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Sample records for referral patterns proactive

  1. Physician Referral Patterns

    Data.gov (United States)

    U.S. Department of Health & Human Services — The physician referral data was initially provided as a response to a Freedom of Information (FOIA) request. These files represent data from 2009 through June 2013...

  2. Referral pattern of hemodialysis patients to nephrologists

    International Nuclear Information System (INIS)

    Anees, M.; Mumtaz, A.; Nazir, M.; Ibrahim, M.; Kausar, T.

    2007-01-01

    To determine the referral pattern of dialysis patients to nephrologists and the effects of late referral on clinical, hematological and biochemical parameters in patients presenting for the first-time to dialysis center. This study was conducted on all patients of end stage renal diseases presenting for the first-time for undergoing hemodialysis at our center. Patients with acute renal failure were excluded from the study. At presentation, a history was taken from all the patients regarding seeking of nephrology services and referral pattern. Early and late referral was defined as the time of first referral or admission to a nephrologists greater or less than six months respectively before initiation of hemodialysis. All the patients were examined and their blood sample was drawn at the same time for routine hematological, biochemical parameters (urea, creatinine, serum potassium, calcium, phosphate and albumin) and viral markers (Anti HCV and HbsAg). In this study, 248 patients were enrolled, amongst them, 131 (52.8%) were male and 117 (47.2%) were female. Major causes of renal failure were diabetes mellitus, chronic glomerulonephritis and hypertension. Most of the patients were euvolemic and hypertensive. Sixty percent of patients were having very high urea (>200 mg/dl) and creatinine (>8.0 mg/dl). Most of the patients, 226 (91.1%), were anemic (Hemoglobin <11gm/dl) and 224 (90%) were hypoalbuminemic (serum albumin < 4gm/dl) on first presentation. Majority of patients were hyperkalemic, 139 (56.0%), hypocalcemic, 168 (67.7%) and serum phosphate level was high in only 117 (47%) patients. All the patients presented in emergency room to nephrologists at very late stage (100% late referral), when disease was very much advanced. All of them did not have permanent vascular access for hemodialysis on first presentation to dialysis center. Reasons for late referral were non-availability of nephrologists and nephrology services, non-renal doctors biased, unawareness and

  3. Primary care physician referral patterns in Ontario, Canada: a descriptive analysis of self-reported referral data.

    Science.gov (United States)

    Liddy, Clare; Arbab-Tafti, Sadaf; Moroz, Isabella; Keely, Erin

    2017-08-22

    In many countries, the referral-consultation process faces a number of challenges from inefficiencies and rising demand, resulting in excessive wait times for many specialties. We collected referral data from a sample of family doctors across the province of Ontario, Canada as part of a larger program of research. The purpose of this study is to describe referral patterns from primary care to specialist and allied health services from the primary care perspective. We conducted a prospective study of patient referral data submitted by primary care providers (PCP) from 20 clinics across Ontario between June 2014 and January 2016. Monthly referral volumes expressed as a total number of referrals to all medical and allied health professionals per month. For each referral, we also collected data on the specialty type, reason for referral, and whether the referral was for a procedure. PCPs submitted a median of 26 referrals per month (interquartile range 11.5 to 31.8). Of 9509 referrals eligible for analysis, 97.8% were directed to medical professionals and 2.2% to allied health professionals. 55% of medical referrals were directed to non-surgical specialties and 44.8% to surgical specialties. Medical referrals were for procedures in 30.8% of cases and non-procedural in 40.9%. Gastroenterology received the largest share (11.2%) of medical referrals, of which 62.3% were for colonoscopies. Psychology received the largest share (28.3%) of referrals to allied health professionals. We described patterns of patient referral from primary care to specialist and allied health services for 30 PCPs in 20 clinics across Ontario. Gastroenterology received the largest share of referrals, nearly two-thirds of which were for colonoscopies. Future studies should explore the use of virtual care to help manage non-procedural referrals and examine the impact that procedural referrals have on wait times for gastroenterology.

  4. A Review Of Referral Patterns For Sagittal Synostosis In Ireland: 2008-2013

    LENUS (Irish Health Repository)

    Berney, M J

    2018-01-01

    Sagittal synostosis (SS) is the commonest form of craniosynostosis. Children with sagittal synostosis in Ireland are treated in the National Paediatric Craniofacial Centre (NPCC) in Temple Street Children’s University Hospital. This retrospective study analysed the correlation between referral patterns to the unit and age at operation. The notes of 81 patients referred over a 5 year period (April 2008 – April 2013) to the NPCC with non-syndromic SS were reviewed and demographics and referral information were recorded. Of 81 patients reviewed, 60 (74%) were referred before 6 months of age, while 21 (26%) had late referrals. Neonatologists referred 100% of infants before 6 months, paediatricians referred 71%, and GPs 64%. Later referral was associated with a more complex referral pathway, including multiple-steps of referral and unnecessary investigations. Improved clinician knowledge and emphasis on the importance of early referral may lead to a reduction in late referrals.

  5. Schema benefit vs. proactive interference: Contradicting behavioral outcomes and coexisting neural patterns.

    Science.gov (United States)

    Oren, Noga; Shapira-Lichter, Irit; Lerner, Yulia; Tarrasch, Ricardo; Hendler, Talma; Giladi, Nir; Ash, Elissa L

    2017-09-01

    Prior knowledge can either assist or hinder the ability to learn new information. These contradicting behavioral outcomes, referred to as schema benefit and proactive interference respectively, have been studied separately. Here we examined whether the known neural correlates of each process coexist, and how they are influenced by attentional loading and aging. To this end we used an fMRI task that affected both processes simultaneously by presenting pairs of related short movies in succession. The first movie of each pair provided context for the second movie, which could evoke schema benefit and/or proactive interference. Inclusion of an easy or hard secondary task performed during encoding of the movies, as well as testing both younger (22-35y) and older (65-79y) adults, allowed examining the effect of attentional load and older age on the neural patterns associated with context. Analyses focused on three predefined regions and examined how their inter-subject correlation (inter-SC) and functional connectivity (FC) with the hippocampi changed between the first and second movie. The results in the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) matched and expanded previous findings: higher inter-SC and lower FC were observed during the second compared to the first movie; yet the differentiation between the first and second movies in these regions was attenuated under high attentional load, pointing to dependency on attentional resources. Instead, at high load there was a significant context effect in the FC of the left ventrolateral prefrontal cortex (vlPFC), and greater FC in the second movie was related to greater proactive interference. Further, older adults showed context effect in the PCC and vlPFC. Intriguingly, older adults with inter-SC mPFC patterns similar to younger adults exhibited schema benefit in our task, while those with inter-SC PCC patterns similar to younger adults showed proactive interference in an independent task. The

  6. Referral patterns of community health workers diagnosing and treating malaria

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Magnussen, Pascal

    2016-01-01

    Malaria-endemic countries have implemented community health worker (CHW) programs to provide malaria diagnosis and treatment to populations living beyond the reach of health systems. However, there is limited evidence describing the referral practices of CHWs. We examined the impact of malaria...... rapid diagnostic tests (mRDTs) on CHW referral in two cluster-randomized trials, one conducted in a moderate-to-high malaria transmission setting and one in a low-transmission setting in Uganda, between January 2010 and July 2012. All CHWs were trained to prescribe artemisinin-based combination therapy...... (ACT) for malaria and recognize signs and symptoms for referral to health centers. CHWs in the control arm used a presumptive diagnosis for malaria based on clinical symptoms, whereas intervention arm CHWs used mRDTs. CHWs recorded ACT prescriptions, mRDT results, and referral inpatient registers...

  7. Referral patterns of children with poor growth in primary health care

    NARCIS (Netherlands)

    Grote, F.K.; Oostdijk, W.; Muinck Keizer-Schrama, S.M.P.F. de; Dekker, F.W.; Dommelen, P. van; Buuren, S. van; Lodder-van der Kooij, A.M.; Verkerk, P.H.; Wit, J.M.

    2007-01-01

    Background. To promote early diagnosis and treatment of short stature, consensus meetings were held in the mid nineteen nineties in the Netherlands and the UK. This resulted in guidelines for referral. In this study we evaluate the referral pattern of short stature in primary health care using these

  8. Attitude towards psychiatric treatment and referral pattern in the ...

    African Journals Online (AJOL)

    clinical practice in both primary and secondary care.4 It is therefore ... specifically related to stigma4, severity of illness and past ... patients, stigma, concerns about the effect of psychiatric referral on ... They found the use of psychotropic drugs often necessary, ... The cross-sectional study was conducted at the University of.

  9. Clinical neurophysiology referral patterns to a tertiary hospital--a prospective audit.

    LENUS (Irish Health Repository)

    Renganathan, R

    2012-02-03

    BACKGROUND: Cork University Hospital (CUH) provides a tertiary service for all neurophysiology referrals in the Southern Health Board region. AIM: To ascertain the number, source, symptoms and diagnosis of neurophysiology referrals at CUH. METHODS: We did a prospective audit of the referral patterns to the neurophysiology department over a 12 -week period. RESULTS: Of 635 referrals, 254 had electromyograms (EMG), 359 had electro-encephalograms (EEG), 18 had visual evoked potentials (VEP), three had somato-sensory evoked potentials (SSEP) and one had multiple sleep latency tests (MSLT). We analysed the demographic pattern, reason for referrals, the average waiting time for neurophysiology tests and the patterns of diagnosis in this audit. CONCLUSIONS: Patients from County Cork are making more use of the neurophysiology services than patients from other counties within the Southern Health Board. The average waiting time for an EEG was 32 days and for an EMG was 74 days. However, more than 35% of those patients waiting for an EEG or an EMG had their tests done within four weeks of referral. The appointments of EEG and EMG were assigned on the basis of clinical need.

  10. Referral patterns of children with poor growth in primary health care

    Directory of Open Access Journals (Sweden)

    van Buuren Stef

    2007-05-01

    Full Text Available Abstract Background To promote early diagnosis and treatment of short stature, consensus meetings were held in the mid nineteen nineties in the Netherlands and the UK. This resulted in guidelines for referral. In this study we evaluate the referral pattern of short stature in primary health care using these guidelines, comparing it with cut-off values mentioned by the WHO. Methods Three sets of referral rules were tested on the growth data of a random sample (n = 400 of all children born between 01-01-1985 and 31-12-1988, attending school doctors between 1998 and 2000 in Leiden and Alphen aan den Rijn (the Netherlands: the screening criteria mentioned in the Dutch Consensus Guideline (DCG, those of the UK Consensus Guideline (UKCG and the cut-off values mentioned in the WHO Global Database on Child growth and Malnutrition. Results Application of the DCG would lead to the referral of too many children (almost 80%. The largest part of the referrals is due to the deflection of height, followed by distance to target height and takes primarily place during the first 3 years. The deflection away from the parental height would also lead to too many referrals. In contrast, the UKCG only leads to 0.3% referrals and the WHO-criteria to approximately 10%. Conclusion The current Dutch consensus guideline leads to too many referrals, mainly due to the deflection of length during the first 3 years of life. The UKCG leads to far less referrals, but may be relatively insensitive to detect clinically relevant growth disorders like Turner syndrome. New guidelines for growth monitoring are needed, which combine a low percentage of false positive results with a good sensitivity.

  11. Effects on referral patterns of reducing intensive informational campaigns about first-episode psychosis

    DEFF Research Database (Denmark)

    Joa, Inge; Johannessen, Jan Olav; Auestad, Bjørn

    2007-01-01

    The primary aim of this study was to assess referral patterns and duration of untreated psychosis (DUP) following the partial dismantling of intensive, information campaigns (IC) to help detect first-episode, non-affective psychosis via early detection teams in the TIPS study.......The primary aim of this study was to assess referral patterns and duration of untreated psychosis (DUP) following the partial dismantling of intensive, information campaigns (IC) to help detect first-episode, non-affective psychosis via early detection teams in the TIPS study....

  12. Referral patterns and service utilization in a pediatric hospital-wide intimate partner violence program.

    Science.gov (United States)

    Cruz, Mario; Cruz, Patricia B; Weirich, Christine; McGorty, Ryan; McColgan, Maria D

    2013-08-01

    To describe the referral patterns and utilization of on-site intimate partner violence (IPV) services in both inpatient and outpatient settings at a large urban children's hospital. Retrospective review of case records from IPV victims referred to an on-site IPV counselor between September 2005 and February 2010. Descriptive statistics were used to examine IPV victim demographics, number of referrals per hospital department, referral source (type of staff member), time spent by IPV counselor for initial consultation, and services provided to IPV victims. A total of 453 unique referrals were made to the IPV counselor: 81% were identified by universal screening and 19% by risk-based screening. Thirty-six percent of IPV victims were referred from primary care clinics; 26% from inpatient units; 13% from outpatient subspecialty clinics; 12.5% from the emergency department; 5% from the Child Protection Program; and 4% were employee self-referrals. Social workers generated the most referrals (55%), followed by attending physicians (17%), residents (13%), nurses (7%), and other individuals (self-referrals) (4%). The median initial IPV intervention required 42 minutes. Supportive counseling and safety planning were the services most often utilized by IPV victims. IPV screening can be successfully integrated in both inpatient and outpatient settings by a multidisciplinary group of hospital staff. Most referrals were generated by universal screening outside of the primary care setting. IPV victims generally desired supportive counseling and safety planning over immediate housing relocation. Many IPV screening opportunities were missed by using verbal screening alone. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Patient referral patterns and the spread of hospital-acquired infections through national health care networks.

    Directory of Open Access Journals (Sweden)

    Tjibbe Donker

    2010-03-01

    Full Text Available Rates of hospital-acquired infections, such as methicillin-resistant Staphylococcus aureus (MRSA, are increasingly used as quality indicators for hospital hygiene. Alternatively, these rates may vary between hospitals, because hospitals differ in admission and referral of potentially colonized patients. We assessed if different referral patterns between hospitals in health care networks can influence rates of hospital-acquired infections like MRSA. We used the Dutch medical registration of 2004 to measure the connectedness between hospitals. This allowed us to reconstruct the network of hospitals in the Netherlands. We used mathematical models to assess the effect of different patient referral patterns on the potential spread of hospital-acquired infections between hospitals, and between categories of hospitals (University medical centers, top clinical hospitals and general hospitals. University hospitals have a higher number of shared patients than teaching or general hospitals, and are therefore more likely to be among the first to receive colonized patients. Moreover, as the network is directional towards university hospitals, they have a higher prevalence, even when infection control measures are equally effective in all hospitals. Patient referral patterns have a profound effect on the spread of health care-associated infections like hospital-acquired MRSA. The MRSA prevalence therefore differs between hospitals with the position of each hospital within the health care network. Any comparison of MRSA rates between hospitals, as a benchmark for hospital hygiene, should therefore take the position of a hospital within the network into account.

  14. Profile of atrial fibrillation inpatients: Cardiovascular risk factors and cardiac rehabilitation programme delivery and referral patterns.

    Science.gov (United States)

    Gallagher, Robyn; Zhang, Ling; Roach, Kellie; Sadler, Leonie; Belshaw, Julie; Kirkness, Ann; Proctor, Ross; Neubeck, Lis

    2015-12-01

    Atrial fibrillation (AF) is increasingly common; however, the cardiovascular risk factor profile and the patterns of delivery and referral to cardiac rehabilitation (CR) in this population are poorly described. We conducted an audit of medical records (n = 145) of patients admitted with AF in one local health district in Sydney, Australia. Patients were aged a mean 72 years, and 51% were male. Lack of risk factor documentation was common. Despite this, 65% had two or more modifiable cardiovascular risk factors, including hypertension (63%) and hypercholesterolaemia (52%). Referral to Phase II CR occurred for 25% and was decreased with permanent AF diagnosis and increased with more risk factors. AF patients admitted to hospital have multiple cardiovascular risk factors but limited risk factor screening and/or referral to outpatient CR programmes. © 2014 Wiley Publishing Asia Pty Ltd.

  15. Referral to the Hospital And Emergency Ambulance Service Uses Patterns of the Inmates and Convicts

    Directory of Open Access Journals (Sweden)

    Emine Oncu

    2014-03-01

    Full Text Available Aim: The purpose of this study was to determine the reasons for referral to the hospital and 112 emergency ambulance service uses patterns of the inmates and convicts in an E type prison. Material and Method: In this descriptive study, it was evaluated the prison records associated with referral to the hospital and 112 emergency ambulance service uses for one year in 2010- 2011. Of the statistical analysis, descriptive statistics, chi-square test and Fisher%u2019s Exact Test were used. Results: All inmates and convicts were man, the median of age was 30,0 (min 18- max 68 years and substance use was 34,5%. The number of prisoners were referred to the hospital 815, total referrals were 1491; (referrals ranged from one to six and most common in January; and according to frequency, reasons of the referral were eyes problems, musculoskeletal disorders and psychological problems. Emergency medical service was used for in medical causes (78,3%, accident, trauma and injuries (16,4%, suicide (5,3%. Discussion: Findings from the study show that prisoners are more likely to have suffered physical and mental health problems that compared to the rest of society and have significantly high substance use rates.

  16. Patterns of Palliative Care Referral in Patients Admitted With Heart Failure Requiring Mechanical Ventilation.

    Science.gov (United States)

    Wiskar, Katie J; Celi, Leo Anthony; McDermid, Robert C; Walley, Keith R; Russell, James A; Boyd, John H; Rush, Barret

    2018-04-01

    Palliative care is recommended for advanced heart failure (HF) by several major societies, though prior studies indicate that it is underutilized. To investigate patterns of palliative care referral for patients admitted with HF exacerbations, as well as to examine patient and hospital factors associated with different rates of palliative care referral. Retrospective nationwide cohort analysis utilizing the National Inpatient Sample from 2006 to 2012. Patients referred to palliative care were compared to those who were not. Patients ≥18 years of age with a primary diagnosis of HF requiring mechanical ventilation (MV) were included. A cohort of non-HF patients with metastatic cancer was created for temporal comparison. Between 2006 and 2012, 74 824 patients underwent MV for HF. A referral to palliative care was made in 2903 (3.9%) patients. The rate of referral for palliative care in HF increased from 0.8% in 2006 to 6.4% in 2012 ( P care referral in patients with cancer increased from 2.9% in 2006 to 11.9% in 2012 ( P care ( P care. The use of palliative care for patients with advanced HF increased during the study period; however, palliative care remains underutilized in this setting. Patient factors such as race and SES affect access to palliative care.

  17. Referral patterns of patients with liver metastases due to colorectal cancer for resection.

    LENUS (Irish Health Repository)

    Al-Sahaf, O

    2012-02-01

    INTRODUCTION: Colorectal carcinoma accounts for 10% of cancer deaths in the Western World, with the liver being the most common site of distant metastases. Resection of liver metastases is the treatment of choice, with a 5-year survival rate of 35%. However, only 5-10% of patients are suitable for resection at presentation. AIMS: To examine the referral pattern of patients with liver metastases to a specialist hepatic unit for resection. METHODOLOGY: Retrospective review of patient\\'s charts diagnosed with colorectal liver metastases over a 10-year period. RESULTS: One hundred nine (38 women, 71 men) patients with liver metastases were included, mean age 61 years; 79 and 30 patients had synchronous and metachronus metastases, respectively. Ten criteria for referral were identified; the referral rate was 8.25%, with a resection rate of 0.9%. Forty two percent of the patients had palliative chemotherapy; 42% had symptomatic treatment. CONCLUSION: This study highlights the advanced stage of colorectal cancer at presentation; in light of modern evidence-based, centre-oriented therapy of liver metastasis, we conclude that criteria of referral for resection should be based on the availability of treatment modalities.

  18. Referral patterns, diagnosis, and disease management of patients with axial spondyloarthritis: results of an international survey.

    Science.gov (United States)

    van der Heijde, Désirée; Sieper, Joachim; Elewaut, Dirk; Deodhar, Atul; Pangan, Aileen L; Dorr, Alexander P

    2014-12-01

    Recognition, diagnosis, and management of axial spondyloarthritis (axial SpA) continue to advance. The objectives of this study were to compare referrals, diagnosis, and management of axial SpA in Western Europe (WE), North America (US and Canada), and the rest of world (RoW) in academic and community rheumatology practices and to identify areas for further education. Rheumatologists responded online to the MAXIMA (Management of Axial SpA International and Multicentric Approaches) survey. Questions pertained to referral, diagnosis, and management of axial SpA. Rheumatologists (N = 809) from 56 countries completed the survey about patients with chronic back pain (≥3 months) starting before age 45 years. Responses from academic and community practice rheumatologists were generally similar. Most referrals were from primary care providers. Symptom duration of 3 years or more at referral was reported more frequently by WE and RoW than US respondents. More WE and RoW than US rheumatologists referred to the Assessment of SpondyloArthritis International Society criteria for axial SpA in clinical practice. Rheumatologists reported prescribing disease-modifying antirheumatic drugs for the management of axial SpA. Sulfasalazine was frequently prescribed across regions; methotrexate was more commonly prescribed by US rheumatologists compared with other regions. Referral patterns, diagnosis, and disease management for axial SpA were similar among WE, North America, and RoW rheumatologists and in academic/community practices, although more WE and RoW rheumatologists referred to Assessment of SpondyloArthritis International Society criteria in clinical practice. Disease-modifying antirheumatic drugs were commonly prescribed for axial SpA patients, although it was unclear whether these were prescribed for axial or peripheral symptoms.

  19. Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive Study

    Directory of Open Access Journals (Sweden)

    Sarah E. P. Munce

    2016-01-01

    Full Text Available Introduction. Evidence of inappropriate bone mineral density (BMD testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario’s family physicians (FPs. Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing. Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described. Conclusions. These findings lend support to what has been documented at the population level suggesting a tendency among FPs to refer menopausal women (at low risk. Emphasis on referral of high-risk groups as well as men and further clarification and education on the appropriate intervals for follow-up testing is warranted.

  20. Referral patterns and general anesthesia in a specialized paediatric dental service.

    Science.gov (United States)

    Alkilzy, Mohammad; Qadri, Ghalib; Horn, Janina; Takriti, Moutaz; Splieth, Christian

    2015-05-01

    The caries patterns of child populations in Germany have changed during the last 20 years. This affects the referrals and provision of specialist dental care for children. This study has two aims: first, to investigate referrals received by a specialized pediatric dental institution in 1995 and 2008, and second, to assess the treatments performed during full oral rehabilitations under general anesthesia in this institution from 2007 to 2008. All data of referred patients were evaluated for 1995 and 2008 separately. Comparisons were carried out for different socio-demographic, medical, and dental parameters. All patients treated under general anesthesia (GA) between March/2007 and December/2008 were examined retrospectively and their data were analyzed. In 1995 (n = 191), significantly older children were referred to specialized pediatric dental care compared to 2008 (n = 179). In addition, a shift of surgical referrals to very young children with high caries levels was clearly noticed, resulting in considerably more oral rehabilitation performed under GA in 2008 (n = 73). Thus, the mean values of 6.4 fillings and 2.7 extractions per child were quite high. Preventive treatment approaches for primary dentition in Germany need further improvement by focusing on high caries-risk groups, as specialized pediatric dentistry bears the great burden of providing oral rehabilitations under GA in young children. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Causes and patterns of referral to a tertiary, multidisciplinary program for the treatment of childhood obesity.

    Science.gov (United States)

    Yaeger-Yarom, Gili; Nemet, Dan; Eliakim, Alon

    2011-01-01

    Despite the childhood obesity epidemic, few obese children receive therapy and relatively few weight management multidisciplinary programs exist. The objective of this study was to examine the patterns and causes for obese children referrals to a tertiary multidisciplinary childhood obesity treatment program. A total of 227 children (10.6 +/- 2.6 years; 108 boys, 119 girls) were evaluated at the beginning of the programs for personal and familial demographic and anthropometric details, the referring agent to the program, and the main reasons for participation and for the child's desire to lose weight. The majority of participants had an obese family member (83%), in particular an obese parent (62%). The majority of patients were self-referred (86.8%), mainly by their mothers (74%). Only a small fraction were referred by healthcare providers (15.4%). The desire to improve appearance (44.5%), social/psychological issues (39.2%) and the will to improve fitness (29.5%) were the main reasons for joining the program. Understanding the motives for participation and referral patterns can improve recruitment and participation of obese children in weight reduction intervention programs.

  2. Conotruncal anomalies in the fetus: Referral patterns and pregnancy outcomes in a dedicated fetal cardiology unit in South India

    OpenAIRE

    Vaidyanathan, Balu; Kumar, Shine; Sudhakar, Abish; Kumar, Raman Krishna

    2013-01-01

    Objective: To describe the referral patterns and pregnancy outcomes of fetuses with conotruncal anomalies (CTA) from a fetal cardiology unit in South India. Methods: Records of 68 women identified to have diagnosis of CTA on fetal echocardiography (mean gestational age 26.8 ? 5.9 weeks; range 17-38 weeks) during the period 2008-2011 were reviewed. Results: The most common indication for referral was suspected congenital heart disease during routine antenatal scan (89.7%). The various CTA diag...

  3. Post-acute referral patterns for hospitals and implications for bundled payment initiatives.

    Science.gov (United States)

    Lau, Christopher; Alpert, Abby; Huckfeldt, Peter; Hussey, Peter; Auerbach, David; Liu, Hangsheng; Sood, Neeraj; Mehrotra, Ateev

    2014-09-01

    Under new bundled payment models, hospitals are financially responsible for post-acute care delivered by providers such as skilled nursing facilities (SNFs) and home health agencies (HHAs). The hope is that hospitals will use post-acute care more prudently and better coordinate care with post-acute providers. However, little is known about existing patterns in hospitals׳ referrals to post-acute providers. Post-acute provider referrals were identified using SNF and HHA claims within 14 days following hospital discharge. Hospital post-acute care network size and concentration were estimated across hospital types and regions. The 2008 Medicare Provider Analysis and Review claims for acute hospitals and SNFs, and the 100% HHA Standard Analytic Files were used. The mean post-acute care network size for U.S. hospitals included 57.9 providers with 37.5 SNFs and 23.4 HHAs. The majority of these providers (65.7% of SNFs, 60.9% of HHAs) accounted for 1 percent or less of a hospital׳s referrals and classified as "low-volume". Other post-acute providers we classified as routine. The mean network size for routine providers was greater for larger hospitals, teaching hospitals and in regions with higher per capita post-acute care spending. The average hospital works with over 50 different post-acute providers. Moreover, the size of post-acute care networks varies considerably geographically and by hospital characteristics. These results provide context on the complex task hospitals will face in coordinating care with post-acute providers and cutting costs under new bundled payment models. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Trends in referral patterns, invasive management, and mortality in elderly patients referred for exercise stress testing.

    Science.gov (United States)

    Bouzas-Mosquera, Alberto; Peteiro, Jesús; Broullón, Francisco J; Calviño-Santos, Ramón; Mosquera, Víctor X; Barbeito-Caamaño, Cayetana; Larrañaga-Moreira, José María; Maneiro-Melón, Nicolás; Álvarez-García, Nemesio; Vázquez-Rodríguez, José Manuel

    2015-12-01

    Scarce data are available on the temporal patterns in clinical characteristics and outcomes of elderly patients referred for exercise stress testing. We aimed to assess the trends in baseline characteristics, tests results, referrals for invasive management, and mortality in these patients. We evaluated 11,192 patients aged ≥65years who were referred for exercise stress testing between January 1998 and December 2013. Calendar years were grouped into four quadrennia (1998-2001, 2002-2005, 2006-2009, and 2010-2013), and trends in clinical characteristics of the patients, type and results of the tests, referrals for invasive management, and mortality across the different periods were assessed. Despite a progressive decrease in the proportion of patients with non-interpretable baseline electrocardiograms or prior history of coronary artery disease, there was a gradual and marked increase in the use of cardiac imaging from 32.8% in 1998-2001 to 67.6% in 2010-2013 (pstress testing both without imaging (from 18.9 to 13.6%, pstress testing, we observed a decline over time in the probability of inducible myocardial ischemia, an increase in the use of cardiac imaging and in the rate of coronary revascularization, and an improvement in the survival rate at 1year. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  5. Physician referral patterns and racial disparities in total hip replacement: A network analysis approach.

    Directory of Open Access Journals (Sweden)

    Hassan M K Ghomrawi

    Full Text Available Efforts to reduce racial disparities in total hip replacement (THR have focused mainly on patient behaviors. While these efforts are no doubt important, they ignore the potentially important role of provider- and system-level factors, which may be easier to modify. We aimed to determine whether the patterns of interaction among physicians around THR episodes differ in communities with low versus high concentrations of black residents.We analyzed national Medicare claims from 2008 to 2011, identifying all fee-for-service beneficiaries who underwent THR. Based on physician encounter data, we then mapped the physician referral networks at the hospitals where beneficiaries' procedures were performed. Next, we measured two structural properties of these networks that could affect care coordination and information sharing: clustering, and the number of external ties. Finally, we estimated multivariate regression models to determine the relationship between the concentration of black residents in the community [as measured by the hospital service area (HSA] served by a given network and each of these 2 network properties.Our sample included 336,506 beneficiaries (mean age 76.3 ± SD, 63.1% of whom were women. HSAs with higher concentrations of black residents tended to be more impoverished than those with lower concentrations. While HSAs with higher concentrations of black residents had, on average, more acute care beds and medical specialists, they had fewer surgeons per capita than those with lower concentrations. After adjusting for these differences, we found that HSAs with higher concentrations of black residents were served by physician referral networks that had significantly higher within-network clustering but fewer external ties.We observed differences in the patterns of interaction among physicians around THR episodes in communities with low versus high concentrations of black residents. Studies investigating the impact of these differences

  6. Proactive Reviews

    DEFF Research Database (Denmark)

    Kolbæk, Ditte

    2014-01-01

    with solving a task. They found improved ways of doing the job and identified management challenges. They shared their experience with colleagues who did not attend the Proactive Review and addressed the management challenges to the senior management. Proactive Reviews were reported 50-100 times a year....... Valid feedback from various stakeholders improved the original design of After Action Reviews into Proactive Reviews, which is helpful for local as well as global companies to learn from experience. The educational design started with personal experience that was shared with colleagues who cooperated...

  7. Pattern of congenital brain malformations at a referral hospital in Saudi Arabia: An MRI study

    International Nuclear Information System (INIS)

    Alorainy, Ibrahim A.

    2006-01-01

    More than 2000 different congenital cerebral malformations have been described in the literature, for which several classification systems have been proposed. With the help of these classification systems, it is now possible, with neuroimaging, to time neuroembtyologic events. Magnetic resonance imaging (MRI), in particular, is useful in studying these malformations. This study evaluated the pattern of congenital brain malformations in a university referral hospital setting. The records of all MRI brain examinations at our hospital over a period of 3 years for children younger than 15 years of age were reviewed. Cases of congenital cerebral malformations were analyzed by sex, age at presentation, type of congenital cerebral malformation and other associated congenital cerebral malformations. Of the 808 MR examinations of different parts of the body for children in the study period, 719 (89%), on 581 patients, were of the brain. Eighty-six children (14.8%) were found to have single or multiple congenital brain malformations. In these children, 114 congenital brain malformations were identified, the commonest being cortical migrational defects (25 patients, 22%), neural tube closure defects (22 patients, 19%), and corpus callosum dysgenesis (22 patients 19%). The least common was vascular malformation. Sixteen patients (18.6%) had more than one congenital brain malformations. Neural tube closer defects, cortical migrational abnormalities, and corpus callosum anomalies were the commonest congenital brain malformations, while vascular malformations were the least common. Most of the identified malformations demonstrated the usual pattern, but a few showed unusual patterns and associations. (author)

  8. Proactive Review

    DEFF Research Database (Denmark)

    Kolbæk, Ditte

    2015-01-01

    This chapter will explore how to learn from working experience through the use of an educational approach called Proactive Review. From 2005 to 2012, Proactive Review was developed and implemented in a world-class IT company based in more than 40 countries across Europe, the Middle East, and Africa....... This chapter will include some of the theoretical considerations as well as the final educational design for a Proactive Review, as exemplified in a case study from the IT company. The aim of this chapter is to provide a theoretically based and proven educational design for Lessons Learned, including...... recommendations for successful Proactive Reviews. The theory section will explore theories regarding the following two topics: first, how an organization may understand the term “learning”; and second, the starting point of learning and how an organization may maintain a learning environment. The research...

  9. Pattern of Uveitis in a Referral Eye Clinic in North India

    Directory of Open Access Journals (Sweden)

    Singh Ramandeep

    2004-01-01

    Full Text Available Purpose: To report the pattern of uveitis in a north Indian tertiary eye center. Methods: A retrospective study was done to identify the pattern of uveitis in a uveitis clinic population of a major referral center in north India from January 1996 to June 2001. A standard clinical protocol, the "naming and meshing" approach with tailored laboratory investigations, was used for the final diagnosis. Results: 1233 patients were included in the study; 641 (51.98% were males and 592 (48.01% females ranging in age from 1.5 to 75 years. The anterior uveitis was seen in 607 patients (49.23% followed by posterior uveitis (247 patients, 20.23%, intermediate uveitis (198 patients, 16.06% and panuveitis (181 patients, 14.68%. A specific diagnosis could be established in 602 patients (48.82%. The infective aetiology was seen in 179 patients, of which tuberculosis was the commonest cause in 125 patients followed by toxoplasmosis (21 patients, 11.7%. Non-infectious aetiology was seen in 423 patients, of which ankylosing spondylitis was the commonest cause in 80 patients followed by sepigionous choroidopathy (62 patients, 14.65% . Conclusion: Tuberculosis and toxoplasmosis were the commonest form of infective uveitis, while ankylosing spondylitis and serpiginous choroidopathy were commonly seen as the non-infective causes of uveitis in North India.

  10. Impact of Ages and Stages Questionnaire Scores on Pediatrician Referral Patterns

    Science.gov (United States)

    Roane, Brandy Michelle; Valleley, Rachel J.; Allen, Keith D.

    2012-01-01

    The American Academy of Pediatrics has recommended an algorithm for identifying children with potential developmental delays. It includes a recommendation that positive screening should result in referral for additional evaluation or intervention. Yet, it is not known whether positive screens do, in fact, influence physician referrals. The primary…

  11. Pattern of midface trauma with associated concomitant injuries in a Nigerian Referral Centre

    Directory of Open Access Journals (Sweden)

    Samuel Udeabor

    2014-01-01

    Full Text Available Aim: The aim of this study was to determine the pattern of midface trauma with associated concomitant injuries seen in our environment. Methodology: This was a prospective analysis of trauma patients with midfacial injuries presenting at a referral center in South West Nigeria. In addition to socio-demographic data, the following information was also obtained: Mechanism of injuries, type of midfacial injuries, concomitant/associated injuries and treatment. Results: A total of 101 patients with midfacial injuries were involved. They were made up of 85 males and 16 females. The 20-29 year age group was mostly affected (44.6% and the most common cause of midface injuries was road traffic accident (91.1%. The zygoma was fractured more than any other midfacial bone (46.0%. A total of 144 associated injuries were recorded among these patients, head and ocular injuries accounted for 49 (34% and 35 (24.3% respectively. The patients were mostly treated conservatively or by closed reduction. Conclusion: The rate of head and ocular injuries among patients with midfacial injury was high. Knowledge of these associated injuries provides useful strategies for patient care and prevention of further complications. A multidisciplinary approach is important for optimum management of these patients.

  12. Pediatricians' attitudes, experience and referral patterns regarding complementary/alternative medicine: a national survey

    Directory of Open Access Journals (Sweden)

    Thomas Ronald

    2007-06-01

    Full Text Available Abstract Background To assess pediatricians' attitudes toward & practice of Complementary/Alternative Medicine (CAM including their knowledge, experience, & referral patterns for CAM therapies. Methods An anonymous, self-report, 27-item questionnaire was mailed nationally to fellows of the American Academy of Pediatrics in July 2004. 648 of 3500 pediatricians' surveyed responded (18%. Results The median age ranged from 46–59 yrs; 52% female, 81% Caucasian, 71% generalists, & 85% trained in the US. Over 96% of pediatricians' responding believed their patients were using CAM. Discussions of CAM use were initiated by the family (70% & only 37% of pediatricians asked about CAM use as part of routine medical history. Majority (84% said more CME courses should be offered on CAM and 71% said they would consider referring patients to CAM practitioners. Medical conditions referred for CAM included; chronic problems (headaches, pain management, asthma, backaches (86%, diseases with no known cure (55.5% or failure of conventional therapies (56%, behavioral problems (49%, & psychiatric disorders (47%. American born, US medical school graduates, general pediatricians, & pediatricians who ask/talk about CAM were most likely to believe their patients used CAM (P Conclusion Pediatricians' have a positive attitude towards CAM. Majority believe that their patients are using CAM, that asking about CAM should be part of routine medical history, would consider referring to a CAM practitioner and want more education on CAM.

  13. Specialist Physicians' Attitudes and Practice Patterns Regarding Disclosure of Pre-referral Medical Errors.

    Science.gov (United States)

    Dossett, Lesly A; Kauffmann, Rondi M; Lee, Jay S; Singh, Harkamal; Lee, M Catherine; Morris, Arden M; Jagsi, Reshma; Quinn, Gwendolyn P; Dimick, Justin B

    2018-06-01

    Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. Physicians are encouraged to disclose their own errors to patients. However, no clear professional norms exist regarding disclosure when physicians discover errors in diagnosis or treatment that occurred at other institutions before referral. We conducted semistructured interviews of cancer specialists from 2 National Cancer Institute-designated Cancer Centers. We purposively sampled specialists by discipline, sex, and experience-level who self-described a >50% reliance on external referrals (n = 30). Thematic analysis of verbatim interview transcripts was performed to determine physician attitudes regarding disclosure of pre-referral medical errors; whether and how physicians disclose these errors; and barriers to providing full disclosure. Participants described their experiences identifying different types of pre-referral errors including errors of diagnosis, staging and treatment resulting in adverse events ranging from decreased quality of life to premature death. The majority of specialists expressed the belief that disclosure provided no benefit to patients, and might unnecessarily add to their anxiety about their diagnoses or prognoses. Specialists had varying practices of disclosure including none, non-verbal, partial, event-dependent, and full disclosure. They identified a number of barriers to disclosure, including medicolegal implications and damage to referral relationships, the profession's reputation, and to patient-physician relationships. Specialist physicians identify pre-referral errors but struggle with whether and how to provide disclosure, even when clinical circumstances force disclosure. Education- or communication-based interventions that overcome barriers to disclosing pre-referral errors warrant development.

  14. Disease patterns and clinical outcomes of patients admitted in intensive care units of tertiary referral hospitals of Tanzania.

    Science.gov (United States)

    Sawe, Hendry R; Mfinanga, Juma A; Lidenge, Salum J; Mpondo, Boniventura C T; Msangi, Silas; Lugazia, Edwin; Mwafongo, Victor; Runyon, Michael S; Reynolds, Teri A

    2014-09-23

    In sub-Saharan Africa the availability of intensive care unit (ICU) services is limited by a variety of factors, including lack of financial resources, lack of available technology and well-trained staff. Tanzania has four main referral hospitals, located in zones so as to serve as tertiary level referral centers. All the referral hospitals have some ICU services, operating at varying levels of equipment and qualified staff. We analyzed and describe the disease patterns and clinical outcomes of patients admitted in ICUs of the tertiary referral hospitals of Tanzania. This was a retrospective analysis of ICU patient records, for three years (2009 to 2011) from all tertiary referral hospitals of Tanzania, namely Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Mbeya Referral Hospital (MRH) and Bugando Medical Centre (BMC). MNH is the largest of the four referral hospitals with 1300 beds, and MRH is the smallest with 480 beds. The ratio of hospital beds to ICU beds is 217:1 at MNH, 54:1 at BMC, 39:1 at KCMC, and 80:1 at MRH. KCMC had no infusion pumps. None of the ICUs had a point-of-care (POC) arterial blood gas (ABG) analyzer. None of the ICUs had an Intensive Care specialist or a nutritionist. A masters-trained critical care nurse was available only at MNH. From 2009-2011, the total number of patients admitted to the four ICUs was 5627, male to female ratio 1.4:1, median age of 34 years. Overall, Trauma (22.2%) was the main disease category followed by infectious disease (19.7%). Intracranial injury (12.5%) was the leading diagnosis in all age groups, while pneumonia (11.7%) was the leading diagnosis in pediatric patients (<18 years). Patients with tetanus (2.4%) had the longest median length ICU stay: 8 (5,13) days. The overall in-ICU mortality rate was 41.4%. The ICUs in tertiary referral hospitals of Tanzania are severely limited in infrastructure, personnel, and resources, making it difficult or impossible to provide optimum care

  15. Candidemia in a major regional tertiary referral hospital – epidemiology, practice patterns and outcomes

    Directory of Open Access Journals (Sweden)

    Jocelyn Qi-Min Teo

    2017-03-01

    Full Text Available Abstract Background Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. Methods A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. Results In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%, C. tropicalis (29.9%, and C. albicans (23.8% were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0–0.007, p = 0.04. Fluconazole resistance was detected primarily in C. tropicalis (16.7% and C. glabrata (7.2%. fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01, neutropenia (p < 0.001 and higher SAPS II scores (p = 0.02, while prior exposure to echinocandins was associated with isolation of C. parapsilosis (p = 0.001. Echinocandins (73.3% were most commonly prescribed as initial treatment. The median (range time to initial treatment was 1 (0–9 days. The 30-day in-hospital mortality rate was 49.8%. High SAPS II score (Odds ratio, OR 1.08; 95% confidence interval, CI 1.05–1.11 and renal replacement therapy (OR 5.54; CI 2.80–10.97 were independent predictors of mortality, while drain placement (OR 0.44; CI 0.19–0.99 was protective. Conclusions Decreasing azole susceptibilities to C. tropicalis and the emergence of echinocandin resistance suggest that susceptibility

  16. Retrospective study to determine the change in referral pattern to St George's Hospital Orthodontic Department before and after the 2006 NHS Dental Contract changes.

    Science.gov (United States)

    Izadi, Maryam; Gill, Daljit S; Naini, Farhad B

    2010-07-01

    The aim of this study was to determine the possible effects of the 2006 National Health Service General Dental Services contract changes on the referral pattern to the orthodontic department at St George's Hospital, South West London. This study was carried out on a retrospective basis. The notes of consecutive patients referred between 1st May and 30th September in 2005 and 2008 were assessed, and the patient's Index of Orthodontic Treatment Need (IOTN) and the source of referral noted. The total numbers of referrals increased from 260 in 2005 to 405 in 2008. The number of referrals from general dental practitioners decreased slightly from 165 to 156, as did the numbers of referrals from other sources, such as tertiary referrals. The number of referrals made by specialist practitioners increased from 41 in 2005 to 207 in 2008, representing an increase from 16% to 51% of overall referrals. Overall, the number of patients being referred with an IOTN dental health component grade of 5 increased from 27% to 55%. The increase in referrals from specialist practitioners may be partly due to the changes brought to the commissioning of orthodontic services for specialist practitioners. Overall, the number of cases being referred with IOTN grades 4 and 5 remains high at St George's Hospital, indicating that appropriate referrals are being made.

  17. An audit of referral and treatment patterns of high-risk prostate cancer patients in Alberta.

    Science.gov (United States)

    Alghamdi, Majed; Taggar, Amandeep; Tilley, Derek; Kerba, Marc; Kostaras, Xanthoula; Gotto, Geoffrey; Sia, Michael

    2016-01-01

    We aimed to determine the impact of clinical practice guidelines (CPG) on rates of radiation oncologist (RO) referral, androgen-deprivation therapy (ADT), radiation therapy (RT), and radical prostatectomy (RP) in patients with high-risk prostate cancer (HR-PCa). All men >18 years, diagnosed with PCa in 2005 and 2012 were identified from the Alberta Cancer Registry. Patient age, aggregated clinical risk group (ACRG) score, Gleason score (GS), pre-treatment prostate-specific antigen (PSA), RO referral, and treatment received were extracted from electronic medical records. Logistic regression modelling was used to examine associations between RO referral rates and relevant factors. HR-PCa was diagnosed in 261 of 1792 patients in 2005 and 435 of 2148 in 2012. Median age and ACRG scores were similar in both years (p>0.05). The rate of patients with PSA >20 were 67% and 57% in 2005 and 2012, respectively (p=0.004). GS ≤6 was found in 13% vs. 5% of patients, GS 7 in 27% vs. 24%, and GS ≥8 in 59% vs. 71% in 2005 and 2012, respectively (p<0.001). In 2005, RO referral rate was 68% compared to 56% in 2012 (p=0.001), use of RT + ADT was 53% compared to 32% (p<0.001), and RP rate was 9% vs. 17% (p=0.002). On regression analysis, older age, 2012 year of diagnosis and higher PSA were associated with decreased RO referral rates (odds ratios [OR] 0.49, 95% confidence interval [CI] 0.39-0.61; OR 0.51, 95% CI 0.34-0.76; and OR 0.64, 95% CI 0.39-0.61), respectively [p<0.001]). Since CPG creation in 2005, RO referral rates and ADT + RT use declined and RP rates increased, which demonstrates a need to improve adherence to CPG in the HR-PCa population.

  18. Demographic data, referral patterns and interventions used for children and adolescents with tinnitus and hyperacusis in Denmark

    DEFF Research Database (Denmark)

    Rosing, Susanne Nemholt; Kapandais, Anestis; Schmidt, Jesper Hvass

    2016-01-01

    OBJECTIVES: To investigate whether children and adolescents with tinnitus and/or hyperacusis are seen in Ear-Nose-Throat (ENT) clinics and to report the clinical data, treatment and referral patterns of these children. To describe the population of children and adolescents with tinnitus and...... to February 2015. All children with a primary complaint of tinnitus and/or hyperacusis was reported. No changes in daily practice regarding diagnostics, treatment or referral were made. A retrospective case review was undertaken during a five-year period from 01/01/2009 to 31/12/2013 in each Danish.......5%) had been diagnosed with tinnitus as a primary complaint. Hyperacusis was the primary complaint in 9 cases (12.8%), and both tinnitus and hyperacusis were reported in 11 cases (15.7%). The findings of this study indicate that a majority of children with tinnitus and/or hyperacusis are seen in settings...

  19. Pattern of referral of noncancer patients to palliative care in the Eastern province of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Hafez M Ghanem

    2011-01-01

    Results : From 474 patients, 20 (4.2% had a noncancer diagnosis. The main reason for the referral of noncancer patients was pain control. The most prevalent diagnoses were sickle cell disease (SCD in 6 (30% patients and peripheral arterial disease (PAD in 5 (25%. Conclusions : These findings suggest that the PC needs of noncancer patients are largely unmet in our region. Further efforts are necessary to advance noncancer PC in Saudi Arabia. The PC needs of patients with SCD and PAD need to be addressed in future research.

  20. Patterns of self-referral in men with symptoms of prostate disease.

    Science.gov (United States)

    Hale, Susan; Grogan, Sarah; Willott, Sara

    2007-09-01

    Analysis of health statistics reveals that, although men have a shorter life expectancy and a higher mortality rate than women, they have less contact with their GP. This study investigates men's experiences of prostate disease, with a particular focus on how they made the decision to seek medical help. Semi-structured interviews were carried out with 20 men aged 51-75 with prostate disease who had recently contacted their GP. These were audiotaped, transcribed and subjected to interpretative phenomenological analysis. Analysis revealed that their referral behaviours were profoundly influenced by a need to live up to traditional images of masculinity. Far from being uncaring, men were extremely anxious about their health and fears about the effects of illness and treatment emerged as major influences on their decision to seek help. Their delay in approaching their GP was due to their beliefs about symptoms as markers of serious disease, their ability to hide symptoms from others and their attitude towards male GPs who were often seen as having negative attitudes towards male patients. This study identifies some reasons why men with prostate disease may fail to seek medical care and has implications for increasing referral rates for men.

  1. Conotruncal anomalies in the fetus: Referral patterns and pregnancy outcomes in a dedicated fetal cardiology unit in South India.

    Science.gov (United States)

    Vaidyanathan, Balu; Kumar, Shine; Sudhakar, Abish; Kumar, Raman Krishna

    2013-01-01

    To describe the referral patterns and pregnancy outcomes of fetuses with conotruncal anomalies (CTA) from a fetal cardiology unit in South India. Records of 68 women identified to have diagnosis of CTA on fetal echocardiography (mean gestational age 26.8 ± 5.9 weeks; range 17-38 weeks) during the period 2008-2011 were reviewed. The most common indication for referral was suspected congenital heart disease during routine antenatal scan (89.7%). The various CTA diagnosed included Tetralogy of Fallot (TOF, 44.1%), Double outlet right ventricle (DORV, 27.9%), Transposition of great vessels (TGA, 8.8%), TOF with pulmonary atresia (TOF-PA, 8.8%), TOF absent pulmonary valve (TOF-APV, 7.4%) and truncus arteriosus (TA, 2.9%). Extra cardiac anomalies were reported in 4 fetuses (7.1%). Pregnancy outcomes included pregnancies not culminating in live-birth (54.4%), delivery at term (41.2%) with 3 patients (4.4%) being lost to follow-up. Proportion of pregnancies not culminating in live-birth lesion wise include: TOF (53.3%), DORV (52.6%), TGA (50%), TOF -APV (80%), TOF-PA (50%), and TA (50%). Twenty-four babies (35.3%) received post-natal cardiac care with 5 (7.4%) undergoing neonatal surgical procedures. Seven babies (10.3%) died in neonatal period, including 2 who underwent surgery. The accuracy of fetal echo was 96.4% for primary lesion and 67.9% for complete segmental diagnosis. Pre-natal diagnosis of CTA, despite a high diagnostic accuracy, prompted utilization of post-natal tertiary cardiac care in a limited proportion of patients, including those with reparable lesions. Focus in developing countries should shift towards earlier referral, improving awareness about treatment options and a comprehensive evaluation for associated anomalies.

  2. Pattern of childhood blindness at a referral center in Saudi Arabia.

    Science.gov (United States)

    Tabbara, Khalid F; El-Sheikh, Hisham F; Shawaf, Shucri S

    2005-01-01

    An understanding of the causes of blindness and the magnitude of the problem is crucial in designing effective intervention and prevention programs. We undertook this retrospective review to determine the causes of childhood blindness at an eye referral center. We reviewed charts of children who presented between August 1997 and August 2003. All children had a complete ophthalmologic examination. Blindness was defined as a visual acuity < 20/400, visual impairment as visual acuity between 20/400 and 20/60, and visual loss as a visual acuity < 20/60. A total of 5217 children included 220 (59%) males and 152 (41%) females (age range 2 to 18 years, mean age, 10 years). One hundred twelve (2%) were blind and 260 (5%) had visual impairment. The most common causes of bilateral blindness included optic nerve diseases, retinal disorders, and cataract. The most common causes of unilateral blindness included trauma, retinal diseases, refractive errors, and optic nerve diseases. The most common causes of bilateral visual impairment included refractive errors, corneal diseases, retinal disorders, cataract, and congenital nystagmus. Genetically determined disorders were observed in 37 (70%) of 53 patients with bilateral blindness, and in 52 (56%) of 93 patients with bilateral visual impairment. The incidence of consanguinity among parents of children with acquired causes was 2 (3%) of 59 patients compared to 34 (38%) of 89 among genetically determined causes (P < 0.001). Genetically determined disorders continue to play an important role in the causation of childhood blindness among patients attending our referral center in Saudi Arabia. Genetic counseling, early eye screening of children and public education may help in the prevention of visual disorders in children.

  3. Adult and paediatric mortality patterns in a referral hospital in Liberia 1 year after the end of the war.

    Science.gov (United States)

    Huerga, Helena; Vasset, Brigitte; Prados, Elisa

    2009-05-01

    The aim of this study was to describe and analyse hospital mortality patterns after the Liberian war. Data were collected retrospectively from January to July 2005 in a referral hospital in Monrovia, Liberia. The overall fatality rate was 17.2% (438/2543) of medical admissions. One-third of deaths occurred in the first 24h. The adult fatality rate was 23.3% (241/1034). Non-infectious diseases accounted for 56% of the adult deaths. The main causes of death were meningitis (16%), stroke (14%) and heart failure (10%). Associated fatality rates were 48%, 54% and 31% respectively. The paediatric fatality rate was 13.1% (197/1509). Infectious diseases caused 66% of paediatric deaths. In infants or =1 month old were respiratory infections (27%), malaria (23%) and severe malnutrition (16%). Associated fatality rates were 12%, 10% and 19%. Fatality rates were similar to those found in other sub-Saharan countries without a previous conflict. Early deaths could decrease through recognition and early referral of severe cases from health centres to the hospital and through assessment and priority treatment of these patients at arrival.

  4. Contrasting patterns of deficits in visuospatial memory and executive function in patients with major depression with and without ECT referral.

    Science.gov (United States)

    Tsaltas, E; Kalogerakou, S; Papakosta, V-M; Kontis, D; Theochari, E; Koutroumpi, M; Anyfandi, E; Michopoulos, I; Poulopoulou, C; Papadimitriou, G; Oulis, P

    2011-05-01

    The pretreatment neuropsychological profile of drug-resistant patients with major depressive disorder (MDD) referred for electroconvulsive therapy (ECT) may differ from that of their drug-respondent MDD counterparts. Such differences could help in identifying distinct MDD subtypes, thus offering insights into the neuropathology underlying differential treatment responses. Depressed patients with ECT referral (ECTs), depressed patients with no ECT referral (NECTs) and non-psychiatric Controls (matched groups, n=15) were assessed with memory and executive function tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). ECTs scored significantly lower than NECTs in the Mini-Mental State Examination (MMSE; p=0.01). NECTs performed worse than Controls in the Paired Associates Learning (PAL) task (p<0.03; Control/NECT p<0.01) and the Spatial Recognition Memory (SRM) task (p<0.05; Controls/NECTs p<0.05); ECTs performed between Controls and NECTs, not differing from either. In the Intra/Extradimensional (IED) set-shifting task, ECTs performed worse that Controls and NECTS (IED: p<0.01; Controls/ECTs p<0.01), particularly in the shift phases, which suggests reduced attentional flexibility. In Stockings of Cambridge (SOC), ECTs abandoned the test early more often than Controls and NECTs (H=11, p<0.01) but ECTs who completed SOC performed comparably to the other two groups. A double dissociation emerged from the comparison of cognitive profiles of ECT and NECT patients. ECTs showed executive deficits, particularly in attentional flexibility, but mild deficits in tests of visuospatial memory. NECTs presented the opposite pattern. This suggests predominantly frontostriatal involvement in ECT versus temporal involvement in NECT depressives.

  5. Assessment of Referral and Chemotherapy Treatment Patterns for Elderly Patients With Non-small-Cell Lung Cancer.

    Science.gov (United States)

    Dawe, David E; Pond, Gregory R; Ellis, Peter M

    2016-11-01

    Physiologic changes of aging in combination with greater comorbidity could lead to treatment nihilism for elderly patients (≥ 70 years old) with non-small-cell lung cancer (NSCLC). Randomized trials have shown improved survival with chemotherapy since 1999, but it remains unclear whether these data have translated into practice. We conducted a retrospective, population-based cohort study of NSCLC cases diagnosed in Ontario, Canada from 2000 to 2010. We compared referral and treatment patterns among patients aged treatment with chemotherapy. Of 61,646 patients with NSCLC, 32,131 (52.1%) were ≥ 70 years. Fewer adenocarcinomas were diagnosed in the elderly (29.8% vs. 44%), and more elderly patients lacked microscopic confirmation of malignancy (20.1% vs. 6.2%). Charlson co-morbidity scores ≥ 2 (14.0% vs. 7.4%) were higher in the elderly. Only 59.5% of elderly patients with NSCLC were referred to a medical oncologist, versus 78.5% of younger patients. Elderly patients were less likely to receive chemotherapy (18.3% vs. 46.7%), even among those referred to a medical oncologist (30.1% vs. 58.6%). Neither referral nor treatment changed substantially over time. The elderly also had a shorter median survival (5.8 vs. 9.6 months); however, there was less difference in median survival (13.6 vs. 14.9 months) among patients receiving chemotherapy. Elderly patients are less likely to be considered for systemic therapy for NSCLC, and evidence of benefit has had minimal impact on practice. We believe this disparity could be improved through systematically using tools to comprehensively assess elderly patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Possibilities for Proactive Library Services.

    Science.gov (United States)

    Morgan, Eric Lease

    1999-01-01

    Considers ways in which library services can be more proactive in today's networked-computer environment. Discusses how to find and use patterns of behavior, such as borrowing behavior and profiles of patrons' interests; making a CD-ROM with information describing the library's services and products; and reviving telephone reference. (LRW)

  7. Visual symptomatology and referral patterns for Operation Iraqi Freedom and Operation Enduring Freedom veterans with traumatic brain injury.

    Science.gov (United States)

    Bulson, Ryan; Jun, Weon; Hayes, John

    2012-01-01

    Advances in protective armor technology and changes in the "patterns of war" have created a population of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans with traumatic brain injury (TBI) that provide a unique challenge to Department of Veterans Affairs (VA) healthcare practitioners. The purpose of the study was to determine the frequency of symptomatic ocular and visual sequelae of TBI in OIF/OEF veterans at the Portland VA Medical Center, a Polytrauma Support Clinic Team site. A retrospective analysis of 100 OIF/OEF veterans with TBI was conducted to determine the prevalence of ocular and visual complaints. Referral patterns were also investigated. Visual symptoms were reported in approximately 50% of veterans with TBI. Loss of consciousness, but not number of deployments or number of blast exposures, was found to have a statistically significant association with severity of reported visual symptoms. The most commonly reported symptoms included blurred vision (67%), photosensitivity (50%), and accommodative problems (40%). Visual symptoms of OIF/OEF veterans at the Portland VA Medical Center are reported at slightly lower rates than similar studies conducted at the Palo Alto and Edward Hines Jr VA facilities.

  8. Changes in patterns of uveitis at a tertiary referral center in Northern Italy: analysis of 990 consecutive cases.

    Science.gov (United States)

    Luca, Cimino; Raffaella, Aldigeri; Sylvia, Marchi; Valentina, Mastrofilippo; Fabiana, Viscogliosi; Marco, Coassin; Annamaria, Soldani; Luisa, Savoldi; Alessandro, De Fanti; Lucia, Belloni; Alessandro, Zerbini; Maria, Parmeggiani; Matthew, Chersich; Alessandra, Soriano; Carlo, Salvarani; Luigi, Fontana

    2018-02-01

    The role of uveitis, an uncommon ocular disease, is often neglected in research and treatment of autoimmune conditions. The study described the spectrum of uveitis at a referral center in North Italy, and compared that to a previously published series of patients. We reviewed all patients with uveitis diagnosed from 2013 to 2015 at the Immunology Eye Unit, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy. We examined patient characteristics, disease spectrum, and etiologies. In total, 990 cases of uveitis were identified, who were mostly female (59%) with a median age at presentation of 44 years (interquartile range = 29-57). Anterior uveitis was most frequent (53.5%), followed by panuveitis (22.8%), posterior (16.2%), and intermediate uveitis (5.5%). Anterior herpetic uveitis (15.6%), Fuchs uveitis (9.7%), and HLA-B27 positive anterior uveitis (7.7%) were the most common specific diagnoses. Compared with the previous series, we observed an increased incidence of uveitis, and a different pattern of diagnoses. Rates of herpetic, HLA-B27 positive uveitis, and presumed ocular tuberculosis were higher, but Fuchs uveitis was less frequent. The pattern of uveitis appears to be changing, very likely due to population-level increases in infectious diseases, to the availability of new diagnostic tests and to the interdisciplinary approach used in patient diagnosis.

  9. Comparison of microbial pattern in early and late onset neonatal sepsis in referral center Haji Adam Malik hospital Medan Indonesia

    Science.gov (United States)

    Hasibuan, B. S.

    2018-03-01

    Neonatal sepsis contributes a significant rate of infants mortality and morbidity. The pathogens are diverse from region to another and change time to time even in the same place. To analyze the microbial pattern in early and late onset neonatal sepsis andthe pattern of antibiotic resistance of the causative microbes at one of referral center hospital in Indonesia, Haji Adam Malik Hospital, a cross-sectional descriptive study was conducted on neonates with sepsis diagnosis proven with positive blood culture within one year period (2015-2016). Among 626 neonates admitted to perinatology unit, the total of 154 neonates was proven to have neonatal sepsis with positive blood culture with the incidence rate 24.6%. Seventy-nine (51.3%) neonates were diagnosed with early onset sepsis while 75 (48,7%) neonates had late-onset sepsis. Klebsiella pneumonia was the most commonly isolated organism in both early and late onset sepsis, encompassing 19.5% of cases. Periodic surveillance of the causative agents of neonatal sepsis is needed to implement the rational, empirical choice of antibiotic prescription while waiting for blood culture result to come out.

  10. [Microbiological characteristics and patterns of resistance in prosthetic joint infections in a referral hospital].

    Science.gov (United States)

    Ortega-Peña, Silvestre; Colín-Castro, Claudia; Hernández-Duran, Melissa; López-Jácome, Esaú; Franco-Cendejas, Rafael

    2015-01-01

    The prosthetic joint infection is the most feared and catastrophic complication for cause severe physical damage to patients and, generates high economic costs. To describe the microbiological characteristics and to determine the resistance pattern in prosthetic joint infections in a reference hospital in Mexico. Patients whose prosthetic devices were withdrawn due to suspicion of septic and aseptic loosening were included. Cultures were performed to identify microorganisms and susceptibility analysis. Of the 111 patients included, 55% were diagnosed with prosthetic joint infection, with the most frequent prosthesis being of the hip (43%). Positive cultures were obtained in 97% of the infected cases, of which 75% were monomicrobial infections. The most frequent bacterial species isolated were: Staphylococcus epidermidis (31%), Enterococcus faecalis (16%), Staphylococcus aureus (13%), and Escherichia coli (8%). The resistance patterns for the Staphylococcus genus were: oxacillin (79%), erythromycin (45%) and ciprofloxacin (37%). Enterococcus faecalis showed a high percentage of resistance to erythromycin and clindamycin (86%), and fluoroquinolones (43%). The large majority (86%) of Escherichia coli were extended spectrum beta-lactamases positive, in addition to having high resistance to fluoroquinolones (86%), trimethoprim/sulfamethoxazole (86%) and gentamicin (72%). The microbiological characteristics found in prosthetic joint infections vary according to the hospitals. In this series, a high proportion of coagulase-negative Staphylococci and Enterococcus spp. were found, as well as a high bacterial resistance. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  11. Current antimicrobial sensitivity pattern of typhoidal salmonellae in a referral diagnostic centre

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    Umer Shujat

    2016-03-01

    Full Text Available Background: Infections caused by typhoidal salmonellae are an important public health concern in Pakistan. Inappropriate and injudicious use of fluoroquinolones has reduced their efficacy due to development of high level resistance. Aim: To ascertain the current susceptibility pattern of typhoidal salmonellae thus guiding the physicians for better management of typhoid patients.Materials and Methods: A study was conducted at our institution from January 2012 through December 2013 to investigate current susceptibility pattern of typhoidal salmonellae. Results: Out of 200 isolates, 107 (53.5% were identified as Salmonella Typhi and 93 (46.5% as Salmonella Paratyphi A. Sensitivities of Salmonella Typhi were as follows: ampicillin (48.6%, chloramphenicol (45.8%, co-trimoxazole (40.1%, ciprofloxacin (11.2%. Sensitivities of Salmonella Paratyphi A were: ampicillin (80.6%, chloramphenicol (89.2%, co-trimoxazole (90.3%, and ciprofloxacin (16.1%. No resistance was detected against third generation cephalosporins. Conclusions: Typhoidal salmonellae are still entirely susceptible to third generation cephalosporins in our setting. Marked rise in resistance to fluoroquinolones has reduced their empirical usage. Sensitivity of Salmonella Paratyphi A to conventional antityphoid drugs was encouraging.

  12. Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia, 2015.

    Science.gov (United States)

    Haftu, Hansa; Hailu, Tedrose; Medhaniye, Araya; G/Tsadik, Teklit

    2018-05-24

    To describe admission pattern and outcome with its predictor variable on the mortality of children admitted to pediatric intensive care unit (PICU), Ayder Referral Hospital, Northern Ethiopia, from September 2012 to August 2014. From 680 admitted patients, 400 patients were analyzed. Average age at admission was 62.99 ± 60.94 months, with F:M ratio of 1:1.2. Overall (from infectious and non-infectious) the most commonly affected systems were respiratory (90/400 pts., 22.5%) and central nervous system (83/400 pts., 20.75%). Most were admitted due to meningitis (44/400 pts., 11%), post-operative (43/400 pts., 10.8%) and acute glomerulonephritis (41/400 pts., 10.3%). The overall mortality rate was 8.5%. Multivariable logistic regression shows, use of inotropes (p = 0.000), need for mechanical ventilator (p = 0.007) and presence of comorbid illness (p = 0.002), infectious cause (p = 0.015) and low level of Glasgow coma scale less than eight (p = 0.04) were independent predictors of mortality. From this study, common cause of PICU admission and death was meningitis. This highlights the importance of focusing on the preventable methods in the public such as vaccine, creating awareness about hygiene, and expanding ICU for early detection and for treatment acutely ill children.

  13. Patterns of severe acute renal failure in a referral center in Sudan: Excluding intensive care and major surgery patients

    International Nuclear Information System (INIS)

    Kaballo, Babikir G.; Khogali, Mohamed S.; Khalifa, Eman H.; Khalil, Eltahir A.G.; El-Hasaan, Ahmad M.; Abu-Aisha, H.

    2007-01-01

    Acute renal failure (ARF) is a common health problem worldwide. There is limited data on the pattern of ARF in Sudan. Moreover, glomerular diseases, which are a well known cause of ARF, have not been accurately and adequately diagnosed previously. A retrospective study on the patterns of ARF was carried out in a general nephrology referral center in Sudan during the period from February 2003 to February 2004.Patients from intensive care units with ARF and those who developed ARF after massive surgery were excluded from the study. Renal biopsy was performed when indicated and studied with light and immunofluorescent microscopy. Eighty-nine patients (57 (64%) cases were males and mean age was 39+-19.4 years) fulfilled the criteria for the diagnosis of advanced renal failure requiring renal function replacement therapy. Acute tubular necrosis (ATN) was diagnosed in 50 (56%) patients; 33 (66%) ATN patients had renal failure as a complication of volume depletion, fulminant infections (particularly malaria and typhoid fever) or snakebites, and 12 (13.4%) patients ingested paraphenylene-diamine (PPD) (hair/Henna dye) in suicidal attempts. Eight (9%) patients of the total study group had glomerural diseases and 11 (12.3%) had obstructive uropathy associated with ARF; cause of ARF could not be determined in 17 (19%) patients. Fifty-three (60%) patients recovered their renal function, six (6.7%) patients progressed to chronic kidney disease (CKD), 16(18%) died and 14(16%) were lost to follow-up. In conclusion, patients with ARF associated with ATN had a favorable prognosis except when ATN was associated PPD poisoning. (author)

  14. Patterns of severe acute renal failure in a referral center in Sudan: Excluding intensive care and major surgery patients

    Energy Technology Data Exchange (ETDEWEB)

    Kaballo, Babikir G; Khogali, Mohamed S [Nephrology Unit, Military Hospital, Omdurman (Sudan); Khalifa, Eman H [Faculty of Medical Laboratory Sciences, Univ. of Khartoum (Sudan); Khalil, Eltahir A.G.; El-Hasaan, Ahmad M [Institute of Endemic Diseases, Univ. of Khartoum (Sudan); Abu-Aisha, H [The National Ribat Univ., Khartoum (Sudan)

    2007-07-01

    Acute renal failure (ARF) is a common health problem worldwide. There is limited data on the pattern of ARF in Sudan. Moreover, glomerular diseases, which are a well known cause of ARF, have not been accurately and adequately diagnosed previously. A retrospective study on the patterns of ARF was carried out in a general nephrology referral center in Sudan during the period from February 2003 to February 2004.Patients from intensive care units with ARF and those who developed ARF after massive surgery were excluded from the study. Renal biopsy was performed when indicated and studied with light and immunofluorescent microscopy. Eighty-nine patients (57 (64%) cases were males and mean age was 39+-19.4 years) fulfilled the criteria for the diagnosis of advanced renal failure requiring renal function replacement therapy. Acute tubular necrosis (ATN) was diagnosed in 50 (56%) patients; 33 (66%) ATN patients had renal failure as a complication of volume depletion, fulminant infections (particularly malaria and typhoid fever) or snakebites, and 12 (13.4%) patients ingested paraphenylene-diamine (PPD) (hair/Henna dye) in suicidal attempts. Eight (9%) patients of the total study group had glomerural diseases and 11 (12.3%) had obstructive uropathy associated with ARF; cause of ARF could not be determined in 17 (19%) patients. Fifty-three (60%) patients recovered their renal function, six (6.7%) patients progressed to chronic kidney disease (CKD), 16(18%) died and 14(16%) were lost to follow-up. In conclusion, patients with ARF associated with ATN had a favorable prognosis except when ATN was associated PPD poisoning. (author)

  15. Scoliosis detection, patient characteristics, referral patterns and treatment in the absence of a screening program in Norway

    Directory of Open Access Journals (Sweden)

    Adobor Raphael

    2012-10-01

    Full Text Available Abstract Background Early diagnosis of idiopathic scoliosis allows for observation and timely initiation of brace treatment in order to halt progression. School scoliosis screening programs were abolished in Norway in 1994 for lack of evidence that the programs improved outcome and for the costs involved. The consequences of this decision are discussed. Objectives To describe the detection, patient characteristics, referral patterns and treatment of idiopathic scoliosis at a scoliosis clinic during the period 2003–2011, when there was no screening and to compare treatment modalities to the period 1976–1988 when screening was performed. Methods Patient demographics, age at detection, family history, clinical and radiological charts of consecutive patients referred for scoliosis evaluation during the period 2003–2011, were prospectively registered. Patients were recruited from a catchment area of about 500000 teenagers. Maturity was estimated according to Risser sign and menarcheal status. Severity of pain was recorded by a verbal 5-point scale from no pain to pain at all times. Physical and neurological examinations were conducted. The detector and patient characteristics were recorded. Referral patterns of orthopedic surgeons at local hospitals and other health care providers were recorded. Patient data was obtained by spine surgeons. Treatment modalities in the current period were compared to the period 1976–1988. Results We registered 752 patients with late onset juvenile and adolescent idiopathic scoliosis from 2003–2011. There were 644 (86% girls and 108 (14% boys. Mean age at detection was 14.6 (7–19 years. Sixty percent had Risser sign ≥ 3, whilst 74% were post menarche with a mean age at menarche of 13.2 years. Thirty-one percent had a family history of scoliosis. The mean major curve at first consultation at our clinic was 38° (10°-95°. About 40% had a major curve >40°. Seventy-one percent were detected by patients

  16. Clinical features of functional somatic symptoms in children and referral patterns to child and adolescent mental health services

    DEFF Research Database (Denmark)

    Tøt-Strate, Simone; Dehlholm-Lambertsen, Gitte; Lassen, Karin

    2016-01-01

    AIM: Functional somatic symptoms (FSS) are common in paediatric patients who are referred to Child and Adolescent Mental Health Service (CAMHS), but little is known about current referral practices. The aim of this study was to systematically investigate clinical features of paediatric inpatients...... who had been referred and 44 children who had not. RESULTS: Most paediatric records lacked information on psychosocial factors and symptoms. Referred children were significantly more multisymptomatic of FSS (p controls, had longer symptom duration, underwent more clinical...... reasons were generally vague and psychosocial information was frequently missing. Clinical guidelines are needed to improve and systematise mental health referrals for children with FSS....

  17. Conotruncal anomalies in the fetus: Referral patterns and pregnancy outcomes in a dedicated fetal cardiology unit in South India

    Directory of Open Access Journals (Sweden)

    Balu Vaidyanathan

    2013-01-01

    Conclusions: Pre-natal diagnosis of CTA, despite a high diagnostic accuracy, prompted utilization of post-natal tertiary cardiac care in a limited proportion of patients, including those with reparable lesions. Focus in developing countries should shift towards earlier referral, improving awareness about treatment options and a comprehensive evaluation for associated anomalies.

  18. Proactive Public Disclosure

    DEFF Research Database (Denmark)

    Boll, Karen; Tell, Michael

    2015-01-01

    This article discusses proactive public disclosure of taxpayer information and how this may form a new strategy for securing tax compliance by tax administrators. It reports a case study from the Danish Customs and Tax Administration in which consumers of services–over a short period of time...... proactive public disclosure is compatible with the Duty of Confidentiality, but incompatible with Good Public Governance. Furthermore, the analyses show that there are a number of strong organizational rationales for using proactive public disclosure, despite its apparent incompatibility with Good Public...... Governance. The article is innovative in that it combines a legal and organizational approach to analyse a new regulatory strategy within tax administration....

  19. Characteristics of Successful and Unsuccessful Mental Health Referrals of Refugees

    Science.gov (United States)

    Shannon, Patricia J.; Vinson, Gregory A.; Cook, Tonya; Lennon, Evelyn

    2018-01-01

    In this community based participatory research study, we explored key characteristics of mental health referrals of refugees using stories of providers collected through an on-line survey. Ten coders sorted 60 stories of successful referrals and 34 stories of unsuccessful referrals into domains using the critical incident technique. Principal Components Analysis yielded categories of successful referrals that included: active care coordination, proactive resolution of barriers, establishment of trust, and culturally responsive care. Unsuccessful referrals were characterized by cultural barriers, lack of care coordination, language barriers, system barriers, providers being unwilling to see refugees. Recommendations for training and policy are discussed. PMID:25735618

  20. Proactive malware detection

    Science.gov (United States)

    Gloster, Jonathan; Diep, Michael; Dredden, David; Mix, Matthew; Olsen, Mark; Price, Brian; Steil, Betty

    2014-06-01

    Small-to-medium sized businesses lack resources to deploy and manage high-end advanced solutions to deter sophisticated threats from well-funded adversaries, but evidence shows that these types of businesses are becoming key targets. As malicious code and network attacks become more sophisticated, classic signature-based virus and malware detection methods are less effective. To augment the current malware methods of detection, we developed a proactive approach to detect emerging malware threats using open source tools and intelligence to discover patterns and behaviors of malicious attacks and adversaries. Technical and analytical skills are combined to track adversarial behavior, methods and techniques. We established a controlled (separated domain) network to identify, monitor, and track malware behavior to increase understanding of the methods and techniques used by cyber adversaries. We created a suite of tools that observe the network and system performance looking for anomalies that may be caused by malware. The toolset collects information from open-source tools and provides meaningful indicators that the system was under or has been attacked. When malware is discovered, we analyzed and reverse engineered it to determine how it could be detected and prevented. Results have shown that with minimum resources, cost effective capabilities can be developed to detect abnormal behavior that may indicate malicious software.

  1. Canadian Physicians' Use of Antiobesity Drugs and Their Referral Patterns to Weight Management Programs or Providers: The SOCCER Study

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    R. S. Padwal

    2011-01-01

    Full Text Available Antiobesity pharmacotherapy and programs/providers that possess weight management expertise are not commonly used by physicians. The underlying reasons for this are not known. We performed a cross-sectional study in 33 Canadian medical practices (36 physicians examining 1788 overweight/obese adult patients. The frequency of pharmacotherapy use and referral for further diet, exercise, behavioral management and/or bariatric surgery was documented. If drug treatment or referral was not made, reasons were documented by choosing amongst preselected categories. Logistic regression models were used to identify predictors of antiobesity drug use. No single antiobesity management strategy was recommended by physicians in more than 50% of patients. Referral was most common for exercise (49% of cases followed by dietary advice (46%, and only 5% of eligible patients were referred for bariatric surgery. Significant predictors of initiating/continuing pharmacotherapy were male sex (OR 0.70; 95% CI 0.52–0.94, increasing BMI (1.02; 95% CI 1.01–1.03, and private drug coverage (1.78; 95% CI 1.39–2.29. “Not considered” and “patient refusal” were the main reasons for not initiating further weight management. We conclude that both physician and patient factors act as barriers to the use of weight management strategies and both need to be addressed to increase uptake of these interventions.

  2. An integrated village maternity service to improve referral patterns in a rural area in West-Java.

    Science.gov (United States)

    Alisjahbana, A; Williams, C; Dharmayanti, R; Hermawan, D; Kwast, B E; Koblinsky, M

    1995-06-01

    The Regionalization of Perinatal Care, an intervention study carried out in Tanjungsari, a subdistrict in rural West Java, aimed to develop a comprehensive maternal health program to improve maternal and perinatal health outcomes. The main inputs included training at all levels of the health care system (informal and formal) and the establishment of birthing homes in villages to make services more accessible. Special attention was given to referral, transportation, communication and appropriate case management, A social marketing program was conducted to inform people of the accessible birthing homes for clean delivery, located near the women, and with better transportation and communications to referral facilities should complications arise. The study design was longitudinal, following all pregnant women from early pregnancy until 42 days postpartum in an intervention and a comparison area. The population was +/- 90,000 in the intervention area and 40,000 in the comparison area. Inclusion criteria were all mother and infant units delivered between June 1st, 1992 and May 31st, 1993. Analysis showed the following results: Most women sought antenatal care (> 95%). In Tanjungsari, nearly 90% sought such care from professional providers as versus 75% in the control area of Cisalak. Most women with bleeding or bleeding and edema during pregnancy sought professional assistance in both the study and control areas. However, fever for more than 3 days received more attention in the study area versus control area (93 vs. 69%). Greater than 85% of deliveries in both areas were conducted by TBAs. However, in the study area, nearly one-third of those with intrapartum complications (17%) delivered in a health facility compared to one-tenth in the control area. This meant a hospital delivery, primarily with assistance of a doctor or doctor/midwife combination. Overall referral rates by TBAs were low -13% of women with complications in Tanjungsari and 6% in Cisalak. More women

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

    OpenAIRE

    Bass, Willa S.; Oswald, Karl M.

    2014-01-01

    Proactive interferencebuilds up with exposure to multiple lists of similar items with a resulting reduction in recall. This study examined the effectiveness of using a proactive strategy of the method of loci to reduce proactive interference in a list recall paradigm of categorically similar words. While all participants reported using some form of strategy to recall list words, this study demonstrated that young adults were able to proactively use the method of loci after 25 min of instructi...

  4. Changes in Gram Negative Microorganisms' Resistance Pattern During 4 Years Period in a Referral Teaching Hospital; a Surveillance Study

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    Hossein Khalili

    2012-09-01

    Full Text Available Background and purpose Surveillance studies evaluating antimicrobial susceptibilities are of great value in preventing the spread of resistant pathogens by elucidating the trend of resistance in commonly used antibiotics and as a consequence providing information for prescribing the most appropriate agent. This study is a longitudinal antimicrobial resistance surveillance study designed to evaluate the trend in antimicrobial resistance to gram negative microorganisms from 2007 to 2010. Method:During a four-year period (2007-2010 isolates derived from all patients admitted to infectious diseases ward of Imam Khomeini Hospital, the major referral center for infectious disease in Iran with the highest admission rates, were evaluated. Based on disk diffusion method and zone of inhibition size, the microorganism was regarded as to be sensitive, resistant or has intermediate susceptibility to the antimicrobial agents. Results:The widest spread Gram-negative microorganism in all of isolates taken together in our study was E.coli (30% followed by Stenotrophomonas maltophilia in 28.6% and Enterobacter spp. in 11.9%, respectively. The susceptibility to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin was equal or above 50% for all microorganisms over four years. However, the susceptibility to ampicillin, ampicillin/sulbactam, cefotaxim, and ceftriaxone was less than 50% in derived isolates during the study period.Conclusion:In conclusion, the finding of the present study revealed that resistance rate to common antimicrobial agents in Iran is growing and isolates were susceptible mostly to broadspectrum antibiotics including imipenem and piperacillin/tazobactam

  5. Pattern of Bacterial Pathogens and Their Susceptibility Isolated from Surgical Site Infections at Selected Referral Hospitals, Addis Ababa, Ethiopia

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    Walelign Dessie

    2016-01-01

    Full Text Available Background. The emergence of multidrug resistant bacterial pathogens in hospitals is becoming a challenge for surgeons to treat hospital acquired infections. Objective. To determine bacterial pathogens and drug susceptibility isolated from surgical site infections at St. Paul Specialized Hospital Millennium Medical College and Yekatit 12 Referral Hospital Medical College, Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted between October 2013 and March 2014 on 107 surgical site infected patients. Wound specimens were collected using sterile cotton swab and processed as per standard operative procedures in appropriate culture media; and susceptibility testing was done using Kirby-Bauer disc diffusion technique. The data were analyzed by using SPSS version 20. Result. From a total of 107 swabs collected, 90 (84.1% were culture positive and 104 organisms were isolated. E. coli (24 (23.1% was the most common organism isolated followed by multidrug resistant Acinetobacter species (23 (22.1%. More than 58 (75% of the Gram negative isolates showed multiple antibiotic resistance (resistance ≥ 5 drugs. Pan-antibiotic resistance was noted among 8 (34.8% Acinetobacter species and 3 (12.5% E. coli. This calls for abstinence from antibiotic abuse. Conclusion. Gram negative bacteria were the most important isolates accounting for 76 (73.1%. Ampicillin, amoxicillin, penicillin, cephazoline, and tetracycline showed resistance while gentamicin and ciprofloxacin were relatively effective antimicrobials.

  6. Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India

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    A K Maurya

    2012-01-01

    Full Text Available Background: Drug-resistant tuberculosis is one of major current challenges to global public health. The transmission of resistant strains is increasing as a burden of multidrug-resistant tuberculosis (MDR-TB patients in extra pulmonary tuberculosis (EPTB cases in India. Aim and Objectives: The aim was to study trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of EPTB in referral hospitals in northern India. Study Design and Setting: A prospectively observational study and referral medical institutions in northern India. Materials and Methods: All EPTB specimens were processed for Ziehl Neelsen staining, BACTEC culture and BACTEC NAP test for Mycobacterium tuberculosis complex. All M. tuberculosis complex isolates were performed for radiometric-based drug susceptibility pattern against streptomycin, isoniazid, rifampicin and ethambutol using the 1% proportion method. Results: We found that 165/756 (20.5% isolates were identified as M. tuberculosis complex by the NAP test. We observed that 39.9% were resistant to first-line antitubercular drugs. The resistance rate was higher in previously treated patients: H (30.3%, R (16.3%, E (15.7% and S (16.3%. MDR-TB was observed in 13.4%, but, in new cases, this was 11.4% and 19.1% of the previously treated patients (P<0.05. Conclusion: MDR-TB is gradually increased in EPTB cases and predominant resistance to previous treated cases of EPTB. The molecular drug sensitivity test (DST method can be an early decision for chemotherapy in MDR-TB patients. The International Standards of TB Care need to be used by the RNTCP and professional medical associations as a tool to improve TB care in the country.

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

    Science.gov (United States)

    Bass, Willa S; Oswald, Karl M

    2014-01-01

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

  8. Pattern of palliative care, pain management and referral trends in patients receiving radiotherapy at a tertiary cancer center

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    Kuldeep Sharma

    2009-01-01

    Full Text Available Background: Pain is a common primary symptom of advanced cancer and metastatic disease, occurring in 50-75% of all patients. Although palliative care and pain management are essential components in oncology practice, studies show that these areas are often inadequately addressed. Materials and Methods: We randomly selected 152 patients receiving palliative radiotherapy (PRT from October 2006 to August 2008, excluding metastatic bone lesions. Patients′ records were studied retrospectively. Results: A median follow-up of 21 weeks was available for 119 males and 33 females with a median age of 55 years. Maximum (60% patients were of head and neck cancers followed by esophagus (14%, lung (10% and others. Dysphagia, growth/ulcer and pain were the chief indications for PRT. Pain was present in 93 (61% cases out of which, 56 (60% were referred to pain clinic. All except one consulted pain clinic with a median pain score of 8 (0-10 point scale. Fifty-three of these 56 patients (96% received opioid-based treatment with adequate pain relief in 33% cases and loss of follow-up in 40% cases. Only five (3% cases were referred to a hospice. Twenty-two (14% cases were considered for radical treatment following excellent response to PRT. Conclusion: In this selective sample, the standard of analgesic treatment was found to be satisfactory. However, there is a lot of scope for improvement regarding referral to pain clinic and later to the hospice. Patients′ follow-up needs to be improved along with future studies evaluating those patients who were considered for further RT till radical dose. Programs to change the patients′ attitude towards palliative care, physicians′ (residents′ training to improve communication skills, and institutional policies may be promising strategies.

  9. Bacterial profile of urinary tract infection and antimicrobial susceptibility pattern among pregnant women attending at Antenatal Clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia

    Directory of Open Access Journals (Sweden)

    Derese B

    2016-02-01

    Full Text Available Behailu Derese,1 Haji Kedir,2 Zelalem Teklemariam,3 Fitsum Weldegebreal,3 Senthilkumar Balakrishnan4 1Department of Medical Laboratory, Dil Chora Referral Hospital, Dire Dawa, 2Department of Public Health, 3Department of Medical Laboratory Sciences, 4Department of Medical Microbiology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Purpose: The aim of this study was to determine the bacterial profile of urinary tract infection (UTI and antimicrobial susceptibility pattern among pregnant women attending at antenatal clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia.Patients and methods: An institutional-based cross-sectional study was conducted from February 18, 2015 to March 25, 2015. Clean-catch midstream urine specimens were collected from 186 pregnant women using sterile containers. Then, culture and antimicrobial susceptibility tests were performed by standard disk diffusion method. Patient information was obtained using pretested structured questionnaire. Data were entered and cleaned using EpiData Version 3 and then exported to Statistical Package for Social Science (Version 16 for further analysis.Results: The prevalence of significant bacteriuria was 14%. Gram-negative bacteria were more prevalent (73%. Escherichia coli (34.6%, coagulase-negative staphylococci (19.2%, Pseudomonas aeruginosa (15.4%, and Klebsiella spp. (11.5% were common bacterial isolates, where most of them were resistant against ampicillin, amoxicillin, tetracycline, trimethoprim–sulfamethoxazole, and chloramphenicol. Multidrug resistance (resistance in ≥2 drugs was seen in 100% of the isolated bacteria. A majority of the bacterial isolates were sensitive to ciprofloxacin, ceftriaxone, erythromycin, and gentamicin.Conclusion: This study found a number of bacterial isolates with very high resistance to the commonly prescribed drugs from pregnant women with and without symptoms of UTI. Therefore, the early routine

  10. Neural mechanisms of proactive interference-resolution.

    Science.gov (United States)

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

    2007-12-01

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

  11. Rating Methods for Proactive Recommendation on Smartwatches

    OpenAIRE

    Janosch Maier, Wolfgang Wörndl

    2015-01-01

    This paper analyzes possible interaction methods for using a recommender system on a smartwatch. As prerequisite, we describe interaction patterns currently used by Android Wear applications. Based on a prototype implementation the interaction methods action buttons, two button card and swipes are compared against each other. In a user study, 31 participating students were asked to rate restaurant recommendations offered in the setting of a context-aware, proactive recommender system. For eac...

  12. Changing patterns and trends of multidrug-resistant tuberculosis at referral centre in Northern India: A 4-year experience

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    A K Maurya

    2013-01-01

    Full Text Available Purpose: India has a high burden of drug-resistant tuberculosis (TB, although there is little data on multidrug-resistant tuberculosis (MDR-TB. Although MDR-TB has existed for long time in India, very few diagnostic laboratories are well-equipped to test drug sensitivity. The objectives of this study were to determine the prevalence of MDR-TB, first-line drug resistance patterns and its changing trends in northern India in the 4 years. Materials and Methods: This was a prospective study from July 2007 to December 2010. Microscopy, culture by Bactec460 and p-nitro-α-acetylamino-β-hydroxypropiophenone (NAP test was performed to isolate and identify Mycobacterium tuberculosis (M. tb complex (MTBC. Drug sensitivity testing (DST was performed by 1% proportional method (Bactec460 for four drugs: Rifampicin, isoniazid, ethambutol and streptomycin. Various clinical and demographical profiles were evaluated to analyse risk factors for development of drug resistance. Results: We found the overall prevalence rate of MDR-TB to be 38.8%, increasing from 36.4% in 2007 to 40.8% in 2010. we found that the prevalence of MDR-TB in new and previously treated cases was 29.1% and 43.3% ( P < 0.05; CI 95%. The increasing trend of MDR-TB was more likely in pulmonary TB when compared with extra-pulmonary TB ( P < 0.05; CI 95%. Conclusions: we found a high prevalence (38.8% of MDR-TB both in new cases (29.1% and previously treated cases (43.3%.This study strongly highlights the need to make strategies for testing, surveillance, monitoring and management of such drug-resistant cases.

  13. Developmental Change in Proactive Interference.

    Science.gov (United States)

    Kail, Robert

    2002-01-01

    Two studies examined age-related change in proactive interference from previously learned material. The meta-analysis of 26 studies indicated that proactive interference decreased with age. The cross-sectional study found that third through sixth graders' and college students' recall was accurate on Trial 1, but became less so over Trials 2…

  14. Piloting proactive marketing to recruit disadvantaged adults to a community-wide obesity prevention program.

    Science.gov (United States)

    O'Hara, Blythe J; Eggins, Dianne; Phongsavan, Philayrath; Milat, Andrew J; Bauman, Adrian E; Wiggers, John

    2015-03-30

    Population-wide obesity prevention and treatment programs are fundamental to addressing the increasing overweight and obesity rates in socioeconomically disadvantaged populations. Innovative recruitment strategies, including proactive marketing strategies, are needed to ensure such programs have universal reach and target vulnerable populations. This study aimed to determine the success of proactive recruitment to Australia's Get Healthy Information and Coaching Service® (GHS) and to assess whether the recruitment strategy influenced participants' outcomes. Sociodemographic information was collected from all GHS participants who joined the service between February 2009 and August 2013, and anthropometric information regarding behavioural risk factors was collected from all GHS coaching participants at baseline and six months. Data were analysed according to the participants' referral source (self-referral and secondary referral versus proactive recruitment). Participants recruited through proactive marketing were more likely to be male, aged 50 years or older, have high school education, not be in paid employment and be from the lowest three quintiles of socioeconomic advantage. The risk factor profile of coaching participants recruited through proactive marketing did not vary significantly from those recruited via other mechanisms, although they were less likely to be obese and less likely to have a higher 'at risk' waist circumference measurement. Proactively recruited coaching participants reported significant improvements from baseline to six months (consistent with improvements made by participants recruited through other strategies), although they were significantly more likely to withdraw from coaching before they completed the six-month program.Proactive marketing facilitated use of an obesity prevention service; similar services may have greater reach if proactive marketing recruitment strategies are used. These strategies could be encouraged to assist

  15. Bacterial Isolates and Their Antimicrobial Susceptibility Patterns of Wound Infections among Inpatients and Outpatients Attending the University of Gondar Referral Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Aynalem Mohammed

    2017-01-01

    Full Text Available Background. The widespread uses of antibiotics, together with the length of time over which they have been available, have led to the emergence of resistant bacterial pathogens contributing to morbidity and mortality. This study was aimed to assess bacterial isolates and their drug susceptibility patterns from inpatients and outpatients with pus and/or wound discharge. Methods. A cross-sectional study was conducted at the University of Gondar Referral Hospital from March to May, 2014. Wound swab samples were collected from each study participant and inoculated into appropriate media. The bacterial pathogens were identified using standard microbiological methods. Antimicrobial susceptibility tests were performed using disk diffusion technique following Kirby-Bauer method. Results. A total of 137 study subjects were included in the study with bacterial isolation rate of 115 (83.9%. Of all, 81 (59.1% were males. Seventy-seven (57% of the isolates were Gram-negative and 59 (43% were Gram-positive. From the total isolates, Staphylococcus aureus was the most predominant isolate 39/115 (34% followed by Klebsiella species (13%, coagulase negative staphylococci spp. (12% and Pseudomonas aeruginosa. Gram-positive isolates were resistant to ampicillin (86.4%, amoxicillin (83%, penicillin (81.3%, oxacillin (74.6%, and tetracycline (59.4%, while Gram-negative isolates were resistant to amoxicillin (97.4%, ampicillin (94.8%, tetracycline (72.7%, trimethoprim/sulfamethoxazole (66%, and chloramphenicol (54.5%. Conclusion. High prevalence of bacterial isolates was found, Staphylococcus aureus being the most dominant. High rates of multiple drug resistance pathogens to the commonly used antimicrobial agents were isolated. Therefore, concerned bodies should properly monitor the choice of antibiotics to be used as prophylaxis and empiric treatment in the study area.

  16. Asymptomatic bacteriuria and antimicrobial susceptibility pattern of the isolates among pregnant women attending Dessie referral hospital, Northeast Ethiopia: A hospital-based cross-sectional study.

    Science.gov (United States)

    Ali, Ismail Ebrie; Gebrecherkos, Teklay; Gizachew, Mucheye; Menberu, Martha Alemayehu

    2018-05-01

    The aim of the current study was to find out the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility pattern of the isolates and related risk factors among pregnant women. A hospital-based cross-sectional study was carried out from February 2017 to May 2017 among asymptomatic pregnant mothers attending Dessie Referral Hospital, Northeast Ethiopia. About 10-15 mL of freshly voided midstream urine samples were collected from each study participants, and analyzed at Dessie regional research microbiology laboratory with conventional antibiotic susceptibility, and biochemical tests. Isolates were tested against commonly used antimicrobials using Kirby Bauer disc diffusion method. Data were analyzed by SPSS version 20 software and in all cases, p-values below 0.05 was considered as statistically significant. Overall, 358 pregnant women were included in the study with a mean age of 26.5±4.6 years (range, 19-43 yrs). The overall prevalence of asymptomatic bacteriuria was 56% (15.6%). Isolated microorganisms were mainly Escherichia coli and Staphylococcus aureus (for each, n=18; 31%). Escherichia coli and Staphylococcus aureus were resistant to ampicillin (66.7%), and penicillin (94.44%). The prevalence of multidrug- resistant isolates was 72.4%. History of catheterization [AOR=2.28, 95% CI=(1.03-5.06)] and anemia [AOR=4.98, 95% CI=(2.395-10.34) were statistically significant regarding the prevalence of asymptomatic bacteriuria. The overall prevalence of asymptomatic bacteriuria among pregnant women in the study area was high. The presence of asymptomatic bacteriuria and their antibiotic susceptibility test results should be taken into consideration during the management of pregnant women who are visiting antenatal care clinic.

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

    Science.gov (United States)

    Gibbs, Graham; Regan, Peter; Simpson, Ormond

    2007-01-01

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

  18. Proactive Self Defense in Cyberspace

    National Research Council Canada - National Science Library

    Caulkins, Bruce D

    2009-01-01

    ... and standards to properly secure and defend the Global Information Grid (GIG) from cyber attacks. This paper will discuss the strategic requirements for enacting a proactive self-defense mechanism in cyberspace...

  19. Pattern of chemotherapy-related adverse effects among adult cancer patients treated at Gondar University Referral Hospital, Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Belachew SA

    2016-12-01

    Full Text Available Sewunet Admasu Belachew,1 Daniel Asfaw Erku,2 Abebe Basazn Mekuria,3 Begashaw Melaku Gebresillassie1 1Department of Clinical Pharmacy, 2Department of Pharmaceutical Sciences, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, Ethiopia Background: Adverse drug reactions (ADRs are a global problem and constitute a major clinical problem in terms of human suffering. The high toxicity and narrow therapeutic index of chemotherapeutic agents makes oncology pharmacovigilance essential. The objective of the present study was to assess the pattern of ADRs occurring in cancer patients treated with chemotherapy in a tertiary care teaching hospital in Ethiopia.Methods: A cross-sectional study over a 2-year period from September 2013 to August 2015 was conducted on cancer patients undergoing chemotherapy at Gondar University Referral Hospital Oncology Center. Data were collected directly from patients and their medical case files. The reported ADRs were assessed for causality using the World Health Organization’s causality assessment scale and Naranjo’s algorithm. The severities of the reported reactions were also assessed using National Cancer Institute Common Terminology CTCAE version 4.0. The Pearson’s chi-square test was employed to examine the association between two categorical variables.Results: A total of 815 ADRs were identified per 203 patients included in the study. The most commonly occurring ADRs were nausea and vomiting (18.9%, infections (16.7%, neutropenia (14.7%, fever and/or chills (11.3%, and anemia (9.3%. Platinum compounds (31.4% were the most common group of drugs causing ADRs. Of the reported ADRs, 65.8% were grades 3–4 (severe level, 29.9% were grades 1–2 (mild level, and 4.3% were grade 5 (toxic level. Significant association was found between age, number of chemotherapeutic agents, as well as dose of chemotherapy with the occurrence of grades 3–5 toxicity.Conclusion: The high incidence of

  20. PREGO (presentation of Graves' orbitopathy) study: changes in referral patterns to European Group On Graves' Orbitopathy (EUGOGO) centres over the period from 2000 to 2012

    NARCIS (Netherlands)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio; Ayvaz, Göksun; Baldeschi, Lelio; Bartalena, Luigi; Boschi, Antonella; Bournaud, Claire; Brix, Thomas Heiberg; Covelli, Danila; Ćirić, Slavica; Daumerie, Chantal; Eckstein, Anja; Fichter, Nicole; Führer, Dagmar; Hegedüs, Laszlo; Kahaly, George J.; Konuk, Onur; Lareida, Jürg; Lazarus, John; Leo, Marenza; Mathiopoulou, Lemonia; Menconi, Francesca; Morris, Daniel; Okosieme, Onyebuchi; Orgiazzi, Jaques; Pitz, Susanne; Salvi, Mario; Vardanian-Vartin, Cristina; Wiersinga, Wilmar; Bernard, Martine; Clarke, Lucy; Currò, Nicola; Dayan, Colin; Dickinson, Jane; Knežević, Miroslav; Lane, Carol; Marcocci, Claudio; Marinò, Michele; Möller, Lars; Nardi, Marco; Neoh, Christopher; Pearce, Simon; von Arx, George; Törüner, Fosun Baloş

    2015-01-01

    The epidemiology of Graves' orbitopathy (GO) may be changing. The aim of the study was to identify trends in presentation of GO to tertiary centres and initial management over time. Prospective observational study of European Group On Graves' Orbitopathy (EUGOGO) centres. All new referrals with a

  1. Employability Transcripts: Proactive Career Planning

    Science.gov (United States)

    Metcalf, Elaine

    2010-01-01

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

  2. Sleep can reduce proactive interference.

    Science.gov (United States)

    Abel, Magdalena; Bäuml, Karl-Heinz T

    2014-01-01

    Sleep has repeatedly been connected to processes of memory consolidation. While extensive research indeed documents beneficial effects of sleep on memory, little is yet known about the role of sleep for interference effects in episodic memory. Although two prior studies reported sleep to reduce retroactive interference, no sleep effect has previously been found for proactive interference. Here we applied a study format differing from that employed by the prior studies to induce a high degree of proactive interference, and asked participants to encode a single list or two interfering lists of paired associates via pure study cycles. Testing occurred after 12 hours of diurnal wakefulness or nocturnal sleep. Consistent with the prior work, we found sleep in comparison to wake did not affect memory for the single list, but reduced retroactive interference. In addition we found sleep reduced proactive interference, and reduced retroactive and proactive interference to the same extent. The finding is consistent with the view that arising benefits of sleep are caused by the reactivation of memory contents during sleep, which has been suggested to strengthen and stabilise memories. Such stabilisation may make memories less susceptible to competition from interfering memories at test and thus reduce interference effects.

  3. High Performance Proactive Digital Forensics

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  4. Global Imaging referral guidelines

    International Nuclear Information System (INIS)

    Kawooya, M.; Perez, M.; Lau, L.; Reeed, M.

    2010-01-01

    The medical imaging specialists called for global referral guidelines which would be made available to referring doctors. These referral guidelines should be:- Applicable in different health care settings, including resource-poor settings; Inclusive in terms of the range of clinical conditions; User-friendly and accessible (format/media); Acceptable to stakeholders, in particular to the referrers as the main target audience. To conceive evidence-based medicine as an integration of best research evidence with clinical expertise and patient values. The Direct recipients of the Referral Guidelines would be:- Referrers: general practitioners / family doctors; paediatricians; emergency department doctors; other specialists and health workers. Providers (medical imaging practitioners): radiologists; nuclear medicine physicians; radiographers; other appropriately qualified practitioners providing diagnostic imaging services. For the Referral Guidelines to be effective there need to be: Credibility evidence-based Practicality end user involvement Context local resources, disease profiles Endorsement, opinion leaders Implementation- policy, education, CPOE - Monitoring of the use clinical audit, report feedback. The aim of the Referral Guidelines Project was to: Produce global referral guidelines that are evidence-based, cost effective and appropriate for the local setting, and include consideration of available equipment and expertise (RGWG; SIGs); Include supporting information about radiation doses, potential risks, protection of children and pregnant women (introductory chapter); Facilitate the implementation of the guidelines through guidance and tools (e.g. implementation guides, checklists, capacity building tools, guides on stakeholders engagement, audit support criteria); Conduct pilot testing in different clinical settings from each of the six WHO regions; Promote the inclusion of the referral guidelines in the curricula of medical schools; Develop and implement

  5. Proactive Assessment for Collaboration Success

    Directory of Open Access Journals (Sweden)

    Teresa L. Ju

    2014-07-01

    Full Text Available This study describes a government–academia–industry joint training project that produces Vietnamese midlevel technical managers. To ensure collaboration success, a proactive assessment methodology was developed as a supplement to the conventional project management practices. In the postproject feedback, the funding agencies acknowledged that the project fulfilled its contractual obligations and achieved its objectives. The implementing university was pleased as it broke ground in this type of collaboration in Taiwan. The industrial partners, however, were not so sure about the effectiveness of this collaborative training endeavor because there were many skirmishes between company supervisors and Vietnamese interns caused by the interns’ self-interested perception and expectation. Consequently, a theoretical framework for predicting internship acceptance and preventing unfavorable perceptions was proposed to strengthen the proactive assessment methodology. Collaboration research, funding agencies, academia, and industry could all benefit from this study.

  6. Proactive ecology for the Anthropocene

    Directory of Open Access Journals (Sweden)

    F. Stuart Chapin

    2013-12-01

    Full Text Available Abstract The rapid, directional global changes that characterize the Anthropocene provide unprecedented opportunities for ecologists and other scientists to discover new paradigms that shape our understanding of the ways that the world is changing. These paradigms will likely focus more strongly on interactions, feedbacks, thresholds, and model uncertainty than on steady-state dynamics and statistical uncertainty. We advocate a shift in ecology and other disciplines to a more proactive leadership role in defining problems and possibilities in a rapidly changing world rather than being relegated to a reactive role of trying to fix the problems after the horse has left the barn. This requires not only renewed commitment by ecologists (and other citizens to a more proactive ethic of environmental citizenship but also institutional changes in education, the scientific review and funding processes, and promotion and tenure processes to encourage and celebrate those who seek to shape trajectories toward greater ecosystem and social resilience and well-being.

  7. Prevalence and antimicrobial susceptibility patterns of extended spectrum beta-lactamase producing Entrobacteriaceae in the University of Gondar Referral Hospital environments, northwest Ethiopia.

    Science.gov (United States)

    Engda, Tigist; Moges, Feleke; Gelaw, Aschalew; Eshete, Setegn; Mekonnen, Feleke

    2018-05-22

    This study aimed at assessing the magnitude, distribution, and the antimicrobial susceptibility of the extended spectrum beta-lactamase producing Entrobacteriaceae in the University of Gondar Referral Hospital environments. Out of a total of 384 samples, 14.8% were ESBL producing Entrobacteriaceae, where 42.10% Klebsiella pneumoniae, 35.09% Escherchia coli and 7.01% Proteus mirabilis were the predominant isolates. Most ESBL producing isolates, that is, 24.56, 22.8, and 22.8% were found from waste water, sinks and bedside tables respectively. All ESBL producing Entrobacteriaceae were found to be resistant to ceftriaxone, ceftazidime, cefpirome, cefpodoxime, and amoxicillin with Clavulanic acid. Resistance rate was also high for non-beta-lactam antimicrobials, like chloramphenicol (70.18%), cotrimoxazole (64.91%), norfloxacin (42.10%), ciprofloxacin (43.86%), and gentamicin (19.30%).

  8. Evaluation of specialist referrals at a rural health care clinic.

    Science.gov (United States)

    Biggerstaff, Mary Ellen; Short, Nancy

    2017-07-01

    Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%. The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals. The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements. ©2017 American Association of Nurse Practitioners.

  9. Changes in gram negative microorganisms’ resistance pattern during 4 years period in a referral teaching hospital; a surveillance study

    Directory of Open Access Journals (Sweden)

    Khalili Hossein

    2012-09-01

    Full Text Available Abstract Background and purpose Surveillance studies evaluating antimicrobial susceptibilities are of great value in preventing the spread of resistant pathogens by elucidating the trend of resistance in commonly used antibiotics and as a consequence providing information for prescribing the most appropriate agent. This study is a longitudinal antimicrobial resistance surveillance study designed to evaluate the trend in antimicrobial resistance to gram negative microorganisms from 2007 to 2010. Method During a four-year period (2007–2010 isolates derived from all patients admitted to infectious diseases ward of Imam Khomeini Hospital, the major referral center for infectious disease in Iran with the highest admission rates, were evaluated. Based on disk diffusion method and zone of inhibition size, the microorganism was regarded as to be sensitive, resistant or has intermediate susceptibility to the antimicrobial agents. Results The widest spread Gram-negative microorganism in all of isolates taken together in our study was E.coli (30% followed by Stenotrophomonas maltophilia in 28.6% and Enterobacter spp. in 11.9%, respectively. The susceptibility to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin was equal or above 50% for all microorganisms over four years. However, the susceptibility to ampicillin, ampicillin/sulbactam, cefotaxim, and ceftriaxone was less than 50% in derived isolates during the study period. Conclusion In conclusion, the finding of the present study revealed that resistance rate to common antimicrobial agents in Iran is growing and isolates were susceptible mostly to broad-spectrum antibiotics including imipenem and piperacillin/tazobactam.

  10. Proactive Interference in Human Predictive Learning

    OpenAIRE

    Castro, Leyre; Ortega, Nuria; Matute, Helena

    2002-01-01

    The impairment in responding to a secondly trained association because of the prior training of another (i.e., proactive interference) is a well-established effect in human and animal research, and it has been demonstrated in many paradigms. However, learning theories have been concerned with proactive interference only when the competing stimuli have been presented in compound at some moment of the training phase. In this experiment we investigated the possibility of proactive interference b...

  11. Proactive control in early and middle childhood: An ERP study

    Directory of Open Access Journals (Sweden)

    Sarah Elke

    2017-08-01

    Full Text Available Children experience important cognitive control improvements in the transition to school. This study examined 4–5-year-olds’ (n = 17 and 7–8-year-olds’ (n = 22 ability to proactively deploy cognitive control. Children performed a cued task-switching paradigm presenting them with a cue indicating which attribute, color or shape, they should use to sort the upcoming stimulus. Following both cue and stimulus, we analyzed two event-related potentials: the P2 and P3, positive peaks reflecting sensory and attentional components of cognitive control, respectively. Following the cue, we also analyzed a positive slow-wave, indexing working memory engagement. We predicted that on switch trials, which required switching tasks, proactive control would result in larger cue-P3 amplitudes, reflecting recognition of the need to switch, and larger slow-wave amplitudes, reflecting maintenance of the new task-sets over the post-cue delay. This pattern was observed in both age groups. At the stimulus, in switch trials, both age groups had shorter stimulus-P2 latencies, consistent with processing facilitation. These results suggest that both 4–5- and 7–8-year-olds engaged cognitive control proactively. Older children, however, demonstrated better performance and larger cue-P2 amplitudes, suggesting more effective proactive control engagement in middle childhood.

  12. EFFECTS OF PROACTIVE PERSONALITY ON POLITICAL SKILLS

    Directory of Open Access Journals (Sweden)

    Tahsin AKÇAKANAT

    2017-12-01

    Full Text Available The aim of this study was to determine the effect of the proactive personality on the political skills of the administrative staff working at the university. For this purpose, Proactive Personality Scale (Claes et.al., 2005 and Political Skill Inventory (Ferris et.al.:2005 were conducted for university administrative staff. The relationship between proactive personality traits and political skills of the staff was determined through correlation and regression analysis. As a result, it has been found that proactive personality has a significant effect in explaining both its general political skill and its sub-dimensions.

  13. When does transformational leadership enhance employee proactive behavior? The role of autonomy and role breadth self-efficacy.

    Science.gov (United States)

    Den Hartog, Deanne N; Belschak, Frank D

    2012-01-01

    Two multisource studies address the interactive effects of personal and contextual variables on employees' proactive behavior. In line with previous work, we find positive main effects of transformational leadership, role breadth self-efficacy, and job autonomy on employee proactive behavior (personal initiative in Study 1 and prosocial proactive behavior in Study 2). As expected, a 3-way interaction qualifies these main effects: In situations of high autonomy, transformational leadership relates positively to proactive behavior for individuals high (but not low) on self-efficacy. Vice versa, in situations low on job autonomy, transformational leadership relates positively to proactive behavior for individuals low (but not high) on self-efficacy. This pattern is found both for self-ratings and peer-ratings of employees' proactive behavior in Study 1 and for supervisor ratings of such behavior in Study 2.

  14. Optimization of burn referrals

    DEFF Research Database (Denmark)

    Reiband, Hanna K; Lundin, Kira; Alsbjørn, Bjarne

    2014-01-01

    INTRODUCTION: Correct estimation of the severity of burns is important to obtain the right treatment of the patient and to avoid over- and undertriage. In this study we aimed to assess how often the guidelines for referral of burn injured patients are met at the national burn centre (NBC), Denmar...

  15. Audit of Referrals to an Ophthalmic Outpatient Clinic of a Tertiary ...

    African Journals Online (AJOL)

    Objectives: To determine the referral pattern and assess the quality and accuracy of referral letters to the ophthalmic outpatient clinic of University of Nigeria Teaching Hospital, Enugu. Methods: This study is a prospective cross-sectional survey of all new ophthalmic referrals to the ophthalmic outpatient clinic at University of ...

  16. Prevalence and drug susceptibility pattern of group B Streptococci (GBS) among pregnant women attending antenatal care (ANC) in Nekemte Referral Hospital (NRH), Nekemte, Ethiopia.

    Science.gov (United States)

    Mengist, Hylemariam Mihiretie; Zewdie, Olifan; Belew, Adugna; Dabsu, Regea

    2017-08-10

    The main objective of this study was to determine the prevalence and drug susceptibility pattern of group B Streptococci (GBS) among pregnant women. The specific objectives include; (1) To determine the prevalence of GBS colonization among pregnant women (2) To determine the drug susceptibility pattern of GBS among pregnant women and (3) To identify associated risk factors with GBS colonization among pregnant women. The median age of the participants was 24.5 years (range 16-38) and 86% participants were urban residents. The total prevalence of maternal GBS colonization from vaginal swab culture was 12.2% (22/180). The prevalence of GBS colonization rate was significantly higher in those pregnant women above 37 weeks of gestation [AOR, 95% CI 2.1 (1.2, 11.6), P = 0.03] and married ones [AOR, 95% CI 3.2 (1.8, 11.6), P < 0.021]. Twenty (91%) of GBS isolates were sensitive to vancomycin and the highest resistance was observed against penicillin G (77.3%). The prevalence of GBS colonization in this study was significantly high and differed by gestational age and marital status. None of the GBS isolates were resistant to vancomycin but higher resistance was shown against Penicillin G.

  17. Patterns of abuse amongst Sri Lankan women returning home after working as domestic maids in the Middle East: An exploratory study of medico-legal referrals.

    Science.gov (United States)

    Wickramage, Kolitha; De Silva, Malintha; Peiris, Sharika

    2017-01-01

    Migrant worker abuse is well recognised, but poorly characterised within the scientific literature. This study aimed to explore patterns of abuse amongst Sri Lankan women returning home after working as domestic maids. Sri Lanka has over 2 million of its citizens employed overseas as international labor migrants. A cross-sectional study was conducted on Sri Lankan female domestic maids returning from the Middle East region who were referred for medico-legal opinion. A total of 20 women were included in the study. Average length of their employment overseas was 14 months. Complaints of physical violence directed mainly through their employers were made by 60% of women. Upon physical examination, two-thirds had evidence of injuries, with a third being subjected to repetitive/systematic violence. Eighty percent suffered some form of psychological trauma. Personal identity papers and travel documents had been confiscated by the employer in 85% of cases, with two thirds indicating they were prevented and/or restricted from leaving their place of work/residence. Our study demonstrates that female domestic maid abuse manifests through multiple pathways. Violence against such workers span the full spectrum of physical, financial, verbal, emotional abuse and neglect, as defined by the World Health Organization. Findings from this exploratory study cannot be generalized to the large volume of migrant worker outflows. Further research is needed to determine incidence and define patterns in other migrant worker categories such as low-skilled male workers. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  18. Proactive data mining with decision trees

    CERN Document Server

    Dahan, Haim; Rokach, Lior; Maimon, Oded

    2014-01-01

    This book explores a proactive and domain-driven method to classification tasks. This novel proactive approach to data mining not only induces a model for predicting or explaining a phenomenon, but also utilizes specific problem/domain knowledge to suggest specific actions to achieve optimal changes in the value of the target attribute. In particular, the authors suggest a specific implementation of the domain-driven proactive approach for classification trees. The book centers on the core idea of moving observations from one branch of the tree to another. It introduces a novel splitting crite

  19. ENTERPRISE PROACTIVITY AS ELEMENT OF COMPETITIVENESS

    Directory of Open Access Journals (Sweden)

    Alejandra López Salazar

    2010-05-01

    Full Text Available The businessman rol must be based on stimulate a change and the development of organizations counting on abilities and features needed to achieve this. Analyze the vision and business proactivity as corporate culture variables, has a great importance for survival and competitiveness of micro, small and medium-sized enterprises. This study aims to analyze the level of proactivity and vision that have 418 businessmen in the region of Celaya, and determine the relationship of these variables. Results show that there is a great aspiration of businessmen to achieve growth; however, their vision is not aligned with the level of proactivity that they use to manage their organizations.

  20. Etiology and Antimicrobial Susceptibility Pattern of Pathogenic Bacteria in Children Subjected to UTI: A Referral Hospital-Based Study in Northwest of Iran.

    Science.gov (United States)

    Rezaee, Mohammad Ahangarzadeh; Abdinia, Babak

    2015-09-01

    Urinary tract infection (UTI) is 1 of the most common bacterial diseases in children with a considerable resistance to antimicrobials. This 5 years prospective study was carried out to determine the frequency of isolation and antimicrobial resistance patterns of uropathogens among children subjected to urine culture at Tabriz Children Educational-Health Care Center, in the northwest of Iran. Organisms were isolated using standard culture techniques. Frequency of UTI among children examined by urine culture was 3.6%. The isolated bacteria were Escherichia coli (71.4%), followed by Klebsiella spp. (9.6%), Enterococcus spp. (6.4%), Pseudomonas aeruginosa (4.2%), Serratia spp. (4.2%), and Enterobacter spp. (4.2%). E coli resistance levels were 11% for nitrofurantoin, 15% for ciprofloxacin, 25% for nalidixic acid, and 30% to 75% for amikacin, gentamicin, ceftriaxone, ceftizoxime, cefotaxime, and co-trimoxazole. Among the tested antibiotics, ciprofloxacin, showed the highest activity (100%) against Klebsiella and P aeruginosa isolates followed by amikacin, nalidixic acid, and gentamicin. Overall, the highly active antibiotic against Gram-negative and Gram-positive organisms was amikacin and then ciprofloxacin. On the other hand, the empirical initial therapy with co-trimoxazole and third-generation cephalosporins would be inadequate for more cases of UTI in the study area. Moreover, susceptibility testing should be carried out on all clinical isolates, and the empirical antibiotic treatment changed accordingly.

  1. An audit of clinical practice, referral patterns, and appropriateness of clinical indications for brain MRI examinations: A single-centre study in Ghana.

    Science.gov (United States)

    Piersson, A D; Nunoo, G; Gorleku, P N

    2018-05-01

    The aim of this study was to investigate current brain MRI practice, pattern of brain MRI requests, and their appropriateness using the American College of Radiology (ACR) Appropriateness Criteria. We used direct observation and questionnaires to obtain data concerning routine brain MRI practice. We then retrospectively analyzed (i) demographic characteristics, (ii) clinical history, and (iii) appropriateness of brain MRI requests against published criteria. All patients were administered the screening questionnaire; however, no reviews were undertaken directly with patients, and no signature of the radiographer was recorded. Apart from routine brain protocol, there were dedicated protocols for epilepsy and stroke. Brain MRI images from 161 patients (85 Males; 76 Females) were analyzed. The age group with most brain MRI requests were from 26 to 45 year olds. The commonest four clinical indications for imaging were brain tumour, headache, seizure, and stroke. Using the ACR Appropriateness Criteria, almost 43% of the brain MRI scans analyzed were found to be "usually appropriate", 38% were "maybe appropriate" and 19% were categorized as "usually not appropriate". There was knowledge gap with regards to MRI safety in local practice, thus there is the utmost need for MRI safety training. Data on the commonest indications for performing brain MRI in this study should be used to inform local neuroradiological practice. Dedicated stroke and epilepsy MRI protocols require additional sequences i.e. MRA and 3D T1 volume acquisition, respectively. The ACR Appropriateness Criteria is recommended for use by the referring practitioners to improve appropriateness of brain MRI requests. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  2. Release From Proactive Interference with Young Children

    Science.gov (United States)

    Cann, Linda F.; And Others

    1973-01-01

    This demonstration of release from proactive interference with young children confirms the suggestion that the technique is appropriate for the study of developmental changes in the encoding of information. (Authors/CB)

  3. Content Analysis for Proactive Protective Intelligence

    Energy Technology Data Exchange (ETDEWEB)

    Sanfilippo, Antonio P.

    2010-12-15

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

  4. Implicit proactive interference, age, and automatic versus controlled retrieval strategies.

    Science.gov (United States)

    Ikier, Simay; Yang, Lixia; Hasher, Lynn

    2008-05-01

    We assessed the extent to which implicit proactive interference results from automatic versus controlled retrieval among younger and older adults. During a study phase, targets (e.g., "ALLERGY") either were or were not preceded by nontarget competitors (e.g., "ANALOGY"). After a filled interval, the participants were asked to complete word fragments, some of which cued studied words (e.g., "A_L_ _GY"). Retrieval strategies were identified by the difference in response speed between a phase containing fragments that cued only new words and a phase that included a mix of fragments cuing old and new words. Previous results were replicated: Proactive interference was found in implicit memory, and the negative effects were greater for older than for younger adults. Novel findings demonstrate two retrieval processes that contribute to interference: an automatic one that is age invariant and a controlled process that can reduce the magnitude of the automatic interference effects. The controlled process, however, is used effectively only by younger adults. This pattern of findings potentially explains age differences in susceptibility to proactive interference.

  5. Identity Building in Organisations: Proactive Capability Development

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard

    2002-01-01

    Identity building in organisations is often viewed as legitimacy of value systems of the organisation. Based on empirical studies the task of this article is to argue that such a legitimacy approach risks failing in the longer perspective, if the proactive capability development is neglected....... The participatory scenario method presented in this article is one of the possible methods to enhance identity building based on proactive capability development....

  6. The value and feasibility of proactive recycling

    International Nuclear Information System (INIS)

    Fthenakis, V.M.; Moskowitz, P.D.

    1999-01-01

    Photovoltaics (PV) technology has definite environmental advantages over competing electricity generation technologies, and so far these advantages have driven market penetration. The PV industry follows a pro-active approach to preserve its safe and environmentally friendly nature. Industrial ecology considerations raise the issue of what to do with the PV modules at the end of their useful life. One option is recycling. This paper discusses the value of proactive recycling and compares several alternatives. copyright 1999 American Institute of Physics

  7. Visual Working Memory Capacity and Proactive Interference

    OpenAIRE

    Hartshorne, Joshua

    2008-01-01

    BACKGROUND: Visual working memory capacity is extremely limited and appears to be relatively immune to practice effects or the use of explicit strategies. The recent discovery that visual working memory tasks, like verbal working memory tasks, are subject to proactive interference, coupled with the fact that typical visual working memory tasks are particularly conducive to proactive interference, suggests that visual working memory capacity may be systematically under-estimated. METHODOLOGY/P...

  8. Referral expectations of radiology

    International Nuclear Information System (INIS)

    Smith, W.L.; Altmaier, E.; Berberoglu, L.; Morris, K.

    1989-01-01

    The expectation of the referring physician are key to developing a successful practice in radiology. Structured interviews with 17 clinicians in both community care and academic practice documented that accuracy of the radiologic report was the single most important factor in clinician satisfaction. Data intercorrelation showed that accuracy of report correlated with frequency of referral (r = .49). Overall satisfaction of the referring physician with radiology correlated with accuracy (r = .69), patient satisfaction (r = .36), and efficiency in archiving (r = .42). These data may be weighted by departmental managers to allocate resources for improving referring physician satisfaction

  9. Motor Preparation Disrupts Proactive Control in the Stop Signal Task

    Directory of Open Access Journals (Sweden)

    Wuyi Wang

    2018-05-01

    Full Text Available In a study of the stop signal task (SST we employed Bayesian modeling to compute the estimated likelihood of stop signal or P(Stop trial by trial and identified regional processes of conflict anticipation and response slowing. A higher P(Stop is associated with prolonged go trial reaction time (goRT—a form of sequential effect—and reflects proactive control of motor response. However, some individuals do not demonstrate a sequential effect despite similar go and stop success (SS rates. We posited that motor preparation may disrupt proactive control more in certain individuals than others. Specifically, the time interval between trial and go signal onset—the fore-period (FP—varies across trials and a longer FP is associated with a higher level of motor preparation and shorter goRT. Greater motor preparatory activities may disrupt proactive control. To test this hypothesis, we compared brain activations and Granger causal connectivities of 81 adults who demonstrated a sequential effect (SEQ and 35 who did not (nSEQ. SEQ and nSEQ did not differ in regional activations to conflict anticipation, motor preparation, goRT slowing or goRT speeding. In contrast, SEQ and nSEQ demonstrated different patterns of Granger causal connectivities. P(Stop and FP activations shared reciprocal influence in SEQ but FP activities Granger caused P(Stop activities unidirectionally in nSEQ, and FP activities Granger caused goRT speeding activities in nSEQ but not SEQ. These findings support the hypothesis that motor preparation disrupts proactive control in nSEQ and provide direct neural evidence for interactive go and stop processes.

  10. Employee Referrals and Efficiency Wages

    OpenAIRE

    Kugler, Adriana D.

    2002-01-01

    Many workers believe that personal contacts are crucial for obtaining jobs in high-wage sectors. On the other hand, firms in high-wage sectors report using employee referrals because they help provide screening and monitoring of new employees. This Paper develops a matching model that can explain the link between inter-industry wage differentials and the use of employee referrals. Referrals lower monitoring costs because high-effort referees can exert peer pressure on co-workers, allowing fir...

  11. Radiologists' responses to inadequate referrals

    International Nuclear Information System (INIS)

    Lysdahl, Kristin Bakke; Hofmann, Bjoern Morten; Espeland, Ansgar

    2010-01-01

    To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

  12. Compliance with referral of sick children: a survey in five districts of Afghanistan

    Directory of Open Access Journals (Sweden)

    Newbrander William

    2012-04-01

    Full Text Available Abstract Background Recognition and referral of sick children to a facility where they can obtain appropriate treatment is critical for helping reduce child mortality. A well-functioning referral system and compliance by caretakers with referrals are essential. This paper examines referral patterns for sick children, and factors that influence caretakers’ compliance with referral of sick children to higher-level health facilities in Afghanistan. Methods The study was conducted in 5 rural districts of 5 Afghan provinces using interviews with parents or caretakers in 492 randomly selected households with a child from 0 to 2 years old who had been sick within the previous 2 weeks with diarrhea, acute respiratory infection (ARI, or fever. Data collectors from local nongovernmental organizations used a questionnaire to assess compliance with a referral recommendation and identify barriers to compliance. Results The number of referrals, 99 out of 492 cases, was reasonable. We found a high number of referrals by community health workers (CHWs, especially for ARI. Caretakers were more likely to comply with referral recommendations from community members (relative, friend, CHW, traditional healer than with recommendations from health workers (at public clinics and hospitals or private clinics and pharmacies. Distance and transportation costs did not create barriers for most families of referred sick children. Although the average cost of transportation in a subsample of 75 cases was relatively high (US$11.28, most families (63% who went to the referral site walked and hence paid nothing. Most caretakers (75% complied with referral advice. Use of referral slips by health care providers was higher for urgent referrals, and receiving a referral slip significantly increased caretakers’ compliance with referral. Conclusions Use of referral slips is important to increase compliance with referral recommendations in rural Afghanistan.

  13. Compliance with referral of sick children: a survey in five districts of Afghanistan.

    Science.gov (United States)

    Newbrander, William; Ickx, Paul; Werner, Robert; Mujadidi, Farooq

    2012-04-27

    Recognition and referral of sick children to a facility where they can obtain appropriate treatment is critical for helping reduce child mortality. A well-functioning referral system and compliance by caretakers with referrals are essential. This paper examines referral patterns for sick children, and factors that influence caretakers' compliance with referral of sick children to higher-level health facilities in Afghanistan. The study was conducted in 5 rural districts of 5 Afghan provinces using interviews with parents or caretakers in 492 randomly selected households with a child from 0 to 2 years old who had been sick within the previous 2 weeks with diarrhea, acute respiratory infection (ARI), or fever. Data collectors from local nongovernmental organizations used a questionnaire to assess compliance with a referral recommendation and identify barriers to compliance. The number of referrals, 99 out of 492 cases, was reasonable. We found a high number of referrals by community health workers (CHWs), especially for ARI. Caretakers were more likely to comply with referral recommendations from community members (relative, friend, CHW, traditional healer) than with recommendations from health workers (at public clinics and hospitals or private clinics and pharmacies). Distance and transportation costs did not create barriers for most families of referred sick children. Although the average cost of transportation in a subsample of 75 cases was relatively high (US$11.28), most families (63%) who went to the referral site walked and hence paid nothing. Most caretakers (75%) complied with referral advice. Use of referral slips by health care providers was higher for urgent referrals, and receiving a referral slip significantly increased caretakers' compliance with referral. Use of referral slips is important to increase compliance with referral recommendations in rural Afghanistan.

  14. Goal orientation and work role performance: predicting adaptive and proactive work role performance through self-leadership strategies.

    Science.gov (United States)

    Marques-Quinteiro, Pedro; Curral, Luís Alberto

    2012-01-01

    This article explores the relationship between goal orientation, self-leadership dimensions, and adaptive and proactive work role performances. The authors hypothesize that learning orientation, in contrast to performance orientation, positively predicts proactive and adaptive work role performances and that this relationship is mediated by self-leadership behavior-focused strategies. It is posited that self-leadership natural reward strategies and thought pattern strategies are expected to moderate this relationship. Workers (N = 108) from a software company participated in this study. As expected, learning orientation did predict adaptive and proactive work role performance. Moreover, in the relationship between learning orientation and proactive work role performance through self-leadership behavior-focused strategies, a moderated mediation effect was found for self-leadership natural reward and thought pattern strategies. In the end, the authors discuss the results and implications are discussed and future research directions are proposed.

  15. Neurogenesis-mediated forgetting minimizes proactive interference.

    Science.gov (United States)

    Epp, Jonathan R; Silva Mera, Rudy; Köhler, Stefan; Josselyn, Sheena A; Frankland, Paul W

    2016-02-26

    Established memories may interfere with the encoding of new memories, particularly when existing and new memories overlap in content. By manipulating levels of hippocampal neurogenesis, here we show that neurogenesis regulates this form of proactive interference. Increasing hippocampal neurogenesis weakens existing memories and, in doing so, facilitates the encoding of new, conflicting (but not non-conflicting) information in mice. Conversely, decreasing neurogenesis stabilizes existing memories, and impedes the encoding of new, conflicting information. These results suggest that reduced proactive interference is an adaptive benefit of neurogenesis-induced forgetting.

  16. Some effects of cognitive similarity on proactive and retriactive interference in short-term memory

    NARCIS (Netherlands)

    Bunt, A.A.; Sanders, A.F.

    1972-01-01

    An experiment is reported on the effects of cognitive similarity on proactive and retroactive interference (PI, RI) in short term memory. To avoid confounding between cognitive and acoustic similarity, the materials - i.e. words and digits - were matched with respect to vowel pattern. Effects of

  17. Proactive and Retroactive Effects of Negative Suggestion

    Science.gov (United States)

    Brown, Alan S.; Brown, Christine M.; Mosbacher, Joy L.; Dryden, W. Erich

    2006-01-01

    The negative effects of false information presented either prior to (proactive interference; PI) or following (retroactive interference; RI) true information was examined with word definitions (Experiment 1) and trivia facts (Experiment 2). Participants were explicitly aware of which information was true and false when shown, and true-false…

  18. Using Proactive Law for Competitive Advantage

    Directory of Open Access Journals (Sweden)

    Helena Haapio

    2016-12-01

    Full Text Available This article analyzes the role of law as a positive force within companies through parallel developments in Europe and the United States and a Colombian case study that illustrates how contract simplification and visualization can help bring user-friendly contracts and Proactive Law to practice.

  19. A Proactive Approach to Technological Literacy

    Science.gov (United States)

    Weber, Katherine

    2005-01-01

    With the increasing complexity of technology, it is important for each citizen to be able to make informed decisions about the technology that he or she uses. This article suggests that a proactive approach to advocating technological literacy is important in changing the greater public's misconceptions of what it means to be technologically…

  20. Coping Proactively with Middle Years Students.

    Science.gov (United States)

    Hindle, Douglas R.

    1994-01-01

    To deal proactively with middle-years students, educators must consider four areas: development of an effective home-school team; student counseling; classroom management and discipline; and instructional strategies focused on students' personal growth and academic achievement. Teachers should use diverse approaches and materials, increase student…

  1. Young Children Proactively Remedy Unnoticed Accidents

    Science.gov (United States)

    Warneken, Felix

    2013-01-01

    Human adults will sometimes help without being asked to help, including in situations in which the helpee is oblivious to the problem and thus provides no communicative or behavioral cues that intervention is necessary. Some theoretical models argue that these acts of "proactive helping" are an important and possibly human-specific form of…

  2. Preserved Proactive Interference in Autism Spectrum Disorder

    Science.gov (United States)

    Carmo, Joana C.; Duarte, Elsa; Pinho, Sandra; Filipe, Carlos N.; Marques, J. Frederico

    2016-01-01

    In this study, we aimed to evaluate further the functioning and structuring of the semantic system in autism spectrum disorders (ASD). We analyzed the performance of 19 high-functioning young adults with ASD and a group of 20 age-, verbal IQ- and education-matched individuals with the Proactive Interference (PI) Paradigm to evaluate semantic…

  3. Evaluating Mobile Proactive Context-Aware Retrieval

    DEFF Research Database (Denmark)

    Menegon, Davide; Mizzaro, Stefano; Nazzi, Elena

    We present the evaluation of a novel application for Web content perusal by means of context-aware mobile devices that proactively query an external search engine. To this aim, we develop a TREC-like benchmark and we use it to evaluate different strategies for automatic query construction...

  4. Plagiarism: Moving from Punitive to Proactive Approaches

    Science.gov (United States)

    Eaton, Sarah Elaine; Guglielmin, Melanie; Otoo, Benedict Kojo

    2017-01-01

    Plagiarism continues to be an issue in postsecondary contexts. This paper discusses how educators can take a proactive stance to prevent plagiarism and cultivate students' sense of honour and academic integrity, rather than focusing on punitive consequences after plagiarism has already occurred. Strategies include assessment design, formative…

  5. Conceptual framework for proactive crisis enterprise management

    Directory of Open Access Journals (Sweden)

    G. S. Merzlikina

    2017-01-01

    Full Text Available There has been a significant increase in requests for recognition of the debtor insolvent, this situation actualize proactive crisis management in combination with low rehabilitation potential of the institution of bankruptcy since 2014. The crisеs in the development of enterprises are inevitable, moreover it can have positive aspects, for example, increase the company's susceptibility to progress and prevention of more serious crises, so the main objective of proactive crisis management isn`t the avoidance of crisis but optimization of the crisis process. Optimization of process involves the correlation of the costs of implementation of preventive measures and available resources to allocated resources are sufficient for implementation of all phases of proactive crisis solutions, but at the same time, the company has not incurred unreasonably high costs. The authors conducted a comparative analysis of definitions of “proactivecrisis management” and specified the content of this concept. The adoptionprocess of proactive crisis solutions should be clearly structured, so the authors highlighted and discussed in detail the process of adoption of proactivecrisis solutions, which includes 4 stages: obtaining information about the internal and external enterprise environment, the stage of processing the gathered information and taking necessary proactive crisis decisions, the implementation of the adopted decisions and control their implementation.Modern tools of proactivecrisis management are varied and take into account the specifics of modern Russian system of market relations, because they include analysis of internal and external enterprise environment, quantitative and qualitative indicators. The authors suggest to consider innovation as one of the possible instruments of preventive crisis management.

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

    Science.gov (United States)

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

    2018-04-19

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

  7. Creative Proactive-Concluding Theory of Motivating

    OpenAIRE

    Blašková, Martina

    2010-01-01

    The article deals with necessity to change the understanding of human resource philosophy to the new philosophy: philosophy of human potential. In these intentions, it is very important to motivate human potential in the organisations. But, in the area of motivating, situation within the organisations isn't sufficient. Thereto the article gives an introductive presentation of a new theory of motivating: creative proactive-concluding theory of motivating. The theory leads the managers to utili...

  8. Proactive Recommender Systems in Automotive Scenarios

    OpenAIRE

    Bader, Roland

    2013-01-01

    This thesis investigates proactive recommender systems to avoid information overload inside a car. The proposed system delivers context-adaptive items in the right situation. Explicit explanations are used to make the system comprehensible because it works without user request. To show the applicability of our system, we investigate the acceptance of the drivers. The results show that the drivers tend to accept such a system. Zur Vermeidung von Informationsüberflutung im Fahrzeug werden in...

  9. Proactive interference effects on sentence production

    OpenAIRE

    FERREIRA, VICTOR S.; FIRATO, CARLA E.

    2002-01-01

    Proactive interference refers to recall difficulties caused by prior similar memory-related processing. Information-processing approaches to sentence production predict that retrievability affects sentence form: Speakers may word sentences so that material that is difficult to retrieve is spoken later. In this experiment, speakers produced sentence structures that could include an optional that, thereby delaying the mention of a subsequent noun phrase. This subsequent noun phrase was either (...

  10. Psychophysiology of proactive and reactive relational aggression.

    Science.gov (United States)

    Murray-Close, Dianna; Holterman, Leigh Ann; Breslend, Nicole L; Sullivan, Alexandra

    2017-12-01

    This study investigated the joint effects of parasympathetic and sympathetic nervous system reactivity to social and non-social stressors on proactive (i.e., goal-directed, unemotional) and reactive (i.e., emotional, impulsive) functions of relational aggression. Two hundred and forty-seven (M age =18.77years) participants completed a series of stressor tasks while their sympathetic arousal (i.e., skin conductance) and parasympathetic arousal (i.e., respiratory sinus arrhythmia) were assessed. Participants also provided self-reports of their aggressive behavior. In the standardized social stressor only, physiological reactivity was related to aggression, such that respiratory sinus arrhythmia augmentation predicted proactive relational aggression whereas heightened skin conductance reactivity predicted reactive relational aggression. Finally, in the context of low skin conductance reactivity, respiratory sinus arrhythmia augmentation was related to heightened proactive and reactive aggression, whereas respiratory sinus arrhythmia withdrawal was protective. Results suggest that the benefits hypothesized to accompany respiratory sinus arrhythmia withdrawal may only occur among individuals with low "fight or flight" stress responses. Findings extend research on the physiological indicators of aggression to relational aggression, and highlight the importance of assessing functions of aggression, as well as physiological reactivity to multiple stressors. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Visual working memory capacity and proactive interference.

    Science.gov (United States)

    Hartshorne, Joshua K

    2008-07-23

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

  12. Visual working memory capacity and proactive interference.

    Directory of Open Access Journals (Sweden)

    Joshua K Hartshorne

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

  13. Caregivers' compliance with referral advice

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy

    2018-01-01

    BACKGROUND: Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance...... in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. RESULTS: CHW saw 18......,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings

  14. Release from proactive interference in rat spatial working memory.

    Science.gov (United States)

    Roberts, William A; MacDonald, Hayden; Brown, Lyn; Macpherson, Krista

    2017-09-01

    A three-phase procedure was used to produce proactive interference (PI) in one trial on an eight-arm radial maze. Rats were forced to enter four arms for reward on an initial interference phase, to then enter the four remaining arms on a target phase, and to then choose among all eight arms on a retention test, with only the arms not visited in the target phase containing reward. Control trials involved only the target phase and the retention test. Lower accuracy was found on PI trials than on control trials, but performance on PI trials significantly exceeded chance, showing some retention of target memories. Changes in temporal and reward variables between the interference, target, and retention test phases showed release from PI, but changes in context and pattern of arm entry did not. It is suggested that the release from PI paradigm can be used to understand spatial memory encoding in rats and other species.

  15. Gastrointestinal malignancies at five regional referral hospitals in ...

    African Journals Online (AJOL)

    The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the five referral hospitals was ... Conclusion: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and their rate is .... intake, poor dietary patterns such as consumption of a.

  16. Education of Physicians and Implementation of a Formal Referral System Can Improve Cardiac Rehabilitation Referral and Participation Rates after Percutaneous Coronary Intervention.

    Science.gov (United States)

    Dahhan, Ali; Maddox, William R; Krothapalli, Siva; Farmer, Matthew; Shah, Amit; Ford, Benjamin; Rhodes, Marc; Matthews, Laurie; Barnes, Vernon A; Sharma, Gyanendra K

    2015-08-01

    Cardiac rehabilitation (CR) is an effective preventive measure that remains underutilised in the United States. The study aimed to determine the CR referral rate (RR) after percutaneous coronary intervention (PCI) at an academic tertiary care centre, identify barriers to referral, and evaluate awareness of CR benefits and indications (CRBI) among cardiologists. Subsequently, it aimed to evaluate if an intervention consisting of physicians' education about CRBI and implementation of a formal CR referral system could improve RR and consequently participation rate (PR). Data were retrospectively collected for all consecutive patients who underwent PCI over 12 months. Referral rate was determined and variables were compared for differences between referred and non-referred patients. A questionnaire was distributed among the physicians in the Division of Cardiology to assess awareness of CRBI and referral practice patterns. After implementation of the intervention, data were collected retrospectively for consecutive patients who underwent PCI in the following six months. Referral rate and changes in PRs were determined. Prior to the intervention, RR was 17.6%. Different barriers were identified, but the questionnaire revealed lack of physicians' awareness of CRBI and inconsistent referral patterns. After the intervention, RR increased to 88.96% (Odds Ratio 37.73, 95% CI 21.34-66.70, pEducation of providers and implementation of a formal referral system can improve RR and PR. Published by Elsevier B.V.

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

    Science.gov (United States)

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

    2011-06-01

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

  18. Proactiveness in entrepreneurial software firms: the executives' voice

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Boissin

    2010-12-01

    Full Text Available This article approaches proactiveness in firms, considered to be one of the dimensions of the entrepreneurial orientation. Its goal is to introduce the results of an exploratory and qualitative study, which aimed to characterize the proactiveness in entrepreneurial software firms. The theory resumes the concepts of entrepreneurial firms, entrepreneurial orientation and proactiveness. The data gathering was accomplished through deeper interviews with executives from 13 software firms that stand out in terms of entrepreneurship in Rio Grande do Sul state. The results of the study demonstrate that firms are proactive and show a characterization regarding this behavior, starting from the conceptual base adopted in the present study. Among the proactiveness elements in the researched organizations, the onesrelated to environment monitoring and opportunities quest are highlighted. The study also consoliding a components’ set of proactiveness based on the theory and organizational practice reported by executives.

  19. Short Stature Diagnosis and Referral

    Directory of Open Access Journals (Sweden)

    Mohamad Maghnie

    2018-01-01

    Full Text Available The “360° GH in Europe” meeting, which examined various aspects of GH diseases, was held in Lisbon, Portugal, in June 2016. The Merck KGaA (Germany funded meeting comprised three sessions entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management,” and “Managing Transition.” Each session had three speaker presentations, followed by a discussion period, and is reported as a manuscript, authored by the speakers. The first session examined current processes of diagnosis and referral by endocrine specialists for pediatric patients with short stature. Requirements for referral vary widely, by country and by patient characteristics such as age. A balance must be made to ensure eligible patients get referred while healthcare systems are not over-burdened by excessive referrals. Late referral and diagnosis of non-GH deficiency conditions can result in increased morbidity and mortality. The consequent delays in making a diagnosis may compromise the effectiveness of GH treatment. Algorithms for growth monitoring and evaluation of skeletal disproportions can improve identification of non-GH deficiency conditions. Performance and validation of guidelines for diagnosis of GH deficiency have not been sufficiently tested. Provocative tests for investigation of GH deficiency remain equivocal, with insufficient information on variations due to patient characteristics, and cutoff values for definition differ not only by country but also by the assay used. When referring and diagnosing causes of short stature in pediatric patients, clinicians need to rely on many factors, but the most essential is clinical experience.

  20. Iterative Contracts as Proactive Law Instruments

    DEFF Research Database (Denmark)

    Henschel, René Franz

    2012-01-01

    The purpose of this article is to analyse the use of proactive law in contracts illustrated by the use of a particular type of contract within the IT industry, the so-called iterative contract. This type of contract has its root in a special software development process called iterative and incre...... the potential to create more business success. However, empirical research still needs to be done in order to confirm that these types of contracts are better at securing business success than traditional contract forms....

  1. BUILDUP OF PROACTIVE INTERFERENCE IN JAPANESE KANJI LEARNING

    OpenAIRE

    FUJITA, Tadashi

    1995-01-01

    The discriminative assumption on buildup of proactive interference in short-term memory predicts that when intertrial similarity of items is high, the proactive interference is built up while interlist similarity of items is low, the proactive interference is not built up. To test the discriminative assumption in Japanese Kanji learning, intertrial similarity was changed by the acoustic, the radical (as one of the figurative properties), and the radical plus semantic properties in Kanji. For ...

  2. The research of Proactive Coping Behavior of Patients with Chronic Non-Specific Lung Disease

    Directory of Open Access Journals (Sweden)

    Marija A. Yaroslavskaya

    2011-01-01

    Full Text Available The purpose of the research was to study the patterns of using proactive coping and adherences to it's different types in patients with chronic non-specifi c lung diseases. Participants of the study (N=180 were 30 to 60 years old. The Proactive Coping Inventory was used to assess the patients' psychological status. According to the results of the study patients with chronic non-specifi c lung diseases use dif-ferent types of proactive coping behavior while solving problematic and stressful situations. The research revealed that patients with bronchial asthma don't have the skills of independent decision making, definition of objectives, considering of options in solving conflicts or other inconvenient situations sufficiently developed. Patients with chronic obstructive pulmonary disease are less satisfied with the emotional support that they receive from their relatives and closest people, it's harder for them to reveal their feelings and emotions than for those who suffer from bronchial asthma and healthy ones. The results of the study may be useful in developing educational systems of proactive coping behavior skills for patients with chronic non-specific lung diseases for their health and well-being support.

  3. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  4. Managing Consumer Referrals in a Chain Network

    OpenAIRE

    Maria Arbatskaya; Hideo Konishi

    2014-01-01

    We consider the optimal pricing and referral strategy of a monopoly that uses a simple consumer communication network (a chain) to spread product information. The first-best policy with fully discriminatory position-based referral fees involves standard monopoly pricing and referral fees that provide consumers with strictly positive referral incentives. Effective price discrimination among consumers based on their positions in the chain occurs in both the first-best solution and the second-be...

  5. Traditional test administration and proactive interference undermine visual-spatial working memory performance in schizophrenia-spectrum disorders.

    Science.gov (United States)

    Girard, Todd A; Wilkins, Leanne K; Lyons, Kathleen M; Yang, Lixia; Christensen, Bruce K

    2018-05-31

    Introduction Working-memory (WM) is a core cognitive deficit among individuals with Schizophrenia Spectrum Disorders (SSD). However, the underlying cognitive mechanisms of this deficit are less known. This study applies a modified version of the Corsi Block Test to investigate the role of proactive interference in visuospatial WM (VSWM) impairment in SSD. Methods Healthy and SSD participants completed a modified version of the Corsi Block Test involving both high (typical ascending set size from 4 to 7 items) and low (descending set size from 7 to 4 items) proactive interference conditions. Results The results confirmed that the SSD group performed worse overall relative to a healthy comparison group. More importantly, the SSD group demonstrated greater VSWM scores under low (Descending) versus high (Ascending) proactive interference; this pattern is opposite to that of healthy participants. Conclusions This differential pattern of performance supports that proactive interference associated with the traditional administration format contributes to VSWM impairment in SSD. Further research investigating associated neurocognitive mechanisms and the contribution of proactive interference across other domains of cognition in SSD is warranted.

  6. The Effects of Age on Short-Term Memory Loss due to Proactive Interference

    OpenAIRE

    Alisha Berkauzer

    2011-01-01

    This project focused on how proactive interference affects the short-term memory of people based on their age. The goal was to find the prime age for learning information and storing it in one's memory. Seven people from ages fifteen to forty were tested individually, using a set color pattern, in order to see how well each individual could remember the different color patterns as difficulty of the pattern increased. The obtained data was fitted by the polynomial regression. The “fitted...

  7. Automatic referral to cardiac rehabilitation.

    Science.gov (United States)

    Fischer, Jane P

    2008-01-01

    The pervasive negative impact of cardiovascular disease in the United States is well documented. Although advances have been made, the campaign to reduce the occurrence, progression, and mortality continues. Determining evidence-based data is only half the battle. Implementing new and updated clinical guidelines into daily practice is a challenging task. Cardiac rehabilitation is an example of a proven intervention whose benefit is hindered through erratic implementation. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA) have responded to this problem by publishing the AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services. This new national guideline recommends automatic referral to cardiac rehabilitation for every eligible patient (performance measure A-1). This article offers guidance for the initiation of an automatic referral system, including individualizing your protocol with regard to electronic or paper-based order entry structures.

  8. Proactive Interference in Short-Term Recognition and Recall Memory

    Science.gov (United States)

    Dillon, Richard F.; Petrusic, William M.

    1972-01-01

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

  9. Proactive and Preventive Coping in Adjustment to College

    Science.gov (United States)

    Gan, Yiqun; Hu, Yueqin; Zhang, Yiwen

    2010-01-01

    The current study compared the relative importance of proactive coping and preventive coping in the adjustment to university life among 403 freshmen at a Chinese university and evaluated the function of proactive coping in the stress process. Participants completed the Future-Oriented Coping Inventory (Gan, Yang, Zhou, & Zhang, 2007), the…

  10. The summarize of the technique about proactive network security protection

    International Nuclear Information System (INIS)

    Liu Baoxu; Li Xueying; Cao Aijuan; Yu Chuansong; Xu Rongsheng

    2003-01-01

    The proactive protection measures and the traditional passive security protection tools are complementarities each other. It also can supply the conventional network security protection system and enhance its capability of the security protection. Based upon sorts of existing network security technologies, this article analyses and summarizes the technologies, functions and the development directions of some key proactive network security protection tools. (authors)

  11. Monitoring the referral system through benchmarking in rural Niger: an evaluation of the functional relation between health centres and the district hospital

    Directory of Open Access Journals (Sweden)

    Miyé Hamidou

    2006-04-01

    Full Text Available Abstract Background The main objective of this study is to establish a benchmark for referral rates in rural Niger so as to allow interpretation of routine referral data to assess the performance of the referral system in Niger. Methods Strict and controlled application of existing clinical decision trees in a sample of rural health centres allowed the estimation of the corresponding need for and characteristics of curative referrals in rural Niger. Compliance of referral was monitored as well. Need was matched against actual referral in 11 rural districts. The referral patterns were registered so as to get an idea on the types of pathology referred. Results The referral rate benchmark was set at 2.5 % of patients consulting at the health centre for curative reasons. Niger's rural districts have a referral rate of less than half this benchmark. Acceptability of referrals is low for the population and is adding to the deficient referral system in Niger. Mortality because of under-referral is highest among young children. Conclusion Referral patterns show that the present programme approach to deliver health care leaves a large amount of unmet need for which only comprehensive first and second line health services can provide a proper answer. On the other hand, the benchmark suggests that well functioning health centres can take care of the vast majority of problems patients present with.

  12. Proactive and defensive self-regulation in learning

    Directory of Open Access Journals (Sweden)

    Darko Lončarić

    2008-12-01

    Full Text Available Although self-regulation research is fragmented over several interdisciplinary areas and theories, the concept of self-regulation could represent a cohesive force for integrating different areas of psychology, such as clinical, educational, or organisational psychology. This paper focuses on self-regulation within the educational framework and elaborates the concept of self-regulated learning. Current advances in self-regulated learning research indicated that concepts, such as cognition and motivation, need to be integrated into a coherent self-regulation model. Two models that integrate cognitive and motivational constructs are described in this paper, namely the motivational and cognitive self-regulation components described by Pintrich and colleagues (e.g., Garcia & Pintrich 1994, and a six component model of self-regulated learning provided by Boekaerts (1997. These models were used to formulate new and parsimonious organisational constructs that classify self-regulation components into proactive and defensive self-regulation patterns. At the end, the applicative value of the models and the need for further research, regarding the question of specific self-regulation failures (the depressive self-regulation pattern, are being discussed.

  13. Winning community support through proactive communications

    International Nuclear Information System (INIS)

    Zelmer, R.L.; Stickley, S.; Gerestein, B.

    2006-01-01

    For over 20 years the Low-Level Radioactive Waste Management Office (LLRWMO) has conducted remedial projects in communities across Canada. Through experience in the various social climates of Canadian communities, the LLRWMO has learned that community involvement and communications are integral to a project's overall success. The Port Hope Area Initiative is the largest project ever undertaken by the LLRWMO and all the proactive communications and consultation lessons learned from other projects have been applied in the Port Hope and Port Granby communities. The relationship of trust and credibility built over 20 years of LLRWMO operations in Port Hope provides a firm foundation for moving forward with the cleanup and long-term safe management of approximately two million cubic metres of low-level radioactive waste and contaminated soil in the Port Hope and Port Granby communities. (author)

  14. Proactive condition monitoring of low-speed machines

    CERN Document Server

    Stamboliska, Zhaklina; Moczko, Przemyslaw

    2015-01-01

    This book broadens readers’ understanding of proactive condition monitoring of low-speed machines in heavy industries. It focuses on why low-speed machines are different than others and how maintenance of these machines should be implemented with particular attention. The authors explain the best available monitoring techniques for various equipment and the principle of how to get proactive information from each technique. They further put forward possible strategies for application of FEM for detection of faults and technical assessment of machinery. Implementation phases are described and industrial case-studies of proactive condition monitoring are included. Proactive Condition Monitoring of Low-Speed Machines is an essential resource for engineers and technical managers across a range of industries as well as design engineers working in industrial product development. This book also: ·         Explains the practice of proactive condition monitoring and illustrates implementation phases ·   ...

  15. The weakest link: competence and prestige as constraints to referral by isolated nurses in rural Niger

    Directory of Open Access Journals (Sweden)

    Van Lerberghe Wim

    2004-04-01

    Full Text Available Abstract Background For a health district to function referral from health centres to district hospitals is critical. In many developing countries referral systems perform well below expectations. Niger is not an exception in this matter. Beyond obvious problems of cost and access this study shows to what extent the behaviour of the health worker in its interaction with the patient can be a barrier of its own. Methods Information was triangulated from three sources in two rural districts in Niger: first, 46 semi-structured interviews with health centre nurses; second, 42 focus group discussions with an average of 12 participants – patients, relatives of patients and others; third, 231 semi-structured interviews with referred patients. Results Passive patients without 'voice' reinforce authoritarian attitudes of health centre staff. The latter appear reluctant to refer because they see little added value in referral and fear loss of power and prestige. As a result staff communicates poorly and show little eagerness to convince reluctant patients and families to accept referral proposals. Conclusions Diminishing referral costs and distance barriers is not enough to correct failing referral systems. There is also a need for investment in district hospitals to make referrals visibly worthwhile and for professional upgrading of the human resources at the first contact level, so as to allow for more effective referral patterns.

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

    Science.gov (United States)

    Lebel, R David; Patil, Shefali V

    2018-03-26

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

  17. Proactive personality and job performance: a social capital perspective.

    Science.gov (United States)

    Thompson, Jeffery A

    2005-09-01

    This study of 126 employee-supervisor dyads examined a mediated model of the relationship between proactive personality and job performance. The model, informed by the social capital perspective, suggests that proactive employees reap performance benefits by means of developing social networks that provide them the resources and latitude to pursue high-level initiatives. Structural equation modeling suggested that the relationship between proactive personality and job performance is mediated by network building and initiative taking on the part of the employee. Copyright 2005 APA, all rights reserved.

  18. Are proactive personalities always beneficial? Political skill as a moderator.

    Science.gov (United States)

    Sun, Shuhua; van Emmerik, Hetty I J

    2015-05-01

    Does proactive personality always enhance job success? The authors of this study draw on socioanalytic theory of personality and organizational political perspectives to study employees' political skill in moderating the effects of proactive personality on supervisory ratings of employee task performance, helping behaviors, and learning behaviors. Multisource data from 225 subordinates and their 75 immediate supervisors reveal that proactive personality is associated negatively with supervisory evaluations when political skill is low, and the negative relationship disappears when political skill is high. Implications and future research directions are discussed. (c) 2015 APA, all rights reserved.

  19. Proactive Review – learn from experience to improve bottom line

    DEFF Research Database (Denmark)

    Kolbæk, Ditte

    2016-01-01

    This article aims to provide a theoretically based and proven educational design for lessons learned. Called a Proactive Review, this educational design is exemplified in a case study of a global information technology company classified as big business, where Proactive Reviews were developed...... and implemented in over 40 countries. This article explores how employees who solve a task together can learn from the experience and share this learning with relevant colleagues to improve work practices, services, and/or products. This article describes the format of Proactive Reviews, suggestions for starting...

  20. Improve Business Results by Learning from Experience in Proactive Reviews

    DEFF Research Database (Denmark)

    Kolbæk, Ditte

    2018-01-01

    This article aims to provide a theoretically based and proven educational design for lessons learned. Called a Proactive Review, this educational design is exemplified in a case study of a global information technology company classified as big business, where Proactive Reviews were developed...... and implemented in over 40 countries. This article explores how employees who solve a task together can learn from the experience and share this learning with relevant colleagues to improve work practices, services, and/or products. This article describes the format of Proactive Reviews, suggestions for starting...

  1. Development of a quarterly referral productivity report.

    Science.gov (United States)

    Wu, Cai; Sandoval, Alex; Hicks, Katrina N; Edwards, Tim J; Green, Lyle D

    2007-10-11

    The Office of Physician Relations at The University of Texas M. D. Anderson Cancer Center (MDACC) has developed a dynamic referral productivity reporting tool for its Multidisciplinary Care Centers (MCC). The tool leverages information within the institution's Enterprise Information Warehouse (EIW) using business intelligent software Hyperion Intelligent Explorer Suite 8.3. the referral productivity reports are intended to provide each MCC with detailed referral and registration data outlining how, and from where, patients arrive here for treatment. The reports supports operational and strategic initiatives aimed at improving referral processes and market related program development.

  2. Radiologists' responses to inadequate referrals

    Energy Technology Data Exchange (ETDEWEB)

    Lysdahl, Kristin Bakke [Oslo University College, Faculty of Health Sciences, Oslo (Norway); University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Hofmann, Bjoern Morten [University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Gjoevik University College, Faculty of Health Care and Nursing, Gjoevik (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway)

    2010-05-15

    To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

  3. Blocked vs. interleaved presentation and proactive interference in episodic memory.

    Science.gov (United States)

    Del Missier, Fabio; Sassano, Alessia; Coni, Valentina; Salomonsson, Martina; Mäntylä, Timo

    2018-05-01

    Although a number of theoretical accounts of proactive interference (PI) in episodic memory have been proposed, existing empirical evidence does not support conclusively a single view yet. In two experiments we tested the predictions of the temporal discrimination theory of PI against alternative accounts by manipulating the presentation schedule of study materials (lists blocked by category vs. interleaved). In line with the temporal discrimination theory, we observed a clear buildup of (and release from) PI in the blocked condition, in which all the lists of the same category were presented sequentially. In the interleaved condition, with alternating lists of different categories, a more gradual and smoother buildup of PI was observed. When participants were left free to choose their presentation schedule, they spontaneously adopted an interleaved schedule, resulting again in more gradual PI. After longer delays, we observed recency effects at the list level in overall recall and, in the blocked condition, PI-related effects. The overall pattern of findings agrees with the predictions of the temporal discrimination theory of PI, complemented with categorical processing of list items, but not with alternative accounts, shedding light on the dynamics and underpinnings of PI under diverse presentation schedules and over different time scales.

  4. Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, Tina B; Berg, Selina K; Sibilitz, Kirstine L

    2015-01-01

    variation. The overall uptake rate was 52%. Simultaneous CABG was associated with a higher probability of referral to CR (OR 2.02 (95%CI 1.12-3.65)); being unmarried (0.44 (0.27-0.72)) and having TAVI with a lower probability (0.26; 0.13-0.52). The referral pattern varied across administrative regions...... were linked to nationwide registries. We analysed the provision and content of programmes using descriptive statistics, and factors associated with referral and participation using logistic regression analysis. RESULTS: Coverage of CR programmes for these patients was high, with national programme......- and patient-level influenced uptake and included significant regional variation in referral pattern. Further research into the effect and organization of CR post heart valve surgery is needed....

  5. Proactive Student Engagement with Fitness to Practise

    Directory of Open Access Journals (Sweden)

    Kristin Lo

    2014-01-01

    Full Text Available Fitness to practise (FTP is fundamental to health professional education and health service delivery, impacting on both practitioner and client wellbeing. Literature exploring FTP support policies primarily identifies retrospective student support and management. This study describes student perceptions of an innovative FTP policy which supports students and staff to proactively identify FTP management strategies prior to entering the clinical environment. Forty-nine final year physiotherapy students were surveyed regarding their perceptions of self-declaring FTP. Ordinal data from Likert scales were reported using descriptive statistics. Thematic analysis was undertaken for open text responses. The response rate was 88%. Forty-two percent of students stated that they had experienced FTP concerns during the course. Concerns included physical and mental impairment and clinical competence issues. The majority of students (80% indicated that they were “comfortable” or “very comfortable” in self-declaring FTP issues. Confidentiality, positive relationships with staff and a supportive environment enhanced likelihood of declaration. Eight students (19% met with university staff to develop management strategies and all rated these meetings as “helpful” or “very helpful.” Students had positive perceptions of self-declaring their FTP to enable early development of management strategies. This strategy successfully navigates sensitive ethicolegal issues, empowering students to take responsibility for their own FTP.

  6. Proactive learning for artificial cognitive systems

    Science.gov (United States)

    Lee, Soo-Young

    2010-04-01

    The Artificial Cognitive Systems (ACS) will be developed for human-like functions such as vision, auditory, inference, and behavior. Especially, computational models and artificial HW/SW systems will be devised for Proactive Learning (PL) and Self-Identity (SI). The PL model provides bilateral interactions between robot and unknown environment (people, other robots, cyberspace). For the situation awareness in unknown environment it is required to receive audiovisual signals and to accumulate knowledge. If the knowledge is not enough, the PL should improve by itself though internet and others. For human-oriented decision making it is also required for the robot to have self-identify and emotion. Finally, the developed models and system will be mounted on a robot for the human-robot co-existing society. The developed ACS will be tested against the new Turing Test for the situation awareness. The Test problems will consist of several video clips, and the performance of the ACSs will be compared against those of human with several levels of cognitive ability.

  7. Proactive Management of the Equine Athlete

    Directory of Open Access Journals (Sweden)

    Erica K. Gee

    2012-12-01

    Full Text Available Across many equestrian disciplines the median competition career of a horse is relatively short. One of the major reasons for short career length is musculoskeletal injury and a consistent variable is the trainer effect. There are significant opportunities within equestrian sport for a holistic approach to horse health to attenuate musculoskeletal injury. Proactive integration of care by health professionals could provide a mechanism to attenuate injury risk and the trainer effect. However, the limited data available on current exercise regimens for sport horses restricts interpretation of how management and exercise volume could be modified to reduce injury risk. Early exercise in the juvenile horse (i.e., pre weaning has a positive effect on stimulating the musculoskeletal system and primes the horse for an athletic career. The early introduction to sport competition has also been identified to have a positive effect on career length. These data indicate that management systems reflecting the cursorial evolution of the horse may aid in attenuating loss from sport due to musculoskeletal injury.

  8. Survey of the Statewide Impact of Payer Source on Referral of Small Burns to Burn Centers.

    Science.gov (United States)

    Penny, Rachel; Coffey, Rebecca; Jones, Larry; Bailey, J Kevin

    It is generally agreed that patients with large burns will be referred to organized burn centers, however, the referral of patients with smaller burns is less certain. A two-part survey was conducted to identify referral patterns for burn patients that meet American Burn Association referral criteria, and any effect insurance type might have on the referral patterns. The emergency departments of our state hospital association's member hospitals were contacted seeking a referral for a fictitious patient with a third-degree scald of the dominant hand. The referral sites were contacted twice, first stating that the patient had commercial insurance, next stating that the patient had Medicaid. Data collected included wait time for an appointment or reasons for denial of an appointment. Of 218 hospitals, 46 were excluded because they did not offer emergency care, and eight because they were listed as burn centers on the American Burn Association website. Of the remaining 164, 119 (73%) would refer to a burn center, 21 (13%) to a plastic surgeon, 10 (6%) to a hand surgeon, 7 (4%) to a wound center, 7 (4%) to another nonburn physician resource. There was no difference in wait time to the first available appointment with regards to insurance type (6.56 ± 4.68 vs 6.53 ± 5.05 days). Our state's referral pattern gives us insight into the regional referral pattern. This information will be used to guide a focused education and communication program to provide better service for the burn victims of our state.

  9. Release from Proactive Interference: Insufficiency of an Attentional Account

    Science.gov (United States)

    MacLeod, Colin M.

    1975-01-01

    If an attentional cue affects retroactive interference, perhaps a similar mechanism underlies release from proactive interference. This study tested this hypothesis by inserting an attentional cue before the final trial in Wickens' paradigm. (Author/RK)

  10. From reactive to proactive apporach of interactive leadership

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard

    2010-01-01

    In order to enhance a constructive approach to technological and organisational development it seems important to involve employees proactively. The chapter discribe and analyse different approaches to do that and analyse the impacts on organisational change...

  11. Referrals to a regional allergy clinic - an eleven year audit

    Directory of Open Access Journals (Sweden)

    Hewson Paul

    2010-12-01

    Full Text Available Abstract Background Allergy is a serious and apparently increasing public health problem yet relatively little is known about the types of allergy seen in routine tertiary practice, including their spatial distribution, co-occurrence or referral patterns. This study reviewed referrals over an eleven year period to a regional allergy clinic that had a well defined geographical boundary. For those patients confirmed as having an allergy we explored: (i differences over time and by demographics, (ii types of allergy, (iii co-occurrence, and (iv spatial distributions. Methods Data were extracted from consultant letters to GPs, from September 1998 to September 2009, for patients confirmed as having an allergy. Other data included referral statistics and population data by postcode. Simple descriptive analysis was used to describe types of allergy. We calculated 11 year standardised morbidity ratios for postcode districts and checked for spatial clustering. We present maps showing 11 year rates by postcode, and 'difference' maps which try to separate referral effect from possible environmental effect. Results Of 5778 referrals, 961 patients were diagnosed with an allergy. These were referred by a total of 672 different GPs. There were marked differences in referral patterns between GP practices and also individual GPs. The mean age of patients was 35 and there were considerably more females (65% than males. Airborne allergies were the most frequent (623, and there were very high rates of co-occurrence of pollen, house dust mite, and animal hair allergies. Less than half (410 patients had a food allergy, with nuts, fruit, and seafood being the most common allergens. Fifteen percent (142 had both a food and a non-food allergy. Certain food allergies were more likely to co-occur, for example, patients allergic to dairy products were more likely to be allergic to egg. There were age differences by types of allergy; people referred with food allergies were

  12. Gaps in referral to cardiac rehabilitation of patients undergoing percutaneous coronary intervention in the United States.

    Science.gov (United States)

    Aragam, Krishna G; Dai, Dadi; Neely, Megan L; Bhatt, Deepak L; Roe, Matthew T; Rumsfeld, John S; Gurm, Hitinder S

    2015-05-19

    Rates of referral to cardiac rehabilitation after percutaneous coronary intervention (PCI) have been historically low despite the evidence that rehabilitation is associated with lower mortality in PCI patients. This study sought to determine the prevalence of and factors associated with referral to cardiac rehabilitation in a national PCI cohort, and to assess the association between insurance status and referral patterns. Consecutive patients who underwent PCI and survived to hospital discharge in the National Cardiovascular Data Registry between July 1, 2009 and March 31, 2012 were analyzed. Cardiac rehabilitation referral rates, and patient and institutional factors associated with referral were evaluated for the total study population and for a subset of Medicare patients presenting with acute myocardial infarction. Patients who underwent PCI (n = 1,432,399) at 1,310 participating hospitals were assessed. Cardiac rehabilitation referral rates were 59.2% and 66.0% for the overall population and the AMI/Medicare subgroup, respectively. In multivariable analyses, presentation with ST-segment elevation myocardial infarction (odds ratio 2.99; 95% confidence interval: 2.92 to 3.06) and non-ST-segment elevation myocardial infarction (odds ratio: 1.99; 95% confidence interval: 1.94 to 2.03) were associated with increased odds of referral to cardiac rehabilitation. Models adjusted for insurance status showed significant site-specific variability in referral rates, with more than one-quarter of all hospitals referring rehabilitation. Site-specific variation in referral rates is significant and is unexplained by insurance coverage. These findings highlight the potential need for hospital-level interventions to improve cardiac rehabilitation referral rates after PCI. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Proactive supply chain risk management approach: The case of Serbia

    OpenAIRE

    Anđelković Aleksandra

    2017-01-01

    Supply chain risk management has become imperative. Therefore, needs for proactive supply chain risk management continuously is growing. Proactive supply chain risk management is not a great problem in developed countries. The problem is present in transition countries and underdeveloped countries. In those countries has not been built awareness about the importance of networking through supply chains and risk management within the supply chain. One of them...

  14. Intelligent Transportation Control based on Proactive Complex Event Processing

    OpenAIRE

    Wang Yongheng; Geng Shaofeng; Li Qian

    2016-01-01

    Complex Event Processing (CEP) has become the key part of Internet of Things (IoT). Proactive CEP can predict future system states and execute some actions to avoid unwanted states which brings new hope to intelligent transportation control. In this paper, we propose a proactive CEP architecture and method for intelligent transportation control. Based on basic CEP technology and predictive analytic technology, a networked distributed Markov decision processes model with predicting states is p...

  15. Simplified Threshold RSA with Adaptive and Proactive Security

    DEFF Research Database (Denmark)

    Almansa Guerra, Jesus Fernando; Damgård, Ivan Bjerre; Nielsen, Jesper Buus

    2006-01-01

    We present the currently simplest, most efficient, optimally resilient, adaptively secure, and proactive threshold RSA scheme. A main technical contribution is a new rewinding strategy for analysing threshold signature schemes. This new rewinding strategy allows to prove adaptive security...... of a proactive threshold signature scheme which was previously assumed to be only statically secure. As a separate contribution we prove that our protocol is secure in the UC framework....

  16. Characteristics Of Referrals To An Oral And Maxillofacial Surgery ...

    African Journals Online (AJOL)

    ... Practitioners (GMPS) sent the most referrals (507 or 74.0%), specialist medical practitioners (SMPs) sent 86(12.6%) and general dental practitioners (GDPs) sent 59(8.6%) referrals. The medical specialty with most referrals was paediatrics (29.0 % of the SMPs referrals). 44.5% of the referrals had no provisional diagnosis, ...

  17. Referral for assisted reproductive technology: Indications and ...

    African Journals Online (AJOL)

    Ramakantb

    Over an 8-year period, 23 consenting infertile patients/ couples were given referral for assisted conception. The median age was 36 years and mean duration of infertility was 43 months. Indications for referral as shown in Table 1 were male factor in five (21.7%) patients, female factor in seven (30.4%) patients, and both ...

  18. Reading Intervention and Special Education Referrals

    Science.gov (United States)

    Polcyn, Dawn M.; Levine-Donnerstein, Deborah; Perfect, Michelle M.; Obrzut, John E.

    2014-01-01

    This study examined whether consistently implementing reading fluency interventions prior to referring students for a special education evaluation led to fewer overall special education referrals, as well as more accurate special education referrals. Results indicated that the implementation of a peer-mediated reading fluency intervention…

  19. Proactive life extension of pressure vessels

    Science.gov (United States)

    Mager, Lloyd

    1998-03-01

    place while our vessels are in service. As the inspection takes place we are able to view a real time image of detected discontinuities on a video monitor. The B-scan ultrasonic technique is allowing us to perform fast accurate examinations covering up to 95% of the surface area of each pressure vessel. Receiving data on 95% of a pressure vessel provides us with a lot of useful information. We use this data to determine the condition of each pressure vessel. Once the condition is known the vessels are classed by risk. The risk level is then managed by making decisions related to repair, operating parameters, accepting and monitoring or replacement of the equipment. Inspection schedules are set at maximum intervals and reinspection is minimized for the vessels that are not at risk. The remaining life of each pressure vessel is determined, mechanical integrity is proven and regulatory requirements are met. Abbott Laboratories is taking this proactive approach because we understand that our process equipment is a critical element for successful operation. A run to failure practice would never allow Abbott Laboratories to achieve the corporation's objective of being the world's leading health care company. Nondestructive state of the art technology and the understanding of its capabilities and limitations are key components of a proactive program for life extension of pressure vessels. 26

  20. The Differences in Normative Beliefs among Schoolchildren with Reactive, Proactive, Reactive-Proactive Aggression, and without Aggression

    OpenAIRE

    Annis Lai Chu Fung

    2015-01-01

    This study is to fill up a research gap on examining the differences in normative beliefs (namely acceptance of weaknesses, acceptance of provoked aggression, and acceptance of unprovoked aggression) among different subtypes of aggressors and non-aggressors (reactive aggressors, proactive aggressors, reactive-proactive aggressors, and non-aggressors). 2,236 students (1,372 males and 864 females), aged from 11 to 18, completed a self-reported questionnaire. Results reveale...

  1. The Effects of Age on Short-Term Memory Loss due to Proactive Interference

    Directory of Open Access Journals (Sweden)

    Alisha Berkauzer

    2011-01-01

    Full Text Available This project focused on how proactive interference affects the short-term memory of people based on their age. The goal was to find the prime age for learning information and storing it in one's memory. Seven people from ages fifteen to forty were tested individually, using a set color pattern, in order to see how well each individual could remember the different color patterns as difficulty of the pattern increased. The obtained data was fitted by the polynomial regression. The “fitted” curve shows that as age increases, the individual's performance in memorizing the more difficult patterns decreases. Also, the peaked level of memory performance was found to be 24 for our experimental data.

  2. Referral bias in ALS epidemiological studies.

    Science.gov (United States)

    Logroscino, Giancarlo; Marin, Benoit; Piccininni, Marco; Arcuti, Simona; Chiò, Adriano; Hardiman, Orla; Rooney, James; Zoccolella, Stefano; Couratier, Philippe; Preux, Pierre-Marie; Beghi, Ettore

    2018-01-01

    Despite concerns about the representativeness of patients from ALS tertiary centers as compared to the ALS general population, the extent of referral bias in clinical studies remains largely unknown. Using data from EURALS consortium we aimed to assess nature, extent and impact of referral bias. Four European ALS population-based registries located in Ireland, Piedmont, Puglia, Italy, and Limousin, France, covering 50 million person-years, participated. Demographic and clinic characteristics of ALS patients diagnosed in tertiary referral centers were contrasted with the whole ALS populations enrolled in registries in the same geographical areas. Patients referred to ALS centers were younger (with difference ranging from 1.1 years to 2.4 years), less likely to present a bulbar onset, with a higher proportion of familial antecedents and a longer survival (ranging from 11% to 15%) when compared to the entire ALS population in the same geographic area. A trend for referral bias is present in cohorts drawn from ALS referral centers. The magnitude of the possible referral bias in a particular tertiary center can be estimated through a comparison with ALS patients drawn from registry in the same geographic area. Studies based on clinical cohorts should be cautiously interpreted. The presence of a registry in the same area may improve the complete ascertainment in the referral center.

  3. Referral Regions for Time-Sensitive Acute Care Conditions in the United States.

    Science.gov (United States)

    Wallace, David J; Mohan, Deepika; Angus, Derek C; Driessen, Julia R; Seymour, Christopher M; Yealy, Donald M; Roberts, Mark M; Kurland, Kristen S; Kahn, Jeremy M

    2018-03-24

    Regional, coordinated care for time-sensitive and high-risk medical conditions is a priority in the United States. A necessary precursor to coordinated regional care is regions that are actionable from clinical and policy standpoints. The Dartmouth Atlas of Health Care, the major health care referral construct in the United States, uses regions that cross state and county boundaries, limiting fiscal or political ownership by key governmental stakeholders in positions to create incentive and regulate regional care coordination. Our objective is to develop and evaluate referral regions that define care patterns for patients with acute myocardial infraction, acute stroke, or trauma, yet also preserve essential political boundaries. We developed a novel set of acute care referral regions using Medicare data in the United States from 2011. For acute myocardial infraction, acute stroke, or trauma, we iteratively aggregated counties according to patient home location and treating hospital address, using a spatial algorithm. We evaluated referral political boundary preservation and spatial accuracy for each set of referral regions. The new set of referral regions, the Pittsburgh Atlas, had 326 distinct regions. These referral regions did not cross any county or state borders, whereas 43.1% and 98.1% of all Dartmouth Atlas hospital referral regions crossed county and state borders. The Pittsburgh Atlas was comparable to the Dartmouth Atlas in measures of spatial accuracy and identified larger at-risk populations for all 3 conditions. A novel and straightforward spatial algorithm generated referral regions that were politically actionable and accountable for time-sensitive medical emergencies. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  4. A simultaneous modulation of reactive and proactive inhibition processes by anodal tDCS on the right inferior frontal cortex.

    Directory of Open Access Journals (Sweden)

    Toni Cunillera

    Full Text Available Proactive and reactive inhibitory processes are a fundamental part of executive functions, allowing a person to stop inappropriate responses when necessary and to adjust performance in in a long term in accordance to the goals of a task. In the current study, we manipulate, in a single task, both reactive and proactive inhibition mechanisms, and we investigate the within-subjects effect of increasing, by means of anodal transcranial direct current stimulation (tDCS, the involvement of the right inferior frontal cortex (rIFC. Our results show a simultaneous enhancement of these two cognitive mechanisms when modulating the neural activity of rIFC. Thus, the application of anodal tDCS increased reaction times on Go trials, indicating a possible increase in proactive inhibition. Concurrently, the stop-signal reaction time, as a covert index of the inhibitory process, was reduced, demonstrating an improvement in reactive inhibition. In summary, the current pattern of results validates the engagement of the rIFC in these two forms of inhibitory processes, proactive and reactive inhibition and it provides evidence that both processes can operate concurrently in the brain.

  5. Popularity differentially predicts reactive and proactive aggression in early adolescence.

    Science.gov (United States)

    Stoltz, Sabine; Cillessen, Antonius H N; van den Berg, Yvonne H M; Gommans, Rob

    2016-01-01

    Previous research has indicated that peer popularity is associated with aggressive behavior. However, it is not yet clear whether popularity is uniquely related to different functions of aggression. In this study, we examined associations between peer-perceived popularity, and reactive and proactive aggression using a cross-sectional and a longitudinal design. Yearly sociometric measures of popularity, and reactive and proactive aggression were gathered from 266 seventh and eight grade adolescents (Mage grade 7 = 12.80, SDage  = .40). Popularity was positively correlated with proactive aggression and negatively correlated with reactive aggression, both concurrently as over time. Curvilinear trends indicated that a significant minority of low versus high popular adolescents showed both functions of aggression. Somewhat stronger effects of popularity on proactive aggression were found for boys than girls. Stably popular adolescents showed the highest levels of proactive aggression, whereas stably unpopular youth showed the highest levels of reactive aggression. Implications and directions for future research are discussed. © 2015 Wiley Periodicals, Inc.

  6. Electronic referrals: what matters to the users.

    Science.gov (United States)

    Warren, Jim; Gu, Yulong; Day, Karen; White, Sue; Pollock, Malcolm

    2012-01-01

    Between September 2010 and May 2011 we evaluated three implementations of electronic referral (eReferral) systems at Hutt Valley, Northland and Canterbury District Health Boards in New Zealand. Qualitative and quantitative data were gathered through project documentation, database records and stakeholder interviews. This paper reports on the user perspectives based on interviews with 78 clinical, management and operational stakeholders in the three regions. Themes that emerge across the regions are compared and synthesised. Interviews focused on pre-planned domains including quality of referral, ease of use and patient safety, but agendas were adapted progressively to elaborate and triangulate on themes emerging from earlier interviews and to clarify indications from analysis of database records. The eReferral users, including general practitioners, specialists and administrative staff, report benefits in the areas of: (1) availability and transparency of referral-related data; (2) work transformation; (3) improved data quality and (4) the convenience of auto-population from the practice management system into the referral forms. eReferral provides enhanced visibility of referral data and status within the limits of the implementation (which only goes to the hospital door in some cases). Users in all projects indicated the desire to further exploit IT to enhance two-way communication between community and hospital. Reduced administrative handling is a clear work transformation benefit with mixed feedback regarding clinical workload impact. Innovations such as GP eReferral triaging teams illustrate the further potential for workflow transformation. Consistent structure in eReferrals, as well as simple legibility, enhances data quality. Efficiency and completeness is provided by auto-population of forms from system data, but opens issues around data accuracy. All three projects highlight the importance of user involvement in design, implementation and refinement. In

  7. Neural mechanisms of proactive and reactive cognitive control in social anxiety.

    Science.gov (United States)

    Schmid, Petra C; Kleiman, Tali; Amodio, David M

    2015-09-01

    Social anxiety--the fear of social embarrassment and negative evaluation by others--ranks among people's worst fears, and it is often thought to impair task performance. We investigated the neurocognitive processes through which trait social anxiety relates to task performance, proposing a model of the joint contributions of reactive control, theoretically associated with conflict monitoring and activity of the dorsal anterior cingulate cortex (dACC), and proactive control, theoretically associated with top-down regulation and activity of the dorsolateral prefrontal cortex (dlPFC). Participants varying in their degree of trait social anxiety completed the Eriksen flanker task while electroencephalography (EEG) was recorded. Task-related left dlPFC activity was indexed by relative left prefrontal EEG (inverse alpha), and conflict-related dACC activity was indexed by the N2r component of the event-related potential. Stronger activity in both regions predicted better response control, and greater social anxiety was associated with worse response control. Furthermore, for all participants, greater left prefrontal EEG activity predicted better behavioral control, but for high social anxiety participants only, greater N2r responses also predicted behavioral control. This pattern suggests that low social anxiety individuals engaged a proactive control process, driven by dlPFC activity, whereas high social anxiety individuals relied additionally on a reactive control process, driven by conflict-related dACC activity. These findings support a model of control that involves different patterns of interplay between proactive and reactive strategies and may help to explain self-regulatory impairments in social anxiety. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Why doctors do not answer referral letters

    African Journals Online (AJOL)

    Referral letters act as permission slips to allow patients easy access to ... Methods: A qualitative study method was used, as the purpose of this study was to .... The total list of topics ..... Research design: qualitative and quantitative approaches.

  9. Appropriateness of Referrals for Upper Gastrointestinal Endoscopy ...

    African Journals Online (AJOL)

    Appropriateness of Referrals for Upper Gastrointestinal Endoscopy. ... Accra between January and December, 2008 were interviewed and evaluated for this study. ... Presentations with bleeding and suspicion of malignancy showed statistical ...

  10. Attitudes regarding specialist referrals in periodontics.

    Science.gov (United States)

    Sharpe, G; Durham, J A; Preshaw, P M

    2007-02-24

    To examine the attitudes of dental practitioners towards specialist periodontal referral in the North East of England. Semi-structured interviews were conducted with a purposive sample of 10 practitioners. Interviews continued until data saturation occurred. The data were organised using a framework and analysed by two researchers working independently. Perceptions of periodontal disease and treatment appear to be heavily influenced by the NHS remuneration system. Treatment in general practice was limited to simple scaling and there was an apparent reluctance to treat advanced periodontitis. Such cases were commonly referred to specialists, confirming the demand for a referral service in periodontics. The perceived potential for medico-legal consequences was a strong driver of referrals. Distance to the referral centre and the perceived costs of treatment were significant barriers to referral. Dentists valued the specialist's personal reputation and clinical skills more highly than academic status. Deficiencies in communication between primary and secondary care were highlighted. Increased resources are required to manage periodontal diseases within the NHS. There is a need for a periodontal referral service in the North East of England to improve accessibility to specialist care. This would appear to be most appropriately delivered by increased numbers of specialist practitioners.

  11. A Proactive Approach to Building Security.

    Science.gov (United States)

    Winters, Sharon

    1994-01-01

    Describes building security procedures developed at the Hampton Public Library (Virginia) to deal with problem patrons. Highlights include need for the library monitor program; staffing patterns; monitor selection criteria; training procedures; library behavior guidelines; library policy statements; theft detection systems; and sample job…

  12. Intelligent Transportation Control based on Proactive Complex Event Processing

    Directory of Open Access Journals (Sweden)

    Wang Yongheng

    2016-01-01

    Full Text Available Complex Event Processing (CEP has become the key part of Internet of Things (IoT. Proactive CEP can predict future system states and execute some actions to avoid unwanted states which brings new hope to intelligent transportation control. In this paper, we propose a proactive CEP architecture and method for intelligent transportation control. Based on basic CEP technology and predictive analytic technology, a networked distributed Markov decision processes model with predicting states is proposed as sequential decision model. A Q-learning method is proposed for this model. The experimental evaluations show that this method works well when used to control congestion in in intelligent transportation systems.

  13. In the Nick of Time: Proactive Prevention of Obligation Violations

    DEFF Research Database (Denmark)

    Basin, David; Debois, Søren; Hildebrandt, Thomas

    2016-01-01

    We present a system model, an enforcement mechanism, and a policy language for the proactive enforcement of timed provisions and obligations. Our approach improves upon existing formalisms in two ways: (1) we exploit the target system's existing functionality to avert policy violations proactively...... declaratively express timed provisions and obligations as causal relationships between events, and DCR states explicitly represent pending obligations. As key technical results, we show that enforceability of DCR policies is decidable, we give a sufficient polynomial time verifiable condition for a policy...... to be enforceable, and we give an algorithm for determining from a DCR state a sequence of actions that discharge impending obligations....

  14. Access to specialty care in autism spectrum disorders-a pilot study of referral source

    Directory of Open Access Journals (Sweden)

    West Therese

    2011-05-01

    Full Text Available Abstract Background In the United States, a medical home model has been shown to improve the outcomes for children with special health care needs. As part of this model, primary care physicians provide comprehensive medical care that includes identification of delayed and/or atypical development in children and coordination of care with specialists. However, it is not clear if families of children with Autism Spectrum Disorder (ASD rely on the medical home model for care of their child to the same extent as families of children with other special health care needs. This study aims to add to the understanding of medical care for children with ASD by examining the referral source for specialty care. Methods This retrospective study was accomplished by evaluating parent completed intake data for children with ASD compared to those with other neurological disorders in a single physician Pediatric Neurology Practice at a major urban medical center in Northern New Jersey. To account for referral bias, a similar comparison study was conducted using a multispecialty ASD practice at the same medical center. Parent reported "source of referral" and "reason for the referral" of 189 ASD children and 108 non-ASD neurological disordered children were analyzed. Results The specialty evaluations of ASD were predominantly parent initiated. There were significantly less referrals received from primary care physicians for children with ASD compared to children with other neurodevelopmental disorders. Requirement of an insurance referral was not associated with a primary care physician prompted specialty visit.We identified different patterns of referral to our specialty clinics for children with ASD vs. children with other neurolodevelopmental disorders. Conclusion The majority of the families of children with ASD evaluated at our autism center did not indicate that a primary care physician initiated the specialty referral. This study suggests that families of

  15. Social Skills Efficacy and Proactivity among Native American Adolescents

    Science.gov (United States)

    Turner, Sherri L.; Conkel, Julia L.; Reich, Allison N.; Trotter, Michelle J.; Siewart, Jason J.

    2006-01-01

    This article discusses Native American urban adolescents' construal of social skills, and relationships between these skills and proactivity behaviors as identified in the Integrative Contextual Model of Career Development (Lapan, 2004). Recommendations that build upon the social skills strengths of Native American young people are included.…

  16. Assessment of proactive transmission power control for wireless sensor networks

    NARCIS (Netherlands)

    kotian, Roshan; Exarchakos, Georgios; Liotta, Antonio

    2014-01-01

    In order to prolong lifetime of Wireless Sensor Networks (WSN), Transmission Power Control (TPC) techniques are employed. The existing TPC schemes adjust the transmission power mostly reacting to changes at link quality between communicating nodes. Proactive TPC has been proposed in the recent past

  17. Risk management plans as a tool for proactive pharmacovigilance

    DEFF Research Database (Denmark)

    Vermeer, N S; Duijnhoven, R G; Straus, S M J M

    2014-01-01

    Risk Management Plans (RMPs) have become a cornerstone in the pharmacovigilance of new drugs in Europe. The RMP was introduced in 2005 to support a proactive approach in gaining knowledge on safety concerns through early planning of pharmacovigilance activities. However, the rate at which...... of uncertainties, suggests that opportunities for optimization exist while ensuring feasible and risk-proportionate pharmacovigilance planning....

  18. Inhibitory Control of Proactive Interference in Adults with ADHD

    Science.gov (United States)

    White, Holly A.

    2007-01-01

    Objective: Attention deficit hyperactivity disorder (ADHD) is associated with poor inhibition of prepotent responses and deficits in distractor inhibition, but relatively few studies have addressed inhibitory control of proactive interference (PI) in individuals with ADHD. Thus, the goal of the present study was to evaluate resistance to spatial…

  19. The Contribution of Encoding and Retrieval Processes to Proactive Interference

    Science.gov (United States)

    Kliegl, Oliver; Pastötter, Bernhard; Bäuml, Karl-Heinz T.

    2015-01-01

    Proactive interference (PI) refers to the finding that memory for recently studied (target) material can be impaired by the prior study of other (nontarget) material. Previous accounts of PI differed in whether they attributed PI to impaired retrieval or impaired encoding. Here, we suggest an integrated encoding-retrieval account, which assigns a…

  20. Identifying cognitive predictors of reactive and proactive aggression

    NARCIS (Netherlands)

    Brugman, S.; Lobbestael, J.; Arntz, A.R.; Cima, M.; Schumann, T.; Dambacher, F.

    2015-01-01

    The aim of this study was to identify implicit cognitive predictors of aggressive behavior. Specifically, the predictive value of an attentional bias for aggressive stimuli and automatic association of the self and aggression was examined for reactive and proactive aggressive behavior in a

  1. Transfer Failure and Proactive Interference in Short-Term Memory

    Science.gov (United States)

    Ellis, John A.

    1977-01-01

    Two experiments tested the hypothesis that proactive interference over a series of Brown-Peterson trials results from a combination of the subject's failure to transfer information to a permanent memory state and failure to retrieve information from permanent memory. (Editor)

  2. Release from Proactive Interference with Positive and Negative Words

    Science.gov (United States)

    Ferraro, F. Richaro; King, Brent

    2004-01-01

    Using the release from proactive interference (RPI) task, college students (n = 40) received 4 trials comprised of 3-word triads of either positive (P) or negative (N) words. Word-triad recall served as the dependent measure, and results revealed typical buildup of PI (i.e., no significant group X trial interaction across Trials 1-3). Significant…

  3. Proactive Interference Slows Recognition by Eliminating Fast Assessments of Familiarity

    Science.gov (United States)

    Oztekin, Ilke; McElree, Brian

    2007-01-01

    The response-signal speed-accuracy tradeoff (SAT) procedure was used to investigate how proactive interference (PI) affects retrieval from working memory. Participants were presented with 6-item study lists, followed immediately by a recognition probe. A variant of a release from PI design was used: All items in a list were from the same semantic…

  4. Proactive Interference and Item Similarity in Working Memory

    Science.gov (United States)

    Bunting, Michael

    2006-01-01

    Proactive interference (PI) may influence the predictive utility of working memory span tasks. Participants in one experiment (N=70) completed Ravens Advanced Progressive Matrices (RAPM) and multiple versions of operation span and probed recall, modified for the type of memoranda (digits or words). Changing memoranda within- or across-trials…

  5. The Role of Response Confusion in Proactive Interference

    Science.gov (United States)

    Dillon, Richard F.; Thomas, Heather

    1975-01-01

    In two experiments using the Brown-Peterson memory paradigm, instructions to guess had small effects on recall, but sizeable effects on incidence of prior list intrustion. However, results indicate that proactive interference is primarily the result of inability to generate correct items, rather than confusion between present and previous items.…

  6. Mature age job seekers : The role of proactivity

    NARCIS (Netherlands)

    Zacher, Hannes; Bock, Angelika

    2014-01-01

    Purpose - In the context of demographic and economic changes, helping mature age job seekers find employment is imperative. The purpose of this paper is to examine mature age job seekers' proactive personality as a moderator of the relationship between age and job search intensity; and to examine

  7. Proactivity, job characteristics, and engagement : a longitudinal study

    NARCIS (Netherlands)

    Dikkers, Josje S. E.; Jansen, Paul G. W.; de Lange, Annet H.; Vinkenburg, Claartje J.; Kooij, Dorien

    2010-01-01

    Purpose - This paper sets out to examine proactive personality in relation to job demands, job resources and engagement. Design/methodology/approach - The current study employed a two-wave complete panel study among 794 Dutch government employees. Based upon the Job Demands-Resources (ID-R) model,

  8. Relationship between Implicit Leadership and Proactive Behaviors of School Principals

    Science.gov (United States)

    Keskinkilic-Kara, Sultan-Bilge; Zafer-Gunes, Demet

    2017-01-01

    The aim of this research is to define the school principals' implicit leadership theory and to reveal its relationship with the proactive behavior. The study is conducted in Bagcilar and Basaksehir districts in Istanbul and the target population of the research is 153 school principals working in state elementary schools, middle schools and high…

  9. The referral backfire effect: The identity threatening nature of referral failure

    NARCIS (Netherlands)

    Claus, B.; Geyskens, K.; Millet, K.; Dewitte, S.

    2012-01-01

    The present paper shows that when a person has the experience of giving advice but that advice is not acted upon, there is a reduced openness to external information. We call this the "referral backfire effect". We argue that this referral backfire effect is due to the identity threatening nature of

  10. Resumes as a Proactive Career Development Tool: An Innovation at Keuka College Career Center.

    Science.gov (United States)

    Miner, Todd

    2000-01-01

    A proactive resume can help individuals understand workplace demands and their fit with them. Development of proactive resumes focuses first on employability skills and then on skills and attributes of specific professions or careers. (SK)

  11. Neurology referrals to a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Fitzgerald, P

    2012-02-03

    The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

  12. Testing can counteract proactive interference by integrating competing information

    Science.gov (United States)

    Wahlheim, Christopher N.

    2015-01-01

    Testing initially learned information before presenting new information has been shown to counteract the deleterious effects of proactive interference by segregating competing sources of information. The present experiments were conducted to demonstrate that testing can also have its effects in part by integrating competing information. Variations of classic A–B, A–D paired-associate learning paradigms were employed that included two lists of word pairs and a cued-recall test. Repeated pairs appeared in both lists (A–B, A–B), control pairs appeared in List 2 only (A–B, C–D), and changed pairs appeared with the same cue in both lists but with different responses (A–B, A–D). The critical manipulation was whether pairs were tested or restudied in an interpolated phase that occurred between Lists 1 and 2. On a final cued-recall test, participants recalled List 2 responses and then indicated when they recollected that responses had earlier changed between lists. The change recollection measure indexed the extent to which competing responses were integrated during List 2. Change was recollected more often for tested than for restudied pairs. Proactive facilitation was obtained in cued recall when change was recollected, whereas proactive interference was obtained when change was not recollected. These results provide evidence that testing counteracted proactive interference in part by making List 1 responses more accessible during List 2, thus promoting integration and increasing later recollection of change. These results have theoretical implications because they show that testing can counteract proactive interference by integrating or segregating competing information. PMID:25120241

  13. Testing can counteract proactive interference by integrating competing information.

    Science.gov (United States)

    Wahlheim, Christopher N

    2015-01-01

    Testing initially learned information before presenting new information has been shown to counteract the deleterious effects of proactive interference by segregating competing sources of information. The present experiments were conducted to demonstrate that testing can also have its effects in part by integrating competing information. Variations of classic A-B, A-D paired-associate learning paradigms were employed that included two lists of word pairs and a cued-recall test. Repeated pairs appeared in both lists (A-B, A-B), control pairs appeared in List 2 only (A-B, C-D), and changed pairs appeared with the same cue in both lists but with different responses (A-B, A-D). The critical manipulation was whether pairs were tested or restudied in an interpolated phase that occurred between Lists 1 and 2. On a final cued-recall test, participants recalled List 2 responses and then indicated when they recollected that responses had earlier changed between lists. The change recollection measure indexed the extent to which competing responses were integrated during List 2. Change was recollected more often for tested than for restudied pairs. Proactive facilitation was obtained in cued recall when change was recollected, whereas proactive interference was obtained when change was not recollected. These results provide evidence that testing counteracted proactive interference in part by making List 1 responses more accessible during List 2, thus promoting integration and increasing later recollection of change. These results have theoretical implications because they show that testing can counteract proactive interference by integrating or segregating competing information.

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

    Science.gov (United States)

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

    2017-01-01

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

  15. Proactive personality and job performance: the role of job crafting and work engagement

    NARCIS (Netherlands)

    Bakker, A.B.; Tims, M.; Derks, D.

    2012-01-01

    The article examines the role of proactive personality in predicting work engagement and job performance. On the basis of the literature on proactive personality and the job demands-resources model, we hypothesized that employees with a proactive personality would be most likely to craft their own

  16. Treatment procedures and referral patterns of general dentists in Lithuania

    Directory of Open Access Journals (Sweden)

    Vilija Berlin

    2015-11-01

    Conclusions: There is a clear need for Lithuanian dental practitioners to refer patients to all types of dental specialists. Undergraduate dental education program and postgraduate training should be more directed toward the extraction of teeth and roots, treatment of young children and provision of dental prostheses to patients.

  17. Patterns of referral to Red Cross War Memorial Children's Hospital ...

    African Journals Online (AJOL)

    Memorial Children's Hospital, K1ipfontein Road, Rondebosch, 7700 RSA,. Accepted 10 Apt 1990, ... of every patient referred in the study period, or recorded the folder number of ..... Council for providing a short-term grant; Mariah Jacobs of the.

  18. A Fast-Track Referral System for Skin Lesions Suspicious of Melanoma

    DEFF Research Database (Denmark)

    Jarjis, Reem Dina; Hansen, Lone Bak; Matzen, Steen Henrik

    2016-01-01

    in the FTRS.  Methods. Patients referred to the Department of Plastic Surgery and Breast Surgery in Zealand University Hospital were registered prospectively over a 1-year period in 2014. A cross-sectional study was performed analyzing referral patterns, including patient and tumor characteristics.  Results...

  19. Acute Care Referral Systems in Liberia: Transfer and Referral Capabilities in a Low-Income Country.

    Science.gov (United States)

    Kim, Jimin; Barreix, Maria; Babcock, Christine; Bills, Corey B

    2017-12-01

    Introduction Following two decades of armed conflict in Liberia, over 95% of health care facilities were partially or completely destroyed. Although the Liberian health system has undergone significant rehabilitation, one particular weakness is the lack of organized systems for referral and prehospital care. Acute care referral systems are a critical component of effective health care delivery and have led to improved quality of care and patient outcomes. Problem This study aimed to characterize the referral and transfer systems in the largest county of Liberia. A cross-sectional, health referral survey of a representative sample of health facilities in Montserrado County, Liberia was performed. A systematic random sample of all primary health care (PHC) clinics, fraction proportional to district population size, and all secondary and tertiary health facilities were included in the study sample. Collected data included baseline information about the health facility, patient flow, and qualitative and quantitative data regarding referral practices. A total of 62 health facilities-41 PHC clinics, 11 health centers (HCs), and 10 referral hospitals (RHs)-were surveyed during the 6-week study period. In sum, three percent of patients were referred to a higher-level of care. Communication between health facilities was largely unsystematic, with lack of specific protocols (n=3; 5.0%) and standardized documentation (n=26; 44.0%) for referral. While most health facilities reported walking as the primary means by which patients presented to initial health facilities (n=50; 81.0%), private vehicles, including commercial taxis (n=37; 60.0%), were the primary transport mechanism for referral of patients between health facilities. This study identified several weaknesses in acute care referral systems in Liberia, including lack of systematic care protocols for transfer, documentation, communication, and transport. However, several informal, well-functioning mechanisms for

  20. Quality of oral surgery referrals and how to improve them

    Directory of Open Access Journals (Sweden)

    Bjorkeborn M

    2017-11-01

    Full Text Available Mikael Björkeborn,1 Henrik Nilsson,2 Jonas Anderud1 1Department of Oral and Maxillofacial Surgery, Halmstad Hospital, Halmstad, Sweden; 2Department of Oral and Maxillofacial Surgery, Växjö Hospital, Växjö, Sweden Aim: To assess the quality of routine oral surgery referrals received at Halmstad Hospital and Växjö Hospital and to emphasize areas for improvement. Method: A retrospective study was performed on all routine oral surgery referrals received between 2014 and 2015 at both Halmstad Hospital and Växjö Hospital. A total of 1,891 referral letters were assessed for their quality against a predetermined checklist of basic requirements of a satisfactory referral. The referrals were also categorized according to if it was sent by a male, female, private dental service, or the Swedish Public Dental Health service. Results: A diagnosis was missing in 30% of all referrals. Radiographs and information about previous radiographic examinations were not included in 10% of the referrals. Of those referrals that included radiographs, only around half were deemed adequate for diagnostic purposes. The presenting complaint was missing in 40% of all referrals. Current medical history was absent in 40% and current medication was omitted in 60% of the referrals. Information about tobacco use was only included in 10% of all referrals. Overall, female referrers performed better than male colleagues. Private referrals more regularly included information about diagnosis, previous treatment, and current medication. On the other hand, referrals from the public dental health service more frequently included radiographs, tobacco use, and current medical history. Conclusion: There is plenty of room for improving the standards of oral surgery referrals. We suggest that future electronic referral systems should only allow for submission once all of the essential information has been considered. Keywords: clinical audit, referral quality, oral surgery referrals

  1. Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study.

    LENUS (Irish Health Repository)

    Montgomery, Anthony J

    2006-01-01

    BACKGROUND: To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. METHOD: Randomly selected general practitioners (N = 51) were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians); influence of patient age, marital status and co-morbidity on referral. RESULTS: Referral levels varied widely with the full range of cases (0-32; median = 15) referred by different doctors after consideration of first laboratory results. Less than half (44%) of cases were referred to a nephrologist. Patient age (40 vs 70 years), marital status, co-morbidity (none vs rheumatoid arthritis) and general practitioner prior specialist renal training (yes or no) did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 micromol\\/l (47% not referred) or 250 micromol\\/l (45%). While all patients were referred at higher levels (350 and 480 micromol\\/l), referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 micromol\\/l creatinine; 28% at 250 micromol\\/l; 18% at 350 micromol\\/l and 14% at 480 micromol\\/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3). CONCLUSION: The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

  2. Chiropractors' Characteristics Associated with Physician Referrals

    DEFF Research Database (Denmark)

    Blanchette, M. A.; Rivard, M.; Dionne, C. E.

    2015-01-01

    , and the percentage of patients referred to other health care providers were associated with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral conditions, using a particular chiropractic technique (hole in one and Thompson), taking his/her own radiographs, being the client...

  3. Behavior Analytic Consultation for Academic Referral Concerns

    Science.gov (United States)

    Dufrene, Brad A.; Zoder-Martell, Kimberly A.; Dieringe, Shannon Titus; Labrot, Zachary

    2016-01-01

    Applied behavior analysis provides a technology of human behavior that demonstrates great potential for improving socially important outcomes for individuals. School-based consultation may provide a vehicle for delivering applied behavior analysis services in schools to address academic referral concerns. In this article, we propose that…

  4. 32 CFR 701.9 - Referrals.

    Science.gov (United States)

    2010-07-01

    ... referral, a point of contact by name, a telephone number (commercial and DSN), and an e-mail address (if... record any FOIA request for investigative, intelligence, or any other type of records that are on loan to.... However, if for investigative or intelligence purposes, the outside agency desires anonymity, a DON...

  5. Testing protects against proactive interference in face-name learning.

    Science.gov (United States)

    Weinstein, Yana; McDermott, Kathleen B; Szpunar, Karl K

    2011-06-01

    Learning face-name pairings at a social function becomes increasingly more difficult the more individuals one meets. This phenomenon is attributable to proactive interference--the negative influence of prior learning on subsequent learning. Recent evidence suggests that taking a memory test can alleviate proactive interference in verbal list learning paradigms. We apply this technique to face-name pair learning. Participants studied four lists of 12 face-name pairings and either attempted to name the 12 faces just studied after every list or did not. Recall attempts after every list improved learning of the fourth list by over 100%. Moreover, no reduction in learning of face-name pairings occurred from list 1 to list 4 for participants who attempted to name studied faces between lists. These results suggest that testing oneself on the names of a group of new acquaintances before moving on to the next group is an effective mnemonic technique for social functions.

  6. A proactive method for safety management in nuclear facilities

    International Nuclear Information System (INIS)

    Grecco, Claudio Henrique dos Santos; Carvalho, Paulo Victor Rodrigues de; Santos, Isaac Antonio Luquetti dos

    2014-01-01

    Due to the modern approach to address the safety of nuclear facilities which highlights that these organizations must be able to assess and proactively manage their activities becomes increasingly important the need for instruments to evaluate working conditions. In this context, this work presents a proactive method of managing organizational safety, which has three innovative features: 1) the use of predictive indicators that provide current information on the performance of activities, allowing preventive actions and not just reactive in safety management, different from safety indicators traditionally used (reactive indicators) that are obtained after the occurrence of undesired events; 2) the adoption of resilience engineering approach in the development of indicators - indicators are based on six principles of resilience engineering: top management commitment, learning, flexibility, awareness, culture of justice and preparation for the problems; 3) the adoption of the concepts and properties of fuzzy set theory to deal with subjectivity and consistency of human trials in the evaluation of the indicators. The fuzzy theory is used primarily to map qualitative models of decision-making, and inaccurate representation methods. The results of this study aim an improvement in performance and safety in organizations. The method was applied in a radiopharmaceutical shipping sector of a nuclear facility. The results showed that the method is a good monitoring tool objectively and proactively of the working conditions of an organizational domain

  7. How to be proactive about interference: lessons from animal memory.

    Science.gov (United States)

    Wright, Anthony A; Katz, Jeffrey S; Ma, Wei Ji

    2012-05-01

    Processes of proactive interference were explored using the pigeon as a model system of memory. This study shows that proactive interference extends back in time at least 16 trials (and as many minutes), revealing a continuum of interference and providing a framework for studying memory. Pigeons were tested in a delayed same/different task containing trial-unique pictures. On interference trials, sample pictures from previous trials reappeared as test pictures on different trials. Proactive-interference functions showed greatest interference from the most recent trial and with the longer of two delays (10 s vs. 1 s). These interference functions are accounted for by a time-estimation model based on signal detection theory. The model predicts that accuracy at test is determined solely by the ratio of the elapsed time since the offset of the current-trial sample to the elapsed time since the offset of the interfering sample. Implications for comparing memory of different species and different types of memory (e.g., familiarity vs. recollection) are discussed.

  8. Optimism and proactive coping in relation to burnout among nurses.

    Science.gov (United States)

    Chang, Yuhsuan; Chan, Hsin-Ju

    2015-04-01

    The study investigated the three symptoms of burnout among hospital nurses and examined the buffering effects of optimism and proactive coping in relation to burnout. Nursing is a profession that can easily lead to burnout. Burnout has been one of the most investigated work outcomes in current research. Previous research has largely ignored the positive influence of individuals on job outcomes and has not tested a constructive framework that might facilitate interventions to prevent burnout. A cross-sectional survey of 314 staff nurses in general hospitals in Taiwan. Participants completed a set of questionnaires with demographic information. The findings suggested that higher levels of proactive coping behaviours and optimism were associated with lower levels of burnout. Optimism was found to have the strongest relationship with the decreased personal accomplishment of burnout. The findings of this study confirmed the importance of optimism and proactive coping in prevention of symptoms of burnout. The results of this study provided important recommendations regarding stress management interventions for health-care managers, nurses, psychologists and human resource staff in the reduction of burnout to promote mental health in an organisation. © 2013 John Wiley & Sons Ltd.

  9. Prevention and control of zebra mussels: proactive and reactive strategies

    International Nuclear Information System (INIS)

    Claudi, R.

    1998-01-01

    Most plant people would agree that having zebra mussels in any raw water system is not desirable. System blockage, loss of heat transfer and other associated safety hazards are not pleasant to deal with. Therefore most industries strive to minimise the effect of infestation. Opinions differ as to how to do this most efficiently and economically. Some facilities are committed to preventing the settlement of veligers in their piping systems and on some of the external structures they consider critical. This is the proactive approach. Others allow settlement and only treat the system or surface after fouling has occurred. This is the reactive approach. Which is the best and most economical treatment will depend on the individual facility and sometimes on the individual system. The paper examines the different proactive and reactive strategies available to-date and how they are being used. It will also discuss some of the criteria for choosing a proactive vs. reactive approach and why the decision has to be made individually by each facility. (author)

  10. Prevention and control of zebra mussels: proactive and reactive strategies

    Energy Technology Data Exchange (ETDEWEB)

    Claudi, R. [Ontario Hydro Nuclear, Toronto, ON (Canada)

    1998-07-01

    Most plant people would agree that having zebra mussels in any raw water system is not desirable. System blockage, loss of heat transfer and other associated safety hazards are not pleasant to deal with. Therefore most industries strive to minimise the effect of infestation. Opinions differ as to how to do this most efficiently and economically. Some facilities are committed to preventing the settlement of veligers in their piping systems and on some of the externalstructures they consider critical. This is the proactive approach. Others allow settlement and only treat the system or surface after fouling has occurred. This is the reactive approach. Which is the best and most economical treatment will depend on the individual facility and sometimes on the individual system. The paper examines the different proactive and reactive strategies available to-date and how they are being used. It will also discuss some of the criteria for choosing a proactive vs. reactive approach and why the decision has to be made individually by each facility. (author)

  11. High Age Predicts Low Referral of Hyperthyroid Patients to Specialized Hospital Departments

    DEFF Research Database (Denmark)

    Carlé, Allan; Pedersen, Inge Bülow; Perrild, Hans

    2013-01-01

    Background: Hospital-based studies may be hampered by referral bias. We investigated how the phenomenon may influence studies of hyperthyroid patients. Methods: By means of a computer-based linkage to the laboratory database and subsequent detailed evaluation of subjects with abnormal test results......, we prospectively identified all 1,148 patients diagnosed with overt hyperthyroidism in a four-year period in and around Aalborg City, Denmark. Each patient was classified according to nosological type of hyperthyroidism. We studied the referral pattern of patients to local hospital units......, and analyzed how referral depended on subtype of disease, sex, age, and degree of biochemical hyperthyroidism. Results: In a 4-year period, 1,032 hyperthyroid patients were diagnosed at primary care offices, and 435 of these (42.2%) were referred to specialized units, 92 patients had hyperthyroidism diagnosed...

  12. Baby or bathwater? Referrals of "non-cases" in a targeted early identification intervention for psychosis.

    Science.gov (United States)

    Jordan, Gerald; Kinkaid, Miriam; Iyer, Srividya N; Joober, Ridha; Goldberg, Karen; Malla, Ashok; Shah, Jai L

    2018-03-14

    To explore the unintended impact of a targeted case identification (TCI) campaign for first episode psychosis (FEP) on people not experiencing FEP ("non-cases") with respect to referral patterns and reasons for being a non-case. Sources of referral, reasons for being a non-case, and subsequent referral destinations of non-cases were examined before and after a TCI. Following the TCI, a greater proportion of non-cases lived outside the study catchment area. A smaller proportion was referred by the parent hospital's emergency room or had a substance-induced psychosis. TCIs for FEP may have unintended effects, with implications for early case identification and early intervention services.

  13. A review of tuberculosis-related referrals among children in Ireland.

    LENUS (Irish Health Repository)

    Iroh Tam, P Y

    2012-02-01

    BACKGROUND: Immigration has been shown to have an increasingly important effect on the epidemiology of tuberculosis (TB) in developed countries. AIM: To review patterns of TB-related referrals to a paediatric infectious diseases clinic. METHODS: Retrospective chart review of TB-related referrals of children attending the Rainbow Clinic at OLCHC between 2003-2005. RESULTS: Forty-seven children were assessed: 18 referred from public health clinics, 5 from general practitioners, and 24 from paediatricians. Most common reason for referral was history of TB exposure (60%). Eighteen (38%) were female, 29 (62%) were male. Thirteen (28%) had latent TB, and 17 (36%) had active disease. Of children with TB disease, 25 (83%) were Caucasian Irish, and the remainder was African. Twenty-five children completed TB treatment and were discharged, and 2 (7%) were lost to follow-up. CONCLUSION: Our study highlights the problem of TB in children, the majority of whom are native to this country.

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

    Science.gov (United States)

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

    2012-03-01

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

  15. Factors affecting subspecialty referrals by pediatric primary care providers for children with obesity-related comorbidities.

    Science.gov (United States)

    Walsh, Carolyn O; Milliren, Carly E; Feldman, Henry A; Taveras, Elsie M

    2013-08-01

    To determine referral patterns from pediatric primary care to subspecialists for overweight/obesity and related comorbidities. We used the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to identify overweight/obesity and 5 related comorbidities in primary care visits between 2005 and 2009 by children 6 to 18 years. The primary outcome was whether the visit ended in referral. We used multivariable analysis to examine factors associated with referral. We identified 34,225 database visits. A total of 17.1% were with overweight (body mass index=85th to 94th percentile) or obese (body mass index≥95th percentile) patients. A total of 7.1% of primary care visits with overweight/obese children ended in referral. Referral was more likely when obesity was the reason for visit (odds ratio=2.83; 95% confidence interval=1.61-4.97) but was not associated with presence of a comorbidity (odds ratio=1.35; 95% confidence interval=0.75-2.44). Most overweight or obese children are not referred, regardless of comorbidity status. One reason may be low levels of appropriate diagnosis.

  16. determinants of referral practices of clients by traditional birth

    African Journals Online (AJOL)

    GBENGY

    referral of high risk and complicated pregnancies and deliveries (Afr. J. Reprod. Health 2010 ... proportion of pregnant women are attended at childbirth ... tility; management of threatened abortion; ... refuse referral and whatever is the outcome.

  17. evaluative study of medical doctors' mode of referral for physiother

    African Journals Online (AJOL)

    Olwafemi Odebiyi

    physicians' mode of referral of patients for physiotherapy in Nigeria. A total of 1192 physicians .... The Influence of Medical School of Graduation. Table 1 shows the .... This must have also been responsible for the high rate of referral observed.

  18. Factor Structure of the Reactive-Proactive Aggression Questionnaire in Turkish Children and Gender, Grade-Level, and Socioeconomic Status Differences in Reactive and Proactive Aggression

    Science.gov (United States)

    Uz Bas, Asli; Yurdabakan, Irfan

    2012-01-01

    The present study aimed to evaluate the factor structure of the Reactive-Proactive Aggression Questionnaire (RPQ) with Turkish children, and to investigate gender, grade-level, and socioeconomic status (SES) differences in reactive and proactive aggression. Participants consisted of 1,081 Turkish children (544 boys and 537 girls) aged 9 to 14…

  19. 24 CFR 17.9 - Referral to Department of Justice.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Referral to Department of Justice... Procedures § 17.9 Referral to Department of Justice. When Department of Justice approval or consultation is required under § 17.8, the referral or request shall be transmitted to the Department of Justice by the...

  20. 10 CFR 1014.7 - Referral to Department of Justice.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Referral to Department of Justice. 1014.7 Section 1014.7... § 1014.7 Referral to Department of Justice. (a) When Department of Justice approval or consultation is required under § 1014.6, the referral or request shall be transmitted to the Department of Justice by the...

  1. 8 CFR 235.6 - Referral to immigration judge.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Referral to immigration judge. 235.6 Section 235.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS INSPECTION OF PERSONS APPLYING FOR ADMISSION § 235.6 Referral to immigration judge. (a) Notice—(1) Referral by Form I...

  2. The role of referrals in financing technology-based ventures

    NARCIS (Netherlands)

    Heuven, J.M.J.

    2009-01-01

    Many referral mechanisms can be found in the context of entrepreneurship. Networks and third party referrals play a prominent role in spotting entrepreneurial opportunities and in acquiring the resources necessary for growth. In this dissertation, the focus is on the role of referrals in acquiring

  3. Referral for Outpatients Urological Services: Poor Conformity and ...

    African Journals Online (AJOL)

    Background: This study was aimed at establishing the degree of conformity with the referral system, level of pre-referral investigative evaluations and degree of diagnosis concordance between the referring centres and the referral hospital in Western region of Kenya. Methods: This was a hospital based descriptive, ...

  4. Qualitative study on maternal referrals in rural Tanzania: Decision ...

    African Journals Online (AJOL)

    Administrator

    The process in deciding to seek referral care is envisaged within community .... The three phases of delays model in accessing .... as dangerous at home and immediate care is required, the ... referral or is unable to pay the costs of referral, the ...

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

    Science.gov (United States)

    Grant, Adam M; Rothbard, Nancy P

    2013-09-01

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

  6. Utilisation of a direct access echocardiography service by general practitioners in a remote and rural area--distance and rurality are not barriers to referral.

    Science.gov (United States)

    Choo, Wai K; McGeary, Katie; Farman, Colin; Greyling, Andre; Cross, Stephen J; Leslie, Stephen J

    2014-01-01

    This study aimed to examine whether general practitioner (GP) practice locations in remote and rural areas affected the pattern of direct access echocardiography referral and to assess any variations in echocardiographic findings. All referrals made by all GP practices in the Scottish Highlands over a 36-month period were analysed. Referral patterns were examined according to distance and rurality based on the Scottish Government's Urban-Rural Classification. Reasons for referral and cardiac abnormality detection rates were also examined. In total, 1188 referrals were made from 49 different GP practices; range of referral rates was 0.3-20.1 per 1000 population with a mean of 6.5 referrals per 1000 population. Referral rates were not significantly different between urban and rural practices after correction for population size. There was no correlation between the referral rates and the distance from the centre (r2=0.004, p=0.65). The most common reason for referral was the presence of new murmur (46%). The most common presenting symptom was breathlessness (44%). Overall, 28% of studies had significant abnormal findings requiring direct input from a cardiologist. There was no clear relationship between referral rates and cardiac abnormality detection rates (r2=0.07, p=0.37). The average cardiac abnormality detection rate was 56%, (range 52-60%), with no variation based on rurality (p=0.891). In this cohort, rurality and distance were not barriers to an equitable direct access echocardiography service. Cardiac abnormality detection rates are consistent with that of other studies.

  7. Referral Criteria from Community Clinics to Pediatric Emergency Departments

    Directory of Open Access Journals (Sweden)

    Jacob Urkin

    2008-01-01

    Full Text Available Referral of patients to a pediatric emergency department (PED should be medically justified and the need for referral well communicated. The objectives of this paper were (1 to create a list of criteria for referral from the community to the PED, (2 to describe how community physicians categorize their need for referral, and (3 to determine agreement between the physician's referral letter and the selected criteria. We present a descriptive study of referrals to the PED of Soroka University Medical Center, Beer-Sheva, Israel, during February to April 2003. A list of 22 criteria for referral was created, using the Delphi method for reaching consensus. One or more criteria could be selected from this list for each referral, by the referring community physicians and, independently, based on the physicians' referral letters, by two consultants, and compared. There were 140 referrals included in the study. A total of 262 criteria for referral were selected by the referring community physicians. The criteria most frequently selected were: “Need for same-day consultation/laboratory/imaging result not available in the community” (32.1%, “Suspected life- or organ-threatening infection” (16.4%, and “Need for hospitalization” (15.7%. Rates of agreement regarding criteria for referral between the referring physicians and the two consultants, and a senior community pediatrician and a senior PED pediatrician, were 57.9 and 48.6%, respectively. We conclude that the standard referral letter does not convey in full the level of need for referral to the PED. A list of criteria for referral could augment efficient utilization of emergency department services and improve communication between community physicians and the PED.

  8. Employee-referral schemes and discrimination law

    OpenAIRE

    Connolly, M.

    2015-01-01

    Employee-referral schemes (‘introduce a friend’) are in common usage in recruitment. They carry a potential to discriminate by perpetuating an already unbalanced workforce (say, by gender and ethnicity). With this, or course, comes the risk of litigation and bad publicity as well as any inherent inefficiencies associated with discrimination. This article is threefold. First, it examines the present state of the law. Second, it is based on a survey of employers who use these schemes. Third, it...

  9. Obstetrical referrals by traditional birth attendants.

    Science.gov (United States)

    Mustafa, Rozina; Hashmi, Haleema; Mustafa, Rubina

    2012-01-01

    In Pakistan 90% of births are conducted by TBA's. In most cases, TBA's are unable to diagnose the complications and are often unable to take decisions on timely referral. The objective of this study was to determine the prevalence, nature and outcome of life threatening obstetrical conditions in referrals by Traditional Birth Attendants (TBAs). This Observational, Descriptive study was conducted from January to December 2007, in the obstetrical unit of Fatima Hospital, Baqai Medical University, a tertiary care community based hospital. The study included patients referred by TBA's who developed life threatening obstetric conditions (LTOCs). Total 64 patients were referred by TBA's. The prevalence was 7.8%. Out of them, 53 (82.8%) patients admitted with life threatening obstetric conditions. The near-miss morbidities and mortalities were 45 (84.9%) and 8 (15%) respectively. Maternal mortality to Near-miss morbidity ratio was 1:6. Obstructed labour caused near-miss morbidity in 32 (60.3%) patients with no mortality. Postpartum haemorrhage as life threatening condition developed in 16 (30.1%) patients with 10 (18.8%) near-miss morbidities and 6 (11.3%) mortalities. Puerperal sepsis accounted for 1 (1.88%) near-miss morbidity and 2 (3.76%) mortalities. The mortality index for puerperal sepsis is (66.6%) almost double of postpartum haemorrhage (37.5%). Mortality to near miss morbidity ratio is high. Misidentification and late referrals of complicated cases by TBA's were responsible for near-miss morbidities and mortalities.

  10. Safety performance evaluation using proactive indicators in a selected industry

    Directory of Open Access Journals (Sweden)

    Abolfazl Barkhordari

    2015-03-01

    Full Text Available Background & Objectives: Quality and effectiveness of safety systems are critical factors in achieving their goals. This study was aimed to represent a method for performance evaluation of safety systems by proactive indicators using different updated models in the field of safety which will be tested in a selected industry. Methods: This study is a cross-sectional study. Proactive indicators used in this study were: Unsafe acts rate, Safety Climate, Accident Proneness, and Near-miss incident rate. The number of in 1473 safety climate questionnaires and 543 Accident Proneness questionnaires was completed. Results: The minimum and maximum safety climate score were 56.88 and 58.2, respectively, and the minimum and maximum scores of Accident Proneness were 98.2 and 140.7, respectively. The maximum number of Near-miss incident rate were 408 and the minimum of that was 196. The maximum number of unsafe acts rate was 43.8 percent and the minimum of that was 27.2 percent. In nine dimensions of Safety climate the eighth dimension (personal perception of risk with the score of 4.07 has the lowest score and the fourth (laws and safety regulations dimension with 8.05 has the highest score. According to expert opinions, the most important indicator in the assessment of safety performance was unsafe acts rate, while near-miss incident rate was the least important one. Conclusion: The results of this survey reveal that using proactive (Prospective indicators could be an appropriate method in organizations safety performance evaluation.

  11. THE APIPHYTOTHERAPY WITH PROACTIVATOR IN THE VETERINARY DERMATOLOGY AND SURGERY

    Directory of Open Access Journals (Sweden)

    A. SICEANU

    2008-10-01

    Full Text Available The main objective of this clinical study consisted in evaluation of the therapeutic effects of the propolis extract used in different disorders at company animals, thus being improved the palette of the apitherapeutical products used in veterinary purposes. The experiments were carried out on company animals (two experimental groups during the 2007-2008 period, in the frame of the Veterinary Medicine Faculty – Bucharest and the University - Spiru Haret, at the veterinary departments: Parasitology, Dermatology and Surgery. The raw propolis was collected from the bee colonies belonging to the Institute of the Beekeeping Research & Development– Bucharest and the apiphytotherapeutical product based on propolis was obtained in the Apitherapy sector of the same Institute. In a first stage were obtained the antiparasite, dermatological and surgical veterinary product PROACTIVATOR based on propolis alcoholic extract and Aloe vera gel. The experiments consisted in administration of the obtained preparation in different disorders on the experimental groups as: dermatological (plagues, chemical and physical burns, parasitological (extern parasites: scabies supra infected or not and in veterinary surgery (as a protective layer applied on the sutured plague. In dermatologic disorders the effects of the PROACTIVATOR product were established by way of clinical periodical examinations until the total recover were done. In external parasites and connected disorders it was established the repellent or killing effect of the preparation on the infestation with parasites and the degree of control in the correlated infections. In skin tissue surgery it was established the cicatrising effect in sutured plagues and the anaesthesic local effect. The established of the studied preparation efficiency was similar as those used in classical treatments with synthesis products. The advantage of the utilization of PROACTIVATOR eliminates the toxic and cumulative effects

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

    Science.gov (United States)

    Gan, Yiqun; Cheung, Fanny M

    2010-06-01

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

  13. Proactive materials aging management and multi-layered maintenance

    International Nuclear Information System (INIS)

    Shoji, Tetsuo

    2009-01-01

    Long term operation of NPP has been receiving a great concern based upon the plant operation experiences and progressive improvement in countermeasures and mitigations. At the same time of this LTO movement, proactive materials aging management is also receiving a great concern to realize the LTO in NPP. Recent PMDM activities in Japan as well as some international one are reviewed and a necessity of an international cooperation is emphasized in relation to reliable maintenance performance connected from the top of the organization to operators and maintenance engineers at plant sites. (author)

  14. Proactive restoration of slow-failures in optical networks

    DEFF Research Database (Denmark)

    Siracusa, Domenico; Pederzolli, Federico; Salvadori, Elio

    2014-01-01

    Current optical networks, while offering outstanding reliability, still suffer from occasional failures. A resource-efficient procedure to handle these failures in un-protected scenarios is to perform restoration, i.e., to dynamically setup a backup lightpath after the primary one stops working......, which leads to traffic losses while such operation completes. In this paper we propose a technique, applicable to optical networks with centralized control, to better handle failures with slow transients. The idea is to proactively perform the backup lightpath's setup, triggered by either a fixed...

  15. Marketing-mix and technology: evolution and proactive development

    Directory of Open Access Journals (Sweden)

    Oberemok Svetlana

    2015-10-01

    Full Text Available In order to survive the marketing subjects have to be able to adapt their business-processes to the changing environmental conditions. Those who will correctly predict the direction of the economic vector and will apply adequate and proactive tools and marketing technologies will achieve the greatest success. The article presents the results of the analysis of the leading specialists in the field of marketing and management ideas concerning the transformation of the existing tools and marketing technologies and appearing of the new ones.

  16. Cognitive Impairments in Occupational Burnout – Error Processing and Its Indices of Reactive and Proactive Control

    Directory of Open Access Journals (Sweden)

    Krystyna Golonka

    2017-05-01

    Full Text Available The presented study refers to cognitive aspects of burnout as the effects of long-term work-related stress. The purpose of the study was to investigate electrophysiological correlates of burnout to explain the mechanisms of the core burnout symptoms: exhaustion and depersonalization/cynicism. The analyzed error-related electrophysiological markers shed light on impaired cognitive mechanisms and the specific changes in information-processing in burnout. In the EEG study design (N = 80, two components of error-related potential (ERP, error-related negativity (ERN, and error positivity (Pe, were analyzed. In the non-clinical burnout group (N = 40, a significant increase in ERN amplitude and a decrease in Pe amplitude were observed compared to controls (N = 40. Enhanced error detection, indexed by increased ERN amplitude, and diminished response monitoring, indexed by decreased Pe amplitude, reveal emerging cognitive problems in the non-clinical burnout group. Cognitive impairments in burnout subjects relate to both reactive and unconscious (ERN and proactive and conscious (Pe aspects of error processing. The results indicate a stronger ‘reactive control mode’ that can deplete resources for proactive control and the ability to actively maintain goals. The analysis refers to error processing and specific task demands, thus should not be extended to cognitive processes in general. The characteristics of ERP patterns in burnout resemble psychophysiological indexes of anxiety (increased ERN and depressive symptoms (decreased Pe, showing to some extent an overlapping effect of burnout and related symptoms and disorders. The results support the scarce existing data on the psychobiological nature of burnout, while extending and specifying its cognitive characteristics.

  17. Referrals and relationships: in-practice referrals meetings in a general practice.

    Science.gov (United States)

    Rowlands, G; Willis, S; Singleton, A

    2001-08-01

    GP referrals to secondary care are an important factor in the cost of running the NHS. The known variation in referral rates between doctors has the potential to cause tension within primary care which will be exacerbated by the latest reorganization of primary care and the trend towards capitation-based budgets. The importance of postgraduate learning for GPs has been recognized; continuing professional development is moving towards self-directed practice-based learning programmes. Educational interventions have been shown to alter doctors' prescribing behaviour. This, together with the pressure on accounting for referral activity, makes the prospect of improving, and possibly reducing, referral activity through educational interventions very attractive. This study complemented a randomized controlled trial (RCT) which investigated whether an intervention of the type which had reduced prescribing costs would have a similar effect on referral activity. The context of the study, description of the characteristics of the practice and the issues seen as important by the doctors and practice manager were identified through preliminary semi-structured interviews. The practice then held a series of educational in-practice meetings to discuss referrals and issues arising from referrals. The audio- and videotaped transcripts were interpreted using content and group dynamic analysis. Participants commented upon our preliminary findings. In addition, we used dimensional analysis to induce a preliminary theory describing the effect of the intervention on this general practice which enabled us to review the findings of the parallel RCT. The educational value of the meetings and the learning needs of the participants were also assessed. Our complementary study showed no alteration of practice referral rates following the educational intervention. The qualitative study, unencumbered by the assumptions inherent in the development of the hypothesis tested in the RCT, highlighted

  18. Proactive coping and gambling disorder among young men.

    Science.gov (United States)

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

    2016-12-01

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

  19. A Proactive Recommendation System for Writing in the Internet Age

    Directory of Open Access Journals (Sweden)

    Olga Muñoz

    2010-03-01

    Full Text Available With the use of the computers, the task of writing is intertwined with the task of searching for information that can be relevant for the document that is being written, however very little research has been done to understand how the two tasks intertwine. In this paper we present an initial attempt to develop a model of writing and information seeking with computers and to develop helpful software that can improve the quality of the information searched and the written paper. Proactive Recommendation System (PRS can relieve authors from explicit searching by means of automatically searching, retrieving and recommending information relevant to the text currently being written, and therefore PRS can be helpful to writers. However it is also possible that there are some moments during writing in which presenting proactive information can be an interruption rather than a help. In our research, we have used the PRS IntelliGent™ to investigate its impact in the different stages of writing. We found that when IntelliGent™ offers relevant information the time to task completion is shorter and the quality of the written product increases compared with the control situations in which writers have to look actively for information. We discuss these findings in the context of developing models and tools that integrate searching and writing processes when using computers as the writing environment.

  20. The PROactive innovative conceptual framework on physical activity

    Science.gov (United States)

    Dobbels, Fabienne; de Jong, Corina; Drost, Ellen; Elberse, Janneke; Feridou, Chryssoula; Jacobs, Laura; Rabinovich, Roberto; Frei, Anja; Puhan, Milo A.; de Boer, Willem I.; van der Molen, Thys; Williams, Kate; Pinnock, Hillary; Troosters, Thierry; Karlsson, Niklas; Kulich, Karoly; Rüdell, Katja; Brindicci, Caterina; Higenbottam, Tim; Troosters, Thierry; Dobbels, Fabienne; Decramer, Marc; Tabberer, Margaret; Rabinovich, Roberto A; MacNee, William; Vogiatzis, Ioannis; Polkey, Michael; Hopkinson, Nick; Garcia-Aymerich, Judith; Puhan, Milo; Frei, Anja; van der Molen, Thys; de Jong, Corina; de Boer, Pim; Jarrod, Ian; McBride, Paul; Kamel, Nadia; Rudell, Katja; Wilson, Frederick J.; Ivanoff, Nathalie; Kulich, Karoly; Glendenning, Alistair; Karlsson, Niklas X.; Corriol-Rohou, Solange; Nikai, Enkeleida; Erzen, Damijan

    2014-01-01

    Although physical activity is considered an important therapeutic target in chronic obstructive pulmonary disease (COPD), what “physical activity” means to COPD patients and how their perspective is best measured is poorly understood. We designed a conceptual framework, guiding the development and content validation of two patient reported outcome (PRO) instruments on physical activity (PROactive PRO instruments). 116 patients from four European countries with diverse demographics and COPD phenotypes participated in three consecutive qualitative studies (63% male, age mean±sd 66±9 years, 35% Global Initiative for Chronic Obstructive Lung Disease stage III–IV). 23 interviews and eight focus groups (n = 54) identified the main themes and candidate items of the framework. 39 cognitive debriefings allowed the clarity of the items and instructions to be optimised. Three themes emerged, i.e. impact of COPD on amount of physical activity, symptoms experienced during physical activity, and adaptations made to facilitate physical activity. The themes were similar irrespective of country, demographic or disease characteristics. Iterative rounds of appraisal and refinement of candidate items resulted in 30 items with a daily recall period and 34 items with a 7-day recall period. For the first time, our approach provides comprehensive insight on physical activity from the COPD patients’ perspective. The PROactive PRO instruments’ content validity represents the pivotal basis for empirically based item reduction and validation. PMID:25034563

  1. Reducing proactive aggression through non-invasive brain stimulation

    Science.gov (United States)

    Schuhmann, Teresa; Lobbestael, Jill; Arntz, Arnoud; Brugman, Suzanne; Sack, Alexander T.

    2015-01-01

    Aggressive behavior poses a threat to human collaboration and social safety. It is of utmost importance to identify the functional mechanisms underlying aggression and to develop potential interventions capable of reducing dysfunctional aggressive behavior already at a brain level. We here experimentally shifted fronto-cortical asymmetry to manipulate the underlying motivational emotional states in both male and female participants while assessing the behavioral effects on proactive and reactive aggression. Thirty-two healthy volunteers received either anodal transcranial direct current stimulation to increase neural activity within right dorsolateral prefrontal cortex, or sham stimulation. Aggressive behavior was measured with the Taylor Aggression Paradigm. We revealed a general gender effect, showing that men displayed more behavioral aggression than women. After the induction of right fronto-hemispheric dominance, proactive aggression was reduced in men. This study demonstrates that non-invasive brain stimulation can reduce aggression in men. This is a relevant and promising step to better understand how cortical brain states connect to impulsive actions and to examine the causal role of the prefrontal cortex in aggression. Ultimately, such findings could help to examine whether the brain can be a direct target for potential supportive interventions in clinical settings dealing with overly aggressive patients and/or violent offenders. PMID:25680991

  2. Neural correlates of proactive and reactive aggression in adolescent twins.

    Science.gov (United States)

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

    2017-05-01

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

  3. Escaping the recent past: which stimulus dimensions influence proactive interference?

    Science.gov (United States)

    Craig, Kimberly S; Berman, Marc G; Jonides, John; Lustig, Cindy

    2013-07-01

    Proactive interference occurs when information from the past disrupts current processing and is a major source of confusion and errors in short-term memory (STM; Wickens, Born, & Allen, Journal of Verbal Learning and Verbal Behavior, 2:440-445, 1963). The present investigation examines potential boundary conditions for interference, testing the hypothesis that potential competitors must be similar along task-relevant dimensions to influence proactive interference effects. We manipulated both the type of task being completed (Experiments 1, 2, and 3) and dimensions of similarity irrelevant to the current task (Experiments 4 and 5) to determine how the recent presentation of a probe item would affect the speed with which participants could reject that item. Experiments 1, 2, and 3 contrasted STM judgments, which require temporal information, with semantic and perceptual judgments, for which temporal information is irrelevant. In Experiments 4 and 5, task-irrelevant information (perceptual similarity) was manipulated within the recent probes task. We found that interference from past items affected STM task performance but did not affect performance in semantic or perceptual judgment tasks. Conversely, similarity along a nominally irrelevant perceptual dimension did not affect the magnitude of interference in STM tasks. Results are consistent with the view that items in STM are represented by noisy codes consisting of multiple dimensions and that interference occurs when items are similar to each other and, thus, compete along the dimensions relevant to target selection.

  4. Proactive Traffic Information Control in Emergency Evacuation Network

    Directory of Open Access Journals (Sweden)

    Zhengfeng Huang

    2015-01-01

    Full Text Available Traffic demand in emergency evacuation is usually too large to be effectively managed with reactive traffic information control methods. These methods adapt to the road traffic passively by publishing real-time information without consideration of the routing behavior feedback produced by evacuees. Other remedy measures have to be prepared in case of nonrecurring congestion under these methods. To use the network capacity fully to mitigate near-future evacuation traffic congestion, we propose proactive traffic information control (PTIC model. Based on the mechanism between information and routing behavior feedback, this model can change the route choice of evacuees in advance by dissipating strategic traffic information. Generally, the near-future traffic condition is difficult to accurately predict because it is uncertain in evacuation. Assume that the value of traffic information obeys certain distribution within a range, and then real-time traffic information may reflect the most-likely near-future traffic condition. Unlike the real-time information, the proactive traffic information is a selection within the range to achieve a desired level of the road network performance index (total system travel time. In the aspect of the solution algorithm, differential equilibrium decomposed optimization (D-EDO is proposed to compare with other heuristic methods. A field study on a road network around a large stadium is used to validate the PTIC.

  5. The PROactive innovative conceptual framework on physical activity.

    Science.gov (United States)

    Dobbels, Fabienne; de Jong, Corina; Drost, Ellen; Elberse, Janneke; Feridou, Chryssoula; Jacobs, Laura; Rabinovich, Roberto; Frei, Anja; Puhan, Milo A; de Boer, Willem I; van der Molen, Thys; Williams, Kate; Pinnock, Hillary; Troosters, Thierry; Karlsson, Niklas; Kulich, Karoly; Rüdell, Katja

    2014-11-01

    Although physical activity is considered an important therapeutic target in chronic obstructive pulmonary disease (COPD), what "physical activity" means to COPD patients and how their perspective is best measured is poorly understood. We designed a conceptual framework, guiding the development and content validation of two patient reported outcome (PRO) instruments on physical activity (PROactive PRO instruments). 116 patients from four European countries with diverse demographics and COPD phenotypes participated in three consecutive qualitative studies (63% male, age mean±sd 66±9 years, 35% Global Initiative for Chronic Obstructive Lung Disease stage III-IV). 23 interviews and eight focus groups (n = 54) identified the main themes and candidate items of the framework. 39 cognitive debriefings allowed the clarity of the items and instructions to be optimised. Three themes emerged, i.e. impact of COPD on amount of physical activity, symptoms experienced during physical activity, and adaptations made to facilitate physical activity. The themes were similar irrespective of country, demographic or disease characteristics. Iterative rounds of appraisal and refinement of candidate items resulted in 30 items with a daily recall period and 34 items with a 7-day recall period. For the first time, our approach provides comprehensive insight on physical activity from the COPD patients' perspective. The PROactive PRO instruments' content validity represents the pivotal basis for empirically based item reduction and validation. ©ERS 2014.

  6. Referral recommendations for osteoarthritis of the knee incorporating patients' preferences

    Science.gov (United States)

    Musila, Nyokabi; Underwood, Martin; McCaskie, Andrew W; Black, Nick; Clarke, Aileen; van der Meulen, Jan H

    2011-01-01

    Background. GPs have to respond to conflicting policy developments. As gatekeeper they are supposed to manage the growing demand for specialist services and as patient advocate they should be responsive to patients' preferences. We used an innovative approach to develop a referral guideline for patients with chronic knee pain that explicitly incorporates patients' preferences. Methods. A guideline development group of 12 members including patients, GPs, orthopaedic surgeons and other health care professionals used formal consensus development informed by systematic evidence reviews. They rated the appropriateness of referral for 108 case scenarios describing patients according to symptom severity, age, body mass, co-morbidity and referral preference. Appropriateness was expressed on scale from 1 (‘strongly disagree’) to 9 (‘strongly agree’). Results. Ratings of referral appropriateness were strongly influenced by symptom severity and patients' referral preferences. The influence of other patient characteristics was small. There was consensus that patients with severe knee symptoms who want to be referred should be referred and that patient with moderate or mild symptoms and strong preference against referral should not be referred. Referral preference had a greater impact on the ratings of referral appropriateness when symptoms were moderate or severe than when symptoms were mild. Conclusions. Referral decisions for patients with osteoarthritis of the knee should only be guided by symptom severity and patients' referral preferences. The guideline development group seemed to have given priority to avoiding inefficient resource use in patients with mild symptoms and to respecting patient autonomy in patients with severe symptoms. PMID:20817791

  7. Surgical pathology of excised heart valves in a referral hospital in iran

    International Nuclear Information System (INIS)

    Yaghoubi, A.R.; Raeesi, K.

    2007-01-01

    Assessment of surgical pathology of excised heart valves in a referral hospital in Iran in a five years period. This retrospective descriptive study was done from 2002 to 2005 in Rajaie heart center in Tehran, Iran. Surgery and pathology records of patients who underwent valve replacement or repair surgery were reviewed. Of 1563 patients 738 (47.2%) underwent mitral, 565 (36.1%) aortic, and 215 (14%) multivalve operation. Most common pathology of mitral valve was rheumatic (68%), while degenerative calcific pathology was dominant in aortic valve (52%). Rheumatic involvement was 46%, and degenerative pathology was common in tricuspid and pulmonary valves (50% and 67%, respectively). Time trend analysis shows no significant variation in excised valves pathology or pattern from 2002 to 2005 (p=0.112). Rheumatic pathology in excised heart valves is still common in this referral heart center in Iran, and no obvious change in this pattern was found during a 5 years period. (author)

  8. Black–White Disparities in Criminal Justice Referrals to Drug Treatment: Addressing Treatment Need or Expanding the Diagnostic Net?

    Directory of Open Access Journals (Sweden)

    Karen McElrath

    2016-10-01

    Full Text Available Slightly more than half of admissions to U.S. publicly-funded treatment for marijuana use are referred by the criminal justice system; this pattern has remained for at least 20 years. Nationally, Blacks comprise nearly a third of treatment admissions for marijuana use. This article explores the interplay between race and criminal justice referrals to treatment for marijuana use. Using data from the (U.S. 2011 Treatment Episode Data Set, we examine the relationship between race and diagnosis of cannabis use disorder (dependence versus abuse among referrals to community-based treatment in North Carolina. We compare Black/White differences in cannabis diagnoses across four referral sources: the criminal justice system, healthcare providers, self, and other sources. Race was significantly related to type of diagnosis across all four referral sources, however, the nature of the relationship was distinctly different among criminal justice referrals with Whites being more likely than Blacks to be diagnosed with cannabis dependence. Moreover, the marijuana use profiles of criminal justice referrals differed substantially from individuals referred by other sources. The findings suggest that diagnoses of cannabis abuse (rather than dependence may have worked to widen the diagnostic net by “capturing” individuals under control of the criminal justice system who manifested few problems with marijuana use, other than their involvement in the criminal justice system. The potential for a net-widening effect appeared to be most pronounced for Blacks.

  9. Black–White Disparities in Criminal Justice Referrals to Drug Treatment: Addressing Treatment Need or Expanding the Diagnostic Net?

    Science.gov (United States)

    McElrath, Karen; Taylor, Angela; Tran, Kimberly K.

    2016-01-01

    Slightly more than half of admissions to U.S. publicly-funded treatment for marijuana use are referred by the criminal justice system; this pattern has remained for at least 20 years. Nationally, Blacks comprise nearly a third of treatment admissions for marijuana use. This article explores the interplay between race and criminal justice referrals to treatment for marijuana use. Using data from the (U.S.) 2011 Treatment Episode Data Set, we examine the relationship between race and diagnosis of cannabis use disorder (dependence versus abuse) among referrals to community-based treatment in North Carolina. We compare Black/White differences in cannabis diagnoses across four referral sources: the criminal justice system, healthcare providers, self, and other sources. Race was significantly related to type of diagnosis across all four referral sources, however, the nature of the relationship was distinctly different among criminal justice referrals with Whites being more likely than Blacks to be diagnosed with cannabis dependence. Moreover, the marijuana use profiles of criminal justice referrals differed substantially from individuals referred by other sources. The findings suggest that diagnoses of cannabis abuse (rather than dependence) may have worked to widen the diagnostic net by “capturing” individuals under control of the criminal justice system who manifested few problems with marijuana use, other than their involvement in the criminal justice system. The potential for a net-widening effect appeared to be most pronounced for Blacks. PMID:27706092

  10. Community health workers adherence to referral guidelines

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy

    2016-01-01

    artemisinin-based combination therapy (ACT) and recognize symptoms in children that required immediate referral to the nearest health centre. Intervention arm CHWs had additional training on how to conduct an RDT; CHWs in the control arm used a presumptive diagnosis for malaria using clinical signs......Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs...

  11. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    Energy Technology Data Exchange (ETDEWEB)

    Bluekens, Adriana M.J. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Preventicon Screening Centre/Mid-West, Utrecht (Netherlands); Engen, Ruben E. van [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Academic Medical Centre (AMC), Department of Radiology, Amsterdam (Netherlands)

    2010-09-15

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  12. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates.

    Science.gov (United States)

    Bluekens, Adriana M J; Karssemeijer, Nico; Beijerinck, David; Deurenberg, Jan J M; van Engen, Ruben E; Broeders, Mireille J M; den Heeten, Gerard J

    2010-09-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p < .001), with a significant increase in cancer detection (p = .010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection.

  13. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    International Nuclear Information System (INIS)

    Bluekens, Adriana M.J.; Karssemeijer, Nico; Beijerinck, David; Deurenberg, Jan J.M.; Engen, Ruben E. van; Broeders, Mireille J.M.; Heeten, Gerard J. den

    2010-01-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  14. Dysphagia referrals to a district general hospital gastroenterology unit: hard to swallow.

    Science.gov (United States)

    Melleney, Elizabeth Mary-Ann; Subhani, Javaid Mohammed; Willoughby, Charles Peter

    2004-01-01

    The aim of our study was to audit dysphagia referrals received by a specialist gastroenterology unit during an entire year. We used a prospective audit carried out over a 12-month period at the District General Hospital gastroenterology unit. The audit included 396 consecutive patients who were referred with swallowing difficulties. We found that 60 referrals (15.2%) were inaccurate and the patients had no swallowing problem. Of the 336 patients with genuine dysphagia, only 29 (8.6%) were new cancer cases. The large majority of subjects had benign disease mostly related to acid reflux. Weight loss was significantly associated with malignancy but also occurred in one third of patients with reflux alone. The temporal pattern of dysphagia was not significantly predictive of cancer. All the cancer patients were above the age of 50 years. Although patients were in general assessed rapidly after hospital referral, the productivity, in terms of early tumor diagnosis, was extremely low. We conclude that there is a substantial rate of inaccurate referrals of dysphagia patients. Most true cases of swallowing difficulty relate to benign disease. Even the devotion of considerable resources to the early diagnosis of esophago gastric malignancy in an attempt to conform with best practice guidelines results in a very low success rate in terms of the detection of potentially curable tumors.

  15. Relation of Psychiatric Symptoms with Epilepsy, Asthma, and Allergy in Youth with ASD vs. Psychiatry Referrals.

    Science.gov (United States)

    Weber, Rebecca J; Gadow, Kenneth D

    2017-08-01

    The present study aimed to characterize the association of psychopathology with the clinical correlates of epilepsy, asthma, and allergy within and between neurobehavioral syndromes. Participants were consecutively evaluated youth (6-18 years, 75 % male) with autism spectrum disorder (ASD; n = 589) and non-ASD outpatient psychiatry referrals (n = 653). Informants completed a background questionnaire (parents) and a psychiatric symptom severity rating scale (parents, teachers). Youth with ASD had higher rates of epilepsy and allergy but not asthma than psychiatry referrals, even when analyses were limited to youth with IQ ≥ 70. Somatic conditions evidenced variable associations with medical services utilization, educational interventions, family income, and maternal education. Youth with ASD with versus without epilepsy had more severe ASD social deficits (parents' ratings) and less severe ASD repetitive behaviors (teachers' ratings). Epilepsy was associated with more severe depression, mania, and schizophrenia symptoms in youth with ASD. Youth with allergy (psychiatry referrals only) had more severe anxiety and depression symptoms (parents' ratings) but less severe aggression (teachers' ratings) thus providing evidence of both context- and diagnostic-specificity. Youth with ASD versus non-ASD psychiatry referrals evidence a variable pattern of relations between somatic conditions and a range of clinical correlates, which suggests that the biologic substrates and psychosocial concomitants of neurodevelopmental disorders and their co-occurring somatic conditions may interact to produce unique clinical phenotypes.

  16. Physicians' opinions about partner notification methods: case reporting, patient referral, and provider referral.

    Science.gov (United States)

    Hogben, M; St Lawrence, J S; Montaño, D E; Kasprzyk, D; Leichliter, J S; Phillips, W R

    2004-02-01

    The United States has relied upon partner notification strategies to help break the chain of infection and re-infection for sexually transmitted diseases (STD). Physicians are a vital link in the system of STD control, but little is known of physician opinions about partner notification strategies. We collected opinions about partner notification from a national probability sample of physicians in specialties diagnosing STDs. Physicians responded to 17 questions about three relevant forms of STD partner notification: patient based referral, provider based referral, and case reporting. Exploratory factor analyses showed that responses for each form of partner notification could be grouped into four categories: perceived practice norms, infection control, patient relationships, and time/money. Multivariate analyses of the factors showed that physicians endorsed patient based referral most favourably and provider based referral least favourably. Physicians' opinions about partner notification strategies appear to reflect objective reality in some areas, but not in others. Strategies that improve the fit between physicians' opinions and effective notification are needed: some are discussed here.

  17. Verification in Referral-Based Crowdsourcing

    Science.gov (United States)

    Naroditskiy, Victor; Rahwan, Iyad; Cebrian, Manuel; Jennings, Nicholas R.

    2012-01-01

    Online social networks offer unprecedented potential for rallying a large number of people to accomplish a given task. Here we focus on information gathering tasks where rare information is sought through “referral-based crowdsourcing”: the information request is propagated recursively through invitations among members of a social network. Whereas previous work analyzed incentives for the referral process in a setting with only correct reports, misreporting is known to be both pervasive in crowdsourcing applications, and difficult/costly to filter out. A motivating example for our work is the DARPA Red Balloon Challenge where the level of misreporting was very high. In order to undertake a formal study of verification, we introduce a model where agents can exert costly effort to perform verification and false reports can be penalized. This is the first model of verification and it provides many directions for future research, which we point out. Our main theoretical result is the compensation scheme that minimizes the cost of retrieving the correct answer. Notably, this optimal compensation scheme coincides with the winning strategy of the Red Balloon Challenge. PMID:23071530

  18. Referral system in rural Iran: improvement proposals

    Directory of Open Access Journals (Sweden)

    Mansour Naseriasl

    2018-03-01

    Full Text Available Because of insufficient communication between primary health care providers and specialists, which leads to inefficiencies and ineffectiveness in rural population health outcomes, to implement a well-functioning referral system is one of the most important tasks for some countries. Using purposive and snowballing sampling methods, we included health experts, policy-makers, family physicians, clinical specialists, and experts from health insurance organizations in this study according to pre-determined criteria. We recorded all interviews, transcribed and analyzed their content using qualitative methods. We extracted 1,522 individual codes initially. We also collected supplementary data through document review. From reviews and summarizations, four main themes, ten subthemes, and 24 issues emerged from the data. The solutions developed were: care system reform, education system reform, payment system reform, and improves in culture-building and public education. Given the executive experience, the full familiarity, the occupational and geographical diversity of participants, the solutions proposed in this study could positively affect the implementation and improvement of the referral system in Iran. The suggested solutions are complementary to each other and have less interchangeability.

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

    Science.gov (United States)

    Sankey, Kim S.; Machin, M. Anthony

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  1. The role of pre-treatment proactive coping skills in successful weight management

    NARCIS (Netherlands)

    Vinkers, Charlotte D. W.; Adriaanse, Marieke A.; Kroese, Floor M.; de Ridder, Denise T. D.

    2014-01-01

    Objectives: Proactive coping encompasses future-oriented self-regulatory skills that help people prepare for future difficulties before they occur, such as planning and monitoring. The aim of the present study was to examine the interplay between pre-treatment proactive coping skills and expected

  2. Cognitive and Affective Empathy as Predictors of Proactive and Reactive Aggression

    Science.gov (United States)

    Gordon, Gina M.

    2013-01-01

    This study examined cognitive and affective empathy as predictors of proactive and reactive aggression. This study also explored whether levels of cognitive and affective empathy differed among children who use proactive and reactive aggression. Cognitive and affective empathy were measured by the Basic Empathy Scale (Jolliffe & Farrington,…

  3. The Influence of Proactive Socialization Behaviors and Team Socialization on Individual Performance in the Team

    Science.gov (United States)

    Pennaforte, Antoine

    2016-01-01

    On the basis of the role and the social exchange theories, this research investigated the direct and indirect antecedents of three dimensions of team performance (proficiency, adaptivity, proactivity) developed through cooperative education. The theoretical model examined how proactive socialization behaviors led to team socialization and team…

  4. Change Driven by Nature: A Meta-Analytic Review of the Proactive Personality Literature

    Science.gov (United States)

    Fuller, Bryan, Jr.; Marler, Laura E.

    2009-01-01

    This study provides the first comprehensive review of literature examining proactive personality. The authors use career success as a broad organizing framework, meta-analyzing 313 correlations from 107 studies. Results indicate proactive personality is positively related to objective and subjective career success. Further, results indicate…

  5. Proactive environmental strategy in a supply chain context: the mediating role of investments

    NARCIS (Netherlands)

    Akin, M.; Bloemhof, J.M.; Raaij, van E.M.; Wynstra, F.

    2012-01-01

    There is a growing body of knowledge on the link between environmental management and supply chain management, but there is contradicting evidence on the impact of a proactive environmental strategy on environmental performance. Therefore, this paper investigates the impact of proactive

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

    Science.gov (United States)

    Uz Bas, Asli; Öz Soysal, Fatma Selda

    2016-01-01

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

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

    Science.gov (United States)

    Bialystok, Ellen; Feng, Xiaojia

    2009-01-01

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

  8. Individual Differences in Digit Span, Susceptibility to Proactive Interference, and Aptitude/Achievement Test Scores.

    Science.gov (United States)

    Dempster, Frank N.; Cooney, John B.

    1982-01-01

    Individual differences in digit span, susceptibility to proactive interference, and various aptitude/achievement test scores were investigated in two experiments with college students. Results indicated that digit span was strongly correlated with aptitude/achievement scores, but did not indicate that susceptibility to proactive interference…

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Attention! An affective approach to anticipated action : Cognitive, affective, and motivational processes underlying proactive behavior

    NARCIS (Netherlands)

    Wolsink, I.

    2017-01-01

    Proactivity is popular: on vacancy websites, ‘proactive’ generates more hits than any other competency. Proactive individuals do not wait for instructions. They actively try to anticipate future problems and opportunities and initiate improvement in themselves and their environment. Despite

  11. Improved Academic Performance and Enhanced Employability? The Potential Double Benefit of Proactivity for Business Graduates

    Science.gov (United States)

    Tymon, Alex; Batistic, Sasa

    2016-01-01

    This study contributes to proactivity theory and debate on how universities meet competing stakeholder demands in an increasingly marketized higher education environment. We explore how the interplay between the stable facet of proactive personality and the situated behaviour of personal initiative influence academic performance. We hypothesized…

  12. Linking Extroversion and Proactive Personality to Career Success: The Role of Mentoring Received and Knowledge

    Science.gov (United States)

    Turban, Daniel B.; Moake, Timothy R.; Wu, Sharon Yu-Hsien; Cheung, Yu Ha

    2017-01-01

    Although extroversion and proactive personality are related to career success, the mechanisms through which the relationships occur are unclear. Based on the contest- and sponsored-mobility processes, we examine a model linking extroversion and proactive personality to career success through the mediating effects of mentoring received and…

  13. TOXIC LEADERSHIP: A SYSTEMIC APPROACH TO SHIFT FROM REACTIVE TO PROACTIVE SOLUTIONS

    Science.gov (United States)

    2017-03-01

    AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY TOXIC LEADERSHIP: A SYSTEMIC APPROACH TO SHIFT FROM REACTIVE TO PROACTIVE SOLUTIONS...DISTRIBUTION A. Approved for public release: distribution unlimited. Toxic Leadership: A Systemic Approach to Shift From Reactive to Proactive Solutions 1...US military loses valuable personnel when it is too late to implement corrective action and after those toxic Toxic Leadership: A Systemic Approach

  14. Proactive outreach smoking cessation program for Chinese employees in China.

    Science.gov (United States)

    Wang, Man Ping; Suen, Yi Nam; Li, William Ho Cheung; Lau, Oi Sze; Lam, Tai Hing; Chan, Sophia Siu Chee

    2018-03-04

    We evaluated the first workplace intervention to help smokers quit in Hong Kong. Smoking employees (N = 642) received a 26-page self-help booklet and 15 fix SMS within 3 months and chose to receive cognitive behavioral workshop (N = 76), or face-to-face counseling (N = 11), or group health talk (N = 516), or telephone counseling (N = 39). Twenty participants were interviewed individually for their opinions about the interventions. By intention-to-treat, the overall self-reported past 7-day point prevalence quit rate was 31.0% and 32.9%, and reduction rate was 15.0% and 13.2% at 6 and 12-months, respectively. More than 20% of the unmotivated smokers at baseline (N = 399) quit in this program. Proactive outreach workplace smoking cessation programs with diverse intensity but without medications, chosen by smokers and supported by employers without further incentives, were feasible in busy working environment in Hong Kong.

  15. How a high working memory capacity can increase proactive interference.

    Science.gov (United States)

    Steinwascher, Merle A; Meiser, Thorsten

    2016-08-01

    Previous findings suggested that a high working memory capacity (WMC) is potentially associated with a higher susceptibility to proactive interference (PI) if the latter is measured under high cognitive load. To explain such a finding, we propose to consider susceptibility to PI as a net effect of individual executive processes and the intrinsic potential for PI. With the latter, we refer to the amount of information that is activated at a given time and that has the potential to exert PI subsequently. In two studies deploying generalized linear mixed models, susceptibility to PI was modeled as the decline of performance over trials of a complex span task. The results revealed that a higher WMC was associated with a higher susceptibility to PI. Moreover, the number of stimuli recalled in one trial as a proxy variable for the intrinsic potential for PI negatively affected memory performance in the subsequent trial. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Performance modeling of neighbor discovery in proactive routing protocols

    Directory of Open Access Journals (Sweden)

    Andres Medina

    2011-07-01

    Full Text Available It is well known that neighbor discovery is a critical component of proactive routing protocols in wireless ad hoc networks. However there is no formal study on the performance of proposed neighbor discovery mechanisms. This paper provides a detailed model of key performance metrics of neighbor discovery algorithms, such as node degree and the distribution of the distance to symmetric neighbors. The model accounts for the dynamics of neighbor discovery as well as node density, mobility, radio and interference. The paper demonstrates a method for applying these models to the evaluation of global network metrics. In particular, it describes a model of network connectivity. Validation of the models shows that the degree estimate agrees, within 5% error, with simulations for the considered scenarios. The work presented in this paper serves as a basis for the performance evaluation of remaining performance metrics of routing protocols, vital for large scale deployment of ad hoc networks.

  17. Increased susceptibility to proactive interference in adults with dyslexia?

    Science.gov (United States)

    Bogaerts, Louisa; Szmalec, Arnaud; Hachmann, Wibke M; Page, Mike P A; Woumans, Evy; Duyck, Wouter

    2015-01-01

    Recent findings show that people with dyslexia have an impairment in serial-order memory. Based on these findings, the present study aimed to test the hypothesis that people with dyslexia have difficulties dealing with proactive interference (PI) in recognition memory. A group of 25 adults with dyslexia and a group of matched controls were subjected to a 2-back recognition task, which required participants to indicate whether an item (mis)matched the item that had been presented 2 trials before. PI was elicited using lure trials in which the item matched the item in the 3-back position instead of the targeted 2-back position. Our results demonstrate that the introduction of lure trials affected 2-back recognition performance more severely in the dyslexic group than in the control group, suggesting greater difficulty in resisting PI in dyslexia.

  18. Item-specific proactive interference in olfactory working memory.

    Science.gov (United States)

    Moss, Andrew; Miles, Christopher; Elsley, Jane; Johnson, Andrew

    2018-04-01

    We examine item-specific olfactory proactive interference (PI) effects and undertake comparisons with verbal and non-verbal visual stimuli. Using a sequential recent-probes task, we show no evidence for PI with hard-to-name odours (Experiment 1). However, verbalisable odours do exhibit PI effects (Experiment 2). These findings occur despite above chance performance and similar serial position functions across both tasks. Experiments 3 and 4 apply words and faces, respectively, to our modified procedure, and show that methodological differences cannot explain the null finding in Experiment 1. The extent to which odours exhibit analogous PI effects to that of other modalities is, we argue, contingent on the characteristics of the odours employed.

  19. Prevention Strategies Against HIV Transmission: A Proactive Approach.

    Science.gov (United States)

    Carrion, Antonio J; Miles, Jovan D; Mosley, Juan F; Smith, Lillian L; Prather, April S; Gurley, Marcus M; Phan, Linh D; Everton, Emily C

    2018-02-01

    Human immunodeficiency virus (HIV) has now transformed into a manageable chronic condition. Highly active antiretroviral therapy (HAART) has proven efficacious at controlling the disease progression. Based on compelling evidence, the Department of Health and Human Services (DHHS) and the Infectious Disease Society of America (IDSA) developed guidelines for the management of persons infected with HIV. However, there are approximately 50 000 new cases of HIV in the United States each year. In this article, we review proactive methods to reduce the transmission of HIV, which include reinforcing patient education, gel-coated condoms that destroy HIV, HIV vaccinations, and adequately utilizing pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Further development and consistent utilization of innovative prevention tools can significantly reduce the incidence of HIV infections regardless of HIV status.

  20. Cleared risks? Proactive strategies as service in Cloud Computing contexts

    Directory of Open Access Journals (Sweden)

    Manuela Moro-Cabero

    2018-02-01

    Full Text Available The increasing use of Cloud Computing services at organizations is an undeniable reality nowadays. Record managers must then adopt a proactive and compromised position, giving advice to users. However, as a consequence of lack of knowledge in the function and regulation of the field, the implementation of those services faces no little confrontation. This descriptive essay, supported by a relevant number of heterogeneous resources, systematizes the menaces of managing and storing information with these services. At the same time, the study establishes a set of action-strategies for both reaching and hiring agreements. The objective of the paper is, therefore, to make the professional aware of the potential of these services as assessing and controlling tools, as well as ensuring the digital continuity and the record resources preservation in the Cloud.

  1. Making things happen through challenging goals: leader proactivity, trust, and business-unit performance.

    Science.gov (United States)

    Crossley, Craig D; Cooper, Cecily D; Wernsing, Tara S

    2013-05-01

    Building on decades of research on the proactivity of individual performers, this study integrates research on goal setting and trust in leadership to examine manager proactivity and business unit sales performance in one of the largest sales organizations in the United States. Results of a moderated-mediation model suggest that proactive senior managers establish more challenging goals for their business units (N = 50), which in turn are associated with higher sales performance. We further found that employees' trust in the manager is a critical contingency variable that facilitates the relationship between challenging sales goals and subsequent sales performance. This research contributes to growing literatures on trust in leadership and proactivity by studying their joint effects at a district-unit level of analysis while identifying district managers' tendency to set challenging goals as a process variable that helps translate their proactivity into the collective performance of their units. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  2. Flexible and Scalable Data Fusion using Proactive, Schemaless Information Services

    Energy Technology Data Exchange (ETDEWEB)

    Widener, Patrick M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Scalable System Software Dept.

    2014-05-01

    Exascale data environments are fast approaching, driven by diverse structured and unstructured data such as system and application telemetry streams, open-source information capture, and on-demand simulation output. Storage costs having plummeted, the question is now one of converting vast stores of data to actionable information. Complicating this problem are the low degrees of awareness across domain boundaries about what potentially useful data may exist, and write-once-read- never issues (data generation/collection rates outpacing data analysis and integration rates). Increasingly, technologists and researchers need to correlate previously unrelated data sources and artifacts to produce fused data views for domain-specific purposes. New tools and approaches for creating such views from vast amounts of data are vitally important to maintaining research and operational momentum. We propose to research and develop tools and services to assist in the creation, refinement, discovery and reuse of fused data views over large, diverse collections of heterogeneously structured data. We innovate in the following ways. First, we enable and encourage end-users to introduce customized index methods selected for local benefit rather than for global interaction (flexible multi-indexing). We envision rich combinations of such views on application data: views that span backing stores with different semantics, that introduce analytic methods of indexing, and that define multiple views on individual data items. We specifically decline to build a big fused database of everything providing a centralized index over all data, or to export a rigid schema to all comers as in federated query approaches. Second, we proactively advertise these application-specific views so that they may be programmatically reused and extended (data proactivity). Through this mechanism, both changes in state (new data in existing view collected) and changes in structure (new or derived view exists) are

  3. Flexible and Scalable Data Fusion using Proactive Schemaless Information Services

    Energy Technology Data Exchange (ETDEWEB)

    Widener, Patrick [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-05-01

    Exascale data environments are fast approaching, driven by diverse structured and unstructured data such as system and application telemetry streams, open-source information capture, and on-demand simulation output. Storage costs having plummeted, the question is now one of converting vast stores of data to actionable information. Complicating this problem are the low degrees of awareness across domain boundaries about what potentially useful data may exist, and write-once- read-never issues (data generation/collection rates outpacing data analysis and integration rates). Increasingly, technologists and researchers need to correlate previously unrelated data sources and artifacts to produce fused data views for domain-specific purposes. New tools and approaches for creating such views from vast amounts of data are vitally important to maintaining research and operational momentum. We propose to research and develop tools and services to assist in the creation, refinement, discovery and reuse of fused data views over large, diverse collections of heterogeneously structured data. We innovate in the following ways. First, we enable and encourage end-users to introduce customized index methods selected for local benefit rather than for global interaction (flexible multi-indexing). We envision rich combinations of such views on application data: views that span backing stores with different semantics, that introduce analytic methods of indexing, and that define multiple views on individual data items. We specifically decline to build a big fused database of everything providing a centralized index over all data, or to export a rigid schema to all comers as in federated query approaches. Second, we proactively advertise these application-specific views so that they may be programmatically reused and extended (data proactivity). Through this mechanism, both changes in state (new data in existing view collected) and changes in structure (new or derived view exists) are

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

    Science.gov (United States)

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

    2016-12-01

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

  5. Dentists' Preferences for Diagnosis, Management and Referral of Chronic Oro-Facial Pain: Results from a National Survey

    Science.gov (United States)

    Aggarwal, Vishal R.; Joughin, Amy; Zakrzewska, Joanna; Appelbe, Priscilla; Tickle, Martin

    2012-01-01

    Aim: To explore the diagnosis, treatment and referral patterns of chronic oro-facial pain patients by generalist primary care dentists (GDPs) in the UK. Methods: A cross-sectional survey was conducted using a non-stratified random sample of 500 GDPs who were selected from the General Dental Council register. A self-complete postal questionnaire…

  6. Is Strategic Proactivity a Driver of an Environmental Strategy? Effects of Innovation and Internationalization Leadership

    Directory of Open Access Journals (Sweden)

    Ines Suarez-Perales

    2017-10-01

    Full Text Available This study analyses strategic proactivity as a driving factor in the implementation of an advanced environmental strategy in a firm. Strategic proactivity is defined as a firm’s tendency to initiate voluntary changes instead of reacting to events in the environment and according to previous literature, can be interpreted as a combination of internal factors that characterise a firm’s business strategy as that of a prospector firm. In this study, we measured this through innovation, with two variables related to the firm’s entire production cycle: R&D expenditure and patents. However, we also considered two more strategic proactivity indicators: innovation proactivity and internationalisation proactivity. These two proactivity variables take into account the innovative and international actions of the firms, going beyond the actions usually taken by firms in the same sector. Using panel data methodology, we obtained results that show that firms who invest in R&D and patent their innovations achieve more advanced positions in their environmental strategies. Empirical evidence also shows that firms with a greater innovation effort throughout the production cycle (product, process, organisation and marketing than their competitors also attain more advanced positions (proactivity in environmental matters. In other words, innovation proactivity is a driver of environmental strategy. In relation to internationalization, the results also showed that firms that operate in a larger geographical area than their competitors adapt to the most demanding environmental legislation, placing them in a position of environmental leadership in their respective sectors. The inclusion of internationalization as an indicator of strategic proactivity, the measurement of proactivity variables and the correction of firms’ specific unobserved aspects are some of this paper’s contributions.

  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. User satisfaction with referrals at a collaborative virtual reference service Virtual reference services, Reference services, Referrals, User satisfaction

    Directory of Open Access Journals (Sweden)

    Nahyun Kwon

    2006-01-01

    Full Text Available Introduction. This study investigated unmonitored referrals in a nationwide, collaborative chat reference service. Specifically, it examined the extent to which questions are referred, the types of questions that are more likely to be referred than others, and the level of user satisfaction with the referrals in the collaborative chat reference service. Method. The data analysed for this study were 420 chat reference transaction transcripts along with corresponding online survey questionnaires submitted by the service users. Both sets of data were collected from an electronic archive of a southeastern state public library system that has participated in 24/7 Reference of the Metropolitan Cooperative Library System (MCLS. Results. Referrals in the collaborative chat reference service comprised approximately 30% of the total transactions. Circulation-related questions were the most often referred among all question types, possibly because of the inability of 'outside' librarians to access patron accounts. Most importantly, user satisfaction with referrals was found to be significantly lower than that of completed answers. Conclusion. The findings of this study addressed the importance of distinguishing two types of referrals: the expert research referrals conducive to collaborative virtual reference services; and the re-directional local referrals that increase unnecessary question traffic, thereby being detrimental to effective use of collaborative reference. Continuing efforts to conceptualize referrals in multiple dimensions are anticipated to fully grasp complex phenomena underlying referrals.

  9. Managing outpatient consultations: from referral to discharge.

    Science.gov (United States)

    Mitchell, Rachael; Jacob, Hannah; Morrissey, Benita; Macaulay, Chloe; Gomez, Kumudini; Fertleman, Caroline

    2017-08-01

    Although a great deal of paediatric consultations are not urgent, doctors in training spend so much time providing service for acute conditions that they spend little time focusing on outpatient work before they become a consultant. Engaging clinicians in the managerial aspects of providing clinical care is a key to improving outcomes, and this article addresses these aspects of the outpatient consultation from referral to discharge. We aim to provide doctors in training with a tool to use during their training and their first few years as a consultant, to think about how outpatient work is organised and how it can be improved to maximise patient experience. The non-urgent consultation varies across the world; this article is aimed to be relevant to an international audience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Proactivity directed toward the team and organization : the role of leadership, commitment and role-breadth self-efficacy

    OpenAIRE

    Strauss, Karoline; Griffin, Mark A.; Rafferty, Alannah E.

    2009-01-01

    Employees' proactive behaviour is increasingly important for organizations seeking to adapt in uncertain economic environments. This study examined the link between leadership and proactive behaviour. We differentiated between organizational leadership and team leadership and proposed that transformational leadership by team leaders would enhance commitment to the team, which would predict team member proactivity. In contrast, transformational leadership by leaders of the organization would e...

  11. 7 CFR 3.21 - Referrals of Debts to Justice.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Referrals of Debts to Justice. 3.21 Section 3.21... and Compromise of Claims § 3.21 Referrals of Debts to Justice. An agency shall promptly refer to Justice for litigation debts on which aggressive collection activity has been taken in accordance with...

  12. 5 CFR 177.108 - Referral to Department of Justice.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Referral to Department of Justice. 177... ADMINISTRATIVE CLAIMS UNDER THE FEDERAL TORT CLAIMS ACT § 177.108 Referral to Department of Justice. When Department of Justice approval or consultation is required, or the advice of the Department of Justice is...

  13. 44 CFR 11.17 - Referral to Department of Justice.

    Science.gov (United States)

    2010-10-01

    ... Justice. 11.17 Section 11.17 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Referral to Department of Justice. When Department of Justice approval or consultation is required under § 11.16, the referral or request shall be transmitted to the Department of Justice by the Chief Counsel...

  14. 40 CFR 1620.8 - Referral to Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Referral to Department of Justice... ADMINISTRATIVE CLAIMS ARISING UNDER THE FEDERAL TORT CLAIMS ACT § 1620.8 Referral to Department of Justice. When Department of Justice approval or consultation is required, or the advice of the Department of Justice is...

  15. Why Doctors Do Not Answer Referral Letters | Smith | South African ...

    African Journals Online (AJOL)

    Background: Healthcare workers at primary healthcare (PHC) clinics are frustrated by the fact that they do not receive replies to their referral letters to doctors. Referral letters act as permission slips to allow patients easy access to treatment by specialists at secondary and tertiary service levels and communicate reasons for ...

  16. 10 CFR 820.72 - Referral to the Attorney General.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Referral to the Attorney General. 820.72 Section 820.72... Referral to the Attorney General. If there is reason to believe a criminal violation of the Act or the DOE Nuclear Safety Requirements has occurred, DOE may refer the matter to the Attorney General of the United...

  17. 29 CFR 1601.29 - Referral to the Attorney General.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Referral to the Attorney General. 1601.29 Section 1601.29... of Civil Actions § 1601.29 Referral to the Attorney General. If the Commission is unable to obtain... shall inform the Attorney General of the appropriate facts in the case with recommendations for the...

  18. 24 CFR 107.65 - Referral to the Attorney General.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Referral to the Attorney General... Referral to the Attorney General. If the results of a complaint investigation or a compliance review... appropriate cases shall recommend that the General Counsel refer the case to the Attorney General of the...

  19. 10 CFR 430.54 - Referral to the Attorney General.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Referral to the Attorney General. 430.54 Section 430.54... Business Exemptions § 430.54 Referral to the Attorney General. Notice of the application for exemption under this subpart shall be transmitted to the Attorney General by the Secretary and shall contain (a) a...

  20. Referral letters to the psychiatrist in Nigeria: is communication ...

    African Journals Online (AJOL)

    Result: A majority (>80%) of the referral letters had no information on the current medication list, relevant psychosocial history, outline of management to date, results of investigations to date, and known allergies. Conclusion: Deficits in communication or information transfer through referral letters to the psychiatrist are ...

  1. 8 CFR 1235.6 - Referral to immigration judge.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Referral to immigration judge. 1235.6 Section 1235.6 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS INSPECTION OF PERSONS APPLYING FOR ADMISSION § 1235.6 Referral to immigration judge...

  2. Referral letters to the psychiatrist in Nigeria: is communication ...

    African Journals Online (AJOL)

    history, may not be elements that non-psychiatrist phy- sicians routinely collect during their examinations and, therefore, one would not expect such information to be available to be included in referral letters. Conclusion. Deficits in communication or information transfer through referral letters to the psychiatrist are common.

  3. Quality of psychiatric referrals to secondary-level care | Struwig ...

    African Journals Online (AJOL)

    Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system ...

  4. Open-access ultrasound referrals from general practice.

    LENUS (Irish Health Repository)

    Hughes, P

    2015-03-01

    Direct access referral for radiological investigations from General Practice (GP) provides an indispensable diagnostic tool and avoids the inherently long waiting time that referral through a hospital based specialty would entail. Improving access to hospital based radiology services is one of Health Information and Quality Authority\\'s key recommendations in its report on patient referrals from general practice. This study aimed to review all GP referrals for ultrasound investigations to a tertiary referral teaching hospital over a seven month period with respect to their demographics, waiting times and diagnostic outcomes. 1,090 ultrasounds originating in general practice were carried out during the study period. Positive findings were recorded in 332 (30.46%) examinations. The median waiting time from receipt of referral to the diagnostic investigation was 56 days (range 16 - 91 years). 71 (6.5%) patients had follow-up imaging investigations while recommendation for hospital based specialty referral was made in 35 cases (3.2%). Significant findings included abdominal aortic aneurysms, metastatic disease and lymphoma. Direct access to ultrasound for general practitioners allows the referring physician to make an informed decision with regard to the need for specialist referral. We believe these findings help support the case for national direct access to diagnostic ultrasound for general practitioners.

  5. User Satisfaction with Referrals at a Collaborative Virtual Reference Service

    Science.gov (United States)

    Kwon, Nahyun

    2006-01-01

    Introduction: This study investigated unmonitored referrals in a nationwide, collaborative chat reference service. Specifically, it examined the extent to which questions are referred, the types of questions that are more likely to be referred than others, and the level of user satisfaction with the referrals in the collaborative chat reference…

  6. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Objective: To review the management of childhood intussusception at the Moi Teaching and Referral Hospital, Eldoret and identify factors that require attention for improved outcome. Design: A retrospective descriptive study covering the period January 2000 to December 2003. Setting: Moi Teaching and Referral Hospital, ...

  7. 45 CFR 1619.3 - Referral to the Corporation.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Referral to the Corporation. 1619.3 Section 1619.3 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION DISCLOSURE OF INFORMATION § 1619.3 Referral to the Corporation. If a person requests information, not required...

  8. Are Empowered Employees More Proactive? The Contingency of How They Evaluate Their Leader.

    Science.gov (United States)

    Yin, Kui; Xing, Lu; Li, Can; Guo, Yungui

    2017-01-01

    Finding ways to enhance employee proactive behavior is a focal concern for academics and practitioners. Previous studies have found a positive association between empowering leadership and proactive behavior (Martin et al., 2013; Li et al., 2017). However, these studies lack elaboration on mechanisms and do not rule out the effect of employees' proactive personality during empirical testing. We investigate empowering leadership from individual perspective due to the variation of empowerment levels even in the same team. Our research proposes a more elaborated theoretical model that explains why, and when, empowering leadership might promote employee proactive behavior. Specifically, we examine mediating mechanisms based on social cognitive theory and propose trust in leader competency as boundary condition. Using a sample of 280 leader-follower dyads from a large state-owned Chinese company, our results revealed that (1) empowering leadership was positively related to proactive behavior, with role breadth self-efficacy acting as a mediator for this relationship; (2) employees' trust in leader competency moderated both the empowering leadership-subordinate proactive behavior relationship and the mediating effect of role breadth self-efficacy, such that the empowering leadership-subordinate proactive behavior relationship was weaker, and the mediating effect of role breadth self-efficacy was stronger, for employees with high levels of trust in leader competency.

  9. Are Empowered Employees More Proactive? The Contingency of How They Evaluate Their Leader

    Directory of Open Access Journals (Sweden)

    Kui Yin

    2017-11-01

    Full Text Available Finding ways to enhance employee proactive behavior is a focal concern for academics and practitioners. Previous studies have found a positive association between empowering leadership and proactive behavior (Martin et al., 2013; Li et al., 2017. However, these studies lack elaboration on mechanisms and do not rule out the effect of employees’ proactive personality during empirical testing. We investigate empowering leadership from individual perspective due to the variation of empowerment levels even in the same team. Our research proposes a more elaborated theoretical model that explains why, and when, empowering leadership might promote employee proactive behavior. Specifically, we examine mediating mechanisms based on social cognitive theory and propose trust in leader competency as boundary condition. Using a sample of 280 leader–follower dyads from a large state-owned Chinese company, our results revealed that (1 empowering leadership was positively related to proactive behavior, with role breadth self-efficacy acting as a mediator for this relationship; (2 employees’ trust in leader competency moderated both the empowering leadership–subordinate proactive behavior relationship and the mediating effect of role breadth self-efficacy, such that the empowering leadership–subordinate proactive behavior relationship was weaker, and the mediating effect of role breadth self-efficacy was stronger, for employees with high levels of trust in leader competency.

  10. Proactive effects of memory in young and older adults: The role of change recollection

    Science.gov (United States)

    Wahlheim, Christopher N.

    2015-01-01

    Age-related deficits in episodic memory are sometimes attributed to older adults being more susceptible to proactive interference. These deficits have been explained by impaired abilities to inhibit competing information and to recollect target information. In the present article, I propose that a change recollection deficit also contributes to age differences in proactive interference. Change recollection occurs when individuals can remember how information changed across episodes, and this counteracts proactive interference by preserving the temporal order of information. Three experiments were conducted to determine whether older adults are less likely to counteract proactive interference by recollecting change. Paired-associate learning paradigms with two lists of word pairs included pairs that repeated across lists, pairs that only appeared in List 2 (control items), and pairs with cues that repeated and responses that changed across lists. Young and older adults’ abilities to detect changed pairs in List 2 and to later recollect those changes at test were measured, along with cued recall of the List 2 responses and confidence in recall performance. Change recollection produced proactive facilitation in the recall of changed pairs, whereas the failure to recollect change resulted in proactive interference. Confidence judgments were sensitive to these effects. The critical finding was that older adults recollected change less than did young adults, and this partially explained older adults’ greater susceptibility to proactive interference. These findings have theoretical implications, showing that a change recollection deficit contributes to age-related deficits in episodic memory. PMID:24710672

  11. Are Empowered Employees More Proactive? The Contingency of How They Evaluate Their Leader

    Science.gov (United States)

    Yin, Kui; Xing, Lu; Li, Can; Guo, Yungui

    2017-01-01

    Finding ways to enhance employee proactive behavior is a focal concern for academics and practitioners. Previous studies have found a positive association between empowering leadership and proactive behavior (Martin et al., 2013; Li et al., 2017). However, these studies lack elaboration on mechanisms and do not rule out the effect of employees’ proactive personality during empirical testing. We investigate empowering leadership from individual perspective due to the variation of empowerment levels even in the same team. Our research proposes a more elaborated theoretical model that explains why, and when, empowering leadership might promote employee proactive behavior. Specifically, we examine mediating mechanisms based on social cognitive theory and propose trust in leader competency as boundary condition. Using a sample of 280 leader–follower dyads from a large state-owned Chinese company, our results revealed that (1) empowering leadership was positively related to proactive behavior, with role breadth self-efficacy acting as a mediator for this relationship; (2) employees’ trust in leader competency moderated both the empowering leadership–subordinate proactive behavior relationship and the mediating effect of role breadth self-efficacy, such that the empowering leadership–subordinate proactive behavior relationship was weaker, and the mediating effect of role breadth self-efficacy was stronger, for employees with high levels of trust in leader competency. PMID:29163249

  12. Consultation and referral between physicians in new medical practice environments.

    Science.gov (United States)

    Schaffer, W A; Holloman, F C

    1985-10-01

    The traditional exchange of medical expertise between physicians for patient benefit has been accomplished by referral. Physicians have traditionally decided when and to whom to refer patients. Health care "systems" now dominate medical practice, and their formats can alter spontaneous collegial interaction in referral. Institutional programs now pursue patient referrals as part of a marketing strategy to attract new patients who then become attached to the institution, rather than to a physician. Referral behavior can affect a physician's personal income in prepaid insurance programs where referrals are discouraged. The referring physician may bear legal liability for actions of the consultant. New practice arrangements and affiliations may place physicians in financial conflict-of-interest situations, challenge ethical commitments, and add new moral responsibility.

  13. What Is Engagement? Proactivity as the Missing Link in the HEXACO Model of Personality.

    Science.gov (United States)

    de Vries, Reinout E; Wawoe, Kilian W; Holtrop, Djurre

    2016-04-01

    We tested the hypothesis that proactivity represents the engagement vector in the HEXACO model of personality. Questionnaire data were obtained in five studies, three of which consisted (mostly) of students: Study 1 (N = 188, Mage  = 20.0, 89.4% women), Study 3 (N = 315, Mage  = 20.4, 80.6% women), and Study 4 (N = 309 self-ratings, Mage  = 20.0, 78.3% women; N = 307 other-ratings, Mage  = 24.5, 62.2% women). Participants in the other two studies came from an ISO-certified representative community panel: Study 2 (N = 525, Mage  = 51.2, 52.0% women) and Study 5 (N = 736, Mage  = 42.2, 48.0% women). Proactive Personality and Proactivity were positively related to Extraversion, Conscientiousness, and Openness to Experience, but only weakly related or unrelated to Honesty-Humility, Emotionality, and Agreeableness, supporting the alignment of Proactive Personality/Proactivity with the hypothesized HEXACO engagement vector. Additionally, Proactivity explained incremental variance in self-rated job performance on top of the HEXACO facets that were most closely associated with Proactive Personality/Proactivity, that is, Social Boldness (an Extraversion facet), Diligence (a Conscientiousness facet), and Creativity (an Openness to Experience facet), but not in entrepreneurship and intrapreneurship. Proactivity is the missing engagement link in the HEXACO model of personality. The results are discussed in light of higher-order factors (e.g., general factor of personality and Alpha and Beta) of personality and bandwidth-fidelity controversies. © 2014 Wiley Periodicals, Inc.

  14. The integrated proactive surveillance system for prostate cancer.

    Science.gov (United States)

    Wang, Haibin; Yatawara, Mahendra; Huang, Shao-Chi; Dudley, Kevin; Szekely, Christine; Holden, Stuart; Piantadosi, Steven

    2012-01-01

    In this paper, we present the design and implementation of the integrated proactive surveillance system for prostate cancer (PASS-PC). The integrated PASS-PC is a multi-institutional web-based system aimed at collecting a variety of data on prostate cancer patients in a standardized and efficient way. The integrated PASS-PC was commissioned by the Prostate Cancer Foundation (PCF) and built through the joint of efforts by a group of experts in medical oncology, genetics, pathology, nutrition, and cancer research informatics. Their main goal is facilitating the efficient and uniform collection of critical demographic, lifestyle, nutritional, dietary and clinical information to be used in developing new strategies in diagnosing, preventing and treating prostate cancer.The integrated PASS-PC is designed based on common industry standards - a three tiered architecture and a Service- Oriented Architecture (SOA). It utilizes open source software and programming languages such as HTML, PHP, CSS, JQuery, Drupal and MySQL. We also use a commercial database management system - Oracle 11g. The integrated PASS-PC project uses a "confederation model" that encourages participation of any interested center, irrespective of its size or location. The integrated PASS-PC utilizes a standardized approach to data collection and reporting, and uses extensive validation procedures to prevent entering erroneous data. The integrated PASS-PC controlled vocabulary is harmonized with the National Cancer Institute (NCI) Thesaurus. Currently, two cancer centers in the USA are participating in the integrated PASS-PC project.THE FINAL SYSTEM HAS THREE MAIN COMPONENTS: 1. National Prostate Surveillance Network (NPSN) website; 2. NPSN myConnect portal; 3. Proactive Surveillance System for Prostate Cancer (PASS-PC). PASS-PC is a cancer Biomedical Informatics Grid (caBIG) compatible product. The integrated PASS-PC provides a foundation for collaborative prostate cancer research. It has been built to

  15. A proactive approach to sustainable management of mine tailings

    Science.gov (United States)

    Edraki, Mansour; Baumgartl, Thomas

    2015-04-01

    The reactive strategies to manage mine tailings i.e. containment of slurries of tailings in tailings storage facilities (TSF's) and remediation of tailings solids or tailings seepage water after the decommissioning of those facilities, can be technically inefficient to eliminate environmental risks (e.g. prevent dispersion of contaminants and catastrophic dam wall failures), pose a long term economic burden for companies, governments and society after mine closure, and often fail to meet community expectations. Most preventive environmental management practices promote proactive integrated approaches to waste management whereby the source of environmental issues are identified to help make a more informed decisions. They often use life cycle assessment to find the "hot spots" of environmental burdens. This kind of approach is often based on generic data and has rarely been used for tailings. Besides, life cycle assessments are less useful for designing operations or simulating changes in the process and consequent environmental outcomes. It is evident that an integrated approach for tailings research linked to better processing options is needed. A literature review revealed that there are only few examples of integrated approaches. The aim of this project is to develop new tailings management models by streamlining orebody characterization, process optimization and rehabilitation. The approach is based on continuous fingerprinting of geochemical processes from orebody to tailings storage facility, and benchmark the success of such proactive initiatives by evidence of no impacts and no future projected impacts on receiving environments. We present an approach for developing such a framework and preliminary results from a case study where combined grinding and flotation models developed using geometallurgical data from the orebody were constructed to predict the properties of tailings produced under various processing scenarios. The modelling scenarios based on the

  16. Implications of Lateral Cerebellum in Proactive Control of Saccades.

    Science.gov (United States)

    Kunimatsu, Jun; Suzuki, Tomoki W; Tanaka, Masaki

    2016-06-29

    Although several lines of evidence establish the involvement of the medial and vestibular parts of the cerebellum in the adaptive control of eye movements, the role of the lateral hemisphere of the cerebellum in eye movements remains unclear. Ascending projections from the lateral cerebellum to the frontal and parietal association cortices via the thalamus are consistent with a role of these pathways in higher-order oculomotor control. In support of this, previous functional imaging studies and recent analyses in subjects with cerebellar lesions have indicated a role for the lateral cerebellum in volitional eye movements such as anti-saccades. To elucidate the underlying mechanisms, we recorded from single neurons in the dentate nucleus of the cerebellum in monkeys performing anti-saccade/pro-saccade tasks. We found that neurons in the posterior part of the dentate nucleus showed higher firing rates during the preparation of anti-saccades compared with pro-saccades. When the animals made erroneous saccades to the visual stimuli in the anti-saccade trials, the firing rate during the preparatory period decreased. Furthermore, local inactivation of the recording sites with muscimol moderately increased the proportion of error trials, while successful anti-saccades were more variable and often had shorter latency during inactivation. Thus, our results show that neuronal activity in the cerebellar dentate nucleus causally regulates anti-saccade performance. Neuronal signals from the lateral cerebellum to the frontal cortex might modulate the proactive control signals in the corticobasal ganglia circuitry that inhibit early reactive responses and possibly optimize the speed and accuracy of anti-saccades. Although the lateral cerebellum is interconnected with the cortical eye fields via the thalamus and the pons, its role in eye movements remains unclear. We found that neurons in the caudal part of the lateral (dentate) nucleus of the cerebellum showed the increased

  17. Community care workers, poor referral networks and consumption of personal resources in rural South Africa.

    Directory of Open Access Journals (Sweden)

    Ilona Sips

    Full Text Available Although home-based care (HBC programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs, in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs. An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data - CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25% of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers.

  18. Community care workers, poor referral networks and consumption of personal resources in rural South Africa.

    Science.gov (United States)

    Sips, Ilona; Haeri Mazanderani, Ahmad; Schneider, Helen; Greeff, Minrie; Barten, Francoise; Moshabela, Mosa

    2014-01-01

    Although home-based care (HBC) programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs), in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs). An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data - CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25%) of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers.

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

    Science.gov (United States)

    Jia, Shoumei; Wang, Ling; Shi, Yingjuan

    2014-04-01

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

  20. The Role of Hostile Attributions in the Associations between Child Maltreatment and Reactive and Proactive Aggression

    Science.gov (United States)

    Richey, Allora; Brown, Shaquanna; Fite, Paula J.; Bortolato, Marco

    2017-01-01

    The present study examined the relations between child maltreatment and reactive and proactive functions of aggression, and whether hostile attribution biases partially accounted for these associations in a sample of 339 college students (mean age = 19; 51% male). Child maltreatment was associated with reactive, but not proactive, aggression, and instrumental hostile attribution biases accounted for this association. Relational hostile attributions were correlated with both reactive and proactive aggression, but did not play a role in the link between child maltreatment and reactive aggression. PMID:29386881

  1. LWR aging management using a proactive approach to control materials degradation

    International Nuclear Information System (INIS)

    Bond, L.J.; Doctor, S.R.; Cumblidge, S.E.; Bruemmer, S.M.; Taylor, W.B.; Hull, A.B.; Malik, S.N.

    2009-01-01

    Material issues can be the limiting factor for the operation of nuclear power plants. There is growing interest in new and improved philosophies and methodologies for plant life management (PLiM), which include the migration from reliance on periodic inservice inspection to include condition-based maintenance. A further step in the development of plant management is the move from proactive responses based on ISI to become proactive, through the investigation of the potential for implementation of a proactive management of materials degradation (PMMD) program and its potential impact on the management of LWRs. (author)

  2. Factors influencing adherence to referral advice following pre-referral treatment with artesunate suppositories in children in rural Tanzania.

    Science.gov (United States)

    Simba, Daudi O; Warsame, Marian; Kimbute, Omari; Kakoko, Deodatus; Petzold, Max; Tomson, Goran; Premji, Zul; Gomes, Melba

    2009-07-01

    WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers' adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories. The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions taken post-referral: taking their children to a drug shop, a traditional healer, or not seeking further treatment, and added to a random selection of patients who complied with referral advice. Caretakers of the children were interviewed about their socio-economic status (SES), knowledge about malaria, referral advice given and actions they took following pre-referral treatment. Interview data for 587 caretakers were matched with symptoms of the children, the time of treatment, arrival at a health facility or other actions taken post-pre-referral treatment. The majority (93.5%) of caretakers reported being given referral advice by the community drug dispenser. The odds of adherence with this advice were three times greater for children with altered consciousness and/or convulsions than for children with other symptoms [odds ratio (OR) 3.47, 95% confidence interval (CI) 2.32-5.17, P < 0.001]. When questioned, caretakers who remembered when (OR 2.19, 95% CI 1.48-3.23, P < 0.001) and why (OR 1.77, 95% CI 1.07-2.95, P = 0.026) they were advised to proceed to health facility - were more likely to follow referral advice. Cost did not influence adherence except within a catchment area of facilities that charged for services. In these areas, costs deterred adherence by

  3. The Stoplight Program: A Proactive Physical Therapy Intervention for Children With Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Tanner, Lynn; Sencer, Susan; Hooke, Mary C

    Chemotherapy may cause neuromuscular impairments that can have life-long effects. The Stoplight Program (SLP) was developed as a proactive physical therapy (PT) intervention directed at impairments in children with acute lymphoblastic leukemia (ALL). In this program evaluation, we assessed the feasibility of the SLP delivered as part of standard care and identified body function and activity patterns in patients who received the intervention. Children ages 1 to 22 years, diagnosed with ALL, received an assessment by a physical therapist as part of usual care. The SLP intervention used 3 levels to categorize the impairment levels and intensity of PT. Of the children (n = 135) screened, 46% completed 5 intervention visits and 32% completed the program and met discharge criteria. At initial assessment, 46% of children ages 1 to 5 years and 67% of children ages 6 to 22 years had abnormal motor function. Those completing the program tested within the healthy norms. Research is needed on variables that influence adherence to a PT program and the range of functional impairment and activity limitations in this population.

  4. Recovery from Proactive Semantic Interference and MRI Volume: A Replication and Extension Study.

    Science.gov (United States)

    Loewenstein, David A; Curiel, Rosie E; DeKosky, Steven; Rosselli, Monica; Bauer, Russell; Grieg-Custo, Maria; Penate, Ailyn; Li, Chunfei; Lizagarra, Gabriel; Golde, Todd; Adjouadi, Malek; Duara, Ranjan

    2017-01-01

    The rise in incidence of Alzheimer's disease (AD) has led to efforts to advance early detection of the disease during its preclinical stages. To achieve this, the field needs to develop more sensitive cognitive tests that relate to biological markers of disease pathology. Failure to recover from proactive interference (frPSI) is one such cognitive marker that is associated with volumetric reductions in the hippocampus, precuneus, and other AD-prone regions, and to amyloid load in the brain. The current study attempted to replicate and extend our previous findings that frPSI is a sensitive marker of early AD, and related to a unique pattern of volumetric loss in AD prone areas. Three different memory measures were examined relative to volumetric loss and cortical thickness among 45 participants with amnestic mild cognitive impairment. frPSI was uniquely associated with reduced volumes in the hippocampus (r = 0.50) precuneus (r = 0.41), and other AD prone regions, replicating previous findings. Strong associations between frPSI and lower entorhinal cortex volumes and cortical thickness (r≥0.60) and precuneus (r = 0.50) were also observed. Unique and strong associations between volumetric reductions and frPSI as observed by Loewenstein and colleagues were replicated. Together with cortical thickness findings, these results indicate that frPSI is worthy of further study as a sensitive and early cognitive marker of AD.

  5. Dissociation between working memory performance and proactive interference control in post-traumatic stress disorder.

    Science.gov (United States)

    Swick, Diane; Cayton, Julien; Ashley, Victoria; Turken, And U

    2017-02-01

    Deficits in working memory (WM) and cognitive control processes have been reported in post-traumatic stress disorder (PTSD), in addition to clinical symptoms such as hypervigilance, re-experiencing, and avoidance of trauma reminders. Given the uncontrollable nature of intrusive memories, an important question is whether PTSD is associated with altered control of interference in WM. Some studies also suggest that episodic memory shows a material-specific dissociation in PTSD, with greater impairments in verbal memory and relative sparing of nonverbal memory. It is unclear whether this dissociation applies to WM, as no studies have used identical task parameters across material. Here we tested 29 combat Veterans with PTSD and 29 age-matched control Veterans on a recent probes WM task with words and visual patterns in separate blocks. Participants studied four-item sets, followed by a probe stimulus that had been presented in the previous set (recent probe) or not (nonrecent probe). Participants with PTSD made more errors than controls, and this decrement was similar for verbal and visual stimuli. Proactive interference from items recently presented, but no longer relevant, was not significantly different in the PTSD group and showed no relationship to re-experiencing symptom severity. These results demonstrate that PTSD is not reliably associated with increased intrusions of irrelevant representations into WM when non-emotional stimuli are used. Future studies that use trauma-related material may provide insight into the flashbacks and intrusive thoughts that plague those with PTSD. Published by Elsevier Ltd.

  6. Determining factors for implant referral rates.

    Science.gov (United States)

    Levin, Roger P

    2002-01-01

    The research findings indicate that the field of implant dentistry will only grow at a moderately low level unless certain changes are made. Findings indicated that the effort by the implant companies has been nothing short of dramatic, and yet almost 60% of restorative doctors do not participate annually in any implant case. There was no clear indication that younger restorative doctors will significantly increase the number of implant referrals, as their overall implant education has not dramatically differed from those dentists who graduated in earlier years. Once the research was completed, it became obvious to Levin Group that the driving force behind implant referral growth will be implant surgeons, because of their one-to-one relationship with restorative doctors. The Levin Group Implant Management and Marketing Consulting Program is based on approaching restorative doctors in several different levels, starting with awareness all the way through to case facilitation and long-term tracking and communication. Finally, a continuing marketing/education effort needs to be consistently in place with effective materials, not only to create a high level of awareness, but also to motivate restorative doctors to refer cases and then work through the case with the implant surgeon to a satisfactory completion for the restorative doctor, implant surgeon, and patient. While the surgical insertion of implants may seem to carry a high-profit margin relative to the restoration of implants, the truth is that the restoration of implants usually provides a 40% higher profit margin for the restorative doctor than traditional dental services. One of the key issues is that referring doctors have not necessarily learned how to set fees and present cases with regard to implant dentistry. The key factor here is to ensure that the patient understands that implant services involve higher fees than traditional services, because of the necessarily higher levels of experience, education

  7. A proactive outreach intervention that decreases readmission after hepatectomy.

    Science.gov (United States)

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

    2018-04-01

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

  8. Proactive Supply Chain Performance Management with Predictive Analytics

    Directory of Open Access Journals (Sweden)

    Nenad Stefanovic

    2014-01-01

    Full Text Available Today’s business climate requires supply chains to be proactive rather than reactive, which demands a new approach that incorporates data mining predictive analytics. This paper introduces a predictive supply chain performance management model which combines process modelling, performance measurement, data mining models, and web portal technologies into a unique model. It presents the supply chain modelling approach based on the specialized metamodel which allows modelling of any supply chain configuration and at different level of details. The paper also presents the supply chain semantic business intelligence (BI model which encapsulates data sources and business rules and includes the data warehouse model with specific supply chain dimensions, measures, and KPIs (key performance indicators. Next, the paper describes two generic approaches for designing the KPI predictive data mining models based on the BI semantic model. KPI predictive models were trained and tested with a real-world data set. Finally, a specialized analytical web portal which offers collaborative performance monitoring and decision making is presented. The results show that these models give very accurate KPI projections and provide valuable insights into newly emerging trends, opportunities, and problems. This should lead to more intelligent, predictive, and responsive supply chains capable of adapting to future business environment.

  9. Prediction Based Proactive Thermal Virtual Machine Scheduling in Green Clouds

    Science.gov (United States)

    Kinger, Supriya; Kumar, Rajesh; Sharma, Anju

    2014-01-01

    Cloud computing has rapidly emerged as a widely accepted computing paradigm, but the research on Cloud computing is still at an early stage. Cloud computing provides many advanced features but it still has some shortcomings such as relatively high operating cost and environmental hazards like increasing carbon footprints. These hazards can be reduced up to some extent by efficient scheduling of Cloud resources. Working temperature on which a machine is currently running can be taken as a criterion for Virtual Machine (VM) scheduling. This paper proposes a new proactive technique that considers current and maximum threshold temperature of Server Machines (SMs) before making scheduling decisions with the help of a temperature predictor, so that maximum temperature is never reached. Different workload scenarios have been taken into consideration. The results obtained show that the proposed system is better than existing systems of VM scheduling, which does not consider current temperature of nodes before making scheduling decisions. Thus, a reduction in need of cooling systems for a Cloud environment has been obtained and validated. PMID:24737962

  10. A proactive transfer policy for critical patient flow management.

    Science.gov (United States)

    González, Jaime; Ferrer, Juan-Carlos; Cataldo, Alejandro; Rojas, Luis

    2018-02-17

    Hospital emergency departments are often overcrowded, resulting in long wait times and a public perception of poor attention. Delays in transferring patients needing further treatment increases emergency department congestion, has negative impacts on their health and may increase their mortality rates. A model built around a Markov decision process is proposed to improve the efficiency of patient flows between the emergency department and other hospital units. With each day divided into time periods, the formulation estimates bed demand for the next period as the basis for determining a proactive rather than reactive transfer decision policy. Due to the high dimensionality of the optimization problem involved, an approximate dynamic programming approach is used to derive an approximation of the optimal decision policy, which indicates that a certain number of beds should be kept free in the different units as a function of the next period demand estimate. Testing the model on two instances of different sizes demonstrates that the optimal number of patient transfers between units changes when the emergency patient arrival rate for transfer to other units changes at a single unit, but remains stable if the change is proportionally the same for all units. In a simulation using real data for a hospital in Chile, significant improvements are achieved by the model in key emergency department performance indicators such as patient wait times (reduction higher than 50%), patient capacity (21% increase) and queue abandonment (from 7% down to less than 1%).

  11. Prediction Based Proactive Thermal Virtual Machine Scheduling in Green Clouds

    Directory of Open Access Journals (Sweden)

    Supriya Kinger

    2014-01-01

    Full Text Available Cloud computing has rapidly emerged as a widely accepted computing paradigm, but the research on Cloud computing is still at an early stage. Cloud computing provides many advanced features but it still has some shortcomings such as relatively high operating cost and environmental hazards like increasing carbon footprints. These hazards can be reduced up to some extent by efficient scheduling of Cloud resources. Working temperature on which a machine is currently running can be taken as a criterion for Virtual Machine (VM scheduling. This paper proposes a new proactive technique that considers current and maximum threshold temperature of Server Machines (SMs before making scheduling decisions with the help of a temperature predictor, so that maximum temperature is never reached. Different workload scenarios have been taken into consideration. The results obtained show that the proposed system is better than existing systems of VM scheduling, which does not consider current temperature of nodes before making scheduling decisions. Thus, a reduction in need of cooling systems for a Cloud environment has been obtained and validated.

  12. Prediction based proactive thermal virtual machine scheduling in green clouds.

    Science.gov (United States)

    Kinger, Supriya; Kumar, Rajesh; Sharma, Anju

    2014-01-01

    Cloud computing has rapidly emerged as a widely accepted computing paradigm, but the research on Cloud computing is still at an early stage. Cloud computing provides many advanced features but it still has some shortcomings such as relatively high operating cost and environmental hazards like increasing carbon footprints. These hazards can be reduced up to some extent by efficient scheduling of Cloud resources. Working temperature on which a machine is currently running can be taken as a criterion for Virtual Machine (VM) scheduling. This paper proposes a new proactive technique that considers current and maximum threshold temperature of Server Machines (SMs) before making scheduling decisions with the help of a temperature predictor, so that maximum temperature is never reached. Different workload scenarios have been taken into consideration. The results obtained show that the proposed system is better than existing systems of VM scheduling, which does not consider current temperature of nodes before making scheduling decisions. Thus, a reduction in need of cooling systems for a Cloud environment has been obtained and validated.

  13. Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies

    Science.gov (United States)

    Scruggs, Caroline E.; Van Buren, Harry J.

    2014-01-01

    Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood. PMID:27471326

  14. Proactive aquatic ecotoxicological assessment of room-temperature ionic liquids

    Science.gov (United States)

    Kulacki, K.J.; Chaloner, D.T.; Larson, J.H.; Costello, D.M.; Evans-White, M. A.; Docherty, K.M.; Bernot, R.J.; Brueseke, M.A.; Kulpa, C.F.; Lamberti, G.A.

    2011-01-01

    Aquatic environments are being contaminated with a myriad of anthropogenic chemicals, a problem likely to continue due to both unintentional and intentional releases. To protect valuable natural resources, novel chemicals should be shown to be environmentally safe prior to use and potential release into the environment. Such proactive assessment is currently being applied to room-temperature ionic liquids (ILs). Because most ILs are water-soluble, their effects are likely to manifest in aquatic ecosystems. Information on the impacts of ILs on numerous aquatic organisms, focused primarily on acute LC50 and EC50 endpoints, is now available, and trends in toxicity are emerging. Cation structure tends to influence IL toxicity more so than anion structure, and within a cation class, the length of alkyl chain substituents is positively correlated with toxicity. While the effects of ILs on several aquatic organisms have been studied, the challenge for aquatic toxicology is now to predict the effects of ILs in complex natural environments that often include diverse mixtures of organisms, abiotic conditions, and additional stressors. To make robust predictions about ILs will require coupling of ecologically realistic laboratory and field experiments with standard toxicity bioassays and models. Such assessments would likely discourage the development of especially toxic ILs while shifting focus to those that are more environmentally benign. Understanding the broader ecological effects of emerging chemicals, incorporating that information into predictive models, and conveying the conclusions to those who develop, regulate, and use those chemicals, should help avoid future environmental degradation. ?? 2011 Bentham Science Publishers Ltd.

  15. Proactive AP Selection Method Considering the Radio Interference Environment

    Science.gov (United States)

    Taenaka, Yuzo; Kashihara, Shigeru; Tsukamoto, Kazuya; Yamaguchi, Suguru; Oie, Yuji

    In the near future, wireless local area networks (WLANs) will overlap to provide continuous coverage over a wide area. In such ubiquitous WLANs, a mobile node (MN) moving freely between multiple access points (APs) requires not only permanent access to the Internet but also continuous communication quality during handover. In order to satisfy these requirements, an MN needs to (1) select an AP with better performance and (2) execute a handover seamlessly. To satisfy requirement (2), we proposed a seamless handover method in a previous study. Moreover, in order to achieve (1), the Received Signal Strength Indicator (RSSI) is usually employed to measure wireless link quality in a WLAN system. However, in a real environment, especially if APs are densely situated, it is difficult to always select an AP with better performance based on only the RSSI. This is because the RSSI alone cannot detect the degradation of communication quality due to radio interference. Moreover, it is important that AP selection is completed only on an MN, because we can assume that, in ubiquitous WLANs, various organizations or operators will manage APs. Hence, we cannot modify the APs for AP selection. To overcome these difficulties, in the present paper, we propose and implement a proactive AP selection method considering wireless link condition based on the number of frame retransmissions in addition to the RSSI. In the evaluation, we show that the proposed AP selection method can appropriately select an AP with good wireless link quality, i.e., high RSSI and low radio interference.

  16. Effects of proactive interference on non-verbal working memory.

    Science.gov (United States)

    Cyr, Marilyn; Nee, Derek E; Nelson, Eric; Senger, Thea; Jonides, John; Malapani, Chara

    2017-02-01

    Working memory (WM) is a cognitive system responsible for actively maintaining and processing relevant information and is central to successful cognition. A process critical to WM is the resolution of proactive interference (PI), which involves suppressing memory intrusions from prior memories that are no longer relevant. Most studies that have examined resistance to PI in a process-pure fashion used verbal material. By contrast, studies using non-verbal material are scarce, and it remains unclear whether the effect of PI is domain-general or whether it applies solely to the verbal domain. The aim of the present study was to examine the effect of PI in visual WM using both objects with high and low nameability. Using a Directed-Forgetting paradigm, we varied discriminability between WM items on two dimensions, one verbal (high-nameability vs. low-nameability objects) and one perceptual (colored vs. gray objects). As in previous studies using verbal material, effects of PI were found with object stimuli, even after controlling for verbal labels being used (i.e., low-nameability condition). We also found that the addition of distinctive features (color, verbal label) increased performance in rejecting intrusion probes, most likely through an increase in discriminability between content-context bindings in WM.

  17. Auditory memory in monkeys: costs and benefits of proactive interference.

    Science.gov (United States)

    Bigelow, James; Poremba, Amy

    2013-05-01

    Proactive interference (PI) has traditionally been understood as an adverse consequence of stimulus repetition during memory tasks. Herein, we present data that emphasize costs as well as benefits of PI for monkeys performing an auditory delayed matching-to-sample (DMTS) task. The animals made same/different judgments for a variety of simple and complex sounds separated by a 5-s memory delay. Each session used a stimulus set that included eight sounds; thus, each sound was repeated multiple times per session for match trials and for nonmatch trials as the sample (Cue 1) or test (Cue 2) stimulus. For nonmatch trials, performance was substantially diminished when the test stimulus had been previously presented on a recent trial. However, when the sample stimulus had been recently presented, performance was significantly improved. We also observed a marginal performance benefit when stimuli for match trials had been recently presented. The costs of PI for nonmatch test stimuli were greater than the combined benefits of PI for nonmatch sample stimuli and match trials, indicating that the net influence of PI is detrimental. For all three manifestations of PI, the effects are shown to extend beyond the immediately subsequent trial. Our data suggest that PI in auditory DMTS is best understood as an enduring influence that can be both detrimental and beneficial to memory-task performance. © 2012 Wiley Periodicals, Inc.

  18. Proactive Supply Chain Performance Management with Predictive Analytics

    Science.gov (United States)

    Stefanovic, Nenad

    2014-01-01

    Today's business climate requires supply chains to be proactive rather than reactive, which demands a new approach that incorporates data mining predictive analytics. This paper introduces a predictive supply chain performance management model which combines process modelling, performance measurement, data mining models, and web portal technologies into a unique model. It presents the supply chain modelling approach based on the specialized metamodel which allows modelling of any supply chain configuration and at different level of details. The paper also presents the supply chain semantic business intelligence (BI) model which encapsulates data sources and business rules and includes the data warehouse model with specific supply chain dimensions, measures, and KPIs (key performance indicators). Next, the paper describes two generic approaches for designing the KPI predictive data mining models based on the BI semantic model. KPI predictive models were trained and tested with a real-world data set. Finally, a specialized analytical web portal which offers collaborative performance monitoring and decision making is presented. The results show that these models give very accurate KPI projections and provide valuable insights into newly emerging trends, opportunities, and problems. This should lead to more intelligent, predictive, and responsive supply chains capable of adapting to future business environment. PMID:25386605

  19. Proactive supply chain performance management with predictive analytics.

    Science.gov (United States)

    Stefanovic, Nenad

    2014-01-01

    Today's business climate requires supply chains to be proactive rather than reactive, which demands a new approach that incorporates data mining predictive analytics. This paper introduces a predictive supply chain performance management model which combines process modelling, performance measurement, data mining models, and web portal technologies into a unique model. It presents the supply chain modelling approach based on the specialized metamodel which allows modelling of any supply chain configuration and at different level of details. The paper also presents the supply chain semantic business intelligence (BI) model which encapsulates data sources and business rules and includes the data warehouse model with specific supply chain dimensions, measures, and KPIs (key performance indicators). Next, the paper describes two generic approaches for designing the KPI predictive data mining models based on the BI semantic model. KPI predictive models were trained and tested with a real-world data set. Finally, a specialized analytical web portal which offers collaborative performance monitoring and decision making is presented. The results show that these models give very accurate KPI projections and provide valuable insights into newly emerging trends, opportunities, and problems. This should lead to more intelligent, predictive, and responsive supply chains capable of adapting to future business environment.

  20. The Instruments of Management of the Proactive Development of Enterprise

    Directory of Open Access Journals (Sweden)

    Feshchur Roman V.

    2018-02-01

    Full Text Available The article considers the process and develops the conception of management of the proactive development of enterprises. The main instruments of management of enterprises’ development have been allocated on the system, process, and micro-process levels. The economic-mathematical model of formation of the optimal program of enterprise’s development has been built with reflection of interests of the most significant stakeholders and the basic types of projects which are combined in the program of development of enterprise. Taking account of the peculiarities of activity together with the objectives of industrial enterprises’ development, the following groups of projects are selected: technical and technological, providing for the change of the level of technology at the enterprise; productive, aimed at quantitative and qualitative change of production of enterprise, increase of its competitiveness; organizational, leading to changes in the organization, structure, and management of enterprise. The choice of the most acceptable private optimal program of enterprise’s development is carried out using the matrix method. According to this method, the absolute values of indicators of the socio-economic development of enterprises become relative with the subsequent transition to the definition of integral estimates for each program. It is also possible to use the methods of compromise programming that allow to obtain a Pareto-optimal solution.

  1. Why Leading Consumer Product Companies Develop Proactive Chemical Management Strategies.

    Science.gov (United States)

    Scruggs, Caroline E; Van Buren, Harry J

    2016-05-01

    Scholars have studied the various pressures that companies face related to socially responsible behavior when stakeholders know the particular social issues under consideration. Many have examined social responsibility in the context of environmental responsibility and the general approaches companies take regarding environmental management. The issue of currently unregulated, but potentially hazardous, chemicals in consumer products is not well understood by the general public, but a number of proactive consumer product companies have voluntarily adopted strategies to minimize use of such chemicals. These companies are exceeding regulatory requirements by restricting from their products chemicals that could harm human or environmental health, despite the fact that these actions are costly. They do not usually advertise the details of their strategies to end consumers. This article uses interviews with senior environmental directors of 20 multinational consumer product companies to investigate why these companies engage in voluntary chemicals management. The authors conclude that the most significant reasons are to achieve a competitive advantage and stay ahead of regulations, manage relationships and maintain legitimacy with stakeholders, and put managerial values into practice. Many of the characteristics related to the case of chemicals management are extendable to other areas of stakeholder management in which risks to stakeholders are either unknown or poorly understood.

  2. Proactive pavement asset management with climate change aspects

    Science.gov (United States)

    Zofka, Adam

    2018-05-01

    Pavement Asset Management System is a systematic and objective tool to manage pavement network based on the rational, engineering and economic principles. Once implemented and mature Pavement Asset Management System serves the entire range of users starting with the maintenance engineers and ending with the decision-makers. Such a system is necessary to coordinate agency management strategy including proactive maintenance. Basic inputs in the majority of existing Pavement Asset Management System approaches comprise the actual pavement inventory with associated construction history and condition, traffic information as well as various economical parameters. Some Pavement Management System approaches include also weather aspects which is of particular importance considering ongoing climate changes. This paper presents challenges in implementing the Pavement Asset Management System for those National Road Administrations that manage their pavement assets using more traditional strategies, e.g. worse-first approach. Special considerations are given to weather-related inputs and associated analysis to demonstrate the effects of climate change in a short- and long-term range. Based on the presented examples this paper concludes that National Road Administrations should account for the weather-related factors in their Pavement Management Systems as this has a significant impact on the system outcomes from the safety and economical perspective.

  3. [Urine incontinence referral criteria for primary care].

    Science.gov (United States)

    Brenes Bermúdez, F J; Cozar Olmo, J M; Esteban Fuertes, M; Fernández-Pro Ledesma, A; Molero García, J M

    2013-05-01

    Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Changing patterns of clinical PET use - 5 years on

    International Nuclear Information System (INIS)

    Binns, D.; Hicks, R.J.

    2002-01-01

    Full text: Increasing clinical awareness and acceptance of the clinical role of positron emission tomography (PET) has the potential to alter patterns of referral. To assess whether patterns of referral are changing in response to greater experience with this technique, we reviewed indications of new referrals to our facility for each of the past 5 years of operation. Of more than 6,183 studies performed since our facility began operation in September 1996, 4,401 were initial referrals. Of these referrals the most common indications were carcinoma of the lung (n = 970, 22.0 %), colorectal cancer (n = 631, 14.3 %), malignant melanoma (n = 506, 11.5 %), genito-urinary tract cancer (n = 427, 9.7 %), epilepsy (n = 366, 8.3 %), and lymphoma (n = 351, 8.0 %). Referrals for all these indications, other than malignant melanoma, continued to grow in absolute terms throughout the 5 year interval but in relative terms only lung cancer maintained a similar proportion of scans reflecting an expansion of other referral indications. Evaluation of intractable partial complex seizures demonstrated the most marked growth in both absolute and relative terms. Conversely, malignant melanoma referrals declined as patients with thick melanoma began to have sentinel lymph node biopsy rather than PET as their initial staging investigation. Our experience suggests that clinical PET referrals reflect the expanding evidence-base regarding both the strengths and weaknesses of PET. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

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

    Science.gov (United States)

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

    2009-01-01

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

  6. Post engineered nanomaterials lifespan: nanowastes classification, legislative development/implementation challenges, and proactive approaches

    CSIR Research Space (South Africa)

    Musee, N

    2012-05-01

    Full Text Available -1 NANOLCA Symposium, "Safety issues and regulatory challenges of nanomaterials", San Sebastian, Spain, 3-4 May 2012 Post engineered nanomaterials lifespan: nanowastes classification, legislative development/implementation challenges, and proactive...

  7. Bleaching and secondary threats on the corals of Palk Bay: A survey and Proactive conservation needs

    Digital Repository Service at National Institute of Oceanography (India)

    Ravindran, J.; Kannapiran, E.; Manikandan, B.; ManiMurali, R.; Joseph, A.

    and altered environmental conditions warrant the proactive conservation approach guided by scientific principles. Current conservation methods in India offers physical protection to corals by entry restriction and a ban on collection of corals under wild life...

  8. The role of organizational insiders' developmental feedback and proactive personality on newcomers' performance: an interactionist perspective.

    Science.gov (United States)

    Li, Ning; Harris, T Brad; Boswell, Wendy R; Xie, Zhitao

    2011-11-01

    Drawing from an interactionist approach and feedback research, we examine the role of developmental feedback and proactive personality on newcomer task performance and helping behavior. Data were collected from 2 high-tech joint-ventures within the information technology and manufacturing industries located in Shanghai, China. Results based on 151 newcomer-manager dyads showed that supervisor developmental feedback (SDF) positively related to newcomer helping behavior and that SDF and coworker developmental feedback interactively predicted newcomer task performance. We also found differential moderating effects of proactive personality: SDF more strongly related to helping behavior when proactive personality was lower; conversely, coworker developmental feedback more strongly related to helping behavior when proactive personality was higher. (c) 2011 APA, all rights reserved.

  9. Psychometric properties of the Chinese translation of the proactive personality scale.

    Science.gov (United States)

    Zhou, Le; Shi, Junqi

    2009-08-01

    The purpose of the present study was to examine the psychometric properties of the Chinese translation of the Proactive Personality Scale. Four samples were surveyed. In Sample 1 and Sample 2, exploratory and confirmatory factor analysis results confirmed the unidimensional structure of the 10-item abbreviated version of the scale. In Sample 2, Proactive Personality scores were found to be positively correlated with the personality factors of Extraversion, Conscientiousness, Openness, and Agreeableness, and negatively correlated with Neuroticism. In Sample 3, Proactive Personality was found to be positively related to self-efficacy and political skill. In Sample 4, demographics controlled, Proactive Personality explained significant incremental variance in the employees' self-rated career satisfaction and job performance as rated by immediate supervisors.

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

    Science.gov (United States)

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

    2016-05-01

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

  11. Proactive Interference and Directed Forgetting in Short-Term Motor Memory

    Science.gov (United States)

    Burwitz, Leslie

    1974-01-01

    The present study was designed to test the effect of instructions to forget prior motor learning and the results were relevant to the understanding of short-term motor memory (STMM) proactive interference (PI). (Author/RK)

  12. Proactive Interference and Its Release in Short-Term Memory of Mildly Retarded Adolescents

    Science.gov (United States)

    Cody, William J.; Borkowski, John G.

    1977-01-01

    Release from proactive interference in mildly retarded adolescents due to taxonomic shifts and rest periods prior to the final, critical-word triad was investigated with 40 educable mentally handicapped persons 18 years old. (Author/MH)

  13. Connecting HRM and Change Management: The Importance of Proactivity and Vitality

    NARCIS (Netherlands)

    L.G. Tummers (Lars); P.M. Kruyen; D. Vijverberg (Dominique); T. Voesenek (Tessa)

    2014-01-01

    markdownabstract__Abstract__ __Purpose__: Organizations are continuously under pressure to adapt to changing circumstances. Job proactivity and vitality are important in changing environments. For instance, vital employees can better deal with change because they possess more energy. However, it

  14. Probing a Proactive Home: Challenges in Researching and Designing Everyday Smart Environments

    Directory of Open Access Journals (Sweden)

    Frans Mäyrä

    2006-01-01

    Full Text Available Based on the results of a 3-year interdisciplinary study, this article presents an approach in which proactive information technology was introduced into homes, and discusses the derived design principles from a human-centered perspective. The application of proactive computing in homes will face particularly sensitive conditions, as familiar and reliable household elements remain strongly preferred. Since there is considerable resistance towards the increase of information technology in homes, both the calm system behaviors and the degree of variety in aesthetic designs will play major roles in the acceptance of proactive technology. If proactive technology will be an embedded part of a home’s structures and furniture, it needs to blend with the normal, cozy standards of a real living environment and aim to enhance the homeyness or the key social and aesthetic qualities of homes.

  15. The relationship between adult reactive and proactive aggression, hostile interpretation bias, and antisocial personality disorder

    NARCIS (Netherlands)

    Lobbestael, J.; Cima, M.J.; Arntz, A.

    2013-01-01

    Reactive aggression (RA) refers to angry responses to provocation or frustration, while proactive aggression (PA) denotes nonemotional, instrumental, and unprovoked aggression. The current study examined personality-related and cognitive correlates of both aggressive types. Respectively, the

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

    Science.gov (United States)

    Wijethilake, Chaminda

    2017-07-01

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

  17. General Conformity Training Module 2.5: Proactive Role for Federal Agencies

    Science.gov (United States)

    Module 2.5 explains how taking a proactive role will allow a federal agency to more effectively participate in newly promulgated programs under the General Conformity Regulations, such as the emission reduction credits and the emission budgets programs.

  18. Contrasting neural effects of aging on proactive and reactive response inhibition

    NARCIS (Netherlands)

    Bloemendaal, Mirjam; Zandbelt, Bram; Wegman, Joost; Rest, van de O.; Cools, Roshan; Aarts, Esther

    2016-01-01

    Two distinct forms of response inhibition may underlie observed deficits in response inhibition in aging. We assessed whether age-related neurocognitive impairments in response inhibition reflect deficient reactive inhibition (outright stopping) or also deficient proactive inhibition

  19. Introduction of electronic referral from community associated with more timely review by secondary services.

    Science.gov (United States)

    Warren, J; White, S; Day, K J; Gu, Y; Pollock, M

    2011-01-01

    Electronic referral (eReferral) from community into public secondary healthcare services was introduced to 30 referring general medical practices and 28 hospital based services in late 2007. To measure the extent of uptake of eReferral and its association with changes in referral processing. Analysis of transactional data from the eReferral message service and the patient information management system of the affected hospital; interview of clinical, operational and management stakeholders. eReferral use rose steadily to 1000 transactions per month in 2008, thereafter showing moderate growth to 1200 per month in 2010. Rate of eReferral from the community in 2010 is estimated at 56% of total referrals to the hospital from general practice, and as 71% of referrals from those having done at least one referral electronically. Referral latency from letter date to hospital triage improves significantly from 2007 to 2009 (psystem usability issues. With eReferrals, a referral's status can be checked, and its content read, by any authorized user at any time. The period of eReferral uptake was associated with significant speed-up in referral processing without changes in staffing levels. The eReferral system provides a foundation for further innovation in the community-secondary interface, such as electronic decision support and shared care planning systems. We observed substantial rapid voluntary uptake of eReferrals associated with faster, more reliable and more transparent referral processing.

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

    OpenAIRE

    Kahana, Eva; Kahana, Boaz; Zhang, Jianping

    2005-01-01

    Future orientation is considered as a motivational antecedent of late-life proactivity. In a panel study of 453 old-old adults, we linked future orientation to exercise, a key component of late-life proactivity. Findings based on hierarchical linear modeling reveal that future orientation at baseline predicts changes in exercise during the subsequent four years. Whereas exercise behavior generally declined over time, future orientation and female gender were associated with smaller decline. T...

  1. THE MEDIATING EFFECT OF PROACTIVE MARKET ORIENTATION CAPABILITY IN ENTREPRENEURIAL ORIENTATION AND SERVICE INNOVATION

    OpenAIRE

    CANTALEANO, KAREN RAPHAELE; RODRIGUES, GRAZIELA PERRETTO; MARTINS, TOMAS SPARANO

    2018-01-01

    ABSTRACT Purpose: The purpose of this article is to verify the mediating effect of a proactive market orientation capability in the relationship between entrepreneurial orientation (EO) and service innovation in micro and small companies in the food-away from home sector. We analyzed the mediating effect of a marketing capability (proactive market capability) because, according to Morgan et al. (2009), a capability is an ability developed from a strategic orientation, and capabilities and or...

  2. Getting ready to use control: Advances in the measurement of young children's use of proactive control.

    Directory of Open Access Journals (Sweden)

    Sabine Doebel

    Full Text Available A key developmental transition in executive function is in the temporal dynamics of its engagement: children shift from reactively calling to mind task-relevant information as needed, to being able to proactively maintain information across time in anticipation of upcoming demands. This transition is important for understanding individual differences and developmental changes in executive function; however, methods targeting its assessment are limited. We tested the possibility that Track-It, a paradigm developed to measure selective sustained attention, also indexes proactive control. In this task children must track a target shape as it moves unpredictably among moving distractors, and identify where it disappears, which may require proactively maintaining information about the target or goal. In two experiments (5-6 year-olds, Ns = 33, 64, children's performance on Track-It predicted proactive control across two established paradigms. These findings suggest Track-It measures proactive control in children. Theoretical possibilities regarding how proactive control and selective sustained attention may be related are also discussed.

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

    Science.gov (United States)

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

    2016-10-01

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

  4. Proactive Corporate Environmental Responsibility and Financial Performance: Evidence from Chinese Energy Enterprises

    Directory of Open Access Journals (Sweden)

    Ying Jiang

    2018-03-01

    Full Text Available With increasing concerns about environmental issues and the advancement of China’s “going global” strategy, a new issue-proactive corporate social responsibility has emerged. Proactive corporate environmental responsibility refers to business actions that go beyond regulatory requirements for supporting sustainable environmental development. This study examines the role of proactive corporate environmental responsibility on corporate financial performance in the Chinese energy industry by the multi-variables regression analysis of panel data. Using data of 264 firm-year observations from 2009–2014 in the energy industry, the results showed that Proactive corporate environmental responsibility has a positive effect on corporate financial performance passing the endogeneity test. The results also demonstrate that private ownership has stronger promotion on the relationship between proactive corporate environmental responsibility and corporate financial performance. This study helps to increase the body of knowledge about proactive corporate environmental responsibility of the emerging economy, provides insights into the corporate environmental responsibility practice, and government environmental regulation and policy.

  5. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study

    Directory of Open Access Journals (Sweden)

    Bheemsain Tekkalaki

    2017-01-01

    Full Text Available Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20 years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25% of children had no diagnosable physical illness. Intellectual disability (19.62% was the most common psychiatric diagnosis, followed by depressive disorders (14.35%, and dissociative disorders (12.92%. Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

  6. Pro-active Behaviour in Context of Team Climate

    Directory of Open Access Journals (Sweden)

    Ladislav Pilař

    2014-01-01

    Full Text Available Employees are considered to be the main source of creativity, innovation, change and development of the enterprise, which can be considered as key success factors. However, if the company climate does not encourage employee activity, development may slow or stagnate. This article focuses on the possibility of prediction of personal initiative and employee silence based on quantification of the team climate. Relationships between constructs (1 “Team climate” and (2 “Pro-active Behaviour” are evaluated on the basis of Exploratory and Confirmatory factor analysis. All factors of the construct “Team climate”: (T1 Future olrientation, (T2 Peer support of change, (T3 Team Vision and (T4 Regular Contact, have a significant impact on the factors of the construct “Pro-active Behaviour”: (P1 Initiative and a negative impact on (P2 Defence silence. No statistically significant effect in relation to the factors (P3 Loyalty and (P4 Stagnation was identified. The effects, in relation to the initiative of the employees were identified in the interval r = |0.305| − |0.488|. The factor of Defence silence of employees effects “Team climate” factors in the interval r = |0.329| − |0.550|. In both cases this concerns medium dependence. The research results can be used to quantify the quality of team climate in order to enhance the individuals’ long-term initiative and organisational effectiveness. This knowledge serves managers as the basis for leadership and development of pro-active behaviour of team members.

  7. The cost of proactive interference is constant across presentation conditions.

    Science.gov (United States)

    Endress, Ansgar D; Siddique, Aneela

    2016-10-01

    Proactive interference (PI) severely constrains how many items people can remember. For example, Endress and Potter (2014a) presented participants with sequences of everyday objects at 250ms/picture, followed by a yes/no recognition test. They manipulated PI by either using new images on every trial in the unique condition (thus minimizing PI among items), or by re-using images from a limited pool for all trials in the repeated condition (thus maximizing PI among items). In the low-PI unique condition, the probability of remembering an item was essentially independent of the number of memory items, showing no clear memory limitations; more traditional working memory-like memory limitations appeared only in the high-PI repeated condition. Here, we ask whether the effects of PI are modulated by the availability of long-term memory (LTM) and verbal resources. Participants viewed sequences of 21 images, followed by a yes/no recognition test. Items were presented either quickly (250ms/image) or sufficiently slowly (1500ms/image) to produce LTM representations, either with or without verbal suppression. Across conditions, participants performed better in the unique than in the repeated condition, and better for slow than for fast presentations. In contrast, verbal suppression impaired performance only with slow presentations. The relative cost of PI was remarkably constant across conditions: relative to the unique condition, performance in the repeated condition was about 15% lower in all conditions. The cost of PI thus seems to be a function of the relative strength or recency of target items and interfering items, but relatively insensitive to other experimental manipulations. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Event-based proactive interference in rhesus monkeys.

    Science.gov (United States)

    Devkar, Deepna T; Wright, Anthony A

    2016-10-01

    Three rhesus monkeys (Macaca mulatta) were tested in a same/different memory task for proactive interference (PI) from prior trials. PI occurs when a previous sample stimulus appears as a test stimulus on a later trial, does not match the current sample stimulus, and the wrong response "same" is made. Trial-unique pictures (scenes, objects, animals, etc.) were used on most trials, except on trials where the test stimulus matched potentially interfering sample stimulus from a prior trial (1, 2, 4, 8, or 16 trials prior). Greater interference occurred when fewer trials separated interference and test. PI functions showed a continuum of interference. Delays between sample and test stimuli and intertrial intervals were manipulated to test how PI might vary as a function of elapsed time. Contrary to a similar study with pigeons, these time manipulations had no discernable effect on the monkey's PI, as shown by compete overlap of PI functions with no statistical differences or interactions. These results suggested that interference was strictly based upon the number of intervening events (trials with other pictures) without regard to elapsed time. The monkeys' apparent event-based interference was further supported by retesting with a novel set of 1,024 pictures. PI from novel pictures 1 or 2 trials prior was greater than from familiar pictures, a familiar set of 1,024 pictures. Moreover, when potentially interfering novel stimuli were 16 trials prior, performance accuracy was actually greater than accuracy on baseline trials (no interference), suggesting that remembering stimuli from 16 trials prior was a cue that this stimulus was not the sample stimulus on the current trial-a somewhat surprising conclusion particularly given monkeys.

  9. A Proactive Approach to Penicillin Allergy Testing in Hospitalized Patients.

    Science.gov (United States)

    Chen, Justin R; Tarver, Scott A; Alvarez, Kristin S; Tran, Trang; Khan, David A

    Penicillin allergy testing is underutilized in inpatients despite its potential to immediately impact antibiotic treatment. Although most tested patients are able to tolerate penicillin, limited availability and awareness of this tool leads to the use of costly and harmful substitutes. We established an inpatient service at a large academic hospital to identify and test patients with a history of penicillin allergy with the goals of removing inaccurate diagnoses, reducing the use of beta-lactam alternatives, and educating patients and clinicians about the procedure. Eligible inpatients were flagged daily through the electronic medical record and prioritized via a specialized algorithm. A trained clinical pharmacist performed penicillin skin tests and challenges preemptively or by provider request. Clinical characteristics and antibiotic use were analyzed in tested patients. A total of 1203 applicable charts were detected by our system leading to 252 direct evaluations over 18 months. Overall, 228 subjects (90.5%) had their penicillin allergy removed. Of these, 223 were cleared via testing and 5 by discovery of prior penicillin tolerance. Among patients testing negative, 85 (38%) subsequently received beta-lactams, preventing 504 inpatient days and 648 outpatient days on alternative agents. Penicillin allergy testing using a physician-pharmacist team model effectively removes reported allergies in hospitalized patients. The electronic medical record is a valuable asset for locating and stratifying individuals who benefit most from intervention. Proactive testing substantially reduces unnecessary inpatient and outpatient use of beta-lactam alternatives that may otherwise go unaddressed. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Relevant dimensions for proactive environmental assessment of urban mobility

    Directory of Open Access Journals (Sweden)

    Julio Alberto Soria Lara

    2015-02-01

    Full Text Available A reduction of negative environmental impacts in urban transportation (air pollution, energy consumption, etc. is thought to be crucial in promoting sustainable development outcomes in cities, however evidence shows that this objective is hardly achieved in practice. In the case of urban transport planning, the transition to sustainability requests that its performance must be assessed. This has originated important challenges for the academia in providing efficient assessment tools. As a response to these challenges, sustainability assessment has become a rapidly developing area associated with the family of impact assessment tools ((e.g. Environmental Impact Assessment and Strategic Environmental Assessment. In recent years, many countries have conferred to sustainability assessment, and specifically to Environmental Impact Assessment (EIA, an important and decisive role into their planning systems. The effectiveness of the traditional methods for evaluating urban transport plans/interventions (e.g. EIA, EAE, Cost-Benefit Analysis is contested as strongly argued by several academics. A key problem is that these methods currently focus too much on identifying environmental impacts that might happen rather than on finding ways of preventing them from happening. They are used reactively rather than proactively. Underlying this is the belief that traditional evaluation methods have difficulty guiding improvements in urban transport plans and projects in decision-making and their capacity to support technical decisions becomes limited. First, this is a consequence of the fact that the environmental assessment (EA process mainly includes EA-makers and they are not integrated enough in the transport planning process. Second, the used methods not always are the most suitable to identify ways of preventing potential impacts with respect to the particular nature of urban transportation. In seeking to answer these problems, the paper presents a strategy

  11. Audit of Childbirth Emergency Referrals by Trained Traditional Birth ...

    African Journals Online (AJOL)

    Medicine, Enugu State University of Science and Technology, 5Department of Obstetrics and ... Aim: The aim was to audit childbirth emergency referrals by trained TBAs to a ..... training of TBAs has been documented by previous African.

  12. medication history documentation in referral letters of children

    African Journals Online (AJOL)

    CHILDREN PRESENTING AT THE EMERGENCY UNIT OF A TEACHING. HOSPITAL IN LAGOS ... infrequently reported in referral letters to a tertiary care hospital in Lagos,. Nigeria. .... researcher, a pharmacist and clinical pharmacologist.

  13. Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study

    Directory of Open Access Journals (Sweden)

    Cantrell Jennifer

    2009-12-01

    Full Text Available Abstract Background Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax referral program in primary care. Methods The study involved implementation of a fax referral system paired with a chart stamp prompting providers to identify smoking patients, provide advice to quit and refer interested smokers to a state-based fax quitline. Three focus groups (n = 26 and eight key informant interviews were conducted with staff and physicians at two clinics after the intervention. We used the Chronic Care Model as a framework to analyze the data, examining how well the systems changes were implemented and the impact of these changes on care processes, and to develop recommendations for improvement. Results Physicians and staff described numerous benefits of the fax referral program for providers and patients but pointed out significant barriers to full implementation, including the time-consuming process of referring patients to the Quitline, substantial patient resistance, and limitations in information and care delivery systems for referring and tracking smokers. Respondents identified several strategies for improving integration, including simplification of the referral form, enhanced teamwork, formal assignment of responsibility for referrals, ongoing staff training and patient education. Improvements in Quitline feedback were needed to compensate for clinics' limited internal information systems for tracking smokers. Conclusions Establishing sustainable linkages to quitline services in clinical sites requires knowledge of existing patterns of care and tailored organizational changes to ensure new systems are prioritized, easily integrated into current office routines, formally assigned to specific

  14. Physician self-referral and physician-owned specialty facilities.

    Science.gov (United States)

    Casalino, Lawrence P

    2008-06-01

    Physician self-referral ranges from suggesting a follow-up appointment, to sending a patient to a facility in which the doctor has an ownership interest or financial relationship. Physician referral to facilities in which the physicians have an ownership interest is becoming increasingly common and not always medically appropriate. This Synthesis reviews the evidence on physician self-referral arrangements, their effect on costs and utilization, and their effect on general hospitals. Key findings include: the rise in self-referral is sparked by financial, regulatory and clinical incentives, including patient convenience and doctors trying to preserve their income in the changing health care landscape. Strong evidence suggests self-referral leads to increased usage of health care services; but there is insufficient evidence to determine whether this increased usage reflects doctors meeting an unmet need or ordering clinically inappropriate care. The more significant a physician's financial interest in a facility, the more likely the doctor is to refer patients there. Arrangements through which doctors receive fees for patient referrals to third-party centers, such as "pay-per-click," time-share, and leasing arrangements, do not seem to offer benefits beyond increasing physician income. So far, the profit margins of general hospitals have not been harmed by the rise in doctor-owned facilities.

  15. Do poison center triage guidelines affect healthcare facility referrals?

    Science.gov (United States)

    Benson, B E; Smith, C A; McKinney, P E; Litovitz, T L; Tandberg, W D

    2001-01-01

    The purpose of this study was to determine the extent to which poison center triage guidelines influence healthcare facility referral rates for acute, unintentional acetaminophen-only poisoning and acute, unintentional adult formulation iron poisoning. Managers of US poison centers were interviewed by telephone to determine their center's triage threshold value (mg/kg) for acute iron and acute acetaminophen poisoning in 1997. Triage threshold values and healthcare facility referral rates were fit to a univariate logistic regression model for acetaminophen and iron using maximum likelihood estimation. Triage threshold values ranged from 120-201 mg/kg (acetaminophen) and 16-61 mg/kg (iron). Referral rates ranged from 3.1% to 24% (acetaminophen) and 3.7% to 46.7% (iron). There was a statistically significant inverse relationship between the triage value and the referral rate for acetaminophen (p variability in poison center triage values and referral rates for iron and acetaminophen poisoning. Guidelines can account for a meaningful proportion of referral variation. Their influence appears to be substance dependent. These data suggest that efforts to determine and utilize the highest, safe, triage threshold value could substantially decrease healthcare costs for poisonings as long as patient medical outcomes are not compromised.

  16. Factors affecting cardiac rehabilitation referral by physician specialty.

    Science.gov (United States)

    Grace, Sherry L; Grewal, Keerat; Stewart, Donna E

    2008-01-01

    Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists. A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral. Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P negatively impacting CR referral practices than cardiac specialists. Cardiac specialists were significantly more likely to perceive that their colleagues and department would regularly refer patients to CR than primary care physicians (P Marketing CR site locations, provision of standardized referral forms, and ensuring discharge summaries are communicated to primary care physicians may improve their willingness to refer to CR.

  17. Improving the psychological evaluation of exercise referral: Psychometric properties of the Exercise Referral Quality of Life Scale

    Directory of Open Access Journals (Sweden)

    Charlotte Hilton

    2015-07-01

    Full Text Available There is a growing need to assess the psychological outcomes of exercise referral and the National Institute of Health and Care Excellence has called for the routine assessment of life-quality. However, a quality of life scale specific to the requirements of exercise referral is currently unavailable. Therefore, the aim of this study was to produce a quality of life measure for this purpose. The Exercise Referral Quality of Life Scale is a 22-item measure comprising three domains: mental and physical health, injury pain and illness and physical activity facilitators. Exploratory factor analysis determined the initial factor structure and was subsequently confirmed by confirmatory factor analysis. Additional scale properties were also assessed. The scale contributes to the global need for improved consistent psychological outcome assessment of exercise referral.

  18. 40 CFR 13.33 - Referrals to the Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Referrals to the Department of Justice... COLLECTION STANDARDS Referrals § 13.33 Referrals to the Department of Justice. (a) Prompt referral. The... Justice, Washington, DC 20530. (2) Unless otherwise provided by DOJ regulations or procedures, EPA refers...

  19. Proactive enrollment of parents to tobacco quitlines in pediatric practices is associated with greater quitline use: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jeremy E. Drehmer

    2016-06-01

    Full Text Available Abstract Background Every U.S. state has a free telephone quitline that tobacco users can access to receive cessation assistance, yet referral rates for parents in the pediatric setting remain low. This study evaluates, within pediatric offices, the impact of proactive enrollment of parents to quitlines compared to provider suggestion to use the quitline and identifies other factors associated with parental quitline use. Methods As part of a cluster randomized controlled trial (Clinical Effort Against Secondhand Smoke Exposure, research assistants completed post-visit exit interviews with parents in 20 practices in 16 states. Parents’ quitline use was assessed at a 12-month follow-up interview. A multivariable analysis was conducted for quitline use at 12 months using a logistic regression model with generalized estimating equations to account for provider clustering. Self-reported cessation rates were also compared among quitline users based on the type of referral they received at their child’s doctor’s office. Results Of the 1980 parents enrolled in the study, 1355 (68 % completed a 12-month telephone interview and of those 139 (10 % reported talking with a quitline (15 % intervention versus 6 % control; p < .0001. Parents who were Hispanic (aOR 2.12 (1.22, 3.70, black (aOR 1.57 (1.14, 2.16, planned to quit smoking in the next 30 days (aOR 2.32 (1.47, 3.64, and had attended an intervention practice (aOR 2.37 (1.31, 4.29 were more likely to have talked with a quitline. Parents who only received a suggestion from a healthcare provider to use the quitline (aOR 0.45 (0.23, 0.90 and those who were not enrolled and did not receive a suggestion (aOR 0.33 (0.17, 0.64 were less likely to talk with a quitline than those who were enrolled in the quitline during the baseline visit. Self-reported cessation rates among quitline users were similar regardless of being proactively enrolled (19 %, receiving only a suggestion (25 %, or

  20. Children referred for specialty care: Parental perspectives and preferences on referral, follow-up and primary care.

    Science.gov (United States)

    Freed, Gary L; Turbitt, Erin; Kunin, Marina; Gafforini, Sarah; Sanci, Lena; Spike, Neil

    2017-01-01

    Over the last decade, there has been a dramatic increase in the number of referrals for paediatric subspecialty care and in overall appointments (new and review) to these doctors. We sought to determine the perspective of parents regarding their role in the initiation of referrals, their preferences for follow-up and the role of general practitioners (GPs) in care co-ordination. Self-completed survey in outpatient paediatric clinics (general paediatrics and four subspecialties) at two children's hospitals in Victoria. Recruitment targets were 100 parents in each of the general paediatrics clinics and 50 parents in each subspecialty clinic, equally divided between new and review visits (total n = 600). A total of 606 parents provided responses, with a decline rate of 9%. Many (52%) new patients were referred by a GP with the remainder from a variety of other sources. With specific regard to providing general care to their child, only 45% were completely confident in a GP. Most (76%) agreed with the statement that a GP would give their child a referral to see a paediatrician whenever they ask. Approximately, a third of parents reported that a GP rarely or never co-ordinates the care of their child with other doctors. Parents play an important role in both the initiation of paediatric specialty referrals and the patterns of follow-up care provided. Parent perspectives, preferences and motivations on both the referral process and the patterns for ongoing care are essential to develop policies that provide the best and most efficient care for children. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

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

    Science.gov (United States)

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

    2018-02-01

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

  2. The role of self-serving cognitive distortions in reactive and proactive aggression.

    Science.gov (United States)

    Oostermeijer, Sanne; Smeets, Kirsten C; Jansen, Lucres M C; Jambroes, Tijs; Rommelse, Nanda N J; Scheepers, Floor E; Buitelaar, Jan K; Popma, Arne

    2017-12-01

    Aggression is often divided into reactive and proactive forms. Reactive aggression is typically thought to encompass 'blaming others' and 'assuming the worst', while proactive aggression relates to 'self-centeredness' and 'minimising/mislabelling'. Our aim was to evaluate relationships between reactive and proactive aggression and cognitive distortions and to test whether changes in these cognitions relate to changes in aggression. A total of 151 adolescents (60% boys; mean age 15.05 years, standard deviation 1.28) were enrolled in an evidence-based intervention to reduce aggression. Due to attrition and anomalous responses, the post-intervention sample involved 80 adolescents. Correlation and linear regression analyses were used to investigate the relationship between cognitive distortions and aggression. Blaming others was related to reactive aggression before the intervention, while all cognitive distortions were related to proactive aggression both pre- and post-intervention. Changes in reactive aggression were uniquely predicted by blaming others, while changes in proactive aggression were predicted by changes in cognitive distortions overall. To our knowledge, this study is the first to show a relationship between changes in cognitive distortions and changes in aggression. Treatment of reactive aggression may benefit from focusing primarily on reducing cognitive distortions involving misattribution of blame to others. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Mechanisms and neuronal networks involved in reactive and proactive cognitive control of interference in working memory.

    Science.gov (United States)

    Irlbacher, Kerstin; Kraft, Antje; Kehrer, Stefanie; Brandt, Stephan A

    2014-10-01

    Cognitive control can be reactive or proactive in nature. Reactive control mechanisms, which support the resolution of interference, start after its onset. Conversely, proactive control involves the anticipation and prevention of interference prior to its occurrence. The interrelation of both types of cognitive control is currently under debate: Are they mediated by different neuronal networks? Or are there neuronal structures that have the potential to act in a proactive as well as in a reactive manner? This review illustrates the way in which integrating knowledge gathered from behavioral studies, functional imaging, and human electroencephalography proves useful in answering these questions. We focus on studies that investigate interference resolution at the level of working memory representations. In summary, different mechanisms are instrumental in supporting reactive and proactive control. Distinct neuronal networks are involved, though some brain regions, especially pre-SMA, possess functions that are relevant to both control modes. Therefore, activation of these brain areas could be observed in reactive, as well as proactive control, but at different times during information processing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Sleep and memory consolidation: motor performance and proactive interference effects in sequence learning.

    Science.gov (United States)

    Borragán, Guillermo; Urbain, Charline; Schmitz, Rémy; Mary, Alison; Peigneux, Philippe

    2015-04-01

    That post-training sleep supports the consolidation of sequential motor skills remains debated. Performance improvement and sensitivity to proactive interference are both putative measures of long-term memory consolidation. We tested sleep-dependent memory consolidation for visuo-motor sequence learning using a proactive interference paradigm. Thirty-three young adults were trained on sequence A on Day 1, then had Regular Sleep (RS) or were Sleep Deprived (SD) on the night after learning. After two recovery nights, they were tested on the same sequence A, then had to learn a novel, potentially competing sequence B. We hypothesized that proactive interference effects on sequence B due to the prior learning of sequence A would be higher in the RS condition, considering that proactive interference is an indirect marker of the robustness of sequence A, which should be better consolidated over post-training sleep. Results highlighted sleep-dependent improvement for sequence A, with faster RTs overnight for RS participants only. Moreover, the beneficial impact of sleep was specific to the consolidation of motor but not sequential skills. Proactive interference effects on learning a new material at Day 4 were similar between RS and SD participants. These results suggest that post-training sleep contributes to optimizing motor but not sequential components of performance in visuo-motor sequence learning. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. National profiling of elder abuse referrals.

    LENUS (Irish Health Repository)

    Clancy, Marguerite

    2011-05-01

    there is little consistent data on patterns of reporting of elder abuse in Europe. Between 2002 and 2007, the Irish Health Service Executive developed dedicated structures and staff to support the prevention, detection and management of elder abuse without mandatory reporting. Public awareness campaigns, staff training and management briefings heightened awareness regarding this new service. Central to this process is the development of a national database which could provide useful insights for developing coordinated responses to elder abuse in Europe.

  6. Police referrals at the psychiatric emergency service in Taiwan.

    Science.gov (United States)

    Wang, Jen-Pang; Wu, Chia-Yi; Chiu, Chih-Chiang; Yang, Tsu-Hui; Liu, Tzong-Hsien; Chou, Pesus

    2015-12-01

    The police are the frontline workers in crisis situations involving patients with severe mental illness and act as a primary referral source for psychiatric emergency services (PES) in the community. The aims of this study were to investigate the distribution and characteristics of police referral among psychiatric patients in Taiwan. The study cohort consisted of patients who visited the PES of Taipei City Psychiatric Center from January 2009 to December 2010. The associations between the factors of demographics, clinical characteristics, and psychiatric service utilization and police referral were evaluated. Among the 7656 psychiatric emergency visits, 3029 (39.6%) were referred by the police. These patients referred by police were more likely to be male and aged between 30 to 49 years. Clinical factors related to police referrals including a higher triage assessment level, chief problems included violence, disturbance, substance use, less anxiety, and a diagnosis of unspecified psychosis. The triage assessment level and chief problems assessed by nurses were major predictors. These patients tended to be referred from the catchment area and during the nighttime shift, were discharged during the daytime shift, and stayed longer in the PES. Disposition arrangements such as discharge against medical advice and involuntary admission were also associated with police referrals. Patients referred by the police to the PES were those with more severe psychiatric problems and illnesses assessed by psychiatric nurses and psychiatrists. They tended to have more complex service utilization at the PES. © 2015 Wiley Publishing Asia Pty Ltd.

  7. Barriers to palliative radiotherapy referral: A Canadian perspective

    International Nuclear Information System (INIS)

    Samant, Rajiv S.; Fitzgibbon, Edward; Meng, Joanne; Graham, Ian D.

    2007-01-01

    Radiotherapy is an effective but underutilized treatment modality for cancer patients. We decided to investigate the factors influencing radiotherapy referral among family physicians in our region. A 30-item survey was developed to determine palliative radiotherapy knowledge and factors influencing referral. It was sent to 400 physicians in eastern Ontario (Canada) and the completed surveys were evaluated. The overall response rate was 50% with almost all physicians seeing cancer patients recently (97%) and the majority (80%) providing palliative care. Approximately 56% had referred patients for radiotherapy previously and 59% were aware of the regional community oncology program. Factors influencing radiotherapy referral included the following: waiting times for radiotherapy consultation and treatment, uncertainty about the benefits of radiotherapy, patient age, and perceived patient inconvenience. Physicians who referred patients for radiotherapy were more than likely to provide palliative care, work outside of urban centres, have hospital privileges and had sought advice from a radiation oncologist in the past. A variety of factors influence the referral of cancer patients for radiotherapy by family physicians and addressing issues such as long waiting times, lack of palliative radiotherapy knowledge and awareness of Cancer Centre services could increase the rate of appropriate radiotherapy patient referral

  8. Analysis Influence of Proactivity Power Business, Market Orientation, and Competitive Advantage toward Marketing Performance

    Directory of Open Access Journals (Sweden)

    Lili Karmela Fitriani

    2016-02-01

    Full Text Available This research is an empirical study on Batik SMEs (Small Medium Enterprises in Cirebon District, West Java. This study analyzes the effect of proactivity power business, market orientation, and competitive advantage towards marketing performance. The subjects of this research were 215 Batik SMEs in Cirebon District West Java. The analysis was done using Structural Equation Modeling (SEM, AMOS ver. 18. The result shows that proactivity power business, market orientation, and competitive advantage give positive influence on marketing performance of  Batik SMEs. The research implication is when SME businesses focus on the effort in improving their proactivity power business and competitive advantage, it will give positive impact on marketing performance. Other research finding reveals that  the orientation of customer and orientation of competitor have some effects on marketing performance. In addition, SME businesses should know what customers want and they should be able to identify their competitors in order to improve their marketing performance.

  9. PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

    Directory of Open Access Journals (Sweden)

    Vjeran Strahonja

    2007-06-01

    Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

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

    Science.gov (United States)

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

    2010-03-01

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

  11. Differential development of retroactive and proactive interference during post-learning wakefulness.

    Science.gov (United States)

    Brawn, Timothy P; Nusbaum, Howard C; Margoliash, Daniel

    2018-07-01

    Newly encoded, labile memories are prone to disruption during post-learning wakefulness. Here we examine the contributions of retroactive and proactive interference to daytime forgetting on an auditory classification task in a songbird. While both types of interference impair performance, they do not develop concurrently. The retroactive interference of task-B on task-A developed during the learning of task-B, whereas the proactive interference of task-A on task-B emerged during subsequent waking retention. These different time courses indicate an asymmetry in the emergence of retroactive and proactive interference and suggest a mechanistic framework for how different types of interference between new memories develop. © 2018 Brawn et al.; Published by Cold Spring Harbor Laboratory Press.

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

    Science.gov (United States)

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

    2017-01-01

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

  13. Environmental Proactivity and Environmental and Economic Performance: Evidence from the Winery Sector

    Directory of Open Access Journals (Sweden)

    Virginia Barba-Sánchez

    2016-10-01

    Full Text Available Environmental sustainability in the winery sector is receiving increased attention from governments, environmental groups, and consumers. The aim of this study is to explore the relationship between the degree of proactivity of a firm’s environmental strategies and its business performance. The novelty of this research work lies in its definition of business performance, which includes business environmental performance in terms of reducing the firm’s environmental impacts and eco-efficiency in the use of resources such as water, energy, and raw materials, in addition to its economic performance. A model is proposed and tested using a sample of 312 Spanish wineries. Data were analysed using partial least squares path modelling (PLS-PM. The fitness and robustness of the structural model proved adequate. The results indicate positive correlation of environmental proactivity with economic and environmental performance. Although environmental proactivity improves business performance, it has a greater impact on reducing environmental impacts and improving eco-efficiency.

  14. The proactive approach--is it worthwhile? A prospective controlled ergonomic intervention study in office workers.

    Science.gov (United States)

    Laestadius, Jasminka Goldoni; Ye, Jian; Cai, Xiaodong; Ross, Sandra; Dimberg, Lennart; Klekner, Meg

    2009-10-01

    Does proactive ergonomics program enhance office worker health and productivity? The investigation was conducted in connection with the move of 1500 office staff to a building with improved ergonomics. It was focused on associations between workstation features, working postures, musculoskeletal pain symptoms, and eye strain before and 18 months after implementation of a proactive ergonomic program. The outcomes were compared between the intervention and a similar reference group. Associations between improvement of postures and less musculoskeletal pain and eye strain were confirmed. A cross association between several features and postures and improved symptoms was noted, along with improved productivity. The study suggests that a proactive program adhering to the OSHA recommendations needs to include an individual workstation assessment to be effective in reducing symptoms and increasing productivity.

  15. Adolescents and mothers value referral to a specialist service for chronic fatigue syndrome or myalgic encephalopathy (CFS/ME).

    Science.gov (United States)

    Beasant, Lucy; Mills, Nicola; Crawley, Esther

    2014-04-01

    Paediatric chronic fatigue syndrome or myalgic encephalopathy (CFS/ME) is relatively common and disabling. Current guidance recommends referral to specialist services, although some general practitioners believe the label of CFS/ME is harmful and many are not confident about diagnosing CFS/ME. Aim Explore whether or not adolescents and their mothers value referral to a specialist service for young people with CFS/ME. A qualitative study nested within a feasibility study of interventions for CFS/ME [Specialist Medical Intervention and Lightning Evaluation (SMILE)]. In-depth interviews were undertaken with 13 mothers and 12 adolescents participating in the SMILE study. Transcripts were systematically assigned codes using the qualitative data organisation package NVivo and analysed thematically using techniques of constant comparison. Gaining access to the specialist service was difficult and took a long time. Mothers felt that they needed to be proactive and persistent, partly because of a lack of knowledge in primary and secondary care. Having gained access, mothers felt the CFS/ME service was useful because it recognised and acknowledged their child's condition and opened channels of dialogue between health-care professionals and education providers. Adolescents reported that specialist medical care resulted in better symptom management, although some adolescents did not like the fact that the treatment approach limited activity. Adolescents and their mothers value receiving a diagnosis from a specialist service and making progress in managing CFS/ME. General practitioners should support adolescents with CFS/ME in accessing CFS/ME specialist services, consistent with current guidance.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jacqueline L Holloway

    2012-11-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  19. Over- and Undercontrolled Referral Problems among Children and Adolescents from Thailand and the United States: The "Wat" and "Wai" of Cultural Differences.

    Science.gov (United States)

    Weisz, John R.; And Others

    1987-01-01

    Compared Thailand to United States in regard to children's psychological problems and corresponding clinic referral patterns. Overcontrolled problems (somaticizing, fearfulness, nervous movements, worrying) were reported more often for Thai than for American youth. Undercontrolled problems (disobedience, fighting, lying, arguing) were reported…

  20. LINKING ADMINISTRATORS ROLES IN CAREER PROGRAMS TO PROACTIVE BEHAVIOR AS A DETERMINANT OF EMPLOYEES PROMOTION OPPORTUNITIES

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2017-03-01

    Full Text Available This research examines the relationship between administrators roles in career programs, proactive behavior and employees promotion opportunities. Self-administered questionnaires were collected from employees who work in an established private oil and gas firm in West Coast of Peninsular Malaysia. The outcomes of SmartPLS path model analysis demonstrate that the ability of administrators to plan and managecareer programs have strongly invoked employees proactive behavior. As a result, this situation may lead to an enhance employees promotion opportunities in the organizational sample. Further, this study offers discussion, implications and conclusion.

  1. The disruptive effects of methamphetamine on delayed-matching-to-sample performance reflect proactive interference and are reduced by SCH23390.

    Science.gov (United States)

    Macaskill, Anne C; Harrow, Catherine C; Harper, David N

    2015-01-01

    Different drugs produce different patterns of impairment on delayed matching-to-sample tasks. For example, (+/-)3,4-methylenedioxymethamphetamine (MDMA) produces an increase in proactive interference. That is, subjects are less accurate when they are required to make a response different to the one they made on the immediately previous trial. The current study assessed whether methamphetamine also produces this particular pattern of disruption in delayed matching-to-sample performance in rats. Methamphetamine primarily reduced accuracy on trials where the correct response differed from the one made on the previous trial. Thus methamphetamine, like MDMA and other stimulant-based drugs of abuse, increased proactive interference. This impairment was reduced by prior administration of the dopamine D1 antagonist SCH23390. These results further extend a general conclusion that a range of stimulant-based drugs may disrupt working memory function indirectly via a tendency to repeat previously made responses and that this disruption is related to D1 receptor activity. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. The critical roles of task conflict and job autonomy in the relationship between proactive personalities and innovative employee behavior

    NARCIS (Netherlands)

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

    2016-01-01

    We examine why and when proactive personality is beneficial for innovative behavior at work. Based on a survey among 166 employees working in 35 departments of a large municipality in the Netherlands we show that an increase in task conflicts explains the positive relation between a proactive

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

    NARCIS (Netherlands)

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

    2016-01-01

    We examine why and when proactive personality is beneficial for innovative behavior at work. Based on a survey among 166 employees working in 35 departments of a large municipality in the Netherlands we show that an increase in task conflicts explains the positive relation between a proactive

  4. Understanding the relationship between proactive and reactive aggression, and cyberbullying across United States and Singapore adolescent samples.

    Science.gov (United States)

    Ang, Rebecca P; Huan, Vivien S; Florell, Dan

    2014-01-01

    This study examined cyberbullying among adolescents across United States and Singapore samples. Specifically, the purpose of the investigation was to study the differential associations between proactive and reactive aggression, and cyberbullying across two cultures. A total of 425 adolescents from the United States (M age = 13 years) and a total of 332 adolescents from Singapore (M age = 14.2 years) participated in the study. Results of the moderator analyses suggested that nationality was not a moderator of the relationship between proactive aggression and cyberbullying, and between reactive aggression and cyberbullying. As expected, findings showed proactive aggression to be positively associated with cyberbullying, after controlling for reactive aggression, across both samples. Likewise, as hypothesized, reactive aggression and cyberbullying was not found to be significant after controlling for proactive aggression across both samples. Implications of these findings were discussed: (a) Proactive aggression is a possible risk factor for both bullying and cyberbullying; (b) proactive and reactive aggression could be argued to be distinct as they have different correlates-only proactive aggression contributed to cyberbullying after controlling for reactive aggression; (c) this research extends previous work and contributes toward cross-cultural work using similar and comparable measures across different samples; and (d) prevention and intervention programs targeted at proactive aggressive adolescents could adopt a two-pronged approach by changing mind sets, and by understanding and adopting a set of rules for Internet etiquette.

  5. Does affective theory of mind contribute to proactive aggression in boys with conduct problems and psychopathic tendencies?

    DEFF Research Database (Denmark)

    Gillespie, S.; Kongerslev, Mickey; Sharp, Carla

    2018-01-01

    Adolescent psychopathic tendencies are associated with phenotypic increases in proactive aggression. However, the extent to which an understanding of others’ affective mental states, or affective theory of mind (ToM), contributes to proactive aggression remains unknown. We examined how performance...

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

    Science.gov (United States)

    Montani, Francesco; Battistelli, Adalgisa; Odoardi, Carlo

    2017-01-01

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

  7. When does transformational leadership enhance employee proactive behavior? The role of autonomy and role breadth self-efficacy

    NARCIS (Netherlands)

    den Hartog, D.N.; Belschak, F.D.

    2012-01-01

    Two multisource studies address the interactive effects of personal and contextual variables on employees' proactive behavior. In line with previous work, we find positive main effects of transformational leadership, role breadth self-efficacy, and job autonomy on employee proactive behavior

  8. Primary care physician decision making regarding referral for bariatric surgery: a national survey.

    Science.gov (United States)

    Stolberg, Charlotte Røn; Hepp, Nicola; Juhl, Anna Julie Aavild; B C, Deepti; Juhl, Claus B

    2017-05-01

    Bariatric surgery is the most effective treatment for severe obesity. It results in significant and sustained weight loss and reduces obesity-related co-morbidities. Despite an increasing prevalence of severe obesity, the number of bariatric operations performed in Denmark has decreased during the past years. This is only partly explained by changes in the national guidelines for bariatric surgery. The purpose of the cross-sectional study is to investigate referral patterns and possible reservations regarding bariatric surgery among Danish primary care physicians (PCPs). Primary care physicians in Denmark METHODS: A total of 300 Danish PCPs were invited to participate in a questionnaire survey regarding experiences with bariatric surgery, reservations about bariatric surgery, attitudes to specific patient cases, and the future treatment of severe obesity. Most questions required a response on a 5-point Likert scale (strongly disagree, disagree, neither agree nor disagree, agree, and strongly agree) and frequency distributions were calculated. 133 completed questionnaires (44%) were returned. Most physicians found that they had good knowledge about the national referral criteria for bariatric surgery. With respect to the specific patient cases, a remarkably smaller part of physicians would refer patients on their own initiative, compared with the patient's initiative. Fear of postoperative surgical complications and medical complications both influenced markedly the decision to refer patients for surgery. Only 9% of the respondents indicated that bariatric surgery should be the primary treatment option for severe obesity in the future. Danish PCPs express severe concerns about surgical and medical complications following bariatric surgery. This might, in part, result in a low rate of referral to bariatric surgery. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. 49 CFR 219.403 - Voluntary referral policy.

    Science.gov (United States)

    2010-10-01

    ... section, the railroad treats the referral and subsequent handling, including counseling and treatment, as confidential. (3) The railroad will, to the extent necessary for treatment and rehabilitation, grant the employee a leave of absence from the railroad for the period necessary to complete primary treatment and...

  11. Referrals of Ethiopian Orthopedic Patients for Treatment Abroad ...

    African Journals Online (AJOL)

    Most patients were young males from Addis Ababa-the capital. The commonest single diagnosis was osteoarthritis, followed by ACL tear. The top three procedures for which the patients were referred are total hip replacement, ACL reconstruction and total knee replacement. Inter-consultant variation in number of referrals ...

  12. Molecular detection of carbapenemase-producing genes in referral ...

    African Journals Online (AJOL)

    Molecular confirmation of carbapenemase-producing Enterobacteriaceae (CPE) was introduced in South Africa (SA) at the end of 2011. We report on the detection of these resistance genes based on referral isolates. Enterobacteriaceae with non-susceptibility to any of the carbapenems according to defined criteria for ...

  13. Primary care nurses: effects on secondary care referrals for diabetes?

    NARCIS (Netherlands)

    Dijk, C.E. van; Verheij, R.A.; Hansen, J.; Velden, L. van der; Nijpels, G.; Groenewegen, P.P.; Bakker, D.H. de

    2010-01-01

    BACKGROUND: Primary care nurses play an important role in diabetes care, and were introduced in GP-practice partly to shift care from hospital to primary care. The aim of this study was to assess whether the referral rate for hospital treatment for diabetes type II (T2DM) patients has changed with

  14. 29 CFR 15.8 - Referral to Department of Justice.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Referral to Department of Justice. 15.8 Section 15.8 Labor Office of the Secretary of Labor ADMINISTRATIVE CLAIMS UNDER THE FEDERAL TORT CLAIMS ACT AND RELATED... Justice. An award, compromise or settlement of a claim under § 2672 title 28, United States Code, and this...

  15. Linguistic barriers at a Malawian referral hospital | Kamwendo ...

    African Journals Online (AJOL)

    The paper discusses a small segment of the findings of a sociolinguistic study that was conducted at a Republic of China-funded referral hospital located in the predominantly Chitumbuka-speaking Northern Malawi. The main objective of the study was to identify linguistic barriers to communication that existed at the hospital ...

  16. Delays in diagnosis, referral and management of head and neck ...

    African Journals Online (AJOL)

    Delays in diagnosis, referral and management of head and neck cancer presenting at Kenyatta National Hospital, Nairobi. ... Vol 83, No 4 (2006) >. Log in or Register to get access to full text downloads. ... Background: The most important prognostic factor in head and neck cancer is the stage of the disease at presentation.

  17. 20 CFR 628.510 - Intake, referrals and targeting.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Intake, referrals and targeting. 628.510 Section 628.510 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS... training have been provided subsequent to the objective assessment. (g) The SDA's method of meeting the...

  18. Developing evidence-based guidelines for referral for short stature

    NARCIS (Netherlands)

    Grote, F.K.; Dommelen, P. van; Oostdijk, W.; Muinck Keizer-Schrama, S.M.P.F. de; Verkerk, P.H.; Wit, J.M.; Buuren, S. van

    2008-01-01

    Objective: To establish evidence based guidelines for growth monitoring on a population basis. Study design: Several auxological referral criteria were formulated and applied to longitudinal growth data from four different patient groups, as well as three samples from the general population.

  19. Patient satisfaction in neurological second opinions and tertiary referrals

    NARCIS (Netherlands)

    Wijers, D.; Wieske, L.; Vergouwen, M. D. I.; Richard, E.; Stam, J.; Smets, E. M. A.

    2010-01-01

    Although the number of neurological second opinions (SOs) and tertiary referrals (TRs) is increasing, only little is known about expectations and patient satisfaction in this group of patients. Therefore, the purpose of this study was to explore expectations of patients who get a neurological SO or

  20. Primary care referral management: a marketing strategy for hospitals.

    Science.gov (United States)

    Bender, A D; Geoghegan, S S; Lundquist, S H; Cantone, J M; Krasnick, C J

    1990-06-01

    With increasing competition among hospitals, primary care referral development and management programs offer an opportunity for hospitals to increase their admissions. Such programs require careful development, the commitment of the hospital staff to the strategy, an integration of hospital activities, and an understanding of medical practice management.

  1. Qualitative study on maternal referrals in rural Tanzania: Decision ...

    African Journals Online (AJOL)

    The process in deciding to seek referral care is envisaged within community perception of seriousness of the condition, difficulty to access and cost involved in transport, living expenses at the hospital, and perceived quality of care at facility level. The hospitals were seen as providing acceptable quality of care, whereas, the ...

  2. Predicting referral practices of traditional healers of their patients ...

    African Journals Online (AJOL)

    Predicting referral practices of traditional healers of their patients with a mental illness: An application of the Theory of Planned Behaviour. ... From the TPB application, the following cognitive variables were found to predict intentions: attitudes (ß = 0.612, p< 0.01); perceived behavioural control (ß = 0.355, p< 0.01); and past ...

  3. appointed forensic mental observations: Is the referral process ...

    African Journals Online (AJOL)

    2013-11-01

    Nov 1, 2013 ... One can find support for all three proposals in the scientific literature.[3]. Though this is a ... associations is the particular risk that the schizophrenic patient ... illness. This is comparable to the current study, in that all referrals for.

  4. Evaluation and Referral for Child Maltreatment in Pediatric Poisoning Victims

    Science.gov (United States)

    Wood, Joanne N.; Pecker, Lydia H.; Russo, Michael E.; Henretig, Fred; Christian, Cindy W.

    2012-01-01

    Objective: Although the majority of poisonings in young children are due to exploratory ingestions and might be prevented through improved caregiver supervision, the circumstances that warrant evaluation for suspected maltreatment and referral to Child Protective Services (CPS) are unclear. Therefore the objective of this study was to determine…

  5. 29 CFR 502.37 - Referral to Administrative Law Judge.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Referral to Administrative Law Judge. 502.37 Section 502.37 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS ENFORCEMENT OF CONTRACTUAL OBLIGATIONS FOR TEMPORARY ALIEN AGRICULTURAL WORKERS ADMITTED UNDER SECTION 218 OF...

  6. Referral and collaboration between South African psychiatrists and ...

    African Journals Online (AJOL)

    Background. Referral between psychiatrists and spiritual workers (e.g. Christian pastoral care workers, traditional healers, imams, rabbis and others) in the heterogeneous South African (SA) society is complicated and requires investigation to establish appropriate norms. Objective. To capture the views of some local ...

  7. Developing an Educational Workshop on Teen Depression and Suicide: A Proactive Community Intervention.

    Science.gov (United States)

    McArt, Ebba W.; Shulman, Donald A.; Gajary, Elizabeth

    1999-01-01

    An educational workshop was developed in Monroe County, New York on teen depression and suicide. The workshop used a proactive, preventive-educational approach, including both primary and secondary prevention modalities, directly available to teens, parents, and youth professionals. The program subsequently developed new partnerships between…

  8. Integrating statistical machine learning in a semantic sensor web for proactive monitoring and control

    CSIR Research Space (South Africa)

    Adeleke, Jude Adekunle

    2017-04-01

    Full Text Available in an indoor air quality monitoring case study. A sliding window approach that employs the Multilayer Perceptron model to predict short term PM 2 . 5 pollution situations is integrated into the proactive monitoring and control framework. Results show...

  9. Temperament, Harsh and Indulgent Parenting, and Chinese Children's Proactive and Reactive Aggression

    Science.gov (United States)

    Xu, Yiyuan; Farver, Jo Ann M.; Zhang, Zengxiu

    2009-01-01

    This study examined the additive and interactive effects of temperament and harsh and indulgent parenting on Chinese children's proactive and reactive aggression. Participants were 401 children (M [subscript age] = 9.29 years, 203 girls) and their parents who were recruited from 2 elementary schools in Shanghai, People's Republic of China. The…

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

    Science.gov (United States)

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

    2015-12-01

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

  11. Information Processing and Proactive Interference in Children with and without Specific Language Impairment

    Science.gov (United States)

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

    2014-01-01

    Purpose: Increasing evidence suggests that children with specific language impairment (SLI) have a deficit in inhibition control, but research isolating specific abilities is scarce. The goal of this study was to examine whether children with SLI differ from their peers in resistance to proactive interference under different conditions. Method: An…

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

    Science.gov (United States)

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

    2017-01-01

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

  13. Hypothalamic Pituitary Adrenal Axis Functioning in Reactive and Proactive Aggression in Children

    Science.gov (United States)

    Lopez-Duran, Nestor L.; Olson, Sheryl L.; Hajal, Nastassia J.; Felt, Barbara T.; Vazquez, Delia M.

    2009-01-01

    The purpose of this study was to examine the association between hypothalamic-pituitary-adrenal axis (HPA-axis) reactivity and proactive and reactive aggression in pre-pubertal children. After a 30-min controlled base line period, 73 7-year-old children (40 males and 33 females) were randomly assigned to one of two experimental tasks designed to…

  14. Individual differences in the use of proactive coping strategies by middle-aged and older adults.

    NARCIS (Netherlands)

    Ouwehand, C.; Ridder, D.T.D. de; Bensing, J.M.

    2008-01-01

    The concept of proactive coping refers to the process of screening one’s environment for future stressors and undertaking attempts to prevent them. As of yet, few empirical studies have been conducted in relation to this promising concept. The aim of the present study was to identify the personal

  15. The Price of Fame: The Impact of Stimulus Familiarity on Proactive Interference Resolution

    Science.gov (United States)

    Prabhakaran, Ranjani; Thompson-Schill, Sharon L.

    2011-01-01

    Interference from previously learned information, known as proactive interference (PI), limits our memory retrieval abilities. Previous studies of PI resolution have focused on the role of short-term familiarity, or recency, in causing PI. In the present study, we investigated the impact of long-term stimulus familiarity on PI resolution…

  16. Personality, Freshmen Proactive Social Behavior, and College Transition: Predictors beyond Academic Strategies

    Science.gov (United States)

    Wang, Yi; Cullen, Kristin L.; Yao, Xiang; Li, Yixuan

    2013-01-01

    When transitioning to college freshmen must behave proactively in order to strive for success in their collegiate careers and their future life. Past research has mainly focused on the academic strategies of freshmen when investigating the predictors of successful college transition and has paid little attention to students' social strategies. The…

  17. Walking the Walk: The Moderating Role of Proactive Parenting on Adolescents' Value-Congruent Behaviors

    Science.gov (United States)

    Padilla-Walker, Laura M.; Fraser, Ashley M.; Harper, James M.

    2012-01-01

    The current study longitudinally examined adolescents' internalization of values in four domains (drug use, prosocial, school, friends), and how these values were differentially related to behaviors (delinquency, prosocial behavior, school engagement, and deviant peer association) as a function of proactive parenting. Participants included 335…

  18. Abnormal proactive and reactive cognitive control during conflict processing in major depression.

    Science.gov (United States)

    Vanderhasselt, Marie-Anne; De Raedt, Rudi; De Paepe, Annick; Aarts, Kristien; Otte, Georges; Van Dorpe, Jan; Pourtois, Gilles

    2014-02-01

    According to the Dual Mechanisms of Control framework, cognitive control consists of two complementary components: proactive control refers to anticipatory maintenance of goal-relevant information, whereas reactive control acts as a correction mechanism that is activated when a conflict occurs. Possibly, the well-known diminished inhibitory control in response to negative stimuli in Major Depressive Disorder (MDD) patients stems from a breakdown in proactive control, and/or anomalies in reactive cognitive control. In our study, MDD patients specifically showed increased response latencies when actively inhibiting a dominant response to a sad compared with a happy face. This condition was associated with a longer duration of a dominant ERP topography (800-900 ms poststimulus onset) and a stronger activity in the bilateral dorsal anterior cingulate cortex, reflecting abnormal reactive control when inhibiting attention to a negative stimulus. Moreover, MDD patients showed abnormalities in proactive cognitive control when preparing for the upcoming imperative stimulus (abnormal modulation of the contingent negative variation component), accompanied by more activity in brain regions belonging to the default mode network. All together, deficits to inhibit attention to negative information in MDD might originate from an abnormal use of both proactive resources and reactive control processes. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  19. Memory Consequences of Looking Back to Notice Change: Retroactive and Proactive Facilitation

    Science.gov (United States)

    Jacoby, Larry L.; Wahlheim, Christopher N.; Kelley, Colleen M.

    2015-01-01

    Three experiments contrasted recollection of change with differentiation as means of avoiding retroactive interference and proactive interference. We manipulated the extent to which participants looked back to notice change between pairs of cues and targets (A-B, A-D) and measured the effects on later cued recall of either the first or second…

  20. Reactive and Proactive Control in Incarcerated and Community Adolescents and Young Adults

    Science.gov (United States)

    Iselin, Anne-Marie R.; DeCoster, Jamie

    2009-01-01

    This study compared the cognitive control skills of male incarcerated adolescents (n = 44), male control adolescents (n = 33), male incarcerated young adults (n = 41), and male control young adults (n = 35) using the AX-continuous performance test (AX-CPT). This test measures proactive control (the ability to maintain a mental representation of…

  1. What Is Engagement? Proactivity as the Missing Link in the HEXACO Model of Personality

    NARCIS (Netherlands)

    de Vries, Reinout Everhard; Wawoe, Kilian W.; Holtrop, Djurre

    2016-01-01

    We tested the hypothesis that proactivity represents the engagement vector in the HEXACO model of personality. Questionnaire data were obtained in five studies, three of which consisted (mostly) of students: Study 1 (N = 188, Mage = 20.0, 89.4% women), Study 3 (N = 315, Mage = 20.4, 80.6% women),

  2. Effects of proactive and prosocial behavior on critical incidents of Lima schoolchildren

    Directory of Open Access Journals (Sweden)

    Jhon A. Holguin Alvarez

    2017-08-01

    Full Text Available The study focuses on the theoretical approaches of proactive and prosocial behavior of Covey (1996, Xifra (2009 and Roche-Olivar (2004, with the objective of analyzing the significant differences in the decrease of critical incidents in public school students And private schools in the district of San Juan de Lurigancho, for which two experimental workshops with quasiexperimental methodology were applied in three groups of 1st and 2nd high school students (G. Exp. (Proactivity = 17; G. Exp. Prosociality = 15; G. Control = 16; A behavior observation log and the PANIC instrument of Monereo and Monte (2011 were used. The results indicate significant differences with better effects in the workshop of proactive behavior (Hrp = 16.59, p <.05; A comparison of the verbal violence dimension in which better effects were obtained by the prosocial behavior workshop (Hrp = 14.12, p <.05; Finally, the limitations were that students in the proactivity workshop slowed down their critical incidents by demonstrating excessive personalism, and for later studies, it is suggested to work the above mentioned workshops, including assaulted students.

  3. Student Teachers' Proactive Strategies and Experienced Learning Environment for Reducing Study-Related Burnout

    Science.gov (United States)

    Väisänen, Sanna; Pietarinen, Janne; Pyhältö, Kirsi; Toom, Auli; Soini, Tiina

    2018-01-01

    The study aims to gain a better understanding of the interrelation and the development of student teachers' proactive coping strategies, i.e., self-regulative and co-regulative strategies, perceived learning environment and study-related burnout. Longitudinal data were utilized with three annual measurements during bachelor studies. Altogether,…

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

    Science.gov (United States)

    Farmer, Cristan A.; Aman, Michael G.

    2009-01-01

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

  5. Burnout, Depression and Proactive Coping in Underground Coal Miners in Serbia - Pilot Project

    Directory of Open Access Journals (Sweden)

    Manić Saška

    2017-03-01

    Full Text Available Mining is unsurprisingly considered a high-risk occupation because it involves continuous hard labour under highly demanding and stressful conditions. Many of these work stressors can impair individuals’ well-being in both a physiological and psychological sense. The aims of this study were to assess the prevalence of burnout and depressive symptoms and to evaluate aspects of proactive coping among underground coal miners in Serbia. The study involved 46 male underground coal miners. Burnout was measured with the Copenhagen Burnout Inventory, depression was assessed with the Patient Health Questionnaire-9, and level of proactive coping was measured with the Proactive Coping Inventory. The results showed a low level of burnout syndrome among the underground coal miners (12.46±4.879. Depression was slightly above the minimum (1.2±2.094, and the majority of the participants had no symptoms of depression (93.5%. Overall, the underground coal miners’ ability to proactively cope with work stress was very good (42.17±6.567. This is in contrast to the findings of the few previous international studies and is a good basis for further research using a larger sample in Serbia.

  6. Setting priorities for the proactive management of longterm challenges and opportunities in Asset Life Cycle Management

    NARCIS (Netherlands)

    Ruitenburg, Richard Jacob; Braaksma, Anne Johannes Jan; van Diepen, T.

    2016-01-01

    Asset Life Cycle Management concerns the effective management of physical assets over their complete lifetimes, typically lasting decades. Therefore, a large number and a wide variety of challenges and opportunities may need to be dealt with proactively, using limited resources. Therefore, we

  7. Interactive Links between Theory of Mind, Peer Victimization, and Reactive and Proactive Aggression

    Science.gov (United States)

    Renouf, Annie; Brendgen, Mara; Seguin, Jean R.; Vitaro, Frank; Boivin, Michel; Dionne, Ginette; Tremblay, Richard E.; Perusse, Daniel

    2010-01-01

    This study investigated the relation between theory of mind and reactive and proactive aggression, respectively, as well as the moderating role of peer victimization in this context. The 574 participants were drawn from a longitudinal study of twins. Theory of mind was assessed before school entry, when participants were 5 years old. Reactive and…

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

    NARCIS (Netherlands)

    Duenk, R.G.; Verhagen, C.A.; Bronkhorst, E.M.; Mierlo, P. van; Broeders, M.E.A.C.; Collard, S.M.; Dekhuijzen, P.N.R.; Vissers, K.C.P.; Heijdra, Y.F.; Engels, Y.

    2017-01-01

    BACKGROUND AND AIM: Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. TRIAL REGISTRATION: This trial is registered with the Netherlands Trial

  9. Agent-based Simulation of Reactive, Pro-active, and Social Animal Behaviour

    NARCIS (Netherlands)

    Jonker, C.M.; Treur, J.; Mira, J.

    1998-01-01

    In this paper it is shown how animal behaviour can be simulated in an agent-based manner. Different models are shown for different types of behaviour, varying from purely reactive behaviour to pro-active and social behaviour. The compositional development method for multi-agent systems DESIRE and

  10. The Genetic and Environmental Covariation among Psychopathic Personality Traits, and Reactive and Proactive Aggression in Childhood

    Science.gov (United States)

    Bezdjian, Serena; Tuvblad, Catherine; Raine, Adrian; Baker, Laura A.

    2011-01-01

    The present study investigated the genetic and environmental covariance between psychopathic personality traits with reactive and proactive aggression in 9- to 10-year-old twins (N = 1,219). Psychopathic personality traits were assessed with the Child Psychopathy Scale (D. R. Lynam, 1997), while aggressive behaviors were assessed using the…

  11. Social Information Processing, Moral Reasoning, and Emotion Attributions: Relations with Adolescents' Reactive and Proactive Aggression

    Science.gov (United States)

    Arsenio, William F.; Adams, Erin; Gold, Jason

    2009-01-01

    Connections between adolescents' social information processing (SIP), moral reasoning, and emotion attributions and their reactive and proactive aggressive tendencies were assessed. One hundred mostly African American and Latino 13- to 18-year-olds from a low-socioeconomic-status (SES) urban community and their high school teachers participated.…

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

    Science.gov (United States)

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

    2017-06-01

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

  13. Presentation Modality and Proactive Interference in Children's Short-Term Memory.

    Science.gov (United States)

    Douglas, Joan Delahanty

    This study examined the role of visual and auditory presentation in memory encoding processes of 80 second-grade children, using the release-from-proactive-interference short-term memory (STM) paradigm. Words were presented over three trials within one of the presentation modes and one taxonomic category, followed by a fourth trial in which the…

  14. Randomized Controlled Trial Considering Varied Exercises for Reducing Proactive Memory Interference

    Directory of Open Access Journals (Sweden)

    Emily Frith

    2018-06-01

    Full Text Available We evaluated the effects of exercise on proactive memory interference. Study 1 (n = 88 employed a 15-min treadmill walking protocol, while Study 2 (n = 88 included a 15-min bout of progressive maximal exertion treadmill exercise. Each study included four distinct groups, in which groups of 22 participants each were randomly assigned to: (a exercise before memory encoding, (b a control group with no exercise, (c exercise during memory encoding, and (d exercise after memory encoding (i.e., during memory consolidation. We used the Rey Auditory Verbal Learning Test (RAVLT to assess proactive memory interference. In both studies, the group that exercised prior to memory encoding recalled the most words from list B (distractor list of the RAVLT, though group differences were not statistically significant for Study 1 (walking exercise (p = 0.521 or Study 2 (high-intensity exercise (p = 0.068. In this sample of young adults, high intensity exercise prior to memory encoding showed a non-significant tendency to attenuate impairments in recall attributable to proactive memory interference. Thus, future work with larger samples is needed to clarify potential beneficial effects of exercise for reducing proactive memory interference.

  15. Increased Sensitivity to Proactive and Retroactive Interference in Amnestic Mild Cognitive Impairment: New Insights

    Science.gov (United States)

    Hanseeuw, Bernard J.; Seron, Xavier; Ivanoiu, Adrian

    2012-01-01

    Background: Increased sensitivity to proactive (PI) and retroactive (RI) interference has been observed in amnestic mild cognitive impairment (aMCI). PI and RI are often explained as being the result of a response competition mechanism. However, patients with aMCI are supposed to suffer mostly from encoding deficits. We hypothesized that in aMCI…

  16. The Ranschburg Effect: Tests of the Guessing-Bias and Proactive Interference Hypotheses

    Science.gov (United States)

    Walsh, Michael F.; Schwartz, Marian

    1977-01-01

    The guessing-bias and proactive interference hypotheses of the Ranschburg Effect were investigated by giving three groups different instructions as to guessing during recall. Results failed to support the prediction that the effect should be reduced or eliminated on shift trials. Neither hypothesis received significant support. (CHK)

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

    Science.gov (United States)

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

    2005-01-01

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

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

    NARCIS (Netherlands)

    Smets, Jorien; Wessel, Ineke; Raes, Filip

    Background and objectives: Reduced autobiographical memory specificity (rAMS), experiencing intrusive memories, and rumination appear to be risk factors for depression and depressive relapse. The aim of the current study was to investigate whether a weak resistance to proactive interference (PI)

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

    Science.gov (United States)

    Cowan, Nelson; Saults, J. Scott

    2013-01-01

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

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

    Science.gov (United States)

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

    2018-02-07

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

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

    Science.gov (United States)

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

    2018-03-01

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

  2. Does Proactive Interference Play a Significant Role in Visual Working Memory Tasks?

    Science.gov (United States)

    Makovski, Tal

    2016-01-01

    Visual working memory (VWM) is an online memory buffer that is typically assumed to be immune to source memory confusions. Accordingly, the few studies that have investigated the role of proactive interference (PI) in VWM tasks found only a modest PI effect at best. In contrast, a recent study has found a substantial PI effect in that performance…

  3. Randomized Controlled Trial Considering Varied Exercises for Reducing Proactive Memory Interference.

    Science.gov (United States)

    Frith, Emily; Sng, Eveleen; Loprinzi, Paul D

    2018-06-11

    We evaluated the effects of exercise on proactive memory interference. Study 1 ( n = 88) employed a 15-min treadmill walking protocol, while Study 2 ( n = 88) included a 15-min bout of progressive maximal exertion treadmill exercise. Each study included four distinct groups, in which groups of 22 participants each were randomly assigned to: (a) exercise before memory encoding, (b) a control group with no exercise, (c) exercise during memory encoding, and (d) exercise after memory encoding (i.e., during memory consolidation). We used the Rey Auditory Verbal Learning Test (RAVLT) to assess proactive memory interference. In both studies, the group that exercised prior to memory encoding recalled the most words from list B (distractor list) of the RAVLT, though group differences were not statistically significant for Study 1 (walking exercise) ( p = 0.521) or Study 2 (high-intensity exercise) ( p = 0.068). In this sample of young adults, high intensity exercise prior to memory encoding showed a non-significant tendency to attenuate impairments in recall attributable to proactive memory interference. Thus, future work with larger samples is needed to clarify potential beneficial effects of exercise for reducing proactive memory interference.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

  6. "Testing during Study Insulates against the Buildup of Proactive Interference": Correction

    Science.gov (United States)

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

    2009-01-01

    Reports an error in "Testing during study insulates against the buildup of proactive interference" by Karl K. Szpunar, Kathleen B. McDermott and Henry L. Roediger III ("Journal of Experimental Psychology: Learning, Memory, and Cognition," 2008[Nov], Vol 34[6], 1392-1399). Incorrect figures were printed due to an error in the…

  7. The effect of aging on the dynamics of reactive and proactive cognitive control of response interference

    Directory of Open Access Journals (Sweden)

    Ling Xiang

    2016-11-01

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

  8. Proactive Interference & Language Change in Hearing Adult Students of American Sign Language.

    Science.gov (United States)

    Hoemann, Harry W.; Kreske, Catherine M.

    1995-01-01

    Describes a study that found, contrary to previous reports, that a strong, symmetrical release from proactive interference (PI) is the normal outcome for switches between American Sign Language (ASL) signs and English words and with switches between Manual and English alphabet characters. Subjects were college students enrolled in their first ASL…

  9. Developmental Change in Proactive Interference across the Life Span: Evidence from Two Working Memory Tasks

    Science.gov (United States)

    Loosli, Sandra V.; Rahm, Benjamin; Unterrainer, Josef M.; Weiller, Cornelius; Kaller, Christoph P.

    2014-01-01

    Working memory (WM) as the ability to temporarily maintain and manipulate various kinds of information is known to be affected by proactive interference (PI) from previously relevant contents, but studies on developmental changes in the susceptibility to PI are scarce. In the present study, we investigated life span development of item-specific…

  10. Benefits of a hungry mind: When hungry, exposure to food facilitates proactive interference resolution.

    Science.gov (United States)

    Maran, Thomas; Sachse, Pierre; Martini, Markus; Furtner, Marco

    2017-01-01

    Hunger is an everyday motivational state, which biases cognition to detect food. Although evidence exists on how hunger affects basic attentional and mnemonic processes, less is known about how motivational drive for food modulates higher cognition. We aimed to investigate the effects of food deprivation on proactive interference resolution, in the presence and absence of food. Normal-weight participants performed a recency probes paradigm providing an experimental block with food and object stimuli as well as a control block with object stimuli only, in a fasted and a sated state. Results showed that the interaction of shifts in nutritional state with the perception of food cues evoked an altered resolution of proactive interference. Satiety led to impaired performance, whereas a hungry state resulted in strengthened resistance to proactive interference and lying in between, the control block presenting neutral objects remained unaffected by nutritional state manipulation. Additionally, a further increase in proactive interference resolution occurred when the conflicting probe depicted food compared to non-food objects. We conclude that when exposed to food, hunger initiates biased competition of active memory representations in favor of prioritized source information at cost of familiar, but irrelevant information. The implications of these findings are discussed in terms of an arousal-biased competition in working memory. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Focusing the Search: Proactive and Retroactive Interference and the Dynamics of Free Recall

    Science.gov (United States)

    Unsworth, Nash; Brewer, Gene A.; Spillers, Gregory J.

    2013-01-01

    Targeting information in long-term memory is an important cognitive ability, but one that is not well understood. In this study, 4 experiments were conducted to examine the influence of proactive and retroactive interference on memory targeting. Participants were given either 1 or 2 lists and asked to recall List 1, List 2, or in some cases both…

  12. The Critical Role of Retrieval Processes in Release from Proactive Interference

    Science.gov (United States)

    Bauml, Karl-Heinz T.; Kliegl, Oliver

    2013-01-01

    Proactive interference (PI) refers to the finding that memory for recently studied (target) information can be vastly impaired by the previous study of other (nontarget) information. PI can be reduced in a number of ways, for instance, by directed forgetting of the prior nontarget information, the testing of the prior nontarget information, or an…

  13. Reactive and Proactive Interference Control in Adults with Autism Spectrum Disorder across the Lifespan

    Science.gov (United States)

    Lever, Anne G.; Ridderinkhof, K. Richard; Marsman, Maarten; Geurts, Hilde M.

    2017-01-01

    As a large heterogeneity is observed across studies on interference control in autism spectrum disorder (ASD), research may benefit from the use of a cognitive framework that models specific processes underlying reactive and proactive control of interference. Reactive control refers to the expression and suppression of responses and proactive…

  14. Separating intentional inhibition of prepotent responses and resistance to proactive interference in alcohol-dependent individuals.

    Science.gov (United States)

    Noël, Xavier; Van der Linden, Martial; Brevers, Damien; Campanella, Salvatore; Verbanck, Paul; Hanak, Catherine; Kornreich, Charles; Verbruggen, Frederick

    2013-03-01

    Impulsivity is a hallmark of addictive behaviors. Addicts' weakened inhibition of irrelevant prepotent responses is commonly thought to explain this association. However, inhibition is not a unitary mechanism. This study investigated the efficiency of overcoming competition due to irrelevant responses (i.e., inhibition of a prepotent response) and overcoming competition in memory (i.e., resistance to proactive interference) in sober and recently detoxified alcohol-dependent individuals. Three cognitive tasks assessing the inhibition of a prepotent response (Hayling task, anti-saccade task and Stroop task) and two tasks tapping into the capacity to resist proactive interference (cued recall, Brown-Peterson variant) were administered to 30 non-amnesic recently detoxified alcohol-dependent individuals and 30 matched healthy participants without alcohol dependency. In addition, possible confounds such as verbal updating in working memory was assessed. Alcohol-dependent subjects performed worse than healthy participants on the three cognitive tasks assessing the inhibition of irrelevant prepotent responses but group performance was similar in the tasks assessing overcoming proactive interference in memory, updating of working memory and abstract reasoning. These findings suggest that alcohol-dependence is mainly associated with impaired capacity to intentionally suppress irrelevant prepotent response information. Control of proactive interference from memory is preserved. Theoretical and clinical implications are discussed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Connecting HRM and change management: the importance of proactivity and vitality

    NARCIS (Netherlands)

    Tummers, L.G.; Kruyen, P.M.; Vijverberg, D.M.; Voesenek, T.J.

    2015-01-01

    - Purpose – Organizations are continuously under pressure to adapt to changing circumstances. Job proactivity and vitality are important in changing environments. For instance, vital employees can better deal with change because they possess more energy. However, it is still unclear how

  16. Connecting HRM and Change Management: The Importance of Proactivity and Vitality

    NARCIS (Netherlands)

    L.G. Tummers (Lars); P.M. Kruyen; D. Vijverberg (Dominique); T. Voesenek (Tessa)

    2015-01-01

    textabstractPurpose. Organizations are continuously under pressure to adapt to changing circumstances. Job proactivity and vitality are important in changing environments. For instance, vital employees can better deal with change because they possess more energy. However, it is still unclear how

  17. Connecting HRM and Change Management: The Importance of Proactivity and Vitality

    NARCIS (Netherlands)

    Tummers, L.G.; Kruyen, P.M.; Vijverberg, D.; Voesenek, T.

    2015-01-01

    Purpose. Organizations are continuously under pressure to adapt to changing circumstances. Job proactivity and vitality are important in changing environments. For instance, vital employees can better deal with change because they possess more energy. However, it is still unclear how organizations

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

    Science.gov (United States)

    Griffin, Barbara; Loe, David; Hesketh, Beryl

    2012-01-01

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

  19. Adaptive versus proactive behavior in service recovery: The role of self-managing teams

    NARCIS (Netherlands)

    Jong, de A.; Ruyter, de J.C.

    2004-01-01

    In this article, we develop a conceptual model of adaptive versus proactive recovery behavior by self-managing teams (SMTs) in service recovery operations. To empirically test the conceptual model a combination of bank employee, customer, and archival data is collected. The results demonstrate

  20. Proactive behaviour may lead to failure in virtual project-based collaborative learning

    DEFF Research Database (Denmark)

    Bjørn, Pernille; Hertzum, Morten

    2005-01-01

    This paper argues that proactive behaviour, caused by high engagement and motivation of the learners, may lead to failure of collaborative learning. By examining empirical data from real-world text-only virtual negotiations between dispersed participants engaged in project-based collaborative...