Background: Individuals who experience negative life events may be at increased risk for suicidal behavior. Intrapersonal characteristics, such as basic psychological needs, however, may buffer this association. Aims: To assess the potential moderating role of overall basic psychological needs, and the separate components of autonomy, competence, and relatedness, on the association between negative life events and suicidal behavior. MethodOur sample of 439 college students (311 females, 71%) completed the following self-report surveys: Life Events Scale, Basic Psychological Needs Scale, Beck Depression Inventory ; II, and the Suicide Behaviors Questionnaire-Revised. Results: In support of our hypotheses, negative life events were associated with greater levels of suicidal ideation and attempts, and satisfaction of basic psychological needs, including autonomy, relatedness, and competence, significantly moderated this relationship, over and above the effects of the covariates of age, sex, and depressive symptoms. Conclusions: Suicidal behavior associated with the experience of negative life events is not inevitable. Therapeutically bolstering competence, autonomy, and relatedness may be an important suicide prevention strategy for individuals experiencing life stressors.

Objective: We tested a hypothesized model consistent with the notion that self-compassion mediates the association between negative life events and suicidal risk (viz., depressive symptoms and suicidal behaviors) in college students. Method: The sample was comprised of 331 college students. Self-compassion facets (viz., self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification) were used in testing for multiple mediation, controlling for sex. Results: Common humanity, mindfulness, and overidentification were found to mediate the association between negative life events (NLE) and depressive symptoms. However, common humanity was found to be the only mediator of the association between NLE and suicidal behaviors. Conclusion: These findings suggest that there are specific facets of self-compassion that account for the association between NLE and suicidal risk in college students and that (loss of) common humanity plays a central role in this process.

The objective of this study was to examine the combined moderating effects of life stress and loneliness on the association between social problem solving ability (SPS) and suicidal behaviors. We assessed SPS, suicidal behavior, loneliness, and stressful life events in a sample of 385 ethnically diverse college students. Overall, only loneliness moderated the association between SPS and suicidal behaviors. Across ethnic groups, loneliness moderated the association between SPS and suicidal behavior for Blacks, Whites, and Asians; life stress was a moderator for Hispanics. For most individuals, loneliness increases the strength of the association between poor problem-solving and suicidal behaviors. For Hispanics, life stress exacerbates this relationship. Ethnically-specific prevention strategies targeting loneliness and life stress may promote effective problem-solving, reducing suicide risk.

The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians' field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.

This was the first study to quantitatively test the use of SEIPS (Systems Engineering Initiative for Patient Safety) model to identify factors influencing a medication safety outcome. By using a SEIPS model, our study developed a comprehensive approach to identifying potential factors influencing adverse drug events (ADEs). The SEIPS work system is composed of five components which include person, organization, technologies and tools, tasks, and environment. SEIPS model successfully explained the work system factors influencing ADEs and falls in nursing homes (NHs). The second important contribution of our study is that it used the CMS (Centers for Medicare and Medicaid Services) ADE Trigger Tool not only to detect actual ADEs, but also to identify specific potential ADEs in NHs. This study had five objectives: 1) calculate actual ADE incidence rate (number of incidents per 100 residents per month) in NHs using the ADE trigger tool, 2) measure potential ADE incidence rate based on abnormal lab data, vital signs and non-harmful falls, 3) identify the classes of medications most likely to cause ADEs, 4) evaluate the relationships between work system characteristics and the incidence of ADEs, and 5) assess the relationships between work system characteristics and resident fall incidents. This study was an observational quantitative study. It included two quantitative methods: retrospective resident medical chart extraction and survey four types of healthcare practitioners. The staff surveys included four categories of NH practitioners at each facility to ensure comprehensive assessment of the work system: Director of nursing (DON), registered nurse (RN), certified nurse assistant (CNA) and consultant pharmacist. The surveys included questions about the facility conditions, environment, technology, task, and staff/practitioners. Both methods were conducted within the same facilities and during the same period. The study was conducted in 11 NHs in nine cities in Iowa. Data collection was conducted over fall 2016 and spring 2017. Binary logistic regression with Generalized Estimated Equation (GEE) was used to measure the association between the ADE incidence (Yes/No) and characteristics of residents and facilities. The secondary outcome was the incidence of falls. We reviewed 755 medical charts and conducted 44 staff surveys. The rate of ADEs was 6.13 incidents per 100 residents per month. Approximately (64.1%) of the ADEs were preventable. More than half of the ADEs were fall-related (51.1%) and half of those harmful falls were due to hypotension. We considered all the harmful falls as ADEs in residents with one or more psychotropic, antihypertensive, opioid and/or anti-diabetic medications, which can cause fall. The most common ADEs included medication (opioid)-induced constipation (24.6%), psychotropic induced confusion, dizziness or drowsiness (6.5%), antibiotic-induced Clostridium difficile diarrhea (4.2%), anticoagulant induced bleeding (3.9%) and antidiabetic induced hypoglycemia (3.2%). The most common fall-related ADEs were bruise (9.7%) and abrasion or laceration (9.4%). Psychotropic medications (74.9%), antidepressants (61.3%), antihypertensive agents (58.7%), and opioids (51.9%) were the most common medications associated with ADEs. The rate of potential ADEs was 48.6 per 100 residents per month. The rate of falls was 23.38 per 100 residents per month. The regression analysis revealed significant associations between the ADEs and opioid analgesics, psychotropic medications, warfarin, skilled care, consultant pharmacist accessibility, nurse-physician collaboration, CNA skills in taking vital signs, number of physician visits to the facility, nurse workload and the use of electronic health records. On the other hand, the regression analysis showed non-significant relationships between ADEs and cardiac arrhythmia (AFib), DON years in the facility and distracting noise during medication administration. The six significant facility characteristics represent five concepts of the SEIPS model: organization, task, environment, person and technology. In the fall regression analysis, twelve of the resident and the facility SEIPS variables had significant relationships with the incidence of resident falls. The significant variables represent four concepts of the SEIPS model: organization, task, environment, and person. Longer DON years in the facility and more nurse time per resident per day were associated with lower number of fall incidents. The CNA skills in taking vital signs have significant negative association with both ADEs and falls. Finally, the variable “CNAs work fast” and the nurse workload also have positive association with the incidence of falls

The interactions between rivers, surrounding hydrogeological features, and hydraulic structures such as bridges are not well-established or understood at the network scale, especially under transient conditions. The cascading hydraulic effects of local perturbations up- and downstream of the site of perturbation may have significant, unexpected, and far-reaching consequences, and therefore often cause concern among stakeholders. The up- and downstream hydraulic impacts of a single structural modification may extend much farther than anticipated, especially in extreme events. This work presents a framework and methodology to perform an analysis of interdependent bridge-stream interactions along a river corridor. Such analysis may help prioritize limited resources available for bridge and river rehabilitations, allow better-informed cost/benefit analysis, facilitate holistic design of bridges, and address stakeholder concerns raised in response to planned bridge and infrastructure alterations. The stretch of the Otter Creek from Rutland to Middlebury, VT, is used as a test bed for this analysis. A two-dimensional hydraulic model is used to examine the effects individual structures have on the bridge-stream network, particularly during extreme flood events. Results show that, depending on their characteristics, bridges and roadways may either attenuate or amplify peak flood flows up- and downstream, or have little to no impact at all. Likewise, bridges may or may not be sensitive to any changes in discharge that result from perturbation of existing structures elsewhere within the network. Alterations to structures that induce substantial backwaters may result in the most dramatic impacts to the network, which can be either positive or negative. Structures that do not experience relief (e.g., roadway overtopping) may be most sensitive to network perturbations.

Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of the practice change process. The International Nursing Association for Clinical Simulation and Learning standards were used to design simulation scenarios. Surgical acute care nurses (n = 35) including day and night shift nurses, new graduates, and experienced nurses participated. Groups of five to eight nurses participated in a two-hour simulation session at hospital simulation center. Pre- and post-surveys on confidence level data, and National League of Nursing evaluation tool data on educational practices and simulation designs were collected from all participants. Paired t-test statistics showed a significant increase in confidence level from pre to post education (p < .001). Because of the significant impact on patient care due to preventing complications and by improving nursing staff's level of confidence, the project may contribute to positive social change.

A model that emphasizes possible alternative sequences of events that occur over time is presented in paper 1 (chapter 2) of this dissertation. Representing alternative or branching events captures additional semantics unrealized by linear or non-branching approaches. Two basic elements of branching, divergence and convergence are discussed. From these elements, many complex branching models can be built capturing a perspective of events that take place in the future or have occurred in the past. This produces likely sequences of events that a user may compare and analyze using spatial or temporal criteria. The branching events model is especially useful for spatiotemporal decision support systems, as decision-makers are able to identify alternative locations and times of events and, depending on the context, also identify regions of multiple possible events. Based on the formal model, a conceptual framework for a branching events model for flood disasters is presented. The framework has five parts, an event handler, a query engine, data assimilator, web interface, and event database. A branching events viewer application is presented illustrating a case study based on a flood response scenario. A spatiotemporal framework for building evacuation events is developed to forecast building content evacuation events and building vulnerabilities and is presented in paper 2 (chapter 3) of this dissertation. This work investigates the spatiotemporal properties required to trigger building evacuation events in the floodplain during a flood disaster. The spatial properties for building risks are based on topography, flood inundation, building location, building elevation, and road access to determine five categories of vulnerability, vulnerable basement, flooded basement, vulnerable first-floor, flooded first-floor, and road access. The amount of time needed to evacuate each building is determined by the number of vulnerable floors, the number of movers, the mover rate, and the weight of the contents to be moved. Based upon these properties, six possible evacuation profiles are created. Using this framework, a model designed to track the spatiotemporal patterns of building evacuation events is presented. The model is based upon flood forecast predictions that are linked with building properties to create a model that captures the spatiotemporal ordering of building vulnerabilities and building content evacuation events. Applicable to different communities at risk from flooding, the evacuation model is applied a historical flood for a university campus, demonstrating how the defined elements are used to derive a pattern of vulnerability and evacuation for a campus threatened by severe flooding. Paper 3 (Chapter 4) of this dissertation presents a modeling approach for representing event-based response risk. Surveys were sent to emergency managers in six states to determine the priorities of decision makers during the response phase of flood disasters. Based on these surveys, nine response events were determined to be the most important during a flood response, flooded roads, bridges closed, residential evacuations, residential flooding, commercial flooding, agricultural damage, power outage, sheltering, sandbagging. Survey participants were asked to complete pairwise comparisons of these nine events. An analytic hierarchy process analysis was completed to weight the response events for each decision-maker. A k-means clustering analysis was then completed to form 4 distinct profiles, mixed rural and urban, rural, urban, and high population - low population density. The average weights from each profile were calculated. The weights for each profile were then assigned to geospatial layers that identify the locations of these events. These layers are combined to form a map representing the event-based response risk for an area. The maps are then compared against the response events that actually occurred during a flood disaster in June 2008 in two communities.

Pouvoir lutter efficacement contre certains fléaux comme les incendies de forêt, les feux de brousse ou les catastrophes naturelles constitue un enjeu majeur dans plusieurs villes du monde.Avec l'avènement de la technologie de pointe représentée par les réseaux de capteurs, la détection de ces phénomènes devient plus aisée.En effet, des capteurs peuvent être déployés dans des zones difficiles d'accès et s'ils sont suffisamment nombreux pour couvrir la totalité de l'environnement à surveiller, une alerte peut être directement donnée par le capteur ayant détecté un certain type d'évènement (feu, secousse sismique...).Le centre de contrôle ayant reçu l'alerte peut ensuite décider d'intervenir sur la zone en cause.Nos travaux se situent dans ce cadre de la détection de phénomènes par un réseau de capteurs, en supposant que l'environnement est connu et que les capteurs sont mobiles, sans fil et en nombre insuffisant pour couvrir la totalité de l'environnement à surveiller.Parler de surveillance par un nombre faible d'entités mobiles nécessite de parcourir régulièrement certaines zones critiques de l'environnement, ce qui peut s'apparenter à une tâche de patrouille.Dans le cadre de cette thèse, nous nous sommes focalisés sur la détermination de stratégies de patrouille multi-capteurs appliquée à la détection d'évènements.Un problème similaire au nôtre est celui de la patrouille multi-agents dans un environnement connu.Ce problème consiste à faire visiter régulièrement les noeuds d'un graphe (représentant l'environnement) par des agents.Les capteurs peuvent être considérés comme des agents ayant des ressources limitées, en terme d'énergie en particulier.Le cadre de la patrouille multi-agents et les techniques proposées pour le résoudre ne peuvent pas être utilisés ici.Après avoir formulé mathématiquement le problème de la patrouille multi-capteurs appliquée à la détection d'évènements, nous proposons une technique de résolution approchée basée sur des colonies de fourmis.Des simulations ont été réalisées en considérant différents scenarii (topologies d'environnement, populations de capteurs, apparitions des événements) afin d'évaluer la pertinence de notre approche.Les résultats expérimentaux montrent que notre approche permet de déterminer des stratégies de patrouille satisfaisantes dans la majorité des scenarii. / To fight effectively against scourges like forest fires , brush fires or natural disasters is a major issue in many cities worldwide.With the advent of technology represented by sensor networks , detection of these phenomena becomes easier .Indeed , sensors can be deployed in remote areas and they are enough to cover the entire environment to monitor, an alert can be given directly by the sensor has detected a certain type of event (fire, earthquake ... ) .The control center has received the alert may then decide to intervene in the area in question .Our work takes place in the context of the detection of phenomena by a sensor network , assuming that the environment is known and that the sensors are mobile, wireless and insufficient to cover the entire environment to be monitored.Speaking of monitoring a small number of mobile entities requires regularly browse some critical environmental areas, which can be likened to a patrol task .In this thesis , we focused on identifying strategies patrol multi-sensor applied to the detection of events.A similar problem to ours is the multi-agent patrolling in a known environment .This problem is to regularly visit the nodes of a graph (representing the environment) by agents.The sensors can be considered as agents with limited resources , in terms of energy in particular.The framework of multi- agents and techniques proposed to solve patrol can not be used here .After mathematically formulated the problem of multi-sensor patrol applied to the detection of events, we propose an approximate solution technique based on ant colonies .Simulations were made ​​considering different scenarios ( environmental topologies populations sensors appearances events ) to assess the relevance of our approach.The experimental results show that our approach identifies strategies patrol satisfactory in the majority of scenarios.

La Responsabilité Sociétale de l’Entreprise (RSE) est mobilisée comme la traduction managériale du concept plus global de développement durable et l’étude de la RSE est au cœur de nombreuses recherches depuis plus de quatre décennies. En France, les organisations sportives s’engagent progressivement dans des démarches de développement durable et multiplient les initiatives en faveur d’une plus grande responsabilité sociétale des activités sportives.Ce projet de recherche est né de la volonté de comprendre comment le développement durable est concrètement mis en œuvre au sein des organisations sportives en étudiant et en analysant les stratégies de RSE développées. Parmi les champs d’étude des relations entre sport et RSE, nous avons opté pour l’événementiel sportif. Au niveau théorique, nous avons choisi de compléter le cadre d’analyse de la RSE (Johnson, 1971 ; Ackerman & Bauer, 1976 ; Carroll, 1979 ; Jones, 1980 ; Wood, 1991) par les apports fournis par la théorie des parties prenantes (Freeman, 1984 ; Hills & Jones, 1992 ; Clarkson, 1995 ; Donaldson & Preston, 1995 ; Mitchell, Agle & Wood, 1997) afin d’opérationnaliser efficacement le concept de RSE (Mullenbach-Servayre, 2007).L’objectif de la thèse est d’ouvrir de nouvelles voies de recherche à partir de l’observation des données de terrain tout en testant des hypothèses issues de l’exploration. Dès lors, nous avons opté pour une approche qualitative inductive-déductive. L’investigation empirique se décompose en une étude exploratoire et cinq études de cas (Eisenhardt, 1989) : Marathon de Sénart, Playa Tour, Roland Garros, Merrel Oxygen Challenge, Tour de France à la Voile. Les données rassemblées sont issues d’une analyse documentaire (près de 200 documents analysés), d’entretiens semi-directifs (39 au total) et d’observations directes. La démarche de recherche mise en œuvre nous conduit à analyser les formes prises par la Responsabilité Sociétale des Organisateurs d’Evénements Sportifs dans les cas étudiés et le type de relations entretenues avec les parties prenantes. Enfin, sur la base de la revue de la littérature effectuée et des recherches empiriques menées, nous proposons une typologie des comportements stratégique et opérationnel des organisateurs d’événements sportifs en matière de RSE. / In management terms, Corporate Social Responsibility (CSR) translates the broader notion of sustainability and the concept of CSR has played a central role in many studies over the past forty years. In France, the principle of sustainability has progressively become a key notion and major concern for sport organizations who are now promoting a more socially responsible practice of sports.This research project aims at understanding how sustainability is put into concrete practice within sport organizations by looking at and analyzing their CSR strategies. In the fields of CSR-sport relation studies, we have decided to focus on sport events. On the theoretical level, we have attempted to combine the analytical frame of the CSR (Johnson, 1971 ; Ackerman & Bauer, 1976 ; Carroll, 1979 ; Jones, 1980 ; Wood, 1991) with the concepts of the stakeholder theory (Freeman, 1984 ; Hills & Jones, 1992 ; Clarkson, 1995 ; Donaldson & Preston, 1995 ; Mitchell, Agle & Wood, 1997) so as to efficiently operationalize the concept of CSR (Mullenbach-Servayre, 2007).The goal of this thesis is to break new research ground based on the observation of data as well as on the testing of exploration-related hypotheses. We have therefore chosen a qualitative inductive-deductive approach. Our empirical investigation consists in an exploratory study and five case studies (Eisenhardt, 1989): Marathon de Sénart, Playa Tour, Roland Garros, Merrel Oxygen Challenge, Tour de France à la Voile. The data presented in our thesis come out of documentary analyses (200 documents analyzed), as well as of semi-structured interviews (39) and direct observation cases. Our research method led us to analyze the different versions of Corporate Social Responsibility depending on the Organizers of Sport Events in all cases and on the type of relations with stakeholders. Lastly, after reviewing the literature available on the field and the empirical research conducted, we have suggested a CSR-based typology of strategic and operational behaviors of sport event organizers.