Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Goals”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources
PubMed1999

The American Cancer Society challenge goals. How far can cancer rates decline in the U.S. by the year 2015?

BACKGROUND: Cancer incidence and mortality rates both began to decline in the U. S. in the early 1990s. Recognizing the unprecedented potential benefits of accelerating this decline, the American Cancer Society (ACS) has set ambitious challenge goals for the American public for a 25% reduction in cancer incidence rates and a 50% reduction in cancer mortality rates by the year 2015. This analysis examined the feasibility of reaching those goals by estimating future changes in cancer rates that can result from past and future reductions in cancer risk factors. METHODS: Estimates for future declines in cancer risk factors in the U. S. under alternative scenarios were applied to conservative population-attributable risk estimates for cancer incidence and mortality rates in 1990 to estimate cancer rate trends in the year 2015. RESULTS: If the current trends toward a decline in the prevalence of cancer risk factors continue over the next decade, by the year 2015 one can expect a 13% decline in cancer incidence rates and a 21% decline in cancer mortality rates below their 1990 levels. With redoubled efforts to reduce the prevalence of known cancer risk factors further, by the year 2015 cancer incidence rates could be reduced by 19% and cancer mortality rates reduced by 29%. Such redoubled efforts would equate to approximately 100,000 cancer cases and 60,000 cancer deaths prevented each year by the year 2015. CONCLUSIONS: Past reductions in cancer risk factors in the U.S. population have led to recent declines in the rates of cancer incidence and mortality in the U.S. Redoubled efforts to act on current knowledge regarding how to prevent, detect, and treat cancer can result in attaining approximately 80% of the ACS challenge goal for cancer incidence rates and 60% of the ACS challenge goal for cancer mortality rates by the year 2015. New findings from cancer research are needed and will have to be applied quickly if the ACS challenge goals are to be met fully.

Forecasting↗
PubMedDate not supplied

Turning goals into results: the power of catalytic mechanisms.

Most executives have a big, hairy, audacious goal. They write vision statements, formalize procedures, and develop complicated incentive programs--all in pursuit of that goal. In other words, with the best of intentions, they install layers of stultifying bureaucracy. But it doesn't have to be that way. In this article, Jim Collins introduces the catalytic mechanism, a simple yet powerful managerial tool that helps translate lofty aspirations into concrete reality. Catalytic mechanisms are the crucial link between objectives and performance; they are a galvanizing, nonbureaucratic means to turn one into the other. What's the difference between catalytic mechanisms and most traditional managerial controls? Catalytic mechanisms share five characteristics. First, they produce desired results in unpredictable ways. Second, they distribute power for the benefit of the overall system, often to the discomfort of those who traditionally hold power. Third, catalytic mechanisms have teeth. Fourth, they eject "viruses"--those people who don't share the company's core values. Finally, they produce an ongoing effect. Catalytic mechanisms are just as effective for reaching individual goals as they are for corporate ones. To illustrate how catalytic mechanisms work, the author draws on examples of individuals and organizations that have relied on such mechanisms to achieve their goals. The same catalytic mechanism that works in one organization, however, will not necessarily work in another. Catalytic mechanisms must be tailored to specific goals and situations. To help readers get started, the author offers some general principles that support the process of building catalytic mechanisms effectively.

Administrative Personnel↗
PubMed2002

Efficacy of atorvastatin in treating high risk patients to reach low density lipoprotein-cholesterol goals: the Treat to Target (TTT-Israel) Study.

BACKGROUND: Hyperlipidemia is a major risk factor for coronary heart disease. Reducing low density lipoprotein-cholesterol can significantly reduce the risk of CHD, but many patients fail to reach the target LDL-C goals due to low doses of statins or low compliance. OBJECTIVES: To treat high risk patients with atorvastatin in order to reach LDL-C goals (either primary or secondary prevention) of the Israel Atherosclerosis Society. METHODS: In this open-label study of 3,276 patients (1,698 of whom were males, 52%), atorvastatin 10 mg was given as a first dose, with follow-up and adjustment of the dose every 6 weeks. While 1,670 patients did not receive prior hypolipidemic treatment, 1,606 were treated with other statins, fibrates or the combination of both. RESULTS: After 6 weeks of treatment, 70% of the patients who did not receive prior hypolipidemic medications and who needed primary prevention reached target LDL-C levels. Interestingly, a similar number of patients who received prior hypolipidemic treatment (other statins, fibrates or both) and who did not reach the LDL-C treatment goals reached the LDL-C goals for primary prevention with atorvastatin. Only 34% of all patients who needed secondary prevention reached the ISA LDL-C target of 100 mg/dl. Atorvastatin proved to be completely safe, only two patients had creatine kinase elevation above 500 U/L, and another six had mild CK elevation (< 500 U/L). None of the patients had clinical myopathy, and only one had to be withdrawn from the study. CONCLUSION: Atorvastatin is a safe and effective drug that enables most patients requiring primary prevention to reach LDL-C goal levels, even with a low dose of 10 mg. Patients in need of secondary prevention usually require higher doses of statins.

Adult↗
PubMed1975

Formulation of goals for life expectancy at birth in Costa Rica (report of one experience).

Costa Rican authorities have finished a national adaptation of the goals of the Hemisphere's Ten-Year Health Plan for the Americas and have formulated a National Health Plan for 1974-1980. This work was coordinated by the Health Sector Planning Unit and was assisted by various multidisciplinary and multi-institutional working groups. The methodology set forth in this article was developed by a group responsible for formulating goals with regard to life expectancy--the last of five health-related subjects analyzed, and one regarded as dependent on the rest. In brief, this methodology was as follows: Birth rates, death rates, and life expectancy at birth in the other countries of the Region and in a developed country (Sweden) were compared with those prevailing now and in the past in Costa Rica. This served as a basis for projecting Costa Rica's future prospects if no changes were made, or if certain changes were made through implementation of new programs. This was followed by analysis of leading caused of death in the country--by age group and vulnerability of those dying, and by probably reductions in mortality that would result from achieving the goals established for other programs. On this basis, various alternative reductions in mortality for each age groups were considered. Using these alternative, abridged life tables were devised, and these in turn were used to draw up a table showing the life expectancy at birth that would result from realization of each alternative. This made it possible to derive life expectancy goals that were consistent with the goals for reducing mortality in each age group that were formulated during the sectoral planning process. It is hoped that this general procedure, illustrated here with data from the Costa Rican case, may prove useful to others engaged in health planning work.

Adolescent↗
PubMedDate not supplied

[Generation of valuable information and the problem of goal self-setting in living systems].

The problem of origination of capacity for goal self-setting is discussed. It was shown that the definition "goal" in living systems differs from the definition "target function" in physical problems concerned with nonliving systems. It was also shown that the main goal of the elements of a system is the storage of information. In biology, this goal is the extension of the principle of struggle for existence. Conditions were determined that the dynamic system describing the goal self-setting process must satisfy. It was shown that living systems meet these conditions. In inorganic nature, such systems may also arise but only as a result of long-term evolution, after which they become living.

Biological Evolution↗
PubMed2004

Health-related millennium development goals: policy challenges for Pakistan.

OBJECTIVES: There are two objectives: (a) to clearly articulate the Millennium Development Goals (MDGs) adopted by the United Nations in 2000 and their implications for developing countries like Pakistan; and (b) to critically review the challenges faced by Pakistan in achieving the health-related MDGs. METHODS: A critical review of secondary data and information generated primarily by multilateral agencies and United Nations organizations. RESULTS: The MDGs represent a global consensus on the broad goals of development to be achieved by 2015. Of the eight Millennium Development Goals, three are specifically health related--reducing infant (under-5) and maternal mortality; and combating HIV/AIDS, tuberculosis, malaria and other significant communicable diseases. According to various studies, many developing countries will not achieve the MDGs without concerted efforts and commitment of additional resources. Like many other developing countries, Pakistan is also faced with an enormous challenge in reaching the Millennium Development Goals and targets set by the United Nations. For Pakistan, perhaps the most challenging MDG is that of reducing "by three-quarters the maternal mortality ratio." Maternal mortality is so intertwined with other "social" factors--including the status of women--that a comprehensive holistic approach is required. CONCLUSION: In order to achieve the MDGs, Pakistan would require a fundamental shift in its policy and strategic directions. Along with allocation of significant additional resources for health, it needs to review and reprioritize the use of existing resources, focusing more on primary health care. Pakistan must also adopt a holistic integrated approach that views health, education, and other social sector development as intrinsically interrelated and interwoven. Without such an integrated approach, achieving the health-related MDGs is likely to remain illusive for Pakistan. There is a critical need to foster a healthy debate on the health-related Millennium Development Goals in Pakistan so as to inform and, hopefully influence, public policy.

Developing Countries↗
PubMed2004

Coadministration of multidrug therapy to achieve lipid goals.

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are the drug of first choice for lowering low-density lipoprotein cholesterol (LDL-C) levels and reducing risk of coronary heart disease (CHD). Current therapeutic use of statins, however, has resulted in only a small percentage of patients reaching their LDL-C treatment goal. Despite the clinical trial data supporting early aggressive use of statins, prescribing physicians are more likely to use lower doses of statins, leaving many patients at high risk of CHD short of goals. The barrier to achieving cholesterol treatment goals does not appear to be the decision to initiate statin therapy, but the failure of prescribers to titrate statin therapy to a dose sufficient to achieve goals. An alternative to statin monotherapy is coadministration of a statin and a second agent that has a different mechanism of action. This approach can increase the likelihood of achieving target lipid levels and may be more acceptable to physicians. The coadministration of ezetimibe and simvastatin reduces cholesterol derived from both endogenous and exogenous sources. Simvastatin reduces the hepatic production of cholesterol, and ezetimibe decreases the intestinal absorption of dietary and biliary free cholesterol. The coadministration of low doses of these agents has been proved to be as effective as high-dose statin therapy in reducing LDL-C levels and assisting patients achieve their treatment goals.

Anticholesteremic Agents↗
PubMedDate not supplied

[Cholesterol goal attainment with lipid lowering drugs. The COMETA Mexico Trial].

In a retrospective study to determine rate of patients attaining therapeutic LDL-C goal values with lipid-lowering drugs, 20 specialists and general practitioners were selected who enrolled 120 patients whose lipids were measured after at least 12 weeks of treatment. They were grouped in three categories: group A (absolute risk of CHD in 10 years <10%); group B, with 10-20% risk, and group C, with >20% risk. Goal LDL-C values were <160 mg/dL for group A, <130 for group B, and <100 for group C. Mean age was 57 +/- 12 years, 59% were males, and 51% were in group C; 83% took statins, 12% fibrates alone, and 5%, combinations. Atorvastatin and simvastatin were the most used drugs, at medium doses (mean 12 and 27 mg/day). LDL-C was reduced 25%; overall, 22% of patient doses were adjusted. Therapeutic goals were attained in 29% with initial doses and 42% at the end of study. Goal values were better attained in groups with lower risk. No differences were noticed among distinct physician categories. Data show poor compliance with international guidelines and insufficient attainment of therapeutic goals.

Anticholesteremic Agents↗
PubMed2005

Reaching for aggressive blood pressure goals: role of angiotensin receptor blockade in combination therapy.

Elevated blood pressure, particularly systolic blood pressure, increases the risk of cardiovascular and renal complications in patients with diabetes. Current national guidelines set the blood pressure goal for those with diabetes at < 130/80 mm Hg, which is lower than the goal for the general population (<140/90 mm Hg). Achieving this goal, however, remains difficult, with blood pressure control rates being lower for patients with diabetes than for those without diabetes. Large clinical trials have demonstrated that in most cases, patients will require 2 or more antihypertensive agents to achieve goal blood pressure. The renin-angiotensin-aldosterone system plays a key role in regulation of blood pressure. The angiotensin AT1 receptor blockers (ARBs), which block the effects of angiotensin II, not only lower blood pressure but also provide target-organ protection. These agents are generally well-tolerated, with a side effect profile similar to placebo. Clinical comparisons of different drugs within the class have shown that olmesartan, the newest ARB, produced greater reductions in blood pressure than other agents and that a greater percentage of patients treated with olmesartan reached target blood pressure. Combining an ARB with a diuretic may allow more patients to reach goal blood pressure.

Angiotensin II Type 1 Receptor Blockers↗
PubMed2005

Effectiveness of the addition of ezetimibe to ongoing statin therapy in modifying lipid profiles and attaining low-density lipoprotein cholesterol goals in older and elderly patients: subanalyses of data from a randomized, double-blind, placebo-controlled trial.

BACKGROUND: The Ezetimibe Add-on to Statin for Effectiveness (EASE) trial examined the effectiveness and safety profile of ezetimibe (EZE) added to ongoing statin therapy in 3030 patients with low-density lipoprotein cholesterol (LDL-C) levels exceeding National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP 111) goals. OBJECTIVE: Because people aged > 65 years are at increased risk for development of coronary heart disease (CHD), these subgroup analyses of data from the EASE trial were conducted to determine the extent of change in LDL-C levels and attainment of NCEP ATP III LDL-C goals with the addition of EZE to ongoing statin therapy in patients aged 65 to 74 years (the older group) and > or = 75 years (the elderly group). METHODS: In the multicenter (299 sites), community-based, double-blind, placebo-controlled EASE trial, patients were randomly assigned in a 2:1 ratio to receive EZE 10 mg/d or placebo in addition to their ongoing statin therapy for 6 weeks. The primary efficacy end point was the percent reduction in LDL-C levels, and the principal secondary end point was the proportion of patients achieving NCEP ATP III target LDL-C levels. The effects of the addition of EZE on additional lipid and lipoprotein measures and high-sensitivity C-reactive protein were also examined, as was tolerability. Study analyses were performed in the modified intent-to-treat population. RESULTS: This subgroup analysis included data from 841 patients in the older age group (579 EZE + statin, 262 placebo + statin), which constituted 27.8% of the overall EASE population, and 466 in the elderly group (307 EZE + statin, 159 placebo + statin), which constituted 15.4% of the overall EASE population. The former group included 436 (51.8%) men and 405 (48.2%) women, with a mean (SD) age of 69.2 (3.0) years; the latter group included 227 (48.7%) men and 239 (51.3%) women, with a mean age of 78.5 (3.2) years. The characteristics of the 2 groups were comparable at baseline. In the older group, 717 (85.3%) had CHD or a CHD risk equivalent, as did 421 (90.3%) of those in the elderly group. Thirty-two patients in the older group and 17 in the elderly group discontinued the study. The reasons for discontinuation included clinical adverse events (n = 23), withdrawal of consent (n = 15), loss to follow-up (n = 4), protocol deviation (n = 2), and other reasons (n = 5). EZE + statin significantly reduced LDL-C compared with placebo + statin (older group: mean [SE] treatment difference, -25.1% [1.4]; P < 0.001; elderly group: treatment difference, -22.0% [1.8]; P < 0.001). The LDL-Glowering effects of treatment were consistent in the 2 groups. EZE + statin therapy significantly improved other lipid parameters (triglycerides, non high density lipoprotein cholesterol, and total cholesterol, P < 0.001 in both age groups; high-density lipoprotein cholesterol, P < 0.03 in the older group only) and high-sensitivity C-reactive protein levels compared with EZE + placebo (P < 0.03). The attainment of LDL-C goals also was significantly increased with EZE + statin compared with placebo + statin (older group: 72.3% vs 18.9%, respectively; odds ratio [OR] = 14.59; 95% CI, 9.55 to 22.28; P < 0.001; elderly group: 73.3% vs 18.9%; OR = 13.44; 95% CI, 7.72 to 23.41; P < 0.001). EZE + statin therapy was well tolerated by patients in both age groups, with a safety profile comparable to that of placebo + statin. CONCLUSIONS: In these older and elderly patients, many of them at high risk for CHD, EZE added to ongoing statin therapy was well tolerated and was an effective treatment option for improving lipid profiles and attainment of LDL-C goals. Adding EZE improved rates of attainment of NCEP ATP III LDL-C goals without increases in the dose or potency of statin therapy. Further studies are necessary to determine whether these results can be generalized to other older and elderly populations.

Aged↗
PubMed2005

Diabetes mellitus related treatment goals: awareness and attainment in the Ife-Ijesa zone of south-western Nigeria.

Evidence emanating from research data have demonstrated that improved metabolic and blood pressure outcomes reduce the morbidity and mortality associated with diabetes. Primary goals of therapy have also been recommended to realise this objective. This study determined the prevalence of attainment of recommended goals for glycaemic and blood pressure control in type 2 diabetics attending the diabetes clinic of the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. We also assessed the knowledge and use of International guidelines for the clinical management of diabetes mellitus by health care providers in the Ife-Ijesa health zone of Osun State, South Western Nigeria. The charts and case records of One hundred and five (105) type 2 diabetics seen over a five-week period were reviewed to assess the prevalence of attainment of blood pressure and glycaemic control goals. The mean BP and fasting blood glucose of all patients at each clinic visit was determined and were compared statistically. Knowledge and practice of diabetes related treatment goals were assessed by means of a questionnaire administered on 133 diabetes health care providers. Forty-six (43.8%) patients attained the target fasting blood glucose level of = 6.7mmol/l while 52 (49.5%) had blood sugar levels = 7.8mmol/l after three clinic visits. Comparable results were obtained for the target 2 hour post prandial blood glucose targets. 15 (20%) subjects attained the target SBP of = 120/80 mmHg and 25 (25%) if the target was = 130/85 mmHg. All patients demonstrated significant mean BP lowering by the third clinic visit P = 0.000 (ANOVA) in all cases. There was also a significant lowering of mean FBS and 2hrPP blood glucose in all patients after 3 clinic visits P < 0.01. 16 (12%) health care providers had a good knowledge of current treatment recommendations. Of these, 13 (81.3%) were Doctors, 2 (12.5%) were nurses, and 1 (6.3%) other allied health worker. When analysed according to occupational groups, 17.3% doctors, 4.1% nurses and 11.1% amongst the group of allied health providers possessed good knowledge and practice of current treatment guidelines and treatment goals. While our current strategies achieved significant BP and blood glucose lowering, very few patients attained recommended targets. There is still a need for intensification of current strategies and periodic evaluation of its effectiveness in achieving optimal targets.

Awareness↗
PubMed2006

Low-density lipoprotein cholesterol goal attainment among high-risk patients: Does a combined intervention targeting patients and providers work?

BACKGROUND: Physicians are aware of the National Cholesterol Education Program guidelines; however, most patients fail to attain cholesterol goals. OBJECTIVE: To determine whether a combined program of patient education and provider awareness could improve the National Cholesterol Education Program goal attainment among patients at high risk for cardiovascular events. METHODS: One hundred seven high-risk patients with cardiovascular disease were educated in a single 15-minute session regarding their cholesterol levels, risk factors, and medication adherence. Those with scores of 2 or lower on the Morisky questionnaire were classified as low-adherence patients, and those with scores of 3 or higher were classified as high-adherence patients. Seven physicians were provided this information and were requested to evaluate the dyslipidemia management of these patients. Lipid levels were reevaluated 8 to 12 weeks after the intervention. RESULTS: At the start of the study, 38 (35.5%) of the 107 patients were at target low-density lipoprotein cholesterol (LDL-C) levels, and 64 of the 107 patients (59.8%) were at target levels after the intervention. High-adherence patients decreased their LDL-C levels from a mean of 118.6 mg/dL (3.07 mmol/L) to 98.6 mg/dL (2.55 mmol/L); low-adherence patients increased their LDL-C levels after the intervention from 134.5 mg/dL (3.48 mmol/L) to 142.1 mg/dL (3.68 mmol/L). A comparison between the LDL-C goal achievers vs nonachievers revealed a significant difference in adherence (P = .001). Among the goal achievers, significant decreases in preintervention vs postintervention total cholesterol levels (P = .001) and LDL-C levels (P = .001) were also noted. CONCLUSION: This study demonstrates that an intervention simultaneously targeting patients and providers is successful in improving goal attainment among high-risk patients.

Adult↗
PubMed1990

Setting analytical goals for random analytical error in specific clinical monitoring situations.

Strategies abound for the setting of analytical goals in clinical chemistry. Many, especially those more recently proposed for particular clinical situations, are concerned with tests used in diagnosis. We suggest a general theory for the setting of goals in situations that specifically involve the monitoring of individuals. Goals are calculated from the formula CVA less than [(delta c 2/2Z2)-CVB2]1/2, where CVA is the analytical imprecision (as coefficient of variation, CV); delta c is the percentage change in serial results that is considered clinically significant; Z is the Z-statistic, which depends only on the probability selected for statistical significance; and CVB is the average inherent within-subject biological variation (as CV). Examples given show applications in hematology and in monitoring diabetes mellitus, chronic renal failure, and hepatitis. The derived goals are for total random analytical error (imprecision and intermittent systematic variation), and provide objective criteria that should be achieved in practice. The effect of analytical variability on both variability in test results and the probability that a stated change can be considered significant should be calculated whether or not the goals are attained.

Chemistry, Clinical↗
PubMed1988

A survey of age group ice hockey goal keepers.

How large are age group ice hockey goal keepers who defend goals in the Canadian amateur hockey system? This and similar questions regarding physical size were the subject of a survey of age group ice hockey goal keepers from six age categories recognized by the Canadian Amateur Hockey Association. Of these six categories, only four, namely Mite, Pee Wee, Bantam, and Midget were sampled with sufficient frequency to be reported here. A non-amateur seventh category entitled Professional was also examined using the same survey instruments. The goalers participating in the survey provided anecdotal information, were weighed, height measured, and then photographed while in their goal keepers' 'crouch', both with and without their full goal keeping equipment. Non-inferential statistics of central tendency and dispersion were used to examine normalcies of anthropometric measures, proportionality of growth process, and distribution of apparent body size as determined from the blocking area of the body (frontal perspective).

Adolescent↗
PubMed1988

The application of theoretical goals based on biological variation data in proficiency testing.

Proficiency testing schemes must define acceptable standards of performance. A number of strategies have been used to define acceptable standards, or analytical goals, for imprecision, but it does appear that the current widely held view is that imprecision (as SD or coefficient of variation) should be equal to or less than one half of the average intraindividual biological variation. Since the goal for inaccuracy is that results should be unbiased, the biological variation-based goals should be used for total laboratory error. Many data on the biological variation of a wide range of analytes now exist, which facilitates goal-setting. Current proficiency testing schemes generally analyze laboratory data using either a parametric statistical approach or empirical fixed limits of acceptability. The latter strategy appears to have advantages provided that the criteria of acceptability are the objective biological variation-based goals.

Academies and Institutes↗
PubMed1987

[Therapeutic goal of the patient as a criterion for prognosis and success of inpatient psychotherapy].

We assumed that a patient's statements about what he/she wants to achieve by psychotherapy (subjective therapy-goals) may contain information about his/her capability and willingness to cooperate in the therapeutic process; insofar they are relevant for the study of indications and outcome of a psychotherapeutic treatment. We studied therapy-goals given by 480 patients during their first therapeutic contact. We differentiated the data according to contents resp. directions of expectation and conceptualized the level of intended change. 75 of the 480 patients did not receive any treatment, 43 gave up therapy prematurely. In answering the question "what do you want to achieve by psychotherapy?", which forms a part of the first interview as well as of our anamnestic questionnaire, both groups showed prognostically relevant differences in comparison to fully treated patients. For the remaining 362 patients, who had been admitted, their initial goals were compared with finally attained goals. This yielded significant results concerning success of treatment, which were validated by a simultaneous rating of therapy-goals for every individual patient by researchers resp. therapists.

Hospitals, Psychiatric↗
PubMed1979

Some diets that meet the Dietary Goals for the United States.

Few people in the United States have diets with proportions of complex carbohydrate as high and proportions of protein, fat, and sugar as low as proposed in the second edition of the Dietary Goals for the United States by the Senate Select Committee on Nutrition and Human Needs. Sample diets, including low-calorie diets for adults, were planned to meet the Recommended Dietary Allowances and the Dietary Goals. Two possible "first steps" in modifying diets to meet the Goals explored the use of: (a) Specified ranges rather than specific Goals and (b) some but not all of the Goals.

Adolescent↗
PubMed1996

Occupational stresses, goal clarity, control, and strain among nurses in the Finnish health care system.

The aim of this study was to determine how occupational stresses (job demands), control, and goal clarity were related to strain in Finnish nurses (n = 433). It was hypothesized that clear goals moderate the stress-strain relationship. The interaction between stresses, perceived control, and goal clarity was tested by hierarchical regression analysis. Troublesome patients and time pressure imposed the greatest job demands. Job demands and control were related to strain, but control did not moderate the stress-strain relationship. The results supported the moderating effect of goal clarity.

Adult↗