Browsing by Subject "Goals"
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Item Open Access A fast-moving target: achieving marine conservation goals under shifting climate and policies.(Ecological applications : a publication of the Ecological Society of America, 2020-01) Rilov, Gil; Fraschetti, Simonetta; Gissi, Elena; Pipitone, Carlo; Badalamenti, Fabio; Tamburello, Laura; Menini, Elisabetta; Goriup, Paul; Mazaris, Antonios D; Garrabou, Joaquim; Benedetti-Cecchi, Lisandro; Danovaro, Roberto; Loiseau, Charles; Claudet, Joachim; Katsanevakis, SteliosIn the Anthropocene, marine ecosystems are rapidly shifting to new ecological states. Achieving effective conservation of marine biodiversity has become a fast-moving target because of both global climate change and continuous shifts in marine policies. How prepared are we to deal with this crisis? We examined EU Member States Programs of Measures designed for the implementation of EU marine environmental policies, as well as recent European Marine Spatial Plans, and discovered that climate change is rarely considered operationally. Further, our analysis revealed that monitoring programs in marine protected areas are often insufficient to clearly distinguish between impacts of local and global stressors. Finally, we suggest that while the novel global Blue Growth approach may jeopardize previous marine conservation efforts, it can also provide new conservation opportunities. Adaptive management is the way forward (e.g., preserving ecosystem functions in climate change hotspots, and identifying and targeting climate refugia areas for protection) using Marine Spatial Planning as a framework for action, especially given the push for Blue Growth.Item Open Access A Multiple Goal Perspective on Eating Behavior(2016) Liu, Peggy JieAlthough people frequently pursue multiple goals simultaneously, these goals often conflict with each other. For instance, consumers may have both a healthy eating goal and a goal to have an enjoyable eating experience. In this dissertation, I focus on two sources of enjoyment in eating experiences that may conflict with healthy eating: consuming tasty food (Essay 1) and affiliating with indulging dining companions (Essay 2). In both essays, I examine solutions and strategies that decrease the conflict between healthy eating and these aspects of enjoyment in the eating experience, thereby enabling consumers to resolve such goal conflicts.
Essay 1 focuses on the well-established conflict between having healthy food and having tasty food and introduces a novel product offering (“vice-virtue bundles”) that can help consumers simultaneously address both health and taste goals. Through several experiments, I demonstrate that consumers often choose vice-virtue bundles with small proportions (¼) of vice and that they view such bundles as healthier than but equally tasty as bundles with larger vice proportions, indicating that “healthier” does not always have to equal “less tasty.”
Essay 2 focuses on a conflict between healthy eating and affiliation with indulging dining companions. The first set of experiments provides evidence of this conflict and examine why it arises (Studies 1 to 3). Based on this conflict’s origins, the second set of experiments tests strategies that consumers can use to decrease the conflict between healthy eating and affiliation with an indulging dining companion (Studies 4 and 5), such that they can make healthy food choices while still being liked by an indulging dining companion. Thus, Essay 2 broadens the existing picture of goals that conflict with the healthy eating goal and, together with Essay 1, identifies solutions to such goal conflicts.
Item Open Access Amygdala-prefrontal cortex functional connectivity during threat-induced anxiety and goal distraction.(Biol Psychiatry, 2015-02-15) Gold, Andrea L; Morey, Rajendra A; McCarthy, GregoryBACKGROUND: Anxiety produced by environmental threats can impair goal-directed processing and is associated with a range of psychiatric disorders, particularly when aversive events occur unpredictably. The prefrontal cortex (PFC) is thought to implement controls that minimize performance disruptions from threat-induced anxiety and goal distraction by modulating activity in regions involved in threat detection, such as the amygdala. The inferior frontal gyrus (IFG), orbitofrontal cortex (OFC), and ventromedial PFC (vmPFC) have been linked to the regulation of anxiety during threat exposure. We developed a paradigm to determine if threat-induced anxiety would enhance functional connectivity between the amygdala and IFG, OFC, and vmPFC. METHODS: Healthy adults performed a computer-gaming style task involving capturing prey and evading predators to optimize monetary rewards while exposed to the threat of unpredictable shock. Psychophysiological recording (n = 26) and functional magnetic resonance imaging scanning (n = 17) were collected during the task in separate cohorts. Task-specific changes in functional connectivity with the amygdala were examined using psychophysiological interaction analysis. RESULTS: Threat exposure resulted in greater arousal measured by increased skin conductance but did not influence performance (i.e., monetary losses or rewards). Greater functional connectivity between the right amygdala and bilateral IFG, OFC, vmPFC, anterior cingulate cortex, and frontopolar cortex was associated with threat exposure. CONCLUSIONS: Exposure to unpredictable threat modulates amygdala-PFC functional connectivity that may help maintain performance when experiencing anxiety induced by threat. Our paradigm is well-suited to explore the neural underpinnings of the anxiety response to unpredictable threat in patients with various anxiety disorders.Item Open Access Capacity shortfalls hinder the performance of marine protected areas globally.(Nature, 2017-03-22) Gill, David A; Mascia, Michael B; Ahmadia, Gabby N; Glew, Louise; Lester, Sarah E; Barnes, Megan; Craigie, Ian; Darling, Emily S; Free, Christopher M; Geldmann, Jonas; Holst, Susie; Jensen, Olaf P; White, Alan T; Basurto, Xavier; Coad, Lauren; Gates, Ruth D; Guannel, Greg; Mumby, Peter J; Thomas, Hannah; Whitmee, Sarah; Woodley, Stephen; Fox, Helen EMarine protected areas (MPAs) are increasingly being used globally to conserve marine resources. However, whether many MPAs are being effectively and equitably managed, and how MPA management influences substantive outcomes remain unknown. We developed a global database of management and fish population data (433 and 218 MPAs, respectively) to assess: MPA management processes; the effects of MPAs on fish populations; and relationships between management processes and ecological effects. Here we report that many MPAs failed to meet thresholds for effective and equitable management processes, with widespread shortfalls in staff and financial resources. Although 71% of MPAs positively influenced fish populations, these conservation impacts were highly variable. Staff and budget capacity were the strongest predictors of conservation impact: MPAs with adequate staff capacity had ecological effects 2.9 times greater than MPAs with inadequate capacity. Thus, continued global expansion of MPAs without adequate investment in human and financial capacity is likely to lead to sub-optimal conservation outcomes.Item Open Access Cognitive Processes in Response to Goal Failure: A Study of Ruminative Thought and its Affective Consequences.(J Soc Clin Psychol, 2013-05-01) Jones, NP; Papadakis, AA; Orr, CA; Strauman, TJFailure to make progress toward personal goals can lead to negative affective states, such as depression and anxiety. Past research suggests that rumination in response to goal failure may prolong and intensify those acute emotional responses, but that process remains unclear. We examined ruminative thought processes following experimentally manipulated exposure to past failures to attain advancement (promotion) goals and safety (prevention) goals. We predicted that priming of past promotion and prevention goal failures would lead individuals to think repetitively about these failures and that negative affect would be evoked by their recognition of their failures. Further, we predicted that when people experience a sufficient magnitude of negative affect, ruminative thought would intensify and prolong the negative affect associated with that type of goal failure. Results yielded strong support for our predictions regarding promotion goal failure and modest support for those regarding prevention goal failure.Item Open Access COGNITIVE PROCESSES IN RESPONSE TO PROMOTION AND PREVENTION FAILURE: A STUDY OF MALADAPTIVE RUMINATION AND ITS AFFECTIVE CONSEQUENCES(2007-07-13) Jones, Neil PatrickTheories of self-regulation have not adequately specified the psychological events and processes that cause an emotional response following acute failure to be prolonged and intensified. Research on repetitive thought suggests that engaging maladaptive rumination can prolong and intensify existing mood states. However, theories of rumination have not incorporated the implications of failing to attain different types of desired end states for rumination, that is failing to attain goals associated with nurturance and advancement (i.e., promotion goals) versus goals associated with safety and security (i.e., prevention goals). In this investigation, 78 graduate and professional students participated in a within-subjects experimental design testing the overall hypothesis that exposure to past failures to attain promotion and prevention goals will promote maladaptive rumination on dejection- and agitation-related emotions, respectively. Furthermore, under conditions of high negative affect engaging in maladaptive rumination will cause the specific type of negative affect experienced to be intensified and prolonged. Study findings did not result in clear support for the proposed model in the prevention condition. The prevention manipulation failed to induce agitation-related emotions associated with anxiety and instead appeared to induce emotions associated with anger. The prevention condition also did not result in unique changes in quiescence. However, as predicted decreases in quiescence uniquely predicted increased engagement in maladaptive rumination. In this condition, engagement in rumination did not interact with low levels of quiescence to prolong and further decrease quiescence. Stronger support was found for the proposed model in the promotion condition. Individuals with chronic promotion failure experienced significant increases in dejection following exposure to past promotion failures. The level of dejection experienced significantly predicted engaging in greater maladaptive rumination. Furthermore, engaging in maladaptive rumination in the presence of high levels of dejection intensified and prolonged of the experience of dejection-related emotions. Overall, the results suggest that self-regulatory cognition, the level of affect that results, and variability in the tendency to engage in maladaptive rumination all play a significant role in determining a person's cognitive and emotional experiences in the ongoing process of self-regulation.Item Open Access Do the Clothes Make the Man? How Gaps Between Current and Ideal Self Goals Shape Product-Related Perceptions and Behavior(2011) Samper, Luz-AdrianaI present a framework that describes how perceived discrepancies from an ideal, or hoped-for, self influence how people view and behave with products associated with identity attainment (i.e., "symbolic props"). In the first half of this framework, I demonstrate that individuals who perceive that they are more discrepant from their aspired identity (i.e., more aspirationally discrepant individuals) view symbolic props as more "instrumental," or useful, in helping them achieve identity goals. I demonstrate that this effect is egocentric, mediated by motivation, and only occurs when the perceived rate of progress toward one's aspirational goals is high enough to merit engagement toward the goal. In the second half of the framework, I show that for more aspirationally discrepant individuals, the use of symbolic props may actually limit effort on goal-relevant tasks. These studies suggest an ironic effect whereby aspirational discrepancy may lead to acquisition of goal-relevant props to the detriment of performance-relevant effort.
Item Open Access Effective "on-boarding": transitioning from trainee to faculty.(J Palliat Med, 2010-10) Gustin, Jillian; Tulsky, James AAbstract The transition from trainee to junior faculty member can be both exciting and daunting. However, a paucity of medical literature exists to help guide new faculty in this transition. Therefore, we adapted work from the business management literature on what is referred to as "on-boarding"; effectively integrating and advancing one's position as a new employee. This article outlines strategies for cultivating one's own on-boarding as a junior faculty member at large academic medical centers. These strategies are extrapolated from management practices, culled from the medical literature on developing and retaining junior faculty, and, finally, borrowed from the hard-won knowledge of junior and senior faculty members. They advise new faculty to: (1) start early, (2) define your role--"managing yourself," (3) invest in/secure early wins, (4) manage your manager, (5) identify the "true (or hidden)" organizational culture, (6) reassess your own goals--"look in the rearview mirror and to the horizon," and (7) use your mentors effectively. These strategies provide a roadmap for new faculty members to transition as effectively as possible to their new jobs.Item Open Access Evolution of the World Health Organization's programmatic actions to control diarrheal diseases.(Journal of global health, 2019-12) Wolfheim, Cathy; Fontaine, Olivier; Merson, MichaelThe Program for the Control of Diarrheal Diseases (CDD) of the World Health Organization (WHO) was created in 1978, the year the Health for All Strategy was launched at the Alma Ata International Conference on Primary Health Care. CDD quickly became one of the pillars of this strategy, with its primary goal of reducing diarrhea-associated mortality among infants and young children in developing countries. WHO expanded the previous cholera-focused unit into one that addressed all diarrheal diseases, and uniquely combined support to research and to national CDD Programs. We describe the history of the Program, summarize the results of the research it supported, and illustrate the outcome of the Program's control efforts at country and global levels. We then relate the subsequent evolution of the Program to an approach that was more technically broad and programmatically narrow and describe how this affected diarrheal diseases-related activities globally and in countries.Item Open Access Goal Interdependence and the Role of Team Goal System Awareness(2017) Sackett, Esther E.In this dissertation, I propose a new framework for conceptualizing goal interdependence in teams and expand our understanding of team-related goal cognition. In Chapters 1 and 2, I propose that the goals of any one team can be viewed as being embedded a team goal system made up of the goals each member holds for the team as a whole, the individual goals that each member holds in relation to the team’s goal(s), the external, personal goals held by each member of a team (i.e., extra-team goals, ETGs), and the goals each member possesses for one another (i.e., relational goals). In the empirical part of my dissertation (Chapters 3 and 4) I use a mixed methods approach to investigate the role of team goal system awareness on individual and team processes and outcomes. In Chapter 3, I present findings from two qualitative studies and develop theory regarding the factors that influence the development and impact of team goal system awareness for individuals and teams. In Chapter 4, I present results from a laboratory experiment where I compare the effects of disclosing different types of extra-team goals on individual perceptions (commitment, trust, satisfaction, viability) and team performance. I find that, although there are efficiency and motivational benefits associated with team goal system awareness, teams must mitigate the perceived interpersonal costs that are associated with this awareness in order to benefit from it. In Chapter 5, I discuss implications of this work and avenues for future research.
Item Restricted Goal-directed or goal-misdirected - how should we interpret the literature?(Crit Care, 2010) Roche, Anthony M; Miller, Timothy EGoal-directed therapy (GDT) can be a vague term, meaning different things to different people and, depending on the clinical environment, sometimes even different things to the same person. It can refer to perioperative fluid management, clinicians driving oxygen delivery to supramaximal values, early treatment of sepsis in the emergency department, and even to restriction of perioperative crystalloids with the goal of maintaining preadmission body weight. Understandably, strong opinions about GDT vary; some clinicians consider it essential for perioperative care, others completely ineffective in critically ill patients. This commentary aims to further position the excellent review by Lees and colleagues in the context of the critical care and perioperative setting.Item Open Access Goal-Striving Stress and Incident Cardiovascular Disease in Blacks: The Jackson Heart Study.(Journal of the American Heart Association, 2020-05) Glover, LáShauntá M; Cain-Shields, Loretta R; Spruill, Tanya M; O'Brien, Emily C; Barber, Sharrelle; Loehr, Laura; Sims, MarioBackground Goal-striving stress (GSS), the stress from striving for goals, is associated with poor health. Less is known about its association with cardiovascular disease (CVD). Methods and Results We used data from the JHS (Jackson Heart Study), a study of CVD among blacks (21-95 years old) from 2000 to 2015. Participants free of CVD at baseline (2000-2004) were included in this analysis (n=4648). GSS was examined in categories (low, moderate, high) and in SD units. Incident CVD was defined as fatal or nonfatal stroke, coronary heart disease (CHD), and/or heart failure. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident CVD by levels of GSS, adjusting for demographics, socioeconomic status, health behaviors, risk factors, and perceived stress. The distribution of GSS categories was as follows: 40.77% low, 33.97% moderate, and 25.26% high. Over an average of 12 years, there were 140 incident stroke events, 164 CHD events, and 194 heart failure events. After full adjustment, high (versus low) GSS was associated with a lower risk of stroke (HR, 0.38; 95% CI, 0.17-0.83) and a higher risk of CHD (HR, 1.91; 95% CI, 1.10-3.33) among women. A 1-standard deviation unit increase in GSS was associated with a 31% increased risk of CHD (HR, 1.31; 95% CI, 1.10-1.56) among women. Conclusions Higher GSS may be a risk factor for developing CHD among women; however, it appears to be protective of stroke among women. These analyses should be replicated in other samples of black individuals.Item Open Access Importance of patient-reported individualized goals when assessing outcomes for adult spinal deformity (ASD): initial experience with a Patient Generated Index (PGI).(The spine journal : official journal of the North American Spine Society, 2017-10) Scheer, Justin K; Keefe, Malla; Lafage, Virginie; Kelly, Michael P; Bess, Shay; Burton, Douglas C; Hart, Robert A; Jain, Amit; Lonner, Baron S; Protopsaltis, Themistocles S; Hostin, Richard; Shaffrey, Christopher I; Smith, Justin S; Schwab, Frank; Ames, Christopher PBackground context
Current metrics to assess patients' health-related quality of life (HRQOL) may not reflect a true change in the patients' specific perception of what is most important to them.Purpose
This study aimed to describe the initial experience of a Patient Generated Index (PGI) in which patients create their own outcome domains.Study design
This is a single-center prospective study.Patient sample
Patients with adult spinal deformity (ASD) comprise the study sample.Outcome measures
Oswestry Disability Index (ODI), Short Form-36 (SF-36 Physical Component Score [PCS] and Mental Component Score [MCS]), Scoliosis Research Society-22r (SRS-22r), and PGI.Methods
Oswestry Disability Index, SF-36, SRS-22r, and PGI were administered preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 and 2 years. PGI correlations with ODI, SF-36, SRS total score, free-text frequency analysis of PGI exact response with text in ODI and SRS-22r questionnaires, and the responsiveness (effect size [ES]) of the HRQOL metrics were analyzed. No funding was used for this study and there are no conflicts of interest.Results
A total of 59 patients with 209 clinical encounters produced 370 PGI written response topics that included affect or emotions, relationships, activities of daily life, personal care, work, and hobbies. Mean preoperative PGI score was 18.6±13.5 (0-71.7 out of 100 [best]), and mean scores significantly improved at every postoperative time point (p<.05). Preoperative PGI scores significantly correlated with preoperative ODI (r=-0.28, p=.03), MCS (r=0.48, p<.01), and SRS total (r=0.57, p<.01). Postoperative PGI scores correlated with all HRQOL measures (p<.0001): ODI (r=-0.65), PCS (r=0.50), MCS (r=0.55), and SRS total (r=0.63). PGI responses exactly matched ODI and SRS-22r text at 47.8% and 35.4%, respectively, and at 63.2% and 58.9%, respectively, for categories. Patient Generated Index ES at a minimum of 1-year follow-up was -2.39, indicating substantial responsiveness (|ES|>0.8). Effect sizes for ODI, SRS-22r total, SF-36 PCS, and SF-36 MCS were 2.16, -2.06, -2.05, and -0.80, respectively.Conclusions
The PGI is easy to administer and offers additional information about the patients' perspective not captured in standard HRQOL metrics. Patient Generated Index scores correlated with all of the standard HRQOL scores and were more responsive than ODI, SF-36, and SRS-22r, suggesting that the PGI may be a step closer to one HRQOL measure that better encompasses concerns and goals of the individual patients.Item Open Access Machine wanting.(Studies in history and philosophy of biological and biomedical sciences, 2013-12) McShea, Daniel WWants, preferences, and cares are physical things or events, not ideas or propositions, and therefore no chain of pure logic can conclude with a want, preference, or care. It follows that no pure-logic machine will ever want, prefer, or care. And its behavior will never be driven in the way that deliberate human behavior is driven, in other words, it will not be motivated or goal directed. Therefore, if we want to simulate human-style interactions with the world, we will need to first understand the physical structure of goal-directed systems. I argue that all such systems share a common nested structure, consisting of a smaller entity that moves within and is driven by a larger field that contains it. In such systems, the smaller contained entity is directed by the field, but also moves to some degree independently of it, allowing the entity to deviate and return, to show the plasticity and persistence that is characteristic of goal direction. If all this is right, then human want-driven behavior probably involves a behavior-generating mechanism that is contained within a neural field of some kind. In principle, for goal directedness generally, the containment can be virtual, raising the possibility that want-driven behavior could be simulated in standard computational systems. But there are also reasons to believe that goal-direction works better when containment is also physical, suggesting that a new kind of hardware may be necessary.Item Open Access Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.(Anesthesiol Clin, 2015-03) Minto, Gary; Scott, Michael J; Miller, Timothy EPatients having major abdominal surgery need perioperative fluid supplementation; however, enhanced recovery principles mitigate against many of the factors that traditionally led to relative hypovolemia in the perioperative period. An estimate of fluid requirements for abdominal surgery can be made but individualization of fluid prescription requires consideration of clinical signs and hemodynamic variables. The literature supports goal-directed fluid therapy. Application of this evidence to justify stroke volume optimization in the setting of major surgery within an enhanced recovery program is controversial. This article places the evidence in context, reviews controversies, and suggests implications for current practice and future research.Item Open Access Perioperative goal-directed therapy.(J Cardiothorac Vasc Anesth, 2014-12) Waldron, Nathan H; Miller, Timothy E; Gan, Tong JItem Open Access Self-Regulation before and after a Developmental Transition: a Study of Adaptive Goal Change in Retirement(2008-08-08) Aspnes, AnnRetirement is the quintessential transition from mid-life to late-life for many working Americans. However, questions about the positive and negative effects of retirement have sparked widely divergent empirical findings. Developmental theories of self-regulation may add to the understanding of the subtle differences and transitions within retirement. Retirement may be viewed as a transition in resources (e.g., psychological, social, and financial), so that individual mental health outcomes are linked to how well these resources are reallocated. According to goal disengagement perspectives, failure either in disengagement from past goals or reengagement in new goals can lead to decreased well-being and increased depression. Further, as individuals enter late-life, their focus may turn away from growth and achievement and more toward preventing losses and maintaining current resources. In the present study, it was hypothesized that when pre-retirement individuals were compared against early and late post-retirement individuals, engagement in developmentally relevant goals (e.g., self, family, and leisure) in retirees would be associated with better mental health outcomes while retirees who reported continued engagement in less developmentally accessible goals (i.e., occupational and financial) would report worse outcomes.
A total of 100 study participants (aged 50 to 84) were interviewed about their current goals and completed self-report measures of depression, well-being, social support, physical health, and regulatory focus. Interview data were coded for goal content as well as for regulatory focus. Findings did not support the hypotheses, as there were no significant differences among the 47 pre-retirement, 29 early post-retirement, and 24 late post-retirement participants in their goal content or regulatory focus. Goal content also was not associated differentially with depression or well-being among the three groups. However, the interview data did provide valuable information about the heterogeneous and fluid nature of retirement. Retirement, rather than a clear loss in certain resources (i.e., financial and occupational) and a clear gain in others (i.e., time and personal freedom), seemed to be a renegotiation of those resources. Furthermore, even pre-retirement participants named retirement goals, suggesting that, if a goal transition did occur, it may have been a more conscious, gradual process.
Item Open Access Should realignment goals vary based on patient frailty status in adult spinal deformity?(Journal of neurosurgery. Spine, 2023-11) Passias, Peter G; Mir, Jamshaid M; Williamson, Tyler K; Tretiakov, Peter S; Dave, Pooja; Lafage, Virginie; Lafage, Renaud; Schoenfeld, Andrew JObjective
The objective of this study was to adjust the sagittal age-adjusted score (SAAS) to accommodate frailty in alignment considerations and thereby increase the predictability of clinical outcomes and junctional failure.Methods
Surgical adult spinal deformity (ASD) patients with 2-year data were included. Frailty was assessed with the continuous ASD modified frailty index (ASD-mFI). Two-year outcomes were proximal junctional kyphosis (PJK), proximal junctional failure (PJF), major mechanical complications, and best clinical outcome (BCO), defined as Oswestry Disability Index (ODI) score < 15 and Scoliosis Research Society outcomes questionnaire total score > 4.5 by 2 years. Linear regression analysis established a 6-week score based on the component scores of SAAS, frailty, and US normal values for ODI score. Logistic regression analysis followed by conditional inference tree run forest analysis generated categorical thresholds. Multivariate analysis, controlling for age, baseline deformity, and history of revision, was used to compare outcome rates, and logistic regression generated odds ratios for the continuous score. Thirty percent of the cohort was used as a random sample for internal validation.Results
In total, 412 patients were included (mean ± SD age 60.1 ± 14.2 years, 80% female, BMI 26.9 ± 5.4 kg/m2). Baseline frailty categories were as follows: 57% not frail, 30% frail, and 14% severely frail. Overall, by 2 years, 39% of patients had developed PJK, 8% PJF, and 21% mechanical complications; 22% had undergone a reoperation; and 15% met BCO. When the cohort as a whole was assessed, the 6-week SAAS had a correlation with the development of PJK and PJF, but not mechanical complications, reoperation, or BCO. Development of mechanical complications, PJF, reoperation, and BCO demonstrated correlations with ASD-mFI (all p < 0.05). Regression analysis modifying SAAS on the basis of ODI norms and frailty generated the following equation: frailty-adjusted SAAS (FAS) = 0.108 × T1 pelvic angle + 0.162 × pelvic tilt - 0.39 × pelvic incidence - lumbar lordosis - 0.03 × ASD-mFI - 1.6771. With conditional inference tree analysis, thresholds were derived for FAS: aligned < 1.7, offset 1.7-2.2, and severely offset > 2.2. Significance between FAS categories was found for PJK, PJF, mechanical complications, reoperation, and BCO by 2 years. Binary logistic regression, controlling for baseline deformity and revision status, demonstrated significance between FAS and all 5 outcome variables (all p < 0.01). Internal validation saw each outcome variable maintain significance between categories, with even greater odds for PJF (OR 13.4, 95% CI 4.7-38.3, p < 0.001).Conclusions
Consideration of physiological age, in addition to chronological age, may be beneficial in the management of operative goals to maximize clinical outcomes while minimizing junctional failure. This combination enables the spine surgeon to fortify a surgical plan for even the most challenging patients undergoing ASD corrective surgery.Item Open Access The Benefits of Budgeting Time First for Multiple Goal Setting and Pursuit(2020) Memmi, SarahConsumers often have multiple goals and limited time to pursue them. Running out of time means that people may fail to achieve, or to even attempt, one or more valued goals. When time constrains multiple goal pursuit, what might encourage consumers to protect time for downstream goals (i.e., goals that occur later in a sequence)? I propose that a subtle shift in the way people think about setting multiple goals in relation to limited time can help. Nine experiments demonstrate that, compared to only setting goals, budgeting time first (i.e., allocating total time across tasks before specifying goal levels) encourages people to set more realistic (i.e., more accurate) multiple goals that better fit within the total available time. This occurs because, by disaggregating the total time available for multiple goals into distinct accounts, budgeting time reduces implicit “double dipping” into a shared time pool when setting goals. By encouraging people to set more realistic upstream goals, budgeting time first increases time spent on downstream goals, boosting how much people accomplish toward, and whether they ultimately achieve, those goals. Further, by protecting time for downstream goals, budgeting time first discourages consumers from exceeding the total time budget and spending against future periods. This research contributes to understanding of the relationship between goals and time, multiple goal setting and pursuit, and mental accounting and budgeting. The findings also have substantive implications for consumer goal pursuit and well-being.
Item Open Access The Situational Adaptiveness of Implicit Theories of Intelligence and Achievement Goal Orientations(2009) O'Keefe, Paul AndrewPrevious research has largely highlighted the maladaptive consequences of holding an entity theory of intelligence and the adaptive consequences of holding an incremental theory (for reviews, see Dweck, 1999; Dweck & Leggett, 1988). This research, however, has largely ignored the role of the achievement context and how it may conflict with the goals that naturally arise from implicit theories of intelligence. The present research demonstrates that the adaptiveness of theories of intelligence may depend on the demands of the situation. Across two studies, the most adaptive motivation, affect, and use of self-regulatory resources was observed when entity theorists pursued performance goals and when incremental theorists pursued learning goals (fit). Conversely, maladaptive outcomes were observed when entity theorists pursued learning goals and when incremental theorists pursued performance goals (nonfit). For several achievement-related outcomes, however, this pattern of results was moderated by perceived competence, suggesting that fit may be most adaptive when confidence in abilities is high, and nonfit may be most adaptive when it is low. Implications for achievement motivation and goal pursuit are discussed.