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Approved for public release, distribution is unlimited / This study examines the Reserve Non-Prior Service Accession (NPS) program, the effects of the current training process for Reserve readiness, and the effects of proposals to extend the initial active duty training period. In particular, the thesis examines the effects of the extended training programs on recruiting using data derived from a web-based survey of NPS Reservists. Multivariate logistic regression models are used to examine the effects of personal demographic characteristics on an individual's likelihood to enlist in the NPS program for a 28-day or a 77-day active duty training period. Separate models are used for each program and include a model with the Delayed Entry Program (DEP) as an option, and a model without it. Respondents report that they would have been slightly less inclined to enlist under the 28-day options whereas under the 77-day options respondents indicated that they would have been much less inclined to enlist. FY03 cost data is used to conduct the cost-effectiveness analysis, and indicates that the 28-day option would save an estimated $2.8 million, and decrease NPS personnel training time by 5 months. The 77-day option would cost an estimated additional $46.1 million and decrease NPS personnel training time by 21 months. Based on the analysis of this thesis, it is recommended that the current NPS accession program be phased out and the 77-day with DEP training alternative be implemented. Additionally, the recruiting focus should shift to target high school senior and recent graduates. / Lieutenant Commander, United States Naval Reserve

Objectives: The relationship between dissociation and PTSS was studied by examining the moderating role of prior trauma. The relationship between prior trauma and PTSS was studied by examining the mediating role of dissociation. The relationship between various coping styles, dissociation and prior trauma was also addressed. Study Design: The current study was a retrospective correlational between-subjects design. Subjects: The study included 90 subjects who were admitted into a level one trauma center following a traumatic physical injury. Results: Dissociation was most strongly and significantly related to PTSS (r = .583). Childhood sexual abuse, childhood physical abuse, and total prior trauma were also significantly related to PTSS (r = .249, r =.298, r = .295, respectively). The results of the study indicated that prior trauma did not moderate the relationship between dissociation and PTSS. The addition of the interaction term (prior trauma X dissociation) explained 3.5% additional variance in PTSS (F(3,82) = 1.10, p = .354). However, the relationship between prior trauma and PTSS was found to be partially mediated by dissociation. The effect of prior trauma on PTSS was reduced when dissociation was added into the regression equations for each of the prior trauma predictor variables including: childhood sexual abuse (b = 9.122 reduced to b = 2.050), childhood physical abuse (b = 1.011 reduced to b = .547), and total prior trauma (b = .114 reduced to b = .055). Dissociation was also found to be significantly related to maladaptive coping including: emotional venting (r = .373), denial (r = .213), and behavioral disengagement (r = .330). Prior trauma was not found to be related to maladaptive coping styles. Conclusions: The study findings suggest that the relationship between prior trauma and PTSS is partially due to the engagement in dissociation. However, those who have not experienced a prior trauma are also at risk for experiencing dissociation and subsequent PTSS. Additionally, dissociation was found to be related to maladaptive coping, while prior trauma was not significantly related to any coping styles. Therefore, the findings suggest that dissociation is related to more disruptive psychological sequelae, as compared to pre-trauma factors such as the experience of prior trauma.

<p>In 1999, Saskatchewan Health sanctioned licensed pharmacists in the province to initiate Exception Drug Status (EDS), also referred to as prior approval, requests on behalf of their patients. The objectives of this study were to obtain pharmacists opinions about the benefits of the EDS program to stakeholders, and to identify factors associated with pharmacists initiating a request.</p><p>In the fall of 2004, a census of community-pharmacy managers in Saskatchewan was conducted using a postal questionnaire, consisting of an introductory letter, two survey mailings and one reminder card. The questionnaire consisted primarily of seven-point Likert scale questions, and was analyzed using descriptive statistics and frequencies, followed by non-parametric analysis using Mann-Whitney U and Kruskal-Wallis tests; post-hoc analysis was carried out using the Bonferroni test.</p><p>A response rate of 82.6% was achieved. Those living in Saskatoon or Regina made up 39% of respondents, with another 39% located in centres of less than 5,000 people.</p><p>A majority of respondents (63%) agreed or strongly agreed the EDS program benefited patients and the Drug Plan (64%). Only 15%, 37% and 39% of respondents agreed or strongly agreed EDS benefits pharmacists, physicians and the health care system respectively.</p><p>Factors that were important or very important to pharmacists in deciding whether they would initiate an EDS request on behalf of their patient were: the ability of the pharmacist to obtain the required information to initiate the EDS request (77%); their ability to contact the prescribing physician (70%); and patient centred concerns such as the ability to pay (74%) or the patient had exceeded their deductible (66%). However, time (39%) was not as important relative to other factors in whether the pharmacist would apply for EDS on behalf of their patient.</p><p>The majority of respondents agreed or strongly agreed that changing the policy in 1999 was beneficial to patient care (71%), while it also contributed substantially to their administrative workload (87%). </p><p>The results of this study indicate community pharmacy managers in Saskatchewan acknowledge that the Exception Drug Status process is beneficial for their patients. While pharmacists were supportive of the benefits of an EDS program, their apprehensions towards the program lie in the administrative processes, particularly in obtaining the required information, from physicians, to submit a claim. There is also concern with the methods pharmacists must use to apply for EDS, which can be burdensome and prolong the administrative process.</p><p>To enhance pharmacists support for the program it may be necessary to develop strategies designed to reduce the administrative workload associated with the program, and to streamline the efficient communication of required information between the prescriber and pharmacist. Alternatively, financial compensation to pharmacists for their expertise and efforts might be considered; although this would not address the workload and communication concerns of pharmacists, it does provide recognition for their professional role in securing appropriate drug therapy for their patients.

Previous research has identified commitment as one of the major contributing factors in group conflict and this study extends this line of research by considering group conflict as a result of varying members’ prior commitment for groups working on judgmental tasks with a unanimous decision rule. The goal of the group working on a judgmental task is to reach consensus but unanimous decision rule further complicates the decision making process as it requires every member to agree with group’s decision. Given this setting, prior commitment was expected to result in higher group conflict and this elevated level of conflict to have more negative affect on the group. With three judgmental cases formulated, subjects were divided into post-decision and pre-decision groups. In the post-decision groups, each subject was individually presented with each case first and committed to his own decision. With these prior commitments, subjects reached a unanimous decision through a group discussion. In the pre-decision groups, subjects reached a group decision without any prior commitment to their own decisions. Results showed signs of prior commitment contributing to group conflict. Furthermore, the post-experimental questionnaire showed that higher group conflict translates to more negative affects on the perceived performance, the extent to which members agree with the group’s decision, feeling toward other members and willingness to work with the same group.

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Previous research has identified commitment as one of the major contributing factors in group conflict and this study extends this line of research by considering group conflict as a result of varying members’ prior commitment for groups working on judgmental tasks with a unanimous decision rule. The goal of the group working on a judgmental task is to reach consensus but unanimous decision rule further complicates the decision making process as it requires every member to agree with group’s decision. Given this setting, prior commitment was expected to result in higher group conflict and this elevated level of conflict to have more negative affect on the group. With three judgmental cases formulated, subjects were divided into post-decision and pre-decision groups. In the post-decision groups, each subject was individually presented with each case first and committed to his own decision. With these prior commitments, subjects reached a unanimous decision through a group discussion. In the pre-decision groups, subjects reached a group decision without any prior commitment to their own decisions. Results showed signs of prior commitment contributing to group conflict. Furthermore, the post-experimental questionnaire showed that higher group conflict translates to more negative affects on the perceived performance, the extent to which members agree with the group’s decision, feeling toward other members and willingness to work with the same group.

<p>In 1999, Saskatchewan Health sanctioned licensed pharmacists in the province to initiate Exception Drug Status (EDS), also referred to as prior approval, requests on behalf of their patients. The objectives of this study were to obtain pharmacists opinions about the benefits of the EDS program to stakeholders, and to identify factors associated with pharmacists initiating a request.</p><p>In the fall of 2004, a census of community-pharmacy managers in Saskatchewan was conducted using a postal questionnaire, consisting of an introductory letter, two survey mailings and one reminder card. The questionnaire consisted primarily of seven-point Likert scale questions, and was analyzed using descriptive statistics and frequencies, followed by non-parametric analysis using Mann-Whitney U and Kruskal-Wallis tests; post-hoc analysis was carried out using the Bonferroni test.</p><p>A response rate of 82.6% was achieved. Those living in Saskatoon or Regina made up 39% of respondents, with another 39% located in centres of less than 5,000 people.</p><p>A majority of respondents (63%) agreed or strongly agreed the EDS program benefited patients and the Drug Plan (64%). Only 15%, 37% and 39% of respondents agreed or strongly agreed EDS benefits pharmacists, physicians and the health care system respectively.</p><p>Factors that were important or very important to pharmacists in deciding whether they would initiate an EDS request on behalf of their patient were: the ability of the pharmacist to obtain the required information to initiate the EDS request (77%); their ability to contact the prescribing physician (70%); and patient centred concerns such as the ability to pay (74%) or the patient had exceeded their deductible (66%). However, time (39%) was not as important relative to other factors in whether the pharmacist would apply for EDS on behalf of their patient.</p><p>The majority of respondents agreed or strongly agreed that changing the policy in 1999 was beneficial to patient care (71%), while it also contributed substantially to their administrative workload (87%). </p><p>The results of this study indicate community pharmacy managers in Saskatchewan acknowledge that the Exception Drug Status process is beneficial for their patients. While pharmacists were supportive of the benefits of an EDS program, their apprehensions towards the program lie in the administrative processes, particularly in obtaining the required information, from physicians, to submit a claim. There is also concern with the methods pharmacists must use to apply for EDS, which can be burdensome and prolong the administrative process.</p><p>To enhance pharmacists support for the program it may be necessary to develop strategies designed to reduce the administrative workload associated with the program, and to streamline the efficient communication of required information between the prescriber and pharmacist. Alternatively, financial compensation to pharmacists for their expertise and efforts might be considered; although this would not address the workload and communication concerns of pharmacists, it does provide recognition for their professional role in securing appropriate drug therapy for their patients.

This study focused on two areas under the overarching theme of the effects of domain-general and domain-specific scaffolds with different levels of support, continuous or faded. First, the study investigated the effects of scaffolds on learning of scientific content and problem-solving outcomes. Second, the study examined whether students’ prior knowledge and meta cognitive skills predict their success in problem solving across different scaffolding conditions. A total of nineteen classes were randomly assigned to one of the four scaffolding conditions: domain-general continuous (DG-C), domain-general faded (DG-F), domain specific continuous (DS-C), and domain-specific faded (DS-F). Each class had access to different worksheets depending on the scaffolding condition they had been assigned. All students engaged in four problem-solving activities for thirteen class periods. Students’ scores on a multiple-choice pretest, post test, inventory of meta cognitive self-regulation, and four recommendation forms were analyzed. Results of the study revealed that students’ content knowledge in all conditions significantly increased over the thirteen class periods. However, the continuous domain specific condition outperformed the other conditions on the post test. Although domain general scaffolds were not as effective as domain-specific scaffolds on learning of scientific content and problem representation, they helped students develop solutions, make strong justifications, and monitor their learning. Unlike domain-specific scaffolds, domain-general scaffolds helped students transfer problem-solving skills even when they were faded. In terms of individual differences, results indicated that while students with lower prior knowledge and lower meta cognitive skills benefited from the domain general continuous condition, students with lower regulation of cognition benefited from the domain-general faded condition. Moreover, while students with lower prior knowledge, lower knowledge of cognition, and lower problem representation benefited from the domain-specific continuous condition, students with lower problem representation benefited from the domain-specific faded condition. In contrast, results of the study suggested that scaffolds did not substantially benefit the students with higher prior knowledge and higher meta cognitive skills. Several suggestions are discussed for making further improvements in the design of scaffolds in order to facilitate ill-structured problem solving in hypermedia learning environments.