Initial Stage Of Change Research Articles

El arduo despertar de un cambio lingüístico en la distancia comunicativa: paralelismos y divergencias con textos de la inmediatez en las relativas oblicuas del primer español moderno

Within the framework of historical sociolinguistics, the present study deals with the incidence of the textual axis at the dawn of a change affecting relative obliques in early modern Spanish. To this end, both the diffusion and the conditioning of the new variant (en + art + que), as opposed to the traditional one (en + que), are studied comparatively in two corpora composed of texts close to immediacy (private correspondence) and communicative distance (literary and legal-administrative) from the eighteenth century. The results of the study show, on the one hand, that the expansion of innovative forms was significantly greater in the documents of immediacy than in those of distance. On the other hand, it is found that, despite largely similar internal conditions, some of them exhibit idiosyncratic behaviour revealing a certain disparity in these initial stages of change. All this highlights the need to include textual typology in the study of language variation and change, alongside the usual linguistic and extra-linguistic factors. Keywords: historical sociolinguistics, linguistic variation and change, discursive traditions, prepositional relative clauses, early modern Spanish

A corpus‐based analysis of adjective amplification in Hong Kong, Indian and Philippine English

AbstractThis study considers a corpus‐based approach for analysing adjective amplifier systems (very, really, so, etc.) in Hong Kong English (HKE), Indian Englsih (IndE) and Philippine English (PhiE) based on data from the International Corpus of English. The current study adds to existing research by providing insights into the understudied adjective amplifier systems of Asian Englishes. The study describes the amplifier systems in HKE, IndE and PhiE, and it ascertains if these amplifier systems are undergoing change. In the latter context, the analysis assesses if really or so is replacing very as the dominant adjective amplifier in these varieties—a trend shown to be at work in Inner Circle varieties of English. The results of Conditional Inference Trees show that the amplifier systems of HKE and IndE are very stable and amplifier choice in these varieties is determined predominately by intra‐linguistics factors (adjective type, syntactic context and semantic category). In contrast, the amplifier system of PhiE shows notable signs of ongoing change, which is driven predominately by social factors (age and gender of speakers). The results indicate that during stasis and initial stages of change, language‐internal factors determine amplifier choice, while social factors become more important once changes have reached the midrange. The paper argues that once certain variants (really and so) gain social meaning, it is this social meaning (the association with specific social groups) that drives and accelerates change as speakers want to associate with social groups that carry covert prestige.

790-P: Multicomponent Integrated Care Program Benefits on Diabetes-Related Grief and Stage of Change and Glycemic Control Association

Self-care behavior is the cornerstone in diabetes care. Strategies to promote behavior change and overcome grief process to improve diabetes outcomes have been poorly studied. We examined a quality initiative Multicomponent Integrated Care (MIC) program on Grief Stage (GS) and Stage of Change (SOC) allocation and its association with A1c in persons with type 2 diabetes (PwT2D) in a public primary care T2D clinic. DIABEMPIC is a 5-months empowerment-based program including: interdisciplinary case management team, diabetes self-management education, individual/group sessions, shared medical appointments, audit and feedback, and guaranteed supply of medications. We evaluated the effect of the intervention using a ’before and after’ design. Advanced stages were defined by higher than “anger” and higher than “contemplation” for GS and SOC, respectively. Total PwT2D were 451, the mean (SD) age was 54.6 (11) years, 66% were female, diabetes duration was 12 (8) years and baseline A1c was 9.5% (2.1). Baseline GS: denial 43.6%, anger 25.1%, bargaining 22.8%, depression 8.2% and acceptance 0.3%. Baseline SOC: precontemplation 55.4%, contemplation 40.6%, determination 2.5%, action 2.5% and maintenance 0%. GS and SOC improved after the intervention (83% and 68.7% presented advanced stages, respectively), p<0.001. A1c decreased 2.7% (2.2), p-value <0.001. Advanced GS and SOC were associated with an A1c ≦ 8% (OR 0.29, 95% CI, 0.16-0.52 and OR 0.21, 95% CI, 0.12-0.38, respectively). Also, these advanced stages had higher decrease of A1c (-0.8, -0.7%, respectively) than those who persist in earlier stages (p<0.001). We report a high prevalence of initial GS and SOC in PwT2D and poor glycemic control. MIC program participation was associated with improving GS and SOC. Advanced stages of GS and SOC at the end of the program were associated with better glycemic control. MIC strategies must be considered to promote behavior change and overcome grief process in PwT2D. Disclosure R. Silva-Tinoco: Speaker’s Bureau; Self; Novo Nordisk Inc. O. Salas-Martínez: None. V. delaTorre-Saldaña: None. E.B. Guzman: None. E.C. Cuatecontzi: None. D. Cabrera-Gerardo: None. L. Castillo-Martinez: None. H. Gallardo-Rincón: None. J. Serna: None. A. Gonzalez-Cantu: None. M. Romero-Ibarguengoitia: None.

Teachers’ Readiness for a Statewide Change to PjBL in Primary Education in Qatar

This study investigated the readiness of teachers towards implementing project-based learning (PjBL), mandated by a top-down policy at the national level, in Qatari government primary schools. With multiple qualitative data, the study reported a lack of readiness among teachers at the initial stage of change. Despite good intentions, the change message was not successfully communicated to the change recipients, i.e., teachers. Teachers’ lack of understanding of PjBL served as a major reason for difficulties encountered, including their low confidence in implementing PjBL and their inability to recognize the appropriateness or acknowledge its potential benefits. Nevertheless, teachers from a supportive school environment reported positive attitudes and perceptions of valence. Accordingly, system support and effective professional development are crucial for teacher readiness to implement PjBL.

영재교육기관 컨설팅에 대한 영재교육 이해관계자의 관심도 연구

본 연구는 영재교육기관 컨설팅에 대한 관심도를 조사하기 위하여, 영재교육 이해관계자를 대상으로 설문을 실시하였다. 122명의 이해관계자가 SoCQ(The Stages of Concerns Questionnaire, Hall & Hord, 2011)에 응답하였으며, Hall과 Hord(2011)의 채점표(SoCQ scoring device)를 활용하여 이해관계자의 응답 반응을 상대적 강도(relative intensity)로 환산하였다. 본 연구는 영재교육 이해관계자의 특성(소속기관, 영재교육경력, 영재업무 지속여부, 영재 연수유형)에 따른 영재교육기관 컨설팅에 대한 관심도를 살펴보기 위하여 t 분석과 일원분산분석을 실시하였다. 연구결과, 영재교육 이해관계자들은 1단계(정보)에 대한 관심이 가장 높고, 4단계(결과)에 대한 관심이 가장 낮은 변화초기 단계의 양상을 보여주었다. 한편, 전문가 연수를 받은 이해관계자들은 6단계(재조정)에 대한 관심도가 높게 나타나, 영재교육기관 컨설팅에 대하여 저항을 보이는 것으로 나타났다. 이에 본 연구에서는 연구결과에 기초하여 성공적인 영재교육기관 컨설팅을 정착하고 확산하는 방안을 제안하였다. This study examined whether there were differences in stakeholders' concerns regarding consulting in gifted education institutes. A total of 122 stakeholders in gifted and talented education responded to SoCQ(the Stage of Concerns Questionnaire, Hall & Hord, 2011). The SoCQ responses of these stakeholders to consulting for gifted education institutes were converted into relative intensities and SoCQ profiles, which were analyzed by the affiliated areas of institute, teaching years in gifted education, continuities of affairs in gifted education, and approaches to teacher training for gifted education with using t-test and one-way analysis of variance. Results indicated that stakeholders generally showed the highest concern for stage 1(information) and the lowest concerns for stage 4(consequence), which were the initial stage of change and innovation in consulting for gifted education institutes. In the meanwhile, skakeholders having training program for professionals showed the more concern for stage 6(refocusing), which was a kind of resistance for the present consulting for gifted education institutes. On the based on these results, this study suggested ways(or methods) for settlement and the diffusion of successful gifted education consulting.

Motivational stage of change in young patients undergoing day treatment for eating disorders

The objective was to determine whether motivation to change is significantly altered over the course of partial hospitalization in children and adolescents with eating disorders (EDs). This study was a retrospective chart review of 30 sets of adolescents and their parents who completed the Motivational Stage of Change for Adolescents Recovering from an Eating Disorder (MSCARED) at both intake and discharge from partial hospitalization. The main outcome variables included change in stage of change (SOC) for patients and their parents. Secondary outcomes included correlations between SOC and other baseline variables, as well as changes in SOC and psychological test scores. The SOC was significantly higher at discharge than at intake in both the patients and parents, but the two groups were not in agreement at discharge. The change in the SOC was correlated with change in Children's Eating Attitudes Test scores. Assessment of decisional balance showed correlations with SOC. Age, change in weight, and psychiatric diagnoses did not correlate with initial SOC. The MSCARED may be a useful tool for monitoring young ED patients' psychological improvements with day treatment. Initial SOC is not predictive of treatment outcomes.

Do early therapeutic alliance, motivation, and stages of change predict therapy change for high‐risk, psychopathic violent prisoners?

Examination of the extent of offenders' engagement in change, and in rehabilitation programmes, is important to understanding success or failure following rehabilitation. In treatment programmes, the alliance between therapist and offender, and the therapy process itself appear central to progress offenders make that may reduce their criminal risk. But research with offenders seldom has measured therapeutic alliance and clinical writing suggests that it is difficult to form an alliance with those not ready to change their behaviour; especially with higher risk and psychopathic offenders. This study outlines the course of the therapeutic alliance in an 8-month treatment programme for high-risk, PCL-psychopathic violent prisoners. It examines relationships between early-treatment therapeutic alliance, therapists' global ratings of motivation to change, and initial stage of change on dynamic risk factors. In addition, it investigates which factors best predict who will complete treatment and change behaviourally during treatment. In this challenging, high-needs client group, early-programme stage of change, therapists' perceptions of motivation, therapeutic alliance and psychopathy did not predict how much change prisoners made. Regardless of initial levels, prisoners whose alliance increased the most over the course of treatment made the most change.

Intervenção breve em organizações: mudança em coaching de executivos

Coaching de executivos é um processo de suporte a profissionais visando ao atingimento de metas organizacionais por meio da aprendizagem de novas competências. Diferentes propostas foram apresentadas na literatura, sem ou com poucas evidências empíricas de eficiência. O objetivo foi avaliar a eficiência de um programa de coaching desenvolvido e conduzido pela primeira autora, composto por quatro módulos: autopercepção; identificação de melhorias; elaboração/execução do plano de ação e acompanhamento. A amostra se constituiu de dez executivos encaminhados por suas empresas para o programa. A eficiência dos processos foi avaliada comparando-se medidas psicológicas finais com iniciais. Foram utilizados os instrumentos Escala Diagnóstica Adaptativa Operacionalizada (EDAO-R), Escala de Estágios de Mudanças (EEM), Personal Profile Analysis (PPA) e Autoanálise do Desempenho (AAD). Os resultados sugerem que o programa de coaching ajudou na melhora da eficácia adaptativa, permitindo o desenvolvimento de competências. O estágio de mudança inicial permitiu escolher a melhor estratégia cognitiva. Limites metodológicos são apontados.

Effects on Knowledge and Attitudes of Using Stages of Change to Train General Practitioners on Management of Depression: A Randomized Controlled Study

To assess the impact on knowledge and attitudes of a tailored educational intervention on depression using a modified version of the Prochaska stages of change model, compared with standard continuing medical education, for general practitioners (GPs) in primary care in Iran. Using a randomized controlled trial, a total of 192 GPs were evenly randomized to intervention or control arm. The topic for the educational intervention was depressive disorders. The participants were divided in to small and large groups, depending on their initial stage of change. The GPs' knowledge and skills regarding management of depressive disorders were assessed through a questionnaire with 7 multiple choice questions, 11 Likert statements, 3 case vignettes, and 1 essay question. Attitudes toward management of depressive disorders were also assessed. Both questionnaires were validated. There was a significant improvement in knowledge mean scores regarding multiple choice and Likert questions (intervention effect 6%; P = 0.002), as well as for the case vignettes and essay question (intervention effect 12%; P = 0.011) in the intervention arm, in comparison with the control arm. There were significant changes in mean attitude scores in both study arms, but no difference between them. A theoretical model of medical learning and behavioural change can be used to devise educational formats that suit different stages of learning. Such tailored educational formats can improve GPs' knowledge and skills regarding management of depressive disorders.

Adherence to an exercise prescription scheme: The role of expectations, self‐efficacy, stage of change and psychological well‐being

Poor rates of adherence to exercise prescription schemes present a potential barrier to the goal of increasing physical activity in patient samples. This study investigated the role of participant expectations, self-efficacy, stage of change and psychological well-being in adherence to a 12-week course of gym based exercise. It also aimed to assess the impact of failure to adhere on self-efficacy and psychological well-being. The 119 participants, referred by their medical practitioner for a course of exercise, completed questionnaires at the start of the course and 77 went on to complete second questionnaires. Objective measures included a range of physiological measures based on gym assessments. Participants typically had high expectations of the scheme. Those who completed the course had more modest expectations of change and came closer to achieving these expected changes than those who dropped out. Initial stage of change and self-efficacy did not discriminate between the two groups. While self-efficacy improved over the scheme for completers, it tended to deteriorate for drop-outs. GHQ scores also failed to improve over time for drop-outs. Overly optimistic expectations of inexperienced exercisers may lead to disappointment and attrition. Interventions to ensure realistic expectations might increase success and prevent potential negative effects of failure.

Applying a transtheoretical behavioral change model to HIV/STD and pregnancy prevention in adolescent clinics

Purpose To evaluate the application of a transtheoretical model (TTM) of behavioral change to adolescent reproductive health counseling. Methods Family planning counselors in Boston Metro school-based and community health centers used a TTM for pregnancy and human immunodeficiency virus/sexually transmitted disease (HIV/STD) prevention. Data were collected from September 2000 through December 2001. Bivariate analyses using chi-square statistics and multivariate analyses using logistic regression were performed to identify the differences between stage of change (SOC) groups and the predictive variables for SOC movement. Results Data on 539 sexually experienced clients were examined. Site, client’s gender, race, proximity of sexual activity, sexual partner status, level of partner support, and target behavior were significantly associated with initial SOC for both pregnancy and disease prevention ( p < .01). For clients meeting stage movement analysis criteria (n = 86 for pregnancy prevention; 128 for disease prevention), there was suggestive evidence that older ones were more likely to move forward for both pregnancy and disease prevention ( p = .08 and p = .07, respectively) between their first and second visits. For disease prevention, those initially in the precontemplation/contemplation stages were more likely than those in the action/maintenance stages to be forward movers (odds ratio = 3.89, p = .06). Counselors/supervisors reported that the TTM helped structure an integrated message and increased client engagement. Conclusions Efforts to prevent teen pregnancy and HIV/STDs should acknowledge the roles of partner support and age in SOC. Adolescents in preparation may need specific skill-building for behavioral change. Overall, TTM represents a promising approach to promoting integrated pregnancy and disease prevention in family planning counseling.

Bringing Canadian healthcare closer to home: the initial stages of change for senior managers within the province of British Columbia.

This paper explores some recent healthcare reforms within the Canadian healthcare sector. As in most countries across the world, healthcare managers in Canada have been faced with the dilemma of how to achieve a balance between equity of provision and expenditure control. This study explores the external and internal pressures for change at the provincial and national levels within Canada. More significantly, it focuses on how the early stages of these changes have resulted in altered work roles and relationships for healthcare managers. A case study of British Columbia is described, where radical changes occurred in the healthcare sector in the mid-1990s. Interviews conducted with a sample of senior healthcare managers in the province illustrate how the restructuring of healthcare impacted upon management roles, structures and communication. The qualitative interview data is intended to provide an important addition to the body of largely quantitative, statistical data that is collected on international health systems on a regular basis. How the findings of the case study can contribute to learning and practice within the health services management arena is discussed.

A Stage in the Development of the Industrial Town: A Case Study of Cardiff, 1845-75

This study looks at the internal spatial reorganization of a town as it was transformed from a constrained pre-industrial kernel into a rapidly growing industrial metropolis. Starting from the premise that the intra-urban patterns of the Sjoberg and Burgess models represent extremes on a developmental continuum, an attempt is made to analyse the residential adaptations which occurred in the initial stages of change from the pre-industrial to the industrial pattern. The case study is the city of Cardiff, which showed phenomenal growth in the nineteenth century. This remarkable increase was related to the expansion of its port facilities, first for the iron industry, and then, and more importantly, for the coal export trade. The employment opportunities in dock and ancillary activities attracted a steady stream of migrants which could not be accommodated within the narrow confines of the existing medieval market town. Given this situation, what arrangement of residences emerged? The resultant distributions are examined using rateable values for 1846 and 1874-6, social data from the 1851 and 1871 Censuses, and contemporary health reports. The study shows that Cardiff was at a crossroads in terms of internal layout: it still retained some elements of its pre-industrial structure, but it was embarking on a process of suburban extension with a fringe of medium/low value artisan/working-class property. THE initial stimulus to this study was Schnore's observations on the evolution of the internal spatial structure of cities.' He attempted to characterize the changing ecological pattern of the city as it was transformed from a 'pre-industrial' to an 'industrial' or 'modern' state. This was achieved not by taking one city and monitoring its internal progress over time but by making a broad comparison between studies of many cities in North and South America, i.e. between cities in modern industrial and pre-industrial economies, and highlighting the main stages of an evolutionary sequence. To him 'the possibility that the traditional Latin American

Studies on enzyme action. XXIV.—The oxidase effect and the phenomena of oxidation in general: Carbonic oxide

In 1904 I presented a brief communication to the Society on “ The Retardation of Combustion by Oxygen ” (‘ Proceedings,’ vol. 74, p. 86). Friends smiled at the title and no notice has been taken of my argument. Of late years, however, Moureu and his fellow-workers have brought before the French Academy a series of masterly studies of the inhibition of the oxidation of highly oxidisable materials, such as acrolein and linseed oil, by substances which are themselves oxidisable, including phenol and potassium iodide. The explanation they have put forward, involving the recognition of an active antagonism between peroxides, which constitute a reversing mechanism, is essentially that I have long held, the difference being mainly that I have gone more fully into the details of the process. In a recent fascinating brief communication to the Chemical Society (‘ Chem. Soc. Journ.,’ 1925, p. 1), Moureu and Dufraisse discuss the stoppage, by carbonic oxide, of the interaction of hydrogen and oxygen, at a platinum surface, contending that this also is an instance of inhibition owing to the antagonism of incompatible “ peroxides,” formed in the initial stages of change. I fully share their views and regard this communication as the settlement of a problem of prime importance which has been open to solution since early in last century (1833). I have discussed the peculiar “ indifferent ” behaviour of carbonic oxide on many occasions before the Society and elsewhere. I would now take one further and perhaps final step, and proclaim it to be per se an incombustible gas. If the process of combustion be, as I have frequently argued, one in which an electrolytic determinant is concerned (comp. First Messel Memorial Lecture, ‘ Soc. Chem. Ind.,’ 1922, pp. 253-270T), primarily as represented by the schematic equation it is one involving the electrolysis of water, and the “ energy ” developed in the interaction must be at least equal to that involved in the combustion of hydrogen. Actually, the heat of combustion of carbonic oxide is below that of hydrogen (67960 : 68360).