Narrative Therapy and Stigma Management: Restorying the Patient Experience of Being Told, “You have MS

The purpose of this investigation was to determine if the way patients are informed of the diagnosis of multiple sclerosis (MS) affects their feelings about themselves as people with MS. Building on illness narrative, I hoped to examine how patients “storied” their experience of being informed of the diagnosis of MS and whether this “storying” had a lasting impact on their self-concept. The alternative would be that no connection exists between how a neurologist informs a patient of the diagnosis and how a person makes sense of their diagnosis and life with MS. Due to study limitations (e.g., small sample size, threat of response bias), the results are unclear about whether the way in which the news is broken has a lasting effect on patients' perceptions. However, review of the literature and patient responses indicate that there is a need for psychological intervention when patients are diagnosed with MS.

River Recreation Management in Western States: Results of a Recreation Management Survey

This Capstone represents a qualitative analysis of survey responses concerning river recreation management policies and techniques in the Western United States. Respondents were asked about management topics including permits and fees, monitoring, enforcement, resource management, recreational experience, and current and future demand for whitewater rafting. Responses with consistent results include those for questions concerning permits for commercial uses, justification of fees, and enforcement, while responses with variation in results were received for questions concerning permits for private uses, agency self-sufficiency, monitoring, and use capacity. Most respondents do not expect a significant increased demand for commercial or private boating in the next five years. Respondents that do expect an increase do not see a need for additional commercial outfitters.

Update of financial self-sufficiency study and guidelines. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

A memorandum on industrial self-government : together with a draft scheme for a Builders' National Industrial Parliament /

Mode of access: Internet.

The Inefficiency of Self-Sufficiency: Uzbekistan's Response to CASA-1000

Thesis (Master's)--University of Washington, 2016-06

A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings

The persistence of negative attitudes towards cancer pain and its treatment suggests there is scope for identifying more effective pain education strategies. This randomized controlled trial involving 189 ambulatory cancer patients evaluated an educational intervention that aimed to optimize patients' ability to manage pain. One week post-intervention, patients receiving the pain management intervention (PMI) had a significantly greater increase in self-reported pain knowledge, perceived control over pain, and number of pain treatments recommended. Intervention group patients also demonstrated a greater reduction in willingness to tolerate pain, concerns about addiction and side effects, being a "good" patient, and tolerance to pain relieving medication. The results suggest that targeted educational interventions that utilize individualized instructional techniques may alter cancer patient attitudes, which can potentially act as barriers to effective pain management. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

A longitudinal study of employee adaptation to organizational change: The role of change-related information and change-related self-efficacy

This study examined the role of information, efficacy, and 3 stressors in predicting adjustment to organizational change. Participants were 589 government employees undergoing an 18-month process of regionalization. To examine if the predictor variables had long-term effects on adjustment, the authors assessed psychological well-being, client engagement, and job satisfaction again at a 2-year follow-up. At Time 1, there was evidence to suggest that information was indirectly related to psychological well-being, client engagement, and job satisfaction, via its positive relationship to efficacy. There also was evidence to suggest that efficacy was related to reduced stress appraisals, thereby heightening client engagement. Last, there was consistent support for the stress-buffering role of Time I self-efficacy in the prediction of Time 2 job satisfaction.

Subordinate-manager gender combination and perceived leadership style influence on emotions, self-esteem and organizational commitment

A theoretical model was developed to investigate the relationships among subordinate-manager gender combinations, perceived leadership style, experienced frustration and optimism, organization-based self-esteem and organizational commitment. The model was tested within the context of a probabilistic structural model, a discrete Bayesian network, using cross-sectional data from a global pharmaceutical company. The Bayesian network allowed forward inference to assess the relative influence of gender combination and leadership style on the emotions, self-esteem and commitment consequence variables. Further, diagnostics from backward inference were used to assess the relative influence of variables antecedent to organizational commitment. The results showed that gender combination was independent of leadership style and had a direct impact on subordinates' levels of frustration and optimism. Female manager-female subordinate had the largest probability of optimism, while male manager teamed with a male subordinate had the largest probability of frustration. Furthermore, having a female manager teamed up with a male subordinate resulted in the lowest possibility of frustration. However, the findings show that the gender issue is not simply female managers versus male managers, but is concerned with the interaction of the subordinate-manager gender combination and leadership style in a nonlinear manner. (C) 2003 Elsevier Inc. All rights reserved.

Why does dissimilarity matter? Exploring self-categorization, self-enhancement, and uncertainty reduction

Although relational demographers have based their arguments on self-categorization theory, they have paid little attention to the underlying processes associated with this theory. The authors examined whether demographic dissimilarity affects individuals' identification with groups by affecting the group's prototype valence and clarity and the individual's perceptions of self-prototypicality. The data showed that the proportion of women and non-Australians in 34 work groups negatively influenced prototype valence, prototype clarity, and self-prototypicality for all members of the group. These results provide support for the continued use of self-categorization theory by relational demographers.

Multidisciplinary strategies for the management of heart failure patients at high risk for admission - A systematic review of randomized trials

OBJECTIVES The aim of this study was to determine whether multidisciplinary strategies improve outcomes for heart failure (HF) patients. BACKGROUND Because the prognosis of HF remains poor despite pharmacotherapy, there is increasing interest in alternative models of care delivery for these patients. METHODS Randomized trials of multidisciplinary management programs in HF were identified by searching electronic databases and bibliographies and via contact with experts. RESULTS Twenty-nine trials (5,039 patients) were identified but were not pooled, because of considerable heterogeneity. A priori, we divided the interventions into homogeneous groups that were suitable for pooling. Strategies that incorporated follow-up by a specialized multidisciplinary team (either in a clinic or a non-clinic setting) reduced mortality (risk ratio [RR] 0.75, 95% confidence interval [CI] 0.59 to 0.96), HF hospitalizations (RR 0.74, 95% CI 0.63 to 0.87), and all-cause hospitalizations (RR 0.81, 95% CI 0.71 to 0.92). Programs that focused on enhancing patient self-care activities reduced HF hospitalizations (RR 0.66, 95% CI 0.52 to 0.83) and all-cause hospitalizations (RR 0.73, 95% CI 0.57 to 0.93) but had no effect on mortality (RR 1.14, 95% CI 0.67 to 1.94). Strategies that employed telephone contact and advised patients to attend their primary care physician in the event of deterioration reduced HF hospitalizations (RR 0.75, 95% CI 0.57 to 0.99) but not mortality (RR 0.91, 95% CI 0.67 to 1.29) or all-cause hospitalizations (RR 0.98, 95% CI 0.80 to 1.20). In 15 of 18 trials that evaluated cost, multidisciplinary strategies were cost-saving. CONCLUSIONS Multidisciplinary strategies for the management of patients with HF reduce HF hospitalizations. Those programs that involve specialized follow-up by a multidisciplinary team also reduce mortality and all-cause hospitalizations. (C) 2004 by the American College of Cardiology Foundation.

Options for guaranteeing the effective management of the world's protected areas

A rapid increase in the number and size of protected areas has prompted interest in their effectiveness and calls for guarantees that they are providing a good return on investment by maintaining their values. Research reviewed here suggests that many remain under threat and a significant number are already suffering deterioration. One suggestion for encouraging good management is to develop a protected-area certification system: however this idea remains controversial and has created intense debate. We list a typology of options for guaranteeing good protected-area management, and give examples, including: danger lists; self-reporting systems against individual or standardised criteria; and independent assessment including standardised third-party reporting, use of existing certification systems such as those for forestry and farming and certification tailored specifically to protected areas. We review the arguments for and against certification and identify some options, such as: development of an accreditation scheme to ensure that assessment systems meet minimum standards; building up experience from projects that are experimenting with certification in protected areas; and initiating certification schemes for specific users such as private protected areas or institutions like the World Heritage Convention.

Leadership, self, and identity: A review and research agenda

This article reviews empirical research on the role of follower self-conception in leader-ship effectiveness. and specifies an agenda for future research in this area. The review shows that several aspects of follower self-conception (i.e., self-construal, self-efficacy, self-esteem, and self-consistency) may be affected by leadership. and may mediate the effects of leadership on follower behavior. There also is consistent evidence that follower self-construal moderates the impact of leadership on follower attitudes and behavior. Two key themes for future research are defined. First, future research should focus on the development of theory about the role of relational self-construal in the leadership process. Second, it seems particularly valuable to develop theory about the interplay of different aspects of follower self-conception in leadership effectiveness. including the interactive effects of these aspects of self Working backwards from these theoretical models of follower self-conception, specific leader behavior relevant to these aspects of self should then be identified. (C) 2004 Elsevier Inc. All rights reserved.

Measuring impacts of an holistic farm business management training program

A case study approach within an action research framework incorporating qualitative and quantitative domains was adopted to explore the impact on Queensland farmers of a farm business management extension programme. Three new indices were developed to quantify changes perceived by participants. The first measure, the Bennett Change Index, provided statistically significant evidence that attitudinal and behavioural changes were more frequent in participants with less formal education, but also more frequent in participants who had high urbanisation and self-directed learning index scores. The other 2 new indices, Management Constructs Change and Management Objectives Change, provided evidence of statistically significant changes in participant beliefs about, and attitudes towards, farm business management. Although highly correlated with each other, these changes were unrelated statistically to any of 6 other commonly used biographical or psychometric indices employed; including level of formal education. It is concluded that these new measures, with context-relevant modifications, have potential as aids to programme impact evaluation in a range of agricultural and wider applications. They may provide insights into personal psychological issues that complement direct behavioural measures of change.

Cross-cultural perceptions in the leadership process: Theoretical perspective on the influence of culture on self-concepts and manager worker attributions

This article examines the influence of culture on the way managers and workers perceive causes of success and failure in organizational tasks. The author argues that selfserving and actor-observer biases, as well as other attribution errors, will be moderated by culture. Specifically, managers and workers with a sociocentric self-concept from high-context cultures may be biased toward external attributions, while managers from low-context cultures with an idiocentric self-concept have a tendency to make more internal attributions. These variations in attributions have consequences that affect both managers and workers. Theoretical propositions and implications for international management practices are discussed. © 2005 Wiley Periodicals, Inc.

Medication management at home: medication-related risk factors associated with poor health outcomes

Background: some patients may have medication-related risk factors only identified by home visits, but the extent to which those risk factors are associated with poor health outcomes remains unclear. Objective: to determine the association between medication-related risk factors and poor patient health outcomes from observations in the patients' homes. Design: cross-sectional study. Setting: patients' homes. Subjects: 204 general practice patients living in their own homes and at risk of medication-related poor health outcomes. Methods: medications and medication-related risk factors were identified in the patients' homes by community pharmacists and general practitioners (GPs). The medication-related risk factors were examined as determinants of patients' self-reported health related quality of life (SF-36) and their medication use, as well as physicians' impression of patient adverse drug events and health status. Results: key medication-related risk factors associated with poor health outcomes included: Lack of any medication administration routine, therapeutic duplication, hoarding, confusion between generic and trade names, multiple prescribers, discontinued medication repeats retained and multiple storage locations. Older age and female gender were associated with some poorer health outcomes. In addition, expired medication and poor adherence were also associated with poor health outcomes, however, not independently. Conclusion: the findings support the theory that polypharmacy and medication-related risk factors as a result of polypharmacy are correlated to poor health outcomes.