Web-Based, Interactive, Interest-Based Negotiation Training for Managing Conflict in Isolated Environments: Opportunistic Study With an e-Survey.

BACKGROUND: Effective negotiation in relationships is critical for successful long-duration space missions; inadequate conflict resolution has shown serious consequences. Less desirable forms of negotiation, including positional bargaining (eg, negotiating prices), can exacerbate conflicts. Traditional positional bargaining may work for simple, low-stakes transactions but does not prioritize ongoing relationships. High-stakes situations warrant interest-based negotiation, where parties with competing interests or goals collaborate in a mutually beneficial agreement. This is learnable but must be practiced. Refresher training during conflicts is important to prevent out-of-practice crew members from using less effective negotiation techniques. Training should be self-directed and not involve others because, on a space mission, the only other people available may be part of the conflict. OBJECTIVE: We aimed to develop and test an interactive module teaching principles and skills of interest-based negotiation in a way that users find acceptable, valuable for learning, and enjoyable. METHODS: Using a web-based, interactive-media approach, we scripted, filmed, and programmed an interest-based negotiation interactive training module. In the module, the program mentor introduces users to "The Circle of Value" approach to negotiation and highlights its key concepts through interactive scenarios requiring users to make selections at specific decision points. Each selection prompts feedback designed to reinforce a teaching point or highlight a particular negotiation technique. To evaluate the module, we sought populations experiencing isolation and confinement (an opportunistic design). This included 9 participants in isolated, confined environments in the Australian Antarctic Program and the Hawai'i Space Exploration Analog and Simulation Mars simulation, as well as a subset of people who self-identified as being isolated and confined during the COVID-19 pandemic. Feedback was collected from participants (n=54) through free-response answers and questionnaires with numerical scaling (0=strongly disagree to 4=strongly agree) at the end of the module. RESULTS: In total, 51 of 54 (94%) participants found the activity valuable for learning about conflict management (identified by those who selected either "somewhat agree" or "strongly agree"), including 100% of participants in the isolated and confined environment subset (mode=3). In total, 79% (128/162) of participant responses indicated that the module was realistic (mode=3), including 85% (23/27) of responses from participants in isolated and confined environments (mode=3). Most participants felt that this would be particularly valuable for new team members in an isolated, confined environment (46/54, 85% of all participants, mode 4; 7/9, 78% of the isolated and confined environment subset, mode 3) as well as veterans. CONCLUSIONS: This module offers a self-directed, consistent approach to interest-based negotiation training, which is well received by users. Although the data are limited due to the opportunistic study design, the module could be useful for individuals in isolated and confined environments and for anyone involved in high-stakes negotiations where sustaining relationships is essential.

Effect of diuresis on bother related to lower urinary tract symptoms.

AIMS: To explore and objectify the impact of diuresis on the presence of daytime and nighttime LUTS, and associated bother. METHODS: Participants (healthy volunteers and patients referred to our hospital for a urologic consultation) were asked to complete a 72-hour bladder diary and also had to fill in a Likert scale (0: no bother; 10: maximal bother) to evaluate the LUTS-associated bother during daytime and nighttime. Three groups were defined: no/mild bother (Bother ≤2), moderate bother (3 ≤ Bother ≤ 6), and strong bother (Bother ≥7). Questionnaires in order to assess LUTS (ICIQ MLUTS and ICIQ FLUTS), quality of life (SF-36, NqOL), and quality of sleep (PSQI) were completed. RESULTS: During daytime and nighttime, the study of participants with a strong bother associated with LUTS revealed a statistically significant higher fluid intake than those without bother (1640 mL vs 1800 mL during daytime, P = 0.007). Also, those with higher diuresis rate had more bother related to LUTS than the others (71.3 mL/h in group 1 vs 87.3 mL/h in group 3 (P < 0.001) during daytime). As might be expected, lower urinary tract such as bladder, for example, studied through maximal voided volume does play a role. The lower the maximal voided volume is, the more bother the participants described. CONCLUSIONS: This study pointed out the implication of diuresis in bother related to LUTS. Our findings showed that there was an increase in bother by 1 when diuresis increased by 100 mL/h.

Extreme negotiations.

CEOs and other senior executives must make countless complex, high-stakes deals across functional areas and divisions, with alliance partners and critical suppliers, and with customers and regulators. The pressure of such negotiations may make them feel a lot like U.S. military officers in an Afghan village, fending off enemy fire while trying to win trust and get intelligence from the local populace. Both civilian and military leaders face what the authors call "dangerous negotiations," in which the traps are many and good advice is scarce. Although the sources of danger are quite different for executives and officers, they resort to the same kinds of behaviors. Both feel pressure to make quick progress, project strength and control (particularly when they have neither), rely on force rather than collaboration, trade resources for cooperation rather than build trust, and make unwanted compromises to minimize potential damage. The authors outline five core strategies that "in extremis" military negotiators use to resolve conflicts and influence others: maintaining a big-picture perspective; uncovering hidden agendas to improve collaboration; using facts and fairness to get buy-in; building trust; and focusing on process as well as outcomes. These strategies provide an effective framework that business executives can use to prepare for a negotiation and guide their moves at the bargaining table.

The pathophysiology of large capacity bladder.

PURPOSE: We describe the pathophysiology, differential diagnosis and urodynamic findings in patients with a large capacity bladder. MATERIALS AND METHODS: This was a retrospective, observational study of 100 consecutive patients with voiding dysfunction and a cystometric bladder capacity of greater than 700 ml. Clinical data, cystometric bladder capacity and other urodynamic findings were evaluated. Bladder outlet obstruction and impaired detrusor contractility were defined by the Schaefer nomogram in men and the Blaivas-Groutz nomogram in women. RESULTS: A total of 56 men and 44 women 36 to 97 years old (median age 75, mean 71.2) with a bladder capacity of 700 to 5,013 ml (median 931, mean 1,091) were studied. The primary pathophysiological diagnoses were bladder outlet obstruction in 48% of cases, impaired detrusor contractility in 11%, absent detrusor contractility in 24% and normal detrusor pressure/uroflow study in 17%. Bladder outlet obstruction was attributable to anatomical obstruction in 34% of patients, acquired voiding dysfunction in 11% and detrusor-external sphincter dyssynergia in 3%. In patients with detrusor contractions the initial contraction occurred at a median of 1,000 ml (mean 1,154, range 86 to 5,000). Associated diagnoses in men included benign prostatic enlargement in 52% and neurological disease in 14%, and in women they were pelvic organ prolapse in 27%, stress incontinence in 18% and neurological disorders in 9%. CONCLUSIONS: The etiology of large capacity bladder is multifactorial and often a potentially remediable underlying condition exists. A large capacity bladder may be accompanied by bladder outlet obstruction, impaired or absent detrusor contractions, or normal detrusor pressure/uroflow studies. When detrusor contractions are present, they usually occur only at large bladder volumes. Therefore, it is important during cystometry to fill the bladder until capacity is achieved.

Simple rules for making alliances work.

Corporate alliances are growing in number--by about 25% a year--and account for up to a third of revenues and value at many companies. Yet some 60% to 70% of them fail. What is going wrong? Because alliances involve interdependence between companies that may be competitors and may also have vastly different operating styles and cultures, they demand more care and handling than other business arrangements, say Hughes and Weiss, management consultants at Vantage Partners. The authors have developed five principles--based on their two decades of work with alliances -to complement the conventional advice on alliance management: (1) Focus less on defining the business plan and more on how you and your partner will work together. (2) Develop metrics pegged not only to alliance goals but also to performance in working toward them. (3) Instead of trying to eliminate differences, leverage them to create value. (4) Go beyond formal systems and structures to enable and encourage collaborative behavior. (5) Be as diligent in managing your internal stakeholders as you are in managing the relationship with your partner. Companies that have adopted these principles have radically improved their alliance success rate. Schering-Plough, for example, engages in a systematic "alliance relationship launch": four to six weeks of meetings at which the partners explore potential challenges, examine key differences and develop shared protocols for managing them, and establish mechanisms for day-to-day decision making. Blue Cross and Blue Shield of Florida measures the quality of alliance progress through regular surveys of both its own staff and its partners'. These companies have learned that the conventional advice is not so much wrong as incomplete. The five simple rules can help fill in the blanks.

Laboratory study of heavy metal phytoremediation by three wetland macrophytes.

Detention ponds and constructed wetlands have proven to be effective in reducing peak stormwater runoff volume and flow, and recent interest has extended to utilizing them to improve stormwater runoff quality. A review of stormwater runoff studies indicated that lead, zinc, copper, cadmium, phosphorus, and chloride are contaminants of primary concern. In laboratory settings, the uptake of contaminants by three wetland plant species, Glyceria grandis, Scirpus validus, and Spartina pectinata, was examined and removal rates from nutrient solutions inflow and nonflow reactors were measured. The removal rates varied by plant species and target contaminant, and no one species was the best accumulator of all six contaminants. Belowground tissues of all three species accumulated higher concentrations of the four heavy metals and aboveground tissues accumulated higher concentrations of phosphorus and chloride. Plants grown in flow reactors showed significantly higher accumulation rates than those grown in nonflow reactors. Also, plants grown hydroponically accumulated higher concentrations of the six target contaminants than those grown in sand reactors. However, those grown in sand had a much greater increase of biomass and removed a greater mass of the six target contaminants. Removal rates measured in these experiments can be used to design detention ponds to maximize stormwater remediation.

Want collaboration? Accept--and actively manage--conflict.

Companies try all kinds of ways to improve collaboration among different parts of the organization: cross-unit incentive systems, organizational restructuring, teamwork training. While these initiatives produce occasional success stories, most have only limited impact in dismantling organizational silos and fostering collaboration. The problem? Most companies focus on the symptoms ("Sales and delivery do not work together as closely as they should") rather than on the root cause of failures in cooperation: conflict. The fact is, you can't improve collaboration until you've addressed the issue of conflict. The authors offer six strategies for effectively managing conflict: Devise and implement a common method for resolving conflict. Provide people with criteria for making trade-offs. Use the escalation of conflict as an opportunity for coaching. Establish and enforce a requirement of joint escalation. Ensure that managers resolve escalated conflicts directly with their counterparts. Make the process for escalated conflict-resolution transparent. The first three strategies focus on the point of conflict; the second three focus on escalation of conflict up the management chain. Together they constitute a framework for effectively managing discord, one that integrates conflict resolution into day-to-day decision-making processes, thereby removing a barrier to cross-organizational collaboration.