990 resultados para Digital rectal examination


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Organizations are increasingly relying on teams to do the work that has traditionally been done by individuals. At the same time, the environments in which these organizations and teams operate have been becoming progressively more complex and uncertain. These trends raise important questions about the factors that enable teams to adapt. In response to these questions, the current study sought to identify the cognitive, behavioral, and motivational processes and emergent states that promote a team's adaptation to unforeseen changes and novel events, and the team compositional characteristics and leadership processes that enabled these processes and emergent states. Two hundred twenty two undergraduate students from a large Southeastern University composed 74 3-person teams, and participated in a computerized decision-making simulation where each team formed the governing body (i.e., Mayor's cabinet) for two separate simulated cities, and made strategic decisions about city operations. Participants were randomly assigned to one of three roles, distributing expertise and creating mutual interdependence. External team leader sensegiving was manipulated through video recorded communications from an external team leader. Results indicate that team cognitive ability, achievement striving, and psychological collectivism, as well as external team leader sensegiving, were all related to the similarity and quality of team members' strategy-focused mental models (cognitive emergent states), and to the amount of information sharing among members (behavioral process). In turn, teams with more similar and higher quality mental models, and who shared greater levels of information, were found to have a greater ability to react and adapt to environmental changes, and to have greater levels of decision-making effectiveness. Results indicate a pattern of relationships consistent with hypotheses, and have important implications for organizations and knowledge-based teams charged with management responsibilities. Organizations should staff teams with the compositional characteristics that enable the development of similar and high quality mental models, and that promote information sharing among teammates. Similarly, organizations which train and develop leaders to engage in sensegiving behaviors enable team adaptability and promote enhanced decision-making effectiveness when faced with unforeseen changes and novel situations.

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The purpose of this study was to test Lotka’s law of scientific publication productivity using the methodology outlined by Pao (1985), in the field of Library and Information Studies (LIS). Lotka’s law has been sporadically tested in the field over the past 30+ years, but the results of these studies are inconclusive due to the varying methods employed by the researchers. ^ A data set of 1,856 citations that were found using the ISI Web of Knowledge databases were studied. The values of n and c were calculated to be 2.1 and 0.6418 (64.18%) respectively. The Kolmogorov-Smirnov (K-S) one sample goodness-of-fit test was conducted at the 0.10 level of significance. The Dmax value is 0.022758 and the calculated critical value is 0.026562. It was determined that the null hypothesis stating that there is no difference in the observed distribution of publications and the distribution obtained using Lotka’s and Pao’s procedure could not be rejected. ^ This study finds that literature in the field of Library and Information Studies does conform to Lotka’s law with reliable results. As result, Lotka’s law can be used in LIS as a standardized means of measuring author publication productivity which will lead to findings that are comparable on many levels (e.g., department, institution, national). Lotka’s law can be employed as an empirically proven analytical tool to establish publication productivity benchmarks for faculty and faculty librarians. Recommendations for further study include (a) exploring the characteristics of the high and low producers; (b) finding a way to successfully account for collaborative contributions in the formula; and, (c) a detailed study of institutional policies concerning publication productivity and its impact on the appointment, tenure and promotion process of academic librarians. ^

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Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use.^ The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used.^ Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. ^ This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.^

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This nonexperimental, correlational study (N = 283) examined the relation among job fit, affective commitment, psychological climate, discretionary effort, intention to turnover, and employee engagement. An internet-based self-report survey battery of six scales were administered to a heterogeneous sampling of organizations from the fields of service, technology, healthcare, retail, banking, nonprofit, and hospitality. Hypotheses were tested through correlational and hierarchical regression analytic procedures. Job fit, affective commitment, and psychological climate were all significantly related to employee engagement and employee engagement was significantly related to both discretionary effort and intention to turnover. For the discretionary effort model, the hierarchical regression analysis results suggested that the employees who reported experiencing a positive psychological climate were more likely to report higher levels of discretionary effort. As for the intention to turnover model, the hierarchical regression analysis results indicated that affective commitment and employee engagement predicted lower levels of an employee’s intention to turnover. The regression beta weights ranged from to .43 to .78, supporting the theoretical, empirical, and practical relevance of understanding the impact of employee engagement on organizational outcomes. Implications for HRD theory, research, and practice are highlighted as possible strategic leverage points for creating conditions that facilitate the development of employee engagement as a means for improving organizational performance.

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Purpose. The Internet has provided an unprecedented opportunity for psychotropic medication consumers, a traditionally silenced group in clinical trial research, to have voice by contributing to the construction of drug knowledge in an immediate, direct manner. Currently, there are no systematic appraisals of the potential of online consumer drug reviews to contribute to drug knowledge. The purpose of this research was to explore the content of drug information on various websites representing themselves as consumer- and expert-constructed, and as a practical consideration, to examine how each source may help and hinder treatment decision-making.^ Methodology. A mixed-methods research strategy utilizing a grounded theory approach was used to analyze drug information on 5 exemplar websites (3 consumer- and 2 expertconstructed) for 2 popularly prescribed psychotropic drugs (escitalopram and quetiapine). A stratified simple random sample was used to select 1,080 consumer reviews from the websites (N=7,114) through February 2009. Text was coded using QDA Miner 3.2 software by Provalis Research. A combination of frequency tables, descriptive excerpts from text, and chi-square tests for association were used throughout analyses.^ Findings. The most frequently mentioned effects by consumers taking either drug were related to psychological/behavioral symptoms and sleep. Consumers reported many of the same effects as found on expert health sites, but provided more descriptive language and situational examples. Expert labels of less serious on certain effects were not congruent with the sometimes tremendous burden described by consumers. Consumers mentioned more than double the themes mentioned in expert text, and demonstrated a diversity and range of discourses around those themes.^ Conclusions. Drug effects from each source were complete relative to the information provided in the other, but each also offered distinct advantages. Expert health sites provided concise summaries of medications’ effects, while consumer reviews had the added advantage of concrete descriptions and greater context. In short, consumer reviews better prepared potential consumers for what it’s like to take psychotropic drugs. Both sources of information benefit clinicians and consumers in making informed treatment-related decisions. Social work practitioners are encouraged to thoughtfully utilize online consumer drug reviews as a legitimate additional source for assisting clients in learning about treatment options.^

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Diabetes self-management, an essential component of diabetes care, includes weight control practices and requires guidance from providers. Minorities are likely to have less access to quality health care than White non-Hispanics (WNH) (American College of Physicians-American Society of Internal Medicine, 2000). Medical advice received and understood may differ by race/ethnicity as a consequence of the patient-provider communication process; and, may affect diabetes self-management. ^ This study examined the relationships among participants’ report of: (1) medical advice given; (2) diabetes self-management, and; (3) health outcomes for Mexican-Americans (MA) and Black non-Hispanics (BNH) as compared to WNH (reference group) using data available through the National Health and Nutrition Examination Survey (NHANES) for the years 2007–2008. This study was a secondary, single point analysis. Approximately 30 datasets were merged; and, the quality and integrity was assured by analysis of frequency, range and quartiles. The subjects were extracted based on the following inclusion criteria: belonging to either the MA, BNH or WNH categories; 21 years or older; responded yes to being diagnosed with diabetes. A final sample size of 654 adults [MA (131); BNH (223); WNH (300)] was used for the analyses. The findings revealed significant statistical differences in medical advice reported given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), p<0.001]. There were differences among ethnicities for reporting receiving recent diabetes education. Black, non-Hispanics were twice as likely to report receiving diabetes education than WNH [OR = 2.29 (1.36, 3.85), p = 0.004]. Medical advice reported given and ethnicity/race, together, predicted several health outcomes. Having recent diabetes education increased the likelihood of performing several diabetes self-management behaviors, independent of race. ^ These findings indicate a need for patient-provider communication and care to be assessed for effectiveness and, the importance of ongoing diabetes education for persons with diabetes.^

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Although corporate environmental accountability is receiving unprecedented attention in the United States from policy makers, the capital market, and the public at large, extant research is limited in its examination of the implications of strategic corporate environmental initiatives on accounting and auditing. The purpose of my dissertation is to address these implications by examining the association between firm environmental initiatives and audit fees, capital expenditures, and earnings quality using multivariate regression analysis. I find that firms engaged in more strategic environmental initiatives tend to have significantly higher audit fees and capital expenditures, and significantly lower levels of earnings manipulation measured using discretionary accruals. These results support the notion that auditors do recognize the importance of environmental initiatives when conducting the year-end financial statement audit, an idea that positively reflects upon the auditor’s monitoring role. The results also demonstrate the increased amount of capital resources required to participate in strategic environmental initiatives, an anecdotal notion that had yet to be empirically supported. This empirical support provides valuable insights on how environmental initiatives materially impact corporate financial statements. Finally, my results extend the extant literature by demonstrating that the superior financial performance reported by environmentally active firms is less likely driven by earnings manipulation by management, and by implication, more likely a result of real economic gains. Taken together, my dissertation establishes a strong and timely foundation for current and future research to explore corporate environmental initiatives in the United States and globally, a topic increasingly gaining momentum in today’s more eco-conscious world.^

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School principals' leadership is key to successful school reform, as is increased student achievement. This nonexperimental ex post facto study tested relationships among secondary school principals' leadership behaviors, school climate, and student achievement. Of 165 secondary school principals from the three largest school districts in South Florida, 58 completed three online survey instruments: the Leadership Practices Inventory, School Climate Inventory-Revised, and researcher-designed Demographic Questionnaire. Student achievement was measured by students' scores on the reading and mathematics Florida Comprehensive Assessment Tests. Three null hypotheses tested relationships among (a) five principals' leadership behaviors and seven domains of school climate; (b) principals' leadership behaviors and student achievement; and (c) principals' leadership behaviors, school climate, and student achievement. Multiple linear regressions were used to determine the degree to which the independent variables predicted the dependent variables for the first two hypotheses. ANOVAs tested possible group differences between the demographic and research variables as controls for the third hypothesis. Partial correlational analyses tested the strength and direction of relationships among leadership behaviors, climate, and achievement. Results revealed partial support of the hypotheses. None of the leadership variables significantly predicted school climate. No significant relationships were found among the five leadership behaviors and student achievement. Demographic group differences in school climate and student achievement were marginally significant. The leadership behaviors of Inspiring a Shared Vision and Enabling Others to Act were positively linked to reading achievement. Partial correlations were found (r .27 to −.35) among school climate variables of Order, Involvement, and Expectation and achievement variables. The Modeling the Way leadership variable was negatively associated with reading achievement. After controlling for gender, years at current school, and years in the district, partial positive correlations were found among leadership, school climate, and student achievement. Inspiring a Shared Vision, Enabling Others to Act, Encouraging the Heart, and Challenging the Process leadership variables were partially correlated to Order, Leadership (Instructional), and Expectation climate variables. Study results should provide policymakers and educators with a leadership profile for school leaders challenging the status quo who can create schools for enhanced student learning and relevance to the needs of students, families, and society.

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The current study examined the impact of an early summer literacy program and the mediating effects of the home literacy environment on the language and literacy outcomes of a group of children at-risk for long-term developmental and academic delays. Participating children (n=54) were exposed to an intensive book-reading intervention each summer (June through mid August) over a 3-year period. The current study implemented an ex post facto, quasi-experimental design. This nonequivalent group design involved a pretest and posttest over three time points for a non-randomized treatment group and a matched non-treatment comparison group. Results indicated that literacy scores did improve for the children over the 3-year period; however, language scores did not experience the same rate of change over time. Receptive language was significantly impacted by attendance, and race/ethnicity. Expressive language was impacted significantly by gestational age and attendance. Results also indicated that language outcomes for young children who are exposed to a literacy program were higher than those who did not participate; however, only receptive language yielded significance at the p<.05 level. These study results also found that activities in the home that support literacy and learning do indeed impact language and literacy outcomes for these children, specifically, the age at which a child is read to, the number of books in the home, a child’s enjoyment of reading, and whether a child looks at books on his or her own impact language scores. This study concluded that at-risk young children do benefit from center-based literacy intervention. This literacy experience, however, is also driven by the children's home environment, their attendance to the program, whether they were premature or not and the type of caregiver.

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The strong impact of non-native predators in aquatic systems is thought to relate to the evolutionary naiveté of prey. Due to isolation and limited dispersal, this naiveté may be relatively high in freshwater systems. In this study, we tested this notion by examining the antipredator response of native mosquitofish, Gambusia holbrooki, to two non-native predators found in the Everglades, the African jewelfish, Hemichromis letourneuxi, and the Mayan cichlid, Cichlasoma urophthalmus. We manipulated prey naiveté by using two mosquitofish populations that varied in their experience with the recent invader, the African jewelfish, but had similar levels of experience with the longer-established Mayan cichlid. Specifically, we tested these predictions: (1) predator hunting modes differed between the two predators, (2) predation rates would be higher by the novel jewelfish predator, (3) particularly on the naive population living where jewelfish have not invaded yet, (4) antipredator responses would be stronger to Mayan cichlids due to greater experience and weaker and/or ineffective to jewelfish, and (5) especially weakest by the naive population. We assayed prey and predator behavior, and prey mortality in lab aquaria where both predators and prey were free-ranging. Predator hunting modes and habitat domains differed, with jewelfish being more active search predators that used slightly higher parts of the water column and less of the habitat structure relative to Mayan cichlids. In disagreement with our predictions, predation rates were similar between the two predators, antipredator responses were stronger to African jewelfish (except for predator inspections), and there was no difference in response between jewelfish-savvy and jewelfish-naive populations. These results suggest that despite the novelty of introduced predators, prey may be able to respond appropriately if non-native predator archetypes are similar enough to those of native predators, if prey rely on general antipredator responses or predation cues, and/or show neophobic responses.

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The connectivity between the fish community of estuarine mangroves and that of freshwater habitats upstream remains poorly understood. In the Florida Everglades, mangrove-lined creeks link freshwater marshes to estuarine habitats downstream and may act as dry-season refuges for freshwater fishes. We examined seasonal dynamics in the fish community of ecotonal creeks in the southwestern region of Everglades National Park, specifically Rookery Branch and the North and watson rivers. Twelve low-order creeks were sampled via electrofishing, gill nets, and minnow traps during the wet season, transition period, and dry season in 2004-2005. Catches were greater in Rookery Branch than in the North and watson rivers, particularly during the transition period. Community composition varied seasonally in Rookery Branch, and to a greater extent for the larger species, reflecting a pulse of freshwater taxa into creeks as marshes upstream dried periodically. The pulse was short-lived, a later sample showed substantial decreases in freshwater fish numbers. No evidence of a similar influx was seen in the North and watson rivers, which drain shorter hydroperiod marshes and exhibit higher salinities. These results suggest that head-water creeks can serve as important dry-season refugia. Increased freshwater flow resulting from Everglades restoration may enhance this connectivity.

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Approximately 1,700 limited English proficient (LEP) and recently exited LEP students in grades 4 and 10 were tested using both an English and a comparable Spanish language achievement test. Many LEP and former LEP students performed better in math taking the test in Spanish compared to taking it in English.

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This paper discusses the transfer of training as it relates to mandatory continuing education for the radiologic technologist. Through continuing education the technologists' satisfy their requirements for recertification and/or licensure. Continuing education should provide a method to maintain competency, however, attitudes determine the success of learning outcomes.

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The paper examines the nature of qualitative empirical studies published in the AHRD proceedings from 1999-2003 and discusses findings on method, rationale for method, data collection, sampling strategies, and integrity measures.

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The researcher presents the details, findings, and critique of a pre-pilot study conducted on a codebook created for a textbook comparison. She used Cohen’s alpha and percent agreement to determine inter-rater reliabilities for coding categories. These values revealed changes needed in the coding scheme and in the coder training process for the future comparison study.