An Exploration of Self-Reported Training Needs for Anxiety Interventions Among Primary Care Behavioral Health Consultants

Introduction: Despite the need for greater training in evidence-based interventions for the treatment of anxiety in primary care behavioral health (PCBH), there are limited data on which interventions are desired by behavioral healthcare consultants (BHCs). The objective of this study was to identify which interventions BHCs desired more training in when treating anxiety in PCBH practice, and to examine if this preference was associated with theoretical orientation. Method: We conducted an online survey of PCBH providers regarding their training preferences for treatment of anxiety symptoms. The final sample comprised 291 BHCs recruited from e-mail listservs of national professional organizations. Providers reported their primary theoretical orientation as well as the top three interventions they wanted more training in from a list of 17 interventions. Results: BHCs most frequently endorsed training needs for Acceptance and Commitment Therapy (ACT; 63%), mindfulness (43%) and exposure (31%) interventions. Results were independent of theoretical orientation. Discussion: Clear training needs emerged for ACT, mindfulness, and exposure interventions in PCBH. Based on these results, further training should be given to implement these interventions in real world settings. Novel research strategies should also focus on implementing more complex CBT interventions in real-world PCBH settings. These results suggest implications for clinical training, intervention design, and future implementation efforts

Advanced producer service firms as strategic networks, global cities as strategic places

Sassen’s identification of global cities as ‘strategic places’ is explored through world city network analysis. This involves searching out advanced producer service (APS) firms that constitute ‘strategic networks’, from whose activities strategic places can be defined. 25 out of 175 APS firms are found to be strategic and from their office networks, 45 cities out of 526 are designated as strategic places. A measure of ‘strategicness’ of cities is devised and individual findings from this are discussed by drawing on existing literature about how APS firms use specific cities. A key finding shows that New York and London have different levels of strategicness and this is related to the former’s innovation prowess and the latter’s role in global consumption of services. Other cases of strategicness discussed in terms of the balance between production and consumption of advanced producer services are: Beijing, Hong Kong and Shanghai; Palo Alto; Mexico City; Johannesburg; and Dubai and Frankfurt

Knowledge protection in firms: A conceptual framework and evidence from HP Labs

This paper proposes a simple framework to examine organizational methods of knowledge protection. The framework highlights a basic trade‐off between improving decision‐making and innovation through communication and mitigating security risks by imposing restrictions on communication flows. The trade‐off is mediated by factors such as the sensitivity of information, the degree to which employees can be trusted to handle sensitive information appropriately, and firms’ investments in legal protection mechanisms. Evidence from HP Labs supports the basic predictions of the model, in particular the importance of employee trustworthiness and internalized codes of behavior in promoting open communication. Our interviews also suggest a potential conflict between two of the most important appropriability mechanisms: secrecy and lead‐time advantage

Delegation and dynamic incentives

Using an agency model, we show how delegation, by generating additional private information, improves dynamic incentives under limited commitment. It circumvents ratchet effects and facilitates the revelation of persistent private information through two effects: a play-hardball effect, which mitigates an efficient agent’s ratchet incentive, and a carrot effect which reduces an inefficient agent’s take-the-money-and-run incentive. Although delegation entails a loss of control, it is optimal when uncertainty about operational efficiency is large. Moreover, delegation is more effective with production complementarity. We also consider different modes of commitment to yield insights into optimal organizational boundaries

Emergence of high drug resistant bacterial isolates from patients with health care associated infections at Jimma University medical center: a cross sectional study

Background: The rates of resistant microorganisms which complicate the management of healthcare associated infections (HAIs) are increasing worldwide and getting more serious in developing countries. The objective of this study was to describe microbiological features and resistance profiles of bacterial pathogens of HAIs in Jimma University Medical Center (JUMC) in Ethiopia.Methods: Institution based cross sectional study was carried out on hospitalized patients from May to September, 2016 in JUMC. Different clinical specimens were collected from patients who were suspected to hospital acquired infections. The specimens were processed to identify bacterial etiologies following standard microbiological methods. Antibacterial susceptibility was determined in vitro by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines.Results: Overall, 126 bacterial etiologies were isolated from 118 patients who had HAIs. Of these, 100 (79.4%) were gram negative and the remaining were gram positive. The most common isolates were Escherichia coli 31(24.6%), Klebsiella species 30(23.8%) and Staphylococcus aureus 26 (20.6%). Of 126 bacterial isolates, 38 (30.2%), 52 (41.3%), and 24 (19%) were multidrug-resistant (MDR, resistant to at least one agent in three or more antimicrobial categories), extensively drug resistant (XDR, resistant to at least one agent in all but two or fewer antimicrobial categories (i.e. bacterial isolates remain susceptible to only one or two categories), pan-drug resistant (PDR, resistant to all antibiotic classes) respectively. More than half of isolated gram-negative rods (51%) were positive for extended spectrum beta-lactamase (ESBL) and/or AmpC; and 25% of gram negative isolates were also resistant to carbapenem antibiotics.Conclusions: The pattern of drug resistant bacteria in patients with healthcare associated infection at JUMC is alarming. This calls for coordinated efforts from all stakeholders to prevent HAIs and drug resistance in the study setting

Business schools in crisis

Economic, political, and demographic changes, technological advances, two crashes of the economy, ethical scandals, and other developments in the business environment have strained the roles and enrollments of American universities' business schools. The b-schools have not responded adequately. Prevailing theories in many of the management disciplines have broken down, partly as a result of the same environmental changes. Again, schools and curricula have not adapted. Collegiate business education is in dire crisis. In this paper we document the crisis, note measures that have been taken - both constructive and otherwise - and make further suggestions for improving the situation