engagement. Understanding flow and mindfulness may help occupational therapists improve the therapeutic occupational engagement process with their clients through enhancing depth and meaning of occupational experiences, as well as health and well-being.

  4. Impact of non-clinical community-based promotional campaigns on bowel cancer screening engagement: An integrative literature review.

    Science.gov (United States)

    Martini, Angelita; Morris, Julia N; Preen, David

    2016-10-01

    This paper reviewed the relationship between non-clinical, client-oriented promotional campaigns to raise bowel cancer awareness and screening engagement. An integrative literature review using predefined search terms was conducted to summarise the accumulated knowledge. Data was analysed by coding and categorising, then synthesized through development of themes. Eighteen of 116 studies met inclusion criteria. Promotional campaigns had varying impact on screening uptake for bowel cancer. Mass media was found to moderately increase screening, predominately amongst "worried well". Small media used in conjunction with other promotional activities, thus its effect on screening behaviours was unclear. One-on-one education was less effective and less feasible than group education in increasing intention to screen. Financial support was ineffective in increasing screening rates when compared to other promotional activities. Screening engagement increased because of special events and celebrity endorsement. Non-clinical promotional campaigns did impact uptake of bowel cancer screening engagement. However, little is evident on the effect of single types of promotion and most research is based on clinician-directed campaigns. Cancer awareness and screening promotions should be implemented at community and clinical level to maximize effectiveness. Such an approach will ensure promotional activities are targeting consumers, thus strengthening screening engagement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. The Competitive Advantage: Client Service.

    Science.gov (United States)

    Leffel, Linda G.; DeBord, Karen B.

    The adult education literature contains a considerable amount of research on and discussion of client service in the marketing process, management and staff roles in service- and product-oriented businesses, and the importance of client service and service quality to survival in the marketplace. By applying the principles of client-oriented…

  6. Chaperone-client complexes: A dynamic liaison

    Science.gov (United States)

    Hiller, Sebastian; Burmann, Björn M.

    2018-04-01

    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.

  7. Therapist strategies early in therapy associated with good or poor outcomes among clients with low proactive agency.

    Science.gov (United States)

    von der Lippe, Anna Louise; Oddli, Hanne Weie; Halvorsen, Margrethe Seeger

    2017-09-10

    Within a mixed methods program of research the present study aimed at expanding knowledge about interactions in the initial therapeutic collaboration by combining focus on client interpersonal style and therapist contribution. The study involves in-depth analyses of therapist-client interactions in the initial two sessions of good and poor outcome therapies. Based on interpersonal theory and previous research, the Inventory of Interpersonal Problems (IIP-64-C) was used to define poor outcome cases, that is, low proactive agency cases. To compare good and poor outcome cases matched on this interpersonal pattern, cases were drawn from two different samples; nine poor outcome cases from a large multi-site outpatient clinic study and nine good outcome cases from a process-outcome study of highly experienced therapists. Qualitative analysis of therapist behaviors resulted in 2 main categories, fostering client's proactive agentic involvement in change work and discouraging client's proactive agentic involvement in change work, 8 categories and 22 sub-categories. The findings revealed distinct and cohesive differences in therapist behaviors between the two outcome groups, and point to the particular therapist role of fostering client agency through engagement in a shared work on change when clients display strong unassertiveness and low readiness for change. Clinical or Methodological Significance Summary: The present analysis combines focus on client interpersonal style, therapist strategies/process and outcome. The categories generated from the present grounded theory analysis may serve as a foundation for identifying interactions that are associated with agentic involvement in future process research and practice, and hence we have formulated principles/strategies that were identified by the analysis.

  8. Prevalence and risk factors of frailty among home care clients.

    Science.gov (United States)

    Miettinen, Minna; Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma

    2017-11-17

    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. ClinicalTrials.gov: NCT02214758 .

  9. Improving Family Engagement: The Organizational Context and Its Influence on Partnering with Parents in Formal Child Care Settings

    Science.gov (United States)

    Douglass, Anne

    2011-01-01

    Family engagement is widely considered a key component of high-quality early care and education (ECE). While most efforts to improve the quality of family engagement focus on teacher training, strong evidence from health care research suggests that the organizational context is a critical determinant of the quality of client-professional…

  10. Team-client Relationships And Extreme Programming

    Directory of Open Access Journals (Sweden)

    John Karn

    2008-01-01

    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.

  11. Is ownership the decisive factor in collaborations between occupational health services and client companies?

    Science.gov (United States)

    Schmidt, Lisa; Sjöström, John; Antonsson, Ann-Beth

    2017-01-01

    Swedish employers are required to use external resources such as Occupational Health Services (OHS providers) if their own knowledge of occupational health and safety is insufficient. Some large employers have their own in-house OHS units but it is more common to engage the services of an external provider. However, no studies have been carried out from a critical perspective regarding how ownership of the OHS provider is related to a successful collaboration with client companies. This study explores the extent to which the six key factors for a successful collaboration are related to ownership and seeks to identify the challenges that the different models of ownership pose. Interviews with 15 client companies and their OHS providers were conducted in order to identify key factors in achieving a successful collaboration with an OHS provider. This study utilizes existing data to identify challenges related to ownership. Two key factors were identified with challenges related to ownership of the OHS provider: The importance of having a long-term perspective when building a relationship; and ensuring that collaboration extends beyond the client's HR Department to the various organisational levels of the company. Whatever form the ownership of an OHS provider may take, each comes with its own specific set of challenges that must be managed in order to achieve a successful collaboration with the client company.

  12. The lived experience of engaging in everyday occupations in persons with mild to moderate aphasia.

    Science.gov (United States)

    Niemi, Tuuli; Johansson, Ulla

    2013-10-01

    Impairment of language ability, aphasia, can cause barriers to communication and hence impact on participation in many life situations. This study aimed to describe and explore how persons with aphasia following stroke experience engaging in everyday occupations. Six persons from Southwest Finland who had aphasia due to stroke one to four years previously were interviewed for the study. A modified form of the empirical phenomenological psychological method was used for data analysis. Three main characteristics of experiences of engaging in everyday occupations were identified: (1) encountering new experiences in everyday occupations, (2) striving to handle everyday occupations and (3) going ahead with life. The participants had experienced an altering life-world. Engagement in occupations affected their perceptions of competence and identity, and experiences of belonging and well-being. It was also through engagement in everyday occupations that they had discovered and learnt to handle changes in their everyday life. Aphasia can have a long-term impact on engagement in everyday occupations and participation in society, but conversely, engagement in meaningful occupations can also contribute to adaptation to disability and life changes. Aphasia can have a long-term impact on engagement in everyday occupations and participation in society. Health care professionals need to determine what clients with aphasia think about their occupations and life situations in spite of difficulties they may have verbalizing their thoughts. Experiences of engaging in meaningful occupations can help clients with aphasia in reconstructing their life stories, thereby contributing to adaptation to disability and life changes.

  13. Increasing the emotional engagement of first year mature-aged distance students: Interest and belonging

    Directory of Open Access Journals (Sweden)

    Ella Kahu

    2014-08-01

    Full Text Available This research followed 19 mature-aged distance students through their first semester of undergraduate study. The analysis of interviews and video diaries presented in this paper focuses on two key elements of emotional engagement: interest and belonging. Findings highlight the importance of interest triggered by personal preferences and experiences. Interest led to enjoyment, increased behavioural engagement with greater time and effort expended, and improved cognitive engagement in terms of depth and breadth of learning. In contrast, there was less evidence of the social side of emotional engagement, belonging. Participants felt little connection to the university, but connecting with fellow students through face-to-face courses and online forums was important for some to reduce their sense of isolation. However, distance study was not for all. The findings highlight the need for staff to consider emotional engagement when designing and delivering the curriculum and when interacting with students, particularly in the all-important first year.

  14. The impact of a reproductive health franchise on client satisfaction in rural Nepal.

    Science.gov (United States)

    Agha, Sohail; Karim, Ali Mehryar; Balal, Asma; Sosler, Steve

    2007-09-01

    This study evaluates the impact of a nurse and paramedic reproductive health franchise in rural Nepal on client satisfaction and utilization of services. A quasi-experimental study design, with baseline and follow-up measurements on nonequivalent control groups, was used to assess the effects of the intervention. The study collected data from exit interviews with male and female clients at clinics and from household interviews with married women. Our assessment covers the project's performance for about a year of actual implementation. Client satisfaction with the quality of services increased across a range of indicators at intervention clinics but not at control clinics. Overall satisfaction with services also increased only at intervention clinics but not at control clinics. Consistent with these changes, loyalty increased among clients of franchised clinics. The analysis showed a positive relationship between client satisfaction and loyalty. Although the project's implementation was examined over a relatively short period of time, there appears to have been a net positive effect of the intervention on obtaining family planning products from medical stores/pharmacies. The study shows that franchising reproductive health services increases a provider's interest in delivering better quality services in rural areas of a developing country.

  15. Increasing diabetic patient engagement and self-reported medication adherence using a web-based multimedia program.

    Science.gov (United States)

    Elsabrout, Kerri

    2018-05-01

    Evidence-based, multimedia applications to supplement clinical care can improve patient engagement and clinical outcomes. Patients with diabetes with potentially devastating complication of foot ulcers present a substantial opportunity to improve engagement. This project examines how providing an online, multimedia self-management program affects patient engagement and self-reported medication adherence scores within 4-6 weeks compared with preprogram scores. Participants included 14 adult, diabetic outpatients receiving care at a Wound Care Center in suburban New York. Participants watched a Type 2 diabetes Emmi educational module on an electronic tablet during a routine wound treatment visit. Self-reported medication adherence was measured immediately before and at 4-6 weeks after the educational intervention. Patient engagement was measured immediately before, immediately after, and at 4-6 weeks postintervention. Self-reported medication adherence results demonstrated a modest increase at the delayed postintervention time. In addition, there was a large increase in engagement scores at the delayed postintervention time. The direction of change for both measures was consistent with the intervention being effective. Incorporating this type of novel, multimedia patient education resource may provide opportunities to enhance diabetes care.

  16. HIV Clients as Agents for Prevention: A Social Network Solution

    Directory of Open Access Journals (Sweden)

    Sarah Ssali

    2012-01-01

    Full Text Available HIV prevention efforts to date have not explored the potential for persons living with HIV to act as change agents for prevention behaviour in their social networks. Using egocentric social network analysis, this study examined the prevalence and social network correlates of prevention advocacy behaviours (discussing HIV in general; encouraging abstinence or condom use, HIV testing, and seeking HIV care enacted by 39 HIV clients in Uganda. Participants engaged in each prevention advocacy behaviour with roughly 50–70% of the members in their network. The strongest determinant of engaging in prevention advocacy with more of one’s network members was having a greater proportion of network members who knew one’s HIV seropositive status, as this was associated with three of the four advocacy behaviours. These findings highlight the potential for PLHA to be key change agents for HIV prevention within their networks and the importance of HIV disclosure in facilitating prevention advocacy.

  17. Identifying challenges in project consultants engagement practices

    Science.gov (United States)

    Shariffuddin, Nadia Alina Amir; Abidin, Nazirah Zainul

    2017-10-01

    Construction projects, green or conventional, involve multi-faceted disciplines engaged with the goal of delivering products i.e. building, infrastructure etc. at the best quality within stipulated budgets. For green projects, additional attention is added for environmental quality. Due to the various responsibilities and liabilities involved as well as the complexity of the construction process itself, formal engagement of multi-disciplinary professionals i.e. project consultants is required in any construction project. Poor selection of project consultants will lead to a multitude of complications resulting in delay, cost escalation, conflicts and poor quality. This paper explores the challenges that occur during the engagement of project consultants in a green project. As the engagement decision involves developers and architects, these two groups of respondents with green project backgrounds were approached qualitatively using interview technique. The challenges identified are limited experience and knowledge, consultants' fee vs. quality, green complexity, conflicts of interest, clients' extended expectation and less demand in green projects. The construction shifts to green project demands engagement of project consultants with added skills. It is expected that through the identification of challenges, better management and administration can be created which would give impact to the overall process of engagement in green projects.

  18. Institutional policy changes aimed at addressing obesity among mental health clients.

    Science.gov (United States)

    Knol, Linda L; Pritchett, Kelly; Dunkin, Jeri

    2010-05-01

    People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. This intervention was implemented in a rural mental health system in the southeastern United States. Clients live in small group homes, where they are served breakfast, dinner, and a snack, and attend outpatient day treatment programs, where they are served lunch and can purchase snacks from vending machines. This intervention included institutional policy changes that altered menus and vending machine options and implemented group walking programs. Primary outcome measures were changes in clients' weight at 3 and 6 months after policy implementation. At the 3-month follow-up, the median weight loss for overweight/obese clients (n = 45) was 1.4 kg. The 33 overweight/obese clients who were still in the group homes at the 6-month follow-up either maintained or continued to lose weight. Institutional policy changes aimed at improving dietary intake and physical activity levels among clients receiving mental health services can promote weight loss in overweight clients.

  19. Using Mobile Marketing to Engage NASCAR Fans and Increase Sales

    Directory of Open Access Journals (Sweden)

    MARK DODDS

    2011-01-01

    Full Text Available Mobile marketing displays engage the consumer. This sponsorship activation tactic is highly visible at NASCAR races. Some common elements include show cars, interactive race simulators, video games and race suit/equipment displays. The authors of this study argue that by using mobile marketing effectively as a sponsorship activation tactic, the race fans derive more enjoyment from the race experience. This increased enjoyment links to higher product sales for the sponsor. The implications of this study show that sponsors in other sports should use mobile marketing to increase the fan satisfaction of the game experience in order to increase their product sales. Additionally, event mangers should support mobile marketing as a sponsorship activation tactic with the intention of increasing fan enjoyment and improving attendance.

  20. Plastic with personality: Increasing student engagement with manikins.

    Science.gov (United States)

    Power, Tamara; Virdun, Claudia; White, Haidee; Hayes, Carolyn; Parker, Nicola; Kelly, Michelle; Disler, Rebecca; Cottle, Amanda

    2016-03-01

    Simulation allows students to practice key psychomotor skills and gain technical proficiency, fostering the development of clinical reasoning and student confidence in a low risk environment. Manikins are a valuable learning tool; yet there is a distinct lack of empirical research investigating how to enhance engagement between nursing students and manikins. To describe student perspectives of a layered, technology enhanced approach to improve the simulation learning experience. Tanner's Model of Clinical Judgment underpins the entire curriculum. This study additionally drew on the principles of narrative pedagogy. Across ten teaching weeks, five separate case studies were introduced to students through short vignettes. Students viewed the vignettes prior to their laboratory class. In the labs, manikins were dressed in the props used in the vignettes. The innovation was trialed in a second year core subject of a Bachelor of Nursing program in a large urban university in the autumn semester of 2014. Following ethics approval, students were emailed a participant information sheet. A focus group of nine students was held. The discussion was digitally recorded and transcribed verbatim prior to being subject to thematic analysis. Students' comments (143) about the vignettes in their standard subject specific student feedback surveys were also considered as data. Four themes were identified: Getting past the plastic; knowing what to say; connecting and caring; and, embracing diversity. The feedback indicated that these measures increased students ability to suspend disbelief, feel connected to, and approach the manikins in a more understanding and empathetic fashion. In addition to achieving increased engagement with manikins, other advantages such as students reflecting on their own values and pre-conceived notions of people from diverse backgrounds were realized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Increasing Student Engagement Using Asynchronous Learning

    Science.gov (United States)

    Northey, Gavin; Bucic, Tania; Chylinski, Mathew; Govind, Rahul

    2015-01-01

    Student engagement is an ongoing concern for educators because of its positive association with deep learning and educational outcomes. This article tests the use of a social networking site (Facebook) as a tool to facilitate asynchronous learning opportunities that complement face-to-face interactions and thereby enable a stronger learning…

  2. Are You Being Served? The Relationship between School Climate for Service and Teachers' Engagement, Satisfaction, and Intention to Leave: A Moderated Mediation Model.

    Science.gov (United States)

    Eldor, Liat; Shoshani, Anat

    2017-05-19

    The notion of service has been receiving increasing attention in organizational psychology literature in recent years, due to the client-oriented managerial movement. Yet, little to no attention has been paid to the service notion in educational psychology despite its high relevance to educational settings, given the pressure to be more service-oriented and possess a client-focused state of mind. The present study explores the notion of service in school domains by examining the joint effects of climate for service and the internal service in schools on teachers' work attitudes: work engagement, job satisfaction, and intention to leave their work. The notion of climate for service emphasizes the school's attitude of teachers as service providers to its clients (students and their parents); internal climate emphasizes the school's attitude of providing service to its teaching staff. The study was conducted via a sample of 423 teachers from 30 different schools in Israel. We hypothesized that the indirect relationship between the climate for service and teachers' job satisfaction and intention to leave work would be mediated by teacher work engagement. Our findings supported this hypothesis. Moreover, this indirect relationship via teacher work engagement was demonstrated most strongly when the internal service quality received was high, providing teachers with the capability to deliver what the service climate motivates them to do. Therefore, service-oriented resources-both climate for service and internal service-may be crucial in affecting teachers work attitudes and should be specifically targeted by principals and other educational decision makers.

  3. Serving up the self: Role identity and burnout in client service environments

    Directory of Open Access Journals (Sweden)

    Carly Steyn

    2015-12-01

    identities in response to the dominant discourse of the organisation, client service organisations should exercise caution in how they define and refer to the client-employee interaction through this discourse. Contribution/value-add: The article makes a number of practical recommendations, which, if implemented by client service organisations, should result in lower levels of burnout, increased productivity and improved client relations. One such recommendation requires client service organisations to reframe their client discourses in such a way that client service employees are referred to as knowledge experts that are valued by their organisations.

  4. Call center. Centrados en el cliente

    OpenAIRE

    Leal-Alonso-de-Castañeda, José Enrique

    2003-01-01

    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...

  5. Evaluation of the Deadly Liver Mob program: insights for roll-out and scale-up of a pilot program to engage Aboriginal Australians in hepatitis C and sexual health education, screening, and care.

    Science.gov (United States)

    Treloar, Carla; Hopwood, Max; Cama, Elena; Saunders, Veronica; Jackson, L Clair; Walker, Melinda; Ooi, Catriona; Ubrihien, Ashley; Ward, James

    2018-02-01

    Deadly Liver Mob (DLM) is a peer-driven, incentivised health promotion program aimed at increasing understanding of hepatitis C, promoting harm reduction in relation to injecting drug use, and linking participants to screening for hepatitis C, other blood borne viruses and sexually transmissible infections among Aboriginal people in Western Sydney, NSW. This paper presents the evaluation of a pilot study examining the acceptability of the program as a first step of a scalability assessment. Deadly Liver Mob operated in co-located needle and syringe programs and sexual health clinics in two sites: (Site 1: two and a half years for 2 days/week; Site 2: 1 year for 1 day per week). Comparisons were made of the proportion of Aboriginal clients (Site 1) and occasions of service provided to Aboriginal clients (Site 2) in the 12 months prior and post-introduction of DLM. Interviews were conducted with 13 staff involved in delivery of DLM and with 19 clients. A total of 655 and 55 Aboriginal clients, respectively, attended Site 1 and Site 2 for health education. The proportion of Aboriginal clients attending both sites was significantly higher during the DLM compared with prior to its implementation. Of those attending for health education, 79 and 73%, respectively, attended screening following education. DLM clients strongly endorsed the program. Some staff were concerned about workforce capacity to effectively engage Aboriginal clients with multiple and complex needs, managing the differing aims of the participating services involved, and about offering of incentives for attendance at health services. While acceptability was high among staff and clients and preliminary results show high engagement with Aboriginal communities, this evaluation of a pilot program raises some issues to consider in scale up of DLM to other sites. The initiation of additional DLM sites should address issues of alignment with governing strategies and workforce capacity.

  6. PATRON-CLIENT RELATIONSHIP PADA MASYARAKAT MADURA

    OpenAIRE

    Mohammad Hefni

    2012-01-01

    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)....

  7. Cleaner shrimp use a rocking dance to advertise cleaning service to clients.

    Science.gov (United States)

    Becker, Justine H A; Curtis, Lynda M; Grutter, Alexandra S

    2005-04-26

    Signals transmit information to receivers about sender attributes, increase the fitness of both parties, and are selected for in cooperative interactions between species to reduce conflict [1, 2]. Marine cleaning interactions are known for stereotyped behaviors [3-6] that likely serve as signals. For example, "dancing" and "tactile dancing" in cleaner fish may serve to advertise cleaning services to client fish [7] and manipulate client behavior [8], respectively. Cleaner shrimp clean fish [9], yet are cryptic in comparison to cleaner fish. Signals, therefore, are likely essential for cleaner shrimp to attract clients. Here, we show that the yellow-beaked cleaner shrimp [10] Urocaridella sp. c [11] uses a stereotypical side-to-side movement, or "rocking dance," while approaching potential client fish in the water column. This dance was followed by a cleaning interaction with the client 100% of the time. Hungry cleaner shrimp, which are more willing to clean than satiated ones [12], spent more time rocking and in closer proximity to clients Cephalopholis cyanostigma than satiated ones, and when given a choice, clients preferred hungry, rocking shrimp. The rocking dance therefore influenced client behavior and, thus, appears to function as a signal to advertise the presence of cleaner shrimp to potential clients.

  8. A comparison of fusion breeder/fission client and fission breeder/fission client systems for electrical energy production

    International Nuclear Information System (INIS)

    Land, R.J.; Parish, T.A.

    1983-01-01

    A parametric study that evaluated the economic performance of breeder/client systems is described. The linkage of the breeders to the clients was modelled using the stockpile approach to determine the system doubling time. Since the actual capital costs of the breeders are uncertain, a precise prediction of the cost of a breeder was not attempted. Instead, the breakeven capital cost of a breeder relative to the capital cost of a client reactor was established by equating the cost of electricity from the breeder/client system to the cost of a system consisting of clients alone. Specific results are presented for two breeder/client systems. The first consisted of an LMFBR with LWR clients. The second consisted of a DT fusion reactor (with a 238 U fission suppressed blanket) with LWR clients. The economics of each system was studied as a function of the cost of fissile fuel from a conventional source. Generally, the LMFBR/LWR system achieved relatively small breakeven capital cost ratios; the maximum ratio computed was 2.2 (achieved at approximately triple current conventional fissile material cost). The DTFR/LWR system attained a maximum breakeven capital cost ratio of 4.5 (achieved at the highest plasma quality (ignited device) and triple conventional fissile cost)

  9. What role can avatars play in e-mental health interventions? Exploring new models of client-therapist interaction.

    Directory of Open Access Journals (Sweden)

    Imogen C Rehm

    2016-11-01

    Full Text Available In the burgeoning field of e-mental health interventions, avatars are increasingly being utilized to facilitate online communication between clients and therapists, and amongst peers. Avatars are digital self-representations which enable individuals to interact with each other in computer-based virtual environments. In this narrative review, we examine the psychotherapeutic applications of avatars that have been investigated and trialed to date. Five key applications were identified: (1 in the formation of online peer support communities; (2 replicating traditional modes of psychotherapy by using avatars as a vehicle to communicate within a wholly virtual environment; (3 using avatar technology to facilitate or augment face-to-face treatment; (4 as part of serious games, and (5 communication with an autonomous virtual therapist. Across these applications, avatars appeared to serve several functions conducive to treatment engagement: (1 facilitating the development of a virtual therapeutic alliance; (2 reducing communication barriers; (3 promoting treatment-seeking through anonymity; (4 promoting expression and exploration of client identity, and (5 enabling therapists to control and manipulate treatment stimuli. Further research into the feasibility and ethical implementation of avatar-based psychotherapies is required.

  10. What Role Can Avatars Play in e-Mental Health Interventions? Exploring New Models of Client-Therapist Interaction.

    Science.gov (United States)

    Rehm, Imogen C; Foenander, Emily; Wallace, Klaire; Abbott, Jo-Anne M; Kyrios, Michael; Thomas, Neil

    2016-01-01

    In the burgeoning field of e-mental health interventions, avatars are increasingly being utilized to facilitate online communication between clients and therapists, and among peers. Avatars are digital self-representations, which enable individuals to interact with each other in computer-based virtual environments. In this narrative review, we examine the psychotherapeutic applications of avatars that have been investigated and trialed to date. Five key applications were identified (1) in the formation of online peer support communities; (2) replicating traditional modes of psychotherapy by using avatars as a vehicle to communicate within a wholly virtual environment; (3) using avatar technology to facilitate or augment face-to-face treatment; (4) as part of serious games; and (5) communication with an autonomous virtual therapist. Across these applications, avatars appeared to serve several functions conducive to treatment engagement by (1) facilitating the development of a virtual therapeutic alliance; (2) reducing communication barriers; (3) promoting treatment-seeking through anonymity; (4) promoting expression and exploration of client identity; and (5) enabling therapists to control and manipulate treatment stimuli. Further research into the feasibility and ethical implementation of avatar-based psychotherapies is required.

  11. The Loss of Boystown and Transition to Online Sex Work: Strategies and Barriers to Increase Safety Among Men Sex Workers and Clients of Men.

    Science.gov (United States)

    Argento, Elena; Taylor, Matthew; Jollimore, Jody; Taylor, Chrissy; Jennex, James; Krusi, Andrea; Shannon, Kate

    2016-06-28

    Men sex workers in Vancouver have largely transitioned from street to online solicitation coinciding with losing "Boystown," the main outdoor sex work stroll for men. This article explores strategies and barriers to increase safety among men and trans sex workers and clients of men in Vancouver, Canada. Qualitative interviews were conducted (2012-2013) with 61 self-identifed men who currently buy and/or sell sex in a community-based research project known as CHAPS (Community Health Assessment of Men Who Purchase and Sell Sex). Drawing on a socioecological framework, thematic analysis of interview transcripts was conducted utilizing ATLAS.ti 7 software among men (39 workers; 8 buyers). Narratives indicate that gentrification and urban planning led to social isolation and loss of social support networks among men in the sex industry. Concurrently, the restructuring of sex work to online increased workers' safety and control. Narratives reveal how the Internet can provide greater opportunities to negotiate terms of sex work and enhanced screening using webcams, reducing risks of violence, stigma, and police harassment for both workers and clients compared with the street. This study highlights how losing Boystown led to a loss of community and solidarity: key protective measures for sex workers. Online solicitation increased workers' capacity to screen prospective clients and prevent violence. Recent legal reforms in Canada to further criminalize sex work raise significant concern for human rights and health of individuals in the sex industry, and point to the critical need to include voices of men and trans sex workers and buyers in policy discussions. © The Author(s) 2016.

  12. Male nurses' experiences of providing intimate care for women clients.

    Science.gov (United States)

    Inoue, Madoka; Chapman, Rose; Wynaden, Dianne

    2006-09-01

    This paper reports a study of male nurses' experiences of providing intimate care for women clients. The number of men entering the nursing profession has increased worldwide. As a consequence of the move to a more gender-balanced profession, debate has ensued over how intimate care should be performed when this requires male nurses to be physically close to women clients. As there was little previous work on this topic, we wished to provide nurses, clients and other healthcare professionals with a better understanding of male nurses' experiences of working with women clients and within a healthcare system where they often feel excluded. Semi-structured, open-ended interviews were conducted with male nurses working in various clinical settings in Western Australia. Latent content analysis was used to analyse the interviews, which were carried out between June and July 2004. Three themes were identified: the definition of intimate care, the emotional experience associated with providing intimate care and strategies used to assist in the delivery of intimate care for women clients. Providing intimate care for women clients was a challenging experience for male nurses. Participants described how it required them to invade these clients' personal space. Consequently, they often experienced various negative feelings and used several strategies to assist them during care delivery. Nurse educators should assist male nurses to be better prepared to interact with women clients in various settings. Furthermore, workplace environments need to provide additional support and guidance for male nurses to enable them to develop effective coping strategies to manage challenging situations.

  13. Hazardous drinking and HIV-risk-related behavior among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Goodman-Meza, David; Pitpitan, Eileen V; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Strathdee, Steffanie A; Patterson, Thomas L

    2014-01-01

    Male clients of female sex workers (FSWs) are at high risk for HIV. Whereas the HIV risks of alcohol use are well understood, less is known about hazardous alcohol use among male clients of FSWs, particularly in Mexico. We sought to identify risk factors for hazardous alcohol use and test associations between hazardous alcohol use and HIV risk behavior among male clients in Tijuana. Male clients of FSWs in Tijuana (n = 400) completed a quantitative interview in 2008. The AUDIT was used to characterize hazardous alcohol use. Multivariate logistic regression was used to determine independent associations of demographic and HIV risk variables with hazardous alcohol use (vs. non-hazardous). Forty percent of our sample met criteria for hazardous alcohol use. Variables independently associated with hazardous drinking were reporting any sexually transmitted infection (STI), having sex with a FSW while under the influence of alcohol, being younger than 36 years of age, living in Tijuana, and ever having been jailed. Hazardous drinkers were less likely ever to have been deported or to have shared injection drugs. Hazardous alcohol use is associated with HIV risk, including engaging in sex with FSWs while intoxicated and having an STI among male clients of FSWs in Tijuana. We systematically described patterns and correlates of hazardous alcohol use among male clients of FSWs in Tijuana, Mexico. The results suggest that HIV/STI risk reduction interventions must target hazardous alcohol users, and be tailored to address alcohol use. © American Academy of Addiction Psychiatry.

  14. 14 CFR 1261.317 - Attorney-client privilege.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Attorney-client privilege. 1261.317 Section... Injury or Death-Accruing On or After January 18, 1967 § 1261.317 Attorney-client privilege. (a) Attorneys... traditional attorney-client relationship with the employee with respect to application of the attorney-client...

  15. Cognitive Behavioral Therapy for Psychosis (CBT-p) Delivered in a Community Mental Health Setting: A Case Comparison of Clients Receiving CBT Informed Strategies by Case Managers Prior to Therapy.

    Science.gov (United States)

    Sivec, Harry J; Montesano, Vicki L; Skubby, David; Knepp, Kristen A; Munetz, Mark R

    2017-02-01

    This exploratory case comparison examines the influence of case management activities on engagement and progress in psychotherapy for clients with schizophrenia. Six clients were recruited to participate in ten sessions of Cognitive Behavioral Therapy for psychosis (CBT-p). Three clients who had received Cognitive Behavioral techniques for psychosis (CBt-p, a low-intensity case management intervention) prior to receiving therapy were selected from referrals. A comparison group of three clients who had received standard case management services was selected from referrals. Cases within and across groups were compared on outcome measures and observations from case review were offered to inform future research. Delivering CBT-p services on a continuum from low- to high-intensity is discussed.

  16. 32 CFR 776.4 - Attorney-client relationships.

    Science.gov (United States)

    2010-07-01

    ... 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 cases) is the client served by each covered USG attorney unless detailed to represent another client by...

  17. Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

    Science.gov (United States)

    Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

    2005-01-01

    Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

  18. Providing general and preconception health care to low income women in family planning settings: perception of providers and clients.

    Science.gov (United States)

    Bronstein, Janet M; Felix, Holly C; Bursac, Zoran; Stewart, M Kathryn; Foushee, H Russell; Klapow, Joshua

    2012-02-01

    This study examines both provider and client perceptions of the extent to which general health concerns are addressed in the context of publicly supported family planning care. A mail survey of family planning providers (n = 459) accepting Medicaid-covered clients in Arkansas and Alabama gathered data on reported actions and resource referral availability for ten categories of non-contraceptive health concerns. A telephone survey of recent family planning clients of these providers (n = 1991) gathered data on the presence of 16 health concerns and whether and how they were addressed by the family planning provider. Data were collected in 2006-2007. More than half (56%) of clients reported having one or more general health concerns. While 43% of those concerns had been discussed with the family planning providers, only 8% had been originally identified by these providers. Women with higher trust in physicians and usual sources of general health care were more likely to discuss their concerns. Of those concerns discussed, 39% were reportedly treated by the family planning provider. Similarly, over half of responding providers reported providing treatment for acute and chronic health conditions and counseling on health behaviors during family planning visits. Lack of familiarity with referral resources for uninsured clients was identified as a significant concern in the provision of care to these clients. Greater engagement by providers in identifying client health concerns and better integration of publicly supported family planning with other sources of health care for low income women could expand the existing potential for delivering preconception or general health care in these settings.

  19. Counseling and Psychotherapy with Clients of Middle Eastern Descent: A Qualitative Inquiry

    OpenAIRE

    Boghosian, Sara

    2011-01-01

    It is becoming increasingly important for clinical and counseling psychologists to have multicultural competence skills for treating an increasingly diverse client population. The psychology literature related to culturally competent treatment with persons of Middle Eastern descent is currently limited. In this study, qualitative methodology was utilized to explore the mental health attitudes and psychotherapy experiences of clients of Middle Eastern descent. Participants described culturally...

  20. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV.

    Science.gov (United States)

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J Craig; Brion, John M; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2013-11-01

    The engagement of patients with their health care providers (HCP) improves patients' quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client's choices, and management of client concerns. This study compares country-level differences in patients' engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = -5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = -3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL.

  1. Increasing overweight and obesity erodes engagement in one's neighborhood by women, but not men.

    Science.gov (United States)

    Schuster, Roseanne C; Han, Seung Yong; Brewis, Alexandra A; Wutich, Amber

    2018-06-01

    Obesity is socially stigmatized in the U.S., especially for women. Significant research has focused on the role that the social and built environments of neighborhoods play in shaping obesity. However, the role of obesity in shaping neighborhood social structure has been largely overlooked. We test the hypothesis that large body size inhibits an individual's engagement in his or her neighborhood. Our study objectives are to assess if (1) body size (body mass index) interacts with gender to predict engagement in one's neighborhood (neighborhood engagement) and (2) if bonding social capital interacts with gender to predict neighborhood engagement independent of body size. We used data collected from the cross-sectional 2011 Phoenix Area Social Survey (PASS), which systematically sampled residents across four neighborhood types (core urban, urban fringe, suburban, retirement) across the Phoenix Metopolitian Area. Survey data was analyzed using logistic regression for 804 participants, including 35% for whom missing data was computed using multiple imputation. We found that as body size increases, women-but not men-have reduced engagement in their neighborhood, independent of bonding social capital and other key covariates (objective 1). We did not observe the interaction between gender and bonding social capital associated with neighborhood engagement (objective 2). Prior scholarship suggests obesity clusters in neighborhoods due to processes of social, economic, and environmental disadvantage. This finding suggests bi-directionality: obesity could, in turn, undermine neighborhood engagement through the mechanism of weight stigma and discrimination.

  2. Clients of sex workers in Switzerland: it makes sense to counsel and propose rapid test for HIV on the street, a preliminary report.

    Science.gov (United States)

    Diserens, Esther-Amélie; Bodenmann, Patrick; N'Garambe, Chantal; Ansermet-Pagot, Anne; Vannotti, Marco; Masserey, Eric; Cavassini, Matthias

    2010-03-19

    Clients of street sex workers may be at higher risk for HIV infection than the general population. Furthermore, there is a lack of knowledge regarding HIV testing of clients of sex workers in developed countries. This pilot study assessed the feasibility and acceptance of rapid HIV testing by the clients of street-based sex workers in Lausanne, Switzerland. For 5 evenings, clients in cars were stopped by trained field staff for face-to-face interviews focusing on sex-related HIV risk behaviors and HIV testing history. The clients were then offered a free anonymous rapid HIV test in a bus parked nearby. Rapid HIV testing and counselling were performed by experienced nurse practitioners. Clients with reactive tests were offered confirmatory testing, medical evaluation, and care in our HIV clinic. We intercepted 144 men, 112 (77.8%) agreed to be interviewed. Among them, 50 (46.6%) had never been tested for HIV. A total of 31 (27.7%) rapid HIV tests were performed, 16 (51.6%) in clients who had not previously been tested. None were reactive. Initially, 19 (16.9%) additional clients agreed to HIV testing but later declined due to the 40-minute queue for testing. This pilot study showed that rapid HIV testing in the red light district of Lausanne was feasible, and that the clients of sex workers accepted testing at an unexpectedly high rate. This setting seems particularly appropriate for targeted HIV screening, since more than 40% of the clients had not previously been tested for HIV even though they engaged in sex-related HIV risk behaviour.

  3. 49 CFR 1103.23 - Confidences of a client.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Confidences of a client. 1103.23 Section 1103.23... Responsibilities Toward A Client § 1103.23 Confidences of a client. (a) The practitioner's duty to preserve his client's confidence outlasts the practitioner's employment by the client, and this duty extends to the...

  4. Interactive Effects of Counselor-Client Similarity and Client Self-Esteem on Termination Type and Number of Sessions.

    Science.gov (United States)

    Berry, G. William; Sipps, Gary J.

    1991-01-01

    Examined effects of client self-esteem as measured by Rosenberg Self-Esteem Scale and client-counselor similarity as determined by Myers-Briggs Type Indicator (MBTI) on number of sessions and type of termination (unilateral or mutual) for 55 clients and 9 counselors at university counseling center. Self-esteem interacted significantly with…

  5. Client Involvement in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Henriksen, Nina; Kjær, Lone

    2013-01-01

    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 fr...... in public home-care practice remains limited...

  6. 31 CFR 10.28 - Return of client's records.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Return of client's records. 10.28... § 10.28 Return of client's records. (a) In general, a practitioner must, at the request of a client, promptly return any and all records of the client that are necessary for the client to comply with his or...

  7. Correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico.

    Science.gov (United States)

    Volkmann, Tyson; Wagner, Karla D; Strathdee, Steffanie A; Semple, Shirley J; Ompad, Danielle C; Chavarin, Claudia V; Patterson, Thomas L

    2014-05-01

    Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.

  8. The Development of Gamified Learning Activities to Increase Student Engagement in Learning

    Science.gov (United States)

    Poondej, Chanut; Lerdpornkulrat, Thanita

    2016-01-01

    In the literature, the potential efficacy of the gamification of education has been demonstrated. The aim of this study was to explore the influence of applying gamification techniques to increase student engagement in learning. The quasi-experimental nonequivalent-control group design was used with 577 undergraduate students from six classes. The…

  9. Do tilt-in-space wheelchairs increase occupational engagement: a critical literature review.

    Science.gov (United States)

    Harrand, Jenny; Bannigan, Katrina

    2016-01-01

    A wheelchair can enhance the quality of life of an individual with limited mobility, poor trunk control and stability, by enabling activity and participation and so occupational engagement. High specification wheelchairs which can tilt-in-space enable the position of users to be altered to suit activity and context. Despite tilt-in-space wheelchairs being expensive little is known about their therapeutic value. A critical literature review of the evidence was undertaken to evaluate whether the use of tilt-in-space increases occupational engagement. A wide ranging search strategy identified 170 articles which were screened using inclusion criteria. The eligible literature (n = 6) was analysed thematically using open coding. The majority of the participants used tilt-in-space but the data was too heterogeneous to combine. Measures of occupational engagement were not used so the therapeutic value could not be assessed. There is a lack of high quality evidence about the therapeutic benefits of tilt-in-space wheelchairs. Given the expense associated with providing these wheelchairs, and the increase in their provision, research is needed to justify provision of high specification wheelchairs to meet the occupational needs of users within the limited resources of health and social care. Implications for Rehabilitation Tilt-in-space wheelchairs. Wheelchairs are an important and essential assistive device for promoting independence and function. Suggests there are benefits for tilt-in-space wheelchairs. Identifies the need for additional large scale research.

  10. Accounting for the increase of children in care in western Australia: What can a client information system tell us?

    Science.gov (United States)

    Bilson, Andy; Cant, Rosemary L; Harries, Maria; Thorpe, David H

    2017-10-01

    This paper analyses a fourteen-year period of Western Australian data from the client information system of the Department for Child Protection and Family Support. Western Australia saw a large increase in the number of children in state care similar to trends across Australia as a whole. The study shows the following trends: changes in response to 'referrals' with particular increases in the number of findings of neglect and increasing proportions of these followed swiftly by entry to care; changes in patterns of entry to care with more children under one-year-old entering; increased length of stay of children in care; and, the high incidence of Aboriginal children entering and remaining in care. The data demonstrate unequivocally that increased 'referrals' are not associated with increased substantiations of harm or 'acts of commission with dangerous intent', but that neglect assessed early in the lives of children was the major precipitant for entry to care and particularly so for Aboriginal infants. Copyright © 2017. Published by Elsevier Ltd.

  11. Benefits to a life insurance company from providing radon tests for clients

    International Nuclear Information System (INIS)

    Cohen, B.L.

    1993-01-01

    If a life insurance company provided free radon tests to clients, clients' life expectancies would be extended and profits would thereby be increased. This effect is quantified and it is found that the direct monetary benefits to the company could be substantial. Several subsidiary advantages are also discussed

  12. Podemos fidelizar clientes inicialmente insatisfechos

    Directory of Open Access Journals (Sweden)

    Jesús Cambra-Fierro

    2011-01-01

    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. Xerostomia among older home care clients.

    Science.gov (United States)

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

    2016-06-01

    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.

  14. The future of veterinary communication: Partnership or persuasion? A qualitative investigation of veterinary communication in the pursuit of client behaviour change.

    Directory of Open Access Journals (Sweden)

    Alison M Bard

    Full Text Available Client behaviour change is at the heart of veterinary practice, where promoting animal health and welfare is often synonymous with engaging clients in animal management practices. In the medical realm, extensive research points to the link between practitioner communication and patient behavioural outcomes, suggesting that the veterinary industry could benefit from a deeper understanding of veterinarian communication and its effects on client motivation. Whilst extensive studies have quantified language components typical of the veterinary consultation, the literature is lacking in-depth qualitative analysis in this context. The objective of this study was to address this deficit, and offer new critical insight into veterinary communication strategies in the pursuit of client behaviour change. Role-play interactions (n = 15 between UK cattle veterinarians and an actress experienced in medical and veterinary education were recorded, transcribed and analysed thematically. Analysis revealed that, overall, veterinarians tend to communicate in a directive style (minimal eliciting of client opinion, dominating the consultation agenda, prioritising instrumental support, reflecting a paternalistic role in the consultation interaction. Given this finding, recommendations for progress in the veterinary industry are made; namely, the integration of evidence-based medical communication methodologies into clinical training. Use of these types of methodologies may facilitate the adoption of more mutualistic, relationship-centred communication in veterinary practice, supporting core psychological elements of client motivation and resultant behaviour change.

  15. Encounters with unemployment in occupational health care: Nurses' constructions of clients without work.

    Science.gov (United States)

    Romppainen, Katri; Jähi, Rita; Saloniemi, Antti; Virtanen, Pekka

    2010-02-01

    This study explores occupational health nurses' encounters with unemployed clients in Finland. It involved setting up and evaluating a new service, Career Health Care, that resembled occupational health care, except that clients were recruited from among job seekers who were participating in one of three active labour market policy measures: vocational training, subsidised employment in the public sector, or participatory training for entering the labour market. Our main interest focused on nurses' perceptions of the unemployed and their professional practices in the context of Career Health Care. The analysis revealed four overlapping discourses with regard to clients: the client as a casualty of unemployment, the client as unemployed but active, the client as a deviant in the labour market, and the client as a skilled user of the system. Each discourse had implications for professional practice. The risk of negative stereotyping and consequent exclusion from services is discussed here. In conclusion, we stress the complexity of providing health services that can match the increasing diversity of contemporary labour market trajectories. Copyright 2009 Elsevier Ltd. All rights reserved.

  16. Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

    OpenAIRE

    Forchuk, Cheryl; Reiss, Jeffrey P.; O’Regan, Tony; Ethridge, Paige; Donelle, Lorie; Rudnick, Abraham

    2015-01-01

    Background Information technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this...

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

    Directory of Open Access Journals (Sweden)

    Nedim Makarevic

    2016-01-01

    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.

  18. Clients' and therapists' stories about psychotherapy.

    Science.gov (United States)

    Adler, Jonathan M

    2013-12-01

    This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice. © 2012 Wiley Periodicals, Inc.

  19. The Client's Perspective on Voluntary Stuttering.

    Science.gov (United States)

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

    2016-08-01

    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.

  20. [On the clients of public health organizations].

    Science.gov (United States)

    Duran, Júlia; Villalbí, Joan R; Guix, Joan

    2004-01-01

    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.

  1. Client Intimacy & Performance Advice: Determinants of Trust in the Public Accountant - SME Client Relationship

    Directory of Open Access Journals (Sweden)

    Dianne McGrath

    2018-04-01

    Full Text Available This multi-discipline research investigated the determinants of trust in the relationship between Australia’s public accountants and their small and medium-sized (SME clients. In excess of four hundred SME owners, across Australia, were surveyed to test a proposed model and client intimacy variables were found to be the most significant predictors of trust in this important relationship. Offer-related variables, primarily the provision of advisory or performance-related services (rather than conformance-related services, were also found to be significant, however, at a lesser level than client intimacy and relationship variables. The multi-dimensionality of the trust construct was also highlighted.

  2. Les relations entre attentes, valeur, buts, engagement cognitif et engagement comportemental dans un MOOC

    Directory of Open Access Journals (Sweden)

    Bruno Poellhuber

    2016-01-01

    Full Text Available Dans le présent article, nous nous intéressons aux relations entre attentes, valeur, buts et engagement dans un MOOC universitaire de l’initiative Edulib. À partir d’une perspective théorique globale fondée sur l’autorégulation et en utilisant un modèle de motivation sociocognitif des attentes et de la valeur (Pintrich, 2003, nous analysons les liens entre motivation et engagement. Pour ce faire, nous utilisons les données de 531 répondants à un questionnaire distribué aux participants d’un MOOC de l’initiative Edulib (HEC Montréal portant sur l’introduction au marketing, offert à l’automne 2014. Une analyse par correspondances multiples sur les activités rapportées nous a permis de concevoir un score composite d’engagement comportemental. Par la suite, nous utilisons une approche d’équations structurelles pour tester le modèle théorique, après avoir opérationnalisé tous les liens anticipés entre les différentes variables. Nos résultats suggèrent un modèle acceptable qui confirme plusieurs des prévisions théoriques. Ainsi, la valeur est liée aussi bien aux buts extrinsèques qu’aux buts intrinsèques, mais les buts intrinsèques sont beaucoup plus fortement liés à l’engagement cognitif que les buts extrinsèques. Toutefois, aucune relation significative n’est observée entre l’engagement cognitif et l’engagement comportemental, ce qui soulève des questions de mesure, mais aussi des questions de nature théorique pour une clientèle d’adultes participant à un MOOC.

  3. Comparative analysis of a client's verbal responses in counseling sessions: quantitative case study.

    Science.gov (United States)

    Lee, Han-Jong

    2011-04-01

    This study investigated how the in-session change in a client's verbal behavior might influence the effectiveness of counseling sessions. 10 sessions of counseling with a male undergraduate suffering from depressive mood were conducted by a humanistically oriented counselor. The two most effective and the two least effective sessions were identified according to the client's evaluation of the effectiveness of counseling sessions. Results indicated that over the three segments of the most effective sessions, the client gradually increased responses that indicated exploration of his own emotions, thoughts, and behaviors. By contrast, the client continued talking mainly about past events in a storytelling manner throughout the least effective sessions.

  4. BAG3 induces the sequestration of proteasomal clients into cytoplasmic puncta

    Science.gov (United States)

    Minoia, Melania; Boncoraglio, Alessandra; Vinet, Jonathan; Morelli, Federica F; Brunsting, Jeanette F; Poletti, Angelo; Krom, Sabine; Reits, Eric; Kampinga, Harm H; Carra, Serena

    2014-01-01

    Eukaryotic cells use autophagy and the ubiquitin–proteasome system as their major protein degradation pathways. Upon proteasomal impairment, cells switch to autophagy to ensure proper clearance of clients (the proteasome-to-autophagy switch). The HSPA8 and HSPA1A cochaperone BAG3 has been suggested to be involved in this switch. However, at present it is still unknown whether and to what extent BAG3 can indeed reroute proteasomal clients to the autophagosomal pathway. Here, we show that BAG3 induces the sequestration of ubiquitinated clients into cytoplasmic puncta colabeled with canonical autophagy linkers and markers. Following proteasome inhibition, BAG3 upregulation significantly contributes to the compensatory activation of autophagy and to the degradation of the (poly)ubiquitinated proteins. BAG3 binding to the ubiquitinated clients occurs through the BAG domain, in competition with BAG1, another BAG family member, that normally directs ubiquitinated clients to the proteasome. Therefore, we propose that following proteasome impairment, increasing the BAG3/BAG1 ratio ensures the “BAG-instructed proteasomal to autophagosomal switch and sorting” (BIPASS). PMID:25046115

  5. Using a Media Campaign to Increase Engagement With a Mobile-Based Youth Smoking Cessation Program.

    Science.gov (United States)

    Sanders, Amy; Robinson, Cendrine; Taylor, Shani C; Post, Samantha D; Goldfarb, Jeffrey; Shi, Rui; Hunt, Yvonne M; Augustson, Erik M

    2018-06-01

    To describe the impact of the National Cancer Institute's promotion of its youth smoking cessation program, Smokefree Teen (SFT). We provide a description of campaign strategies and outcomes as a means to engage a teen audience in cessation resources using a cost-effective approach. The campaign occurred nationally, using traditional (TV and radio), online, and social media outreach. Ads targeted adolescent smokers (aged 14-17). The baseline population was 42 586 and increased to 464 357 during the campaign. Metrics used to assess outcomes include (1) visits to SFT website from traditional and online ads, (2) cost to get an online ad clicked (cost-per-click), and (3) SmokefreeTXT program enrollments during the 8-week campaign period. We conducted a quantitative performance review of all tactics. The SFT campaign achieved an online ad click-through rate of 0.33%, exceeding industry averages of 0.15%. Overall, web traffic to teen.smokefree.gov increased by 980%, and the online cost-per-click for ads, including social media actions, was approximately $1 as compared with $107 for traditional ads. Additionally, the campaign increased the SmokefreeTXT program teen sign-ups by 1334%. The campaign increased engagement with evidence-informed cessation resources for teen smokers. Results show the potential of using multiple, online channels to help increase engagement with core resources.

  6. 49 CFR 1103.22 - Restraining clients from improprieties.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Restraining clients from improprieties. 1103.22... Practitioner's Duties and Responsibilities Toward A Client § 1103.22 Restraining clients from improprieties. A practitioner should see that his clients act with the same restraint that the practitioner himself uses...

  7. 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

    2004-12-01

    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.

  8. Male clients' behaviours with and perspectives about their last male escort encounter: comparing repeat versus first-time hires.

    Science.gov (United States)

    Wolff, Margaret M; Grov, Christian; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T

    2014-01-01

    Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via daddysreviews.com completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, lifetime number of escorts hired and number hired in the past year were positively associated with the last encounter being a repeat encounter. Cuddling, sharing a meal, drinking alcohol, taking a walk, watching a show and shopping were also positively associated with repeat encounters. Conversely, none of the sexual behaviours were significantly associated with repeat encounters. Repeat encounters were significantly more likely to include non-sexual behaviours alongside sexual activities, but no more likely to involve condomless anal intercourse. Moreover, clients' knowledge of escorts' HIV status was not significantly associated with engaging in condomless anal intercourse with repeat encounters.

  9. 29 CFR 402.11 - Attorney-client communications exempted.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Attorney-client communications exempted. 402.11 Section 402... LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION INFORMATION REPORTS § 402.11 Attorney-client... communicated to such attorney by any of his clients in the course of a legitimate attorney-client relationship. ...

  10. 29 CFR 403.9 - Attorney-client communications exempted.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Attorney-client communications exempted. 403.9 Section 403... LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION ANNUAL FINANCIAL REPORTS § 403.9 Attorney-client... communicated to such attorney by any of his clients in the course of a legitimate attorney-client relationship. ...

  11. 32 CFR 776.33 - Client under a disability.

    Science.gov (United States)

    2010-07-01

    ... 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 client's ability to make adequately considered decisions in connection with the representation is...

  12. 29 CFR 404.5 - Attorney-client communications exempted.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Attorney-client communications exempted. 404.5 Section 404... LABOR-MANAGEMENT STANDARDS LABOR ORGANIZATION OFFICER AND EMPLOYEE REPORTS § 404.5 Attorney-client... communicated to such attorney by any of his clients in the course of a legitimate attorney-client relationship. ...

  13. 42 CFR 483.420 - Condition of participation: Client protections.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Client protections. 483... Condition of participation: Client protections. (a) Standard: Protection of clients' rights. The facility must ensure the rights of all clients. Therefore, the facility must— (1) Inform each client, parent (if...

  14. 31 CFR 10.21 - Knowledge of client's omission.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Knowledge of client's omission. 10.21... § 10.21 Knowledge of client's omission. A practitioner who, having been retained by a client with respect to a matter administered by the Internal Revenue Service, knows that the client has not complied...

  15. Uncovering client retention antecedents in service organizations

    Directory of Open Access Journals (Sweden)

    Mari Jansen van Rensburg

    2014-01-01

    Full Text Available This paper develops a multi-dimensional model of retention to provide a more complete and integrated view of client retention and its determinants in service contexts. To uncover the antecedents of client retention, social and economic exchanges were reviewed under the fundamental ideas of the Social Exchange Theory. Findings from a survey of senior South African advertising executives suggest that client retention is the result of evaluative as well as relational factors that can influence client responses. Despite contractual obligations, advertisers are willing to pay the costs and make the sacrifices of switching should their expectations be unmet. An important contribution of this study is the use of multi-item scales to measure retention. The model developed provides valuable insight to agencies on client retention management and the optimal allocation of resources for maximum customer equity. This model may also be applied to other service organisations to provide insight to client retention.

  16. Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Men who have sex with men (MSM in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

  17. Client Contacts Improve Quality of Copywriting.

    Science.gov (United States)

    McCann, Guy

    1988-01-01

    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)

  18. Ten-year audit of clients presenting to a specialised service for young people experiencing or at increased risk for psychosis.

    Science.gov (United States)

    Conrad, Agatha M; Lewin, Terry J; Sly, Ketrina A; Schall, Ulrich; Halpin, Sean A; Hunter, Mick; Carr, Vaughan J

    2014-11-18

    Despite strong research interest in psychosis risk identification and the potential for early intervention, few papers have sought to document the implementation and evaluation of specialised psychosis related services. Assessment of Ultra High Risk (UHR) has been given priority, but it is equally as important to identify appropriate comparison groups and other baseline differences. This largely descriptive service evaluation paper focuses on the 'baseline characteristics' of referred clients (i.e., previously assessed characteristics or those identified within the first two months following service presentation). Data are reported from a 10-year layered service audit of all presentations to a 'Psychological Assistance Service' for young people (PAS, Newcastle, Australia). Baseline socio-demographic and clinical characteristics (N =1,997) are described (including clients' psychosis and UHR status, previous service contacts, hospitalisation rates, and diagnostic and comorbidity profiles). Key groups are identified and comparisons made between clients who received ongoing treatment and those who were primarily assessed and referred elsewhere. Clients averaged 19.2 (SD =4.5) years of age and 59% were male. One-tenth of clients (9.6%) were categorised as UHR, among whom there were relatively high rates of attenuated psychotic symptoms (69.1%), comorbid depression (62.3%), anxiety (42.9%), and attentional and related problems (67.5%). Overall, one-fifth (19.8%) experienced a recent psychotic episode, while a further 14.5% were categorised as having an existing psychosis (46.7% with a schizophrenia diagnosis), amongst whom there were relatively high rates of comorbid substance misuse (52.9%), psychosocial (70.2%) and physical health (37.7%) problems. The largest group presenting to PAS were those with non-psychotic disorders (43.7%), who provide a valuable comparison group against which to contrast the health trajectories of those with UHR and recent psychosis. Ongoing

  19. Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

    Science.gov (United States)

    Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

    2015-03-01

    Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. There was a significant difference in the mean ratings for clients and clinicians for

  20. Material Matters: Increasing Emotional Engagement in Learning

    Science.gov (United States)

    Taylor, Steven S.; Statler, Matt

    2014-01-01

    Organizational scholars and neuroscientists suggest that when people are more emotionally engaged, they learn more effectively. Clinical art therapists suggest that the experience as well as the expression of emotions can be enabled or constrained by different materials. So then, what materials can be employed by management educators to achieve…

  1. Group Work with Transgender Clients

    Science.gov (United States)

    Dickey, Lore M.; Loewy, Michael I.

    2010-01-01

    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…

  2. 45 CFR 1608.7 - Attorney-client relationship.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Attorney-client relationship. 1608.7 Section 1608... PROHIBITED POLITICAL ACTIVITIES § 1608.7 Attorney-client relationship. Nothing in this part is intended to prohibit an attorney or staff attorney from providing any form of legal assistance to an eligible client...

  3. Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

    Science.gov (United States)

    Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

    2015-01-01

    To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the

  4. 17 CFR 205.3 - Issuer as client.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Issuer as client. 205.3... ISSUER § 205.3 Issuer as client. (a) Representing an issuer. An attorney appearing and practicing before...'s clients. (b) Duty to report evidence of a material violation. (1) If an attorney, appearing and...

  5. 19 CFR 111.39 - Advice to client.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Advice to client. 111.39 Section 111.39 Customs... CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.39 Advice to client. (a) Withheld or false information. A broker must not withhold information relative to any customs business from a client...

  6. Análise da lucratividade dos clientes

    OpenAIRE

    Madeira, Paulo

    2000-01-01

    Um bom sistema de Análise da lucratividade de Clientes pode ajudar a melhorar a rendibilidade global do negócio, selecionando os clientes de qualidade, e a indicar o principal caminho a segui rpara atingir uma maior lucartividade, indicando o impacto financeiro actual e potencial dos movimentos estratégicos dos clientes.

  7. Legal Client Counseling for Sharia Law Students: An Innovative Approach toward Increasing Professionalism in Sharia Counseling

    Science.gov (United States)

    Samuri, Mohd Al-Adib; Wahab, Norazla Abdul; Kusrin, Zuliza Mohd; Muda, Mohd Zamro; Manap, Norhoneydayatie Abdul

    2013-01-01

    One of the issues that often circulates among newly recruited Sharia lawyers is the lack of the required capability or aptitude to be a Sharia counsel, especially when conducting legal counseling with clients. The Department of Sharia law, Faculty of Islamic Studies, Universiti Kebangsaan Malaysia (UKM), must play an important role in preparing…

  8. Letter Writing as a Tool To Increase Client Motivation To Change: Application to an Inpatient Crisis Unit.

    Science.gov (United States)

    Tubman, Jonathan G.; Montgomery, Marilyn J.; Wagner, Eric F.

    2001-01-01

    Describes the application of a letter writing exercise as a motivational technique for group counseling in contemporary crisis unit settings. Discusses guidelines and implications for clinical practice with clients with multiple, chronic problems. (Contains 37 references and 1 table.) (GCP)

  9. Connecting Music, Art, and Science for Increased Creativity and Topic Engagement ?

    OpenAIRE

    McNealy, Tamara L.

    2013-01-01

    ‘Attention spans have shortened,’ is a common phrase often used in reference to today’s college students. As faculty and instructors, we need to address this issue through the utilization of innovative and creative techniques that aid in making our subjects accessible to our students. Connecting a serious topic such as microbiology with a ‘fun’ activity can increase student engagement and learning. Ideas to maintain student attention on a subject include providing information in 15- to 20-min...

  10. Improving UK client-contractor relations

    International Nuclear Information System (INIS)

    Brant, A.W.

    1996-01-01

    The client's aim in any decommissioning project is that the originally intended end point is achieved, within budget and on time. The contractor's aim is to have a satisfied client, so that both are happy to work together again, and to have a reasonable return for his efforts. How can these - not incompatible - aims best be achieved? (UK)

  11. Thin Client Architecture: The Promise and the Problems.

    Science.gov (United States)

    Machovec, George S.

    1997-01-01

    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…

  12. Designing indonesian teacher engagement index (itei) applications based on android

    Science.gov (United States)

    Manalu, S. R.; Sasmoko; Permai, S. D.; Widhoyoko, S. A.; Indrianti, Y.

    2018-03-01

    Teachers who have a good level of engagement will be able to produce students who engage and excel. Level of national teachers’ engagement needs to be a reference to the level of educational success and equity of national education. The spread of geographically inaccessible Indonesian teachers is a barrier to these measurements. ITEI Android application developed by analysing the geographical problem, so that each teacher can participate wherever they are. The ITEI app is designed by implementing Android on the client side and load balancer on the server side. Android ITEI will feature a number of questions questionnaire to teachers. Meanwhile, the load balancer will distribute the answers to each server for processing. Load Balancer ensures fast data processing and minimize server failure. The results of the processing on the server will be sent back to Android in the form of profiling themselves ITEI teachers. While the data obtained and stored in the server can be used to measure the level of national teachers’ engagement. The result of this research is the design of ITEI application ready to be implemented in order to support the data collection process of teacher national engagement level.

  13. The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition.

    Science.gov (United States)

    Van de Velde, Dominique; Devisch, Ignaas; De Vriendt, Patricia

    2016-08-01

    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.

  14. Use of community engagement strategies to increase research participation in practice-based research networks (PBRNs).

    Science.gov (United States)

    Spears, William; Tsoh, Janice Y; Potter, Michael B; Weller, Nancy; Brown, Anthony E; Campbell-Voytal, Kimberly; Getrich, Christina M; Sussman, Andrew L; Pascoe, John; Neale, Anne Victoria

    2014-01-01

    Practice-based research networks (PBRNs) are increasingly encouraged to use community engagement approaches. The extent to which PBRNs engage clinic and community partners in strategies to recruit and retain participants from their local communities (specifically racial/ethnic communities) is the focus of this study. The design was a cross-sectional survey of PBRN directors in the United States. Survey respondents indicated whether their research network planned for, implemented, and has capacity for activities that engage clinic and community partners in 7 recommended strategies organized into study phases, called the cycle of trust. The objectives of the national survey were to (1) describe the extent to which PBRNs across the United States routinely implement the strategies recommended for recruiting diverse patient groups and (2) identify factors associated with implementing the recommended strategies. The survey response rate was 63%. Activities that build trust often are used more with clinic partners than with community partners. PBRNs that adopt engagement strategies when working with clinic and community partners have less difficulty in recruiting diverse populations. Multivariate analysis showed that the targeting racial/ethnic communities for study recruitment, Clinical and Translational Science Award affiliation, and planning to use community engagement strategies were independent correlates of PBRN implementation of the recommended strategies. PBRNs that successfully engage racial/ethnic communities as research partners use community engagement strategies. New commitments are needed to support PBRN researchers in developing relationships with the communities in which their patients live. Stable PBRN infrastructure funding that appreciates the value of maintaining community engagement between funded studies is critical to the research enterprise that values translating research findings into generalizable care models for patients in the community.

  15. Institutional Policy Changes Aimed at Addressing Obesity Among Mental Health Clients

    OpenAIRE

    Knol, Linda L.; Pritchett, Kelly; Dunkin, Jeri

    2010-01-01

    Background People with mental illness often experience unique barriers to healthy eating and physical activity. For these clients, interventions should focus on changes in the immediate environment to change behaviors. The purpose of this project was to implement and evaluate policy changes that would limit calorie intake and increase calorie expenditure of clients receiving mental health services. Context This intervention was implemented in a rural mental health system in the southeastern U...

  16. Implementing a Principal Tutor to Increase Student Engagement and Retention within the First Year of a Professional Program

    Directory of Open Access Journals (Sweden)

    Jason Lodge

    2012-03-01

    Full Text Available With ongoing changes to the requirements for professional registration, greater demand for professional services, and targets for increasing participation, universities must adapt quickly to ensure that the quality of accredited professional programs is continually improving. The problem of retaining students is particularly relevant in accredited professional courses where students often have unrealistic expectations about course content and the profession. In order to address issues surrounding student engagement and retention in an accredited psychology course, a Principal Tutor was appointed to a first year cohort. By using a transition pedagogy framework to support student engagement through incorporating administrative and profession-specific advice within and outside the formal curriculum, the program appears to have been successful in increasing student engagement. Indicators of student engagement were higher than national averages and retention rates improved. Implications for possible application of the initiatives included in this program elsewhere are discussed. 

  17. Evaluating the use of twitter as a tool to increase engagement in medical education.

    Science.gov (United States)

    Diug, Basia; Kendal, Evie; Ilic, Dragan

    2016-01-01

    Social media is regularly used by undergraduate students. Twitter has a constant feed to the most current research, news and opinions of experts as well as organisations. Limited evidence exists that examines how to use social media platforms, such as Twitter, effectively in medical education. Furthermore, there is limited evidence to inform educators regarding social media's potential to increase student interaction and engagement. To evaluate whether social media, in particular Twitter, can be successfully used as a pedagogical tool in an assessment to increase student engagement with staff, peers and course content. First year biomedical science students at Monash University completing a core public health unit were recruited into the study. Twitter-related activities were incorporated into the semester long unit and aligned with both formative and summative assessments. Students completed a structured questionnaire detailing previous use of social media and attitudes towards its use in education post engagement in the Twitter-specific activities. Likert scale responses compared those who participated in the Twitter activities with those who did not using student's t-test. A total of 236 (79.4%) of invited students participated in the study. Among 90% of students who reported previous use of social media, 87.2% reported using Facebook, while only 13.1% reported previous use of Twitter. Social media was accessed most commonly through a mobile device (49.1%). Students actively engaging in Twitter activities had significantly higher end-of-semester grades compared with those who did not [Mean Difference (MD) = 3.98, 95% CI 0.40, 7.55]. Students perceived that the use of Twitter enabled greater accessibility to staff, was a unique method of promoting public health, and facilitated collaboration with peers. Use of social media as an additional, or alternate, teaching intervention is positively supported by students. Specific use of micro-blogs such as Twitter can

  18. Agreement between clients with schizophrenia and mental health workers on clients' social quality of life: The role of social cognition and symptoms.

    Science.gov (United States)

    Ofir-Eyal, Shani; Hasson-Ohayon, Ilanit; Bar-Kalifa, Eran; Kravetz, Shlomo; Lysaker, Paul H

    2017-06-01

    Studies have showed that therapists and mental health workers of persons with schizophrenia tend to estimate their patients' social quality of life (SQoL) as poorer than the clients' own estimation. This study explores the hypothesis that this discrepancy is related to clients' social cognition and symptomatology. Cross-sectional assessment of both clients and their mental health workers. Ninety persons with schizophrenia and 12 persons who were formal care providers participated in the study. All responded to a parallel version (client and clinician) of social quality-of-life scales. Clients' emotion identification, theory of mind and symptoms were also assessed. Low social cognitive abilities of persons with schizophrenia, as well as negative symptomatology and having children, may be related to the negative bias of mental health workers, with regard to their client's SQoL. While more severe levels of negative symptoms and more deficits of social cognition were related to reduced levels of agreement, paradoxically, a relatively normative family life that includes parenting was also related to lower levels of agreement. Attention should be given to low agreement between clients with schizophrenia and clinicians with regard to the client's quality of life, as it is central to alliance and outcome. Clinicians tend to estimate clients' social quality of life as poorer than the clients' own estimation when those clients have low social cognition, high negative symptomatology and children. There is a need to identify additional factors that contribute to agreement and alliance in therapy. Longitudinal assessment during therapy can trace the process of construction of agreement. © 2016 The British Psychological Society.

  19. Managing Client Values in Construction Design

    DEFF Research Database (Denmark)

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

    2008-01-01

    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...... for capturing and managing client values within a lean framework. This paper describes the initial findings of a joint research project between academia and industry practitioners that seeks to develop the workshop method to create a state of the art approach in construction design management. This includes...... of the multiple stakeholders that constitutes the “client”. However, seeing client satisfaction as the end-goal of construction it is imperative to make client values explicit in the early project phase and make sure that these values are reflected in all subsequent phases of design and construction...

  20. 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

    2010-12-01

    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.

  1. Client Involvement in Home Care Practice

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Henriksen, Nina; Kjær, Lone

    2013-01-01

    , political and administrative frames that rule home- care practice. Client involvement is shown within four constructed analytical categories: ‘Structural conditions of providing and receiving home care’; ‘Client involvement inside the home: performing a professional task and living an everyday life......’; ‘Client involvement outside the home: liberal business and mutual goal setting’; and ‘Converting a home to a working place: refurnishing a life’. The meaning of involvement is depending on which position it is viewed from. On the basis of this analysis, we raise the question of the extent to which...

  2. Barriers and Facilitators to Implementing Functional Family Therapy in a Community Setting: Client and Practitioner Perspectives.

    Science.gov (United States)

    McPherson, Kerri E; Kerr, Susan; Casey, Beth; Marshall, John

    2017-10-01

    While Functional Family Therapy (FFT) is known to be effective in addressing adolescent behavioral problems, there has been little exploration of issues relevant to its transport from the tightly controlled setting of clinical trials into routine service delivery. This study sought the views of key stakeholders, clients, and practitioners, on barriers and facilitators to the successful implementation of FFT. Undertaken in a community setting in Scotland, interviews were carried out with 12 adolescents, 14 parents/caregivers, and 6 practitioners. Results focus on: Referral process and pre-intervention contact; Engagement of families; Structure and delivery; Organizational factors. Although barriers to engagement were identified, FFT was viewed as an acceptable, appropriate and feasible intervention with the potential to improve adolescent wellbeing in 'real-world' settings. © 2017 American Association for Marriage and Family Therapy.

  3. Experiences in occupational therapy with Afghan clients in Australia.

    Science.gov (United States)

    Maroney, Pamela; Potter, Marianne; Thacore, Vinod Rai

    2014-02-01

    With a steady increase of refugees arriving in Australia from Afghanistan coupled with reports that prevalence of mental illness amongst Afghan refugees in South-East Melbourne is particularly high, mental health providers will need to acquire cultural competence to provide effective treatment. There is a dearth of literature on the subject of rehabilitation of Afghan psychiatric clients in the Australian context, providing the impetus for this article. To illustrate the impact of Afghan socio-cultural beliefs and attitudes on the implementation of occupational therapy and rehabilitation programmes in a mental health facility and adaptations to accommodate the needs of the clients and their families. Two case vignettes of Afghan clients are presented to illustrate the variance in goals and expectations of the clients and their families to that of the occupational therapy and rehabilitation programmes offered. Family expectations and involvement, culture-specific factors and religion play significant roles in the presentation and treatment of clients from the Muslim culture and require modification in implementation of rehabilitation programmes. A need for developing family or community-based services is proposed coupled with culturally responsive practices. Culture sensitive models of occupational therapy will need to be developed as younger generations of refugee families acculturate and need psychological help to deal with conflicts with parents and elders who hold values different from those adopted by their children born and brought up in the Australian socio-cultural environment. These and other issues mentioned above provide fertile fields for research in this evolving area of occupational therapy. © 2014 Occupational Therapy Australia.

  4. The insecure psychotherapy base: Using client and therapist attachment styles to understand the early alliance.

    Science.gov (United States)

    Marmarosh, Cheri L; Kivlighan, Dennis M; Bieri, Kathryn; LaFauci Schutt, Jean M; Barone, Carrie; Choi, Jaehwa

    2014-09-01

    The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  5. The effectiveness of staff training focused on increasing emotional intelligence and improving interaction between support staff and clients.

    Science.gov (United States)

    Zijlmans, L J M; Embregts, P J C M; Gerits, L; Bosman, A M T; Derksen, J J L

    2015-07-01

    Recent research addressed the relationship between staff behaviour and challenging behaviour of individuals with an intellectual disability (ID). Consequently, research on interventions aimed at staff is warranted. The present study focused on the effectiveness of a staff training aimed at emotional intelligence and interactions between staff and clients. The effects of the training on emotional intelligence, coping style and emotions of support staff were investigated. Participants were 214 support staff working within residential settings for individuals with ID and challenging behaviour. The experimental group consisted of 76 staff members, 138 staff members participated in two different control groups. A pre-test, post-test, follow-up control group design was used. Effectiveness was assessed using questionnaires addressing emotional intelligence, coping and emotions. Emotional intelligence of the experimental group changed significantly more than that of the two control groups. The experimental group showed an increase in task-oriented coping, whereas one control group did not. The results with regard to emotions were mixed. Follow-up data revealed that effects within the experimental group were still present four months after the training ended. A staff training aimed at emotional intelligence and staff-client interactions is effective in improving emotional intelligence and coping styles of support staff. However, the need for more research aiming at the relationship between staff characteristics, organisational factors and their mediating role in the effectiveness of staff training is emphasised. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  6. Screen Time Engagement Is Increased in Urban Children With Asthma.

    Science.gov (United States)

    Rota, Alexandra P; Bacharier, Leonard B; Jaffee, Katy; Visness, Cynthia M; Kattan, Meyer; O'Connor, George T; Wood, Robert A; Gergen, Peter J; Gern, James E; Bloomberg, Gordon R

    2017-10-01

    Physical activity in children has been shown to play a role in its relationship to asthma, both in terms of prevalence and incidence. One measure of physical activity in children is sedentary behavior, which might be measured by the degree of engagement with media electronic screens. We found that children with asthma, as compared with children without asthma, engage in significantly more hours of screen time (median 35 vs 26 h/wk, P = .004). In this birth cohort, those who developed a diagnosis of asthma at 8 years of age were significantly more engaged in electronic screen time than their peers. No other clinical or lifestyle behaviors were significantly associated with a diagnosis of asthma. Further study will be needed to determine directionality of this finding.

  7. The Use of Stuffed Microbes in an Undergraduate Microbiology Course Increases Engagement and Student Learning

    Directory of Open Access Journals (Sweden)

    Ginny Webb

    2015-08-01

    Full Text Available Student engagement, attention, and attendance during a microbiology lecture are crucial for student learning.  In addition, it is challenging to cover a large number of infectious diseases during a one-semester introductory microbiology course.  The use of visual aids helps students retain the information presented during a lecture.  Here, I discuss the use of stuffed, plush microbes as visual aids during an introductory microbiology course.  The incorporation of these stuffed microbes during a microbiology lecture results in an increase in engagement, interest, attendance, and retention of material.

  8. 32 CFR 776.28 - Conflict of interest: Former client.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Conflict of interest: Former client. 776.28... ADVOCATE GENERAL Rules of Professional Conduct § 776.28 Conflict of interest: Former client. (a) Conflict of interest: Former client. A covered attorney who has represented a client in a matter shall not...

  9. 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...

  10. HIV testing experiences and their implications for patient engagement with HIV care and treatment on the eve of 'test and treat'

    DEFF Research Database (Denmark)

    Wringe, Alison; Moshabela, Mosa; Nyamukapa, Constance

    2017-01-01

    Objective: In view of expanding ‘test and treat’ initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. Methods: As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South...... without consent, which could lead to disengagement from care. Conflicting rationalities for HIV testing between health workers and their clients caused tensions that undermined engagement in HIV care among people living with HIV. Although many health workers helped clients to accept their diagnosis...... may cure HIV. Repeat testing provided an opportunity to develop familiarity with clinical procedures, address concerns about HIV services and build trust with health workers. Conclusion: The principles of consent and confidentiality that should underlie HIV testing and counselling practices may...

  11. Community-Engaged Strategies to Increase Diversity of Participants in Health Education Research.

    Science.gov (United States)

    Khubchandani, Jagdish; Balls-Berry, Joyce; Price, James H; Webb, Fern J

    2016-05-01

    Minorities have historically been underrepresented in health-related research. Several strategies have been recommended to increase the participation of minorities in health-related research. However, most of the recommendations and guidelines apply to research in clinical or laboratory contexts. One of the more prominent methods to enhance minority participation in health-related research that has recently come to the fore is the use of community-engaged strategies. The purpose of this article is to summarize community-engaged outreach efforts that can be translated into useable strategies for health education research teams seeking to diversify the pool of research participants. Also, we provide a succinct overview of the various components of a research endeavor that may influence minority participation in health-related research. Finally, we analyze how health education specialists and SOPHE (Society of Public Health Education) can play a leading role in helping enhance minority participation in health-related research. © 2016 Society for Public Health Education.

  12. On Being "Attractive" With Resistant Clients.

    Science.gov (United States)

    Miller, Mark J.; Wells, Don

    1990-01-01

    Calls client resistance a frequent occurrence within the helping profession. Defines client resistance, provides a brief review of related literature, and offers counselor attractiveness as one way of addressing the issue. Identifies attractive counselor behaviors and attitudes and presents case study illustrating specific attractive counselor…

  13. 37 CFR 10.84 - Representing a client zealously.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client... Office Code of Professional Responsibility § 10.84 Representing a client zealously. (a) A practitioner shall not intentionally: (1) Fail to seek the lawful objectives of a client through reasonably available...

  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. Student Engagement

    DEFF Research Database (Denmark)

    Conduit, Jodie; Karpen, Ingo; Farrelly, Francis

    2017-01-01

    system (the university), the narrow service system (the course), and the individual dyadic level of engagement (the student-lecturer interaction). These findings could be further considered and empirically tested in other engagement contexts (e.g. employee engagement, customer engagement).......Universities are seeking to actively and strategically manage student engagement through providing opportunities for students to interact and engage with the institution on a range of levels and in different ways. However, this increasingly complex and multi-layered nature of student engagement...... within a tertiary education environment is not well understood. Through qualitative focus groups and a series of interviews with undergraduate and postgraduate students, this study explores and articulates the cognitive, emotional, behavioural and social dimensions of engagement that depict the nature...

  16. Cognitive Behavioural Therapy from the Perspective of Clients with Mild Intellectual Disabilities: A Qualitative Investigation of Process Issues

    Science.gov (United States)

    Pert, C.; Jahoda, A.; Stenfert Kroese, B.; Trower, P.; Dagnan, D.; Selkirk, M.

    2013-01-01

    Background: Clinicians working with clients who have mild intellectual disabilities (IDs) have shown growing enthusiasm for using a cognitive behavioural approach, amid increasing evidence of good treatment outcomes for this client group. However, very little is known about the views and experiences of clients with IDs who have undergone cognitive…

  17. 31 CFR 8.34 - Knowledge of client's omission.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Knowledge of client's omission. 8.34... client's omission. Each attorney, certified public accountant, or enrolled practitioner who knows that a client has not complied with applicable law, or has made an error in or omission from any document...

  18. Successful Vocational Rehabilitation of Clients with Retinitis Pigmentosa.

    Science.gov (United States)

    Taheri-Araghi, M.; Hendren, G.

    1994-01-01

    Statistical analysis of 10 personal (client) variables and four program variables related to 76 people who became blind from retinitis pigmentosa revealed that 6 variables predicted clients' rehabilitation outcomes: age, gender, race, work status, amount of case-service money spent on the client's behalf, and number of changes in career objectives…

  19. Increasing medical students' engagement in public health: case studies illustrating the potential role of online learning.

    Science.gov (United States)

    Sheringham, J; Lyon, A; Jones, A; Strobl, J; Barratt, H

    2016-09-01

    The value of e-learning in medical education is widely recognized but there is little evidence of its value in teaching medical students about public health. Such evidence is needed because medical students' engagement with public health has been low. We present three recent case studies from UK medical schools to illustrate diverse ways in which online approaches can increase medical students' engagement with learning public health. A comparative case study approach was used applying quantitative and qualitative data to examine engagement in terms of uptake/use amongst eligible students, acceptability and perceived effectiveness using an analytic framework based on Seven Principles of Effective Teaching. Across the three case studies, most (67-85%) eligible students accessed online materials, and rated them more favourably than live lectures. Students particularly valued opportunities to use e-learning flexibly in terms of time and place. Online technologies offered new ways to consolidate learning of key public health concepts. Although students found contributing to online discussions challenging, it provided opportunities for students to explore concepts in depth and enabled students that were uncomfortable speaking in face-to-face discussions to participate. E-learning can be applied in diverse ways that increase medical student engagement with public health teaching. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Mutual powerlessness in client participation practices in mental health care

    Science.gov (United States)

    Broer, Tineke; Nieboer, Anna P.; Bal, Roland

    2012-01-01

    Abstract Background  Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation process. Many articles have concluded that client participation is limited; professionals often still control the participation process and outcomes. Objective  The objective of this study is to gain insight into (i) the practice of client participation within a quality improvement collaborative in mental health care and (ii) the consequences of a Foucauldian conceptualization of power in analysing practices of client participation. Design  We used an ethnographic design consisting of observations of national events and improvement team meetings and interviews with the collaborative’s team members and programme managers. Results  Contrary to many studies on client participation, we found both clients and service providers frequently felt powerless in its practice. Professionals and clients alike struggled with the contributions clients could make to the improvement processes and what functions they should fulfil. Moreover, professionals did not want to exert power upon clients, but ironically just for that reason sometimes struggled with shaping practices of client participation. This mutual powerlessness (partly) disappeared when clients helped to determine and execute specific improvement actions instead of participating in improvement teams. Conclusion  Recognizing that power is inescapable might allow for a more substantive discussion concerning the consequences that power arrangements produce, rather than looking at who is exerting how much power. PMID:22390793

  1. Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

    Science.gov (United States)

    Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

    2004-12-01

    Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

  2. Asymmetry of Responsiveness in Client-Centered Therapy

    Science.gov (United States)

    Shapiro, David A.

    1977-01-01

    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)

  3. Experimental Blind Quantum Computing for a Classical Client

    Science.gov (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

    2017-08-01

    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.

  4. Experimental Blind Quantum Computing for a Classical Client.

    Science.gov (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

    2017-08-04

    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.

  5. 37 CFR 10.78 - Limiting liability to client.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Limiting liability to client... Office Code of Professional Responsibility § 10.78 Limiting liability to client. A practitioner shall not attempt to exonerate himself or herself from, or limit his or her liability to, a client for his or her...

  6. Who cares for involuntary clients?

    Science.gov (United States)

    Soliman, Soheil; Pollack, Harold A; Alexander, Jeffrey A

    2009-01-01

    The objectives of this study were to compare characteristics of outpatient substance abuse treatment (OSAT) units that serve high proportions of involuntary clients (ICs) with those that serve a low percentage of such clients. The authors analyze unit-level 1995-2005 data from the National Drug Abuse Treatment System Survey (NDATSS). Approximately 1/6 of OSAT units draw the dominant majority of their clients from involuntary referrals. OSAT units that treat a high proportion of ICs are less likely to be accredited by professional organizations, have fewer treatment staff with advanced degrees, and have shorter average treatment duration than do OSAT units that serve few ICs. OSAT units that serve ICs are more likely to offer legal and domestic violence services but are less likely to offer mental health services or aftercare. OSAT units that serve ICs are less likely to be hospital-affiliated than are other units. Clients at such facilities are more likely to be convicted of driving while intoxicated (DWI), are younger, are less likely to have received prior treatment, are more likely to remain abstinent after treatment, but are more likely to be remanded back to courts. The authors conclude that ICs are an important market niche in OSAT care. DWI is by far the most common offense reported in units that specialize in ICs. Aside from legal and domestic violence services, units with a high proportion of ICs appear to offer somewhat less intensive and professionalized services than do other facilities; however, clients at these units are more likely to be abstinent at the end of treatment and but more likely to be remanded back to the courts.

  7. Which Individual Therapist Behaviors Elicit Client Change Talk and Sustain Talk in Motivational Interviewing?

    Science.gov (United States)

    Apodaca, Timothy R; Jackson, Kristina M; Borsari, Brian; Magill, Molly; Longabaugh, Richard; Mastroleo, Nadine R; Barnett, Nancy P

    2016-02-01

    To identify individual therapist behaviors which elicit client change talk or sustain talk in motivational interviewing sessions. Motivational interviewing sessions from a single-session alcohol intervention delivered to college students were audio-taped, transcribed, and coded using the Motivational Interviewing Skill Code (MISC), a therapy process coding system. Participants included 92 college students and eight therapists who provided their treatment. The MISC was used to code 17 therapist behaviors related to the use of motivational interviewing, and client language reflecting movement toward behavior change (change talk), away from behavior change (sustain talk), or unrelated to the target behavior (follow/neutral). Client change talk was significantly more likely to immediately follow individual therapist behaviors [affirm (p=.013), open question (pmotivational interviewing can either elicit both client change talk and sustain talk or suppress both types of client language. Affirm was the only therapist behavior that both increased change talk and also reduced sustain talk. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Client capital as a source of enterprise cost

    Directory of Open Access Journals (Sweden)

    Verba Veronika A.

    2014-01-01

    Full Text Available The article presents the authors’ vision of the essence of the client capital and its influence upon the enterprise cost. The goal of the article is explanation of the role of the client capital in the process of enterprise capitalisation with the help of the business cost capitalisation model: investments into assets – cash flow generation – enterprise capitalisation. The result of the study is the authors’ position regarding the essence and structuring the client capital, which gives a possibility to detect financial and managerial instruments of capitalisation of the client capital. The conducted analysis of dynamics of financial parameters of the world leaders of IT industry, car building, clothes manufacture and beverages production allows detection of interconnection of the enterprise cost with the volume of assets and profit and identification of influence of the client capital upon capitalisation of enterprises of various spheres of activity. The article develops a model of capitalisation of the client capital on the basis of detection of cash flows, caused by formation of enterprises of B2C and B2B types.

  9. Criminalizing Sex Work Clients and Rushed Negotiations among Sex Workers Who Use Drugs in a Canadian Setting.

    Science.gov (United States)

    Landsberg, Adina; Shannon, Kate; Krüsi, Andrea; DeBeck, Kora; Milloy, M-J; Nosova, Ekaterina; Kerr, Thomas; Hayashi, Kanna

    2017-08-01

    Previous research indicates that criminalization of sex work is associated with harms among sex workers. In 2013, the Vancouver Police Department changed their sex work policy to no longer target sex workers while continuing to target clients and third parties in an effort to increase the safety of sex workers (similar to "end-demand sex work" approaches being adopted in a number of countries globally). We sought to investigate the trends and correlates of rushing negotiations with clients due to police presence among 359 sex workers who use drugs in Vancouver before and after the guideline change. Data were derived from three prospective cohort studies of people who use drugs in Vancouver between 2008 and 2014. We used sex-stratified multivariable generalized estimating equation models. The crude percentages of sex workers who use drugs reporting rushing client negotiations changed from 8.9% before the guideline change to 14.8% after the guideline change among 259 women, and from 8.6 to 7.1% among 100 men. In multivariable analyses, there was a significant increase in reports of rushing client negotiation after the guideline change among women (p = 0.04). Other variables that were independently associated with increased odds of rushing client negotiation included experiencing client-perpetrated violence (among both men and women) and non-heterosexual orientation (among women) (all p sex workers who use drugs. It was also associated with client-perpetrated violence and other markers of vulnerability. These findings lend further evidence that criminalizing the purchase of sexual services does not protect the health and safety of sex workers.

  10. Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

    Science.gov (United States)

    Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

    2015-01-01

    The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS.

  11. Prevalence and Correlates of Client-Perpetrated Violence against Female Sex Workers in 13 Mexican Cities.

    Directory of Open Access Journals (Sweden)

    Shirley J Semple

    Full Text Available Globally, client-perpetrated violence against female sex workers (FSWs has been associated with multiple health-related harms, including high-risk sexual behavior and increased exposure to HIV/STIs. This study examined correlates of client-perpetrated sexual, physical, and economic violence (e.g., robbery against FSWs in 13 cities throughout Mexico.FSWs (N = 1,089 who were enrolled in a brief, evidence-based, sexual risk reduction intervention for FSWs (Mujer Segura were interviewed about their work context, including experiences of violence perpetrated by clients, sexual risk and substance use practices, financial need, and social supports. Three broad categories of factors (sociodemographic, work context, behavioral and social characteristics of FSWs were examined as correlates of sexual, physical, and economic violence.The prevalence of different types of client-perpetrated violence against FSWs in the past 6 months was: sexual (11.7%, physical (11.8%, economic (16.9%, and any violence (22.6%. Greater financial need, self-identification as a street worker, and lower perceived emotional support were independently associated with all three types of violence. Alcohol use before or during sex with clients in the past month was associated with physical and sexual violence. Using drugs before or during sex with clients, injection drug use in the past month, and population size of city were associated with sexual violence only, and FSWs' alcohol use score (AUDIT-C was associated with economic violence only.Correlates of client-perpetrated violence encompassed sociodemographic, work context, and behavioral and social factors, suggesting that approaches to violence prevention for FSWs must be multi-dimensional. Prevention could involve teaching FSWs strategies for risk avoidance in the workplace (e.g., avoiding use of alcohol with clients, enhancement of FSWs' community-based supports, development of interventions that deliver an anti

  12. Do new ways of working increase work engagement?

    NARCIS (Netherlands)

    Gerards, Ruud; de Grip, Andries; Baudewijns, C.

    2018-01-01

    Purpose The purpose of this paper is to shed more light on the impact of the various facets of new ways of working (NWW) on employee work engagement, taking into account multiple sectors and occupational fields. Design/methodology/approach Insights from the literature and the job demands-resources

  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. Multi-client quantum key distribution using wavelength division multiplexing

    International Nuclear Information System (INIS)

    Grice, Warren P.; Bennink, Ryan S.; Earl, Dennis Duncan; Evans, Philip G.; Humble, Travis S.; Pooser, Raphael C.; Schaake, Jason; Williams, Brian P.

    2011-01-01

    Quantum Key Distribution (QKD) exploits the rules of quantum mechanics to generate and securely distribute a random sequence of bits to two spatially separated clients. Typically a QKD system can support only a single pair of clients at a time, and so a separate quantum link is required for every pair of users. We overcome this limitation with the design and characterization of a multi-client entangled-photon QKD system with the capacity for up to 100 clients simultaneously. The time-bin entangled QKD system includes a broadband down-conversion source with two unique features that enable the multi-user capability. First, the photons are emitted across a very large portion of the telecom spectrum. Second, and more importantly, the photons are strongly correlated in their energy degree of freedom. Using standard wavelength division multiplexing (WDM) hardware, the photons can be routed to different parties on a quantum communication network, while the strong spectral correlations ensure that each client is linked only to the client receiving the conjugate wavelength. In this way, a single down-conversion source can support dozens of channels simultaneously--and to the extent that the WDM hardware can send different spectral channels to different clients, the system can support multiple client pairings. We will describe the design and characterization of the down-conversion source, as well as the client stations, which must be tunable across the emission spectrum.

  15. 37 CFR 10.65 - Limiting business relations with a client.

    Science.gov (United States)

    2010-07-01

    ... with a client. 10.65 Section 10.65 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... a client. A practitioner shall not enter into a business transaction with a client if they have differing interests therein and if the client expects the practitioner to exercise professional judgment...

  16. Empathy from the client's perspective: A grounded theory analysis.

    Science.gov (United States)

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

    2017-03-01

    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.

  17. 49 CFR 1103.15 - The practitioner's duty to clients, generally.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false The practitioner's duty to clients, generally... Practitioner's Duties and Responsibilities Toward A Client § 1103.15 The practitioner's duty to clients... all clients to observe the statutory law to the best of his knowledge or as interpreted by competent...

  18. Counselling the (Self?) Diagnosed Client: Generative and Reflective Conversations

    Science.gov (United States)

    Strong, Tom; Ross, Karen H.; Sesma-Vazquez, Monica

    2015-01-01

    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…

  19. An Initial Evaluation of a Comprehensive Continuing Care Intervention for Clients with Substance Use Disorders: My First Year of Recovery (MyFYR).

    Science.gov (United States)

    McKay, James R; Knepper, Cheryl; Deneke, Erin; O'Reilly, Christopher; DuPont, Robert L

    2016-08-01

    Physician health programs (PHPs) generate high rates of sustained abstinence in addicted physicians, through a combination of formal treatment, self-help involvement, regular monitoring via random urine toxicology tests, and powerful incentives generated by the threat of losing one's medical license. Recently, Caron Treatment Centers developed a new continuing care intervention, "My First Year of Recovery" (MyFYR), which is modeled after PHPs but provides extended recovery support to a broader segment of those with substance use disorders. This paper presents initial outcome data from MyFYR. MyFYR features frequent outcomes monitoring via urine toxicology tests, and also includes a web-based social platform to coordinate efforts of recovery coaches, family members, and others (e.g., employers, probation officers). Participants were the first 198 clients who enrolled in MyFYR after participating in residential treatment at Caron. Substance use outcomes were determined by a combination of urine toxicology tests, client self-report, and information from family members obtained during a 12-month period following entry into MyFYR. Clients in MyFYR provided 70% of scheduled urine samples, for an average of 16.4 urine samples per client. Only 4.1% of the samples tested positive for alcohol or any drug. As determined by urine toxicology and client and family reports, 54% of the participants had some use of alcohol or drugs during the follow-up. Of these relapsed clients, 70.1% were retained or re-engaged in MyFYR, and of these, half were able to re-establish abstinence of two months duration or more, as documented by urine toxicology. These initial results are extremely promising, as they document high rates of sustained participation in urine drug test monitoring and positive outcome in clients not under the threat of losing a professional license or incarceration. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Automated Detection of Client-State Manipulation Vulnerabilities

    DEFF Research Database (Denmark)

    Møller, Anders; Schwarz, Mathias

    2012-01-01

    automated tools that can assist the programmers in the application development process by detecting weaknesses. Many vulnerabilities are related to web application code that stores references to application state in the generated HTML documents to work around the statelessness of the HTTP protocol....... In this paper, we show that such client-state manipulation vulnerabilities are amenable to tool supported detection. We present a static analysis for the widely used frameworks Java Servlets, JSP, and Struts. Given a web application archive as input, the analysis identifies occurrences of client state...... and infers the information flow between the client state and the shared application state on the server. This makes it possible to check how client-state manipulation performed by malicious users may affect the shared application state and cause leakage or modifications of sensitive information. The warnings...

  1. Servidor de claves públicas pgp, cliente administrador y cliente para ciframiento y desciframiento de correo electrónico

    OpenAIRE

    Redrovan Castillo, Fabian; Ruiz Ampuero, Luis M.; Vaca Ruiz, Carmen K.; Yanez Godoy, Ricardo E.; Caicedo Rossi, Guido Alfredo

    2009-01-01

    Basándose en el paradigma Cliente-Servidor bajo la arquitectura TCP/IP, se implementaran tres aplicaciones. Cada aplicación tiene un nombre que refleja su propósito: el Cliente Administrador, el Cliente de Correo Electrónico y finalmente el servidor PGP. Este último ofrece varios servicios, sobresaliendo por su importancia, el proporcionar a quien lo necesite, la clave pública de encriptación PGP (Pretty Good Privacy) de una persona determinada. Para que esto sea posible, dicha persona deb...

  2. PATRON-CLIENT RELATIONSHIP PADA MASYARAKAT MADURA

    Directory of Open Access Journals (Sweden)

    Mohammad Hefni

    2012-03-01

    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.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    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: pretreatm...

  4. Understanding the psychology of seeking support to increase Health Science student engagement in academic support services. A Practice Report

    Directory of Open Access Journals (Sweden)

    Gerard Francis Hoyne

    2013-04-01

    Full Text Available Increasing student engagement within higher education academic support services is a constant challenge. Whilst engagement with support is positively associated with successful retention, and non-engagement connected to attrition, the most vulnerable students are often the least likely to engage. Our data has shown that Health Science students are reluctant to engage with academic support services despite being made aware of their academic deficiencies. The “psychology of seeking support” was used as a lens to identify some of the multifaceted issues around student engagement. The School of Health Sciences made attendance at support courses compulsory for those students who were below the benchmark score in a post entrance literacy test. Since the policy change was implemented, there has been a 50% reduction in the fail rate of “at risk” students in a core literacy unit. These findings are encouraging and will help reduce student attrition in the long term.

  5. 32 CFR 776.32 - Department of the Navy as client.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Department of the Navy as client. 776.32 Section... Rules of Professional Conduct § 776.32 Department of the Navy as client. (a) Department of Navy as client: (1) Except when representing an individual client pursuant to paragraph (a)(6) of this section, a...

  6. Verbal interactional dominance and coordinative structure of speech rhythms of staff and clients with an intellectual disability.

    Science.gov (United States)

    Reuzel, Ellen; Embregts, Petri J C M; Bosman, Anna M T; Cox, Ralf F A; van Nieuwenhuijzen, Maroesjka; Jahoda, Andrew

    2014-10-01

    Social interactions between staff and clients with an intellectual disability contain synchronized turn-taking patterns. Synchrony can increase rapport and cooperation between individuals. This study investigated whether verbal interactional dominance and balance, an indication of attunement between staff and clients with ID, are associated with synchrony of turn-taking patterns during staff-client interactions and whether the level of dominance and balance is related to the observed quality of the social interactions. Nineteen staff members video-recorded a social interaction with one of their clients in which the client asked for support. The recordings were analyzed using Cross Recurrence Quantification Analysis and Initiative Response Analysis. Fifteen staff observers as well as client observers completed a questionnaire on the quality of the video-recorded interactions. Staff and clients' patterns of verbal interactional dominance and balance were associated with the synchrony of their turn-taking behaviors. Staff's dominance was associated with a higher level of synchrony of turn taking, whereas client's dominance was associated with a lower level of synchrony. The patterns of verbal interactional dominance and balance were associated with staff observer reports about the quality of the interactions. The study suggested that staff and clients have a tendency to be sensitive to different aspects of interactions, which in turn may have different functions.

  7. 45 CFR 1639.4 - Permissible representation of eligible clients.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Permissible representation of eligible clients... CORPORATION WELFARE REFORM § 1639.4 Permissible representation of eligible clients. Recipients may represent an individual eligible client who is seeking specific relief from a welfare agency. [62 FR 30766...

  8. 37 CFR 10.33 - Direct contact with prospective clients.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Direct contact with prospective clients. 10.33 Section 10.33 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... clients. A practitioner may not solicit professional employment from a prospective client with whom the...

  9. Can job crafting reduce job boredom and increase work engagement? A three-year cross-lagged panel study

    NARCIS (Netherlands)

    Harju, Lotta K.; Hakanen, Jari J.; Schaufeli, Wilmar B.|info:eu-repo/dai/nl/073779563

    2016-01-01

    Building upon the Conservation of Resources (COR) theory, this longitudinal study examined whether job crafting behaviors (i.e. increasing structural and social job resources and increasing challenges) predict less job boredom and more work engagement. We also tested the reverse causation effects of

  10. Estimating Client Out-of-Pocket Costs for Accessing Voluntary Medical Male Circumcision in South Africa.

    Directory of Open Access Journals (Sweden)

    Michel Tchuenche

    Full Text Available In 2010, South Africa launched a countrywide effort to scale up its voluntary medical male circumcision (VMMC program on the basis of compelling evidence that circumcision reduces men's risk of acquiring HIV through heterosexual intercourse. Even though VMMC is free there, clients can incur indirect out-of-pocket costs (for example transportation cost or foregone income. Because these costs can be barriers to increasing the uptake of VMMC services, we assessed them from a client perspective, to inform VMMC demand creation policies. Costs (calculated using a bottom-up approach and demographic data were systematically collected through 190 interviews conducted in 2015 with VMMC clients or (for minors their caregivers at 25 VMMC facilities supported by the government and the President's Emergency Plan for AIDS Relief in eight of South Africa's nine provinces. The average age of VMMC clients was 22 years and nearly 92% were under 35 years of age. The largest reported out-of-pocket expenditure was transportation, at an average of US$9.20 (R 100. Only eight clients (4% reported lost days of work. Indirect expenditures were childcare costs (one client and miscellaneous items such as food or medicine (20 clients. Given competing household expense priorities, spending US$9.20 (R100 per person on transportation to access VMMC services could be a significant burden on clients and households, and a barrier to South Africa's efforts to create demand for VMMC. Thus, we recommend a more focused analysis of clients' transportation costs to access VMMC services.

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

    African Journals Online (AJOL)

    Results. Clients appreciated the students' services; however, data revealed communication barriers and unmet expectations. Students reported struggling to adapt to the context, resulting in interventions not being sufficiently client-centred. They voiced a need for language competency and earlier exposure to such contexts.

  12. Evaluating the Influence of the Client Behavior in Cloud Computing.

    Science.gov (United States)

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

    2016-01-01

    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.

  13. 75 FR 82236 - Principal Trades with Certain Advisory Clients

    Science.gov (United States)

    2010-12-30

    ... 3235-AJ96 Principal Trades with Certain Advisory Clients AGENCY: Securities and Exchange Commission... certain of their advisory clients. The amendment extends the date on which rule 206(3)- 3T will sunset... a principal capacity in transactions with certain of their advisory clients.\\1\\ In December 2009, we...

  14. Organizational and Client Commitment among Contracted Employees

    Science.gov (United States)

    Coyle-Shapiro, Jacqueline A-M.; Morrow, Paula C.

    2006-01-01

    This study examines affective commitment to employing and client organizations among long-term contracted employees, a new and growing employment classification. Drawing on organizational commitment and social exchange literatures, we propose two categories of antecedents of employee commitment to client organizations. We tested our hypotheses…

  15. Risk Factors for Hip Fracture in Older Home Care Clients

    Science.gov (United States)

    Poss, Jeff; Cook, Richard J.; Byrne, Kerry; Hirdes, John P.

    2009-01-01

    Background Little information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. Methods This was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set–Home Care assessment instrument. Results In all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65–74, relative risk [95% confidence interval]: 0.52 [0.43–0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51–0.70)]. Other risk factors include osteoporosis (1.19 [1.03–1.36]), falls (1.31 [1.15–1.49]), unsteady gait (1.18 [1.03–1.36]), use of ambulation aide (1.39 [1.21–1.59]), tobacco use (1.42, [1.13–1.80]), severe malnutrition (2.61 [1.67–4.08]), and cognitive impairment (1.30 [1.12–1.51]). Arthritis (0.86 [0.76–0.98]) and morbid obesity (0.34 [0.16–0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. Conclusions Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies [22]. PMID:19196903

  16. Information provision to clients with stroke and their carers: self-reported practices of occupational therapists.

    Science.gov (United States)

    Gustafsson, Louise; Hodge, Anna; Robinson, Mia; McKenna, Kryss; Bower, Kylie

    2010-06-01

    The literature promotes the use of a wide range of educational materials for teaching and training clients with chronic conditions such as stroke. Client education is a valuable tool used by occupational therapists to facilitate client and carer ability to manage the stroke-affected upper limb. The aim of this study was to identify what information was provided to clients and carers, how this information was delivered, when the information was delivered and the client factors that influenced the method of information provision. Convenience and snowball sampling was used to recruit occupational therapists working in stroke. Twenty-eight participants completed the study questionnaire anonymously and their responses were summarised descriptively. There was a clinically important trend for carers to receive less information than clients. Written and/or verbal information was the favoured method for delivering information related to handling (57%), soft-tissue injury minimisation (46.4%) and oedema management (50%). Information was delivered with decreasing frequency from admission (86%) to discharge (64%). More than 90% of participants indicated that the client's cognitive ability, visual ability, level of communication, primary language and perceptual ability were considered prior to the delivery of information. Participants regularly conveyed information to clients and carers with respect to management of the stroke-affected upper limb. However, an increased emphasis on the development of practical self-management skills, awareness of the impact of personal factors and a timeline for information provision may prove useful.

  17. Discrimination against Obese Exercise Clients: An Experimental Study of Personal Trainers.

    Science.gov (United States)

    Fontana, Fabio; Bopes, Jonathan; Bendixen, Seth; Speed, Tyler; George, Megan; Mack, Mick

    2018-01-01

    The aim of the study was to compare exercise recommendations, attitudes, and behaviors of personal trainers toward clients of different weight statuses. Fifty-two personal trainers participated in the study. The data collection was organized into two phases. In phase one, trainers read a profile and watched the video displaying an interview of either an obese or an average-weight client. Profiles and video interviews were identical except for weight status. Then, trainers provided exercise recommendations and rated their attitude toward the client. In phase two, trainers personally met an obese or an average-weight mock client. Measures were duration and number of advices provided by the trainer to a question posed by the client and sitting distance between trainer and client. There were no significant differences in exercise intensity ( p = .94), duration of first session ( p = .65), and total exercise duration of first week ( p = .76) prescribed to the obese and average-weight clients. The attitude of the personal trainers toward the obese client were not significantly different from the attitude of personal trainers toward the average-weight client ( p = .58). The number of advices provided ( p = .49), the duration of the answer ( p = .55), and the distance personal trainers sat from the obese client ( p = .68) were not significantly different from the behaviors displayed toward the average-weight client. Personal trainers did not discriminate against obese clients in professional settings.

  18. clientes surdos

    Directory of Open Access Journals (Sweden)

    Wiliam César Alves Machado

    2015-01-01

    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.

  19. 37 CFR 10.67 - Settling similar claims of clients.

    Science.gov (United States)

    2010-07-01

    ... clients. 10.67 Section 10.67 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE... Office Code of Professional Responsibility § 10.67 Settling similar claims of clients. A practitioner who represents two or more clients shall not make or participate in the making of an aggregate settlement of the...

  20. Psychometrics of the Personal Questionnaire: A client-generated outcome measure.

    Science.gov (United States)

    Elliott, Robert; Wagner, John; Sales, Célia M D; Rodgers, Brian; Alves, Paula; Café, Maria J

    2016-03-01

    We present a range of evidence for the reliability and validity of data generated by the Personal Questionnaire (PQ), a client-generated individualized outcome measure, using 5 data sets from 3 countries. Overall pretherapy mean internal consistency (alpha) across clients was .80, and within-client alphas averaged .77; clients typically had 1 or 2 items that did not vary with the other items. Analyses of temporal structure indicated high levels of between-clients variance (58%), moderate pretherapy test-retest correlation (r = .57), and high session-to-session Lag-1 autocorrelation (.82). Scores on the PQ provided clear evidence of convergence with a range of outcome measures (within-client r = .41). Mean pre-post effects were large (d = 1.25). The results support a revised caseness cutoff of 3.25 and a reliable change index interval of 1.67. We conclude that PQ data meet criteria for evidence-based, norm-referenced measurement of client psychological distress for supporting psychotherapy practice and research. (c) 2016 APA, all rights reserved).

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    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......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...

  2. Research Study on the Migration of Clients on Banking Market

    Directory of Open Access Journals (Sweden)

    Cornelia Tureac

    2013-02-01

    Full Text Available In this paper we present the relevancy and importance of knowing the reasons on clients’migration to competitive banking institutions. The main reason of being the client of several banks isdue to the fierce competition between credit institutions,thusthe banking market has changed. Basedon a case study within the Raiffeisen Bank we researched and presented the reasons fordiscontinuation of banking tiesand the migration of clients to other banks. The used researchmethodology consisted of the application of analysis point of contact by sending a questionnairethrough which there could have been identified 105 migrating clients, out of which 89 were formerclients of Raiffeisen Bank. Since both in the specialized literatureand in practice there is very littleinformation about migration behavior of banking clients-especially in the category of small andmedium enterprises-the present research was not limited to the Raiffeisen Bank clients, but to all 105respondents whodiscontinued totally or partially their connection with the bank. It can be concludedthat the attitude of the bank clients has a considerable influence on the migration behavior. The most“infidel” banking clients are considered in the category of “clients oriented towards the conditions.”

  3. Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

    Science.gov (United States)

    de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

    2008-01-01

    Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

  4. Writing about Clients: Ethical Considerations and Options

    Science.gov (United States)

    Sperry, Len; Pies, Ronald

    2010-01-01

    Today, the decision to prepare clinical case material for publication is a decision that cannot be taken lightly. The decision involves reviewing ethical considerations and choosing among various options to safeguard client privacy. Such options include seeking the client's permission, disguising case material, and developing composite case…

  5. Experiential Interventions for Clients with Genital Herpes.

    Science.gov (United States)

    Cummings, Anne L.

    1999-01-01

    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…

  6. Can Knowledge of Client Birth Order Bias Clinical Judgment?

    Science.gov (United States)

    Stewart, Allan E.

    2004-01-01

    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…

  7. The utilisation of storytelling as a therapeutic intervention by educational psychologists to address behavioural challenges relating to grief of adolescent clients

    OpenAIRE

    2014-01-01

    M.Ed. (Educational Psychology) Storytelling as a therapeutic intervention entails the narrating of events by externalising emotions, thoughts and responses to life-changing events such as loss and grief. This creates the opportunity for clients to engage with psychologists by projecting various beliefs and challenges, such as grief, through a range of therapeutic modalities. This study conducts an inquiry into the ways in which storytelling can be utilised by educational psychologists with...

  8. Finding Paradise Within: How Spirituality Protects Palliative Care Clients and Caregivers From Depression.

    Science.gov (United States)

    Penman, Joy

    2017-06-01

    The aims of this article are to explore the experience of depression among palliative care clients and caregivers, describe the strategies they use in coping with depression, and clarify the role of spirituality in preventing and/or overcoming depression. This article discusses an aspect of the findings of a larger doctoral study that explored the nature of spirituality and spiritual engagement from the viewpoint of individuals with life-limiting conditions and their caregivers. van Manen's phenomenology was used in the study. The data generated from the doctoral study were subjected to secondary analysis to uncover the experience of depression. The methodology underpinning the secondary analysis was phenomenology also by van Manen. Fourteen clients and caregivers from across regional and rural South Australia informed the study. Data collection involved in-depth nonstructured home-based interviews that were audiotaped and transcribed verbatim. The findings highlighted relate to participants succumbing to depression, but having spiritual beliefs and practices helped them cope. One of the most insightful understanding was the role spirituality played in protecting individuals from depression, encapsulated in the theme "finding paradise within." Spirituality, understood from a religious or secular perspective, must be embedded in palliative care as it assisted in preventing and overcoming depression.

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

    CERN Multimedia

    2006-01-01

    In the coming weeks, users of mail clients other than Outlook (e.g. Pine, Mozilla, Mac Mail, etc.) may receive an e-mail from Mail-service@cern.ch 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 http://cern.ch/mmmservices/Help/?kbid=191040. 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 ARAC client system: network-based access to ARAC

    International Nuclear Information System (INIS)

    Leach, M J; Sumikawa, D; Webster, C

    1999-01-01

    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

  11. Client/server models for transparent, distributed computational resources

    International Nuclear Information System (INIS)

    Hammer, K.E.; Gilman, T.L.

    1991-01-01

    Client/server models are proposed to address issues of shared resources in a distributed, heterogeneous UNIX environment. Recent development of automated Remote Procedure Call (RPC) interface generator has simplified the development of client/server models. Previously, implementation of the models was only possible at the UNIX socket level. An overview of RPCs and the interface generator will be presented and will include a discussion of generation and installation of remote services, the RPC paradigm, and the three levels of RPC programming. Two applications, the Nuclear Plant Analyzer (NPA) and a fluids simulation using molecular modelling, will be presented to demonstrate how client/server models using RPCs and External Data Representations (XDR) have been used production/computation situations. The NPA incorporates a client/server interface for transferring/translation of TRAC or RELAP results from the UNICOS Cray to a UNIX workstation. The fluids simulation program utilizes the client/server model to access the Cray via a single function allowing it to become a shared co-processor to the workstation application. 5 refs., 6 figs

  12. What Business Students Should Know about Attorney-Client Privilege

    Science.gov (United States)

    Draba, Robert; Marshall, Brent

    2012-01-01

    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,…

  13. Enhancing Clients' Communication Regarding Goals for Using Psychiatric Medications.

    Science.gov (United States)

    Deegan, Patricia E; Carpenter-Song, Elizabeth; Drake, Robert E; Naslund, John A; Luciano, Alison; Hutchison, Shari L

    2017-08-01

    Discordance between psychiatric care providers' and clients' goals for medication treatment is prevalent and is a barrier to person-centered care. Power statements-short self-advocacy statements prepared by clients in response to a two-part template-offer a novel approach to help clients clarify and communicate their personal goals for using psychiatric medications. This study described the power statement method and examined a sample of power statements to understand clients' goals for medication treatment. More than 17,000 adults with serious mental illness at 69 public mental health clinics had the option to develop power statements by using a Web application located in the clinic waiting areas. A database query determined the percentage of clients who entered power statements into the Web application. The authors examined textual data from a random sample of 300 power statements by using content analysis. Nearly 14,000 (79%) clients developed power statements. Of the 277 statements in the sample deemed appropriate for content analysis, 272 statements had responses to the first part of the template and 230 had responses to the second part. Clients wanted psychiatric medications to help control symptoms in the service of improving functioning. Common goals for taking psychiatric medications (N=230 statements) were to enhance relationships (51%), well-being (32%), self-sufficiency (23%), employment (19%), hobbies (15%), and self-improvement (10%). People with serious mental illness typically viewed medications as a means to pursue meaningful life goals. Power statements appear to be a simple and scalable technique to enhance clients' communication of their goals for psychiatric medication treatment.

  14. Increasing Motivation and Engagement in Elementary and Middle School Students through Technology-Supported Learning Environments

    Science.gov (United States)

    Godzicki, Linda; Godzicki, Nicole; Krofel, Mary; Michaels, Rachel

    2013-01-01

    This action research project report was conducted in order to increase motivation and engagement in elementary and middle school students through technology-supported learning environments. The study was conducted from August 27, 2012, through December 14, 2012 with 116 participating students in first-, fourth-, fifth- and eighth-grade classes. To…

  15. A Proposal to Increase Employee Performance Through Employee Engagement Survey in PT KBI

    OpenAIRE

    Harvid, Albertus; Gustomo, Aurik

    2013-01-01

    PT. Karunia Berca Indonesia (KBI) is one of the best steel galvanizing factory in Indonesia. KBI have some problems like lack of willingness to train, lack of employee development program, and lack of facilities. That 3 factors are performance indicator. Low on employee performance will decrease the revenue. With root cause analysis can be found the main problem in PT KBI is lack of performance. To increase employee performance, KBI must determine the engagement for the employee using employe...

  16. CONCEPT MODEL OF CREATION AND EVALUATION OF THE DEGREE OF FOCUS-ON-CLIENTS OF THE ENTERPRISE

    Directory of Open Access Journals (Sweden)

    Ladygina Ekaterina Evgen'evna

    2017-03-01

    Full Text Available This article considers the problem of ensuring competitive capacity of an enterprise, and identifies the reserves for increasing it. The focus-on-clients of an enterprise was identified to be the main direction for increasing the competitive capacity. This article features the parameters for assessment of the degree of focus-on-clients of an enterprise, as well as formulae for the said assessment. It also presents methods to evaluate the priority of the criteria. The article contains the model created for evaluating the development of focus-on-clients of the enterprise. This model allows to assess the parameters that influence the degree of focus-on-clients, priority of such parameters, and identify the reserves for improving them. In particular, method for calculating quantitative parameters by converting qualitative parameters into quantitative was introduced. In addition, plan of activities aimed at improving the degree of focus-on-clients and, therefore, competitive capacity of the enterprise, is presented. The article features formulae, functional relations, and calculation of all parameters as well. The model for assessment and development of focus-on-customers presented in the work defines the degree of conformance between the selected strategy and accounting for consumers' preferences when the plan of activities aimed at ensuring competitive capacity of the enterprise is implemented.

  17. 37 CFR 10.68 - Avoiding influence by others than the client.

    Science.gov (United States)

    2010-07-01

    ... than the client. 10.68 Section 10.68 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND... the client. (a) Except with the consent of the practitioner's client after full disclosure, a practitioner shall not: (1) Accept compensation from one other than the practitioner's client for the...

  18. 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 ...

  19. Training Therapists about Client Expectations of Psychotherapy.

    Science.gov (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…

  20. Palliative care clients' and caregivers' notion of fear and their strategies for overcoming it.

    Science.gov (United States)

    Penman, Joy; Ellis, Bronwyn

    2015-06-01

    This paper aims to clarify our understanding of fear and explore the strategies employed by people with life-limiting conditions and their caregivers in addressing the emotion of fear as they journey through the dying process. The role of fear is discussed: different kinds of fear, the tangible and intangible measures by which people manage their fear, and the ways of transcending fear. The findings of a larger research project funded by the Australian Department of Health and Ageing are drawn upon. In-depth interviews were conducted with clients and caregivers relating to the psychosocial and emotional issues in palliative care. Secondary analysis was utilized to examine the perceptions of fear in this cohort. While there were many other findings, the results highlighted in this paper relate to the notion of fear among interview participants. Interview data showed that people with life-limiting conditions and their caregivers had different types of fear and employed a variety of strategies to deal with fear. Four themes emerged embodying these strategies: calling on their own resilience and inner resources, maintaining human relationships, gaining the ability to "keep one step ahead" in the dying process, and engaging in spirituality and religion. The implications of the findings for healthcare professionals are highlighted. The recognition of emotions is embedded in palliative care; healthcare professionals should view the management of emotions as an integral part of professional practice. Addressing fear is essential because unresolved fear can impinge on one's ability to cope. Our paper brings together different perspectives on fear and how vulnerable individuals attempt to cope with it while at the same time providing a view of the challenges confronting healthcare professionals who are engaged with them and committed to optimizing health outcomes for palliative care clients and their caregivers.

  1. Client experiences of motivational interviewing: An interpersonal process recall study.

    Science.gov (United States)

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

    2016-03-01

    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.

  2. Client capital as a source of enterprise cost

    OpenAIRE

    Verba Veronika A.; Tyshchenko Oleksandr O.

    2014-01-01

    The article presents the authors’ vision of the essence of the client capital and its influence upon the enterprise cost. The goal of the article is explanation of the role of the client capital in the process of enterprise capitalisation with the help of the business cost capitalisation model: investments into assets – cash flow generation – enterprise capitalisation. The result of the study is the authors’ position regarding the essence and structuring the client capital, which gives a poss...

  3. Performance of consultants on government projects in ghana: Client and contractor pespective

    Directory of Open Access Journals (Sweden)

    J. Dadzie

    2013-07-01

    Full Text Available Construction project consultants share the characteristics of helping their clients address problems and improve upon project performance; they have a passion for the wisdom and expertise they bring to the project, and they have the ability to galvanize clients into action. However, it is an open secret that many projects often delay. Also, it is a known fact that most project contract figures swell more than double the original tender figure. Meanwhile, there are supervising consultants who are engaged and paid to manage such important projects. Their role however, is to complement the effort of contractors to ensure a successful completion of a project. The aim of this research is to identify factors affecting the performance of consultants on government projects, and to rank these factors according to their relative importance from the perspective of consultants. Analysis of the factors considered in a survey indicate that the main factors negatively affecting the performance of consultants are: urgency of the project at hand, project duration, variations, political influence from higher authority, timely decision making on the part of the consulting team and the experience of the design team on the project. The others are the ability of the consultants to work as a team, creativity on the part of the consultants in controlling cost and developing own efficiencies so that contract sums are kept within budget .

  4. Medicaid care management: description of high-cost addictions treatment clients.

    Science.gov (United States)

    Neighbors, Charles J; Sun, Yi; Yerneni, Rajeev; Tesiny, Ed; Burke, Constance; Bardsley, Leland; McDonald, Rebecca; Morgenstern, Jon

    2013-09-01

    High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    African Journals Online (AJOL)

    Characteristics of clients accessing HIV counseling and testing services in a tertiary hospital in ... Introduction: Client-initiated HIV testing and counseling has helped millions of people learn their HIV status. ... AJOL African Journals Online.

  6. Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro

    Directory of Open Access Journals (Sweden)

    Laušević Dragan

    2016-01-01

    Full Text Available Introduction. Female sex workers (FSWs are a group at increased risk for human immunodeficiency virus (HIV infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0% of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR = 22.7, 95% confidence interval (CI = 2.3-228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4-118.9 towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0, and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5. Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.

  7. Emotional congruence between clients and therapists and its effect on treatment outcome.

    Science.gov (United States)

    Atzil-Slonim, Dana; Bar-Kalifa, Eran; Fisher, Hadar; Peri, Tuvia; Lutz, Wolfgang; Rubel, Julian; Rafaeli, Eshkol

    2018-01-01

    The present study aimed to (a) explore 2 indices of emotional congruence-temporal similarity and directional discrepancy-between clients' and therapists' ratings of their emotions as they cofluctuate session-by-session; and (b) examine whether client/therapist emotional congruence predicts clients' symptom relief and improved functioning. The sample comprised 109 clients treated by 62 therapists in a university setting. Clients and therapists self-reported their negative (NE) and positive emotions (PE) after each session. Symptom severity and functioning level were assessed at the beginning of each session using the clients' self-reports. To assess emotional congruence, an adaptation of West and Kenny's (2011) Truth and Bias model was applied. To examine the consequences of emotional congruence, polynomial regression, and response surface analyses were conducted (Edwards & Parry, 1993). Clients and therapists were temporally similar in both PE and NE. Therapists experienced less intense PE on average, but did not experience more or less intense NE than their clients. Those therapists who experienced more intense NE than their clients were more temporally similar in their emotions to their clients. Therapist/client incongruence in both PE and NE predicted poorer next-session symptomatology; incongruence in PE was also associated with lower client next-session functioning. Session-level symptoms were better when therapists experienced more intense emotions (both PE and NE) than their clients. The findings highlight the importance of recognizing the dynamic nature of emotions in client-therapist interactions and the contribution of session-by-session emotional dynamics to outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  8. Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal.

    Science.gov (United States)

    Agha, Sohail; Gage, Anastasia; Balal, Asma

    2007-05-01

    With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to

  9. The Potential for Using Gamification in Academic Libraries in Order to Increase Student Engagement and Achievement

    Directory of Open Access Journals (Sweden)

    Andrew Walsh

    2014-06-01

    Full Text Available This paper discusses the potential benefits of using gamification techniques to increase student engagement with library resources. It outlines the link between student use of library resources and academic achievement, and suggests that gamification has to potential to increase usage of resources, which may also increase academic achievement. Some early findings from an implementation of a gamification project, Lemontree, are also discussed in which students reported increased usage of library resources and their acceptance of gamification techniques in Higher Education.

  10. Evidence-based practice guidelines for prescribing home modifications for clients with bariatric care needs.

    Science.gov (United States)

    de Lange, Laura; Coyle, Emma; Todd, Helen; Williams, Cylie

    2018-04-01

    Home modifications maintain people's functional independence and safety. No literature exists to guide the prescription of home modifications for clients with bariatric care needs. With Australia's increasing obesity rate, more evidence is needed to support home modification prescribers. This study aimed to map Australian home modification prescribing practices for clients with bariatric care needs and to establish and evaluate a clinical resource for this prescription process. The study included two phases. Phase 1 conducted a cross-sectional survey of therapists practicing in Australia, and Australian industry partners who prescribe or install home modifications for clients with bariatric care needs. Phase 2 included design, implementation and evaluation of a clinical resource. Data were analysed with means and frequencies; multivariable regression analysis was used to explore prescribing habits. Therapists surveyed (n = 347) reported 11 different bariatric weight definitions. Less than 3% constantly or regularly prescribed home modifications for these clients; rails were most commonly prescribed. Many therapists (n = 171, 58%) 'never' or 'rarely' knew rail load capacity. Therapists' knowledge of rail load capacity was associated with previous experience prescribing home modifications (P = 0.009); rail manufacturer's advice (P = 0.016) and not using advice from builders (P = 0.001). Clinical resources were used by 11% (n = 26) of therapists to support their prescription, and industry sporadically relied on therapists to specify modification design requirements (n = 5, 45%). Post-implementation of a clinical resource increased consensus regarding understanding of the term bariatric and increased consultation with builders and manufacturers. There was a lack of consistency in bariatric terminology, uncertainty of rail load capacities and minimal use of clinical practice guidelines. Additional resources will assist with consistency in prescribing

  11. 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.

    2006-01-01

    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

  12. 77 FR 17367 - Permissible Sharing of Client Records by Customs Brokers

    Science.gov (United States)

    2012-03-26

    ...-0038] RIN 1651-AA80 Permissible Sharing of Client Records by Customs Brokers AGENCY: U.S. Customs and... would allow brokers, upon the client's consent in a written authorization, to share client information... services to the broker's clients. Although the proposed rule was prepared in response to a request from a...

  13. Dreaming of you: client and therapist dreams about each other during psychodynamic psychotherapy.

    Science.gov (United States)

    Hill, Clara E; Knox, Sarah; Crook-Lyon, Rachel E; Hess, Shirley A; Miles, Joe; Spangler, Patricia T; Pudasaini, Sakar

    2014-01-01

    Our objectives were to describe the frequency of therapists' dreams about their clients and clients' dreams about their therapists, to determine how therapists and clients who had such dreams differed from those who did not have such dreams, whether therapy process and outcome differed for those who had and did not have such dreams, and to describe the content and consequences of these dreams. Thirteen doctoral student therapists conducted psychodynamic psychotherapy with 63 clients in a community clinic. Therapists who had dreams about clients had higher estimated and actual dream recall than did therapists who did not dream about clients. Qualitative analyses indicated that therapists' dreams yielded insights about the therapist, clients, and therapy; therapists used insights in their work with the clients. Among the clients, only two (who were particularly high in attachment anxiety and who feared abandonment from their therapists) reported dreams that were manifestly about their therapists. Therapists-in-training dreamed more about their clients than their clients dreamed about them. Dreams about clients can be used by therapists to understand themselves, clients, and the dynamics of the therapy relationship.

  14. The Survey of Treatment Entry Pressures (STEP): identifying client's reasons for entering substance abuse treatment.

    Science.gov (United States)

    Dugosh, Karen Leggett; Festinger, David S; Lynch, Kevin G; Marlowe, Douglas B

    2014-10-01

    Systematically identifying reasons that clients enter substance abuse treatment may allow clinicians to immediately focus on issues of greatest relevance to the individual and enhance treatment engagement. We developed the Survey of Treatment Entry Pressures (STEP) to identify the specific factors that precipitated an individual's treatment entry. The instrument contains 121 items from 6 psychosocial domains (i.e., family, financial, social, medical, psychiatric, legal). The current study examined the STEP's psychometric properties. A total of 761 participants from various treatment settings and modalities completed the STEP prior to treatment admission and 4-7 days later. Analyses were performed to examine the instrument's psychometric properties including item response rates, test-retest reliability, internal consistency, and factor structure. The items displayed adequate test-retest reliability and internal consistency within each psychosocial domain. Generally, results from exploratory and confirmatory factor analyses support a 2-factor structure reflecting type of reinforcement schedule. The study provides preliminary support for the psychometric properties of the STEP. The STEP may provide a reliable way for clinicians to characterize and capitalize on a client's treatment motivation early on which may serve to improve treatment retention and therapeutic outcomes. © 2014 Wiley Periodicals, Inc.

  15. Stakeholder engagement and feedback efforts to increase use of the iCSS ToxCast Dashboard (SETAC)

    Science.gov (United States)

    In the era of ‘Big Data’ research, many government agencies are engaged in generating and making public large amounts of data that underly both research and regulatory decisions. Public access increases the ‘democratization’ of science by enhancing transparency and access. Howev...

  16. THE CITIZEN CLIENT PROFILE

    Directory of Open Access Journals (Sweden)

    Ângela Cristina Bueno Vieira

    2006-12-01

    Full Text Available ABSTRACT: In our experience and work in the Medical Clinic at the Federal University of Goiás Clinical Hospital (HC/UFG, we observe that in despite of the most patients get orientations about their pathology by the health team, they don’t accomplish these orientations. For the continuous self-care promotion was implanted project "Citizen Client", with intention to contribute to patient citizenship rescue, guiding and strengthening its rights and duties while carrying on pathology. This article is an experience related by a qualitative approach with a group of patients interned in the Medical Clinic of the HC/UFG that rambles, their familiars and that ones who participates in the project Citizen Client during their internment in the year of 2003. On the meeting we work with lectures, workshops and groups by the multi-professional team and coordinated by a Nurse. The subjects had been diverse, approaching some pathology and its cares, social and spiritual assistance. The client participation in its recovery has extreme importance and, so that this occurs, it is necessary health education understood in its extended form, recognizing the client’s life reality, their day-by-day, providing mechanisms for them to become an asset subject with autonomy to act in favor of own health. KEYWORDS: Health Education; Self Care; Quality of Life.

  17. Restating a Client-Centered Approach to Career Counseling.

    Science.gov (United States)

    Miller, Mark J.

    1988-01-01

    Asserts career counseling too often is associated with objective test scores and rational decision making. Reiterates the importance of considering the client's developing self-concept in career counseling. Provides sample client centered career counseling session. (Author/ABL)

  18. Exercise and physical therapy help restore body and self in clients with severe anorexia nervosa.

    Science.gov (United States)

    Kolnes, Liv-Jorunn

    2017-07-01

    Exercise in the context of anorexia nervosa is a multifaceted endeavour surrounded by controversy and uncertainty. A broader comprehension of this poorly understood phenomenon is required. Informed by the findings of a body examination of six individuals with anorexia nervosa, as well as exercise science, phenomenology and neurocognition, the purpose of this article is to elaborate on the potential role of exercise and physical therapy in the treatment of anorexia nervosa. The findings of the body assessment include constriction of posture, muscles and pattern of breathing. These bodily restraints are not necessarily merely associated with high levels of exercise, they may also reflect psychological strain accompanying the illness. The restricted breathing in particular is assumed to be associated with difficult thoughts and suppressed feelings. Based on the results of the body examination, as well as medical and psychological considerations accompanying the illness, it is suggested that interventions should focus on improving postural stability and restoring related muscular function. Integral to engaging in these activities, the potential to integrate proprioceptive information in this process may generate a more coherent experience of the body, as well as of the self, in these clients. Accordingly, constrictions of the body may have a vital role in constraining the experience of the self. As such, addressing bodily restraints in these clients may facilitate the experience of being the subject causing and controlling the movements. This is in marked contrast to clients' previous exercise experiences, which were associated with compulsion, rigidity and the absence of coherence and control. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. 34 CFR 370.1 - What is the Client Assistance Program (CAP)?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Client Assistance Program (CAP)? 370.1... § 370.1 What is the Client Assistance Program (CAP)? The purpose of this program is to establish and carry out CAPs that— (a) Advise and inform clients and client applicants of all services and benefits...

  20. Clients' outcomes of home health nursing in Taiwan.

    Science.gov (United States)

    Yeh, L; Wen, M J

    2001-09-01

    The home health nursing movement is expanding rapidly. Home health nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from home health nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity-number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping home health nursing services in Taiwan.

  1. 13 CFR 113.3-3 - Structural accommodations for handicapped clients.

    Science.gov (United States)

    2010-01-01

    ... handicapped clients. 113.3-3 Section 113.3-3 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... ADMINISTRATOR General Provisions § 113.3-3 Structural accommodations for handicapped clients. (a) Existing... by handicapped clients. Where structural changes are necessary to make the recipient's goods or...

  2. Prenatal screening for congenital anomalies: exploring midwives' perceptions of counseling clients with religious backgrounds.

    Science.gov (United States)

    Gitsels-van der Wal, Janneke T; Manniën, Judith; Gitsels, Lisanne A; Reinders, Hans S; Verhoeven, Pieternel S; Ghaly, Mohammed M; Klomp, Trudy; Hutton, Eileen K

    2014-07-19

    In the Netherlands, prenatal screening follows an opting in system and comprises two non-invasive tests: the combined test to screen for trisomy 21 at 12 weeks of gestation and the fetal anomaly scan to detect structural anomalies at 20 weeks. Midwives counsel about prenatal screening tests for congenital anomalies and they are increasingly having to counsel women from religious backgrounds beyond their experience. This study assessed midwives' perceptions and practices regarding taking client's religious backgrounds into account during counseling. As Islam is the commonest non-western religion, we were particularly interested in midwives' knowledge of whether pregnancy termination is allowed in Islam. This exploratory study is part of the DELIVER study, which evaluated primary care midwifery in The Netherlands between September 2009 and January 2011. A questionnaire was sent to all 108 midwives of the twenty practices participating in the study. Of 98 respondents (response rate 92%), 68 (69%) said they took account of the client's religion. The two main reasons for not doing so were that religion was considered irrelevant in the decision-making process and that it should be up to clients to initiate such discussions. Midwives' own religious backgrounds were independent of whether they paid attention to the clients' religious backgrounds. Eighty midwives (82%) said they did not counsel Muslim women differently from other women. Although midwives with relatively many Muslim clients had more knowledge of Islamic attitudes to terminating pregnancy in general than midwives with relatively fewer Muslim clients, the specific knowledge of termination regarding trisomy 21 and other congenital anomalies was limited in both groups. While many midwives took client's religion into account, few knew much about Islamic beliefs on prenatal screening for congenital anomalies. Midwives identified a need for additional education. To meet the needs of the changing client population

  3. Trust and Professional Skepticism in the Relationship between auditors and Clients

    DEFF Research Database (Denmark)

    Aschauer, Ewald; Fink, Matthias; Moro, Andrea

    2017-01-01

    This study empirically investigates the relationship between auditors' identification-based trust in client firm's managers and their perceptions of auditors' professional skepticism. We employ a multimethod approach broken Down into two studies. First, in study 1, we approached auditors...... collected from 233 real auditor-client dyads in Germany reveals that auditors' identification-based trust is positively Associated with their clients' perception of the auditors' professional skepticism. The identified coexistence of trust and professional skepticism in auditor-client dyads implies...... that regulatory measures that impede the evolution of trust between auditors and their clients will fail to enhance professional skepticism. instead, regulations should give auditors and their clients sufficient leeway to establish identification-based trust....

  4. Hybrid Client Side Phishing Websites Detection Approach

    OpenAIRE

    Firdous Kausar; Bushra Al-Otaibi; Asma Al-Qadi; Nwayer Al-Dossari

    2014-01-01

    Phishing tricks to steal personal or credential information by entering victims into a forged website similar to the original site, and urging them to enter their information believing that this site is legitimate. The number of internet users who are becoming victims of phishing attacks is increasing beside that phishing attacks have become more sophisticated. In this paper we propose a client-side solution to protect against phishing attacks which is a Firefox extension integrated as a tool...

  5. Animal-assisted therapy for clients with dementia.

    Science.gov (United States)

    Buettner, Linda L; Fitzsimmons, Suzanne; Barba, Beth

    2011-05-01

    The purpose of this article is to increase nurses' awareness of animal-assisted therapy as a treatment option for older adults with dementia. We describe the differences between animal visitation programs and goal-directed therapy. We also address credentials of human-animal teams and provide an overview of possible therapeutic outcomes for older adults with dementia. Step-by-step methods are outlined for nurses to advocate for clients with dementia to receive these services. Copyright 2011, SLACK Incorporated.

  6. Mutual powerlessness in client participation practices in mental health care

    NARCIS (Netherlands)

    T. Broer (Tineke); A.P. Nieboer (Anna); R.A. Bal (Roland)

    2014-01-01

    textabstractBackground Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation

  7. Engendering Change within a Water Infrastructure Client Organisation: A Participatory Action Research Approach

    Directory of Open Access Journals (Sweden)

    Michael Potts

    2015-07-01

    Full Text Available Continuing demands by stakeholders for improved service delivery has caused Infrastructure Client Organisations (ICO in the UK to embark upon organisational restructuring. It is expected that such restructuring would enhance cost-effectiveness and quality in asset management and service delivery. However, this change, if not properly managed and sustained, could result in the inability of the ICO to achieve these targets. This study outlines the use of systemic thinking and Participatory Action Research (PAR in driving and managing such change within a UK-based Water and Wastewater ICO (UK WASC. Besides highlighting the context for change in response to policy, austerity and regulatory pressures, this study portrays how the PAR approach can assist in the management of change within ICOs. Furthermore, it provides an insight into the evolution of an external researcher, from novice to expert within the ICO, imbued with the required knowledge to encourage other stakeholders to participate in driving the change management process. Preliminary findings indicate the usefulness of this phased approach toward PAR. This study provides a platform for researchers wishing to engage with ICOs to improve service delivery, identifying the value of engagement, change and systemic thinking.

  8. Momentary Work Happiness as a Function of Enduring Burnout and Work Engagement.

    Science.gov (United States)

    Bakker, Arnold B; Oerlemans, Wido G M

    2016-08-17

    The present study (N = 136) combined global measures with specific, experience-based measures to investigate how enduring job burnout and engagement influence the impact of daily work activities on momentary need satisfaction and happiness. We used the day reconstruction method (DRM) to ask employees from various occupations to reconstruct their working days. On the basis of employee work engagement and self-determination theories, we hypothesized that time spent on (a) core work tasks; (b) administrative work tasks; (c) client interactions; (d) interactions with colleagues; and (e) meetings would be negatively related to need satisfaction on the task level for employees high (vs. low) in enduring burnout; and positively related to need satisfaction on the task level for employees high (vs. low) in enduring work engagement. In addition, we predicted that psychological need satisfaction would mediate the relationships between time spent on work tasks and happiness during the tasks. The results of multilevel analyses largely supported these hypotheses. Our findings contribute to the literature by showing how those with high levels of burnout do not manage to satisfy their basic needs through their work, whereas those with high levels of work engagement satisfy their daily needs and stay happy.

  9. Qualidade de vida de clientes pós-infarto agudo do miocárdio Calidad de vida de los clientes pós-infarto agudo del miocardio Client's quality of life after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Joselany Afio Caetano

    2007-03-01

    Full Text Available Objetivou-se neste estudo avaliar a qualidade de vida de clientes que sofreram infarto agudo do miocárdio. A amostra constou de 30 clientes selecionados pela busca em prontuários de uma unidade cardiológica, que nos permitiu a identificação e localização desses clientes, internados no ano de 2004. Para coleta de dados utilizamos a Escala de Qualidade de Vida de Flanagan e o tratamento estatístico com desvio-padrão. Os resultados mostraram maior índice de respostas nos níveis "indiferentes" a "pouco satisfeitos" em suas qualidades de vida. A relação interpessoal apresentou o mais alto índice de satisfação, contrariando o bem-estar físico e material, com o mais baixo índice de satisfação. Concluiu-se que a avaliação da qualidade de vida de clientes que sofreram infarto agudo do miocárdio se mostra comprometida, o que vem corroborar outros estudos anteriormente realizados.El objetivo del estudio fue evaluar la calidad de vida de los clientes que han sufrido infarto agudo del miocardio. La muestra ha consistido de 30 pacientes escogidos por la búsqueda en historias clínicas de una unidad cardiológica, que nos permitió la identificación y localización de estos clientes, internados en el año 2004. Para la colecta de los datos utilizamos la Escala de Calidad de Vida de Flanagan y el tratamiento estadístico con desvío medio. Los resultados muestran mayor índice de respuestas en los niveles "indiferentes" a "poco satisfechos" en sus calidades de vida. La relación interpersonal presentó el más alto índice de satisfacción, contrariando el bienestar físico y material, con el más bajo índice de satisfacción. Ha concluído que la evaluación de la calidad de vida de clientes que sufrieron infarto agudo del miocardio muéstrase comprometida, lo que viene a confirmar otros estudios anteriormente realizados.This study evaluates the quality of life of clients who suffered myocardial infarction. The sample consisted of 30

  10. A study on client needs regarding FDG-PET for cancer screening

    International Nuclear Information System (INIS)

    Yamane, Tomohiko; Yoshiya, Kazuhiko; Nagata, Takeshi; Ito, Shinichi; Ito, Satoshi; Mezaki, Yukio; Uchida, Hideo

    2006-01-01

    We researched client needs regarding FDG-PET for cancer screening. The study included 1,527 individuals who underwent FDG-PET for cancer screening at our hospital. An interview sheet was distributed after injecting FDG. Clients listed the organs that required examination and the symptoms causing them anxiety. Results indicated that 9.8% of the clients listed organs for which FDG-PET would not be useful in detecting cancer. This study suggested that there exists a gap between client needs and FDG-PET utility; hence we need improved methods of providing correct information to clients. (author)

  11. Comparison and selection of client computer in nuclear instrument

    International Nuclear Information System (INIS)

    Ma Guizhen; Xie Yanhui; Peng Jing; Xu Feiyan

    2012-01-01

    The function of modern new nuclear instrument is very much. And the information degree is high requested. Through close matching for host computer and client computer, the data processing function can be carried out. This article puts forward a few of projects for the client computer of general nuclear instrument. The function and features of several common client computers, such as FPGA, ARM and DSP, are analyzed and compared. The applied scope is discussed also. At the same time, using a practical design as an example, the selection ideas of client computer are described. This article can be used for reference for the hardware design of data acquisition processing unit in nuclear instrument. (authors)

  12. Security Injections 2.0: Increasing Engagement and Faculty Adoption Using Enhanced Secure Coding Modules for Lower-Level Programming Courses

    OpenAIRE

    Raina , Sagar; Taylor , Blair; Kaza , Siddharth

    2015-01-01

    Part 2: Software Security Education; International audience; Learning interventions based on modules are common in computer science education. Traditional learning modules that present a large amount of content in a linear format can lead to students skimming and skipping content resulting in lower student engagement and effectiveness. In this paper, we present theoretical support for increasing engagement and effectiveness of learning modules, describe a system that implements these principl...

  13. Patient Engagement: The Key to Redesign the Exchange Between the Demand and Supply for Healthcare in the Era of Active Ageing.

    Science.gov (United States)

    Graffigna, Guendalina; Barello, Serena; Riva, Giuseppe; Bosio, A Claudio

    2014-01-01

    The last decades' changes in the epidemiological trends of chronic disease - also due to the ageing population - and the increased length and quality of life among the majority of Western population have introduced important changes in the organization and management of the healthcare systems. Consequently, health systems throughout the world are searching for new and effective ways to make their services more responsive to new patients and the public's health needs and demands. The idea of patient engagement - borrowed from the marketing conceptualization of consumer engagement - moves from the assumption that making patients/clients co-producers of their health can enhance their satisfaction with the healthcare system as well as their responsibility in both care and prevention by improving clinical outcomes and reducing health delivery costs. To make people aware of their health services options by supporting them in the decision-making process and to engage them in enacting preventive and healthy behaviors is vital for achieving successful health outcomes and preventing waste of resources. In this chapter, we outline a model (PHE model) that explains the patients' subjective experience with their health management process and the levers that may enact the passage from one phase of the process to the other. Based on this conceptual model of patient engagement will be proposed a tool kit of priority actions that may sustain the patient in its process of engagement.

  14. The effect of human engagement depicted in contextual photographs on the visual attention patterns of adults with traumatic brain injury.

    Science.gov (United States)

    Thiessen, Amber; Brown, Jessica; Beukelman, David; Hux, Karen

    2017-09-01

    Photographs are a frequently employed tool for the rehabilitation of adults with traumatic brain injury (TBI). Speech-language pathologists (SLPs) working with these individuals must select photos that are easily identifiable and meaningful to their clients. In this investigation, we examined the visual attention response to camera- (i.e., depicted human figure looking toward camera) and task-engaged (i.e., depicted human figure looking at and touching an object) contextual photographs for a group of adults with TBI and a group of adults without neurological conditions. Eye-tracking technology served to accurately and objectively measure visual fixations. Although differences were hypothesized given the cognitive deficits associated with TBI, study results revealed little difference in the visual fixation patterns of adults with and without TBI. Specifically, both groups of participants tended to fixate rapidly on the depicted human figure and fixate more on objects in which a human figure was task-engaged than when a human figure was camera-engaged. These results indicate that strategic placement of human figures in a contextual photograph may modify the way in which individuals with TBI visually attend to and interpret photographs. In addition, task-engagement appears to have a guiding effect on visual attention that may be of benefit to SLPs hoping to select more effective contextual photographs for their clients with TBI. Finally, the limited differences in visual attention patterns between individuals with TBI and their age and gender matched peers without neurological impairments indicates that these two groups find similar photograph regions to be worthy of visual fixation. Readers will gain knowledge regarding the photograph selection process for individuals with TBI. In addition, readers will be able to identify camera- and task-engaged photographs and to explain why task-engagement may be a beneficial component of contextual photographs. Copyright © 2017

  15. 45 CFR 1609.5 - Acceptance of reimbursement from a client.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Acceptance of reimbursement from a client. 1609.5... CORPORATION FEE-GENERATING CASES § 1609.5 Acceptance of reimbursement from a client. (a) When a case results in recovery of damages or statutory benefits, a recipient may accept reimbursement from the client...

  16. Corruption of Client Advocacy in a Community Mental Health System.

    Science.gov (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…

  17. Changing the Context of Student Engagement: Using Facebook to Increase Community College Student Persistence and Success

    Science.gov (United States)

    Fagioli, Loris; Rios-Aguilar, Cecilia; Deil-Amen, Regina

    2015-01-01

    Background: Community college leaders are now turning to social media/social networking sites for new avenues and opportunities to increase students' interaction, engagement, and collaboration with peers, faculty, and staff. Social media may be a particularly attractive option because it can provide a potentially effective and exciting mechanism…

  18. Geophysicists' views about public engagement

    Science.gov (United States)

    Besley, J. C.; Dudo, A.; Yuan, S.

    2016-12-01

    The proposed talk would present the results of 2016 survey of American Geophysical Union members (n = 2040) about public engagement. This survey took place as part of a broader, NSF funded, study of engagement views across eight different U.S.-based scientific societies. The presentation would include data about geophysicists' past engagement behavior and willingness to engage alongside data about engagement attitudes, perceived norms (i.e. beliefs about whether peers engage and value engagement), and perceived efficacy (i.e., scientists' beliefs about their own communication skills and the impact of engagement). The presentation would also include results that describe scientists' overall goals for engagement (e.g., increasing support for specific policy positions, changing citizen behavior, etc.), as well as their communication-specific objectives (e.g., increasing knowledge, increase excitement, etc.). All of the results would be put in the context of equivalent results from scientists from seven other societies across a variety of fields, including chemistry, biology, and the social sciences. Three themes that would be emphasized in the presentation include (1) the fact that there are substantial commonalities in engagement views across scientific fields, (2) the important role that perceived engagement skill (efficacy) appears to play in predicting engagement willingness, and (3) a lack of evidence that scientists are thinking about engagement in strategic ways. Strategic engagement, in this regard, would involve setting clear goals and then choosing activities that the social science of science communication suggests might allow one to achieve those goals. The presentation would conclude with thoughts about what might be done to improve the effectiveness of science communication training.

  19. Understanding the usage of the Helioviewer Project clients and services

    Science.gov (United States)

    Ireland, J.; Zahniy, S.; Mueller, D.; Nicula, B.; Verstringe, F.; Bourgoignie, B.; Buchlin, E.; Alingery, P.

    2017-12-01

    The Helioviewer Project enables visual exploration of the Sun and the inner heliosphere for everyone, everywhere via intuitive interfaces and novel technology. The project mainly develops two clients, helioviewer.org and JHelioviewer, and the server-side capabilities accessed via those clients. Images from many different ground and space-based sources are currently available from multiple servers. Solar and heliospheric feature and event information, magnetic field extrapolations and important time-series can also be browsed and visualized using Helioviewer Project clients. Users of the Helioviewer Project have made over two million movies and many millions of screenshots since detailed (and anonymous) logging of Helioviewer Project usage was implemented in February 2011. These usage logs are analyzed to give a detailed breakdown on user interaction with solar and heliospheric data via Helioviewer Project clients and services. We present summary statistics on how our users are using our clients and services, which data they are interested in, and how they choose to interact with different data sources. At the poster presentation we will also be soliciting ideas from the community to improve our clients and services.

  20. Towards Increased Engagement of Geoscientists in Global Development Frameworks

    Science.gov (United States)

    Gill, Joel

    2016-04-01

    Geoscientists have the potential to make a significant contribution to tackling some of the major socio-environmental challenges of today, including extreme poverty, sustainable development, disaster risk reduction and climate change. This presentation explores the importance and social responsibility of geoscientists to engage in such work through understanding and supporting key global development frameworks. During 2015 the international community agreed three important agendas for change. Each framework relates to the intersection of environmental processes with human activities and behaviours, addressing significant challenges affecting society. The frameworks are (i) the UN Global Goals for Sustainable Development, (ii) the Sendai Framework for Disaster Risk Reduction 2015-2030, and (iii) subject to final confirmation at the time of writing, an agreement on climate change at the Paris Conference of the Parties - COP21. The UN Global Goals for Sustainable Development, for example, includes 17 goals aiming to end extreme poverty, fight inequality and ensure environmental sustainability. Specific goals relate to clean water and sanitation, clean and affordable energy, the development of resilient infrastructure, and the need for climate action. Given this context, here (i) a synthesis is presented of the role of geoscience in successfully achieving these major global development frameworks agreed in 2015, (ii) the ethical and social understanding that underpins effective engagement by geoscientists in the science-policy-practice interface is discussed, and (iii) this required ethical understanding is placed into the context of geoscience training and development needs. This approach demonstrates the importance of geoscientists from across all sectors and specialisms, engaging in the implementation, monitoring and evaluation of global development frameworks. It highlights the importance of a greater awareness and consideration of our ethical responsibilities in

  1. A client-centred, occupation-based occupational therapy programme for adults with psychiatric diagnoses.

    Science.gov (United States)

    Schindler, Victoria P

    2010-09-01

    The purpose of this study was to assess the effectiveness of a client-centred, occupation-based occupational therapy programme for individuals with psychiatric diagnoses. The study took place in a college campus. A pre-test/post-test design was used. There were 38 participants which included college students and community members who desired to attend college, work and/or address life skill goals. The Canadian Occupational Performance Measure (COPM) was used as a pre- and post-test measure. Goals were based on problems identified in the COPM, reflected academic, vocational, life skill, and leisure goals, and were systematically addressed weekly through activities developed by the participant and a graduate occupational therapy student who acted as a mentor. The Participant Overall Satisfaction Scale was completed by each participant. A case study was used to describe the programme in more depth. The results support that the client-centred, occupation-based occupational therapy programme increased client scores on satisfaction and performance of occupational performance problems identified on the COPM. Further research is recommended to explore how client-centred occupational therapy programmes can be effective in improving academic, vocational and life skill goals. Copyright 2010 John Wiley & Sons, Ltd.

  2. Design and Implementation of High Interaction Client Honeypot for Drive-by-Download Attacks

    Science.gov (United States)

    Akiyama, Mitsuaki; Iwamura, Makoto; Kawakoya, Yuhei; Aoki, Kazufumi; Itoh, Mitsutaka

    Nowadays, the number of web-browser targeted attacks that lead users to adversaries' web sites and exploit web browser vulnerabilities is increasing, and a clarification of their methods and countermeasures is urgently needed. In this paper, we introduce the design and implementation of a new client honeypot for drive-by-download attacks that has the capacity to detect and investigate a variety of malicious web sites. On the basis of the problems of existing client honeypots, we enumerate the requirements of a client honeypot: 1) detection accuracy and variety, 2) collection variety, 3) performance efficiency, and 4) safety and stability. We improve our system with regard to these requirements. The key features of our developed system are stepwise detection focusing on exploit phases, multiple crawler processing, tracking of malware distribution networks, and malware infection prevention. Our evaluation of our developed system in a laboratory experiment and field experiment indicated that its detection variety and crawling performance are higher than those of existing client honeypots. In addition, our system is able to collect information for countermeasures and is secure and stable for continuous operation. We conclude that our system can investigate malicious web sites comprehensively and support countermeasures.

  3. Psychotherapy for Suicidal Clients.

    Science.gov (United States)

    Lester, David

    1994-01-01

    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)

  4. 17 CFR 275.206(3)-2 - Agency cross transactions for advisory clients.

    Science.gov (United States)

    2010-04-01

    ... advisory clients. 275.206(3)-2 Section 275.206(3)-2 Commodity and Securities Exchanges SECURITIES AND... Agency cross transactions for advisory clients. (a) An investment adviser, or a person registered as a... advisory client, if: (1) The advisory client has executed a written consent prospectively authorizing the...

  5. Care requirements for clients who present after rape and clients who presented after consensual sex as a minor at a clinic in Harare, Zimbabwe, from 2011 to 2014.

    Directory of Open Access Journals (Sweden)

    Rebecca E Harrison

    - 132 (23% vs 241 (15% p<0.001; less likely to request a termination of pregnancy if pregnant-10 (8% vs 74 (31% p<0.001; and less likely to come for at least one follow up 281 (47% vs 1304 (58% p<0.001.The experiences of those who consent to sex as a minor and those that have experienced forced sex were very different. The standardised SGBV medical response does not fully meet the needs to protect minors who have consented to sex from HIV or unwanted pregnancies. Clients who present for having consented to sex as a minor might benefit more from being offered long-term family planning or being assessed as a sero-discordant couple rather than simply PEP and ECP as is relevant for clients who have been raped. More provision of health care is needed for minors to ensure they have access to enough information and protection from HIV, other STIs and unwanted pregnancy, before they decide to engage in sexual intercourse, rather than as an emergency at an SGBV clinic.

  6. 37 CFR 10.57 - Preservation of confidences and secrets of a client.

    Science.gov (United States)

    2010-07-01

    ... and secrets of a client. 10.57 Section 10.57 Patents, Trademarks, and Copyrights UNITED STATES PATENT... confidences and secrets of a client. (a) “Confidence” refers to information protected by the attorney-client or agent-client privilege under applicable law. “Secret” refers to other information gained in the...

  7. Weight and body mass index among female contraceptive clients.

    Science.gov (United States)

    Kohn, Julia E; Lopez, Priscilla M; Simons, Hannah R

    2015-06-01

    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.

  8. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV

    Science.gov (United States)

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S.; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J. Craig; Brion, John M.; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2014-01-01

    The engagement of patients with their health care providers (HCP) improves patients’ quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client’s choices, and management of client concerns. This study compares country-level differences in patients’ engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p < 0.001) and that PLHIV in China had the least engagement (OR −7.03, p < 0.0001) compared to the PLHIV in the Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = −5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = −3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL. PMID:24575329

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

    OpenAIRE

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

    2011-01-01

    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. 37 CFR 10.112 - Preserving identity of funds and property of client.

    Science.gov (United States)

    2010-07-01

    ... and property of client. 10.112 Section 10.112 Patents, Trademarks, and Copyrights UNITED STATES PATENT... funds and property of client. (a) All funds of clients paid to a practitioner or a practitioner's firm... therein. (2) Funds belonging in part to a client and in part presently or potentially to the practitioner...

  11. 49 CFR 1103.19 - Advising upon the merits of a client's cause.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Advising upon the merits of a client's cause. 1103... Practitioner's Duties and Responsibilities Toward A Client § 1103.19 Advising upon the merits of a client's cause. A practitioner shall try to obtain full knowledge of his client's cause before advising thereon...

  12. Student Engagement in Assessments: What Students and Teachers Find Engaging

    Science.gov (United States)

    Bae, Soung; Kokka, Kari

    2016-01-01

    Although research has shown that student engagement is strongly related to performance on assessment tasks, especially for traditionally underserved subgroups of students, increasing student engagement has not been the goal of standardized tests of content knowledge. Recent state and federal policies, however, are changing the assessment…

  13. Improving client-centred care and services: the role of front/back-office configurations.

    Science.gov (United States)

    Broekhuis, Manda; de Blok, Carolien; Meijboom, Bert

    2009-05-01

    This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases. Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006). The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency. The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.

  14. Is a Transdisciplinary Theory of Engagement in Organized Settings Possible? A Concept Analysis of the Literature on Employee Engagement, Consumer Engagement and Patient Engagement.

    Science.gov (United States)

    Graffigna, Guendalina

    2017-01-01

    Organizations are experiencing increased competition, disruptive innovation, and continuous changes in their social and economic context. Furthermore, the decrease of resources (economic and human) in such a demanding context make it imperative for organizations to find new models and strategies to make their service delivery more sustainable at the economic, environmental and psychological levels. In such a complex scenario the concept of engagement of the individuals involved in organized settings (either as service providers or as final receivers) is a promising lever for innovation. However, despite the number of studies on the matter, the debate on engagement is still very fragmented because the corpus of literature addressing the different areas of engagement is divided and diverse in its nature. In this paper, we discuss the results of a conceptual analysis of the literature conducted in order to investigate overlapping features and areas of divergence among three different areas of investigation and application of the engagement phenomenon in organized settings: the domains of employee engagement, consumer engagement, and patient engagement. These are deliberately selected as prototypical of the phenomenon of engagement along the "inside/outside" of organizational settings. The analysis consisted in a qualitative conceptual survey? Of the scholarly literature indexed with the key terms "employee engagement," "consumer engagement," and "patient engagement." We performed a key-word based survey? Of the literature in the Scopus database. A total of 163 articles were selected and analyzed. The analysis cast light on the following areas of conceptual overlap among employee, consumer and patient engagement: (1) engagement is different from empowerment and activation; (2) engagement is a multi-componential psychological experience; (3) engagement is a self-transformative experience; (4) engagement develops within a relational context; (5) engagement is a systemic

  15. Is a Transdisciplinary Theory of Engagement in Organized Settings Possible? A Concept Analysis of the Literature on Employee Engagement, Consumer Engagement and Patient Engagement

    Directory of Open Access Journals (Sweden)

    Guendalina Graffigna

    2017-07-01

    Full Text Available Organizations are experiencing increased competition, disruptive innovation, and continuous changes in their social and economic context. Furthermore, the decrease of resources (economic and human in such a demanding context make it imperative for organizations to find new models and strategies to make their service delivery more sustainable at the economic, environmental and psychological levels. In such a complex scenario the concept of engagement of the individuals involved in organized settings (either as service providers or as final receivers is a promising lever for innovation. However, despite the number of studies on the matter, the debate on engagement is still very fragmented because the corpus of literature addressing the different areas of engagement is divided and diverse in its nature. In this paper, we discuss the results of a conceptual analysis of the literature conducted in order to investigate overlapping features and areas of divergence among three different areas of investigation and application of the engagement phenomenon in organized settings: the domains of employee engagement, consumer engagement, and patient engagement. These are deliberately selected as prototypical of the phenomenon of engagement along the “inside/outside” of organizational settings. The analysis consisted in a qualitative conceptual survey? Of the scholarly literature indexed with the key terms “employee engagement,” “consumer engagement,” and “patient engagement.” We performed a key-word based survey? Of the literature in the Scopus database. A total of 163 articles were selected and analyzed. The analysis cast light on the following areas of conceptual overlap among employee, consumer and patient engagement: (1 engagement is different from empowerment and activation; (2 engagement is a multi-componential psychological experience; (3 engagement is a self-transformative experience; (4 engagement develops within a relational context

  16. Meeting the Needs of Clients with Dissociative Identity Disorder: Considerations for Psychotherapy

    Science.gov (United States)

    Ringrose, Jo L.

    2011-01-01

    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…

  17. Designing for user engagement

    CERN Document Server

    Geisler, Cheryl

    2013-01-01

    Designing for User Engagement on the Web: 10 Basic Principles is concerned with making user experience engaging. The cascade of social web applications we are now familiar with - blogs, consumer reviews, wikis, and social networking - are all engaging experiences. But engagement is an increasingly common goal in business and productivity environments as well. This book provides a foundation for all those seeking to design engaging user experiences rich in communication and interaction. Combining a handbook on basic principles with case studies, it provides readers with a ric

  18. Developing Pluralistic Practice in Counselling and Psychotherapy: Using What the Client Knows

    Directory of Open Access Journals (Sweden)

    John McLeod

    2013-03-01

    Full Text Available The concept of pluralism is increasingly used to indicate the rich diversity of theory and practice in the field of counselling and psychotherapy. A version of pluralism is described that takes account of the range of ideas about health and healing that exist within contemporary culture, and the expression of these positions in the personal knowledge and preferences held by clients in respect of different therapy formats and techniques. A review of recent research is used to provide a basis for discussion of some of the practical manifestations of client knowledge, and the ways in which practitioners can work with these factors.

  19. Fidelização de clientes na web: como conhecer e fidelizar clientes por meio da internet

    OpenAIRE

    Benossi, Claudio

    2010-01-01

    A dissertação intitulada Fidelização de Clientes na WEB: Como conhecer e fidelizar clientes através da Internet do Mestrado em Tecnologias da Inteligência e Design Digital (TIDD) tem como objetivo analisar a contribuição da tecnologia da informação para o marketing de relacionamento, incrementando a competitividade empresarial. O atual ambiente globalizado implica numa era de concorrência e competição, resultado da desintegração de fronteiras e da abertura de mercados anteriormente protegidos...

  20. Healing Relationships: A Qualitative Study of Healers and Their Clients in Germany

    Directory of Open Access Journals (Sweden)

    B. M. H. Stöckigt

    2015-01-01

    Full Text Available Background. The aim of this study was to investigate the nature of the relationships between healers and their clients in Germany. Methods. An interdisciplinary research team performed semistructured interviews with healers and clients and participatory observation of healing sessions. All interviews were digitally recorded, transcribed, and analyzed using content analysis. Results. Fifteen healers and sixteen clients were included. The healer-client relationship was described as a profound and unique experience, which brought forth interpersonal and spiritual connections. The healers were seen as role models for healing to occur and support for being connected spiritually. The clients had to be open-minded and responsible. The importance of the healers’ empathy was emphasized. Discussion. The relationship between healer and client can be seen as a triangular connection between client, healer, and a transcendent source which is not the case in typical patient-doctor relationships. The spiritual connection is also said to enhance the empathetic understanding of the healer. The personality and a partner-like attitude of the healer supported the client in giving a more positive meaning to his life, in reconnecting to his spirituality, and in taking responsibility. Future studies should address the role of spirituality in health care and the development of enduring healer-client relationships.

  1. Efficient Mobile Client Caching Supporting Transaction Semantics

    Directory of Open Access Journals (Sweden)

    IlYoung Chung

    2000-05-01

    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.

  2. La clientèle de l’architecte Barry Dierks sur la Côte d’Azur

    Directory of Open Access Journals (Sweden)

    François Fray

    2012-05-01

    Full Text Available Architecte américain formé au Carnegie Institute of Technology de Pittsburgh, Barry Dierks (1899-1960 a passé toute sa carrière sur la Côte d’Azur à partir de 1925. Il y construisit la maison qui devait être sa résidence, son agence et sa vitrine. Il a su, avec son ami anglais Eric Sawyer, capter l’intérêt d’une clientèle internationale, exigeante, cultivée et informée, venue chercher sur cette côte à la fois le dépaysement et des résonances à sa propre culture, mais pas forcément des réalisations d’avant-garde. Barry Dierks a su y répondre et se muer en architecte à la fois moderne et méditerranéen en se coulant sans se renier dans les desiderata de ses clients. La Seconde Guerre mondiale a interrompu ses activités. Mais ses actions humanitaires et leur engagement pendant cette période leur valut à tous deux respect et reconnaissance. Une centaine de chantiers ont pu être identifiés, grandes et petites maisons, pavillons de bain et même un bowling privé.

  3. Counseling Older Japanese American Clients: An Overview and Observations.

    Science.gov (United States)

    Itai, Goro; McRae, Cynthia

    1994-01-01

    Discusses important aspects of providing counseling to older Japanese American clients, including ethical issues based on cultural differences and nontraditional approaches to counseling. Examines unique historical and cultural characteristics of these clients. Includes 26 citations. (Author/CRR)

  4. Visualization Software for VisIT Java Client

    Energy Technology Data Exchange (ETDEWEB)

    2017-01-01

    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.

  5. 75 FR 66050 - Permissible Sharing of Client Records by Customs Brokers

    Science.gov (United States)

    2010-10-27

    .... USCBP-2010-0038] RIN 1651-AA80 Permissible Sharing of Client Records by Customs Brokers AGENCIES... the Code of Federal Regulations (CFR) pertaining to the obligations of customs brokers to keep clients' information confidential. The proposed amendment would allow brokers, upon the client's consent in a written...

  6. Difficult Clients: Who Are They and How Do We Help Them?

    Science.gov (United States)

    Seligman, Linda; Gaaserud, Lynn

    1994-01-01

    Reviewed literature on dealing with resistant clients and, based on review, developed survey to elicit counselors' reactions to and experiences with resistant clients. Responses from 215 American Mental Health Counselors Association members suggest that nearly all counselors have encountered resistant clients, but counselors' reactions to and…

  7. A Client-Centered Review of Rogers with Gloria

    Science.gov (United States)

    Moon, Kathryn A.

    2007-01-01

    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.…

  8. Client Views of TESOL Service: Expectations and Perceptions.

    Science.gov (United States)

    Walker, John

    2001-01-01

    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,…

  9. Propuesta metodológica para la gestión del cliente

    Directory of Open Access Journals (Sweden)

    Luis Ignacio López Villegas

    2016-03-01

    Full Text Available La investigación tuvo como objetivo diseñar una propuesta metodológica para la fidelización del cliente bancario. Situando al cliente como la razón de ser de su negocio, aportando a dicha entidad bancaria una visión más amplia del valor de sus clientes y un punto de partida para el diseño de acciones o estrategias realmente efectivas a la hora de gestionar en torno a éstos. La metodología se aplicó considerando clientes externos; mediante técnicas estadísticas aleatorias se les aplicó un instrumento —encuesta— validada previamente mediante prueba piloto, y a los clientes internos —funcionarios del banco— se les aplicó una entrevista, dando como resultado una propuesta metodológica de intervención hacia el cumplimiento del objetivo: incrementar la rentabilidad mediante la fidelización de clientes.

  10. assessment of clients' satisfaction with health service deliveries at ...

    African Journals Online (AJOL)

    Abrham

    Hence, the objective of this study was to assess the perceived levels of clients' ... doctor. Furthermore, satisfaction with the health care was found to have a significant association with the age ... those client values and expectations, which are.

  11. Migration to Current Open Source Technologies by MagIC Enables a More Responsive Website, Quicker Development Times, and Increased Community Engagement

    Science.gov (United States)

    Jarboe, N.; Minnett, R.; Koppers, A.; Constable, C.; Tauxe, L.; Jonestrask, L.

    2017-12-01

    The Magnetics Information Consortium (MagIC) supports an online database for the paleo, geo, and rock magnetic communities ( https://earthref.org/MagIC ). Researchers can upload data into the archive and download data as selected with a sophisticated search system. MagIC has completed the transition from an Oracle backed, Perl based, server oriented website to an ElasticSearch backed, Meteor based thick client website technology stack. Using JavaScript on both the sever and the client enables increased code reuse and allows easy offloading many computational operations to the client for faster response. On-the-fly data validation, column header suggestion, and spreadsheet online editing are some new features available with the new system. The 3.0 data model, method codes, and vocabulary lists can be browsed via the MagIC website and more easily updated. Source code for MagIC is publicly available on GitHub ( https://github.com/earthref/MagIC ). The MagIC file format is natively compatible with the PmagPy ( https://github.com/PmagPy/PmagPy) paleomagnetic analysis software. MagIC files can now be downloaded from the database and viewed and interpreted in the PmagPy GUI based tool, pmag_gui. Changes or interpretations of the data can then be saved by pmag_gui in the MagIC 3.0 data format and easily uploaded to the MagIC database. The rate of new contributions to the database has been increasing with many labs contributing measurement level data for the first time in the last year. Over a dozen file format conversion scripts are available for translating non-MagIC measurement data files into the MagIC format for easy uploading. We will continue to work with more labs until the whole community has a manageable workflow for contributing their measurement level data. MagIC will continue to provide a global repository for archiving and retrieving paleomagnetic and rock magnetic data and, with the new system in place, be able to more quickly respond to the community

  12. Clients' experiences of a community based lifestyle modification program: a qualitative study.

    Science.gov (United States)

    Chan, Ruth S M; Lok, Kris Y W; Sea, Mandy M M; Woo, Jean

    2009-10-01

    There is little information about how clients attending lifestyle modification programs view the outcomes. This qualitative study examined the clients' experience of a community based lifestyle modification program in Hong Kong. Semi-structured interviews were conducted with 25 clients attending the program. Clients perceived the program had positive impacts on their health and nutrition knowledge. They experienced frustration, negative emotion, lack of motivation, and pressure from others during the program. Working environment and lack of healthy food choices in restaurants were the major perceived environmental barriers for lifestyle modification. Clients valued nutritionists' capability of providing professional information and psychological support in the program. Our results suggest that nutritionist's capability of providing quality consultations and patient-centered care are important for empowering clients achieve lifestyle modification.

  13. Teacher Narratives and Student Engagement: Testing Narrative Engagement Theory in Drug Prevention Education

    Science.gov (United States)

    Miller-Day, Michelle; Hecht, Michael L.; Krieger, Janice L.; Pettigrew, Jonathan; Shin, YoungJu; Graham, John

    2015-01-01

    Testing narrative engagement theory, this study examines student engagement and teachers’ spontaneous narratives told in a narrative-based drug prevention curriculum. The study describes the extent to which teachers share their own narratives in a narrative-based curriculum, identifies dominant narrative elements, forms and functions, and assesses the relationships among teacher narratives, overall lesson narrative quality, and student engagement. One hundred videotaped lessons of the keepin’ it REAL drug prevention curriculum were coded and the results supported the claim that increased narrative quality of a prevention lesson would be associated with increased student engagement. The quality of narrativity, however, varied widely. Implications of these results for narrative-based prevention interventions and narrative pedagogy are discussed. PMID:26690668

  14. Physical Attractiveness: Interactive Effects of Counselor and Client on Counseling Processes.

    Science.gov (United States)

    Vargas, Alice M.; Borkowski, John G.

    1983-01-01

    Assessed how the physical attractiveness of counselors and clients interacted to build rapport in two experiments involving college students (N=128 and N=64). Results showed the counselor's physical attractiveness had a major impact on her perceived effectiveness and the client's expectation of success irrespective of the client's attractiveness…

  15. Clients' perception of service quality of care in health facilities in ...

    African Journals Online (AJOL)

    Introduction: Clients perception of service quality is important for utilization of health services. Clients with positive perception are more likely to comply with treatment and to continue to use health care services. Assessing clients' perception of services offered is crucial for improving delivery and organization of the services.

  16. 17 CFR 275.206(4)-3 - Cash payments for client solicitations.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Cash payments for client... for client solicitations. (a) It shall be unlawful for any investment adviser required to be... client at the time of the solicitation or referral; or (iii) Other than a solicitor specified in...

  17. Speaking for the Client

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna; Silverman, D.

    . Nonetheless staff often assume that their clients were at the centre of the encounter, even when there is little indication that they understand the Danish language spoken. In order to analyze and explain dilemmas like these, we draw on symbolic interactionism and conversation analysis, placing linguistic...

  18. Subjective Experiences of Clients in a Voluntary Money Management Program.

    Science.gov (United States)

    Serowik, Kristin L; Bellamy, Chyrell D; Rowe, Michael; Rosen, Marc I

    2013-01-01

    A large proportion of people diagnosed with mental illnesses have difficulty managing their money, and therefore many psychiatric treatments involve providing money management assistance. However, little is known about the subjective experience of having a money manager, and extant literature is restricted to people forced to work with a representative payee or conservator. In this study, fifteen people were interviewed about their experience receiving a voluntary money management intervention designed to minimize substance use. Clients emphasized the importance of trusting the money manager, financial mindfulness (an enhanced awareness of the financial transactions in clients' day-to-day lives), agency over their own affairs, and addiction. In contrast to evaluations of people assigned representative payees and/or conservators, there was little mention of feeling coerced. These findings suggest that money management programs can address client concerns by building trust, relating budgeting to clients' day-to-day lives, and encouraging clients' control over their own affairs.

  19. Social networks and links to isolation and loneliness among elderly HCBS clients.

    Science.gov (United States)

    Medvene, Louis J; Nilsen, Kari M; Smith, Rachel; Ofei-Dodoo, Samuel; DiLollo, Anthony; Webster, Noah; Graham, Annette; Nance, Anita

    2016-01-01

    The purpose of this study was to explore the network types of HCBS clients based on the structural characteristics of their social networks. We also examined how the network types were associated with social isolation, relationship quality and loneliness. Forty personal interviews were carried out with HCBS clients to assess the structure of their social networks as indicated by frequency of contact with children, friends, family and participation in religious and community organizations. Hierarchical cluster analysis was conducted to identify network types. Four network types were found including: family (n = 16), diverse (n = 8), restricted (n = 8) and religious (n = 7). Family members comprised almost half of participants' social networks, and friends comprised less than one-third. Clients embedded in family, diverse and religious networks had significantly more positive relationships than clients embedded in restricted networks. Clients embedded in restricted networks had significantly higher social isolation scores and were lonelier than clients in diverse and family networks. The findings suggest that HCBS clients' isolation and loneliness are linked to the types of social networks in which they are embedded. The findings also suggest that clients embedded in restricted networks are at high risk for negative outcomes.

  20. Patient-Therapist Value Congruence and Ratings of Client Improvement

    Science.gov (United States)

    Martini, Janie L.

    1978-01-01

    It can be concluded from the results of the two studies described here that value similarity between client and therapist is related to therapists' ratings of client improvement. This phenomenon can be expected in therapies irrespective of theoretical orientation. (Author)

  1. Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

    Science.gov (United States)

    Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

    2017-12-14

    This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

  2. Tweets from the forest: using Twitter to increase student engagement in an undergraduate field biology course

    Science.gov (United States)

    Soluk, Lauren; Buddle, Christopher M.

    2015-01-01

    Twitter is a cold medium that allows users to deliver content-rich but small packets of information to other users, and provides an opportunity for active and collaborative communication. In an education setting, this social media tool has potential to increase active learning opportunities, and increase student engagement with course content. The effects of Twitter on learning dynamics was tested in a field biology course offered by a large Canadian University: 29 students agreed to take part in the Twitter project and quantitative and qualitative data were collected, including survey data from 18 students. Students published 200% more public Tweets than what was required, and interacted frequently with the instructor and teaching assistant, their peers, and users external to the course. Almost 80% of students stated that Twitter increased opportunities for among-group communication, and 94% of students felt this kind of collaborative communication was beneficial to their learning. Although students did not think they would use Twitter after the course was over, 77% of the students still felt it was a good learning tool, and 67% of students felt Twitter had a positive impact on how they engaged with course content. These results suggest social media tools such as Twitter can help achieve active and collaborative learning in higher education. PMID:26594328

  3. Tweets from the forest: using Twitter to increase student engagement in an undergraduate field biology course.

    Science.gov (United States)

    Soluk, Lauren; Buddle, Christopher M

    2015-01-01

    Twitter is a cold medium that allows users to deliver content-rich but small packets of information to other users, and provides an opportunity for active and collaborative communication. In an education setting, this social media tool has potential to increase active learning opportunities, and increase student engagement with course content. The effects of Twitter on learning dynamics was tested in a field biology course offered by a large Canadian University: 29 students agreed to take part in the Twitter project and quantitative and qualitative data were collected, including survey data from 18 students. Students published 200% more public Tweets than what was required, and interacted frequently with the instructor and teaching assistant, their peers, and users external to the course. Almost 80% of students stated that Twitter increased opportunities for among-group communication, and 94% of students felt this kind of collaborative communication was beneficial to their learning. Although students did not think they would use Twitter after the course was over, 77% of the students still felt it was a good learning tool, and 67% of students felt Twitter had a positive impact on how they engaged with course content. These results suggest social media tools such as Twitter can help achieve active and collaborative learning in higher education.

  4. Client Centeredness and Health Reform: Key Issues for Occupational Therapy

    Science.gov (United States)

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

    2015-01-01

    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

  5. Using Assistive Technology to Increase Vocabulary Acquisition and Engagement for Students with Learning Disabilities in the High School Science Classroom

    Science.gov (United States)

    Slemrod, Tal

    There is a growing recognition of the importance and effectiveness of instruction in the STEM subjects, including science. The movement towards increased requirements and expectations in science presents a challenge to both students and teachers as many students with Learning Disabilities (LD) often particularly struggle in their science classes. The purpose of this study was to investigate the use of an assistive technology (AT) intervention targeting the acquisition of science vocabulary for adolescents with LD in a general education secondary biology classroom. Participants for this study included 3 secondary students with LD who were enrolled in a biology class. An alternating treatment design was used to compare the effects of a keyword mnemonic vocabulary intervention via index cards or iPod touch on student, vocabulary acquisition, academic engagement and disruptive behavior. All students' acquired the content vocabulary equally well during both conditions. When using the AT, students' engagement increased compared to baseline conditions. It was clear that the students had a strong interest in using AT to increase their grades and engagement, however the teachers had little access and training on using AT to support their students with disabilities.

  6. A pilot study of an electronic interprofessional evidence-based care planning tool for clients with mental health problems and addictions.

    Science.gov (United States)

    Doran, Diane; Paterson, Jane; Clark, Carrie; Srivastava, Rani; Goering, Paula N; Kushniruk, André W; Bajnok, Irmajean; Nagle, Lynn; Almost, Joan; Carryer, Jennifer

    2010-09-01

    The health system must develop effective solutions to the growing challenges it faces with respect to individuals who suffer with mental health disorders and addictions. The purpose of this study was to evaluate the usability and potential impact on outcomes of a knowledge translation system aimed at improving client-centered, evidence-based care for hospitalized individuals with schizophrenia. A pre-posttest design was used. The e-Volution-TREAT system was implemented on two inpatient units at a large mental health facility. Thirty-seven nurses, allied health workers, and physicians participated from two units. Data collection involved questionnaires, semistructured interviews, and observations. Thirty-eight consenting clients' outcome data were collected from organizational records. Overall, staff participants were very satisfied with the functions of the e-Volution-TREAT system. Barriers to using the system were identified by participants related to the work environment, to understaffing, equipment problems, discomfort with technology, and a focus on short-term rather than long-term goals. There was moderate uptake of guidelines related to social issues, and low uptake of guidelines related to family support and addictions. There were significant improvements in four client outcomes over time, specifically aggressive behavior, depression, withdrawal, and psychosis. In conclusion, users were overall satisfied with the e-Volution-TREAT system, although expressed challenges related to workload that interfered with time to utilize the system. It would be premature to conclude the change in client outcomes was related to the e-Volution-TREAT system without a randomized controlled trial with outcomes compared to a control group. Future research needs to incorporate strategies for modifying the context and engage clinicians who are in a position of influence to model change.

  7. El servicio al cliente: una necesidad imperante en la calidad de la industria. // The client service: a prevailing necessity in the quality of the industry.

    Directory of Open Access Journals (Sweden)

    E. Martínez Delgado

    2006-05-01

    Full Text Available A través de todos los sectores industriales la investigación por la excelencia en el servicio se ha convertido en unapreocupación creciente y los gerentes han reconocido que la ventaja sustancial competitiva puede ganarse a través de unservicio superior al cliente, e igualmente importante, el servicio al cliente se convierte en un medio poderoso de diferenciarlas compañías desde la competencia. La calidad equivale entonces no sólo al producto en sí mismo, sino combinado éstecon lo que le rodea; de hecho, en las normas ISO 9000: 2000 se define al producto como el resultado de un proceso,siendo los servicios una de las cuatro categorías genéricas de éste. Cada vez más se demanda la garantía de la capacidad deproducir establemente una calidad superior y de innovación del producto acorde con los deseos de los clientes; pasándosede la certificación del producto a la certificación de toda la cadena logística, debiendo brindarse servicios de alto valoragregado a los clientes en forma diferenciada. Así, en el mercado globalizado donde sólo es posible ubicar productos dealta calidad para satisfacer a los clientes y al mercado, lo primero que debe hacer el gerente de servicios es comprender lascalidades demandadas por los clientes, así como la información relacionada con la importancia relativa de lascaracterísticas de calidad.El presente trabajo expone los resultados favorables obtenidos en el sistema de producción-distribución a través de unmodelo conformado para la evaluación integral del desempeño de la organización. Éste considera al cliente, con suscriterios y preferencias, como un elemento clave en la planeación de la producción y en la proyección de las capacidadesproductivas, incorporándolo con su oferta de valor.Palabras claves: Calidad industrial, producción-distribución, ISO 9000, cliente._______________________________________________________________________________Abstract.The investigation for the

  8. User experiences with clinical social franchising: qualitative insights from providers and clients in Ghana and Kenya.

    Science.gov (United States)

    Sieverding, Maia; Briegleb, Christina; Montagu, Dominic

    2015-02-01

    Clinical social franchising is a rapidly growing delivery model in private healthcare markets in low- and middle-income countries. Despite this growth, little is known about providers' perceptions of the benefits and challenges of social franchising or clients' reasons for choosing franchised facilities over other healthcare options. We examine these questions in the context of three social franchise networks in Ghana and Kenya. We conducted in-depth interviews with a purposive sample of providers from the BlueStar Ghana, and Amua and Tunza networks in Kenya. We also conducted qualitative exit interviews with female clients who were leaving franchised facilities after a visit for a reproductive or child health reason. The total sample consists of 47 providers and 47 clients across the three networks. Providers perceived the main benefits of participation in a social franchise network to be training opportunities and access to a consistent supply of low-cost family planning commodities; few providers mentioned branding as a benefit of participation. Although most providers said that client flows for franchised services increased after joining the network, they did not associate this with improved finances for their facility. Clients overwhelmingly cited the quality of the client-provider relationship as their main motivation for attending the franchise facility. Recognition of the franchise brand was low among clients who were exiting a franchised facility. The most important benefit of social franchise programs to both providers and their clients may have more to do with training on business practices, patient counseling and customer service, than with subsidies, technical input, branding or clinical support. This finding may lead to a reconsideration of how franchise programs interact with both their member clinics and the larger health-seeking communities they serve.

  9. On the Use of Client-Driven Projects in the Mathematics Classroom

    Science.gov (United States)

    Maki, Dan; Winston, Wayne; Shafii-Mousavi, Morteza; Kochanowski, Paul; Lang, Chris; Ernstberger, Kathy; Hodgson, Ted

    2006-01-01

    In this article, we discuss the use of client-driven projects--projects that are posed by business, government, and non-profit organizations and based upon real problems facing the organization. Although client-driven projects have long been used in business and engineering education, their use in the mathematics classroom is rare. Client-driven…

  10. Client Mobile Software Design Principles for Mobile Learning Systems

    Directory of Open Access Journals (Sweden)

    Qing Tan

    2009-01-01

    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.

  11. Tattoo removal by Q-switched yttrium aluminium garnet laser: client satisfaction.

    Science.gov (United States)

    Hutton Carlsen, K; Esmann, J; Serup, J

    2017-05-01

    Tattoo removal by Q-switched yttrium aluminium garnet (YAG) lasers is golden standard; however, clients' satisfaction with treatment is little known. To determine clients' satisfaction with tattoo removal. One hundred and fifty-four tattoo removal clients who had attended the private clinic 'Centre for Laser Surgery', Hellerup, Denmark, from 2001 to 2013 completed a questionnaire concerning outcome expectations, level of pain experiences and satisfaction with tattoo removal. The laser surgeon and his team were blinded from data handling. The study design included a minimum 2-year postlaser treatment observation period from 2013 to 2015. Overall, clients were satisfied with their laser treatment; 85% assessed their treatment and results to be acceptable to superb, while 15% assessed their treatment and results to be inferior to unacceptable. Effectiveness relative to colour of tattoo on a scale from 0 (no effect) to 10 (complete removal) scored a mean of blue 9.5, black 9.4, yellow 8.9, red 8.8 and green 6.5. Clients were dissatisfied with green pigment remnants, which could mimic bruising. One hundred and twenty-nine clients (84%) experienced moderate to extreme pain during treatment. Twenty-eight (20%) developed minor scarring. There were many reasons for tattoo removal; e.g. stigmatisation (33%), conspicuousness (29%) and poor artistic quality (22%). One hundred and two clients had expected complete removal of tattoos without a blemish, expectations that were only partly fulfilled. During the treatment period, clients adjusted expectations and adapted more realistic views of outcomes. The majority of clients were satisfied with Q-switched YAG laser removal of tattoos despite high pretreatment expectations which were only partly met. The study supports YAG lasers for tattoo removal as acceptable therapy of today, with room for new approaches. © 2017 European Academy of Dermatology and Venereology.

  12. Employment-related information for clients receiving mental health services and clinicians.

    Science.gov (United States)

    King, Joanne; Cleary, Catherine; Harris, Meredith G; Lloyd, Chris; Waghorn, Geoff

    2011-01-01

    Clients receiving public mental health services and clinicians require information to facilitate client access to suitable employment services. However, little is known about the specific employment-related information needs of these groups. This study aimed to identify employment-related information needs among clients, clinicians and employment specialists, with a view to developing a new vocational information resource. Employment-related information needs were identified via a series of focus group consultations with clients, clinicians, and employment specialists (n=23). Focus group discussions were guided by a common semi-structured interview schedule. Several categories of information need were identified: countering incorrect beliefs about work; benefits of work; disclosure and managing personal information; impact of earnings on welfare entitlements; employment service pathways; job preparation, planning and selection; and managing illness once working. Clear preferences were expressed about effective means of communicating the key messages in written material. This investigation confirmed the need for information tailored to clients and clinicians in order to activate clients' employment journey and to help them make informed decisions about vocational assistance.

  13. Performance of Distributed Query Optimization in Client/Server Systems

    NARCIS (Netherlands)

    Skowronek, J.; Blanken, Henk; Wilschut, A.N.

    The design, implementation and performance of an optimizer for a nested query language is considered. The optimizer operates in a client/server environment, in particular an Intranet setting. The paper deals with the scalability challenge by tackling the load of many clients by allocating optimizer

  14. Using Game Elements to Increase Student Engagement in Course Assignments

    Science.gov (United States)

    Armier, David Des, Jr.; Shepherd, Craig E.; Skrabut, Stan

    2016-01-01

    Gamification incorporates game-elements in non-gaming situations to enhance student engagement and desired behavior. This study examined participant's willingness to take part in gamified activities where reward systems were not directly tied to course grades. Participants enrolled in a technology integration course for preservice teachers, were…

  15. Retención de clientes en agencias de eventos

    Directory of Open Access Journals (Sweden)

    Claudia Gómez-Ramírez

    2011-01-01

    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.

  16. Report on Provider-Client Interaction From 68 Methadone Maintenance Clinics in China.

    Science.gov (United States)

    Li, Li; Comulada, W Scott; Lin, Chunqing; Lan, Chiao-Wen; Cao, Xiaobin; Wu, Zunyou

    2017-11-01

    Provider-client interaction is an integral of clinical practice and central to the delivery of high-quality medical care. This article examines factors related to the provider-client interaction in the context of methadone maintenance treatment (MMT). Data were collected from 68 MMT clinics in China. In total, 418 service providers participated in the survey. Linear mixed effects regression models were performed to identify factors associated with provider-client interaction. It was observed that negative attitude toward drug users was associated with lower level of provider-client interaction and less time spent with each client. Other factors associated with lower level of interaction included being female, being younger, being a nurse, and fewer years in medical field. Higher provider-client interaction was associated with provider reported job satisfaction. The findings of this study call for a need to address provider negative attitudes that can impact provider-client interaction and the effectiveness of MMT. Future intervention efforts targeting MMT providers should be tailored by gender, provider type, and medical experiences.

  17. Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

    Science.gov (United States)

    Sigler, Brittany Erika

    2017-03-21

    Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. The aim of our study was to investigate care coordinators' perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients' agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change

  18. 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.

    2013-01-01

    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

  19. Speech Mannerisms: Games Clients Play

    Science.gov (United States)

    Morgan, Lewis B.

    1978-01-01

    This article focuses on speech mannerisms often employed by clients in a helping relationship. Eight mannerisms are presented and discussed, as well as possible interpretations. Suggestions are given to help counselors respond to them. (Author)

  20. Feminist Therapy: A Comparative Study of Therapists and Clients.

    Science.gov (United States)

    Curtin, Catherine A.

    Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical…

  1. Client experiences with perinatal healthcare for high-risk and low-risk women

    NARCIS (Netherlands)

    van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana

    2018-01-01

    Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

  2. Offender and/or client? Fuzzy institutional identities in prison-based drug treatment in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Bjarke; Kolind, Torsten

    2016-01-01

    The last 20 years has witnessed a rise in prison-based drug treatment in Nordic countries. This increase has challenged the prominence of the punitive prison, and created changes in the roles of both clients and staff. This article explores the development of two institutional inmate identities......: the offender and the client, which have occurred as a consequence of this shift in prison policy. However, in their institutional narratives and daily practice both prison officers and counsellors often fluctuate when addressing inmates as offenders and/or clients. This fluctuation creates a “fuzzy” dynamic....... These institutional identities are characterized, on the one hand, by inmates being dealt with by counsellors as ‘real people' and ‘equals’, but simultaneously counsellors are resorting to the control opportunities allowed by the prison authorities such as urine tests and the use of isolation cells. On the other hand...

  3. Employee Engagement Factor for Organizational Excellence

    Directory of Open Access Journals (Sweden)

    Tzvetana Stoyanova

    2017-03-01

    Full Text Available Purpose: The objective of this publication is to identify ways to increase employee engagement in Bulgarian business organizations and identify how such employee engagement affects employee and company performance. Design/methodology/approach: Our research is based on the evaluation of employee engagement methodologies used by well-known companies such as Gallup HCM Advisory Group, Deloitte and Aon Hewitt. Based on these, we derive the factors influencing employee engagement in Bulgarian companies. Findings: This work focuses on management, in recent years, aimed at retaining and developing the best employees, and their evolution into reliable potential leaders of the organization. This is undertaken to maintain and increase the number of those engaged in the business of company employees as well. The management of a successful leader is considered key to increasing employee engagement. Employee commitment implies something special, additional or atypical in the performance of tasks and job role. This is a behaviour that involves innovation, demonstrating initiative via proactive seeking of opportunities that contribute to the company and exceeding the expected standard of employee performance. The findings can strengthen the already-significant role of management. There is no universal way to increase employee engagement and motivation towards increased productivity, activity, and creativity. Research limitations/implications: The study has been undertaken for employees in Bulgaria.

  4. Alienation: A Concept for Understanding Low-Income, Urban Clients

    Science.gov (United States)

    Holcomb-McCoy, Cheryl

    2004-01-01

    The author examines the concept of alienation and how it can be used to understand low-income, urban clients. A description is presented of 4 dimensions of alienation: powerlessness, meaninglessness, normlessness, and social isolation. Case illustrations are provided, and recommendations are made for counseling alienated clients. This article…

  5. Investigation into the value of trained glycaemia alert dogs to clients with type I diabetes.

    Science.gov (United States)

    Rooney, Nicola J; Morant, Steve; Guest, Claire

    2013-01-01

    Previous studies have suggested that some pet dogs respond to their owners' hypoglycaemic state. Here, we show that trained glycaemia alert dogs placed with clients living with diabetes afford significant improvements to owner well-being. We investigated whether trained dogs reliably respond to their owners' hypoglycaemic state, and whether owners experience facilitated tightened glycaemic control, and wider psychosocial benefits. Since obtaining their dog, all seventeen clients studied reported positive effects including reduced paramedic call outs, decreased unconscious episodes and improved independence. Owner-recorded data showed that dogs alerted their owners, with significant, though variable, accuracy at times of low and high blood sugar. Eight out of the ten dogs (for which owners provided adequate records) responded consistently more often when their owner's blood sugars were reported to be outside, than within, target range. Comparison of nine clients' routine records showed significant overall change after obtaining their dogs, with seven clients recording a significantly higher proportion of routine tests within target range after obtaining a dog. HbA1C showed a small, non significant reduction after dog allocation. Based on owner-reported data we have shown, for the first time, that trained detection dogs perform above chance level. This study points to the potential value of alert dogs, for increasing glycaemic control, client independence and consequent quality of life and even reducing the costs of long-term health care.

  6. How to Increase Boys’ Engagement in Reading Mandatory Poems in the Gymnasium

    DEFF Research Database (Denmark)

    Pasalic, A.; Andersen, N.H.; Carlsen, C.S.

    2018-01-01

    This paper outlines how a computer game can be used within transmedia storytelling to engage boys in the Danish gymnasium to read the epic poem “The Odyssey” by Homer. The study is based on a formative evaluation with questionnaires, observations, data logging, and interviews. Interviews...... with classical civilization teachers were further conducted, both in the initial design stage and after participant tests. Through all stages of the transmedia storytelling, it was revealed that curiosity was the main reason behind the engagement. The aesthetics worked out well in the game, and the story...

  7. A macro perspective for client-centred practice in curricula: Critique and teaching methods.

    Science.gov (United States)

    Fleming-Castaldy, Rita P

    2015-07-01

    Client-centred practice is often eclipsed by social, economic, and political inequities. Ignoring these realities obstructs clients' goal attainment. The author advocates for the integration of a macro perspective inclusive of participation barriers and supports in occupational therapy curricula and seeks to motivate educators to adopt teaching approaches that develop students' abilities to address the complexities of client-centred practice. This article integrates a critical analysis of the literature on client-centred practice with reflexivity on disability studies and autoethnography. Educational standards require students to learn about the social, economic, and political contexts that impact on client-centred practice and the need for advocacy to enable participation. Theoretical support of a macro perspective for client-centred practice is strongly evident in the literature. Information on methods for teaching students how to actualize these concepts in practice is scant. Thus, strategies to inform the integration of a macro perspective into curricula and concrete activities to develop students' competencies for empowered client-centred practice are required. Educators have an ethical responsibility to critique their pedagogy to determine whether they are adequately preparing students for client-centred practice. The focus must move from teaching a micro perspective of client-centred practice to a macro perspective that enables occupational justice and empowerment.

  8. Beliefs about medicines and self-reported adherence among pharmacy clients.

    Science.gov (United States)

    Mårdby, Ann-Charlotte; Akerlind, Ingemar; Jörgensen, Tove

    2007-12-01

    To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. Increased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.

  9. BAG3 induces the sequestration of proteasomal clients into cytoplasmic puncta: implications for a proteasome-to-autophagy switch.

    Science.gov (United States)

    Minoia, Melania; Boncoraglio, Alessandra; Vinet, Jonathan; Morelli, Federica F; Brunsting, Jeanette F; Poletti, Angelo; Krom, Sabine; Reits, Eric; Kampinga, Harm H; Carra, Serena

    2014-09-01

    Eukaryotic cells use autophagy and the ubiquitin-proteasome system as their major protein degradation pathways. Upon proteasomal impairment, cells switch to autophagy to ensure proper clearance of clients (the proteasome-to-autophagy switch). The HSPA8 and HSPA1A cochaperone BAG3 has been suggested to be involved in this switch. However, at present it is still unknown whether and to what extent BAG3 can indeed reroute proteasomal clients to the autophagosomal pathway. Here, we show that BAG3 induces the sequestration of ubiquitinated clients into cytoplasmic puncta colabeled with canonical autophagy linkers and markers. Following proteasome inhibition, BAG3 upregulation significantly contributes to the compensatory activation of autophagy and to the degradation of the (poly)ubiquitinated proteins. BAG3 binding to the ubiquitinated clients occurs through the BAG domain, in competition with BAG1, another BAG family member, that normally directs ubiquitinated clients to the proteasome. Therefore, we propose that following proteasome impairment, increasing the BAG3/BAG1 ratio ensures the "BAG-instructed proteasomal to autophagosomal switch and sorting" (BIPASS).

  10. Exploring the field of public construction clients by a graphical network analysis

    NARCIS (Netherlands)

    Eisma, P.R.; Volker, L.

    2014-01-01

    Because public construction clients form the majority of construction clients and procure over 40% of the construction output in most countries, they are important actors in the construction industry. Yet, the field of research on clients is still underdeveloped. In order to identify the research

  11. Student Use of Self-Data for Out-of-Class Graphing Activities Increases Student Engagement and Learning Outcomes†

    Science.gov (United States)

    DeBoy, Cynthia A.

    2017-01-01

    Two out-of-class graphing activities related to hormonal regulation of the reproductive cycle and stress responses are used to determine whether student use of self-data vs. provided data increases engagement, learning outcomes, and attitude changes. Comparisons of quizzes and surveys for students using self- vs. provided data suggest that while both activities increase learning outcomes, use of self-data compared with provided data has a greater impact on increasing learning outcomes, promotes recognition that hormones are relevant, and enhances confidence in graphing skills and graphing efficacy. PMID:29854057

  12. Engaging in an experiential processing mode increases positive emotional response during recall of pleasant autobiographical memories.

    Science.gov (United States)

    Gadeikis, Darius; Bos, Nikita; Schweizer, Susanne; Murphy, Fionnuala; Dunn, Barnaby

    2017-05-01

    It is important to identify effective emotion regulation strategies to increase positive emotion experience in the general population and in clinical conditions characterized by anhedonia. There are indications that engaging in experiential processing (direct awareness of sensory and bodily experience) bolsters positive emotion experience but this has not been extensively tested during memory recall. To further test this notion, 99 community participants recalled two positive autobiographical memories. Prior to the second recall, participants either underwent an experiential, analytical, or distraction induction (n = 33 per condition). Subjective happiness and sadness ratings and heart rate variability (HRV) response were measured during each recall. Greater spontaneous use of experiential processing during the first memory was associated with greater happiness experience, but was unrelated to HRV and sadness experience. Inducing experiential processing increased happiness experience relative to both the analytical and distraction conditions (but had no impact on sadness experience). There was a significant difference in HRV between conditions. The experiential condition led to a trend-significant increase, and the other conditions a non-significant decrease, in HRV from the first to the second memory. These results suggest that engaging in experiential processing is an effective way to up-regulate positive emotion experience during positive memory recall. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Client evaluation of a specialist inpatient parent-infant psychiatric service.

    Science.gov (United States)

    Nair, Revi; Bilszta, Justin; Salam, Nilam; Shafira, Nadia; Buist, Anne

    2010-12-01

    The aim of this paper was to collect feedback on a specialist parent-infant psychiatric service in terms of client satisfaction with inpatient treatment, and the impact on health outcomes of providing written information about available support options in the community following discharge. Women (n = 37) from consecutive admissions between January 2006 and December 2007 were contacted by telephone and administered a service quality evaluation questionnaire. Women were happy with the quality of inpatient care provided but suggested areas of improvement included continuity of staff during the inpatient stay and better communication between inpatient and outpatient services post-discharge. At discharge, women were not confident with their ability in coping with motherhood but confidence with parenting skills increased post-discharge. Use of recommended post-discharge community support and/or health services was poor. As adherence with discharge recommendations was less than ideal, greater involvement of primary/community health care professionals, and active participation of clients and carers, in discharge planning is required. Increased emphasis on the practical skills of motherhood as well as opportunities to develop the mother-infant relationship may assist mothers in gaining confidence to interact with their baby and pick up infant cues.

  14. Client-Controlled Case Information: A General System Theory Perspective

    Science.gov (United States)

    Fitch, Dale

    2004-01-01

    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…

  15. A Call for Feminist Research: A Limited Client Perspective

    Science.gov (United States)

    Murray, Kirsten

    2006-01-01

    Feminist approaches embrace a counselor stance that is both collaborative and supportive, seeking client empowerment. On review of feminist family and couple counseling literature of the past 20 years using several academic databases, no research was found that explored a clients experience of feminist-informed family and couple counseling. The…

  16. 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 ...

  17. Clients' experiences of HIV positive status disclosure to sexual ...

    African Journals Online (AJOL)

    The purpose of the study was to describe the experiences of HIV positive clients as they disclose their HIV positive status to their sexual partners. A qualitative descriptive and phenomenological design was used. Purposive sampling was used to select 15 HIV positive clients to participate in the study. Semi-structured ...

  18. High HIV Prevalence and Risk Among Male Clients of Female Sex Workers in Hanoi and Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Nadol, Patrick; Hoang, Tran Vu; Le, Linh-Vi; Nguyen, Tuan Anh; Kaldor, John; Law, Matthew

    2017-08-01

    In Vietnam's concentrated HIV epidemic, female sex workers (FSWs) are at increased risk for acquiring and transmitting HIV, largely through their male clients. A high proportion of males in Vietnam report being clients of FSWs. Studying HIV-related risk factors and prevalence among male clients is important, particularly given the potential for male clients to be a 'bridge' of HIV transmission to the more general population or to sex workers. Time-location sampling was used to identify FSW in Hanoi and Ho Chi Minh City, Vietnam's largest cities, in 2013-2014. Recruited FSWs were asked to refer one male client to the study. Demographic and risk behavior data were collected from FSWs and male clients by administered questionnaires. Biologic specimens collected from male clients were tested for HIV and opiates. Sampling weights, calculated based on the FSWs probability of being selected for enrolment, were applied to prevalence estimates for both FSWs and male clients. Logistic regression models were developed to obtain odds ratios for HIV infection among male clients. A total of 804 male clients were enrolled. Overall, HIV prevalence among male clients was 10.2%; HIV prevalence was 20.7% (95% confidence interval (CI) 15.0-27.9%) among those reporting a history of illegal drug use and 32.4% (95% CI 20.2-47.7%) among those with opioids detected in urine. HIV prevalence among male clients did not differ across 'bridging' categories defined by condom use with FSWs and regular partners over the previous 6 months. HIV among male clients was associated with a reported history of illegal drug use (OR 3.76; 95% CI 1.87-7.56), current opioid use (OR 2.55; 95% CI 1.02-6.36), and being referred by an FSW who self-reported as HIV-positive (OR 5.37; 95% CI 1.46-19.75). Self-reported HIV prevalence among enrolled FSWs was 2.8%. Based on HIV test results of male clients and self-reported status from FSWs, an estimated 12.1% of male client-FSW pairs were sero-discordant. These

  19. Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

    Directory of Open Access Journals (Sweden)

    Hj.Indirawaty

    2015-08-01

    Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

  20. 77 FR 62185 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients

    Science.gov (United States)

    2012-10-12

    ... 3235-AJ96 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... principal capacity in transactions with certain of their advisory clients. The amendment would extend the... Advisers Act when they act in a principal capacity in transactions with certain of their advisory clients...

  1. 75 FR 75650 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients

    Science.gov (United States)

    2010-12-06

    ... 3235-AJ96 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... principal capacity in transactions with certain of their advisory clients. The amendment would extend the... Advisers Act when they act in a principal capacity in transactions with certain of their advisory clients...

  2. 42 CFR 483.450 - Condition of participation: Client behavior and facility practices.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Client behavior and... Retarded § 483.450 Condition of participation: Client behavior and facility practices. (a) Standard: Facility practices—Conduct toward clients. (1) The facility must develop and implement written policies and...

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

    Directory of Open Access Journals (Sweden)

    Suzanne J. Snodgrass

    2016-11-01

    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.

  4. Client Server design and implementation issues in the Accelerator Control System environment

    International Nuclear Information System (INIS)

    Sathe, S.; Hoff, L.; Clifford, T.

    1995-01-01

    In distributed system communication software design, the Client Server model has been widely used. This paper addresses the design and implementation issues of such a model, particularly when used in Accelerator Control Systems. in designing the Client Server model one needs to decide how the services will be defined for a server, what types of messages the server will respond to, which data formats will be used for the network transactions and how the server will be located by the client. Special consideration needs to be given to error handling both on the server and client side. Since the server usually is located on a machine other than the client, easy and informative server diagnostic capability is required. The higher level abstraction provided by the Client Server model simplifies the application writing, however fine control over network parameters is essential to improve the performance. Above mentioned design issues and implementation trade-offs are discussed in this paper

  5. Comparison of communication skills between trained and untrained students using a culturally sensitive nurse-client communication guideline in Indonesia.

    Science.gov (United States)

    Claramita, Mora; Tuah, Rodianson; Riskione, Patricia; Prabandari, Yayi Suryo; Effendy, Christantie

    2016-01-01

    A communication guideline that is sensitive to the local culture is influential in the process of nursing care. The Gadjah Mada nurse-client communication guideline, the "Ready-Greet-Invite-Discuss," was meant (1) to strengthen the relationship between the nurse and the client despite of socio-culturally hierarchical gap between health providers and clients in Indonesian context, (2) to provide attention to the unspoken concerns especially in the context of indirect communication which mostly using non-verbal signs and politeness etiquettes, and (3) to initiate dialog in the society which hold a more community-oriented decision making. Our aim is to compare the communication skills of nursing students who had and had not received a training using a culture-sensitive Gadjah Mada nurse-client communication guideline. This was a quasi experimental randomized control study to the fifth semester students of a nursing school at Yogyakarta, Indonesia. The intervention group was trained by the Gadjah Mada nurse-client communication guideline. Both intervention and the control group had learned general nurse-client communication guidelines. The training was 4h with role-plays, supportive information and feedback sessions. An objective-structured clinical examination (OSCE) was conducted 1week after the training, in seven stations, with seven simulated clients. Observers judged the communication skills of the students using a checklist of 5-point Likert scale, whereas simulated clients judged their satisfaction using 4-point Likert scale represented in colorful ribbons. There were significant mean differences in each domain of communication guideline observed between the trained and the control groups as judged by the teachers (p≤0.05) and simulated clients. Training using a culture-sensitive communication skills guideline could improve the communication skills of the nursing students and may increase satisfaction of the clients. Copyright © 2015 Elsevier Ltd. All rights

  6. A brain-computer interface controlled mail client.

    Science.gov (United States)

    Yu, Tianyou; Li, Yuanqing; Long, Jinyi; Wang, Cong

    2013-01-01

    In this paper, we propose a brain-computer interface (BCI) based mail client. This system is controlled by hybrid features extracted from scalp-recorded electroencephalographic (EEG). We emulate the computer mouse by the motor imagery-based mu rhythm and the P300 potential. Furthermore, an adaptive P300 speller is included to provide text input function. With this BCI mail client, users can receive, read, write mails, as well as attach files in mail writing. The system has been tested on 3 subjects. Experimental results show that mail communication with this system is feasible.

  7. Request queues for interactive clients in a shared file system of a parallel computing system

    Science.gov (United States)

    Bent, John M.; Faibish, Sorin

    2015-08-18

    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.

  8. Investigating strengths and deficits to increase work engagement: A longitudinal study in the mining industry

    Directory of Open Access Journals (Sweden)

    Pule Mphahlele

    2018-02-01

    Full Text Available Orientation: The motivational process of the Job Demands-Resources (JD-R model indicates that job resources are the main predictors of work engagement. Previous research has found that the two job resources perceived organisational support (POS for strengths use and POS for deficit correction are also positively related to work engagement. However, the causal relationships between these variables have not been investigated longitudinally. Research purpose: To determine if POS for strengths use and POS for deficit correction are significant predictors of work engagement over time. Motivation for the study: In the literature, empirical evidence on the longitudinal relationships between work engagement and specific job resources, namely POS for strengths use and POS for deficit correction, is limited. Research design, approach and method: A longitudinal design was employed in this study. The first wave elicited a total of 376 responses, while the second wave had a total sample size of 79. A web-based survey was used to measure the constructs and to gather data at both points in time. Structural equation modelling was used to investigate the hypotheses. Main findings: The results indicated that both POS for strengths use and POS for deficit correction are positively related to work engagement in the short term. However, only POS for deficit correction significantly predicted work engagement over time. Practical and managerial implications: The results provide valuable insights to organisations by providing knowledge regarding which approach influences work engagement levels of their employees in the short and long term. Contribution or value-add: The study contributes to the limited research on what job resources predict work engagement over time.

  9. Approaching Engagement towards Human-Engaged Computing

    DEFF Research Database (Denmark)

    Niksirat, Kavous Salehzadeh; Sarcar, Sayan; Sun, Huatong

    2018-01-01

    Debates regarding the nature and role of HCI research and practice have intensified in recent years, given the ever increasingly intertwined relations between humans and technologies. The framework of Human-Engaged Computing (HEC) was proposed and developed over a series of scholarly workshops to...

  10. 77 FR 76854 - Temporary Rule Regarding Principal Trades With Certain Advisory Clients

    Science.gov (United States)

    2012-12-31

    ... 3235-AL28 Temporary Rule Regarding Principal Trades With Certain Advisory Clients AGENCY: Securities... transactions with certain of their advisory clients. The amendment extends the date on which rule 206(3)- 3T... releases used RIN 3235-AJ96. (See Temporary Rule Regarding Principal Trades with Certain Advisory Clients...

  11. Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.

    Science.gov (United States)

    Martin, Linda; Gitsels-van der Wal, Janneke T; Pereboom, Monique T R; Spelten, Evelien R; Hutton, Eileen K; van Dulmen, Sandra

    2016-01-01

    This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; pcommunication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Transnational television audiences and modes of engagement: studying audience engagement as a set of experiences

    DEFF Research Database (Denmark)

    Keinonen, Heidi; Jensen, Pia Majbritt; Esser, Andrea

    2018-01-01

    Audience engagement is attracting increasing attention in various academic disciplines. Recently, the industry- and technology-oriented conceptualizations of engagement have been challenged by a more audience-oriented understanding. This article aims at contributing to the development of a more...... nuanced audience-oriented approach. First, we make a theoretical argument by bringing various key theories together and, second, we present an empirical contribution by analysing audience engagement as a set of experiences. Our analysis builds on the empirical material produced by conducting two rounds...... and ritualistic engagement, ludic engagement. We also discovered that audiences at times get disengaged or opt to actively resist engagement....

  13. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    Science.gov (United States)

    Laut, Jeffrey; Cappa, Francesco; Nov, Oded; Porfiri, Maurizio

    2015-01-01

    Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  14. HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China.

    Science.gov (United States)

    Zhu, Jing; Yuan, Rui; Hu, Dan; Zhu, Zhibin; Wang, Ning; Wang, Bei

    2018-04-01

    Female sex workers (FSWs) and their male clients are vulnerable to HIV infection and serve as a bridge in HIV transmission from the high-risk population to the general, low-risk population. To examine the factors of FSWs and male clients that correlate with the prevalence of HIV infection in the Chinese-Vietnamese border region, a cross-sectional survey was conducted in 2014 in the Hekou county of the Yunnan province of China. We performed a questionnaire survey to collect data on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections and drug use. We found that the prevalence of HIV infection among FSWs was 2.74%, and 15 male clients (2.62%) were HIV-positive. Multivariate logistic regression analysis revealed that herpes simplex virus type 2 infection was a risk factor for HIV infection in FSWs and male clients, suggesting the increased role of sexual transmission in the HIV epidemic in the Chinese-Vietnamese border region. Positive urinalysis result for amphetamine-type stimulants was observed in FSWs with HIV infection. History of drug use was correlated with HIV infection, which increased the HIV infection risk of male clients, confirming that drug use is an important target in future interventions for HIV prevention.

  15. The measurement of emotional reactions of bank clients

    Directory of Open Access Journals (Sweden)

    Marinković Veljko

    2014-01-01

    Full Text Available Focus on customers is an important factor in gaining sustainable competitive advantage of retail banks. Modern marketing-oriented banks have to be focused towards understanding and meeting the financial requirements of their clients. Attention of bank management should also be directed towards the study of quality of relationships between a bank and its clients. In this context, it is important to measure emotional reactions of clients. The aim of this paper is to identify the key drivers of emotional reactions. Specifically, two emotional reactions are observed in the paper: satisfaction and affective commitment. In the conducted study, two research models that include four independent variables (service quality, bank image, trust and social bonds are designed, wherein satisfaction is regarded as dependent variable in the first model, while affective commitment is given the role of dependent variable in the second model. The results indicate a moderate degree of satisfaction, but also a low level of affective commitment of the respondents. In addition, trust is stressed as the most important factor of emotional reactions. On the other hand, clients believe that banks provide a good quality service, where the quality stands out as an important driver of satisfaction, but not as a driver of affective commitment.

  16. A Microfinance Program Targeting People Living with HIV in Uganda: Client Characteristics and Program Impact.

    Science.gov (United States)

    Linnemayr, Sebastian; Buzaalirwa, Lydia; Balya, James; Wagner, Glenn

    HIV has disproportionately affected economically vulnerable populations. HIV medical care, including antiretroviral therapy, successfully restores physical health but can be insufficient to achieve social and economic health. It may therefore be necessary to offer innovative economic support programs such as providing business training and microcredit tailored to people living with HIV/AIDS. However, microfinance institutions have shown reluctance to reach out to HIV-infected individuals, resulting in nongovernment and HIV care organizations providing these services. The authors investigate the baseline characteristics of a sample of medically stable clients in HIV care who are eligible for microcredit loans and evaluate their business and financial needs; the authors also analyze their repayment pattern and how their socioeconomic status changes after receipt of the program. The authors find that there is a significant unmet need for business capital for the sample under investigation, pointing toward the potentially beneficial role of providing microfinance and business training for clients in HIV care. HIV clients participating in the loans show high rates of repayment, and significant increases in (disposable) income, as well as profits and savings. The authors therefore encourage other HIV care providers to consider providing their clients with such loans.

  17. Shared Governance and Work Engagement in Emergency Nurses.

    Science.gov (United States)

    Siller, Jennifer; Dolansky, Mary A; Clavelle, Joanne T; Fitzpatrick, Joyce J

    2016-07-01

    Lack of work engagement in emergency nurses has been linked to increased job turnover, burnout, and lack of job satisfaction. Shared governance is a vehicle that can be used by emergency nursing leaders to increase work engagement among emergency nurses. Research is lacking about the relationship between perceptions of shared governance and work engagement in emergency nurses. In this study we examined the relationship between ED nurses' perceptions of shared governance and work engagement. A descriptive correlation design was used with a convenience sample of 43 emergency nurses recruited through the ENA Web site. Participants completed a demographic questionnaire, the Index of Professional Nursing Governance Tool, and the Utrecht Work Engagement Scale. The mean total work engagement score indicated average engagement (M = 4.4, standard deviation = 1.2). A significant positive relationship was found between shared governance and work engagement, indicating that as perceptions of shared governance increase, work engagement increases (r (41) = 0.62, P emergency nurses. Understanding the relationship between perceptions of shared governance and work engagement in emergency nurses may assist emergency nursing leaders in developing and testing interventions to enhance it. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  18. Cultural humility: measuring openness to culturally diverse clients.

    Science.gov (United States)

    Hook, Joshua N; Davis, Don E; Owen, Jesse; Worthington, Everett L; Utsey, Shawn O

    2013-07-01

    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.

  19. 17 CFR 4.31 - Required delivery of Disclosure Document to prospective clients.

    Science.gov (United States)

    2010-04-01

    ... Disclosure Document to prospective clients. 4.31 Section 4.31 Commodity and Securities Exchanges COMMODITY... Advisors § 4.31 Required delivery of Disclosure Document to prospective clients. (a) Each commodity trading... prospective client a Disclosure Document containing the information set forth in §§ 4.34 and 4.35 for the...

  20. A CONCEPTUAL TOOL FOR ASSESSING CLIENT PERFORMANCE IN THE CONSTRUCTION PROJECT COALITION

    Directory of Open Access Journals (Sweden)

    Gary D. Holt

    2002-01-01

    Full Text Available Due to the significant impact of client performance on overall project performance and the interdependence of participant%5C%27s performance in the construction project coalition %28i.e. clients%2C designers and constructors%29%2C there is a need to establish client performance measures. Based on data collected from in-depth interviews with nineteen UK architects and nine UK contractors%2C a generic tool for the on-going formal assessment of client performance is presented. It was found that this approach to performance assessment %28i.e. from the view point of other%2C non-client coalition participants%29 should lead to improved project relationships. Data analysis showed that in addition to %5C%27harder%5C%27 measures such as understanding of project requirements and finance%2C other%2C %5C%27softer%5C%27 measures of client performance %28e.g. attitude%29 were worthy of consideration since they determine the quality of participant relationships. It is recommended that the tool be used to promote more effective client performance and thus enhance coalition relationships%2C enabling continuous improvement. The ultimate aim is to develop similar tools for the assessment of all coalition participants based on a culture of openness and trust. Abstract in Bahasa Indonesia : assessment+tool%2C+coalition+participants%2C+client+performance%2C+perceptions%2C+performance+measures%2C+satisfaction.

  1. Análise de Clientes de uma Distribuidora de Medicamentos

    OpenAIRE

    Sidney Lino Oliveira; Josmária Lima Ribeiro Oliveira

    2004-01-01

    Este artigo trata da análise de clientes por meio de uma pesquisa quantitativa para uma distribuidora farmacêutica. O interesse desta análise foi de identificar os principais clientes para estabelecer um relacionamento mais efetivo, e promo- ver a implantação de um sistema logístico que possibilite uma abordagem voltada para o cliente. O estudo de caso foi desenvolvido em uma distribuidora farmacêutica situada em Juiz de Fora/MG que atende à região da Zona da Mata/MG e o estado do Rio de Jane...

  2. Community ambulation: influences on therapists and clients reasoning and decision making.

    Science.gov (United States)

    Corrigan, Rosemary; McBurney, Helen

    2008-01-01

    Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

  3. Designing e-learning solutions with a client centred approach

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

      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....

  4. The impact of gender and business training for female microfinance clients in Vietnam

    NARCIS (Netherlands)

    Vu, Nhung; van Velzen, Rosine; Lensink, Robert; Bulte, Erwin H.

    2015-01-01

    This study documents the impact of offering a gender and business training to female microfinance clients in Vietnam on business outcomes and women empowerment using a randomised controlled trial. Many researchers argue that management and business skills are crucial to increase productivity and

  5. Integrating Social and Traditional Media in the Client Project

    Science.gov (United States)

    Melton, James; Hicks, Nancy

    2011-01-01

    Based on a client project assigned to students in two undergraduate business classes, this article argues that social media learning is best done in a context that mixes social media with more traditional kinds of media. Ideally, this approach will involve teams of students who are working on different aspects of a larger client project. This…

  6. Prostitución en Galicia: clientes e imaginarios femeninos Prostitution in Galicia: clients and feminine imaginary

    Directory of Open Access Journals (Sweden)

    Agueda Gómez Suárez

    2010-04-01

    Full Text Available Hoy, la prostitución en nuestra sociedad resulta un indicador de la "cultura sexual" dominante en las sociedades patriarcales y capitalistas. Este artículo pretende aportar otro enfoque al análisis de la industria sexual en nuestro país, ajustándose, principalmente, a las experiencias de los hombres implicados en el fenómeno de la prostitución en Galicia. El dramatismo con que las mujeres en prostitución viven su realidad y la frivolidad y ociosidad en la que se recrean los clientes, muestra el controvertido e inquietante semblante de esta realidad. El análisis del discurso de los clientes a través del "Frame Analysis", y el estudio de los imaginarios femeninos dominantes entre ellos son retratados en este texto, junto con el discurso de las mujeres en prostitución y el de los hombres que ocupan espacios masculinizados. Este artículo pretende ser una contribución más al complejo estudio del fenómeno de la prostitución en nuestro país.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.

  7. Increasing work-time influence

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Aust, Birgit

    2012-01-01

    This quasi-experimental study investigated how an intervention aiming at increasing eldercare workers' influence on their working hours affected the flexibility, variability, regularity and predictability of the working hours. We used baseline (n = 296) and follow-up (n = 274) questionnaire data......), or discussion of working hours (subgroup C). Only computerised self-scheduling changed the working hours and the way they were planned. These changes implied more flexible but less regular working hours and an experience of less predictability and less continuity in the care of clients and in the co...... that while increasing the individual flexibility, increasing work-time influence may also result in decreased regularity of the working hours and less continuity in the care of clients and co-operation with colleagues....

  8. Evaluation of a workplace engagement project for people with younger onset dementia.

    Science.gov (United States)

    Robertson, Jacinta; Evans, David

    2015-08-01

    In 2011, a workplace project was established to provide a small group of people who had younger onset dementia with the opportunity to return to the workplace. The project sought to explore the feasibility and safety of engaging these younger people in workplace activities if an appropriate framework of support was provided. Opportunities to engage in meaningful activities are quite limited for younger people with dementia because services are targeted at an older client population. A qualitative exploratory approach was used for the project evaluation. Participants were people who were 65 years or younger and had a diagnosis of dementia. They attended a large metropolitan hardware store one day per week and worked beside a store employee for a four hour work shift. Evaluation of the project included observation of participant's engagement in the workplace, adverse events and a qualitative analysis that used participant-nominated good project outcomes. Nine people with a mean age of 58·8 years participated in the project. Six of these participants have been engaged at the workplace for more than two years. All participants were able to gain the skills needed to complete their respective work duties. Participants initially assisted with simple work tasks, but over time, they were able to expand their range of duties to include more complex activities such as customer sales. Participants achieved their nominated good outcomes of improved well-being, engaging in worthwhile activities, contributing to society and socialisation. The evaluation has shown that this workplace programme is a viable model of engagement for younger people with dementia. This evaluation offers a practical demonstration that it is feasible and safe to provide opportunities for younger people with dementia to engage in meaningful activities in the community if appropriate support is provided. © 2015 John Wiley & Sons Ltd.

  9. Investigation into the value of trained glycaemia alert dogs to clients with type I diabetes.

    Directory of Open Access Journals (Sweden)

    Nicola J Rooney

    Full Text Available Previous studies have suggested that some pet dogs respond to their owners' hypoglycaemic state. Here, we show that trained glycaemia alert dogs placed with clients living with diabetes afford significant improvements to owner well-being. We investigated whether trained dogs reliably respond to their owners' hypoglycaemic state, and whether owners experience facilitated tightened glycaemic control, and wider psychosocial benefits. Since obtaining their dog, all seventeen clients studied reported positive effects including reduced paramedic call outs, decreased unconscious episodes and improved independence. Owner-recorded data showed that dogs alerted their owners, with significant, though variable, accuracy at times of low and high blood sugar. Eight out of the ten dogs (for which owners provided adequate records responded consistently more often when their owner's blood sugars were reported to be outside, than within, target range. Comparison of nine clients' routine records showed significant overall change after obtaining their dogs, with seven clients recording a significantly higher proportion of routine tests within target range after obtaining a dog. HbA1C showed a small, non significant reduction after dog allocation. Based on owner-reported data we have shown, for the first time, that trained detection dogs perform above chance level. This study points to the potential value of alert dogs, for increasing glycaemic control, client independence and consequent quality of life and even reducing the costs of long-term health care.

  10. Location Privacy Techniques in Client-Server Architectures

    DEFF Research Database (Denmark)

    Jensen, Christian Søndergaard; Lu, Hua; Yiu, Man Lung

    2009-01-01

    A typical location-based service returns nearby points of interest in response to a user location. As such services are becoming increasingly available and popular, location privacy emerges as an important issue. In a system that does not offer location privacy, users must disclose their exact...... locations in order to receive the desired services. We view location privacy as an enabling technology that may lead to increased use of location-based services. In this chapter, we consider location privacy techniques that work in traditional client-server architectures without any trusted components other....... Third, their effectiveness is independent of the distribution of other users, unlike the k-anonymity approach. The chapter characterizes the privacy models assumed by existing techniques and categorizes these according to their approach. The techniques are then covered in turn according...

  11. Region specific changes in nonapeptide levels during client fish interactions with allopatric and sympatric cleaner fish.

    Science.gov (United States)

    Soares, Marta C; Cardoso, Sónia C; Mazzei, Renata; André, Gonçalo I; Morais, Marta; Gozdowska, Magdalena; Kalamarz-Kubiak, Hanna; Kulczykowska, Ewa

    2017-01-01

    Social relationships are crucially dependent on individual ability to learn and remember ecologically relevant cues. However, the way animals recognize cues before engaging in any social interaction and how their response is regulated by brain neuromodulators remains unclear. We examined the putative involvement of arginine vasotocin (AVT) and isotocin (IT), acting at different brain regions, during fish decision-making in the context of cooperation, by trying to identify how fish distinguish and recognize the value of other social partners or species. We hypothesized that the behavioural responses of cleaner fish clients to different social contexts would be underlain by changes in brain AVT and IT levels. We have found that changes in AVT at the level of forebrain and optic tectum are linked with a response to allopatric cleaners (novel or unfamiliar stimuli) while those at cerebellum are associated with the willingness to be cleaned (in response to sympatric cleaners). On the other hand, higher brain IT levels that were solely found in the diencephalon, also in response to allopatric cleaners. Our results are the first to implicate these nonapeptides, AVT in particular, in the assessment of social cues which enable fish to engage in mutualistic activities.

  12. Mr. Ngao's proposal: introducing client fees. Case scenarios for training and group discussion.

    Science.gov (United States)

    1992-01-01

    In this supplement to the issue of "The Family Planning Manager" devoted to fees, a hypothetical case scenario is presented to illustrate the introduction of client fees to a family planning program. Managers are instructed to prepare a plan that includes the necessary information for deciding what to charge for, who to charge, and how much to charge; identifies the administrative changes involved in charging fees; and outlines steps that clinic managers should take before introducing client fees. Decisions should be based on factors such as the objectives of fee charging, client willingness and ability to pay, client perception of the quality of current services, services for which clients would be most willing to pay, estimated cost of providing services, and the cost of new administrative procedures inherent in a fee-for-service approach. Administrative procedures for collecting, handling, and accounting for cash; reporting income and expenses; and implementing a fair and flexible system of waivers and exemptions must be defined. Clients should be informed well in advance of fee introduction, and staff trained to manage potential client complaints.

  13. Teaching undergraduate students community nursing: using action research to increase engagement and learning.

    Science.gov (United States)

    Seib, Charrlotte; English, Rebecca; Barnard, Alan

    2011-09-01

    Nurses play a pivotal role in responding to the changing needs of community health care. Therefore, nursing education must be relevant, responsive, and evidence based. We report a case study of curriculum development in a community nursing unit embedded within an undergraduate nursing degree. We used action research to develop, deliver, evaluate, and redesign the curriculum. Feedback was obtained through self-reflection, expert opinion from community stakeholders, formal student evaluation, and critical review. Changes made, especially in curriculum delivery, led to improved learner focus and more clearly linked theory and practice. The redesigned unit improved performance, measured with the university's student evaluation of feedback instrument (increased from 0.3 to 0.5 points below to 0.1 to 0.5 points above faculty mean in all domains), and was well received by teaching staff. The process confirmed that improved pedagogy can increase student engagement with content and perception of a unit as relevant to future practice. Copyright 2011, SLACK Incorporated.

  14. 45 CFR 1621.4 - Complaints by clients about manner or quality of legal assistance.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Complaints by clients about manner or quality of...) LEGAL SERVICES CORPORATION CLIENT GRIEVANCE PROCEDURES § 1621.4 Complaints by clients about manner or... clients about the manner or quality of legal assistance that has been rendered by the recipient to the...

  15. High prevalence of unhealthy alcohol use and comparison of self-reported alcohol consumption to phosphatidylethanol among women engaged in sex work and their male clients in Cambodia.

    Science.gov (United States)

    Couture, Marie-Claude; Page, Kimberly; Sansothy, Neth; Stein, Ellen; Vun, Mean Chhi; Hahn, Judith A

    2016-08-01

    In Cambodia, most of the female sex workers (FSW) work in venues where unhealthy alcohol use is ubiquitous and potentially contributing to the HIV epidemic. However, no accurate data exists. We compare self-reported unhealthy alcohol consumption to a biomarker of alcohol intake in Cambodian FSW and male clients, and determine factors associated with unhealthy alcohol use. A cross-sectional study was conducted among FSW (n=100) and male clients (n=100) in entertainment and sex work venues in Cambodia. Self-reported unhealthy alcohol use (AUDIT-C) was compared to phosphatidylethanol (PEth) positive (≥50ng/ml), a biomarker of alcohol intake. Sociodemographics data was collected. Correlates of self-reported unhealthy alcohol use and PEth positive were determined. The prevalence of PEth positive in FSW was 60.0%. Self-reported unhealthy alcohol consumption was reported by 85.0% of the women. Almost all women (95.0%) testing PEth positive also reported unhealthy alcohol use. Prevalence of unhealthy alcohol consumption (self-report and PEth positive) was higher in FSW working in entertainment establishments compared to other sex work venues (psex work settings. Self-reported unhealthy alcohol use is well reported by FSW, but less by male clients. These findings highlight the urgency of using accurate measures of unhealthy alcohol consumption and integrating this health issue into HIV prevention interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Bringing the client back in

    DEFF Research Database (Denmark)

    Danneris, Sophie; Nielsen, Mathias Herup

    2018-01-01

    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...

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

    NARCIS (Netherlands)

    Varekamp, I.

    2004-01-01

    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

  18. Client participation in moral case deliberation: a precarious relational balance

    NARCIS (Netherlands)

    Weidema, F.C.; Abma, T.A.; Widdershoven, G.A.M.; Molewijk, A.C.

    2011-01-01

    Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client

  19. Toward Healthy Family Breathing: client survey

    National Research Council Canada - National Science Library

    Kaloti, Jiti; Naylor, P.J

    1997-01-01

    .... 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...

  20. Meaning of dancing therapy in therapy of clients with psychological diseases

    OpenAIRE

    NĚMCOVÁ, Barbora

    2010-01-01

    Bachelor thesis deals with meaning and effects of Dance therapy in frame of medical therapy of clients with psychical disease. Theoretical part defines words like dance, movement and Dance therapy. This part also describes history of dance, meaning and aims of Dance therapy, its school, aims and divisions. Mensioned are person of dance therapist, personalities connected with dance and Dance therapy, target groups of clients suitable for Dance therapy, importance of Dance therapy for clients w...

  1. UNDERSTANDING OF NON VERBAL BEHAVIOR CLIENTS AND TECHNIQUES IN COUNSELING SESSION

    Directory of Open Access Journals (Sweden)

    afdal afdal

    2016-06-01

    Full Text Available The practice of counseling by counselor not only need the skills to understand what is expressed by the client, but were further able to understand and have skills in giving meaning to the nonverbal communication, demonstrated by the behavior of a counseling session. During this time many of counselors who focus only on what is revealed by the client and using verbal techniques alone without seeing what goes on inside the client more deeply to understand the communication indicated by nonverbal behavior. The techniques used in the discussion of this article provides the inspiration that counseling is an art, not superficial, not skeptical and just focus on one technique alone, but many of the techniques that can be used to explore client issues. Furthermore, this paper supports the philosophical theory of Gestalt who believe that the client can feel the direct presence in the counseling sessions through the practices of the techniques used, to interpret the expression of various communications made, stationing themselves and find their own meaning.

  2. Neurobiological response to EMDR therapy in clients with different psychological traumas

    Directory of Open Access Journals (Sweden)

    MARCO ePAGANI

    2015-10-01

    Full Text Available We assessed cortical activation differences in real-time upon exposure to traumatic memory between two distinct groups of psychologically traumatised clients also in comparison with healthy controls. We used electroencephalography (EEG to compare neuronal activation throughout the bilateral stimulation phase of Eye Movement Desensitization and Reprocessing (EMDR sessions. We compared activation between the first (T0 and the last (T1 session, the latter performed after processing the index trauma. The group including all clients showed significantly higher cortical activity in orbito-frontal cortex at T0 shifting at T1 towards posterior associative regions. However the subgroup of clients with chronic exposure to the traumatic event showed a cortical firing at both stages which was closer to that of controls. For the first time EEG monitoring enabled to disclose neurobiological differences between groups of clients with different trauma histories during the reliving of the traumatic event. Cortical activations in clients chronically exposed to traumatic memories were moderate, suggesting an association between social and environmental contexts with the neurobiological response to trauma exposure and psychotherapy.

  3. An Exploration of Supervisory and Therapeutic Relationships and Client Outcomes

    Science.gov (United States)

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

    2016-01-01

    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…

  4. Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients

    Science.gov (United States)

    American Psychologist, 2012

    2012-01-01

    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…

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

    Science.gov (United States)

    Varekamp, I

    2004-12-01

    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.

  6. Challenging the Courtesy Bias Interpretation of Favorable Clients' Perceptions of Family Planning Delivery

    Science.gov (United States)

    Len, Federico R.; Lundgren, Rebecka; Huapaya, Ana; Sinai, Irit; Jennings, Victoria

    2007-01-01

    Favorable client perceptions of provider's interpersonal behavior in contraceptive delivery, documented in clinic exit questionnaires, appear to contradict results from qualitative evaluations and are attributed to clients' courtesy bias. In this study, trained simulated clients requested services from Ministry of Health providers in three…

  7. The effect of skill mix in non-nursing assistants on work engagements among home visiting nurses in Japan.

    Science.gov (United States)

    Naruse, Takashi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Sakai, Mahiro; Watai, Izumi; Murashima, Sachiyo

    2015-05-01

    This study evaluated the effect of a skill-mix programme intervention on work engagement in home visiting nurses. A skill-mix programme in which home visiting nurses are assisted by non-nursing workers is assumed to foster home visiting nurses' work engagement. Pre- and post-intervention evaluations of work engagement were conducted using self-administered questionnaires. A skill-mix programme was introduced in the intervention group of home visiting nurses. After 6 months, their pre- and post-intervention work engagement ratings were compared with those of a control group. Baseline questionnaires were returned by 174 home visiting nurses (44 in the intervention group, 130 in the control group). Post-intervention questionnaires were returned by 38 and 97 home visiting nurses from each group. The intervention group's average work engagement scores were 2.2 at baseline and 2.3 at post-intervention; the control group's were 3.3 and 2.6. Generalised linear regression showed significant between-group differences in score changes. The skill-mix programme might foster home visiting nurses' work engagement by improving the quality of care for each client. Future research is needed to explain the exact mechanisms that underlie its effectiveness. In order to improve the efficiency of services provided by home visiting nurses and foster their work engagement, skill-mix programmes might be beneficial. © 2014 John Wiley & Sons Ltd.

  8. Round-Trip Delay Estimation in OPC UA Server-Client Communication Channel

    OpenAIRE

    Nakutis, Zilvinas; Deksnys, Vytautas; Jarusevicius, Ignas; Dambrauskas, Vilius; Cincikas, Gediminas; Kriauceliunas, Alenas

    2017-01-01

    In this paper an estimation of round-trip delay (RTD) in OPC UA server-client channel was investigated in various data communication networks including Ethernet, WiFi, and 3G. Testing was carried out using the developed IoT gateway device running OPC UA server and remote computer running OPC UA client. The server and the client machines were configured to operate in Virtual Private Network powered by OpenVPN. Experimental analysis revealed that RTD values are distributed in the wide range exh...

  9. Communicative principles among corporate clients and regional branches of commercial banks

    OpenAIRE

    Asie TSINTSADZE; Lela ONIANI

    2014-01-01

    The aim of this article is to discuss the share of consumption taken by the corporate clients in the autonomous republic of Adjara. It is remarkable that the most of the share of banks’ total incomes are formed exactly on the base of accumulated resource accounts of corporate clients. So in order to attract corporate clients in the region, there is a great and strong competition among the banks. According to the above mentioned information, we are discussing several principles concerning to t...

  10. Play therapy and art therapy for substance abuse clients who have a history of incest victimization.

    Science.gov (United States)

    Glover, N M

    1999-06-01

    This article discusses the use of play therapy and art therapy treatment techniques for persons in substance abuse treatment who have a history of incest victimization. While substance abuse treatment focuses on substance abuse, neglecting to address issues related to past incest contact may increase the potential for relapse. This population displays unique characteristics that may prevent them from participating in, or benefitting from, traditional treatment modalities (which are highly dependent upon the verbal interactions between clients and therapists). Play therapy and art therapy are discussed in terms of history, rationale, and benefits to clients.

  11. Consumer engagement in social networks brand community

    OpenAIRE

    Rybakovas, Paulius

    2016-01-01

    Consumers increasingly integrate social media into their day-to-day lives. For companies consumer engagement in a brand community on social network is becoming increasingly important for developing relations with consumers. Consumer engagement in a brand community on social network creates a dynamic relationship between the community members and the brand which contributes to an increase in consumer loyalty to the brand. The literature is abundant of studies, which examines the consumer engag...

  12. Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.

    Science.gov (United States)

    Janse, Pauline D; De Jong, Kim; Van Dijk, Maarten K; Hutschemaekers, Giel J M; Verbraak, Marc J P M

    2017-09-01

    Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback. Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer. Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.

  13. Nonromantic/Nonsexual Relationships with Former Clients: Implications for Psychologists' Training.

    Science.gov (United States)

    Anderson, Sharon K.

    The ethical principles and code of conduct of the American Psychological Association are clear: psychologists are to avoid sexual relationships with former clients. But guidelines offer scant guidance on nonromantic and nonsexual relationships with former clients; the ethical risks of such relationships are explored in this paper. The information…

  14. The Challenge of Prejudice: Counsellors' Talk about Challenging Clients' Prejudices

    Science.gov (United States)

    Spong, Sheila J.

    2012-01-01

    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…

  15. Patent Medicine VendorsAND#8217; Clients: Medicine Use Behaviour

    Directory of Open Access Journals (Sweden)

    Asa Auta

    2012-12-01

    Full Text Available AIM: To investigate some medicine use behaviour of Patent Medicine Vendors’ (PMVs clients including self medication practice and medication sharing behaviour. METHOD: A descriptive, cross-sectional survey was conducted in July 2011, on 361 undergraduate students of the University of Jos, Nigeria who visited PMVs within a month preceding the study. A pretested questionnaire was administered to participating students. Participants responded to questions on demography, and medicine use behaviour. Data were entered into the Statistical Package for Social Sciences (SPSS version 16 to generate descriptive statistics which were represented in percentages. RESULTS: The results showed that majority of the respondents (91.7% visited the PMVs for self-medication with the common classes of medicines procured by PMVs clients including analgesics (38.4%, antimalarials (22.2% and nutrition/blood preparations (14.1%. About 78.5% of the medicines sold to PMVs clients were in their original package and only 45.9% of clients reported checking the expiry date of their procured medicine prior to use. Medication sharing behaviour was common (60.2% among respondents. Although most respondents (70.2% said they had read a medicine information leaflet in the past, majority of them depended on unreliable sources such as friends/relatives (23.2%, media (10.8% and the internet (9.9% for medicine information. CONCLUSION: The study therefore demonstrated that PMV clients are those on self-medication practices and medication sharing behaviour is high among them. [TAF Prev Med Bull 2012; 11(6.000: 681-686

  16. Client-Centered Employee Assistance Services.

    Science.gov (United States)

    Bayer, Darryl Lee

    This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

  17. Hsp90: Friends, clients and natural foes.

    Science.gov (United States)

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

    2016-08-01

    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.

  18. A real time multi-server multi-client coherent database for a new high voltage system

    International Nuclear Information System (INIS)

    Gorbics, M.; Green, M.

    1995-01-01

    A high voltage system has been designed to allow multiple users (clients) access to the database of measured values and settings. This database is actively maintained in real time for a given mainframe containing multiple modules each having their own database. With limited CPU nd memory resources the mainframe system provides a data coherency scheme for multiple clients which (1) allows the client to determine when and what values need to be updated, (2) allows for changes from one client to be detected by another client, and (3) does not depend on the mainframe system tracking client accesses

  19. Dinheiro, afeto, sexualidade: a relação de prostitutas com seus clientes Dinero, afecto y sexualidad: la relación de prostitutas com sus clientes Money, affection and sexuality: the prostitutes' relationship with clients

    Directory of Open Access Journals (Sweden)

    Fernanda Burbulhan

    2012-12-01

    Full Text Available A prostituição é alvo constante de diferentes olhares, e para desvelar alguns de seus significados, resolvemos estudar a relação estabelecida entre a prostituta e o seu cliente. Para tanto, elegemos a abordagem qualitativa de pesquisa, com informações obtidas através de entrevista semiestruturada. Nosso estudo contou com sete participantes mulheres, com idade mínima de dezoito anos e envolvimento com a prática da prostituição há pelo menos um ano. As participantes responderam um questionário socioeconômico e foram entrevistadas, sendo as entrevistas posteriormente submetidas à análise de conteúdo. Com base nas informações obtidas, concluímos que a relação estabelecida entre prostitutas e seus clientes fundamenta-se no dinheiro, tanto em relação ao que o cliente paga quanto em relação àquilo que ele não pode pagar, porque "não tem preço". Essa negociação serve de alicerce para o estabelecimento de condições de ser-estar dessas mulheres profissionais do sexo dentro e fora da prostituição.La prostitución es objetivo constante de diferentes puntos de vista y a fin de aclarar algunos de sus significados, se optó por estudiar la relación establecida entre la prostituta y su cliente. Así, elegimos un enfoque cualitativo de la investigación, con la información obtenida a través de entrevista semiestructurada. Nuestro estudio contó con la presencia de siete participantes del sexo femenino, con edad mínima de 18 años y su participación en el ejercicio de la prostitución en al menos un año. Las participantes respondieron a un cuestionario socioeconómico y fueron entrevistadas, y las entrevistas posteriormente objeto de análisis de contenido. Podemos concluir que la relación establecida entre las prostitutas y sus clientes se basa en el dinero, tanto en relación a lo que el cliente paga, así como en lo que respecta a lo que él no puede pagar porque "no tiene un precio". Este acuerdo sirve como base

  20. The Performance and Compatibility of Thin Client Computing with Fleet Operations

    National Research Council Canada - National Science Library

    Landry, Kenneth J

    2006-01-01

    ...) with a thin client/server-based computing (TCSBC) architecture. After becoming nearly extinct in the early 1990s, thin clients are emerging on the forefront of technology with numerous bandwidth improvements and cost reduction benefits...

  1. Paying by the hour: The least appealing option for clients of lawyers

    OpenAIRE

    Seldeslachts, Jo

    2016-01-01

    In this study, we analyze a client's choice of contract in auctions where Dutch law firms compete for cases. The distinguishing feature is that lawyers may submit bids with any fee arrangement they wish. We find robust evidence that bids offering hourly rates are less attractive to clients. Our findings tentatively contradict lawyers' often-made argument that hourly rates are in a client's best interest.

  2. Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective

    OpenAIRE

    Jati Utomo Dwi Hatmoko; Riqi Radian Khasania

    2016-01-01

    By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respo...

  3. Channel Access Client Toolbox for Matlab

    International Nuclear Information System (INIS)

    2002-01-01

    This paper reports on MATLAB Channel Access (MCA) Toolbox--MATLAB [1] interface to EPICS Channel Access (CA) client library. We are developing the toolbox for SPEAR3 accelerator controls, but it is of general use for accelerator and experimental physics applications programming. It is packaged as a MATLAB toolbox to allow easy development of complex CA client applications entirely in MATLAB. The benefits include: the ability to calculate and display parameters that use EPICS process variables as inputs, availability of MATLAB graphics tools for user interface design, and integration with the MATLABbased accelerator modeling software - Accelerator Toolbox [2-4]. Another purpose of this paper is to propose a feasible path to a synergy between accelerator control systems and accelerator simulation codes, the idea known as on-line accelerator model

  4. Distribución comercial: Tema 14. El servicio al cliente en el comercio minorista

    OpenAIRE

    Juan Vigaray, María Dolores de

    2010-01-01

    El servicio al cliente tiene una importancia trascendente a la hora de mantener y recuperar clientes. Un mal servicio al cliente puede anular completamente un producto fantástico. Se debe de recordar al cliente la posibilidad y el interés de la empresa en que reclame y diga cualquier cosa que no le haya satisfecho, para que la empresa pueda corregir el error y compensarle.

  5. Becoming a client of the Danish social service system increases stress in parents of disabled infants.

    Science.gov (United States)

    Graungaard, Anette Hauskov; Skov, Liselotte; Andersen, John Sahl

    2011-06-01

    Parents of a young child with severe disabilities are facing a large range of new challenges; furthermore, most of these families have extended social needs regarding information, financial support, day care facilities, disability aids, etc. Many parents with disabled children have been found to be dissatisfied with social services. This study explores parents' experiences with Danish social services during their transition to a new daily life after the birth of a severely disabled child. Repeated qualitative interviews were performed individually with 16 parents of a severely disabled young child during the first two years after the diagnosis of the child's disabilities. Data were analysed using grounded theory. We found that the encounter with the social services increased stress in the families. Parental expectations were not met, especially regarding information; parents felt clientized, and obtaining social support was very resource consuming. Parents' needs regarding practical support and empathic case-working were not met and they spent much time and effort due to lacking continuity between sectors. Parents have specific needs when becoming clients in the social service system whose organisation of social services needs improvement. Health care professionals are advised to identify problems and support cooperation between the parents and the social service system, as well as to report the health-related consequences of prolonged and inefficient case-working for the child and its parents. was received from Socialministeriet, Landsforeningen LEV, Ronald McDonalds Børnefond, Susie og Peter Robinsohns fond, Rosalie Petersens fond, PLU-fonden, Ville Heises fond, Sygesikringens forskningsfond, Helsefonden, Elsass fonden. not relevant.

  6. Lightweight Tactical Client: A Capability-Based Approach to Command Post Computing

    Science.gov (United States)

    2015-12-01

    bundles these capabilities together is proposed: a lightweight tactical client. In order to avoid miscommunication in the future, it is... solutions and almost definitely rules out most terminal-based thin clients. UNCLASSIFIED Approved for public release

  7. 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 ...

  8. Exploring Psychotherapy Clients' Independent Strategies for Change While in Therapy

    Science.gov (United States)

    Mackrill, Thomas

    2008-01-01

    Psychotherapy research usually describes how client change is caused by therapist interventions. This article describes how clients change by continuing to use and revising the strategies for change that they bring with them when they first enter therapy. This article presents data from a qualitative diary study of psychotherapy. Three cases…

  9. Do Organizational Culture and Climate Matter for Successful Client Outcomes?

    Science.gov (United States)

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

    2014-01-01

    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…

  10. Client Participation in Managing Social Work Service--An Unfinished Quest

    Science.gov (United States)

    Leung, Terry T. F.

    2011-01-01

    "Client participation" is a popular ideal and object of rhetorical commitment in social work service. But the much-touted potential of this concept requires careful and critical scrutiny. This article reports on a study of client-participation initiatives in the Hong Kong welfare sector. The study identified significant differences in…

  11. Parallel Journeys: How a Music Therapist Can Travel with his Client

    OpenAIRE

    Henry Dunn

    2009-01-01

    This paper explores the nature of the client-therapist relationship through the presentation of a case study. In this case study I aim to show how our processes within the therapy had strong parallels and how through being personally affected by my client this enabled me to work therapeutically more effectively and help him on his journey. The case study demonstrates how I was prepared to try new techniques at the same time as my client became more experimental, and also reveals how the clien...

  12. International Engagement Strategy

    Science.gov (United States)

    2017-06-14

    agreements and issue legal guidance on international law and intellectual property issues. ICPO will play an important role in realizing this vision and...the U.S. and its partners. INTERNATIONAL ENGAGEMENT VISION The directorate’s vision is for global S&T engagements to take advantage of emerging ideas...reduce risk to U.S. and partner countries, and increase their resilience; and Establish enduring relationships to provide access to

  13. A corporalidade do cliente segundo representações de estudantes de enfermagem La corporalidad del cliente según representaciones de estudiantes de enfermería The corporality of the client according to nursing students representations

    Directory of Open Access Journals (Sweden)

    Renata Campos de Lima

    2006-12-01

    Full Text Available É um estudo fundamentado na teoria da Representação Social que subsidiou a apreensão e análise de como as estudantes de enfermagem perceberam e representaram o corpo de seus clientes e as subjetividades emergentes do contato da relação do cuidar. Foi realizado junto a 20 estudantes do sexo feminino das quatro séries de graduação em Enfermagem da UNIFESP. Os dados foram obtidos utilizando a entrevista aberta e analisados pelo método Análise de Conteúdo (Análise Categorial, o qual desvelou as seguintes categorias: corpo objeto, estigmatização, relação estudante-cliente, comunicação corporal, invasão de privacidade e constrangimento.Es un estudio basado en la teoría de la Representación Social que subsidió la incautación y análisis de como las estudiantes de enfermería percibieron y representaron el cuerpo de sus clientes y las subjetividades emergentes del contacto de la relación del cuidar. Fue realizado junto la 20 estudiantes del sexo femenino de las cuatro series de graduación en Enfermería de la UNIFESP. Los datos fueron obtenidos utilizando la entrevista abierta y analizados por el método Análisis de Contenido (Análisis Categorial, lo cual desveló las siguientes categorías: cuerpo objeto, estigmatizacion, relación estudiante-cliente, comunicación corporal, invasión de privacidad y constreñimiento.This study based on the theory of the Social Representation that subsidized the apprehension and analysis of how nursing students had perceived and represented the body of their clients and the emergent subjectives of contact and relation of taking care. It was carried with 20 female students of four grades of the nursing faculty of the UNIFESP. The data were obtained using interview and analysed by content analysis method (Categorial Analysis that showed the following categories: body object, stigmatisation, student-client relationship, body communication, privacy's intrusion and embarrassing.

  14. Positive Psychology in the Class: The Effectiveness of a Teaching Method Based on Subjective Well-Being and Engagement Increasing Activities

    Science.gov (United States)

    Eryilmaz, Ali

    2015-01-01

    The aim of the present study is investigate that the effectiveness of a teaching method which is based on subjective well-being increasing activities and engagement increasing activities, has been developed for university students in the present study. The method of the present study is a mixed method. Thus, the most important feature of it has…

  15. 37 CFR 10.85 - Representing a client within the bounds of the law.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Representing a client within... OFFICE Patent and Trademark Office Code of Professional Responsibility § 10.85 Representing a client within the bounds of the law. (a) In representation of a client, a practitioner shall not: (1) Initiate...

  16. Effects of Counselor Gender and Gender-Role Orientation on Client Career Choice Traditionality.

    Science.gov (United States)

    Barak, Azy; And Others

    1988-01-01

    Male (N=120) and female (N=120) clients were counseled by male or female counselor classified as masculine, feminine, or androgynous in sex-role orientation. Clients' career choice traditionality was measured during counseling, following counseling, and with respect to clients' career six months later. Counselor gender and gender-role orientation…

  17. Positive reinforcement to promote safer sex among clients.

    Science.gov (United States)

    Raman, S

    1992-01-01

    The AIDS Research Foundation of India (ARFI) began an intervention program with sex workers in Madras where the women reported that they were willing to use condoms, whereas the customers were not. Accordingly, ARFI is focusing on clients using a positive reinforcement approach: repetition of the desirability of condom use by communication. First, truck drivers and dock workers have been targeted. Drivers interviewed by ARFI were familiar with the condom as a contraceptive method rather than a disease-preventing method, and used it with their wives. The ARFI program has convinced tobacco shopkeepers to stock condoms for drivers. Truckers receive key chains with a holder for a condom. At transit site tea shops songs are aired about road and roadside safety sponsored by a tire manufacturer with a message about rubber (tires and condoms). Women selling sex at transit sites are also educated about the human immunodeficiency virus (HIV) infection and sexually transmitted diseases (STDs) while attempting to increase their level of hygiene. The typical Friday night sex-seeking behavior among dock workers consists of drinking in a wine shop and soliciting sex workers. Port management and unions have also been recruited for promoting AIDS-related education after participating in health education sessions with flip charts and flash cards. Rest rooms display posters on condom use, some men have been recruited as condom holders for distribution on Friday nights, and barber shops also feature posters with messages about safer sex. AIDS/STD prevention programs have to deal with prevailing practices, values, and beliefs. Results indicate increased condom use among clients as shown by increased sales at transit site tobacco shops and shops around the port. In the future the program will pay more attention to improving the negotiation skills of sex workers.

  18. Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective

    Directory of Open Access Journals (Sweden)

    Jati Utomo Dwi Hatmoko

    2016-09-01

    Full Text Available By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respondents. The results show that there is a significant difference between both types of client performance. Three variables related to financial indicators, i.e. timely payment, owner value estimate, and payment approval, rank in the bottom three of the government client performance, but in contrast rank in the top three of the private ones. These results suggest that the government clients’ performance is perceived inferior to the private ones. Establishing a clients’ forum for sharing knowledge and best practices would be a strategic solution to enhance clients’ capacities.

  19. Digital Storytelling: A Method for Engaging Students and Increasing Cultural Competency

    Science.gov (United States)

    Grant, Natalie S.; Bolin, Brien L.

    2016-01-01

    Digital storytelling is explored as a method of engaging students in the development of media literacy and cultural competency. This paper describes the perceptions and experiences of 96 undergraduate students at a large Midwestern university, after completing a digital storytelling project in a semester-long diversity course. Digital storytelling…

  20. The Effects of Client-Counselor Racial Matching on Therapeutic Outcome

    Science.gov (United States)

    Kim, Eunha; Kang, Minchul

    2018-01-01

    This study explored the effects of ethnic/racial matching on psychotherapy outcomes via the number of counseling sessions attended by clients, using clinical data collected from a university's counseling center. A total sample of 644 clients (193 men, 448 women) was selected and the ethnic/racial distribution of the sample comprised 499…