This article presents a description and preliminary evaluation of a nationwide initiative by the Veterans Health Administration (VHA) called Civility, Respect, and Engagement in the Workforce (CREW). The goal of CREW is to increase workplace civility as assessed by employee ratings of interpersonal climate in workgroups. Once endorsed by the VHA leadership and adopted by the leaders of particular VHA hospitals, CREW was conducted by local facility coordinators who were trained and supported by the VHA National Center for Organization Development. This article explains the conceptual and operational background of CREW and the approach used to implement the initiative, presents results from two CREW administrations with a total of 23 sites, and reports significant preintervention to postintervention changes in civility at intervention sites as compared to no significant changes at comparison sites within each administration. It discusses these findings in the conceptual (theoretical) and operational (intervention evaluation) context of interventions targeting civility.T his study presents results from a nationwide organization development initiative in the Veterans Health Administration (VHA), which focused on increasing civility in the workplace. The initiative is called Civility, Respect, and Engagement in the Workforce (CREW). We present the conceptual and operational background of CREW, explain the approach that the VHA used to implement it, share initial results, and discuss these findings in the theoretical and operational context of interventions targeting civility. In the CREW framework, and in this article, civility refers to courteous and considerate workplace behaviors within the workgroup (the group of people who work together and report to the same supervisor). More specific dimensions understood to express civil behavior are coworkers' personal interest and respect

Objective-To determine the benefit of midodrine, an agonist, on symptom frequency and haemodynamic responses during head up tilt in patients with neurocardiogenic syncope. Setting-Cardiovascular investigation unit (a secondary and tertiary referral centre for the investigation and management of syncope). Patients-16 outpatients (mean (SD) age 56 (18) years; five men) with frequent hypotensive symptoms (more than two syncopal episodes and fewer than 20 symptom free days per month), and reproducible syncope with glyceryl trinitrate (GTN) during head up tilt. Design and intervention-Randomised double blind placebo controlled study. Patients were randomised to receive either placebo or midodrine for one month. Symptom events were recorded during each study month. At the end of each study month patients completed a quality of life scoring scale (Short Form 36) and a global assessment of therapeutic response. They received GTN with head up tilt for measurement of heart rate (electrocardiography), phasic blood pressure (digital photoplethysmography), and thoracic fluid index (transthoracic impedance plethysmography) during symptom provocation. Results-Patients administered midodrine had an average of 7.3 more symptom free days than those who received placebo (95% confidence interval (CI) 4.6 to 9; p < 0.0001). Eleven patients reported a positive therapeutic response with midodrine (p = 0.002). All domains of quality of life showed improvement with midodrine, in particular physical function (8.1; 95% CI 3.7 to 12.2), energy and vitality (14.6; 95% CI 7.3 to 22.1), and change in health status (22.2; 95% CI 11 to 33.4 ). Fourteen patients who were given placebo had tilt induced syncope compared with six given midodrine (p = 0.01). Baseline supine systolic blood pressure was higher and heart rate lower in patients who received midodrine than in those who were given placebo ( p < 0.05). A lower thoracic fluid index in patients administered midodrine indicates increased venous return when supine and during head up tilt. There were no serious adverse eVects. Conclusions-Midodrine had a conspicuous beneficial eVect on symptom frequency, symptoms during head up tilt, and quality of life. Midodrine is recommended for the treatment of neurocardiogenic syncope in patients with frequent symptoms. (Heart 1998;79:45-49)

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Collective behavior refers to coordinated group motion, common to many animals. The dynamics of a group can be seen as a distributed model, each "animal" applying the same rule set. This study investigates the use of evolved sensory controllers to produce schooling behavior. A set of artificial creatures "live" in an artificial world with hazards and food. Each creature has a simple artificial neural network brain that controls movement in different situations. A chromosome encodes the network structure and weights, which may be combined using artificial evolution with another chromosome, if a creature should choose to mate. Prey and predators coevolve without an explicit fitness function for schooling to produce sophisticated, nondeterministic, behavior. The work highlights the role of species' physiology in understanding behavior and the role of the environment in encouraging the development of sensory systems.