This study examined the effectiveness of a parenting intervention for abused women and their children called Mothers in MindTM. Based on models of cumulative effects of trauma, it was hypothesized that women who experienced continuous abuse (from childhood to adulthood) would have more parenting difficulties initially and be less receptive to treatment than women whose abuse experiences began later in life (in youth and/or adulthood). Fifty-seven women completed the intervention. Overall, parenting intervention significantly increased women’s parenting competence but did not significantly change mothers’ perceptions of their attachment with their children. Contrary to hypotheses, there were no significant differences in initial parenting difficulties between the two groups and timing of abuse (continuous versus late onset) did not significantly differentiate treatment effects. Contributions of other contextual variables, such as poverty and parental psychopathology, to variation in the effectiveness of intervention for this population of multiply disadvantaged women are discussed.

Objectives: The objectives of the research were to determine which intravenous (IV) antibiotics were cost-effective in Diabetic Foot Infections (DFIs) and to assess the impact of MRSA prevalence on clinical outcome. Methods: A Cost-effectiveness analysis (CEA) was performed on IV antibiotics used to treat moderate to severe DFIs in hospitalized patients. MRSA prevalence was taken into account by calculating an ‘Adjusted cure rate’ and re-analysing the CEA. Results: In the original CEA, imipenem/cilastatin was the cost-effective agent. When MRSA prevalence was taken into account imipenem/cilastatin, moxifloxacin, cefoxitin and ertapenem were cost-effective antibiotics. Conclusion: MRSA prevalence adjustments changed the results of the CEA and included classes of IV antibiotics that are seen being using in practice, such as fluoroquinolones and cephalosporins. These methods could potentially have an impact on the evaluation of clinical cure rates and resistance when evaluating the literature.

Background: Androgen deprivation therapy (ADT) has known adverse effects (AEs). Intermittent (INT) ADT may reduce AEs, improve quality of life, and lower costs compared to continuous (CONT) treatment. Objective: To evaluate the cost-effectiveness of INT vs CONT ADT in men with advanced prostate cancer. Methods: A lifetime Markov individual simulation model was developed to evaluate the incremental cost per quality adjusted life month (QALM) of INT vs CONT ADT. Results: INT dominated CONT ADT (mean total costs $94,460 vs $109,431; mean total QALMs 47.0 vs 46.4). INT ADT resulted in less time on therapy (22.4 vs 56.8 months), fewer hip fractures (0.080 vs 0.093 per patient), and fewer total cases of sexual dysfunction (72.5% vs 87.0% of patients) and cardiovascular disease (38.7% vs 44.6% of patients). Conclusions: These results suggest INT ADT is cost-effective compared to CONT ADT however, differences were small. Additional research is required to confirm these findings.

Objectives: The objectives of the research were to determine which intravenous (IV) antibiotics were cost-effective in Diabetic Foot Infections (DFIs) and to assess the impact of MRSA prevalence on clinical outcome. Methods: A Cost-effectiveness analysis (CEA) was performed on IV antibiotics used to treat moderate to severe DFIs in hospitalized patients. MRSA prevalence was taken into account by calculating an ‘Adjusted cure rate’ and re-analysing the CEA. Results: In the original CEA, imipenem/cilastatin was the cost-effective agent. When MRSA prevalence was taken into account imipenem/cilastatin, moxifloxacin, cefoxitin and ertapenem were cost-effective antibiotics. Conclusion: MRSA prevalence adjustments changed the results of the CEA and included classes of IV antibiotics that are seen being using in practice, such as fluoroquinolones and cephalosporins. These methods could potentially have an impact on the evaluation of clinical cure rates and resistance when evaluating the literature.

Background: Androgen deprivation therapy (ADT) has known adverse effects (AEs). Intermittent (INT) ADT may reduce AEs, improve quality of life, and lower costs compared to continuous (CONT) treatment. Objective: To evaluate the cost-effectiveness of INT vs CONT ADT in men with advanced prostate cancer. Methods: A lifetime Markov individual simulation model was developed to evaluate the incremental cost per quality adjusted life month (QALM) of INT vs CONT ADT. Results: INT dominated CONT ADT (mean total costs $94,460 vs $109,431; mean total QALMs 47.0 vs 46.4). INT ADT resulted in less time on therapy (22.4 vs 56.8 months), fewer hip fractures (0.080 vs 0.093 per patient), and fewer total cases of sexual dysfunction (72.5% vs 87.0% of patients) and cardiovascular disease (38.7% vs 44.6% of patients). Conclusions: These results suggest INT ADT is cost-effective compared to CONT ADT however, differences were small. Additional research is required to confirm these findings.

This dissertation presents a study on project management and its effectiveness in a multinational pharmaceutical company (MPC). A mixed qualitative-quantitative method consisting of a case study (33 managers) and a follow-up survey (122 employees) was conducted. The cybernetics theory and its related concepts were used to formulate the social and technical components of projects as a network of task-related social interactions within an organizational context. Interaction was defined as the variety or possible states one node generates for another node, while degree of coordination was defined as the extent to which a recipient node can handle the variety of interrelated nodes. Interaction Effectiveness (IE) was calculated based on the ratio of “helpful” to “not so helpful” behaviors between interrelated nodes. MPC’s average organizational IE ratio of 1.03 was used as a baseline to determine the relative effectiveness of different interactions. The IE ratio also revealed two structural network properties. First, a departmental-level analysis indicated that most network relationships were asymmetrical (76.5%), reflecting a significant discrepancy in perceptions between interrelated nodes. Second, the variability of IE ratios (standard deviation) ranged from 0.10 to 1.28, reflecting the degree of consistency among the relationships of each single node and its interrelated nodes. The results of a multiple regression analysis indicated a significant relationship between the perceived ranking of a node’s performance and the node’s IE ratio. Multiple regression analysis also indicated a significant relationship between the perceived ranking of a node’s importance and the total of that node’s helpful and not so helpful comments. Finally, the results showed that the IE ratio was almost double for employees’ positive working relationship links compared to links with which they reported negative working relationships. The qualitative findings also provide significant evidence of the method’s sensitivity to capture project management’s most crucial element of “time.” Categorizing the impact of not so helpful comments corresponded mostly to “delays” (68.87%), whereas the impact of helpful comments corresponded mostly to “saving time” (68.14%). Furthermore, categorizing decisions to handle variety revealed the dominance of “adhocracy” mechanisms (62.18%) to handle input variety as opposed to “procedural” variety handling mechanisms (20.63%). Categorizing the comments related to the not so helpful category of “unreasonable expectations” indicated that 51.4% of all comments pertained to “role overload” followed by “role conflict” (36.5%), with only 12.1% of all comments corresponding to “role ambiguity.” The quantitative follow-up survey’s primary objective was to test the research hypotheses regarding the relationship between “variety”-related concepts and different degrees of project complexity (complex versus simple). The survey supported all hypotheses except Hypothesis 7 regarding project management software. Results, limitations, potential improvements to the current study, and future research directions are discussed.

Child-based consultation is an innovative problem-solving consultative model. Essentially, child-based consultation is a process wherein the child is given the role of the consultee to induce a behavioral change in a significant adult (Bergan & Kratochwill, 1990; Kratochwill & Pittman, 2002; Kratochwill, Sladeczek, & Plunge, 1995). The present study was an exploratory investigation to evaluate the efficacy of child-based consultation as an alternative form of problem-solving consultation in the school setting. In the present study, child-based consultation was used to promote behavioral changes in teachers in the classroom environment. In addition, child consultees, manifesting behavioral difficulties, were engaged in this consultative process in order to learn new, individualized skills and strategies to alter their own problematic behaviors. The resulting behavioral changes in four child consultees, and their teachers, were investigated. Specifically, the study measured whether child involvement in child-based consultation increased the teacher's use of positive reinforcement and decreased the teacher's use of punishment with each child consultee. The study also sought to ascertain the impact of the child-based consultative process on the child consultee's problem behaviors targeted for change. Additionally, the teacher's sense of efficacy was measured to evaluate if the use of this form of consultation with children manifesting behavioral difficulties would lead to a heightened sense of teacher efficacy. Finally, the present study evaluated if being involved in child-based consultation would lead to a more adaptive self-concept in the child consultees. Time-series, small- n research designs (i.e., AB, multiple baseline, changing criterions designs) were used to analyze study outcomes. Results indicated that certain teacher behaviors were positively altered from baseline to post-intervention. Generally, positive changes in child consulte

Most LEED (Leadership in Energy and Environmental Design) certified buildings are commercial office buildings and multi-use buildings. As of October 2009, 35,000 projects were registered in the LEED system, "comprising over 4.5 billion square feet of construction space in all 50 states and 91 countries." However, as of April 30, 2009, only 43 healthcare projects had achieved LEED certification. Currently, most studies focus on the economic benefits and energy consumption of LEED certified buildings, rather than human factors. A small gain in productivity can result in a heftier financial gain. Even modest improvements in productivity and absenteeism can substantially outweigh the energy cost. This study surveyed 164 staff in the two healthcare settings for case study, and 146 staff in the six LEED certified healthcare settings for the main study in climate zone 2 and 3. Telephone interviews with the six facility managers were used to verify the survey results and further examine the healthcare facilities? performance and the effectiveness of the LEED strategies from facility managers' perspectives. Independent t-test was used to examine the difference between the LEED and Non-LEED hospitals in one healthcare system and results showed that building performance were rated higher by staff in LEED certified hospital than Non-LEED hospital. MANOVA was conducted to compare the staff's ratings between Silver and Gold certification levels, male and female, and also explore the possibility of interaction effect. Multilevel regression modeling was used to test how the building performance variables affect the overall comfort and productivity. Study results showed that staff in the Gold certified hospital had significant higher ratings in most the performance variables. Gold certified healthcare settings were significant better in rated building overall, overall comfort and controllability than Silver certified healthcare settings. And males felt more comfortable in temperature than females in healthcare facilities. Regarding the overall comfort and productivity, building design, efficiency of the space use, temperature comfort and controllability over building system were significant predictors for staff overall comfort; and lighting comfort, temperature comfort and controllability over building system had significant positive relationship with perceived productivity. LEED certified healthcare settings appear to have a good environment and building performance for occupants. Controllability, lighting, temperature, use of space, building design were important factors in staff comfort and productivity.

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1985. / Bibliography: leaves 326-337. / Photocopy. / xviii, 337 leaves, bound ill. 29 cm

<p>This study focused on understanding inter-organizational relationships (IOR) of a dynamic nature. A dynamic process that has repetitive sequences of negotiation, commitment, and execution stages is central to inter-organizational relationships. The dynamic process is a tool that is used by management through collaboration, co-operation, and coordination to engender formation, governance, and performance of inter-organizational relationships. This report looked into how the resource-dependency theory gives insight into the formation of an inter-organizational relationships and how the transaction-cost theory contributes to the understanding ofinter-organizational relationships governance.</p>