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1.
J Appl Psychol ; 108(7): 1096-1120, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37023300

ABSTRACT

Recent revelations have brought to light the misconduct of high performers across various fields and occupations who were promoted up the organizational ladder rather than punished for their unethical behavior. Drawing on principles of motivated moral reasoning, we investigate how employee performance biases supervisors' moral judgment of employee unethical behavior and how supervisors' performance-focus shapes how they account for moral judgments in promotion recommendations. We test our model in three studies: a field study of 587 employees and their 124 supervisors at a Fortune 500 telecom company, an experiment with two samples of working adults, and an experiment that directly varied explanatory mechanisms. Evidence revealed a moral double standard such that supervisors rendered less punitive judgment of the unethical acts of higher performing employees. In turn, supervisors' bottom-line mentality (i.e., fixation on achieving results) influenced the degree to which they incorporated their punitive judgments into promotability considerations. By revealing the moral leniency afforded to higher performers and the uneven consequences meted out by supervisors, our results carry implications for behavioral ethics research and for organizations seeking to retain and promote their higher performers while also maintaining ethical standards that are applied fairly across employees. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Morals , Social Behavior , Adult , Humans , Problem Solving , Judgment , Organizations
2.
J Appl Psychol ; 108(8): 1372-1390, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37036688

ABSTRACT

Organizations increasingly encourage, recognize, and reward ethical leadership to preempt the economic and reputational risks associated with ethical failures. At the same time, organizational leadership positions are disproportionately occupied by individuals higher in narcissism. We highlight how the combination of these two phenomena carries important organizational implications by examining how ethical leadership behaviors differentially impact leaders based on their level of narcissism. Building upon self-concordance theory, we introduce a model of contingent consequences of ethical leadership. Our model identifies motivational (i.e., self-efficacy of the leader) and social (i.e., admiration of the leader) mechanisms that explain why ethical leadership positively predicts leadership effectiveness for some leaders, but not for others. We test our model using a field study and two experiments. Findings from these three studies point to a problematic leadership paradox: When leaders higher in narcissism behave more ethically, they incur higher motivational costs and reap fewer social benefits compared to their peers who are lower in narcissism. Results reveal risks to leadership effectiveness for narcissistic leaders who attempt to lead more ethically. We discuss implications for ethical leadership research and practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Leadership , Narcissism , Humans , Social Behavior , Peer Group , Organizations
3.
Proc Natl Acad Sci U S A ; 119(18): e2117464119, 2022 05 03.
Article in English | MEDLINE | ID: mdl-35476522

ABSTRACT

As northern latitudes experience rapid winter warming, there is an urgent need to assess the effect of varying winter conditions on tree growth and forest carbon sequestration potential. We examined tree growth responses to variability in cold-season (November­April) frequency of freeze days (FFD) over 1951 to 2018 using tree-ring data from 35,217 trees and 57 species at 4,375 sites distributed across Canada. We found that annual radial growth responses to FFD varied by species, with some commonalities across genera and clades. The growth of gymnosperms with late spring leaf-out strategies was negatively related to FFD; years with high FFD were most detrimental to the annual growth of Pinus banksiana, Pinus contorta, Larix lyalli, Abies amabilis, and Abies lasiocarpa. In contrast, the growth of angiosperms with early leaf-out strategies, namely, Populus tremuloides and Betula papyrifera, was better in the coldest years, and gymnosperms with intermediate leaf-out timing, such as widespread Picea mariana and Picea glauca, had no consistent relationship to FFD. Tree growth responses to FFD were further modulated by tree size, tree age, regional climate (i.e., mean cold-season temperature), and local site conditions. Overall, our results suggest that moderately warming winters may temporarily improve the growth of widespread pines and some high-elevation conifers in western Canada, whereas warming winters may be detrimental to the growth of widespread boreal angiosperms. Our findings also highlight the value of using species-specific climate-growth relationships to refine predictions of forest carbon dynamics.


Subject(s)
Forests , Trees , Carbon Sequestration , Climate Change , Seasons
4.
Bioscience ; 72(3): 233-246, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35241971

ABSTRACT

Tree-ring time series provide long-term, annually resolved information on the growth of trees. When sampled in a systematic context, tree-ring data can be scaled to estimate the forest carbon capture and storage of landscapes, biomes, and-ultimately-the globe. A systematic effort to sample tree rings in national forest inventories would yield unprecedented temporal and spatial resolution of forest carbon dynamics and help resolve key scientific uncertainties, which we highlight in terms of evidence for forest greening (enhanced growth) versus browning (reduced growth, increased mortality). We describe jump-starting a tree-ring collection across the continent of North America, given the commitments of Canada, the United States, and Mexico to visit forest inventory plots, along with existing legacy collections. Failing to do so would be a missed opportunity to help chart an evidence-based path toward meeting national commitments to reduce net greenhouse gas emissions, urgently needed for climate stabilization and repair.

5.
J Appl Psychol ; 107(3): 370-388, 2022 Mar.
Article in English | MEDLINE | ID: mdl-33983780

ABSTRACT

How do relationships among newcomers in the same cohort impact how quickly they develop clear understandings of their new roles and, ultimately, key socialization outcomes? We study newcomers' relationships with cohort members in the same unit (i.e., intra-unit relationships) and those in different units (i.e., inter-unit relationships). While organizations invest substantial time and resources in promoting broad networking among newcomers, we offer a theoretical and empirical account of how too many connections among fellow newcomers early in the socialization process can slow their adjustment-namely, their growth in role clarity. In Study 1, we surveyed 189 newcomers in an international conglomerate from their orientations through their first 4 months and linked responses to 3 years of their job performance and turnover records. After controlling for the initial level of role clarity, we found an inverted U-shaped relationship between newcomers' intra-unit peer connections and growth in role clarity, whereas their inter-unit peer connections did not significantly relate to growth in role clarity. Growth in role clarity positively related to subsequent newcomers' job satisfaction and job performance, which were then negatively related to turnover. Study 2's results indicated that sensemaking with fellow newcomers operated as a key mechanism linking the nonlinear relationships between intra-unit newcomer-newcomer relationships and growth in role clarity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Interpersonal Relations , Socialization , Humans , Job Satisfaction , Peer Group , Personnel Turnover
6.
J Appl Psychol ; 106(3): 422-438, 2021 Mar.
Article in English | MEDLINE | ID: mdl-32463258

ABSTRACT

What are the effects of perceiving peers' higher performance? Social-cognitive theory emphasizes the positive influence that perceiving higher performers can have on observer task and job performance (because observational learning from role models enhances self-efficacy). Social comparison theory emphasizes the negative self-evaluations that accompany perceiving higher performers, which should under many circumstances reduce self-efficacy and subsequent task and job performance. To more fully understand the effects of perceiving higher performance, we argue the effects of perceived higher performers on observer task and job performance depend on individuals' disposition in how they cognitively process coworkers' performance. Drawing on goal orientation theory, we suggest individuals with higher levels of performance prove goal orientation (PPGO) primarily interpret perceived higher performers as comparative referents rather than as instructive role models, inhibiting social learning and reducing self-efficacy. Results from a 2 studies (a field study of 110 corporate employees as well as an experimental study with 107 undergraduate students) support these ideas: Individuals with higher levels of PPGO have decreased self-efficacy and performance when observing higher performing coworkers, and individuals with lower levels of PPGO have increased self-efficacy and performance when observing higher performing coworkers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Self Efficacy , Work Performance , Humans , Motivation , Peer Group , Students
7.
Neurobiol Aging ; 94: 111-120, 2020 10.
Article in English | MEDLINE | ID: mdl-32603776

ABSTRACT

To characterize the influence of apolipoprotein-E (APOE) genotype on cerebral Aß load and longitudinal Aß trajectories, [11C]Pittsburgh compound-B (PiB) positron emission tomography (PET) imaging was used to assess amyloid load in a clinically heterogeneous cohort of 428 elderly participants with known APOE genotype. Serial [11C]PiB data and a repeated measures model were used to model amyloid trajectories in a subset of 235 participants classified on the basis of APOE genotype. We found that APOE-ε4 was associated with increased Aß burden and an earlier age of onset of Aß positivity, whereas APOE-ε2 appeared to have modest protective effects against Aß. APOE class did not predict rates of Aß accumulation. The present study suggests that APOE modifies Alzheimer's disease risk through a direct influence on amyloidogenic processes, which manifests as an earlier age of onset of Aß positivity, although it is likely that other genetic, environmental, and lifestyle factors are important.


Subject(s)
Alzheimer Disease/genetics , Alzheimer Disease/metabolism , Amyloid beta-Peptides/metabolism , Apolipoproteins E/genetics , Brain/metabolism , Genotype , Age of Onset , Aged , Aged, 80 and over , Alzheimer Disease/diagnostic imaging , Alzheimer Disease/etiology , Apolipoprotein E2 , Cohort Studies , Female , Humans , Male , Middle Aged , Positron-Emission Tomography , Risk
8.
Glob Chang Biol ; 25(4): 1222-1234, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30588740

ABSTRACT

Atmospheric CO2 concentrations are now 1.7 times higher than the preindustrial values. Although photosynthetic rates are hypothesized to increase in response to rising atmospheric CO2 concentrations, results from in situ experiments are inconsistent in supporting a CO2 fertilization effect of tree growth. Tree-ring data provide a historical record of tree-level productivity that can be used to evaluate long-term responses of tree growth. We use tree-ring data from old-growth, subalpine forests of western Canada that have not had a stand-replacing disturbance for hundreds of years to determine if growth has increased over 19th and 20th centuries. Our sample consisted of 5,858 trees belonging to five species distributed over two sites in the coastal zone and two in the continental climate of the interior. We calculated annual increments in tree basal area, adjusted these increments for tree size and age, and tested whether there was a detectable temporal trend in tree growth over the 19th and 20th centuries. We found a similar pattern in 20th century growth trends among all species at all sites. Growth during the 19th century was mostly stable or increasing, with the exception of one of the coastal sites, where tree growth was slightly decreasing; whereas growth during the 20th century consistently decreased. The unexpected decrease in growth during the 20th century indicates that there was no CO2 fertilization effect on photosynthesis. We compared the growth trends from our four sites to the trends simulated by seven Earth System Models, and saw that most of the models did not predict these growth declines. Overall, our results indicate that these old-growth forests are unlikely to increase their carbon storage capacity in response to rising atmospheric CO2 , and thus are unlikely to contribute substantially to offsetting future carbon emissions.

9.
J Appl Psychol ; 102(5): 845-866, 2017 May.
Article in English | MEDLINE | ID: mdl-28191991

ABSTRACT

While high performers contribute substantially to their workgroups and organizations, research has indicated that they incur social costs from peers. Drawing from theories of social comparison and conservation of resources, we advance a rational perspective to explain why high performers draw both intentional positive and negative reactions from peers and consider how cooperative work contexts moderate these effects. A multisource field study of 936 relationships among 350 stylists within 105 salons offered support for our model and an experiment with 204 management students constructively replicated our findings and ruled out alternative explanations. Results indicated that peers offered more support and also perpetrated more undermining to high performers. Paradoxical cognitive processes partly explain these behaviors, and cooperative contexts proved socially disadvantageous for high performers. Findings offer a more comprehensive view of the social consequences of high performance and highlight how peer behaviors toward high performers may be calculated and strategic rather than simply reactionary. (PsycINFO Database Record


Subject(s)
Cooperative Behavior , Employment/psychology , Interpersonal Relations , Social Support , Adult , Female , Humans , Male , Peer Group , Young Adult
11.
Implement Sci ; 11: 46, 2016 Apr 02.
Article in English | MEDLINE | ID: mdl-27039077

ABSTRACT

BACKGROUND: Relative to the general population, people with a mental illness are more likely to have modifiable chronic disease health risk behaviours. Care to reduce such risks is not routinely provided by community mental health clinicians. This study aimed to determine the effectiveness of an intervention in increasing the provision of preventive care by such clinicians addressing four chronic disease risk behaviours. METHODS: A multiple baseline trial was undertaken in two groups of community mental health services in New South Wales, Australia (2011-2014). A 12-month practice change intervention was sequentially implemented in each group. Outcome data were collected continuously via telephone interviews with a random sample of clients over a 3-year period, from 6 months pre-intervention in the first group, to 6 months post intervention in the second group. Outcomes were client-reported receipt of assessment, advice and referral for tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption and inadequate physical activity and for the four behaviours combined. Logistic regression analyses examined change in client-reported receipt of care. RESULTS: There was an increase in assessment for all risks combined following the intervention (18 to 29 %; OR 3.55, p = 0.002: n = 805 at baseline, 982 at follow-up). No significant change in assessment, advice or referral for each individual risk was found. CONCLUSIONS: The intervention had a limited effect on increasing the provision of preventive care. Further research is required to determine how to increase the provision of preventive care in community mental health services. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry ACTRN12613000693729.


Subject(s)
Community Mental Health Services , Preventive Medicine , Adult , Chronic Disease/prevention & control , Female , Health Services Accessibility , Humans , Interviews as Topic , Male , Middle Aged , New South Wales , Outcome Assessment, Health Care , Qualitative Research , Risk Reduction Behavior
12.
Implement Sci ; 11: 50, 2016 Apr 06.
Article in English | MEDLINE | ID: mdl-27052329

ABSTRACT

BACKGROUND: Primary care nurses and allied health clinicians are potential providers of opportunistic preventive care. This systematic review aimed to summarise evidence for the effectiveness of practice change interventions in increasing nurse or allied health professional provision of any of five preventive care elements (ask, assess, advise, assist, and/or arrange) for any of four behavioural risks (smoking, inadequate nutrition, alcohol overconsumption, physical inactivity) within a primary care setting. METHODS: A search of Medline, Embase, PsycInfo, and CINAHL databases was undertaken to locate controlled intervention trials published between 1992 and May 2014 that provided practice change interventions to primary care nurses and/or allied health professionals to increase preventive care. The effect of interventions aimed at increasing the provision of any of the five care elements for any of the four behavioural risks was examined. A narrative synthesis was utilised. RESULTS: From 8109 articles, seven trials met the inclusion criteria. All trials bar one, assessed multi-strategic practice change interventions (three to five strategies) focused on care by nurses (six trials) or mixed nursing/allied health clinicians. One trial examined care provision for all four risks, five trials examined care for smoking only, and one trial examined care for alcohol consumption only. For the six trials reporting significance testing (excludes one smoking care trial), significant effects favouring the intervention group were reported in at least one trial for smoking risk assessment (2/4 trials reported an effect for at least one analysis of an assessment outcome), brief advice (2/3), assistance (2/2), and arranging referral (2/3); alcohol risk assessment (1/2) and brief advice (1/2); inadequate nutrition risk assessment (1/1); and physical inactivity risk assessment and brief advice (1/1). When the number of analyses undertaken within trials focusing on smoking care was considered, the results were less promising (e.g. of the 15 analyses conducted on brief advice variables across three trials, four showed a positive effect). CONCLUSIONS: Evidence for the effect of practice change interventions on preventive care by primary care nurses or allied health providers is inconclusive given the small number of trials and inconsistency of results between and within trials. SYSTEMATIC REVIEW REGISTRATION NUMBER: None.


Subject(s)
Allied Health Personnel , Nursing Staff , Primary Health Care , Primary Prevention , Female , Humans , Male , Professional-Patient Relations , Risk Reduction Behavior
13.
Am J Prev Med ; 51(2): 195-205, 2016 08.
Article in English | MEDLINE | ID: mdl-27103495

ABSTRACT

INTRODUCTION: Few interventions have been successful in reducing the physical activity decline typically observed among adolescents. The aim of this paper is to report the 24-month effectiveness of a multicomponent school-based intervention (Physical Activity 4 Everyone) in reducing the decline in moderate to vigorous physical activity (MVPA) among secondary school students in disadvantaged areas of New South Wales, Australia. STUDY DESIGN: A cluster RCT was conducted in five intervention and five control schools with follow-up measures taken at 24 months post-randomization. SETTING/PARTICIPANTS: The trial was undertaken within secondary schools located in disadvantaged communities in New South Wales, Australia. INTERVENTION: A multicomponent school-based intervention based on the Health Promoting Schools Framework was implemented. The intervention consisted of seven physical activity promotion strategies that targeted the curriculum (teaching strategies to increase physical activity in physical education lessons, student physical activity plans, and modification of school sport program); school environment (recess/lunchtime activities, school physical activity policy); parents (parent newsletters); and community (community physical activity provider promotion). Six additional strategies supported school implementation of the physical activity intervention strategies. MAIN OUTCOME MEASURE: Minutes per day spent in MVPA, objectively measured by accelerometer. RESULTS: Participants (N=1,150, 49% male) were a cohort of students aged 12 years (Grade 7) at baseline (March-June 2012) and 14 years (Grade 9) at follow-up (March-July 2014). At 24-month follow-up, there were significant effects in favor of the intervention group for daily minutes of MVPA. The adjusted mean difference in change in daily MVPA between groups was 7.0 minutes (95% CI=2.7, 11.4, p<0.002) (analysis conducted December 2014-February 2015). Sensitivity analyses based on multiple imputation were consistent with the main analysis (6.0 minutes, 95% CI=0.6, 11.3, p<0.031). CONCLUSIONS: The intervention was effective in increasing adolescents' minutes of MVPA, suggesting that implementation of the intervention by disadvantaged schools has the potential to slow the decline in physical activity. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12612000382875.


Subject(s)
Exercise/physiology , Health Promotion , Schools , Adolescent , Child , Female , Humans , Male , New South Wales , Physical Education and Training , Poverty , Sports
14.
J Appl Psychol ; 100(5): 1364-1380, 2015 Sep.
Article in English | MEDLINE | ID: mdl-25774571

ABSTRACT

Integrating insights from the literature on customers' central role in service and the literature on employee creativity, we offer theoretical and empirical account of how and when customer empowering behaviors can motivate employee creativity during service encounters and, subsequently, influence customer satisfaction with service experience. Using multilevel, multisource, experience sampling data from 380 hairstylists matched with 3550 customers in 118 hair salons, we found that customer empowering behaviors were positively related to employee creativity and subsequent customer satisfaction via employee state promotion focus. Results also showed that empowering behaviors from different agents function synergistically in shaping employee creativity: supervisory empowering leadership strengthened the indirect effect of customer empowering behaviors on employee creativity via state promotion focus.


Subject(s)
Creativity , Employment , Leadership , Organizational Culture , Power, Psychological , Adult , Female , Humans , Male
15.
Aust N Z J Psychiatry ; 49(8): 731-41, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25698807

ABSTRACT

OBJECTIVE: Amongst people with a mental illness, modifiable health risk behaviours contribute substantially to increased chronic disease morbidity and mortality. This study examined the prevalence of and interest in changing such behaviours amongst community mental health service clients in Australia. METHOD: A telephone interview was undertaken with Australian community mental health service clients. Participants reported engagement in four health risk behaviours: tobacco smoking, fruit and vegetable consumption, alcohol consumption, and physical activity. Participants were classified as at risk based upon Australian national guidelines. At-risk participants were asked whether they were considering improving their health risk behaviour within the next month. The association between psychiatric diagnosis and risk, and interest in improving health risk behaviours was examined. RESULTS: Risk prevalence was highest for inadequate vegetable consumption (78.3%), followed by inadequate fruit consumption (60%), smoking (50.7%), physical inactivity (46.8%), short-term alcohol risk (40.3%) and chronic alcohol risk (35.3%). A majority of at-risk participants were considering improving their health risk behaviour for smoking, physical inactivity and inadequate fruit and vegetable consumption (65.1%, 71.1%, and 53.3%, respectively). After adjusting for demographic factors, no diagnostic categories were associated with risk for any behaviour. Those with a diagnosis of depression were more likely to be interested in quitting smoking and increasing physical activity. CONCLUSIONS: Regardless of diagnosis, a high prevalence of chronic disease health risk behaviours was identified, with many participants expressing an interest in improving these behaviours. Such findings reinforce recommendations that preventive care addressing the chronic disease risks of clients be provided routinely by mental health clinicians. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000693729. URL: www.anzctr.org.au/.


Subject(s)
Chronic Disease/psychology , Mental Disorders/complications , Mental Disorders/psychology , Risk-Taking , Adolescent , Adult , Aged , Aged, 80 and over , Attitude to Health , Australia , Community Mental Health Services , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Young Adult
16.
Am J Prev Med ; 47(6): 762-70, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25455118

ABSTRACT

BACKGROUND: People with a mental illness have higher prevalence of behavioral risks for chronic disease than the general population. Despite recommendations regarding the provision of preventive care by mental health services, limited research has examined the extent to which such care is provided. PURPOSE: To examine mental health clinician provision of care for preventable chronic disease risks, and whether such care was associated with the availability of practice support strategies. METHODS: A cross-sectional survey was undertaken of 151 community mental health clinicians in New South Wales, Australia regarding the provision of three elements of preventive care (i.e., assessment, brief advice, and referral/follow-up) for four health risk behaviors (i.e., tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol consumption, and inadequate physical activity). Clinicians reported the availability of 16 strategies to support such care delivery. Data were collected in 2010 and analyzed in 2012-2013. RESULTS: Preventive care provision varied by both care element and risk behavior. Optimal care (each care element provided to at least 80% of clients for all health behaviors) was provided by few clinicians: assessment (8.6%), brief advice (24.5%), and referral/follow-up (9.9%). Less than half of clinicians reported more than four support strategies were available (44.4%). The availability of five or more strategies was associated with increased optimal preventive care. CONCLUSIONS: The provision of preventive care focused on chronic disease prevention in community mental health services is suboptimal. Interventions to increase the routine provision of such care should involve increasing the availability of evidence-based strategies to support care provision.


Subject(s)
Chronic Disease , Community Psychiatry/methods , Delivery of Health Care/organization & administration , Health Promotion/methods , Mental Disorders , Adult , Alcohol Drinking/epidemiology , Chronic Disease/epidemiology , Chronic Disease/prevention & control , Chronic Disease/psychology , Comorbidity , Directive Counseling/methods , Female , Health Behavior , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/physiopathology , Middle Aged , Needs Assessment , New South Wales/epidemiology , Nutrition Assessment , Prevalence , Risk Factors , Risk-Taking , Smoking/epidemiology
17.
Am J Prev Med ; 47(4): 424-34, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25240966

ABSTRACT

BACKGROUND: Although primary care nurse and allied health clinician consultations represent key opportunities for the provision of preventive care, it is provided suboptimally. PURPOSE: To assess the effectiveness of a practice change intervention in increasing primary care nursing and allied health clinician provision of preventive care for four health risks. DESIGN: Two-group (intervention versus control), non-randomized controlled study assessing the effectiveness of the intervention in increasing clinician provision of preventive care. SETTING/PARTICIPANTS: Randomly selected clients from 17 primary healthcare facilities participated in telephone surveys that assessed their receipt of preventive care prior to (September 2009-2010, n=876) and following intervention (October 2011-2012, n=1,113). INTERVENTION: The intervention involved local leadership and consensus processes, electronic medical record system modification, educational meetings and outreach, provision of practice change resources and support, and performance monitoring and feedback. MAIN OUTCOME MEASURES: The primary outcome was differential change in client-reported receipt of three elements of preventive care (assessment, brief advice, referral/follow-up) for each of four behavioral risks individually (smoking, inadequate fruit and vegetable consumption, alcohol overconsumption, physical inactivity) and combined. Logistic regression assessed intervention effectiveness. RESULTS: Analyses conducted in 2013 indicated significant improvements in preventive care delivery in the intervention compared to the control group from baseline to follow-up for assessment of fruit and vegetable consumption (+23.8% vs -1.5%); physical activity (+11.1% vs -0.3%); all four risks combined (+16.9% vs -1.0%) and for brief advice for inadequate fruit and vegetable consumption (+19.3% vs -2.0%); alcohol overconsumption (+14.5% vs -8.9%); and all four risks combined (+14.3% vs +2.2%). The intervention was ineffective in increasing the provision of the remaining forms of preventive care. CONCLUSIONS: The intervention's impact on the provision of preventive care varied by both care element and risk type. Further intervention is required to increase the consistent provision of preventive care, particularly referral/follow-up.


Subject(s)
Allied Health Personnel/organization & administration , Preventive Health Services/organization & administration , Primary Care Nursing/methods , Primary Health Care/organization & administration , Adult , Data Collection , Delivery of Health Care/organization & administration , Female , Follow-Up Studies , Humans , Logistic Models , Male , Middle Aged , Referral and Consultation/statistics & numerical data
18.
Patient Educ Couns ; 94(2): 193-201, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24284164

ABSTRACT

OBJECTIVE: Primary care clinicians have considerable potential to provide preventive care. This study describes their preventive care delivery. METHODS: A survey of 384 community health nurses and allied health clinicians from in New South Wales, Australia was undertaken (2010-11) to examine the assessment of client risk, provision of brief advice and referral/follow-up regarding smoking inadequate fruit and vegetable consumption, alcohol misuse, and physical inactivity; the existence of preventive care support strategies; and the association between supports and preventive care provision. RESULTS: Preventive care to 80% or more clients was least often provided for referral/follow-up (24.7-45.6% of clinicians for individual risks, and 24.2% for all risks) and most often for assessment (34.4-69.3% of clinicians for individual risks, and 24.4% for all risks). Approximately 75% reported having 9 or fewer of 17 supports. Provision of care was associated with: availability of a paper screening tool; training; GP referral letter; and number of supports. CONCLUSION: The delivery of preventive care was limited, and varied according to type of care and risk. Supports were variably associated with elements of preventive care. PRACTICE IMPLICATIONS: Further research is required to increase routine preventive care delivery and the availability of supports.


Subject(s)
Allied Health Personnel , Health Behavior , Nurses , Preventive Health Services/organization & administration , Primary Health Care/organization & administration , Referral and Consultation/statistics & numerical data , Risk Reduction Behavior , Adult , Cross-Sectional Studies , Female , Health Care Surveys , Humans , Life Style , Male , Middle Aged , New South Wales , Practice Patterns, Nurses' , Prevalence , Risk Assessment , Risk-Taking , Smoking Prevention , Vegetables , Young Adult
19.
BMC Health Serv Res ; 13: 167, 2013 May 06.
Article in English | MEDLINE | ID: mdl-23642238

ABSTRACT

BACKGROUND: Smoking, poor nutrition, risky alcohol use, and physical inactivity are the primary behavioral risks for common causes of mortality and morbidity. Evidence and guidelines support routine clinician delivery of preventive care. Limited evidence describes the level delivered in community health settings. The objective was to determine the: prevalence of preventive care provided by community health clinicians; association between client and service characteristics and receipt of care; and acceptability of care. This will assist in informing interventions that facilitate adoption of opportunistic preventive care delivery to all clients. METHODS: In 2009 and 2010 a telephone survey was undertaken of 1284 clients across a network of 56 public community health facilities in one health district in New South Wales, Australia. The survey assessed receipt of preventive care (assessment, brief advice, and referral/follow-up) regarding smoking, inadequate fruit and vegetable consumption, alcohol overconsumption, and physical inactivity; and acceptability of care. RESULTS: Care was most frequently reported for smoking (assessment: 59.9%, brief advice: 61.7%, and offer of referral to a telephone service: 4.5%) and least frequently for inadequate fruit or vegetable consumption (27.0%, 20.0% and 0.9% respectively). Sixteen percent reported assessment for all risks, 16.2% received brief advice for all risks, and 0.6% were offered a specific referral for all risks. The following were associated with increased care: diabetes services, number of appointments, being male, Aboriginal, unemployed, and socio-economically disadvantaged. Acceptability of preventive care was high (76.0%-95.3%). CONCLUSIONS: Despite strong client support, preventive care was not provided opportunistically to all, and was preferentially provided to select groups. This suggests a need for practice change strategies to enhance preventive care provision to achieve adherence to clinical guidelines.


Subject(s)
Community Health Services/statistics & numerical data , Health Behavior , Patient Acceptance of Health Care/psychology , Preventive Health Services/standards , Adult , Delivery of Health Care , Diet/standards , Female , Fruit , Health Services, Indigenous/standards , Health Surveys , Humans , Male , Middle Aged , New South Wales , Outcome and Process Assessment, Health Care , Patient Acceptance of Health Care/statistics & numerical data , Risk Factors , Smoking Prevention , Socioeconomic Factors , Vegetables
20.
Ecol Appl ; 22(1): 119-41, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22471079

ABSTRACT

Data points intensively sampling 46 North American biomes were used to predict the geographic distribution of biomes from climate variables using the Random Forests classification tree. Techniques were incorporated to accommodate a large number of classes and to predict the future occurrence of climates beyond the contemporary climatic range of the biomes. Errors of prediction from the statistical model averaged 3.7%, but for individual biomes, ranged from 0% to 21.5%. In validating the ability of the model to identify climates without analogs, 78% of 1528 locations outside North America and 81% of land area of the Caribbean Islands were predicted to have no analogs among the 46 biomes. Biome climates were projected into the future according to low and high greenhouse gas emission scenarios of three General Circulation Models for three periods, the decades surrounding 2030, 2060, and 2090. Prominent in the projections were (1) expansion of climates suitable for the tropical dry deciduous forests of Mexico, (2) expansion of climates typifying desertscrub biomes of western USA and northern Mexico, (3) stability of climates typifying the evergreen-deciduous forests of eastern USA, and (4) northward expansion of climates suited to temperate forests, Great Plains grasslands, and montane forests to the detriment of taiga and tundra climates. Maps indicating either poor agreement among projections or climates without contemporary analogs identify geographic areas where land management programs would be most equivocal. Concentrating efforts and resources where projections are more certain can assure land managers a greater likelihood of success.


Subject(s)
Climate Change , Ecosystem , Human Activities/trends , Plants/classification , Adaptation, Biological , Caribbean Region , Demography , Environment , Humans , North America
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