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PubMed1998

Children's use of looking behavior as a cue to detect another's goal.

Three studies examined children's understanding of the role that looking behavior plays in revealing another's desired goal. In each study, participants were asked which of 2 objects a protagonist wanted to obtain. Four-year-olds did not infer that an object examined via prolonged looking was more likely to be the protagonist's goal than an object that was either glanced at or inadvertently touched. Instead, they were accurate only when the protagonist looked at one of two potential goals. In contrast, the majority of 6-year-olds (and adults in Experiment 1) consistently regarded prolonged looking as the more important cue of the protagonist's goal. These age differences suggest that development is characterized by an increasing appreciation that goal is revealed by comparative differences in the quality of perceptual connectedness to objects in the world. One explanation for these age differences is that preschoolers are limited in their understanding of the difference between perceiving with full attention and without it.

Adult↗
PubMed1998

[Therapy goals in medical rehabilitation].

The definition of appropriate and measurable goals for treatment is a fundamental quality feature of medical practice. In co-operation with experts, we developed a catalogue of therapy goals for medical rehabilitation. In a two-stage procedure we first analyzed the target definitions that are currently used in medical rehabilitation. In a second step we used these targets as input for expert panels. Based on a modified model of the WHO classification ICIDH, the goals were defined on four dimensions: somatic, functional, psychosocial and educative. The established goals are relevant and measurable. Nevertheless, there is still a lack of adequate and sound measurement procedures for many goals. Therefore, there is an urgent need for further research in this field.

Combined Modality Therapy↗
PubMed1997

The Effects of Social Identity on the Self-Set Goals and Task Performance of High and Low Self-Esteem Individuals

Social identification with co-workers was examined as a moderator of the frequently inscrutable link between worker self-esteem and goal setting. Weak or strong social identity was created in groups comprised of either high or low self-esteem persons. As expected, strengthening social identity increased perceived similarity to ingroup members regardless of self-esteem. Furthermore, only high self-esteem individuals with a strong social identity set higher goals for themselves, and achieved better performance, compared to high esteem/weak identity individuals or low self-esteem persons in either social identity condition. Increments in the goals and performance of high self-esteem individuals were associated with perceived similarity to ingroup members, and performance was attributed to personal ability. In contrast, the goals and performance of low self-esteem individuals were associated with certainty of goal achievement, and performance was attributed to perceptions of task difficulty. Asymmetrical effects of social identification are discussed in relation to group member personalities.

Journal Article↗
PubMed2001

Attribute Framing and Goal Framing Effects in Health Decisions.

Levin, Schneider, and Gaeth (LSG, 1998) have distinguished among three types of framing-risky choice, attribute, and goal framing-to reconcile conflicting findings in the literature. In the research reported here, we focus on attribute and goal framing. LSG propose that positive frames should be more effective than negative frames in the context of attribute framing, and negative frames should be more effective than positive frames in the context of goal framing. We test this framework by manipulating frame valence (positive vs negative) and frame type (attribute vs goal) in a unified context with common procedures. We also argue that the nature of effects in a goal-framing context may depend on the extent to which the research topic has "intrinsic self-relevance" to the population. In the context of medical decision making, we operationalize low intrinsic self-relevance by using student subjects and high intrinsic self-relevance by using patients. As expected, we find complete support for the LSG framework under low intrinsic self-relevance and modified support for the LSG framework under high intrinsic self-relevance. Overall, our research appears to confirm and extend the LSG framework. Copyright 2001 Academic Press.

Journal Article↗
PubMed1980

Initiation of a goal-directed movement in the monkey. Role of the cerebellar dentate nucleus.

The participation of the dentate nucleus (DN) in the initiation of a voluntary movement was investigated in five baboons (Papio papio). In these experiments, we have analyzed the effects of excluding the DN on the latency (reaction time, RT) of a learned goal-directed movement. Two techniques were for excluding the DN. In three animals, the structure was cooled with a probe, stereotaxically implanted on the side ipsilateral to the active hand. In two others, a partial electrolytic destruction of the DN ipsilateral to the operant hand was undertaken. In one further animal, both DNs were destroyed electrolytically. A comparison was made of the effect of DN inactivation on the latency of stereotyped goal-directed movements of constant amplitude and direction, and of goal-directed movements whose amplitude and/or direction were varied in random fashion. The exclusion of DN brought about a prolongation of RTs in all animals. This prolongation was not accentuated by variation of different characteristics (amplitude and/or direction) of the impending goal-directed movement. A recovery of the RTs to their prelesion values was observed after irreversible unilateral DN lesion, but no so easily after bilateral destruction. These results show that in the monkey DN is concerned with the initiation of a goal-directed movement, but is not critically implicated in the encoding of direction and amplitude parameters. These findings are discussed in view of the role that is usually attributed to the neocerebellum in programming voluntary movements.

Animals↗
PubMed1996

Forest Planning in an Oregon Case Study: Defining the Problem and Attempting to Meet Goals with a Spatial-Analysis Technique

Five major management goals were identified for the upper Grande Ronde River Basin on the Wallowa-Whitman National Forest in northeastern Oregon: to produce high-quality fish habitat, to maintain elk habitat, to restore and maintain forest conditions within the natural range of viability, and to contribute to community economic stability. From the broad goals, specific goals for stream temperature, habitat effectiveness index (HEI), habitat corridors, maintenance of land in late or old seral stages, and a nondeclining even flow of timber were selected. A case study was undertaken in a small watershed that is under typical societal constraints to determine whether one decision-support tool, SNAP II+, could evaluate the selected goals in a single planning exercise. Three riparian management strategies and two forest road scenarios were used. The exclusion of harvest and road-building from riparian zones in order to increase habitat protection decreased harvest levels and net present value but maintained preactivity stream temperatures. Other resources were generally maintained within prescribed management levels. Although the technique has limitations (e.g., it does not account for riparian zones in calculations of forage and cover for HEI, and it can use the maximum but not minimum acreage goal for some resources), it shows promise for evaluating management tradeoffs in watershed analysis.

Journal Article↗
PubMed2005

Attaining and maintaining isometric and isokinetic goals of the Shaker exercise.

Previous studies have shown that the Shaker Exercise is effective in restoring oral intake in patients with deglutitive failure due to upper esophageal sphincter (UES) dysfunction. Our aim was to determine (1) exerciser compliance among healthy older adults, (2) number of days required to attain the isometric (IM) and isokinetic (IK) exercise goals, (3) rate and reason for dropout of exercisers, and (4) complaints associated with performance of the exercise. Twenty-six nondysphagic older adults were enrolled from an independent-living community (66-93 yr) to perform the Shaker Exercise. Each participant completed a questionnaire on exercise performance and its associated difficulties three times a day for six weeks. Four randomly chosen nondysphagic participants underwent pre- and postexercise videofluoroscopic swallow studies for biomechanical measurements. Maximum anterior hyoid and laryngeal excursions, as well as maximum anteroposterior UES opening increased (p<0.05) following exercise. Duration to attain Shaker Exercise performance goals varied among participants. IK was more easily attained than IM. Only 50% and 70% of those enrolled initially were able to complete the exercise duration and attain its IK and IM goals, respectively. However, those who stayed in the program attained the IK and IM goals (100% and 74%, respectively). Most dropouts occurred in the first two weeks of exercise. Performance of the exercise was associated with mild muscle discomfort that resolved spontaneously after a couple of weeks. We concluded that although the Shaker Exercise can be performed independently, a structured and gradually progressive program is needed to attain the exercise goals completely.

Aged↗
PubMed2006

Goal achievement and the accountability of consumer-run organizations.

This study explores how consumer-run organizations (CROs) can maintain independence while meeting the accountability needs of funding agencies. The importance of both funding agency needs for accountability and CRO needs for independence are discussed. A goal-tracking process is proposed as a potential strategy for balancing the potentially conflicting needs of accountability and independence. To demonstrate the utility of the goal tracking approach, this study analyzes goal tracking documentation in 3 years of quarterly reports from 21 CROs (also known as consumer drop-in centers and self-help agencies). Results detail the different goals of CROs. A 68% goal achievement rate suggests general organizational competence. Furthermore, CRO operations appear to be relatively cost-efficient, with an average of $11.51 spent per person per day. The analysis of quarterly reports leads to a discussion of several insights that may be useful to CROs, funding agencies, researchers, and mental health professionals.

Community Mental Health Services↗
PubMed2004

Achieving lipoprotein goals in patients at high risk with severe hypercholesterolemia: efficacy and safety of ezetimibe co-administered with atorvastatin.

BACKGROUND: Despite the efficacy of statins in lowering low-density lipoprotein cholesterol (LDL-C) levels, many patients who are at high risk for heart disease with hypercholesterolemia require additional LDL-C level reduction. The cholesterol absorption inhibitor, ezetimibe, has been shown to provide significant incremental reductions in LDL-C levels when co-administered with statins. This study was performed to compare the efficacy and safety of ezetimibe (10 mg) plus response-based atorvastatin titration versus response-based atorvastatin titration alone in the attainment of LDL-C goals in subjects who are at high risk for coronary heart disease (CHD) and are not at their LDL-C goal on the starting dose of atorvastatin. METHODS: This was a 14-week, multicenter, randomized, double-blind, active-controlled study conducted in 113 clinical research centers in 21 countries. Participants were adults with heterozygous familial hypercholesterolemia (HeFH), CHD, or multiple (> or =2) cardiovascular risk factors, and a LDL-C level > or =130 mg/dL after a 6- to 10-week dietary stabilization and atorvastatin (10 mg/day) open-label run-in period. Eligible subjects continued to receive atorvastatin (10 mg) and were randomized to receive blinded treatment with ezetimibe (10 mg/day; n = 305) or an additional 10 mg/day of atorvastatin (n = 316). The atorvastatin dose in both groups was doubled after 4 weeks, 9 weeks, or both when the LDL-C level was not at its goal (< or =100 mg/dL), so that patients receiving combined therapy could reach 40 mg/day and patients receiving atorvastatin alone could reach 80 mg/day. The primary end point was the proportion of subjects achieving their LDL-C level goal at week 14. A secondary end point was the change in LDL-C level and other lipid parameters at 4 weeks after ezetimibe co-administration with 10 mg/day of atorvastatin versus 20 mg/day of atorvastatin monotherapy. RESULTS: The proportion of subjects reaching their target LDL-C level goal of < or =100 mg/dL was significantly higher in the co-administration group than in the atorvastatin monotherapy group (22% vs 7%; P <.01). At 4 weeks, levels of LDL-C, triglycerides, and non-high-density lipoprotein cholesterol were reduced significantly more by combination therapy than by doubling the dose of atorvastatin (LDL-C -22.8% versus -8.6%; P <.01). The combination regimen had a safety and tolerability profile similar to that of atorvastatin alone. CONCLUSIONS: The addition of ezetimibe to the starting dose of 10 mg/day of atorvastatin followed by response-based atorvastatin dose titration to a maximum of 40 mg/day provides a more effective means for reducing LDL-C levels in patients at high risk for CHD than continued doubling of atorvastatin as high as 80 mg/day alone.

Adolescent↗
PubMed2005

Theta phase locking across the neocortex reflects cortico-hippocampal recursive communication during goal conflict resolution.

EEG theta coherence, EEG theta power and subjective levels of response were examined in a continuous monitoring target detection task where periodic goal conflicts were introduced as 34 participants progressed through a stimulus sequence leading to response. EEG theta coherence revealed increases in phase locking between cortical areas at specific task stages involving goal conflict. Theta power also increased at points of goal conflict. The temporal characteristics of subjective response (measured continuously throughout the task) indicated a delay between participants actually experiencing goal conflict and overt indications of conflict. The starting point for the study was based on a specific aspect of Gray and McNaughton's [Gray, J.A., McNaughton, N., 2000. The Neuropsychology of Anxiety: An Enquiry into the Functions of the Septo-Hippocampal System, 2nd ed. Oxford University Press, Oxford] behavioural inhibition system model-namely, septo-hippocampal system involvement in the resolution of goal conflicts. We drew on Gray and McNaughton's [Gray, J.A., McNaughton, N., 2000. The Neuropsychology of Anxiety: An Enquiry into the Functions of the Septo-Hippocampal system, 2nd ed. Oxford University Press, Oxford] suggestion that septo-hippocampal involvement in this process is reflected by EEG theta. While their theory explains many of our findings, we also drew upon Given's [Givens, B., 1996. Stimulus-evoked reseting of the dentate theta rhythm: relation to working memory. Neuroreport 8 (1), 159-163] proposal that the dentate theta rhythm is reset by behaviourally relevant stimuli. We made further proposals based on Makeig et al.'s [Makeig, S., Westerfield, M., Jung, T.-P., Enghoff, S., Townsend, J., Courchesne, E., Sejnowski, T.J., 2002. Dynamic brain sources of visual evoked responses. Science 295, 690-694] view that specific stimulus events invoke concurrent phase resetting and transient frequency domain coherence across different areas of neocortex. Relations with Go/NoGo event related potentials (P300 and N2; e.g., [Bokura, H., Yamaguchi, S., Kobayashi, S., 2001. Electrophysiological correlates of response inhibition in a Go/NoGo task. Clin. Neurophysiol. 112 (12), 2224-2232]) were also discussed, as well as parallels between our data and interpretation, and other theoretical models of theta (e.g., [Kahana, M.J., Selig, D., Madsen, J.R., 2001. Theta returns. Curr. Opin. Neurobiol. 11, 739-744]). Suggestions for further research were made.

Adolescent↗
PubMed2006

Improving the quality of residential care using goal attainment scaling.

OBJECTIVE: To illustrate the potential of goal attainment scaling (GAS) as a means to improve the quality of care provided by residential care facilities to frail older adults. DESIGN: A pre-test/post-test single-group design. SETTINGS/PARTICIPANTS: Twenty facilities providing inadequate care to at least one resident. These facilities were identified with a case-finding questionnaire followed by a thorough investigation of the quality of care delivered to a sample of frail older adults. INTERVENTION: The 6-month intervention was conducted by three interdisciplinary teams of health professionals experienced in caring for frail older adults. The intervention was tailored to the main quality problems identified at baseline in the facility. The first task of the intervention team was to set weighted priority goals in conjunction with the facility manager. Subsequent monthly on-site visits, interspersed with frequent telephone calls, were devoted to assisting the manager and staff implement permanent changes in the areas of care targeted for improvement. MEASUREMENTS: Pre- and post-intervention GAS scores. RESULTS: Two facilities were lost to follow-up. A total of 81 facility goals were established at the onset of the study. Goals per facility ranged from 2 to 9 (mean = 4.5, SD = 2.04). GAS scores increased significantly between pre- and post-intervention (P < .001). Goal achievement varied with the manager's own rating of the quality of care provided in the facility (P = .008), his/her education level (P = .037), and the intervention team (P = .049). CONCLUSIONS: This study shows that quality improvement objectives established with the manager following a thorough evaluation of the quality of care provided in the facility can, on average, be attained with the help of experienced health professionals. It also provides some insight into the types of facilities where preset objectives are more likely to be achieved.

Journal Article↗
PubMed1996

Drug therapy for hypercholesterolemia in patients with cardiovascular disease: factors limiting achievement of lipid goals.

PURPOSE: To determine the extent that goal lipid levels derived from the National Cholesterol Education Program (NCEP) are achievable in clinical practice, and to identify factors associated with the achievement of these goals. PATIENTS AND METHODS: We conducted a retrospective cohort study consisting of a consecutive sample of 244 patients with either coronary artery disease or peripheral vascular disease treated for hypercholesterolemia at a large Veterans Affairs medical center. Primary outcomes, recorded prospectively, were lipid levels and lipoprotein cholesterol response, and tolerance and compliance to drug therapy. Goal lipid levels were defined as low-density lipoprotein cholesterol (LDL-C) < or = 130 mg/dL and triglyceride (TG) < or = 200 mg/dL. RESULTS: Lipid-lowering drug therapy reduced LDL-C from 25% to 42% below baseline in patients with hypercholesterolemia varying from mild (130 to 160 mg/dL) to severe ( > 220 mg/dL), respectively. Approximately 75% of patients with LDL-C < or = 160 mg/dL ultimately achieved their lipid goal with drug therapy; however, less than half of patients with baseline LDL-C > 160 mg/dL achieved target lipid values. Multivariate analysis indicated that lower baseline LDL-C and triglycerides, use of combinations of drug therapy rather than monotherapy, and patient adherence to treatment predicted the achievement of goal lipid levels. CONCLUSIONS: Successful implementation of NCEP guidelines, frequently requires combination drug therapies, and is limited by poor patient tolerance and acceptance of niacin and the sequestrants.

Aged↗
PubMed2003

Global health goals: lessons from the worldwide effort to eradicate poliomyelitis.

The Global Polio Eradication Initiative was launched in 1988. Assessment of the politics, production, financing, and economics of this international effort has suggested six lessons that might be pertinent to the pursuit of other global health goals. First, such goals should be based on technically sound strategies with proven operational feasibility in a large geographical area. Second, before launching an initiative, an informed collective decision must be negotiated and agreed in an appropriate international forum to keep to a minimum long-term risks in financing and implementation. Third, if substantial community engagement is envisaged, efficient deployment of sufficient resources at that level necessitates a defined, time-limited input by the community within a properly managed partnership. Fourth, although the so-called fair-share concept is arguably the best way to finance such goals, its limitations must be recognised early and alternative strategies developed for settings where it does not work. Fifth, international health goals must be designed and pursued within existing health systems if they are to secure and sustain broad support. Finally, countries, regions, or populations most likely to delay the achievement of a global health goal should be identified at the outset to ensure provision of sufficient resources and attention. The greatest threats to poliomyelitis eradication are a financing gap of US 210 million dollars and difficulties in strategy implementation in at most five countries.

Communicable Disease Control↗
PubMed1999

Time structure of a goal-directed bimanual skill and its dependence on task constraints.

The aim of the study was to elucidate the underlying principles of bimanual coordination and to establish quantitative coordination criteria. Healthy human subjects were instructed to open a loaded drawer with the left hand and to grasp, lift and reinsert with the right hand a small peg in the drawer recess. This bimanual goal-oriented task was executed promptly and consistently after a few trials. The temporal structure of the individual limb actions was assessed for computing interlimb synchronization and temporal correlation. In all subjects, both hands were well synchronized at the goal with high intermanual correlation in reaching the goal (event times of drawer opening and grasping the peg). This temporal goal-invariance was independent of movement speed and of the highly variable timing of the individual hands and persisted when subjects were blindfolded. Unilateral loading of the pulling hand and cutaneous anesthesia of the left index finger and thumb used for grasping the drawer handle significantly increased the pull-phase. This slowing of the left hand was matched by an adaptive delay of the right non-disturbed hand, thus preserving goal invariance. As a working hypothesis, we propose that multimodal sensory signals generated in the leading arm be transmitted centrally to re-parameterize the non-disturbed arm.

Adult↗
PubMedDate not supplied

Controlled drinking as a treatment goal in Australian alcohol treatment agencies.

Under the broad umbrella of harm minimisation, the Australian National Drug Strategy has emphasised the development of services aimed at reducing hazardous alcohol consumption in problem drinkers thereby shifting the focus of treatment from abstinence to moderation goals. The objective of the present study was to determine the extent to which alcohol treatment agencies offered advice and treatment aimed at moderation of alcohol consumption (i.e., controlled drinking). Of the 179 agencies (40% of identified treatment agencies across Australia) approached, 66% (115) reported giving advice about controlled drinking as a treatment goal. The reported therapeutic strategies used to assist in the attainment of a controlled drinking goal are empirically supported. Thus, controlled drinking as a treatment goal is widely offered by Australian treatment agencies, by workers who appear well versed in validated strategies and techniques used to obtain such a goal. This finding is discussed in relation to comparison studies conducted in the UK and the USA.

Alcohol Drinking↗
PubMed1992

Interpreting and responding to spoken language: children's recognition and use of a speaker's goal.

This study had two purposes. The first was to examine age differences in the extent to which children infer and use a speaker's interpersonal goal to understand speech acts. To this end, the subjects responded to Do you have...? requests in a role-playing task. The goal behind such a request is implicit in the speaker's choice of noun phrase. We sought to determine whether children, like adults, use the noun phrase to infer the speaker's goal and thereby decide whether the request is a yes-no question or a directive. The second purpose was to examine age differences in the extent to which children select responses that carry implications appropriate to the speaker's interpersonal goal. To do this, Do you have...? requests containing general category labels were addressed to the children when they possessed all the category exemplars and when they possessed only a few exemplars. A simple yes implies that the listener has nearly all exemplars and, therefore, is inappropriate for the speaker's goal in the latter situation. The subjects were six-, seven-, nine-, and eleven-year-olds and adults, with 12 subjects per age. Only the eleven-year-olds and the adults used the speaker's noun phrase and considered the implications of yes.

Adult↗
PubMed1975

An experimental study of crowding: effects of room size, intrusion, and goal blocking on nonverbal behavior, self-disclosure, and self-reported stress.

This study hypothesized that stress in high room density, or crowding, depends on interpersonal disturbances such as intrusion and goal blocking. High room density was expected to intensify individual reactions to these disturbances. In a 2 X 2 X 2 design, groups of six male college students containing three subjects and three confederates were placed in a large or small room. Subjects and confederates interacted in pairs; confederates introduced intrusion by leaning forward, touching subjects, and attempting 80% eye contact as confederates talked. Goal blocking involved inattention and interruptions as subjects talked. Interactions were videotaped through two-way mirrors to record nonverbal behaviors associated with affiliation and stress. Subjects also completed self-report measures of stress and self-disclosure. Intrusion led to initial discomfort that decreased with time, and lower levels of facial regard. Goal blocking produced self-reported irritation that increased with time, and lower levels of facial regard, gesturing, and positive head nodding. Contrary to predictions, stress responses to intrusion and goal blocking were not intensified by high room density. Lower levels of affiliative behavior were viewed as coping responses to interpersonal disturbances--subjects apparently coped successfully with intrusion, but not with goal blocking. Results are interpreted in terms of a sequential, interpersonal model of crowding.

Adolescent↗
PubMed1994

Unintended effects of goals on unintended inferences.

Three studies investigated unintended effects of goals on spontaneous trait inferences (STIs). Ss read trait-implying sentences to memorize them, to analyze sentence features, or to make social judgments. Cued recall revealed unintended (spontaneous) trait and behavioral-gist inferences. They were equally frequent with all the social judgment goals and absent or infrequent with feature analysis goals. Memorizing the sentences while ignoring their meaning reduced, but did not eliminate, STIs. Goals also affected whether traits were linked directly to actors in explicit memory. Social inferences can occur without intentions or awareness, even when meanings are intentionally ignored, as incidental results of analyzing stimulus details, and as intermediate but unnoticed results of other social judgments. Goals affect these inference likelihoods.

Adult↗