Intensity Dimensions Research Articles

Physician Work Intensity Among Medical Specialties

Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment. To determine the magnitude and important dimensions of physician work intensity for 4 specialties. Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room. A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia. Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire. Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P < 0.001), and significantly lower intensity on the performance dimensions of the NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008). Level of physician work intensity seems to be similar among specialties.

The response of social anxiety disorder patients to threat scenarios differs from that of healthy controls

The objective of the present study was to evaluate the response of social anxiety disorder (SAD) patients to threat scenarios. First-choice responses to 12 scenarios describing conspecific threatening situations and mean scores of defensive direction and defensive intensity dimensions were compared between 87 SAD patients free of medication and 87 matched healthy controls (HC). A significant gender difference in the first-choice responses was identified for seven scenarios among HCs but only for two scenarios among SAD patients. A significantly higher proportion of SAD patients chose "freezing" in response to "Bush" and "Noise" scenarios, whereas the most frequent response by HCs to these scenarios was "check out". SAD males chose "run away" and "yell" more often than healthy men in response to the scenarios "Park" and "Elevator", respectively. There was a positive correlation between the severity of symptoms and both defensive direction and defensive intensity dimensions. Factorial analysis confirmed the gradient of defensive reactions derived from animal studies. SAD patients chose more urgent defensive responses to threat scenarios, seeming to perceive them as more dangerous than HCs and tending to move away from the source of threat. This is consistent with the hypothesis that the physiopathology of anxiety disorders involves brain structures responsible for defensive behaviors.

Environmental Factors, Managerial Processes, and Information Technology Investment Strategies

Although significant research attention has been directed at understanding the value of information technology (IT) investments for firms, very little attention has been paid to understand the IT investment behavior of firms. This article seeks to fill this void. We introduce the concept of IT investment strategy, defined by dimensions of intensity and proactiveness, to characterize the IT investment behavior of firms. Synthesizing the environmental deterministic and strategic choice perspectives of a firm's strategic decision making, we examine the effects of environmental factors, managerial processes, and the interplay between them on IT investment strategy. Specifically, we examine the impact of environmental factors such as industry clockspeed and information intensity on IT investment strategy. We also incorporate the strategic choice perspective to argue that managerial processes such as frequent chief executive officer—chief information officer communications and collective information systems planning play a critical role in shaping the firm's IT investment strategy. The empirical results show that the environmental variables are related to IT investment strategy. Besides, managerial processes serve as a means to understand the environment and thus moderate the relationships between the environmental variables and the various facets of IT investment strategy. The conceptualization of IT investment strategy and the focus on both environmental determinism and strategic choice should enrich our understanding of firms’ IT investing behavior.

The quality and variety of exports from the new EU member states

The goal of this article is to evaluate the variety and quality of exports from the new EU member states (NMSs) in the period 1999–2009. The practical relevance of such an analysis is threefold: recent studies underline the importance of export variety for economic growth; empirical results show that export variety was influenced by the EU membership; and looking separately at export quality permits a better understanding of price competitiveness. Our results show that all NMSs significantly increased the average number of brands exported to the EU market, the largest increases being observed in 2004 and after. This indicates that integration into the EU market occurs in the extensive as well as the intensive dimension. We also find that all NMSs increased the average quality of their exports during the decade studied although there are differences between countries. Thus, a large part of the increase in the prices of exports from NMSs resulted from improving quality and did not result in a loss of competitiveness. Finally, estimates of relative quality are much more stable than relative prices, suggesting that our measure of relative quality is better than the traditional proxy.

Differential predictability of four dimensions of affect intensity

Individual differences in affect intensity are typically assessed with the Affect Intensity Measure (AIM). Previous factor analyses suggest that the AIM is comprised of four weakly correlated factors: Positive Affectivity, Negative Reactivity, Negative Intensity and Positive Intensity or Serenity. However, little data exist to show whether its four factors relate to other measures differently enough to preclude use of the total scale score. The present study replicated the four-factor solution and found that subscales derived from the four factors correlated differently with criterion variables that assess personality domains, affective dispositions, and cognitive patterns that are associated with emotional reactions. The results show that use of the total AIM score can obscure relationships between specific features of affect intensity and other variables and suggest that researchers should examine the individual AIM subscales.

A Comparison of New Service versus New Product Development: Configurations of Collaborative Intensity as Predictors of Performance

Collaboration among firms for innovation has received considerable attention. However, little is known about how firm-to-firm collaboration is configured in new service development (NSD) versus new product development (NPD). This study takes a multidimensional approach and measures firm-to-firm collaboration on different intensity dimensions of (1) processes (mutual communication, joint engagement, sharing responsibilities) and (2) ownership (relationship commitment and mutual trust). By showing that the phenomenon of collaboration is multifaceted, this study is able to knit a more comprehensive and cohesive understanding of the differences between NSD and NPD success as the result of different patterns of collaboration. Specifically, it utilizes survey data collected from 194 alliances to substantiate how NSD and NPD differ on these collaborative dimensions and then explores their impact on NSD versus NPD performance. The findings suggest that collaboration between firms in NSD is configured and works differently than collaboration between firms in NPD. The results further show that there is a stronger, positive relationship of intensity levels of joint engagement among firms involved in product development and performance than when a new service is developed. However, the intensity of mutual trust has a stronger, positive relationship with development performance when a new service is developed than when a new product is developed. Implications are discussed, and suggestions for future research are given.

Does intensity matter? Preschoolers’ print knowledge development within a classroom-based intervention

Abstract The present study examined the extent to which two dimensions of intervention intensity, ( dose frequency and dose ) of a 30-week print-referencing intervention related to the print knowledge development of 367 randomly selected children from 55 preschool classrooms. Dose frequency refers to the number of intervention sessions implemented per week; teachers were randomly assigned to either the high-dose frequency condition (four intervention sessions per week) or the low-dose frequency condition (two intervention sessions per week). Dose refers to number of print-referencing teaching strategies used per intervention session and was a naturally varying variable across classrooms. Structural models of children's spring print knowledge showed a significant interaction of dose and dose frequency in relation to children's outcomes. Follow-up analyses showed that the benefit of providing four versus two print-referencing sessions per week disappeared when teachers were providing a relatively intense number teaching strategies within sessions (i.e., the dose was high). Considered differently, findings also show that increasing the number of print referencing teaching strategies within a session (i.e., the dose) related positively to children's print knowledge development, but only when the weekly number of intervention sessions were low (i.e., two intervention sessions weekly). Overall, findings show that there is a benefit to increasing the dose or dose frequency of the print referencing intervention, but increasing both aspects of intervention intensity appeared to have a diminishing benefit to children's learning. Findings empirically support the multi-dimensional nature of intervention intensity and implications for research and practice are discussed.

Recall agreement between actual and retrospective reports of competitive anxiety: A comparison of intensity and frequency dimensions

Using a mixed-method design, we compared athletes' abilities to recall intensity and frequency of competitive anxiety. In Phase 1, performers (n = 35) completed the Competitive State Anxiety Inventory-2 (Martens, Burton, Vealey, Bump, & Smith, 1990) at four pre-competition and four post-competition intervals to compare actual and recalled responses. In Phase 2, follow up interviews (n = 6) explored the perceived mechanisms underpinning the quantitative results. Limits of agreement (Bland & Altman, 1999) analysis on the quantitative data indicated that, compared with intensity, memory for frequency was generally more reliable, and recall ability of this dimension was less biased for symptoms that occurred earlier in the week. Inductive analysis of the qualitative interviews suggested athletes were more attuned to the frequency rather than the intensity of their competitive anxiety symptoms. These findings provide support for the notion that the frequency of symptoms may act as a precursor for increasing anxiety levels and this dimension may be a more accurate reflection of experienced symptoms when recalling emotional accounts. The implications are that researchers and practitioners need to consider frequency in addition to intensity when seeking to manage anxiety responses during the time preceding competition.

“My co-wife can borrow my mobile phone!”

A unique census of cell phones in a Western Kenyan village reveals gendered dimensions of access, intensity and breadth of cell phone usage related to contemporary long-distance households and livelihoods. Women bound to marital homesteads far from their birthplace praise the freedom to communicate with family across the country; a housewife uses scarce resources to send ‘greetings’ and ensure peace of mind. Women link with community groups and distant menfolk, spanning rural/urban spaces to manage their increasingly busy and insecure lives. Older women blend these new technologies into traditional agrarian livelihoods and community activities; younger women are eager to navigate into the twenty-first century and away from farms. For cash-strapped rural housewives, their frugal, ingenious, yet constrained uses of “mobile” (stationary) cell phones help them achieve many freedoms. Findings from this village census of cell phones add to a growing body of nuanced research on the social shaping of cell phones and their uses for human development. Research reveals the intersections of adaptive uses with contemporary gendered patterns of poverty, inequality, and deagrarianization. They serve simultaneously as potentially transformative and emancipatory as well as divisive forces in sub-Saharan Africa.

Short-latency sensory afferent inhibition: conditioning stimulus intensity, recording site, and effects of 1 Hz repetitive TMS

The transcranial magnetic stimulation (TMS) paradigm short-latency sensory afferent inhibition (SAI) investigates sensori-motor integration. Conventionally, one stimulation intensity is used for the conditioning pulse to the peripheral nerve. To examine the variability, the dimension of stimulus intensity, and recording site in SAI. In 17 healthy individuals three peripheral nerve stimulation intensities were used: Just above sensory threshold, just above motor threshold, and in between. Motor evoked potentials (MEPs) and long-loop reflexes were recorded from first dorsal interosseus (FDI) and abductor pollicis brevis (APB) before and after repetitive motor cortex TMS (1 Hz, 1800 stimuli at 95% resting motor threshold). Between-subjects variability of SAI was higher than variability between sessions. Median, or ulnar, nerve stimulation decreased MEP size in FDI and APB at interstimulus intervals of N20, N20+2, and N20+4. Only with median nerve stimulation MEP size increased in APB, but not FDI, at N20+8 to N20+16. These effects increased with increasing stimulation intensity. RTMS reduced MEP size but had no effect on SAI, or transcortical reflexes. Effects on MEP size in SAI depend on stimulus intensity and are not limited to anatomically homotopic muscles. Inhibitory rTMS modulates motor output but not the interaction of sensory inputs with the motor cortex.

Invited commentary

Invited commentary

A FIGURA DE JESUS CRISTO NO DISCURSO DA MÍDIA CONTEMPORÂNEA

A figura de Jesus Cristo foi representada de formas variadas no decorrer da história, e essas representações heterogêneas estão relacionadas aos valores das culturas produtoras dos discursos. A sintaxe discursiva que estrutura essas representações é um encadeamento de atos que conjuga a dimensão da intensidade (o sensível, o afetivo) e a dimensão da extensidade (o inteligível, o compreensível). A semiótica discursiva possibilita, por meio de análises, entender a ocorrência das transformações culturais nos discursos produzidos em períodos históricos diferentes e em culturas distintas.

NEW LIGHTS ON THE ROBBINSIAN THEORY OF WORK SUPPLY

We assess the actual relevance of Robbins' paper ‘On the elasticity of Demand for Income in terms of Effort’ to the theory of work supply. First, we show that the paper is the first application of income and substitution effects to this branch of economic research. Next, we analyse Robbins' economic terminology, especially his definition of work. We find that the concept of work he uses could seem vague as he may be considering both the length and intensity dimensions of this activity. To verify this possibility, we formally reassess Robbins' original proposal by introducing this wider definition of work into the mathematical framework he proposes. The resulting model shows that this reading (i) is compatible with his diagrammatic analysis; (ii) clarifies the meaning of the other vague economic concepts the author uses; and (iii) illuminates his verbal explanations. Additionally, we derive all the relevant results of both the income-leisure and the more recent effort-extraction models from this Robbinsian model of work supply. This last outcome allows us to state that Robbins' model comprises current theories of work supply.

Cross-cultural validation and psychometric evaluation of the Dutch language version of the Children’s Assessment of Participation and Enjoyment (CAPE) in children with and without physical disabilities

Objective: To assess construct validity, test—retest reliability and inter-interviewer reliability of the intensity dimension of the Children’s Assessment of Participation and Enjoyment (CAPE) for children with and without physical disabilities in the Netherlands. Subjects: In total, 232 children aged 6—18 years (110 male, 122 female) participated. Seventy-four children with various physical disabilities and 158 without a disability. Design: Participants completed the CAPE and the Peabody Picture Vocabulary Test. In addition, parents of 142 children were interviewed using the Vineland Adaptive Behavior Scales and the Family Environment Scale. For 71 children test— retest reliability and for 60 children inter-interviewer reliability were assessed. Validity was examined by assessing differences in participation intensity in children with disabilities versus without a physical disability, boys versus girls, and younger versus older children. In addition, 13 hypotheses regarding participation, child and family variables were examined. Results: Validity of the CAPE was supported by significant differences in participation for subgroups. Participation differed significantly in children with and without disabilities. Girls participated more in all activities. Older children participated more in social activities and self-improvement activities, younger children participated more in recreational activities. Validity of the CAPE was further supported with significant correlation coefficients in 8 out of 13 hypotheses. Both test—retest and inter-interviewer reliability were good to excellent. Conclusions: The findings indicate that the Dutch language version of the CAPE is a reliable and valid instrument to measure participation in recreation and leisure activities for children with and without physical disabilities aged 6—18 years.

Olfactory fMRI in Patients with Parkinson's Disease

Hyposmia is one of the early signs in idiopathic Parkinson's disease (PD). Olfactory stimuli were applied during fMRI scanning to show disease-related modulation of central nervous system structures and to advance our understanding of olfactory dysfunction in PD patients. All participants received either unpleasant stimuli that smelled like rotten eggs or pleasant ones that smelled like roses. Using a block design at a 1.5 T scanner we investigated a total of 8 PD patients (mean age 60 ± 10.9 years) and 13 age matched controls (mean age 58 ± 9.6 years). PD duration ranged from 1 to 9 years (mean 6.63 years); patients had an average “Unified Parkinson's Disease Rating Scale III” score of 23.25 (range, 6–46). Olfactory function was established using the “Sniffin’ Sticks” test battery. Patients tended to rate the stimuli presented during fMRI scans as less intense, but also as more pleasant than controls. fMRI results revealed differences between PD patients and controls which depended on the type of stimulation. While both pleasant and unpleasant stimulation was associated with lower activation in the amygdalo–hippocampal complex in patients compared to controls, increased activity in response to pleasant stimuli was observed in the striatum and the left inferior frontal gyrus. In contrast, unpleasant stimulation led to hypoactivation of the ventral striatum in patients (but not in controls) and did not enhance left inferior frontal activity. These results may partly reflect differences between PD patients and healthy controls in the processing of primary dimensions of odors, intensity, and valence.

Exploring definitions of food insecurity and vulnerability: time to refocus assessments

Recent high food prices and changes in the world food situation are exacerbating the conditions of households that are vulnerable to food insecurity, especially those with weak livelihood strategies. To address the impact of these and other stressors it is necessary to develop a deeper understanding of concepts such as ‘vulnerability’ and ‘food insecurity’. This is challenging as both concepts are used rather loosely in the food security despite both having at least two dimensions. Vulnerability has an external and internal dimension, and food insecurity has a temporal and intensity dimension. However, assessments are often only concerned with one dimension at a time. An exploration of the two concepts suggests that in both cases the dimensions need to be combined in order to understand the different interactions and the interconnections between different dimensions and the multiple levels of the systems in which they are embedded. This combination of dimensions is important for understanding the significant role that livelihoods play in the accumulation of assets and for accessing food. It makes the understanding of the multiple causes and consequences of vulnerability and food insecurity for different households clearer. Those households and individuals considered chronically poor or food-insecure are likely to experience severe food insecurity in the long-term, as a result of their weak livelihoods and minimal assets. Consequently, future studies on vulnerability to food insecurity should focus on these chronically food insecure households in order to determine the multidimensional nature of the stressors they experience and their ability to cope and adapt to these stressors. This would contribute to our understanding of the contexts in which the data from larger quantitative studies are embedded.

Distraction as a measure of presence: using visual and tactile adjustable distraction as a measure to determine immersive presence of content in mediated environments

To assess and improve the user experience in entertainment products, developers need results of evaluation methods, which in detail measure the relationship between the mediated content and the resulting media experience. This paper proposes a method applying adjustable distraction (AD) to determine presence as immersion (Lombard and Ditton in At the heart of it all: the concept of presence, Department of Broadcasting, Telecommunications and Mass Media, Temple University, 1997) at selectable events (approximated real-time). Two experiments were conducted to investigate its applicability in computer games and movies with respectively visual and tactile AD. The first experiment examined whether the experienced intensity in a survival-shooter game, measured through questionnaires, was proportional to results from the AD method. The intrusiveness of the AD method was also addressed in the experiment by comparing the immersive presence ratings in a between-groups design. The second experiment investigated whether heart rate measurements, intensity ratings and the results of the AD method with vibration as the distraction signal were proportional when test participants watched a movie clip. The outcome of the first experiment indicated that no significant intrusion is caused by the method. In addition, results showed no proportionality between the AD method and intensity ratings. However, as the AD measurements were supported by flow theory, it might be that the results from the AD method using visual distraction are giving a more comprehensive indication of presence as immersion (rather than just the intensity dimension). The second experiment revealed proportionality between the intensity ratings and the heart rate measurements, while the results from the tactile AD method were not proportional. We suspect that this was caused by the great variance found across the test participants’ thresholds of perceivable vibration. Because of this, it is suggested that a thorough screening process is conducted pre-test if the AD method should apply vibration as the distracting stimulus.

Breadth and intensity: Salient, separable, and developmentally significant dimensions of structured youth activity involvement

In recent years, an impressive volume of evidence has accumulated demonstrating that youth involvement in structured, organized activities (e.g. school sports, community clubs) may facilitate positive youth development. We present a theory-based framework for studying structured activity involvement (SAI) as a context for positive youth development based on two key dimensions: breadth and intensity of involvement. Our main goal is to demonstrate the separability, salience, and developmental significance of these two dimensions. We review three developmental theoretical approaches (identity development, life-span selection-optimization-compensation theory, and affordances) that support our conceptualization of breadth and intensity as salient and significant dimensions of SAI. We also summarize our recent program of research on SAI demonstrating the separability of breadth and intensity dimensions, which shows links between these dimensions and indicators of positive development. Finally, we discuss how the proposed breadth-intensity approach could be used to extend research on the linkage between youth SAI and successful development.

Magnetic resonance imaging appearances following hindquarter amputation for pelvic musculoskeletal malignancy

To describe our experience of the magnetic resonance imaging (MRI) appearances after hindquarter amputation, focusing on the normal pattern of time-related changes in signal intensity within the amputation flap and appearances of local disease recurrence. This was a retrospective review of the records of patients identified on our orthopaedic oncology database who had undergone hindquarter amputation at our centre. Examinations were divided into one group consisting of 'normal' postoperative findings and another group demonstrating local recurrence. 'Normal' postoperative findings were assessed for signal intensity, morphology and presence of the 'muscle texture sign' within the amputation flap. Examinations were grouped according to time from surgery. Examinations demonstrating local recurrence were assessed for site, signal intensity, morphology and axial dimensions of recurrent tumour. Comparison was made to pre-operative imaging. Thirty-five patients with postoperative MR images were identified. Seventy-seven examinations were reviewed (range 1-18 per patient). The 'normal group' comprised 18 patients (seven female, 11 male, mean age 44 years, range 16-75 years), with 47 examinations reviewed. The 'muscle texture sign' was preserved in all examinations in this group. Up to 6 months after surgery, 100% (10) of examinations showed hyperintense T2- and short-tau inversion recovery (STIR-weighted) signals within the muscle flap, indicating oedema. Only after 4 years was the muscle flap signal isointense in all cases (13). Up to 6 months after surgery, 50% (5 of 10) of examinations demonstrated flap swelling, but after 1 year, 100% (28) showed atrophy. Twenty percent (2 of 10) of examinations 0-6 months from surgery showed hyperintense T1-weighted signal within the muscle flap, consistent with fatty infiltration, but after 2 years, 100% (20) showed a hyperintense T1-weighted signal. The 'local recurrence' group comprised 20 patients (six female, 14 male, mean age 45.7 years, range 14-69 years), with 30 examinations demonstrating recurrent disease or metastasis. There were 23 recurrent tumours, of which 43% (10) were in the muscle component of the amputation flap, 13% (3 of 23) were in subcutaneous tissues of the flap, 13% (3 of 23) were at the posterior margin of the bone resection and 13% (3 of 23) were paraspinal. All recurrent tumours demonstrated hyperintense T2 and STIR signals. The signal intensity pattern of recurrence closely followed that of the original tumour. The 'muscle texture sign' was absent in all examinations demonstrating recurrence in muscle flap. A pattern of time-related signal intensity and morphological changes is observed within normal hindquarter amputation flaps on MRI. Recurrent disease is most likely to occur within the muscle flap, typically of high T2-weighted signal intensity and characteristically follows the signal pattern of the original tumour.

The effect of moral intensity on ethical decision making in accounting

The purpose of this study was to examine the dimensionality of a moral intensity construct in four ethical accounting scenarios and how the dimensions directly affect the specific processes of moral decision making of accounting students. A survey was conducted with 233 accounting students enrolled in the school of accounting in a university of mainland China. Results indicated that the dimensions of moral intensity were significantly related to moral recognition, moral judgement and moral intention in relation to moral issues. The mediational analyses revealed that moral judgement partly mediated the relation between moral recognition and moral intention and implied that the effect of moral recognition on moral intention was significantly reduced by a combination of moral recognition and moral judgement.