Goals Research Papers - Academia.edu (original) (raw)

Effective goal pursuit is integral to organizational success. Because of this, a large number of models have been developed that describe the process of goal pursuit in whole or part. However, these models often have little overlap with... more

Effective goal pursuit is integral to organizational success. Because of this, a large number of models have been developed that describe the process of goal pursuit in whole or part. However, these models often have little overlap with one another, making it unclear how they relate to each other, and they do not incorporate emerging evidence from neuroscience about “brain-friendly” modes of goal pursuit. We solve these two problems by proposing the AIM framework of goals, a neurally-informed model which divides the goal pursuit process into three parts—Antecedents, Integration, and Maintenance. This framework organizes existing models by describing where in the overall goal pursuit process they fit (e.g., the SMART model is about goal setting, which is an antecedent), and thus has the distinct advantage of being able to integrate across existing models in a meaningful way. Because it is based in neuroscience, the framework can also serve as a bridge between the neuroscience and organizational/ leadership fields over which relevant knowledge about brain functioning can be imported into the study of goal pursuit for organizations. In this paper, we briefly review popular models of goals and describe where they fit within the AIM framework, describe each step of AIM and the corresponding current neuroscience knowledge, and then discuss how the AIM framework can set an agenda for future organizational and neuroscience research in this area. This paper is written to be equally relevant to and useful for those pursuing their own goals as well as those facilitating goal pursuit in others.

Why are people interested in money? Specifically, what could be the biological basis for the extraordinary incentive and reinforcing power of money, which seems to be unique to the human species? We identify two ways in which a commodity... more

Why are people interested in money? Specifically, what could be the biological basis for the extraordinary incentive and reinforcing power of money, which seems to be unique to the human species? We identify two ways in which a commodity which is of no biological significance in itself can become a strong motivator. The first is if it is used as a tool, and by a metaphorical extension this is often applied to money: it is used instrumentally, in order to obtain biologically relevant incentives. Second, substances can be strong motivators because they imitate the action of natural incentives but do not produce the fitness gains for which those incentives are instinctively sought. The classic examples of this process are psychoactive drugs, but we argue that the drug concept can also be extended metaphorically to provide an account of money motivation. From a review of theoretical and empirical literature about money, we conclude that (i) there are a number of phenomena that cannot be accounted for by a pure Tool Theory of money motivation; (ii) supplementing Tool Theory with a Drug Theory enables the anomalous phenomena to be explained; and (iii) the human instincts that, according to a Drug Theory, money parasitizes include trading (derived from reciprocal altruism) and object play.

Three field experiments with high school and college students tested the self-determination theory (E. L. hypotheses that intrinsic (vs. extrinsic) goals and autonomy-supportive (vs. controlling) learning climates would improve students'... more

Three field experiments with high school and college students tested the self-determination theory (E. L. hypotheses that intrinsic (vs. extrinsic) goals and autonomy-supportive (vs. controlling) learning climates would improve students' learning, performance, and persistence. The learning of text material or physical exercises was framed in terms of intrinsic (community, personal growth, health) versus extrinsic (money, image) goals, which were presented in an autonomy-supportive versus controlling manner. Analyses of variance confirmed that both experimentally manipulated variables yielded main effects on depth of processing, test performance, and persistence (all ps Ͻ .001), and an interaction resulted in synergistically high deep processing and test performance (but not persistence) when both intrinsic goals and autonomy support were present. Effects were significantly mediated by autonomous motivation.

Confronted with rising costs and patients who often have multiple comorbidities, the orthopaedic surgeon needs to face the challenge of providing high-quality health care. One solution is to increase and improve coordination,... more

Confronted with rising costs and patients who often have multiple comorbidities, the orthopaedic surgeon needs to face the challenge of providing high-quality health care. One solution is to increase and improve coordination, communication, and teamwork. The orthopaedic surgeon also needs to work effectively and efficiently to manage a fluid and shifting mix of health-care personnel partners from other disciplines and specialties to deliver high-quality patient care. The orthopaedic surgeon must collaborate in a new way with fellow health-care professionals, providing care by following teaming protocols. In the appropriate leadership role and employing the necessary motivational, communication, and conflict-management skills, the orthopaedic surgeon must build the proper foundations for teaming through the selection of compatible, effective team members and establish the necessary collaborative teaming environment. The orthopaedic surgeon needs to lead these teams and promote communication, listening, and collaboration. The em

Despite its theoretical importance, personal goal motivation has rarely been examined in clinical depression. Here we investigate whether clinically depressed persons (n = 23) differ from never-depressed persons (n = 26) on number of... more

Despite its theoretical importance, personal goal motivation has rarely been examined in clinical depression. Here we investigate whether clinically depressed persons (n = 23) differ from never-depressed persons (n = 26) on number of freely generated approach and avoidance goals, appraisals of these goals, and reasons why these goals would and would not be achieved. Participants listed approach and avoidance goals separately and generated explanations for why they would (pro) and would not (con) achieve their most important approach and avoidance goals, before rating the importance, likelihood and perceived control of goal outcomes. Counter to hypothesis, depressed persons did not differ from neverdepressed controls on number of approach or avoidance goals, or on the perceived importance of these goals. However, compared to never-depressed controls, depressed individuals gave lower likelihood judgements for desirable approach goal outcomes, tended to give higher likelihood judgements for undesirable to-be-avoided goal outcomes, and gave lower ratings of their control over goal outcomes. Furthermore, although controls generated significantly more pro than con reasons for goal achievement, depressed participants did not. These results suggest that depressed persons do not lack valued goals but are more pessimistic about their likelihood, controllability and reasons for successful goal attainment. Personal goals systems and depression 3 Although goal dysregulation has been implicated in affective disorders (Johnson, Carver, & Fulford, 2010) and goal pursuit is considered to be central to human motivation (Klinger, 1977), goal-based perspectives on depression have received little attention. Goals provide meaning, purpose, and direction in life, as well as a framework for interpreting life experience (Schmuck & Sheldon, 2001). It remains unclear whether depression is characterized by a general deficit in goal motivation, or by a profile of decreased approach motivation and increased avoidance motivation. It is also unclear whether depression biases Means (SDs) for Number of Goals and Goal Ratings by Group and Condition Number of goals Importance Likelihood Control Group App Avd App Avd App Avd App Avd Control 6.5 (1.9) 4.8 (1.6) 5.8 (0.9) 5.9 (0.7) 5.5 (0.7) 3.4 (0.9) 5.7 (0.8) 5.3 (0.7) Depressed 6.8 (2.5) 5.7 (2.1) 5.9 (0.7) 5.8 (1.1) 4.9 (1.1) 4.0 (1.4) 4.7 (1.2) 4.5 (1.0) Note. App = approach goals, Avd = avoidance goals. Personal goals systems and depression 22 Table 2 Means (SDs) for Number of Reasons by Group and Goal Condition Approach goals Avoidance goals Group Pro Con Pro Con Control 4.5 (1.5) 3.7 (1.9) 4.5 (1.6) 3.7 (1.3) Depressed 4.3 (1.6) 4.2 (1.8) 3.8 (1.8) 4.0 (1.8)

Bipolar disorder has been conceptualized as an outcome of dysregulation in the behavioral activation system (BAS), a brain system that regulates goal-directed activity. On the basis of the BAS model, the authors hypothesized that life... more

Bipolar disorder has been conceptualized as an outcome of dysregulation in the behavioral activation system (BAS), a brain system that regulates goal-directed activity. On the basis of the BAS model, the authors hypothesized that life events involving goal attainment would promote manic symptoms in bipolar individuals. The authors followed 43 bipolar I individuals monthly with standardized symptom severity assessments (the Modified Hamilton Rating Scale for Depression and the Bech-Rafaelsen Mania Rating Scale). Life events were assessed using the Goal Attainment and Positivity scales of the Life Events and Difficulties Schedule. As hypothesized, manic symptoms increased in the 2 months following goal-attainment events, but depressed symptoms were not changed following goal-attainment events. These results are congruent with a series of recent polarity-specific findings. Bipolar disorder exacts a devastating toll from affected individuals. Most strikingly, this disorder leads to suicide in almost one out of every five diagnosed individuals (Isometsa, 1993). With adequate blood serum levels of lithium, one third of bipolar individuals relapse within 3 years (Keller et al., 1992), but in naturalistic studies with varied levels of patient compliance, two thirds of patients relapse within 2 years (Silverstone, McPherson, Hunt, & Romans, 1998). Given these high rates of relapse and the sustained unemployment rates following each episode of mania (Harrow, Goldberg, Grossman, & Meltzer, 1990), it is not surprising that bipolar disorder has been ranked as the sixth leading cause of disability among both physical and psychiatric disorders worldwide (Murray & Lopez, 1996). Fiscal costs for adult Americans with the disorder were estimated in 1991 at $45 billion (Wyatt & Henter, 1995). Although the modal course is severe, bipolar individuals experience substantial heterogeneity in symptom expression. For instance, as many as 25% of bipolar I individuals will never experience a depressive episode (Goodwin & Jamison, 1990). Further,

Background Conductive education (CE) is a holistic educational system that uses an active cognitive approach to teach individuals with motor disorders to become more functional participants in daily activities. While CE's popularity... more

Background Conductive education (CE) is a holistic educational system that uses an active cognitive approach to teach individuals with motor disorders to become more functional participants in daily activities. While CE's popularity continues to grow in North America and Europe, its effectiveness has not been established. The lack of definition of responsive outcome measures for evaluation of CE programmes has limited the interpretability of conclusions from earlier studies evaluating effectiveness. Objective To determine which measures from a core set were most responsive to physical, functional and psychosocial changes associated with a school-based CE programme. Methods This was a one-group before and after data collection design using an 8-month follow-up period. We enrolled a referral sample of nine children with cerebral palsy in Kindergarten or Grade 1 (Gross Motor Function Classification System levels 3, 4 or 5). The study took place within a schoolbased CE programme at a Canadian children's rehabilitation centre. Children participated in a CE fullday class for an entire school year. Physical, functional, psychosocial and participation measures included: Gross Motor Function Measure (GMFM), Quality of Upper Extremity Skills Test (QUEST),

The standard 2 -4 -6 task requires discovery of a single rule and produces success rates of about 20%, whereas the dual-goal (DG) version requests discovery of two complementary rules and elevates success to over 60%. The experiment... more

The standard 2 -4 -6 task requires discovery of a single rule and produces success rates of about 20%, whereas the dual-goal (DG) version requests discovery of two complementary rules and elevates success to over 60%. The experiment examined two explanations of DG superiority: Evans' (1989) positivity-bias account, and Wharton, Cheng, and Wickens' (1993) goal-complementarity theory. Two DG conditions were employed that varied the linguistic labelling of rules (either positively labelled Dax vs. Med, or mixed-valence "fits" vs. "does not fit"). Solution-success results supported the goal-complementarity theory since facilitation arose in both DG conditions relative to singlegoal tasks, irrespective of the linguistic labelling of hypotheses. DG instructions also altered quantitative and qualitative aspects of hypothesis-testing behaviour, and analyses revealed the novel result that the production of at least a single descending triple mediates between DG instructions and task success. We propose that the identification of an appropriate contrast class that delimits the scope of complementary rules may be facilitated through the generation of a descending instance. Overall, our findings can best be accommodated by iterative counterfactual model of hypotheses testing, which can readily subsume key elements of the goalcomplementarity theory.

A randomization method is developed for the calculation of covariation between multiple variables that are linked nonlinearly to a dependent variable. Covariation is a phenomenon often invoked in the study of movement coordination to... more

A randomization method is developed for the calculation of covariation between multiple variables that are linked nonlinearly to a dependent variable. Covariation is a phenomenon often invoked in the study of movement coordination to capture the fact that in coordinated movement the outcome shows greater than expected consistency from the variability in the component processes. However, in most cases, the problem is that more than two variables covary in a nonlinear fashion, which makes quantification with the bivariate linear covariation and correlation coefficient inapplicable. This paper presents a generalization of the calculation of linear bivariate covariance using a variant of a randomization method that is based on the comparison between the empirically measured variability in the outcome and a covariation-free variability. The latter can be estimated by permuting data sets. A generalized correlation coefficient is derived, and it is shown how errors of estimation can be qua...

OBJECTIVE: To examine factors associated with emotional well-being in women with spontaneous primary ovarian insufficiency. DESIGN: Cross-sectional and case–control study. SETTING: Clinical research center, national US health research... more

OBJECTIVE: To examine factors associated with emotional well-being in women with spontaneous primary ovarian insufficiency. DESIGN: Cross-sectional and case–control study. SETTING: Clinical research center, national US health research facility. PATIENT (S ...

Molecular imaging is the visualization, characterization, and measurement of biologic processes at the molecular and cellular levels in humans and other living systems (1). It comprises an emerging set of technologies that builds on... more

Molecular imaging is the visualization, characterization, and measurement of biologic processes at the molecular and cellular levels in humans and other living systems (1). It comprises an emerging set of technologies that builds on advances in imaging procedures (e.g., PET, SPECT, MRI, ultrasound, optical, and photoacoustic), improved understanding of biology, and the development of molecularly targeted agents. These continuously expanding sets of imaging methods are often used in combination, and advances in data acquisition and analyses facilitate a more complete understanding of biology. Molecular imaging aims to improve our understanding of mammalian biology and lead to advances in patient care by providing targeted therapies that will enable personalized medicine and the imaging tools to assess outcome. Implementation of these new technologies in clinical care has many educational, technical, and regulatory challenges that must be overcome before molecular imaging reaches its full potential. The impact of molecular imaging has been significant in several disciplines, because it represents a paradigm shift in how scientists and clinicians can observe biology in real time and in a relatively noninvasive manner to enable the power of repeated measures in living organisms.

This study tested the reliability and validity of Goal-Attainment Scaling (GAS) in assessing outcome in Mann's Time-Limited Psychotherapy (TLP). Judges constructed GAS scales for 33 patients on five dimensions: severity of symptoms,... more

This study tested the reliability and validity of Goal-Attainment Scaling (GAS) in assessing outcome in Mann's Time-Limited Psychotherapy (TLP). Judges constructed GAS scales for 33 patients on five dimensions: severity of symptoms, self-esteem, same-sex friendships, romantic relationships, and work performance. Patients in the treatment group received 12 sessions of TLP, whereas controls were in a waiting list for the same period of time (12 weeks) before starting time-limited psychotherapy. Judges rated all patients on GAS before beginning therapy, at termination, and follow-up. Mean interrater reliability of scores between pairs of judges was r ϭ .88. Convergent validity of the GAS was confirmed by moderate to high correlations with the Health-Sickness Rating Scale (r ϭ .70, p Ͻ .001), the Target Complaints Scale (r ϭ .50, p Ͻ .01), and the Brief Symptom Inventory (r ϭ .38, p Ͻ .05). The findings are discussed and recommendations are made for the reliable and valid use of the GAS in psychotherapy outcome research.

Capital needs during the next twenty years for public wastewater treatment, piping, combined sewer overflow correction, and storm-water management are estimated to be approximately $300 billion for the USA. Financing these needs is a... more

Capital needs during the next twenty years for public wastewater treatment, piping, combined sewer overflow correction, and storm-water management are estimated to be approximately $300 billion for the USA. Financing these needs is a significant challenge, as Federal funding for the Clean Water Act has been reduced by 70% during the last twenty years. There is an urgent need for new approaches to assist states and other decision makers to prioritize wastewater maintenance and improvements. We present a methodology for performing an integrated quantitative watershed-scale goals assessment for sustaining wastewater infrastructure. We applied this methodology to ten watersheds of the Hudson-Mohawk basin in New York State, USA that together are home to more than 2.7 million people, cover 3.5 million hectares, and contain more than 36,000 km of streams. We assembled data on 183 POTWs treating approximately 1.5 million m(3) of wastewater per day. For each watershed, we analyzed eight metrics: Growth Capacity, Capacity Density, Soil Suitability, Violations, Tributary Length Impacted, Tributary Capital Cost, Volume Capital Cost, and Population Capital Cost. These metrics were integrated into three goals for watershed-scale management: Tributary Protection, Urban Development, and Urban-Rural Integration. Our results demonstrate that the methodology can be implemented using widely available data, although some verification of data is required. Furthermore, we demonstrate substantial differences in character, need, and the appropriateness of different management strategies among the ten watersheds. These results suggest that it is feasible to perform watershed-scale goals assessment to augment existing approaches to wastewater infrastructure analysis and planning.

This study explored how nursing practitioners perceived inpatients' anxiety, self-esteem, purpose-in-life and multidimensional health locus of control. Seventy-three nurses, 60 third-year and 70 first-year nursing students, and 61... more

This study explored how nursing practitioners perceived inpatients' anxiety, self-esteem, purpose-in-life and multidimensional health locus of control. Seventy-three nurses, 60 third-year and 70 first-year nursing students, and 61 control students not majoring in nursing science estimated how inpatients rated these four psychological states. Their ratings were compared with those given by 121 inpatients. Findings showed that the nursing practitioners, as well as the control participants, overestimated inpatients' anxiety, while they underestimated their self-esteem and purpose-in-life. The inpatients' scores for internal locus of control were greater than their scores for the two types of external locus of control (powerful others and chance), and were also greater than the scores given by the nursing practitioners in estimating the patients' perception of internal locus of control. The findings indicate that inpatients have a more positive attitude toward themselves...

Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions,... more

Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information.

Jones's control model was adopted to investigate differences in the labelling of symptoms associated with pre-competition anxiety and self-confidence as a function of goal attainment expectation and competition goal generation, Team sport... more

Jones's control model was adopted to investigate differences in the labelling of symptoms associated with pre-competition anxiety and self-confidence as a function of goal attainment expectation and competition goal generation, Team sport performers (IV= 961 were divided into outcome, performance and process goal groups. Anxiety intensity and direction, and self-confidence were then examined as a function of goal expectancy (positive or negative) and perceived input into goal production (input or no input). MANOVA and follow-up ANOVA supported the study predictions. Specifically, participants who reported positive expectations of goal achievement and indicated some input into the goal generation process experienced the most facilitative interpretations of cognitive symptoms and greater self-confidence. The results highlight the need to consider how goals are generated when attempting to foster a sense of control and help athletes cope with the psychological demands of competition. (J Sci Med Sport 2005;8:4:423-432)

in those with life-threatening disease, prognosis is unpredictable. communication with the patient and family must guide the clinician, always weighing up the benefits against the risks and burdens of any intervention, and recognizing... more

in those with life-threatening disease, prognosis is unpredictable. communication with the patient and family must guide the clinician, always weighing up the benefits against the risks and burdens of any intervention, and recognizing when interventions are futile in the face of irreversible deterioration. there is no evidence that patients' lives are shortened when opioids and other drugs are used to control pain and other symptoms, which challenges the usual examples for double effect (having good and bad consequences) as given in many standard textbooks. Some patients make advance decisions to refuse treatment, in the event of losing decision-making capacity. Such advance decisions should be properly drawn up, in writing, be situation specific and be of the patient's own free will. they will then be legally binding, and the patient will have the same standing in law as a competent patient refusing consent to an intervention. When a patient loses capacity without having expressed his wishes in advance, the clinicians must take a decision over what is in the best interests of the patient as a person. this requires that those close to the patient are consulted to seek all that can be known to inform the decision; however, when a best interests decision is taken, it is the clinician who carries the ultimate responsibility.

Opportunism in organizational partnerships may be understood in terms of how partners conclude that their self-interests are related to each other. When partners believe that their goals are competitively but not cooperatively related,... more

Opportunism in organizational partnerships may be understood in terms of how partners conclude that their self-interests are related to each other. When partners believe that their goals are competitively but not cooperatively related, they are tempted to pursue their self-interests opportunistically. Cognitive understandings and values of a shared vision may help partners believe their goals are cooperatively related. Results from 103 pairs of customer and supplier organizations support the argument that partnerships are not inevitably threatened by opportunism. Using structural equation analysis, the authors suggested that shared vision can help partners develop cooperative goals that lead to low levels of opportunism. These results suggest that a shared vision and cooperative goals are important foundations for effective organizational partnerships.

Context : Despite the Psychosocial Strategies and Referral content area, athletic trainers (ATs) generally lack confidence in their ability to use this information.(1) Objective : The current study's primary purpose was to determine:... more

Context : Despite the Psychosocial Strategies and Referral content area, athletic trainers (ATs) generally lack confidence in their ability to use this information.(1) Objective : The current study's primary purpose was to determine: (a) perceived psychological responses and coping behaviors athletes may present to ATs, (b) psychosocial strategies ATs currently use with their athletes, (c) psychosocial strategies ATs deem important to learn more about, and (d) ATs' current practices in referring athletes to counseling or sport psychology services. Design : Mixed-methods study. Setting : Online survey containing both quantitative and qualitative items. Patients or Other Participants : A total of 215 ATs (86 male, 129 female), representing a response rate of 22.50%. Main Outcome Measure(s) : The Athletic Training and Sport Psychology Questionnaire. Results : Stress/anxiety (4.24 ± 0.82), anger (3.70 ± 0.96), and treatment adherence problems (3.62 ± 0.94) were rated as the prim...

Σκοπός της έρευνας ήταν να εξεταστεί ο αθλητικός προσανατολισµός αθλητών καλαθοσφαίρισης σε καρότσι από την άποψη της προδιάθεσης για επίτευξη προσωπικών στόχων, της προδιάθεσης για νίκη και της ανταγωνιστικότητας. Στην έρευνα συµµετείχαν... more

Σκοπός της έρευνας ήταν να εξεταστεί ο αθλητικός προσανατολισµός αθλητών καλαθοσφαίρισης σε καρότσι από την άποψη της προδιάθεσης για επίτευξη προσωπικών στόχων, της προδιάθεσης για νίκη και της ανταγωνιστικότητας. Στην έρευνα συµµετείχαν 45 αθλητές καλαθοσφαίρισης σε αναπηρικό καρότσι από διαφορετικές οµάδες του ελληνικού εθνικού πρωταθλήµατος. Συµπλήρωσαν το ερωτηµατολόγιο αθλητικού προσανατολισµού , το οποίο αξιολογεί τα αποτελέσµατα για τρεις παράγοντες: την ανταγωνιστικότητα, την προδιάθεση κατάκτησης προσωπικών στόχων και την προδιάθεση για νίκη. Τα αποτελέσµατα της έρευνας έδειξαν χαµηλά επίπεδα της ανταγωνιστικότητας και της επίτευξης προσωπικών στόχων και µέτρια επίπεδα προσανατολισµού στη νίκη. Με βάση τα αποτελέσµατα σχετικά µε τον αθλητικό προσανατολισµό των καλαθοσφαιριστών σε καρότσι, έγιναν περαιτέρω προτάσεις για τη διαµόρφωση αποτελεσµατικότερων προγραµµάτων άσκησης.

Research on achievement goal promotion at University has shown that performanceapproach goals are perceived as a means to succeed at University (high social utility) but are not appreciated (low social desirability). We argue that such a... more

Research on achievement goal promotion at University has shown that performanceapproach goals are perceived as a means to succeed at University (high social utility) but are not appreciated (low social desirability). We argue that such a paradox could explain why research has detected that performance-approach goals consistently predict academic grades. First-year psychology students answered a performance-approach goal scale with standard, social desirability and social utility instructions. Participants' grades were recorded at the end of the semester. Results showed that the relationship between performance-approach goals and grades was inhibited by the increase of these goals' social desirability and facilitated by the increase of their social utility, revealing that the predictive validity of performance-approach goals depends on social value.

Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this... more

Discussions of ethical approaches in nursing have been much enlivened in recent years, for instance by new developments in the theory of care. Nevertheless, many ethical concepts in nursing still need to be clarified. The purpose of this contribution is to develop a fundamental ethical view on nursing care considered as moral practice. Three main components are analyzed more deeply -- i.e., the caring relationship, caring behavior as the integration of virtue and expert activity, and "good care" as the ultimate goal of nursing practice. For the development of this philosophical-ethical interpretation of nursing, we have mainly drawn on the pioneering work of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. We will also show that the European philosophical background offers some original ideas for this endeavor.

In previous work we described a modified version of goal scaling, which enabled patients to identify a meaningful change in their condition within important areas of their lives affected by low back pain. The aim of this study was to... more

In previous work we described a modified version of goal scaling, which enabled patients to identify a meaningful change in their condition within important areas of their lives affected by low back pain. The aim of this study was to explore the associations between goal attainment scores and disability, general health and global change in condition, with particular reference to minimal important change. Methods This was an observational cohort study. Patients attending a multidisciplinary clinic to manage unresolving acute low back pain were interviewed using the modified goal scaling schedule, completed the Roland-Morris Disability Questionnaire and rated their general health status. They were reassessed at 3 and 6 months. Results Thirty-five patients were recruited. Minimal important change was identified on 67% of the goals. At follow-up, goal attainment scores were able to distinguish between 'improvers' and 'non-improvers', and these categories showed significant agreement with change in disability (Kappa = 0.865). Goal attainment was highly correlated with satisfaction (Spearman's rho = 0.88) and moderately associated with general health status (Spearman's rho = 0.40). Conclusions The modified version of Goal Attainment Scaling used here may provide useful additional information about both the problems associated with, and the progress of patients who consult with low back pain in Primary Care.

Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33... more

Background In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015).

Purpose. To use a taxonomy of goal content, developed in community-based brain injury rehabilitation to examine and compare the content of goals set within two different service settings; and to further examine the potential of the... more

Purpose. To use a taxonomy of goal content, developed in community-based brain injury rehabilitation to examine and compare the content of goals set within two different service settings; and to further examine the potential of the taxonomy to be a reliable and comprehensive framework for classifying goals. Method. Qualitative analysis and categorization of 1492 goal statements extracted from a community-based brain injury rehabilitation service over two time periods (1996 -97, 1998 -99), and cross-organizational comparison of ratings of goal classifications using a random sample of 100 goal statements drawn from this data set and the original 1765 goal statements used in developing the taxonomy. Results. Application of the taxonomy beyond the original service setting in which it was developed indicated a strong interrater reliability, with a high test-retest agreement reported over time. For both services, a small number of categories accounted for a substantial proportion of goals set within the two time periods, while considerable change was evident in goals between the two periods for one service. Further, both placed emphasis on individually focused goals rather than relationship or family-related goals. Conclusion. The taxonomy provides a reliable means for classifying goals and is a useful tool for exploration of the multiple influences on goal setting. Further application of the taxonomy to examine the relative influence on goal setting of client factors versus a range of organizational factors would be beneficial.

This article represents initial deliberation of an international task force appointed by the US National Multiple Sclerosis Society to develop recommendations for optimal clinical assessment tools for multiple sclerosis clinical trials.... more

This article represents initial deliberation of an international task force appointed by the US National Multiple Sclerosis Society to develop recommendations for optimal clinical assessment tools for multiple sclerosis clinical trials. Presented within this article are the key issues identified by the task force during its initial year of deliberation. These include the precise purpose for a clinical assessment tool, the clinical dimensions to be measured in a multidimensional outcome measure, desirable attributes of an optimal clinical outcome measure, the complexities of multidimensional outcome measures, the relative merits of categorical clinical ratings and quantitative functional assessments, and a number of other important design issues that relate to the use of a multidimensional outcome measure. An action plan for analysis of existing data is summarized, as are the plans for more detailed recommendations from the task force.

Objective: To assess the impact of the implementation of a daily goals sheet upon nursing perception of communication in an academic, tertiary care paediatric intensive care unit (PICU). Design: Prospective, longitudinal, before-and-after... more

Objective: To assess the impact of the implementation of a daily goals sheet upon nursing perception of communication in an academic, tertiary care paediatric intensive care unit (PICU). Design: Prospective, longitudinal, before-and-after intervention surveys. Setting: University affiliated 12-bed PICU. Subjects: Bedside nurses. Interventions: A questionnaire was administered to PICU nurses addressing their perception of communication. Following this questionnaire, the use of a daily goals sheet was instituted. A second questionnaire was administered one year later. Mann-Whitney Rank Sum Test was used to compare differences of the graded outcome variables. Measurements and main results: The primary outcome was the perception of communication taken from a nursing perspective. Eighty-five percent of nurses felt the daily goals sheet led to improved communication between physicians and nurses in the PICU. All questions related to communication demonstrated a positive influence of the goals sheet, with the perception of the PICU staff working as a team reaching statistical significance (p = 0.05). The perception of the care of one surgical service being attending physician directed also significantly improved after the institution of the goals sheet (p = 0.04). Conclusion: The institution of a daily goals sheet led to an improvement in nursing perception of communication. Future studies are required to determine if this The use of a daily goals sheet to improve communication in the paediatric intensive care unit 265 change in process has a demonstrable effect on health care outcomes of critically ill children, or whether this tool can have the same beneficial effects in other academic and non-academic PICUs.

One purpose of this work was to study the relationship of goal orientations and the perceived motivational climate created by the coach in relation to 219 competitive Spanish tennis players': a) perceived improvement in different... more

One purpose of this work was to study the relationship of goal orientations and the perceived motivational climate created by the coach in relation to 219 competitive Spanish tennis players': a) perceived improvement in different facets of the game, b) satisfaction with their competitive results, overall level of play, and coach, and c) ratings of their coach. The second purpose was to examine whether the dependent variables were best predicted by the perceived situationally emphasized goal structure created by the coach and/or the athletes' dispositional goal perspective. Intermediate (N=70), advanced (N=124), and professional (N=25) level players completed Spanish versions of the TEOSQ and the PMCSQ-2 and items assessing perceived improvement specific to tennis, satisfaction and coach ratings. The results were consistent with the tenets of goal perspective theory and provide further support for the promotion of a task involving atmosphere in sport.

This study examines cultural patterning in situational variability in mother-infant interactions among middleclass Anglo and Puerto Rican mothers and their 12 to 15-month-old firstborn children. Forty mothers were interviewed regarding... more

This study examines cultural patterning in situational variability in mother-infant interactions among middleclass Anglo and Puerto Rican mothers and their 12 to 15-month-old firstborn children. Forty mothers were interviewed regarding their long-term socialization goals and childrearing strategies, and videotaped interacting with their infants in four everyday settings: feeding, social play, teaching, and free play. Results suggest that:

This research examined the hypothesis that the concept of power is mentally associated with different goals for individuals with a communal versus an exchange relationship orientation (M. S. Clark & J. Mills, 1979). It was predicted that... more

This research examined the hypothesis that the concept of power is mentally associated with different goals for individuals with a communal versus an exchange relationship orientation (M. S. Clark & J. Mills, 1979). It was predicted that communals associate power with social-responsibility goals, whereas exchangers link power with self-interest goals. Thus, when power is activated, distinct goals should be ignited for communals and exchangers. Power was primed unobtrusively using semantic cues in Study 1 and using naturally occurring, environmental cues in Studies 2 and 3. Across studies, power-primed communals responded in socially responsible ways, whereas power-primed exchangers acted more in line with their self-interests. These power-goal effects occurred nonconsciously. Overall, the data support taking a Person x Situation approach-one that allows for moderators such as relationship orientation-to understand power's positive and negative effects.

The objective of this investigation was to determine the manner by which production standards or goals, performance or production feedback and monetary or wage incentive affected or moderated the relationship between worker satisfaction... more

The objective of this investigation was to determine the manner by which production standards or goals, performance or production feedback and monetary or wage incentive affected or moderated the relationship between worker satisfaction and productivity in a repetitive production task in a fishing industry. The industrial study was conducted to measure worker satisfaction and productivity under various experimental conditions involving production standards, performance feedback and monetary incentive. Only the participative standard and performance feedback condition affected the worker satisfaction-productivity relationship significantly for the fish-trimming task. The positive correlation coefficient (0.87) for this condition was found to be highly significant. This has an important implication for setting a strategy for achieving higher worker satisfaction and productivity in such an industry. Production standards with feedback generally improved worker satisfaction and productivity. Monetary incentive further improved worker performance but added no incremental satisfaction gain. The incorporation of production standards, performance feedback and monetary incentive affected worker satisfaction and productivity differently and this had an effect on the worker satisfaction-productivity relationship. In an earlier laboratory study, no significant worker satisfactionproductivity relationship was found when subjects (college students) were provided with similar experimental conditions.

Electronic health records (EHRs) are essential to improving patient safety. 1 Hospitals and health care providers are implementing EHRs rapidly in response to the American Recovery and Reinvestment Act of 2009. 2-4 The number of certified... more

Electronic health records (EHRs) are essential to improving patient safety. 1 Hospitals and health care providers are implementing EHRs rapidly in response to the American Recovery and Reinvestment Act of 2009. 2-4 The number of certified EHR vendors in the United States has increased from 60 5,6 to more than 1000 7 since mid-2008. Recent evidence has highlighted substantial and often unexpected risks resulting from the use of EHRs and other forms of health information technology. 8-12 These concerns are compounded by the extraordinary pace of EHR development and implementation. Thus, the unique safety risks posed by the use of EHRs should be considered alongside the potential benefits of these systems. At a time when institutions are focused heavily on achieving "meaningful use" requirements, we propose that clearer guidance be provided so that these institutions can align activities related to patient safety with the activities required to support a safe EHRenabled health care system. 13 A set of EHR-specific safety goals, modeled after the Joint Commission's National Patient Safety Goals, may provide organizations with areas of focus for sustained improvements in organizational infrastructure, processes, and culture as they adapt to new technology. EHR implementation is still highly heterogeneous across health care systems and providers, and this heterogeneity leads to equally variable implications for patient safety. For instance, the priorities for patient safety in an organization in the midst of an EHR rollout differ from those of an organization that has used a fully integrated EHR system for 5 or more years. To account for the variation in the stages of implementation and levels of complexity across clinical practice settings, we propose a three-phase framework for the development of EHRspecific patient-safety goals (e-PSGs). The first phase of the framework, aimed at all EHR users but especially at recent and future adopters, includes goals to mitigate risks that are unique and specific to technology 14 (e.g., technology that is unsafe owing to unavailable or malfunctioning hardware or software). The second phase addresses issues created by the failure to use technology appropriately or by misuse of technology. 15 The final phase focuses on the use of technology to monitor health care processes and outcomes and identify potential safety issues before they can harm patients. 16 This framework can lay the foundation for the development of e-PSGs within the context of EHR-enabled health care.

The aim of the experiment was to identify the control mechanisms involved in a goal-directed task by manipulating the temporal constraints. Subjects were required to catch, with one hand, table tennis balls projected by a ball-projection... more

The aim of the experiment was to identify the control mechanisms involved in a goal-directed task by manipulating the temporal constraints. Subjects were required to catch, with one hand, table tennis balls projected by a ball-projection machine under five temporal conditions (ball speed ranged from 5.7 to 9 m/s, giving rise to flight times of 550-350 ms). By means of three-dimensional kinematics analysis the following results were obtained, which are some spatio-temporal adaptations of the catching movement to the increase of temporal constraints: (1) a decrease in movement time, (2) an increase in the straightness of the trajectory of the wrist, and (3) a shift backwards of the place of ball-hand contact while (4) the grasping time was kept constant. Moreover, as a result of increasing temporal constraints, the acceleration phase of the transportation component was kept constant while the deceleration phase was progressively decreased and nearly suppressed. Further, an increased correlation of the initial direction of the transportation component with the initial direction of the ball path was found. These findings show some spatio-temporal adaptations of the catching movement when the time available is manipulated. They also support the contention of a shift in the control mechanisms involved in one-handed catching facing different temporal constraints.

Activity theory has been successfully applied in diverse schools of psychology with particularly extensive work in the fields of education, ergonomics, human factors and industrial-organizational psychology. However, existing efforts of... more

Activity theory has been successfully applied in diverse schools of psychology with particularly extensive work in the fields of education, ergonomics, human factors and industrial-organizational psychology. However, existing efforts of translation and formulation in English suffer from certain limitations. These limitations include the blurring between Vygotsky's sociocultural theory of the development of mind and activity theory, the restriction of activity theory in its entirety to the version offered by Leont'ev, errors in the interpretation of some basic concept and terminology, reliance on studies that use obsolete methods, and failure to consider the Russian work in activity theory in its entirety. This last problem results in the omission of the recent advances in engineering psychology and educational psychology in the former Soviet Union that facilitates the application of activity theory to practical problems. This paper is a description of the evolution of basic theory, concepts and terminology relevant to practitioners-particularly in the field of ergonomics.

The primary purpose of this study was to investigate the effects of cognitive loading on movement kinematics and trajectory formation during goal-directed walking in a virtual reality (VR) environment. The secondary objective was to... more

The primary purpose of this study was to investigate the effects of cognitive loading on movement kinematics and trajectory formation during goal-directed walking in a virtual reality (VR) environment. The secondary objective was to measure how participants corrected their trajectories for perturbed feedback and how participants' awareness of such perturbations changed under cognitive loading. We asked 14 healthy young adults to walk towards four different target locations in a VR environment while their movements were tracked and played back in real-time on a large projection screen. In 75% of all trials we introduced angular deviations of 65u to 630u between the veridical walking trajectory and the visual feedback. Participants performed a second experimental block under cognitive load (serial-7 subtraction, counterbalanced across participants). We measured walking kinematics (joint-angles, velocity profiles) and motor performance (end-point-compensation, trajectory-deviations). Motor awareness was determined by asking participants to rate the veracity of the feedback after every trial. In-line with previous findings in natural settings, participants displayed stereotypical walking trajectories in a VR environment. Our results extend these findings as they demonstrate that taxing cognitive resources did not affect trajectory formation and deviations although it interfered with the participants' movement kinematics, in particular walking velocity. Additionally, we report that motor awareness was selectively impaired by the secondary task in trials with high perceptual uncertainty. Compared with data on eye and arm movements our findings lend support to the hypothesis that the central nervous system (CNS) uses common mechanisms to govern goaldirected movements, including locomotion. We discuss our results with respect to the use of VR methods in gait control and rehabilitation.

Three main questions are central to teaching and learning medical ethics. Can ethics be taught? If it can, what are some of its teachable components? And what teaching methods are appropriate? The author supports the concept of ethical... more

Three main questions are central to teaching and learning medical ethics. Can ethics be taught? If it can, what are some of its teachable components? And what teaching methods are appropriate? The author supports the concept of ethical competence as the basis of an ethical practice. Ethical competence is a set of insights, skills, understandings, ways of thinking which can be taught. The parallel is drawn between these kinds of competencies and the components of rigorous thinking characteristic of the training and experience of medical problem-solvers. Finally the author takes up four common criticisms of this approach.

In a historical revision of the achievement goal construct, Elliot (2005) recognized that there is little consensus on whether the term “goal” in “achievement goal orientations” (GO) is best represented as an “aim”, as an overarching... more

In a historical revision of the achievement goal construct, Elliot (2005) recognized that there is little consensus on whether the term “goal” in “achievement goal orientations” (GO) is best represented as an “aim”, as an overarching orientation encompassing several “aims”, or as a combination of aims and other processes -self-regulation, etc.-. Elliot pointed also that goal theory research provides evidence for different models of GO. As there were no consensus on these issues, we decided to get evidence about the nature and structure of GO, about the role of gender differences in the configuration of such structure, and about relations between GO, expectancies, volitional processes and achievement. A total of 382 university students from different faculties of two public universities of Madrid (Spain) that voluntarily accepted to fill in a questionnaire that assessed different goals, expectancies and self-regulatory processes participated in the study. Scales reliability, confirma...

Although there is increasing focus on provider behavior change as an outcome of continuing medical education (CME), it has long been known that an increase in knowledge alone is rarely sufficient to induce such change. The Personal... more

Although there is increasing focus on provider behavior change as an outcome of continuing medical education (CME), it has long been known that an increase in knowledge alone is rarely sufficient to induce such change. The Personal Learning Plan (PLP), designed to motivate and assess CME learning, was partly derived from SMART goals (specific, measurable, attainable, realistic, and timely), a concept well supported as a strategy to promote behavior change. The goal of this study was to explore the relationship between SMART goals developed after attending a CME conference and subsequent provider behavior change, using the PLP as a tool.