Request Behavior Research Articles

Analysis of necropsy request behaviour of clinicians.

To develop a necropsy related audit system to record accurate information in relation to necropsy requests, necropsy rates and coronial referrals. A simple audit form was used to record detailed necropsy related data via an integrated questionnaire design and data entry system based on available optical image scanning technology. The system recorded the numbers and locations of deaths, referrals to the coroner, clinical necropsy requests, hospital and medicolegal necropsies, the grade of clinician involved in these processes, and the identity of the consultant in charge of the case. The overall, hospital and medicolegal necropsy rates were calculated by individual consultant, specialty and for the whole hospital. Necropsy request rates and coronial referral rates were also calculated and these data were related to the grade of clinician. All data were available on a monthly or an accumulative basis. Of 1398 deaths, 534 (38%) were discussed with the local coroner's office and 167 of these were accepted for further investigation. House officers and senior house officers referred over 80% of all cases, whereas consultants referred only 2%. There were no significant differences in case acceptance rates by grade of clinician. Clinicians made 307 hospital necropsy requests (overall hospital necropsy request rate 22%). House officers made 65% of all necropsy requests. Consultant necropsy requests represented 13% of all requests. There were no significant differences in necropsy request success rates by grade of clinician. The referral of cases to coroners and clinical necropsy requests are still being inappropriately delegated to the most junior clinicians. This study illustrates the type of useful information which can be produced for individual clinicians, specialty audit groups and pathology departments using a simple necropsy related audit system.

A comparative performance analysis of a multidisk system under head-of-the-line and alternating priority disciplines

A multidisk system, evaluated as an M /G /1 queueing model, is analyzed for two different priority disciplines —alternating priority and head of the line. Different measures of system effectiveness, namely, mean response time, mean queue length, and mean delay time, have been obtained for requests (jobs) from two different classes—priority and ordinary. The mean busy period and the squared coefficient of variation of busy periods of a disk in the multidisk system have also been evaluated. The behavior of requests in alternating priority and head of the line is compared both analytically and numerically. These results may prove to be useful decision-making tools for system analysts and computer engineers, as they influence the design and waiting measures of a system.

Modifying the request behaviour of clinicians.

Modifying the request behaviour of clinicians.

Effect of feedback on test ordering behaviour of general practitioners.

To assess the effect of feedback on the test ordering behaviour of general practitioners. Comparison of requests at two diagnostic centres, and internal comparison between tests which were discussed in feedback and tests which were not. A diagnostic centre in Maastricht giving feedback and another elsewhere in the Netherlands (laboratory A) not giving feedback. All 85 general practitioners in the region of Maastricht, and all general practitioners in the region of laboratory A. Numbers of tests requested by general practitioners. Requests at the Maastricht diagnostic centre decreased soon after the onset of feedback whereas there was a persistent increase in requests at laboratory A. Tests that were discussed showed the strongest decrease (maximum 40%), though tests that were not discussed decreased as well (maximum 27%). Feedback on diagnostic requests may exert a strong influence on request behaviour. Four years after the onset of feedback the effects were still noticeable.

Modifying the request behaviour of clinicians.

To evaluate whether the feedback of laboratory use and cost data to clinicians modifies their request behaviour. Over two years the effect of monthly feedback of clinical chemistry test use and revenue expenditure to three consultant physicians on their clinical chemistry and haematology requesting patterns was evaluated. Two physicians who received no information served as controls. Feedback over one year led to an immediate and sustained decrease of 15%, 27%, and 21% in clinical chemistry requests (p less than 0.01), tests (p less than 0.001), and revenue expenditure (p less than 0.001), respectively, and a 10% reduction in haematology tests (p less than 0.05) per outpatient visit. These changes persisted in the six months after the feedback was stopped. These results suggest that feedback of laboratory data to clinicians modifies their request behaviour and that supplying clinicians with information on what they do can influence the way they make decisions.

Measured response times for page-sized fetches on a network

Previous work has examined the response times associated with disk accesses and the response time associated with various memory access operations. Here, we discuss the response time behavior of access requests for pagesized objects which are made using a network connection. We feel that future architectures must include networked resources as a component of the storage hierarchy; such performance measurements will help architects place these resources intelligently.

THE CONTROL OF STARVATION

A generalized discussion of the anomaly of starvation is presented. Starvation is defined to be an infinite or unbounded delay, and classified in terms of its cause and the methods used for its control. A model and a set of control mechanisms are developed. The model, appropriate for various buffered and unbuffered resource systems, allows an ordering of requests by time and by stages of their lifetimes. We investigate the behavior and control of requests during starvation and during various anomalies of conflict.

Does the format really make a difference? Didactic versus facilitative social skills training

One hundred and eleven (111) university undergraduates (25% male) reporting difficulties in making requests or refusing, participated in one of two cognitive behavioral social skills programs which included behavior rehearsal, modeling, coaching, cognitive restructuring, and emphasis on the transferability of skills. The participants were randomly assigned to the facilitative condition, which stressed individualized attention, informality, and emotional understanding and support, with attention to the personal needs of each participant, or to the didactic condition, which was more leader-centered, more formal, and less focused on personalizing the content. Dependent measures included self-reported Conflict Resolution and College Self Expression scores, and judges’ ratings of global verbal and nonverbal request and refusal behavior in standardized role-play scenarios with a live actor. In addition, participants provided anin vivo measure of request and refusal behavior. Results indicated neither self-report nor behavioral outcome differences between the facilitative and didactic approaches. On the other hand both programs produced impressive self-report and behavioral gains in comparison to pre-test scores; these gains were maintained one/two years after the program. The results are discussed as supporting the impact of cognitive behavioral training program elements which are compelling in themselves so that they operate independently of differences in training format. It may be that relationship factors may be less important in the treatment of reasonably functioning undergraduates when behavioral techniques are employed.

Assertion training outcome and generalization effects under didactic vs. facilitative training conditions.

One hundred and eleven college undergraduates (25% male) participated in one of two cognitive behavioral training programs, which included behavior rehearsal, modelling, coaching, cognitive-restructuring, and emphasis on the transferability of skills. Neither self-report nor behavioral outcome differences between the facilitative vs. the didactic approaches were noted. Both programs produced impressive self-report and behavioral gains in comparison to pretest scores; these gains were maintained 1 to 2 years after the program. There was also evidence of verbal and nonverbal bilateral transfer between request behavior and refusal behavior in the short term. The generalization results were interpreted on the basis that the distinctive components of request behavior (such as enunicating a statement of a problem and a specific request) are more difficult than those of refusal behavior, such than there is transfer of request training to refusal behavior, but not vice versa. Request behavior involves the mobilization and personal initiation of a complex interaction with another person rather than the more reactive non-compliance with the initiative of another, as is the case in refusal behavior.

Coping strategies of counselors and school-age mothers.

The direct and indirect coping styles of 61 school-age mothers and 28 counselors working with school-age mothers were examined in this study. Subjects rated the helpfulness of 6 coping strategies (asseerting oneself negotiating demanding avoiding the situation changing the meaning and calming) for each of 18 vignettes representing 4 types of stressful situations: criticism from others offensive behavior of others requests by others and personal upset. Analysis revealed school-age mothers preferred indirect coping methods strategies that are highly associated with distress. Counselors perceived the direct coping strategies of assertion negotiation and demanding as more helpful. Differneces in choice of coping strategy occurred within types of situation and between counselors and high distress adolescents. More than counselors school-age mothers recommend dealing with situations involving criticism by avoidance strategies and by demanding change in the critics behavior. Counselors prefer keeping calm negotiating and asserting oneself. Changing the meaning of the event was not highly preferred by either group. 13-21 year old mothers preferred dealing with a stressful situation due to offensive behavior by changing the meaning of the event and demanding an end to the offensive behavior. Again counselors preferred negotiation and assertion. Findings indicate that counselors must make careful assessments to determine the coping strategies appropriate for each client group. Racial preferences for coping strategies contribute to differences between counselors and adolescent mothers demonstrating the need for careful consideration of cultural contributors to coping choice. The distress ameliorating function of coping strategies across situations and cultures calls for further investigation. Determining which skills are possessed by members of different cultures as well as which skills are functional by culture are important tasks for future research.

Development of a Headlamp Dimming Request Prediction Model

This paper presents results of field studies conducted to predict headlamp beam usage and drivers' dimming request responses as a function of glare headlamp photometry, road background brightness and topography. An instrumented vehicle equipped with a variable intensity headlighting system was driven on two-lane public roads. Dimming distances were computed from separation time and closing rate measured by a radar. A long exposure photograph of each opposing vehicle was taken to determine the trajectory of the driver's eye point through the test car's beam pattern. Subsequent analysis of the film yielded an accurate time history of the glare illumination experienced by opposing drivers. The results show that the driver's dimming request behavior is dependent upon the level of discomfort glare experienced by the driver when the approaching vehicle first appears in his view and the potential glare exposure, i.e., the time-distance during which the glare could be experienced by the driver. On the basis of these results a model to predict when the driver would signal a dimming request to an opposing vehicle is proposed.

Rules, Social Interaction, and Language Behavior

Social rules are manifested in different social groups in a diversity of ways. Important universals, however, make behavior in such social relationships predictable and interpretable in all societies, that is, social interaction is rule-governed. The rules of request behavior, and variables constraining those rules, exemplify an analysis of social behavior. A universal grammar of social interaction is postulated, with current work in anthropology, sociology, and ethnography providing the data for the development of such a grammar. This grammar would account for the interactional universals for all societies and interactional rules for individual societies in a fairly precise analog to linguists' rules for languages. If one accepts the proposition that teaching and learning-as types of social behavior-are governed by systems of rules and that these rules differ for different social groups, and that we do not at present know what the systems of rules are, then one must also tentatively accept the hypothesis that one of the reasons for pedagogic failure lies in the fact that we are continually putting children in situations where they are being asked to violate one set of rules in order to fulfill the demands of another.

Hormones and Blood Chemistry

LAST year we had a unique opportunity to study the reprint request behaviour of scientists, as we published two papers almost simultaneously dealing with biochemical changes in human blood induced by synthetic steroid hormones. The first paper appeared in Nature as a single-page letter1, while the second was a six-page contribution to a specialist journal2. For one year we have collected and analysed reprint requests for these papers.