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PubMedDate not supplied

Occupational goals of mothers of children with disabilities: influence of temporal, social, and emotional contexts.

OBJECTIVE: The purpose of this study was to describe the occupational concerns and goals of mothers who care for children with disabilities. METHOD: Retrospective data collected from 38 mothers of children with disabilities using the Canadian Occupational Performance Measure (COPM) were analyzed qualitatively. RESULTS: Six themes emerged: (I) doing and being alone: taking care of my own health and well-being; (II) doing and being with others: expanding my social life; (III) improving my child's quality of life; (IV) household management: organizing time and resources; (V) balancing work, home, and community responsibilities; and (VI) sharing the workload. CONCLUSION: Overarching patterns in the data suggested that the occupational performance of mothers of children with disabilities is constrained by time, overlaid by difficult emotions, and involves a desire for increased social contact. Qualitative analysis of data from the COPM may provide insight into contextual factors that affect occupational performance as well as signaling point of entry for therapists to facilitate client-centered occupational goals.

Adult↗
PubMed1991

Goals and rationale of cancer treatment.

OBJECTIVE: To provide an overview of the goals and rationale for cancer management. DATA SOURCES: Primarily the series "Changing concepts in the management of cancer" published in the Journal between December 1987 and September 1990 (see Box). STUDY SELECTION: Tumour types chosen for the series of articles were those with a high incidence, such as melanoma and tumours of the lung, breast and prostate, or curable tumours, such as acute leukaemias and lymphomas. DATA SYNTHESIS: Emphasis is placed on primary prevention, with lung cancer related to smoking as a model. Breast cancer serves as a model for secondary prevention and adjuvant therapy. The role of goal setting as the first step in cancer treatment is stressed. Some of the reasons why cure is now possible are discussed, as are criteria for the selection of tumours for adjuvant therapy and indications for starting palliative treatment. CONCLUSIONS: Cancer cure is no longer a myth but a reality. To overcome present barriers to the cure of some cancers, there is need for a better understanding of the biology of epithelial solid tumours including the mechanisms to overcome multiple drug resistance. The restoration of functional health after cure is attained is paramount. Quality of life as a measure of success should be included in all clinical trials.

Goals↗
PubMed1992

Council on Education report: ART progression and long-range goals.

To answer the question of Accredited Record Technician long-range educational goals (including an indication for progression opportunities), the Council on Education (COE) of AHIMA in 1990 sent out a Request for Proposal for a needs assessment. Based on a proposal submitted in July 1990, a contract was awarded to The College of St. Scholastica. Shirley Eichenwald served as the project director. Kathleen LaTour was project associate and David Swenson was project consultant. A survey was developed and distributed with a deadline of February 1991. The findings from the survey were placed in a report entitled "Progression Potential and Educational Goals of ARTs: a Needs Assessment," dated April 1991, which was submitted to the Council on Education and reviewed at the August 1991 COE meeting. This article summarizes and highlights the key findings from this report.

Attitude of Health Personnel↗
PubMed1991

Patient goal setting as a method for program improvement/development in partial hospitalization programs.

Data were collected from a study of 49 patients in 1990 and 106 patients in 1991 admitted into Country View Treatment Center and Green Country Counseling Center. Country View is a 30-bed chemical dependency residential center operating under St. John Medical Center in Tulsa, Oklahoma. Green Country is an evening partial hospital chemical dependency program operating under St. John Medical Center in Tulsa, Oklahoma, The tools used in this study were the Country View Patient Self-Reporting Questionnaire, the global Rating Scale, and the Model of Recovering Alcoholics Behavior Stages and Goal Setting (Wing, 1990). These assessments were specifically designed to measure the patient's perceptions of goal setting and the patient's perspective on treatment outcome. The study outcome resulted in program improvement (Green Country evening partial hospital program) and the development of the Country View Substance Abuse Intermediate Link (SAIL) Program (day partial hospital).

Day Care, Medical↗
PubMed1979

A clarification of the goal setting and appraisal processes in MBO.

Under the guise of Management by Objectives, "goal setting" and "performance appraisal" have assumed many different shapes and purposes. To clarify the concept of MBO, this review examines the writings of leading MBO experts, extracts those elements common to their respective definitions of goal setting and performance appraisal, and joins them into a single definition of MBO.

Employee Performance Appraisal↗
PubMed1987

Mission statement translated into managerial, staff goals.

Although mission statements have the power to unify, this power will be limited unless the values the statements affirm are translated into language that relates to employees' work. St. Joseph Hospital and Health Care Center, Tacoma, WA, has developed a mission awareness project to assist staff in developing goals that reflect the organization's values. The program includes managerial-level discussions of mission goal setting followed by sessions during which the employees of each department create work objectives based on mission values. Evaluation of the program is conducted quarterly. Plans include incorporating the mission effectiveness program into job descriptions, employees evaluations, and the budget process.

Catholicism↗
PubMed1988

Profit vs. public welfare goals in investor-owned and not-for-profit hospitals.

A study of goal formation in a matched sample of investor-owned and not-for-profit hospitals was conducted to determine differences in the perceptions of employees regarding their hospitals' commitments to patient/community welfare goals versus profit maximization. These perceptions were compared to available operating data for the same hospitals. While the investor-owned hospitals as a group generally were found to emphasize patient/community welfare values less than their not-for-profit counterparts, this did not hold true when matched pairs were analyzed. In some of the matched subsets, the not-for-profit hospitals were much more profit-oriented than the investor-owned hospitals. This research reveals that strong patient/community service values do not universally characterize not-for-profit hospitals, and conversely investor-owned hospitals cannot always be characterized as profit maximizers.

Analysis of Variance↗
PubMed2000

Recovery-oriented psychopharmacology: redefining the goals of antipsychotic treatment.

The traditional goals of psychopharmacology stem from the medical model. Rehabilitation interventions attempt to improve aspects of functioning in patients with chronic illnesses that are not responsive to biological intervention. Recovery is a concept emanating from the consumer self-help movement. It describes a move away from the patient role defined by a diagnostic label toward community membership defined by relationships and responsibilities in the community. Comprehensive care for people with psychotic disorders can include attention to each realm. This article provides an overview of the 3 models of care and describes a role for the psychopharmacologist in each as well as his or her unique potential to incorporate all 3. We outline potential synergistic benefits of integrating recovery-, rehabilitation-, and medical-model thinking into the practice of psychopharmacology and explore implications for the goals and outcomes of treatment for people with psychotic disorders.

Adaptation, Psychological↗
PubMed2001

Impaired recognition of the goal location during spatial navigation in rats with hippocampal lesions.

Converging evidence suggests that the hippocampus is essential for goal-directed spatial navigation. Successful navigation requires not only the ability to compute an appropriate path toward the target but is also guided by recognition of places along the trajectory between start and goal. To determine whether the hippocampus contributes to place recognition, we trained rats with hippocampal lesions in an annular water maze with a remotely controlled escape platform at a constant location in the corridor. The platform remained submerged and unavailable until the rat had swum at least one full lap. Probe trials with the platform unavailable for 60 sec were inserted at regular intervals. In these trials, the rat would swim over the platform several times, regardless of its navigational abilities. After a few training sessions, all sham-operated control animals reduced their swim velocity when they approached the platform, indicating that they recognized the target location. Rats with hippocampal lesions, in contrast, swam at the same velocity as elsewhere in the corridor. Preoperative training or prolonged postoperative training did not alleviate the deficit. Rats with hippocampal lesions were able to learn a cued version of the task, which implies that the failure to slow down was not attributable to motor inflexibility. Thus, hippocampal lesions caused a severe but selective deficit in the identification of a location, suggesting that the hippocampus may be essential for image recognition during spatial navigation.

Analysis of Variance↗
PubMed2003

Diagnosis and therapeutic goals. What are you actually treating?

BACKGROUND: Bad prescribing frequently involves writing a prescription for a symptom or a diagnosis and not considering the other steps in the prescribing process. OBJECTIVE: To illustrate the process of therapeutic goals. DISCUSSION: Therapeutic goals are the answer to the patient's question: 'Why am I taking this medication?' Taking this step in the prescribing process allows for a greater consideration of available treatment options, greater individualisation of therapy, avoids treatment on the basis of surrogate endopoints, and may result in greater patient concordance.

Adult↗
PubMed2003

Evidence-based medicine meets goal-directed health care.

Evidence-based medicine and goal-directed, patient-centered health care seem, at times, like parallel universes, though, at a conceptual level, they are perfectly compatible. Part of the problem is that many of the kinds of information required for decision making in primary care are often unavailable or difficult to find. Several case examples are used to illustrate this problem, and reasons and solutions are suggested. The goal-directed health care model could be helpful for directing the search for evidence that is relevant to the decisions that patients and their primary care physicians must make on a regular basis.

Evidence-Based Medicine↗
PubMed2004

Long-term goals in the management of acute and chronic anxiety disorders.

Many anxiety disorders are not treated to remission (symptom-free state); however, this should be the minimum goal of therapy. Antidepressant therapies have shown significant beneficial effects in the management of anxiety disorders, with some variability in results in specific disorders. In social anxiety disorder, selective serotonin reuptake inhibitors and venlafaxine extended release (XR) have demonstrated efficacy, with response rates varying between 40% and 68%. Monoamine oxidase inhibitors and cognitive-behavioural therapies are also effective. In patients with generalized anxiety disorder, benzodiazepines, paroxetine, and venlafaxine XR have demonstrated remission rates that are 15% to 25% higher than placebo. In patients with posttraumatic stress disorder, about 60% to 70% of patients experienced a response with antidepressant therapy, compared with about 40% on placebo, while remission rates in one study were 30% with venlafaxine, 24% with sertraline, and 20% with placebo. In patients with obsessive-compulsive disorder, a 25% to 35% improvement in symptom scores was reported in 20% to 65% of patients. In the management of panic disorder, paroxetine and venlafaxine XR doubled the percentage of patients who were panic-free, compared with placebo. Ongoing antidepressant therapy further improved remission rates, and many patients with anxiety disorders required extended treatment trials before experiencing benefit. In most clinical trials, some benefits were seen within 3 to 4 weeks but continued to accrue throughout the 3- to 6-month duration of the trial. In the acute phase, patients with anxiety disorders should be treated aggressively with antidepressants for extended periods and may require long-term therapy to maintain benefits. Cognitive-behavioural therapy is another mainstay in the treatment of all anxiety disorders; exposure to feared situations is necessary to move beyond phobic avoidance and functional impairment to full recovery, the ultimate goal of therapy.

Acute Disease↗
PubMed1991

Disturbance of brightness discrimination and active avoidance learning after lesions of nucleus reticularis tegmenti pontis (NRTP) of rats are related to impairment of goal-directed behaviour.

Long-Evans hooded rats were not able neither to reach criterion of active avoidance tasks in a Y-maze and in a jump test, nor in brightness discrimination after lesions of the NRTP without preoperative experience in these tests. After preoperative consolidation of active avoidance, the retention of Y-maze avoidance performance was zero and of jump test avoidance at 25%. The Y-maze avoidance was again relearned except in the task with 2:2 alternation of goals whereas retention of brightness discrimination was not affected. In the jump test, avoidance relearning was evidently retarded. Ambulatory and exploratory behaviour in the open field were significantly reduced after NRTP lesions. The NRTP is evidently involved in the establishment and control of goal-directed behaviour.

Animals↗
PubMed1991

[Goals and methods of health training in the rehabilitation hospital for cardiovascular diseases].

Presented are the objectives, premises, and methods of health training in the framework of inpatient rehabilitation of cardiovascular patients, the contents of a two-week group programme are reported. Central among the goals is information on the disease, on how to cope with it, as well as psychosocial reorientation of health behaviour. Various methods for achieving these goals are described, the focus being on group work programmed according to psychological considerations, and placed within a psychosomatic overall approach of the clinic.

Adaptation, Psychological↗
PubMed1990

Quality assurance goals in clinical pathology.

Certain conditions must be fulfilled to meet quality assurance objectives in clinical pathology. Commitment to goals for improving quality and participation by everyone involved are prerequisites. Quality assurance is driven by information that is used to examine processes so that they can be improved. Inspection alone, however, does not produce quality; quality must be designed into the process to reduce the likelihood of errors and to produce long-lasting improvement. Specifications for meeting quality assurance goals should be determined by the expectations of users of the service. Accomplishments are measured by users' perceptions. Integration of laboratory and clinical information, together with communication links between all components of the health care processes, is critical for success.

Goals↗
PubMedDate not supplied

[Spatial-temporal structure of the organization of goal-directed behavior under the action of delta 9-tetrahydrocannabinol].

The effect of delta-9-tetrahydrocannabinol (delta-9-THC) on the goal-directed behavior was studied by the pattern recognition theory methods on cats trained for a differentiated response, to structured visual stimuli. Administration of delta-9-THC was shown to cause noncoordination of certain neocortex regions as well as disagreement of temporal characteristics of the processes involved in the goal-directed behavior organization.

Animals↗
PubMed1987

Cue-sampling and goal-approach correlates of hippocampal unit activity in rats performing an odor-discrimination task.

Several techniques previously used to describe behavioral correlates of hippocampal unit and slow-wave activity are combined in a single odor-discrimination paradigm. Rats repetitively performed a sequence of behaviors during each trial: approach to a stimulus-sampling port, investigatory sniffing of the odor cue, orientation and approach toward a separate reward location, and water reward consumption. In a series of post hoc analyses, spike activity was time-locked to variations of each task event to uncover behavioral and physiological parameters that best synchronized unit firing. Three major categories of cells were identified: (1) "Cue-sampling" cells fired after onset of odor-cue sampling. Response magnitude was related to cue valence on both the current and past trials. (2) "Goal-approach" cells fired prior to arrival at either the odor-sampling port or reward cup. A number of sampling and approach cells also had place correlates. However, detailed analyses indicated that specific behaviors associated with increased firing reliably occurred at the same place. Unit activity was at least as well described by behavioral as spatial parameters. (3) "Theta" cells fired at high rates in strict relation to the ongoing limbic theta rhythm. This categorization suggests a functional organization of the hippocampus in which different cell types play complementary roles. Cue-sampling cells activated by discriminative stimuli during attentive fixations may be involved in comparing relative cue valence. Goal-approach cells may be involved in orientation movements for successive cue-sampling periods. Theta cells may provide synchronization of sensory acquisition during sampling, as well as in orientation movements during approach.

Animals↗