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Fundamental Movement Skill (FMS) proficiency is an important antecedent of physical activity for children and adolescents. Many studies report children’s overall FMS proficiency to be low. However, in order to develop effective intervention strategies, it is critical to understand FMS proficiency at a behavioral component level. This study investigated British primary school children’s FMS proficiency across all three FMS domains, reporting proficiency at both an individual skill level and at a behavioral component level. Participants were 219 primary school children, aged 7–10 years (Boys 111, girls 108) from central England. We assessed (a) eight FMS (run, jump, hop, skip, catch, overarm throw, underarm throw, stability) using the second and third revisions of the Test of Gross Motor Development, and (b) stability, using the rock skill from the Rudd stability assessment tool. We calculated descriptive statistics and frequencies for each FMS and their behavioral components. We explored gender differences using the Mann- Whitney U-test, and differences between school years using the Kruskal- Wallis test. There was a similar pattern in the prevalence of failure for behavioral components across skills, with children failing on components requiring (a) the simultaneous use of both upper and lower limbs and (b) contralateral actions. Detailed descriptive analysis of low proficiency levels highlighted co ordination and the process for power/force production. These data can be used to guide development and plan targeted interventions for the weakest skills and behavioral components of 7-10 year old British primary school children to increase their FMS levels.

Introduction: Depression and anxiety are common affective experiences during the first year following a solid organ transplant. This study examined the degree to which an evidenced-based clinical intervention implemented by social workers—Symptom Targeted Intervention—can alter self-reported depression and anxiety in heart, kidney, liver, and lung transplant recipients. Research Questions: This investigation explored 2 questions: (1) Can symptom-targeted interventions significantly reduce posttransplant recipients’ self-reported depression and anxiety at the conclusion of treatment and at 1-month follow-up? and (2) Does the response differ by gender? Design: A 1-group pretest–posttest design with a 1-month follow-up was used to test for changes in anxiety and depression after transplantation. Forty-eight patients at 2 US transplant centers were enrolled between January 2016 and May 2017. Data were collected using an online platform and analyzed to assess for differences over time and by gender. Results: Anxiety decreased significantly between pretest and posttest using the General Anxiety Disorder-2 ( P < .05). Comparisons by gender indicated that women had a significant decrease in anxiety between pretest and posttest ( P < .001); however, there was no significant decrease in anxiety for men. Analyses by gender and time yielded no significant differences for depression. Discussion: Symptom-targeted interventions have the potential to reduce anxiety in solid organ transplant patients and enhance their psychosocial adjustment after surgery.

Large-scale urban development projects have become the main vehicle by which targeted interventions for place- and scale-specific state initiatives unfold, triggering a series of processes that are associated with the rescaling of state space. This study aims to understand the place-specific conditions, pathways and strategies whereby states’ spatial and scalar restructuring takes place in urban development projects (UDPs) within China’s political economic contexts, and in turn how UDPs act as critical lenses for viewing the changing nature of state spatial strategy in China, through a case study of the Lingang New Town in Shanghai. The major findings are: UDPs in China function as tools not just for land value extraction but also for scale-making to cater to the state’s pursuits of place-specific competitiveness in the global economy; the restructuring of the state apparatus and regulatory frameworks is driven by place-specific tensions and crises triggered by earlier rounds of state rescaling; the state chose state-agents rather than market-agents to reinforce its power, and thus the state space expands through development of UDPs; through developing UDPs, China’s spatial strategies have explicitly and officially engaged with the discourse of globalisation while implicitly engaging with geographically variegated practices of neoliberalisation. At the theoretical level, this article facilitates an investigation of how China’s state spatial strategy, characterised by geographically and chronologically variegated engagement with neoliberalism, is actualised through UDPs. It also demonstrates how, despite being a socialist polity, pragmatic market measures and downscaling are taken as transient measures in times of need.

Objectives: This study aims to identify factors that influence older adults’ reintegration to normal living 2 years following a hip fracture and the association between caregiver burden and reintegration over time. Methods: This longitudinal cohort study followed 76 community-dwelling older adults and their caregivers for 2 years post-hip fracture. The primary outcome was Reintegration to Normal Living Index (RNLI), and the secondary outcome was caregiver burden. Results: Older adults scored significantly lower on RNLI at 18 to 24 months if they had few social interactions, cognitive impairment, or lower pre-fracture functional status. During follow-up, greater independence in activities of daily living and greater mobility were each positively associated with RNLI. Caregiver burden reduced if reintegration improved. Implications: Results suggest a need for targeted interventions for older adults’ post-hip fracture to improve their function to enhance their reintegration to normal living and to support caregivers in decreasing their burden of care.

Patient rescue occurs in phases: recognizing the problem, communicating the concern, and treating the complication. To help improve rescue, we sought to understand facilitators and barriers to managing postoperative complications. We used a criterion-based sample from a large academic medical center. Semistructured interviews ( n = 57) were conducted, which were audio-recorded and transcribed verbatim. Thematic analysis and consensus coding was performed using NVivo 11. We used a framework matrix approach to synthesize our coding and identify themes that facilitate or impede rescue. Clinicians identified root causes for delays in care, such as recognizing patient deterioration, knowing whom to contact and when, and reaching the correct decision-making provider. This study identified significant variation in communication processes across providers caring for surgical patients. Targeted interventions aimed at improving and standardizing these aspects of communication may significantly influence the ability to effectively identify and escalate care for postoperative complications.

Policy actors design and implement targeted interventions to eliminate disparities that exist between groups. Although necessary for achieving health equity, the use of targeting as a policy tool carries the potential for political backlash and social debate, which may influence whether and how policy actors use it. In this research, the authors examine policy actor perceptions regarding the use of targeting in the implementation of health policy. The authors conduct elite interviews with policy actors to better understand their work to design and implement interventions to address health disparities. Findings identify key tensions and trade-offs faced by policy actors related to targeting and reveal sociopolitical influences that shape whether and how targeted programs are considered, who receives them, and by what means they are delivered. The authors discuss the implications of the findings for the use of targeting and related marketing practices by policy actors to address health disparities and other significant public health concerns.

The academic underperformance of high school students with learning disabilities may reduce their access to higher education and decrease their employment opportunities. Based on stereotype threat hypothesis, the present study examined the role of stereotype threat in academic performance among adolescents with learning disabilities and the moderating role of psychological disengagement in this relation. In Study 1, 120 students with learning disabilities finished the measures of stereotype threat vulnerability and psychological disengagement, and their academic score at two time points were collected. Results showed that students who are more vulnerable to stereotype threat tend to have a lower academic score at Time 2 even after controlling for academic score at Time 1, and this relation was moderated by psychological disengagement. In Study 2, 62 sophomore students with learning disabilities finished measures of stereotype threat, academic persistence, and psychological disengagement. The results showed that the effect of stereotype threat on academic persistence was significant among students who were of low psychological disengagement, while this effect was not significant among students who were psychologically disengaged in academics. These results emphasize the individual differences of learning disabled students' response to stereotype threat and have significant implications for framing targeted interventions.

In the context of best practices consultation with high needs teachers, we examined (a) relations between teachers’ appropriate response to student rule violations and rates of rule violations, and (b) rates of student misbehavior among teachers who do and do not achieve various benchmarks of integrity and/or growth in skills. Participants were 48 teachers, 48 target students with or at risk for attention deficit hyperactivity disorder (ADHD; one per teacher), and remaining students in each classroom. Teachers received up to eight consultation sessions on classroom management and implementation of a daily report card (DRC) with the target student. We observed classwide rule violations, target student rule violations, and DRC violations, as well as the percentage of rule violations to which the teacher provided an appropriate response. Teachers who responded to a higher percentage of rule violations had fewer classwide rule violations ( rs = −.32 to –.53) and target student rule violations ( rs = −.22 to –.51) at baseline, Months 1 to 2, and Months 3 to 4 of consultation. Teachers who reached the minimum benchmark of 51% appropriate response and who demonstrated greater growth in appropriate responding witnessed fewer rule violations than teachers who did not achieve these benchmarks. Implications for preservice training, professional development, and consultation are discussed.

The authors acknowledge and respond to three concerns raised by Weber (2018) about oversimplifying psychological barriers to climate policy. First, skepticism about climate change remains a major barrier to climate policy, along with political partisanship. Second, recognizing multifaceted barriers to climate policy calls for multiple targeted interventions to be implemented at critical junctures. Finally, translating pro-environmental attitudes into action requires an appreciation of proximate sociopolitical contexts and cultures. Rather than a one-size-fits-all approach, psychological scientists are well equipped to understand and address the complex barriers to climate policy within the natural flow of everyday social life.

School violence is a public health issue with direct and collateral consequences that has academic and social impacts for youth. School violence is often considered a uniquely urban problem, yet more research is needed to understand how violence in rural and suburban schools may be similar or different from urban counterparts. Using school violence data from a state with urban, suburban, and rural counties, we explored the landscape of school violence in Pennsylvania (PA) through mapping, descriptive statistics, and factor analysis. Results show school violence is not solely an urban problem. Schools in all county types and across grade levels deal with violence to varying degrees, and the majority of schools across county types experience low levels of violence. Types of violence experienced by PA schools loaded onto three factors, suggesting that targeted interventions may be better suited to addressing school violence.

Immigrant travelers who visit friends and relatives (VFR travelers) experience substantially higher rates of travel-related infections than other travelers, in part due to low uptake of pretravel health advice. While barriers to accessing advice have been identified, better characterization is needed to inform targeted interventions. We sought to understand how South Asian VFR travelers perceived and responded to travel-related health risks by conducting group interviews with 32 adult travelers from an ethnoculturally diverse Canadian region. Travelers positioned themselves as knowledgeable of key health risks, despite not seeking pretravel health advice. Their responses to risks were pragmatic and rooted in experience, but often constrained by competing concerns, including rushed travel, familial obligations, cost, and a desire to preserve authentic experiences. Moving beyond risk awareness to reinforcing the value of medical advice and intervention, in a manner that is sensitive to these unique concerns, is needed when delivering tailored health promotion messages to VFR travelers.

Large outbreaks, such as those caused by influenza, put a strain on resources necessary for their control. In particular, children have been shown to play a key role in influenza transmission during recent outbreaks, and targeted interventions, such as school closures, could positively impact the course of emerging epidemics. As an outbreak is unfolding, it is important to be able to estimate reproductive numbers that incorporate this heterogeneity and to use surveillance data that is routinely collected to more effectively target interventions and obtain an accurate understanding of transmission dynamics. There are a growing number of methods that estimate age-group specific reproductive numbers with limited data that build on methods assuming a homogenously mixing population. In this article, we introduce a new approach that is flexible and improves on many aspects of existing methods. We apply this method to influenza data from two outbreaks, the 2009 H1N1 outbreaks in South Africa and Japan, to estimate age-group specific reproductive numbers and compare it to three other methods that also use existing data from social mixing surveys to quantify contact rates among different age groups. In this exercise, all estimates of the reproductive numbers for children exceeded the critical threshold of one and in most cases exceeded those of adults. We introduce a flexible new method to estimate reproductive numbers that describe heterogeneity in the population.

Background: Though there was a high blood supply need in response to high communicable disease and increased emergency conditions; the practice of health professionals and non-health professionals on voluntary blood donation is still unexpectedly low in Ethiopia. Health professionals and non-health professionals working in the health sectors are pivotal in taking the lead to reverse the effect of inadequate blood supply system in the country. Therefore, the study aimed to understand the level and contributing factors of knowledge, attitude and practice of voluntary blood donation among health and non-health professionals in ALERT Hospital, Addis Ababa, Ethiopia. Design and Methods: A cross-sectional study design was conducted among health professionals and non-health professionals in ALERT hospital from 5 to 30 June 2018. A total of 394 hospital staffs participated in this study. A well-structured self-administered questionnaire was used to assess the knowledge, attitude, and practice about voluntary blood donation. The statistical analysis was carried out using R. Results: A total of 203 (51.5%) participants were females. Only 142(36%) of the participants had voluntary blood donation practice. Among these, 60 (42.3%) of them were donated blood more than once. Occupation is the only factor significantly associated with blood donation practice; health professionals had almost two-fold donation practice than non-health professionals (AOR=1.62; 5% CI: 1.02, 2.57, p=0.042). Occupation has also a strong relationship with knowledge, health professionals had better knowledge than non-professionals with (AOR=2.39; 95% CI: 1.39, 4.12; p=0.002). The result also showed that the educational status of the participants was strongly associated with the blood donors’ attitude with (AOR=3.62; 95%CI: 1.1, 11.93, p=0.035). One hundred and two (72.3%) of the blood donors were motivated to donate blood for charity, 133 (94.3%) individuals were felt good after blood donation and lack of request was the major reason 88.6% that causes the respondents not to donate blood frequently. Conclusions: Low blood donation practice of health professionals and non-health professionals was identified from this study. Occupation had significantly associated with blood donation practice. Therefore, targeted interventions aimed at mobilizing hospital staffs and develop accessible blood donation centers are recommended to reverse the effect of inadequate blood supply system in Ethiopia. Significance for public health Health professionals and non-health professionals working in the health sector are pivotal in taking the lead so as to reverse the effect inadequate and unsafe blood supply system in the country. The reasons for this fact are these groups of population are likely to be informed of the necessity of blood to manage disease or problems of some patients and know more regarding the safety, risk and procedures of blood donation. Moreover, front line managers who can deal with the shortage and safety related issues especially in an emergency situation. Together with other concerned bodies, they are the one who should influence their family, the community around, and the students. However, only few percentages of individuals from this sector come forward to donate blood on a regular basis. Therefore, the main aim of this research was to understand the level and various factors contributing to knowledge, attitude and practice of voluntary blood donation among medical and paramedical personnel in the health sector.

Precision medicine aims to fix what is wrong with today’s healthcare: a lack of targeted interventions tailored to the person. It encompasses many aspects of health; chief among these is one’s genetic profile. Researchers are making progress as gene-sequencing technologies get better and cheaper. Although there is cause for optimism, as several initiatives at Sunnybrook Research Institute show, scientific, systemic, and logistical challenges must be surmounted before advances can be integrated into the clinic. Despite these barriers, precision medicine is the only way forward.

Although the crisis is a world phenomenon, its impact is not at all spatially invariant. The aim of the article is to analyse the spatial effects of the crisis, doing so through a scenario-building exercise in which policies are kept constant, and economic growth is mainly driven by macroeconomic and supply side trends on the assumption that the crisis will end in 2015. The final goal is to raise awareness of policy makers on the costs of the present economic crisis and on their spatial impacts, so as to direct growth policies towards more targeted interventions. Our results show that the crisis produces structural breaks in local economy growth patterns; after years of convergence, regional disparities will rise due to an increase in intra-regional disparities, only partially limited by international convergence, strongly reduced in the years of crisis. The scenario is developed thanks to the MASST3 model, a regional growth forecasting model recently updated and enlarged to be able to forecast the impact of the crisis.

Depression during the perinatal period is common and can have adverse consequences for women and their children. Yet, the biobehavioral mechanisms underlying perinatal depression are not known. Adverse early life experiences increase the risk for adult depression. One potential mechanism by which this increased risk occurs is epigenetic embedding of inflammatory pathways. The purpose of this article is to propose a conceptual model that explicates the linkage between early life adversity and the risk for maternal depression. The model posits that early life adversity embeds a proinflammatory epigenetic signature (altered DNA methylation) that predisposes vulnerable women to depression during pregnancy and the postpartum period. As proposed, women with a history of early life adversity are more likely to exhibit higher levels of proinflammatory cytokines and lower levels of oxytocin in response to the demands of pregnancy and new motherhood, both of which are associated with the risk for perinatal depression. The model is designed to guide investigations into the biobehavioral basis for perinatal depression, with emphasis upon the impact of early life adversity. Testing this model will provide a better understanding of maternal depressive risk and improve identification of vulnerable women who would benefit from targeted interventions that can reduce the impact of perinatal depression on maternal–infant health.

The purpose of this article was to provide an overview of the person-oriented approach, describe empirical examples of its use, and discuss how the approach may be used in nursing research. The person-oriented approach consists of theoretical and methodological components and provides a way to explore the heterogeneity of populations related to phenomena of interest. For analytic purposes, the person-oriented approach views the person as a holistic unit rather than a sum of his or her characteristics, and thus, it provides an alternative or complementary approach to the more traditional, variable-oriented approaches most commonly used to study health phenomena. Although the person-oriented approach has not been used extensively in nursing research, it offers promise for nursing scholars who study complex problems within heterogeneous populations and who seek to develop targeted interventions to more effectively promote desired health outcomes.

Gender can have separate and interacting effects on mental health. Gender-based analysis provides insight into these effects on mental health, and it can provide evidence to inform policy and practice to meet these gender-specific needs among persons in forensic mental health settings. Both individual and facility-level characteristics play a role in restriction to room as a form of control intervention in forensic mental health. Understanding the gender differences associated with the factors that increase a person’s risk of restriction to room can allow for more targeted interventions and provide insight into policies that will help reduce these types of control interventions.

Sanitation interventions routinely overlook the implications of secure tenure for investment on the part of households. Drawing upon primary field research in Dakar, this paper presents a citywide sanitation planning framework that combines existing sanitation planning approaches with householders’ investment logic as a function of their tenure security and status. The resulting framework, the Sanitation Cityscape, maps what is happening to faecal material on a citywide scale and why, thus providing a snapshot of the sanitation status of the city and a rationale for targeted interventions along the sanitation service chain. The paper offers an approach for policymakers and practitioners to narrow the decision-making process for citywide sanitation service provision. It aims to target urban sanitation interventions that are appropriate to the urban tenure mix, including non-networked systems, and a greater emphasis on widening the scope of sanitation service provision to include tenure-neutral operational activities, such as faecal sludge management.

Intimate partner violence (IPV) is a serious health problem and a leading cause of nonfatal injury in North American females. Prevalence of IPV has ranged from less than 20% to more than 50% across primary care, emergency medicine, and family medicine. We conducted a systematic review and meta-analysis of the literature to examine best estimates of IPV prevalence as opportunities for targeted interventions in health care specialties. We included 37 articles in this study. Based on our pooled data, best estimates of the lifetime prevalence of any type of IPV were 38% in family medicine and 40% in emergency medicine.

The Behavioral Health Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics has developed Standards of Practice (SOP) and Standards of Professional Performance (SOPP) of Registered Dietitians in Intellectual and Developmental Disabilities (IDD). These guidelines are recommended for use by dietitians in developing and advancing their professional practice in serving individuals with IDD in various settings and circumstances. Two examples of how some of these specific standards are followed in real-life settings are presented. The first example is Carol, a young woman with a learning disability who has recently been diagnosed with celiac disease and is now following a gluten-free diet. Targeted interventions to Carol, her group home, program, and supportive staff, as well as family members and educators are described in addition to other activities related to selected standards to ensure diet understanding and compliance. The second example is about Laura, a 12-year-old girl with spina bifida, hydrocephalus, and scoliosis. Laura will have surgical correction of her scoliosis in 6 months. The registered dietitian will work with Laura, her mom, and the medical team to help Laura optimize her nutritional intake in preparation for the surgery, with activities related to selected standards.

Deliberate firesetting costs our community in destruction to property and lives. Public concern heightens when similar fires occur in a series, raising the specter of copycat firesetting. Difficulties associated with researching copycat crimes in general mean that not a lot is known about copycat firesetting. As an initial step toward filling this research gap, we explore connections between research on copycat crime and research into deliberate firesetting. The intention is to extract salient features from what is known about the phenomena of deliberate firesetting and copycat crime, map them together, and point out shared and unique characteristics. It is argued that a “copycat firesetter” is likely to exist as a distinct subgroup and potentially requiring targeted interventions.

Despite nearly universal insurance coverage for older Americans over the age of 65, the preretirement age cohort is susceptible to gaps in coverage. Related to the Patient Protection and Affordable Care Act (ACA), this study investigated heterogeneity in insurance status for preretirement Asian immigrants by examining the interacting effects of Asian ethnicity and employment type, which is a major factor that determines an individual’s insurance status in the U.S. Data from the 2009 California Health Interview Survey, which included 1,024 Asians between the ages of 50 and 64, were analyzed. Our findings indicate significant moderating effects of employment type and Asian ethnicity. However, regardless of employment type, Koreans had the highest rate of being uninsured. To effectively reach the ACA’s goal of reducing the number of uninsured individuals, targeted interventions specific to Asian subgroups are essential.

Internalizing behaviors are directed inward toward the child and are frequently overlooked in classrooms compared with externalizing behaviors. When internalizing behaviors are identified, cognitive-behavioral interventions (CBIs) are typically the intervention of choice; however, CBIs are time-consuming and require considerable skill and experience for successful implementation. An efficient and time-effective targeted intervention for children with internalizing behavior problems is needed. Check In/Check Out (CICO) has been shown to be an effective targeted intervention for children with externalizing behavior problems, but this intervention has not been implemented directly targeting children with internalizing behavior patterns. The purpose of the present study was to evaluate CICO as a targeted intervention for children with internalizing behavior problems. Four elementary school students with internalizing behavior problems received a CICO intervention. Results showed that ratings of prosocial replacement behaviors increased as a result of the CICO intervention, and students’ levels of internalizing behaviors decreased.

This article highlights the rationale for Namibia's participation in three studies which were conducted under the auspices of the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) during the period 1995–2007. The article provides some of the innovative ways in which the results of the first (SACMEQ I, 1995) and second (SACMEQ II, 2000) studies were disseminated throughout the country. It highlights the analysis of reading and mathematics achievement scores of grade 6 learners at three intervals (1995, 2000 and 2007), and explains how the Ministry of Education used the achievement results from the first two studies (1995 and 2000) to mobilise resources for targeted interventions which contributed to improvements in reading and mathematics achievement during the third SACMEQ study in 2007. The article concludes that participation in well-designed international assessment studies that take the local contexts into account can, when well managed, contribute to improvements in learning outcomes.

Traumatic brain injury (TBI) is a major public health concern in both civilian and military populations. Recently, genetics studies have begun to identify individual differences in polymorphisms that could affect recovery and outcome of cognitive and social processes following TBI. This review considers the potential for polymorphisms to influence six specific cognitive and social functions, which represent the most prominent domains of impairment following TBI: working memory, executive function, decision making, inhibition and impulsivity, aggression, and social and emotional function. Examining the influence of polymorphisms on TBI outcome has the potential to contribute to an understanding of variations in TBI outcome, aid in the triaging and treatment of TBI patients, and ultimately lead to targeted interventions based on genetic profiles.

The care of children and young people is an important part of the role of the GP. As well as promoting the health of children and young people during contacts, GPs may refer children and their families to other health professionals for targeted interventions. Over the past few years, there has been considerable research concerned with the health of children and young people and policy drivers emphasizing a multi-agency approach. Most recently, the government has introduced ‘The Healthy Child Programme 0–19 years' (HCP) which provides further guidance on the commissioning of children's services. This article sets out to provide a greater understanding of the HCP (5–19 years) and the role of the school nurse within the school health team. This insight will assist GPs in understanding how best to support the unique needs of children and young people and the families who care for them as required in the GP curriculum.

Bullying and victimization rates among 90 gifted and nongifted, high-achieving (HA) high school students were assessed by using the Reynolds Bully Victimization Scale (BVS; W. M. Reynolds, 2003). The mean scores indicate that gifted and HA high school students bully others and are victimized by others generally at unelevated rates based on BVS scores. Rates of bullying and victimization found among gifted and HA high school students were not significantly different from each other either. Bullying and victimization rates for male and female participants were also compared, and no significant differences were found between males and females for either bullying or victimization. Results from this study do not provide support for social interventions for gifted students as a group but suggest that gifted programs continue to focus on promoting primarily advanced intellectual endeavors (N. Colangelo, S. Assouline, & M. U. M. Gross, 2004). However, individual gifted students may need targeted interventions focused on reducing bullying and victimization.

This study examines the relation between decoding and spelling performance on tasks that represent identical specific grapho-phonemic patterns. Elementary students ( N = 206) were administered a 597 pseudoword decoding inventory representing 12 specific grapho-phonemic patterns and a 104 real-word spelling inventory representing identical grapho-phonemic patterns presented on the decoding inventory. Correlational and quantile regression analyses revealed a moderate to strong correlation between student performance in decoding and spelling tasks, with stronger relations found among more complex grapho-phonemic patterns and weaker relations found among less complex grapho-phonemic patterns. The results of this study support the utility of a spelling assessment with items representing a wide range of grapho-phonemic patterns as a screener for specific areas of grapho-phonemic knowledge weakness and provide educators with an efficient method of collecting the data needed to develop targeted interventions.

The purpose of this secondary study was to describe the mobility adaptations of community—living older adults. The primary study, designed to understand weakness and aging from the perspective of older adults, revealed that older adults viewed weakness as a progression from inability to an end point of ‘giving up,’ which prompted the use of adaptation strategies to preserve mobility and to counter a self-identity of being weak. A qualitative descriptive design guided the primary study of 15 community—living older adults, who participated in in-depth interviews. A systematic secondary analysis using Baltes and Baltes’ theory of Selective Optimization with Compensation (SOC) showed that older adults used selection, optimization, and compensation adaptations across a range of mobility behaviors. The SOC model offered a framework for profiling older adults’ agency and motivations in meeting mobility challenges as they age and provided the basis for targeted interventions to maximize mobility with aging.

This article provides an overview of current literature about workplace-related musculoskeletal disorders from a biopsychosocial perspective. The authors conclude that disability management and early intervention efforts can only be meaningful within the context of targeted interventions, including mechanisms for psychosocial screening. In addition, they suggest that return to work should be considered an integral, rather than superficial, contribution to the rehabilitative process.

Background: Identifying impairments prior to onset of physical frailty may inform targeted interventions. An objective, clinically feasible early frailty measure, termed performance-based early frailty (PBEF) was developed, and antecedent and current risk factors were examined. Method: Data were from N = 104 participants of the Fels Longitudinal Study. PBEF was derived from age-specific cut points for time to complete five chair stands and walk four meters. “Pre-PBEF” and “PBEF” were defined as impairment in one or both measures, respectively. Candidate PBEF risk factors included body composition, health and quality of life, grip strength, and biomarker measures. Results: Pre-PBEF was identified in 26% and 30% of midlife and older adults, and PBEF was identified in 11% and 14% of midlife and older adults, respectively. When predicting midlife PBEF, only current physical activity was significant (odds ratio [OR] = 0.18). In older adults, PBEF status was predicted by previous heavier drinking (OR = 3.09), previous better grip strength (OR = 0.92), current poorer sleep habits (OR = 1.19), and current higher C-reactive protein concentrations (OR = 1.20). Conclusion: Differing age group patterns of predictors emerged, suggesting that PBEF in midlife is likely a state influenced by current health status, whereas older age PBEF is influenced by both current and antecedent factors.

Because of changes in demography and the emphasis on diversity programming, organizational leaders need to understand how employees' empathy toward diverse groups affects diversity program perceptions. This study examines whether individual ethnic/cultural empathy toward diverse groups relates to intentions to attend and interest in diversity initiatives. The sample consisted of 294 college students at a moderate sized Midwestern University. There were moderate significant relationships found. Women and those higher in ethnic/cultural empathy reported higher behavioral intentions to attend and positive perceptions of diversity programs. Managers and human resource personnel could use these findings to assess the diversity climate of their organization allowing for better targeted interventions based on current workforce attitudes and levels of cultural empathy.

Targeted interventions (also called Tier 2 interventions or secondary interventions) are implemented within a comprehensive three-tiered system of support consisting of universal interventions (for all students), targeted interventions (for students exhibiting mild behavioral difficulties), and intensive interventions (for students requiring individualized support). Check-in/check-out is a targeted intervention designed to reduce incidences of disruptive behavior and increase prosocial behavior. Although check-in/check-out has been shown to be effective in a number of published articles, studies are still needed documenting (a) the utility of this intervention when implemented by educators as part of the larger school system of support and (b) guidelines for increasing the likelihood the intervention is matched to students most likely to benefit. In the current study, the authors address both of these needs by evaluating effects of a school's implementation of check-in/check-out with two typically developing students in the school. When the intervention did not produce significant effects, the authors modified the intervention slightly based on outcomes of functional behavior assessments conducted prior to beginning the intervention; this resulted in positive outcomes for both students. These results demonstrate the utility of considering the function of problem behavior prior to implementing a targeted intervention such as check-in/check-out. Implications for other targeted interventions are discussed.

This article describes the implementation and evaluation of a pilot mentoring program that provided support for Latino college freshmen at risk for poor academic outcomes. Latino is a term used in the United States to identify persons of Spanish-speaking origin or descent who designate themselves as Mexican American, Chicano, Puerto Rican, Cuban, or of some other Hispanic Origin. The study illustrates specific ways in which a mentoring program can promote positive academic outcomes by targeting students at high psychosocial risk.

Behavior support in schools is increasingly viewed as a three-tier prevention effort in which universal interventions are used for primary prevention, targeted interventions are used for secondary prevention, and intensive interventions are used for tertiary prevention. A growing body of research has demonstrated the effectiveness of targeted interventions in decreasing the frequency of problem behaviors. The Check In—Check Out Program (CICO) is becoming a recognized targeted intervention. The present study examines if there is a functional relation between the implementation of CICO and a reduction in problem behaviors. Results indicate that implementation of CICO with four elementary school—age boys was functionally related to a reduction in problem behavior. Clinical and conceptual implications of these results, methodological limitations, and future research directions are reviewed.

This study evaluated the effect of claustrophobia, an abnormal dread or fear of closed spaces, on adherence to continuous positive airway pressure (CPAP) therapy. The design was a secondary analysis of data from a prospective study of participants (N = 153) that completed 3 months of CPAP therapy from seven sleep disorders centers in the United States and Canada. A 15-item subscale adapted from the Fear and Avoidance Scale measured claustrophobic tendencies pre-CPAP treatment and again after 3 months. An overt monitor attached to the CPAP machines recorded mask-on CPAP adherence. There was a statistically significant difference in claustrophobia scores by adherence group (< 2 hours, 2 to < 5 hours, ≥ 5 hours) and time period (pre-CPAP and after 3 months CPAP). Poor CPAP adherence (< 2 hours per night)was more than two times higher in participants with a claustrophobia score ≥ 25. Identification of persons with increased claustrophobia tendencies and targeted interventions may increase adherence.

Confronted by increasing incidents of violent behavior in schools, educators are being asked to make schools safer. Schools, however, receive little guidance or assistance in their attempts to establish and sustain proactive discipline systems. One area of need lies in directions for use of existing discipline information to improve school-wide behavior support. In this article, we describe how office discipline referrals might be used as an information source to provide an indicator of the status of school-wide discipline and to improve the precision with which schools manage, monitor, and modify their universal interventions for all students and their targeted interventions for students who exhibit the most severe problem behaviors.

Just a few years ago, the mechanisms underlying the metabolic alterations associated with infection and inflammation were rather mysterious. Then, a series of startling discoveries suggested that these pathways would soon be unraveled with a clarity that might permit targeted interventions. This was based on extensive information derived from the in vitro study of certain peptide mediators released during infection and inflammation, particularly interleukin (IL)-l and tumor necrosis factor, and more limited in vivo investigations in certain animals concerning their effects on host metabolism. These data are reviewed in the paper by Bistrian and colleagues in this symposium.While the view that these two cytokines are the signals to reorganize metabolic priorities during infection and inflammation remains the most likely mechanism for these events, more recent studies have identified many more mediators with overlapping properties and both up- and down-regulatory controls. In addition, it has been found tha...