Measuring the therapist's impact on the patient's therapeutic progress.

Describes methods and concepts developed by the Mount Zion Psychotherapy Research Group for empirically evaluating the pertinence or suitability of a therapist's interventions (behaviors) to a patient's particular problems, needs, and treatment goals. Intensive studies of 2 brief pychotherapy cases are presented. In these studies, patient-initiated critical incidents (tests) were identified, the case-specific accuracy of the therapist's responses to these incidents was rated, and the impact of these interventions on subsequent patient behavior was measured. The findings indicated that these patients tended to show improvement in the therapeutic process when the therapist's interventions were in accord with their particular problems and treatment goals. The application of this method to clinically relevant studies of psychotherapy is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dante's love and the creation of a new poetry.

Dante's book of prose autobiography, poems, and critical analyses, the Vita Nuova (New Life) shows the progress of his love for Beatrice in sufficient detail to understand how it prompted a creative innovation in his poetry. In response to incidents that were crucial in his love for Beatrice, Dante describes a crisis in his ability to write. With its resolution, he begins to write in an original way and to lay foundations for his masterpiece the Divina Commedia (Divine Comedy). Dante is informative for understanding creativity in the arts because he demonstrates how emotions can set problems to be solved artistically, illustrates the importance of externalization in artistic production, and shows how it is possible to learn from mistakes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infusion devices: risks and user responsibilities

The Medical Devices Agency of the UK Department of Health continues to receive and investigate reports of incidents that arise from the use of infusion devices. In 1996, the Medical Devices Agency received some 4300 reports of incidents, over 400 of which were classified as infusion-, transfusion-, or dialysis-related. There is, however, a trend towards more active management of medical devices focusing on aspects such as purchasing, training, clinical use, and maintenance, and clearly, nursing staff have an important role in developing such policies. Also, nurses with the responsibility for setting up and overseeing infusions should be aware of some of the problems that can arise during routine use, as an awareness of potential hazards allows users to manage the risks more effectively. This article examines some of the risks associated with the use of infusion devices; in particular, problems that arise while loading the administration set or syringe into the pump, the risks of fluid free flow and syringe siphoning, and the risks from air embolism, flow rate accuracy and infusion pump pressure.     

Application of SHS processes for in situ preparation of alumomatrix composite materials discretely reinforced by nanodimensional titanium carbide particles (Review)

Types and fabrication methods of discretely reinforced alumomatrix composite materials (AMCMs), the wide application of which is hindered by a whole series of unresolved problems, are reviewed. These problems are the high cost of both reinforcing materials and the entire production process of composites; a not always sufficient level of strength properties, especially at elevated temperatures; the distribution nonuniformity of reinforcing particles over the volume of the aluminum matrix; and insufficient bond strength with it. It is discussed what contribution can be introduced into the solution of these problems by applying in situ processes, particularly, the SHS process, in order to fabricate cast nanostructured AMCMs. This is shown in more detail by the concrete example of the Al–10%TiC composite discretely reinforced by nanodimensional titanium carbide particles.     

Effect of recycling on residuals,processing, and properties of carbon and low-alloy steels

Because of the continuing increase in electric furnace steelmaking, which is a scrap-intensive process, and also in view of future new sources of scrap, such as municipal solid wastes, it is important to develop more knowledge about: (a) the effects of residual elements on steel, (b) processing strategies for producing high-residual steels, and (c) products in which residuals could be used to advantage. This review will first identify the important residual elements and the trends in their use and levels in steels. The effect of these elements on the processing phenomena and product properties of carbon and low-alloy steels will be discussed in detail. These phenomena and properties include hot shortness, scale adherence, room temperature tensile properties, impact resistance, and hardenability. Also discussed are examples of specific problems that residual elements present, both now and with emerging trends, for steel processing and applications, and the ways of using residuals to advantage.     

SSL: A Theory of How People Learn to Select Strategies.

The assumption that people possess a repertoire of strategies to solve the inference problems they face has been raised repeatedly. However, a computational model specifying how people select strategies from their repertoire is still lacking. The proposed strategy selection learning (SSL) theory predicts a strategy selection process on the basis of reinforcement learning. The theory assumes that individuals develop subjective expectations for the strategies they have and select strategies proportional to their expectations, which are then updated on the basis of subsequent experience. The learning assumption was supported in 4 experimental studies. Participants substantially improved their inferences through feedback. In all 4 studies, the best-performing strategy from the participants' repertoires most accurately predicted the inferences after sufficient learning opportunities. When testing SSL against 3 models representing extensions of SSL and against an exemplar model assuming a memory-based inference process, the authors found that SSL predicted the inferences most accurately. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of problem ownership on teachers' perceptions of and strategies for coping with problem students.

98 elementary school teachers read vignettes depicting incidents involving (fictional) students who presented chronic behavior problems and then told how they would respond if the incidents occurred in their classrooms. Responses were coded for attributions about the students and about the Ss' roles in causing and correcting the problems. Ss attributed controllability and intentionality to students presenting teacher-owned problems but not to students presenting student-owned problems. Students presenting shared problems often were seen as able to control their behavior but not as misbehaving intentionally. The contrasting patterns of attribution seen in these 3 levels of problem ownership were associated with contrasting patterns of goals and strategies, as well. The data bear out expectations based on attributional analyses of helping behavior but raise questions about teachers' preparedness to cope with problem students. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting cooperation and trust in "noisy" situations: The power of generosity.

The authors present an interdependence theoretical framework and advance the argument that generosity serves the important purpose of communicating trust, which is assumed to be of utmost importance to coping with incidents of negative noise (i.e., when the other every now and then behaves less cooperatively than intended). Using a new social dilemma task (the parcel delivery paradigm), it was hypothesized that incidents of negative noise would exert detrimental effects on trust and trust-related judgments and experiences, as well as cooperation, and that relative to tit for tat and self-regarding strategies (stingy or unconditionally cooperative strategies), other-regarding strategies (i.e., unconditional cooperation and generosity) would be more effective at reducing such as detrimental effects. Results from 2 studies provided strong support for these hypotheses, suggesting that the power of generosity is underestimated in the extant literature, especially in its ability to maintain or build trust, which is essential for coping with noise. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Strategic Management: Consideration of Paradoxes, Processes, and Associated Concepts as Applied to Construction

This paper reviews recent literature on the strategic management process and considers several paradoxes viewed from a construction perspective. Many of the key issues surrounding the strategic management process have been discussed, and recommendations have been provided as to how construction organizations should respond. The main paradoxes considered were logical (rational) versus creative (generative) strategies; intended (deliberate) versus realized (emergent) strategies; revolutionary versus transformational strategies; strategic fit versus strategic stretch; and strategy versus organizational effectiveness. Each of these paradoxes was found to have considerable relevance to construction, and examples of how they have been applied to construction have been provided. For many construction organizations the key to success depends upon developing strategies that have an optimal balance within these paradoxes. This optimal balance will vary from one organization to another.     

In conflict with conflict

In a qualitative, retrospective case study to identify, describe, and develop a theoretical analysis of perceived group process among female nursing educators/administrators, the term "conflict," as traditionally defined in discussions of "conflict management strategies," was rejected. The term did not readily fit with the management styles of the 27 female nurse educators and administrators. Participants rejected "conflict" as a term. The word was deliberately avoided. In fact, conflict rejection was a specific administrative process identified as part of the successful working of the group over the three-year period studied. This finding indicates a break with traditional male-oriented literature and therefore may have implications for future research into conflict management strategies, especially into successful management strategies used by women and health care professionals.     

Delay Mitigation in the Malaysian Construction Industry

This paper describes the importance of applying proper management in dealing with delays in construction for a growing economy. The main objective of this paper is to identify the management tools that are practiced in the local construction industry in mitigating delay. It also aims to identify the main factors that lead to project delays and to suggest recommendations on how to overcome or mitigate effects of the problem. Data is gathered from responses from questionnaire survey and interviews with those involved in construction project. The surveys and research findings indicate that delay incidents occur mainly during the construction phase of a project and one or more parties usually contribute to delay. This paper highlights the importance of having more experienced and capable construction managers as well as skilled laborers to enable the industry to develop at a faster rate either nationally or internationally.     

Clinical incidents in general practice. Keeping on track with test results

The incident Monitoring in General Practice Project began as an initiative of the Professional Indemnity Review. Anonymous data from general practitioners about unintended and possibly adverse events were collected in order to develop preventive strategies that might ultimately increase patient safety and therefore reduce litigation. Feedback and sharing of experiences and ideas about these events, possible management strategies or about the project as a whole are invited from readers.     

An in vitro model of human red blood cell production from hematopoietic progenitor cells

Hemoglobinopathies, such as beta-thalassemias and sickle cell anemia (SCA), are among the most common inherited gene defects. Novel models of human erythropoiesis that result in terminally differentiated red blood cells (RBCs) would be able to address the pathophysiological abnormalities in erythrocytes in congenital RBC disorders and to test the potential of reversing these problems by gene therapy. We have developed an in vitro model of production of human RBCs from normal CD34(+) hematopoietic progenitor cells, using recombinant growth factors to promote terminal RBC differentiation. Enucleated RBCs were then isolated to a pure population by flow cytometry in sufficient numbers for physiological studies. Morphologically, the RBCs derived in vitro ranged from early polylobulated forms, resembling normal reticulocytes to smooth biconcave discocytes. The hemoglobin pattern in the in vitro-derived RBCs mimicked the in vivo adult or postnatal pattern of beta-globin production, with negligible gamma-globin synthesis. To test the gene therapy potential using this model, CD34(+) cells were genetically marked with a retroviral vector carrying a cell-surface reporter. Gene transfer into CD34(+) cells followed by erythroid differentiation resulted in expression of the marker gene on the surface of the enucleated RBC progeny. This model of human erythropoiesis will allow studies on pathophysiology of congenital RBC disorders and test effective therapeutic strategies.     

Interface Management within Construction: In Particular, Building Facade

This paper discusses the need for interface management within construction, with particular reference to building facade interfaces. It categorizes the three different types of interface management—physical, contractual, and organizational. The implication of interface management in construction contracting is discussed; it is explained how the U.K. procurement trends have changed, affecting the interface management within projects. U.K. cladding procurement is very fragmented, and the paper maps the development of a typical cladding system showing the complexities of interface management. Finally, the paper discusses CladdISS, a U.K. government funded research project to develop a standardized strategy for the design and management of window and cladding interfaces. It explains the principles of CladdISS with reference to process maps, action plans, management strategy, bibliography, advice on standards, materials, maintenance, joints, movement, and tolerances. This will enable strategies to be developed to avoid the endemic interface problems occurring on-site. It will also guide the management of the interfaces throughout the project.     

Graded functional activation in the visuospatial system with the amount of task demand

Immunocompromised hosts have defects in their immune system that make them at risk of developing a variety of infections. In addition, these persons may develop a wide variety of noninfectious disease processes that involve the lung. These disorders may be caused by the underlying disease process. This may be seen with the development of metastatic disease from the underlying neoplasm, or it may represent the development of a malignancy secondary to therapy, as is seen with posttransplant lymphoproliferative disease. The abnormalities may be a result of the therapy used to treat the patients, as is seen with radiation injury to the lung and drug toxicity. Pulmonary edema may occur and be from a wide variety of causes. All of these disease processes may simulate an infectious process and must be differentiated from infection to allow proper therapeutic intervention.     

Small to Medium Contractor Contingency and Assumption of Risk

This paper is the result of an investigation into the use of contingency in smaller construction firms. It summarizes recent literature classifying construction contract risks and mitigation measures. Eight major classifications are used to organize the types of risk found in the literature. The risks are described in detail with associated risk mitigation strategies. Risk modeling techniques are briefly reviewed for their contribution to the risk categorization and contingency estimating. After reviewing the researcher's concepts of risk management in the literature, interviews were conducted with estimators and∕or construction managers involved in the bidding process at 12 small to medium construction firms. The purpose of the interviews was to investigate the current risk management practices of small and medium size construction firms. The times when smaller companies used contingency had specific interest for the research. The literature findings were compared with important risk factors identified from the interviews. The main conclusion drawn from the comparison was that small to medium size contractors predominately use contingency in those situations where they are construction managers in a reimbursable contract. Generally, they do not use line item contingency in competitive bidding situations. Thus, these firms are assuming proportionally greater business risk than suggested by the literature on contingency.     

Contractor Selection Criteria: Investigation of Opinions of Singapore Construction Practitioners

The construction industry has witnessed the failure of many contractors due to varying reasons such as financial problems, poor performance, or accidents arising from the lack of adequate safety consideration at worksites. All these incidents have led to the impression that the current system of awarding the contracts is inefficient in selecting the contractor capable of meeting the demands and challenges of present times and hence needs to be reviewed accordingly. Therefore, in an attempt to investigate the current situation of the Singapore construction industry a questionnaire survey was conducted for accruing the data required to identify the important contractor selection criteria (CSC) and to draw upon construction practitioners’ opinions regarding the importance of those CSC in assessing the capabilities of the candidate contractors during the selection process. The research reported upon forms part of a larger study that aims to develop a computer-interactive multicriteria decision system for contractor selection involving identification of CSC for inclusion in the system, investigation of CSC preferences of construction practitioners, and establishment of weights for those CSC from their perceived importance determined through the questionnaire survey of Singapore construction practitioners. The study highlights that there are statistically significant differences in opinions regarding the degree of importance assigned to some CSC among public clients, private clients, and contractors. Findings from the study may act as an aid in improving the Singapore construction industry by helping construction clients identify multiple CSC apart from cost which should always be considered when assessing the capability of candidate contractors during the selection process, by assisting contractors in improving their attributes in line with clients’ preferences and by facilitating Singapore construction clients and researchers to develop a contractor selection system capable of assessing multiple attributes of the candidate contractors so that the risk of the project failure due to the selection of an inappropriate contractor is minimized.     

Ethical dilemmas encountered by members of the American Psychological Association: A national survey.

A random sample of 1,319 members of the American Psychological Association (APA) were asked to describe incidents that they found ethically challenging or troubling. Responses from 679 psychologists described 703 incidents in 23 categories. This process of gathering critical incidents from the general membership, pioneered by those who developed APA's original code of ethics, may be useful in considering possible revisions of the code and preserving APA's unique approach to identifying ethical principles that address realistically the emerging dilemmas that the diverse membership confronts in the day-to-day work of psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incident reporting in acute pain management

Incident reporting is an effective tool for continuous quality improvement in clinical practice. A prospective study on voluntary incident reporting in pain management was conducted at a major teaching hospital in Hong Kong. Over a 12-month period, 53 incidents were reported in 1275 patients who received pain relief treatments which were supervised by the acute pain service. The majority of the incidents were first detected by the pain team. The most common incidents involved delivery circuits, delivery pump and drug administration. A large proportion (81.4%) of the incidents were thought to be preventable. Human factors were involved in 41.9% of the patients reported, most commonly associated with unfamiliar technique/inexperience, inattention and inadequate communication. Four patients developed major morbidity of which two were attributed to inadequate analgesia, while three others had major physiological changes without morbidity. Strategies have been formulated to prevent further occurrence of these incidents. We propose that incident reporting is a potentially useful tool in identifying and preventing adverse events in postoperative pain management.     

Behavior management planning for problem behaviors in dementia: A practical model.

Psychologists are often sought out by families or nursing home staff to develop intervention strategies for behavior problems in dementia patients. This article describes a systematic approach, or practical model, for developing these strategies. Variables that may contribute to behavior problems include comfort needs, assaultiveness, anger, patient's perceptions, activity involvement, triggers, patterns of escalation, personal history, caregiver interaction styles, and level of cognitive functioning. Each variable of this model is described in terms of key team members, relevant team dynamics, assessment, and intervention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)