Strategies of Active Dissemination of Workplace Health Promotion

Purpose – A growing body of literature provides evidence for the efficacy of workplace health promotion (WHP). However, little is known about effective dissemination strategies for WHP interventions. The purpose of this paper is to describe how a WHP agency in Zurich, Switzerland, used bulk mailings, information events, telephone marketing and free initial consultations for the large-scale geographic marketing of WHP services, with a focus on tobacco prevention (TP). Design/methodology/approach – To analyze the number of companies responding positively to solicitation, examine the predictors of positive responses and explore the reasons for negative responses, the authors used both quantitative (e.g. a standardized questionnaire) and qualitative (telephone interviews) methods. Findings – The results show that except for telephone marketing (69 percent), the success rates of dissemination activities were very low (3-9 percent). Predictors for a positive response were institutionalization of WHP, the representative’s personal concern about TP, and problems with environmental tobacco smoke within the company. The most prominent reason for a negative Response was that the companies had already implemented TP measures by themselves and needed no further external support. Practical implications – It is suggested that TP was the wrong emphasis for a WHP program to be disseminated at that particular time, because a law on protection from passive smoking was introduced in Switzerland shortly afterwards. Originality/value – The study examines dissemination strategies under real-life Consulting conditions. It builds on on a large sample of companies and uses both quantitative and qualitative research methods. It reports specific numbers and success rates of marketing activities and thereby contributes to the knowledge about an important issue for intervention planning in the field of WHP.

Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

QUESTIONS UNDER STUDY As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. METHODS We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. RESULTS A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p <0.01) compared with the French-speaking region (44%, 36 µg); the Zurich region had intermediate values (52%, 39 µg). We found no association between treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). CONCLUSIONS There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

Overcoming Liability of Newness through Socialization : How Legitimation Strategies of a New Venture evolve

Liability of newness, the tendency of new ventures to die early after market entry, results from lacking legitimacy in their new cultural context and according failure to acquire resources. Based on a longitudinal case study on repeated resource acquisition attempts of a new venture, we found that overcoming liability of newness depended on the socialization of the new venture to the normative environment on which it depended on for resources. Over time and across repeated resource acquisition attempts, socialization - the process of learning the use of legitimate symbols and their culturally contingent meanings - enabled the new venture to become the skillful cultural operator on which legitimation and resource acquisition was contingent. From our data, 'Accumulating a repertoire of legitimate symbols' and 'Assimilating the evaluations of resource-holders' emerged as the two primary mechanisms for new venture socialization. The study's contributions to related literature and its broader theoretical implications are discussed

Tattoo: a multifaceted medium of communication

This article suggests the systems theoretical distinction of form/medium as a useful tool for distinguishing social phenomena that might look as if they stem from the same process. This is shown to be the case for the tattoo and tattooing. The tattoo is conceived as a medium of communication through which different forms of communication emerge. Tattooing is one of these forms of communication that shapes the medium in a particular way. The current article sheds a special light on its intricate, communicational constellation, for which the concept of parallax is suggested. Law, medicine and cosmetics as other forms of communication use the medium of tattoo in their own way as well. The form/medium distinction allows us to grasp these different forms of communication, while it shows that they share the tattoo as medium. The article’s ultimate goal is to illustrate that the tattoo figures as a multifaceted medium of communication.

A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT] — Effects of Three Different Strategies of Implementation

BACKGROUND: Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). METHODS: For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. FINDINGS: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. INTERPRETATION: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. FUNDING: Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF. KEYWORDS: Cognitive behavioral therapy; Evidence-based treatment; Implementation strategies; Randomized controlled trial

Improving the Assessment of Communication Skills at the Swiss Federal Licensing Exam: Results of a Student's Needs Assessment

Introduction With a three year project the assessment of communication skills within the Swiss Federal Licensing Examinations (FLE) shall be improved. As a first step a needs assessment among communication experts and medical students of the Swiss Medical Faculties will be performed. In this presentation the results of the students’ needs assessment will be presented. Methods A bilingual student’s online questionnaire will be developed by an expert panel taking relevant literature, the Swiss Catalogue of Learning Objectives and other consensus statements for communication (e.g., the European and Basler consensus statements) into account. With a think aloud study response process validity evidence will be sought. The questionnaire will focus on the following topics related to communication skills: (1) What has been taught?, (2) What has been assessed in the faculty exams?, (3) What has been assessed in the FLE?, (4) What should have been assessed in the FLE and how should the assessment be improved? Results Results of the students’ needs assessment will be available by the end of 2015 and be presented. Conclusions/ Take-home message We hope for valuable input for improving the assessment of communications skills within the FLE also from the students’ side. Results of the needs assessment from the students and experts will be combined and taken as input for an international expert symposium on how to improve the communication skills assessment within the FLE.

The impact of communication and cultural diversity in utilizing dental services among Saudi Arabian students in U.S.A.

Objectives: The purpose of this study is to understand the perceived effects of patient-dental staff communication and cultural diversity on the utilization of dental services in the U.S. by Saudi Arabian students who live in the U.S. and enrolled into the King Abdullah Scholarship program. Methods: The study design was an analytical cross-sectional study. Data for this study was obtained from the Saudi Dental Servicers Utilization Survey, a voluntary internet survey available online for one month through Facebook. Ordered logistic regression analyses and multinomial logistic regression analyses were used to measure the relationships between patient-dental staff communication and cultural diversity on the utilization of dental services. Results: Eight hundred and forty-seven responses were analyzed for this study. Overall, the majority of Saudi students reported having excellent communication experience with dental providers in the U.S. More than 58% of respondents reported at least one regular dental visit last year. Factors that influenced the use of regular dental care were: dentist's explanation of treatment plan, response of dental staff to patient's needs, respectful and polite dental staff, dental staff kindness, availability of up-to-date equipment, and overall communication with dentist. However, the utilization of emergency dental care was not associated with any measurement of patient-dental provider communication. Overall future utilization of dental care is associated with all aspects of patient-dental staff communication measured in this survey. Furthermore, more utilization of regular dental care was related to respondent's perception of the importance of trustworthiness dental staff and the importance of a dentist's reputation was only marginally associated. Respondent's perception of dentist's reputation was associated with more use of emergency dental services. Respondents are more likely to anticipate using dental care in the future if they perceived trustworthiness dental staff, and the dentist's reputation as influencing factors to their usage of dental services. Conclusions: Patient-dental staff communication was partially associated with utilization of regular dental care, not associated with utilization of emergency dental care, and broadly associated with anticipated future utilization of dental care. In addition, trustworthy dental staff, and a dentist's reputation were considered to be strong influencing factors towards utilization of dental services.^

Energy, Complexity and Strategies of Evolution. En: Avá, nº 14

Cultural evolution has long been among the themes of anthropology but it has never ranked high. It is left mainly to archaeologists because they have to make sense of how society works and survives through time–a concern that has pretty much been abandoned by many cultural anthropologists. Anthropologists today seem little motivated to find out how society works, but rather to make the world a better place to live in for a particular population. The challenges of atmospheric change, nuclear proliferation, environmental degradation and resource exhaustion, the emergence of life threatening species–these challenges of contemporary evolution have awakened less interest in anthropology. The concern with cultural evolution seems to be of greater interest to non-anthropologists, such as in the work of Jarrod Diamond (2005), a biologist, and the genre that as emerged as Big History, with the works of David Christian (2005) and others. Among the few contemporary anthropologists who have sought the dynamics of cultural evolution, the work of Joseph Tainter (1996) stands out.

The Sheepskin Marketing Channel in Ethiopia after Liberalization: The Survival Strategies of the Participants

Sheepskin market in Ethiopia seems to enjoy the benefits of the economic liberalization policy since 1991, such as price deregulation or liberalization of economic activities. The close observation on the profiles and activities of each actor in the marketing channel, however, illustrates that the actors have tried to complement the lack of appropriate infrastructure and legal protection, which should be provided by the government, through utilizing their social and blood ties. While these ties have implemented the role of the government, there are risks that the marketing channel might be developed based on coalition with social network and the poor without the network would be excluded.

A Language to Formalize and to Operationalize Problem-solving Strategies of Structured Knowledge Models

This paper describes a proposal of a language called Link which has been designed to formalize and operationalize problem solving strategies. This language is used within a software environment called KSM (Knowledge Structure Manager) which helps developers in formulating and operationalizing structured knowledge models. The paper presents both its syntax and dynamics, and gives examples of well-known problem-solving strategies of reasoning formulated using this language.

The Influence of Communication Range on Connectivity for Resilient Wireless Sensor Networks Using a Probabilistic Approach.

Wireless sensor networks (WSNs) consist of thousands of nodes that need to communicate with each other. However, it is possible that some nodes are isolated from other nodes due to limited communication range. This paper focuses on the influence of communication range on the probability that all nodes are connected under two conditions, respectively: (1) all nodes have the same communication range, and (2) communication range of each node is a random variable. In the former case, this work proves that, for 0menor queepsmenor quee^(-1) , if the probability of the network being connected is 0.36eps , by means of increasing communication range by constant C(eps) , the probability of network being connected is at least 1-eps. Explicit function C(eps) is given. It turns out that, once the network is connected, it also makes the WSNs resilient against nodes failure. In the latter case, this paper proposes that the network connection probability is modeled as Cox process. The change of network connection probability with respect to distribution parameters and resilience performance is presented. Finally, a method to decide the distribution parameters of node communication range in order to satisfy a given network connection probability is developed.

Evaluation of mission planning strategies of a robotic aerial vehicle for the AIRC international competition

The International Aerial Robotics Competition (IARC) is an important event where teams from universities design flying autonomous vehicles to overcome the last challenges in the field. The goal of the Seventh Mission proposed by the IARC is to guide several mobile ground robots to a target area. The scenario is complex and not determinist due to the random behavior of the ground robots movement. The UAV must select efficient strategies to complete the mission. The goal of this work has been evaluating different alternative mission planning strategies of a UAV for this competition. The Mission Planner component is in charge of taking the UAV decisions. Different strategies have been developed and evaluated for the component, achieving a better performance Mission Planner and valuable knowledge about the mission. For this purpose, it was necessary to develop a simulator to evaluate the different strategies. The simulator was built as an improvement of an existing previous version.

Gestión intelectual de las prácticas comunicativas en arquitectura : S, M, L, XL, el gran evento = The intellectual management of communication practices in architecture : S, M, L, XL, the big event

La tesis doctoral se centra en la posibilidad de entender que la práctica de arquitectura puede encontrar en las prácticas comunicativas un apoyo instrumental, que sobrepasa cualquier simplificación clásica del uso de los medios como una mera aplicación superficial, post-producida o sencillamente promocional. A partir de esta premisa se exponen casos del último cuarto del siglo XX y se detecta que amenazas como el riesgo de la banalización, la posible saturación de la imagen pública o la previsible asociación incorrecta con otros individuos en presentaciones grupales o por temáticas, han podido influir en un crecimiento notable de la adquisición de control, por parte de los arquitectos, en sus oportunidades mediáticas. Esto es, como si la arquitectura hubiera empezado a superar y optimizar algo inevitable, que las fórmulas expositivas y las publicaciones, o más bien del exponer(se) y publicar(se), son herramientas disponibles para activar algún tipo de gestión intelectual de la comunicación e información circulante sobre si misma. Esta práctica de “autoedición” se analiza en un periodo concreto de la trayectoria de OMA -Office for Metropolitan Architecture-, estudio considerado pionero en el uso eficiente, oportunista y personalizado de los medios. Así, la segunda parte de la tesis se ocupa del análisis de su conocida monografía S,M,L,XL (1995), un volumen que contó con gran participación por parte de sus protagonistas durante la edición, y de cuyo proceso de producción apenas se había investigado. Esta publicación señaló un punto de inflexión en su género alterando todo formato y restricciones anteriores, y se ha convertido en un volumen emblemático para la disciplina que ninguna réplica posterior ha podido superar. Aquí se presenta a su vez como el desencadenante de la construcción de un “gran evento” que concluye en la transformación de la identidad de OMA en 10 años, paradójicamente entre el nacimiento de la Fundación Groszstadt y el arranque de la actividad de AMO, dos entidades paralelas clave anexas a OMA. Este planteamiento deviene de cómo la investigación desvela que S,M,L,XL es una pieza más, central pero no independiente, dentro de una suma de acciones e individuos, así como otras publicaciones, exposiciones, eventos y también artículos ensayados y proyectos, en particular Bigness, Generic City, Euralille y los concursos de 1989. Son significativos aspectos como la apertura a una autoría múltiple, encabezada por Rem Koolhaas y el diseñador gráfico Bruce Mau, acompañados en los agradecimientos de la editora Jennifer Sigler y cerca de una centena de nombres, cuyas aportaciones no necesariamente se basan en la construcción de fragmentos del libro. La supresión de ciertos límites permite superar también las tareas inicialmente relevantes en la edición de una publicación. Un objetivo general de la tesis es también la reflexión sobre relaciones anteriormente cuestionadas, como la establecida entre la arquitectura y los mercados o la economía. Tomando como punto de partida la idea de “design intelligence” sugerida por Michael Speaks (2001), se extrae de sus argumentos que lo esencial es el hallazgo de la singularidad o inteligencia propia de cada estudio de arquitectura o diseño. Asimismo se explora si en la construcción de ese tipo de fórmulas magistrales se alojaban también combinaciones de interés y productivas entre asuntos como la eficiencia y la creatividad, o la organización y las ideas. En esta dinámica de relaciones bidireccionales, y en ese presente de exceso de información, se fundamenta la propuesta de una equivalencia más evidenciada entre la “socialización” del trabajo del arquitecto, al compartirlo públicamente e introducir nuevas conversaciones, y la relación inversa a partir del trabajo sobre la “socialización” misma. Como si la consciencia sobre el uso de los medios pudiera ser efectivamente instrumental, y contribuir al desarrollo de la práctica de arquitectura, desde una perspectiva idealmente comprometida e intelectual. ABSTRACT The dissertation argues the possibility to understand that the practice of architecture can find an instrumental support in the practices of communication, overcoming any classical simplification of the use of media, generally reduced to superficial treatments or promotional efforts. Thus some cases of the last decades of the 20th century are presented. Some threats detected, such as the risk of triviality, the saturation of the public image or the foreseeable wrong association among individuals when they are introduced as part of thematic groups, might have encouraged a noticeable increase of command taken by architects when there is chance to intervene in a media environment. In other words, it can be argued that architecture has started to overcome and optimize the inevitable, the fact that exhibition formulas and publications, or simply the practice of (self)exhibition or (self)publication, are tools at our disposal for the activation of any kind of intellectual management of communication and circulating information about itself. This practice of “self-edition” is analyzed in a specific timeframe of OMA’s trajectory, an office that is considered as a ground-breaking actor in the efficient and opportunistic use of media. Then the second part of the thesis dissects their monograph S,M,L,XL (1995), a volume in which its main characters were deeply involved in terms of edition and design, a process barely analyzed up to now. This publication marked a turning point in its own genre, disrupting old formats and traditional restrictions. It became such an emblematic volume for the discipline that none of the following attempts of replica has ever been able to improve this precedent. Here, the book is also presented as the element that triggers the construction of a “big event” that concludes in the transformation of OMA identity in 10 years. Paradoxically, between the birth of the Groszstadt Foundation and the early steps of AMO, both two entities parallel and connected to OMA. This positions emerge from how the research unveils that S,M,L,XL is one more piece, a key one but not an unrelated element, within a sum of actions and individuals, as well as other publications, exhibitions, articles and projects, in particular Bigness, Generic City, Euralille and the competitions of 1989. Among the remarkable innovations of the monograph, there is an outstanding openness to a regime of multiple authorship, headed by Rem Koolhaas and the graphic designer Bruce Mau, who share the acknowledgements page with the editor, Jennifer Sigler, and almost 100 people, not necessarily responsible for specific fragments of the book. In this respect, the dissolution of certain limits made possible that the expected tasks in the edition of a publication could be trespassed. A general goal of the thesis is also to open a debate on typically questioned relations, particularly between architecture and markets or economy. Using the idea of “design intelligence”, outlined by Michael Speaks in 2001, the thesis pulls out its essence, basically the interest in detecting the singularity, or particular intelligence of every office of architecture and design. Then it explores if in the construction of this kind of ingenious formulas one could find interesting and useful combinations among issues like efficiency and creativity, or organization and ideas. This dynamic of bidirectional relations, rescued urgently at this present moment of excess of information, is based on the proposal for a more evident equivalence between the “socialization” of the work in architecture, anytime it is shared in public, and the opposite concept, the work on the proper act of “socialization” itself. As if a new awareness of the capacities of the use of media could turn it into an instrumental force, capable of contributing to the development of the practice of architecture, from an ideally committed and intelectual perspective.