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Background: Obesity is associated with an increased prevalence of vascular risk factors and incidence of stroke. As such weight loss is recommended for patients living with obesity in the secondary prevention of stroke. Few studies, however, have examined the stages and processes of change for weight loss in stroke patients living with obesity. Objective: The aim of the study was to evaluate the stages and processes of change for weight loss in patients living with obesity who have had a recent stroke or TIA. Methods: Using a validated questionnaire, we assessed each patient’s stage of behavioral change according to the transtheoretical model (precontemplation, contemplation, preparation, action, and maintenance). We also examined 4 processes of behavioral change, which quantify activities and experiences that patients undergo on the way to behavioral change: emotional reevaluation (EMR), weight management action (WMA), weight consequence evaluation, and supporting relationships. Processes scores were compared between patients in the action and maintenance stages and those in the precontemplation, contemplation, and preparation stages. Results: Out of 49 patients who provided informed consent, 44 met the inclusion/exclusion criteria. Of these 44 patients, 6 (14%) were in the precontemplation stage of change, 7 (16%) were in contemplation, 2 (5%) were in preparation, 13 (30%) were in action, and 16 (36%) were in maintenance. Those in the action and maintenance stages accounted for the majority of participants (n = 29, 66%). Patients in the action and maintenance stages (N = 29) had higher EMR scores (mean 79, SD 13 vs. mean 68, SD 19, t = 2.0, p = 0.03) and WMA scores (mean 69, SD 13 vs. mean 59, SD 19, t = 2.0, p = 0.03) as compared to those in the precontemplation, contemplation, and preparation stages (N = 15). Conclusions: Our results suggest that without counseling or specific intervention, approximately two-thirds of stroke/TIA patients living with obesity are in the action or maintenance stage of behavior change with respect to weight loss and therefore more likely to succeed in intensive lifestyle-based interventions targeted towards weight loss. Patients who score higher in EMR and WMA are more likely to be in the action or maintenance stage of change.

Background Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available. Purpose To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions. Methods PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Results Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire ( n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being ( n = 50), physical functioning ( n = 32), role functioning ( n = 22) and psychiatric ( n = 22). Conclusions This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures.

Objective: In this study, we examined physical activity (PA) engagement outside of college physical education (PE) classes using the Transtheoretical Model (TTM). Methods: Overall, 414 university students enrolled in PE classes voluntarily participated in this study. Participants were asked to complete a survey packet to measure 4 core constructs of TTM and their PA level performed outside of PE classes. Among the participants, 150 randomly selected students were asked to wear a triaxial accelerometer for 7 consecutive days to identify their PA level. Descriptive statistics and multivariate analyses of variance were used to determine the association between stages of motivational readiness and other strategic core constructions. Results: We categorized 77% of respondents into either the "action" stage or the "maintenance" stage for engaging in additional PA outside of the classes. Behavioral processes of change showed a graded and significant association with the stages. Both self-efficacy and decisional balance were significantly higher in students at higher stages. Conclusion: Our findings showed that most students enrolled in college PE classes had additional PA outside of the class participation. In addition, behavioral processes may be effective strategies for this specific target group to promote PA.

Tobacco smoking is the leading cause of death in the world, accounting for more than eight million casualties. To reduce the prevalence of smoking, government and nongovernment players use interventions to reduce smoking and/or incite smoking cessation. These interventions are based on behavior change models. Foremost among those models is the Transtheoretical Model of Behavior Change developed by Dr Prochaska. The transtheoretical model theorizes that smoking cessation is a stage-wise change. This change is enabled by a set of processes of change. The current study identifies the relationship between two basic constructs of the model: processes of change and stages of change. The study also identifies the relative importance of different processes of change in different stages of change. Data analysis from this study shows that different processes of change have a differing influence on various stages of change. Experiential processes have a significant influence on the precessation stages and lack significant influence on the postcessation stages. On the contrary, behavioral processes have a significant influence on the postcessation stages and lack significant influence on the precessation stages.

The aim of this study is to examine the structural relationship in the transtheoretical model (TTM) of behavioural change constructs among undergraduate students. A cross-sectional study was carried out by randomly selecting students participating in campus co-curricular activities. Questionnaires, comprising queries on the stages of change (SOC) — an 18-item self-efficacy (SE) scale, a 10-item decisional balance (DB) scale, and 30-item processes of change (PoC) scale — were distributed to the students. Their answers were analysed using Mplus 8 software for structural equation modelling. There were 562 participants comprising 118 males (21.0 %) and 444 females (79.0 %) with average age of 19.81±1.22 SD. Most of them were involved in sports (46.3 %) and non-sports (46.6 %) programmes, and exercised at least three times per week for approximately 43 minutes per session. Minority of the undergraduate students (7.1%) are involved in uniform group. The initial hypothesized structural equation modelling showed that the data fitted well. The fit indices were within recommended values (CFI= 0.967; TLI= 0.939; SRMR= 0.034; RMSEA (CI: 90%) = 0.049 (0.028, 0.070); RMSEA p= 0.495). There were three hypothesized path relationships in this model. From the final structural model, the SOC had significant direct effects on SE (p = 0.001), DB (p

In the present study, sessions prior to sudden gains, sudden losses, and neutral control sessions were examined regarding the processes of change resource activation, problem actuation and therapeutic alliance. With respect to these change processes, we examined whether pregain, preloss, and neutral sessions are distinguishable by particular patterns. For the current project, videos of 30 pregain, 29 preloss, and 30 neutral control sessions from n = 89 patients receiving integrative cognitive–behavioral therapy were rated minute-by-minute using Resource-Oriented Microprocess Analysis. The sample was drawn from a total of N = 365 patients, who had completed treatment or who had attended at least 20 sessions of therapy between the years of 2007 and 2011. Discriminant function and survival analyses as well as a binary logistic regression analysis were performed to identify patterns and timing of change processes associated with session types (gains, losses, and neutral sessions). The three session types differed with regard to patterns of resource activation and problem actuation. No difference concerning therapeutic alliance was found. The findings may help future studies to generate new hypotheses regarding processes that are involved in the occurrence of sudden changes. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

El presente artículo expone las ideas centrales del marco de referencia teórico que sirvieron para la construcción teórica de las ideas educativas fundamentales que orientaron el texto de referencia “El sentido del principio de corresponsabilidad frente a las prácticas pedagógicas de los docentes, el papel de la familia y la política educativa” para aspirar el Doctorado en educación de la Universidad Tecnológica de Pereira. En este sentido el presente texto señala la convergencia interdisciplinaria y teórica que permite orientar la necesidad del principio de corresponsabilidad y función fundamental que convierte al docente en “intelectual orgánico” en el quehacer del acto educativo en ejercicio de la ejecución del derecho a la calidad de la educación, que lo interpela por contribuir con su liderazgo a agenciar procesos de cambio.

Pandemic of Covid-19 has made teaching and learning process change from conventional into digital. With “Kurikulum Merdeka Belajar” teachers can choose any learning method which allows more innovation. The purpose of this study is to improve students' vocabulary mastery through Quizizz. This study was an action research project. The research was conducted at SMA Bruderan Purwokerto. The subject of the research was twenty-six students of X MIPA 1. The research was done in two cycles. There were four steps in each cycle. They were planning, action, observation, and reflection. The result shows that the students’ vocabulary mastery is improving. When the pre-test is compared to the post-test, the mean score increases significantly, from 64 to 85. Beside the cognitive ability improves, the affective factors of the learners improve. This is due to their enjoyment and easiness of memorization. Quizizz can be one of the learning media that can make the students more enjoyable in learning English especially vocabulary since the students can memorize and get new vocabulary much easier.

Mindfulness is a two-component skill that includes mindful awareness (attentional monitoring of present moment experience) and mindful acceptance (adopting an attitude of acceptance toward this experience). Although mindfulness-based interventions (MBIs) are efficacious for many conditions, there is a lack of research on MBIs for eating disorders (EDs). We propose that MBIs may be promising for EDs given their potential to mobilize not one, but multiple associative-learning change mechanisms in EDs-defined as adaptive processes of change involving one of two forms of associative-learning: Pavlovian and operant learning. We hypothesize how MBIs-via increasing either mindful awareness or mindful acceptance-may mobilize up to eight associative-learning change mechanisms, two involving Pavlovian learning, and six involving operant learning. We also elaborate on similarities and differences between MBIs and CBT approaches for EDs, as well as opportunities for synergy. Finally, we present recommendations for future research related to the development and evaluation of novel MBI interventions for EDs and the testing of mechanisms and patient-treatment matching hypotheses.

The article examines the impact of pan-/epidemic on transformation processes of practices in the Ukrainian labor market. For this purpose, the youth of one of the largest Ukrainian cities was chosen as an empirical case. The author offers an analysis of the results of a pilot quantitative study using an online survey. This study analyzes the phenomenal and procedural aspects of young people’s labor practices in Kharkov in a pan-/epidemic situation. Changes in labor status, problems arising from the pan-/epidemic situation, perception of the processes of change in the labor market are in the center of attention of the author of the paper. In particular, as a result of the use of a cascade of methods of analysis (factorial and cluster), three groups of respondents (idealists, pragmatists, materialist-professionals) are distinguished, which are studied in detail in terms of their characteristics. Conclusions are offered on the structures and potential trends of change, on the specifics of the transformation of practices in the labor market of Ukrainian cities (on the example of Kharkov), as well as on potential risk groups in terms of possible migratory attitudes and orientations.

En este trabajo se estudian varios expedientes de la Comisión Agraria Mixta del Archivo General del Estado de Veracruz para conseguir información sobre la aplicación de la reforma agraria y la creación de ejidos (propiedad social) en el centro y el sureste del estado, durante las décadas veinte, treinta y cuarenta del siglo XX. Se busca en especial entender el papel que tuvieron los diferentes actores en el proceso de reparto: lo que representó la expropiación de sus propiedades para los hacendados y las distintas estrategias que adoptaron para quedarse con sus tierras; y por otra parte, lo que significó la atribución de una parcela para los ejidatarios, que hasta entonces siempre habían trabajado en tierras ajenas. Se estudia también la reconfiguración que se dio en los territorios después de la dotación, como resultado de la apropiación campesina y de los procesos físicos y simbólicos de cambio.

Recovery is an established term used to describe positive processes of change concerning problems related to alcohol and other drugs (AOD). The present article investigates first-person experiences of recovery self-identification over time in clients who have completed 12-step programs with a positive outcome (sobriety). The data comprises qualitative interviews with 47 individuals five years after the first post-treatment interview, analyzed in a process inspired by reflexive thematic analysis. Although all the individuals had continued their recovery, their recovery paths and how they identified themselves in relation to their AOD problems had taken different directions. Thus, many of the individuals described their recovery in a broader sense which ranges from abstinence to moderation. Some individuals perceived themselves as no longer in recovery. The multitude of recovery processes described in the study underlines the need for acceptance and respect for individual identity processes. Furthermore, the importance is stressed of supporting an individual’s perceptions of how their recovery process should best be outlined. The results should not be interpreted as a critique of the 12-step approach. Instead, there is a need for variety over time in the support and treatment options available for people in need of treatment for AOD problems.

A process-based therapy approach emphasizes examining how and for whom specific therapeutic components linked to specific processes of change function. This preliminary study explored the processes of change for cognitive defusion and restructuring with daily ratings of self-criticism from a larger component trial as well as self-compassion as a moderator of these daily effects. A sample of 51 adults high in self-criticism (M age = 22.69, 78% female, 88% non-Hispanic White) were randomized to a cognitive defusion or restructuring mobile app for two weeks and completed daily assessments. Both conditions improved over time on daily frequency, defused noticing, challenging, and believability of self-critical thoughts as well as valued actions, with larger improvements in the defusion condition only for thought frequency and defused noticing. Global self-compassion moderated several effects such that only participants lower in self-compassion improved over time on daily self-criticism processes in the restructuring condition, while effects over time in the defusion condition generally did not vary by level of self-compassion. Improvements in daily frequency, defused noticing, and challenging self-critical thoughts as well as valued action each predicted global improvements in self-criticism at post-intervention across conditions. Overall, these preliminary results suggest cognitive defusion and restructuring may have some similar effects on self-criticism related processes of change, particularly for those low in self-compassion. However, defusion may produce larger effects on some targeted processes, especially among those with higher self-compassion.

Education for Sustainable Development (ESD) supports processes of change in complex socio-ecological systems. Where and how this change takes place are important considerations as we seek to enhanc...

In this study, we examined processes of change in trauma-focused cognitive behavioral therapy (TF-CBT) delivered to a community sample of 81 youths. Emotional processing theory (EPT) is used as an organizational framework. EPT highlights activating and changing pathological trauma-related responses and increasing adaptive responses across cognitive, emotional, behavioral, and physiological domains. We coded sessions during the trauma-narration and -processing phase of TF-CBT to examine the extent to which pathological and adaptive trauma-related responses were activated across domains. Higher scores indicate that more domains (range = 0–4) were activated at a threshold of moderate to high intensity. Curvilinear change (inverted U, increase then decrease) in multimodal negative response scores across sessions predicted improvement in internalizing symptoms and symptoms of posttraumatic stress disorder after treatment. Linear increases in multimodal positive responses predicted improvement in externalizing symptoms. Findings suggest value in activating and changing both pathological and adaptive trauma responses across multiple domains and examining nonlinear patterns of change.

The objective of this study was to empirically enrich the so far theoretically elaborated concept of Moments of Meeting (MoM), that enable processes of change in psychotherapies as described by the...

espanolEn este articulo se analiza la forma en que las categorias vivas jun pajal o´tanil (un solo corazon) y lequil cuxlejal (vida plena) orientan el proceso de cambio cultural entre las familias tseltales vinculadas a la Mision Jesuita de Bachajon. Se analizo como estudio de caso la experiencia del “hogar tseltal sustentable” construido por un grupo de mujeres campesinas de Pinabetal, municipio de Chilon, Chiapas. Se reviso la informacion documental y se realizaron entrevistas, grupos focales y talleres. La robustez del sistema de cargos comunitarios y el engrandecimiento de las capacidades locales fueron los pilares para construir procesos autonomos de cambio, que permitieron mejorar las condiciones de vida y de trabajo de las familias tseltales. Se concluye que con fundamento en las raices culturales del pueblo tseltal, familias campesinas se apropian de innovaciones a traves de un proceso de control cultural. EnglishThis article analyzes the way in which the live categories jun pajal o´tanil (a single heart) and lequil cuxlejal (full live) guide the process of cultural change among the tseltal families linked to the Jesuit Mision in Bachajon. The experience of the “sustainable tzeltal home” built by a group of peasant women from Pinabetal, municipality of Chilon, Chiapas, was analyzed as a study case. Documental information was reviewed and interviews, focal groups, and workshops were performed. The robustness of the system of the community charge system and the enhancement of local capacities were the pillars to build autonomous processes of change, which allowed improving the living and working conditions of the tseltal families. It is concluded that with a foundation in the cultural roots of the tseltal people, peasant families adopt innovations through a process of cultural control.

Background: This study aimed to generate a grounded theory of change processes as experienced by people with psychosis who engaged in an Acceptance and Commitment Therapy (ACT) group program. A secondary aim was to identify how participants described changes in their relationship to distress following the groups. Methods: The study used a qualitative research methodology, grounded theory. This was used to explore emergent themes in the participants’ subjective experiences of group ACT delivered in community mental health services. The experience of the ACT group process was investigated for nine participants. Semi-structured interviews were used to explore how the group experience and the exercises, metaphors and skills promoted by ACT were used by participants in their daily lives. Results: There were four main themes emerging from the interviews: awareness, relating differently, reconnection with life, leaning on others. Conclusions: The participants all described experiencing subjective benefits from being involved in the ACT groups, along with perspectives on processes of change. These reports of changes were consistent with the model and extend our understanding of the lived experience of engaging in ACT for psychosis groups

Objectives: This study explored a new telehealth educational and development psychologist (EDP) service 10 provided as part of a multidisciplinary team to rural families. We aimed: 1) to examine th...

Churches all over Europe are experiencing decline within a larger context of religious decline. One under-researched field concerns the consequences this decline has at a local organizational level. This article examines congregations experiencing growth in attendance at their regular Sunday worship services, and asks: What has caused growth in attendance among these congregations? What are the consequences of the attendance growth according to parish leadership, staff, committed volunteers and regular churchgoers? The empirical material for the study is interview and observation material from four congregations in the Church of Norway. These congregations have witnessed an increase in attendance of between 15.5% and 31.6% the last five years (2013–2017) compared to the previous five years (2008–2012). The ecclesial ideal in the Church of Norway, as in other national majority churches, has been to balance between “the core congregation” and “the folk church”. However, the Nordic pattern of “belonging without believing” or “believing in belonging” is not as strong as it used to be, and this has made “vicarious religion” more contested within congregations. A more polarized neither-nor understanding of the Sunday service can explain why the studied congregations have been able to grow within a context of decline.

"Democracy and the idea of progress became one of the most important attrib-utes of Hungarian Reformation in the 19th century, both as its self-image and socie-ty’s image of Calvinists (and, more broadly, of Protestants). These indicators are very important because, to this day, they are essential elements of Calvinist identity, but they also illustrate well the way heritage forged into identity. The part of the past reflected and “used” in community memory loosely relates to the actual legacy of the past. Different authors have defined in different ways which exact identity elements are representative of these attributes, and it also varies how long such an el-ement retains its representative quality, if it retains it at all. Without being exhaus-tive, the study outlines the ways the specific content of these attributes changes over the 20th century: that is, in the context of changes in the relationship between church and society, in what situations and what factors these attributes are identi-fied by individual opinion formers. The author first examines the historical context of the emergence of these topoi and then looks at some cases of their use, with par-ticular emphasis on the period of communist dictatorship. Keywords: democracy, Calvinism, heritage transformation, community memory, com-munism."

The advent of containerised cargo completely revolutionised shipping and world trade, also transforming the way that dock workers did their jobs. As a result, the docks are one of the most academic...

Student exchange is associated with many positive outcomes, however, little is known about the experiences that drive such changes. The aim of the current qualitative study was to explore how exchange students conceptualize the processes of change and development during exchange within an identity framework. Twenty interviews were conducted with Australian and French exchange alumni aged 19–23 years. Thematic analysis identified two major themes of change with specific associated driving experiences titled “ I did it, so I can do it” and “ I know who I am, I know what I want.” The second theme included two subthemes addressing an increased valuing of diversity and interest in international experiences. Three themes of influencing factors showed that students’ attitudes, previous experience, and family environments could impact exchange outcomes. The findings suggest that identity development is central to development during exchange, with the findings aligning with pre-existing models from the identity literature.

Previous research has sought to identify the underlying processes and mechanisms that lead to lasting changes in a client’s career development, yet more research needed to understand what elicits effective changes. The present research will explore how life-design career counselling supports change in a group of disadvantaged South African adolescents. The present research study will focus on a post-intervention qualitative strand, which included evaluative worksheets completed post-intervention (n = 265) and a focus data six months later (n = 6). Braun and Clarke’s (2006) content analysis was used to group themes according to the Career Construction Theory (CCT) and process constructs of narrative career counselling. Qualitative findings provide evidence that the intervention had elicited long-term changes in career development and facilitated reflective processes. Implications and recommendations for research and practice will be discussed.

Los procesos de cambio de uso de suelo y vegetación en México son un fenómeno provocado por la expansión de actividades antrópicas. Ante esta y otras problemáticas, la generación de estrategias mediante el decreto de áreas naturales protegidas busca proteger la integridad de ecosistemas representativos. Sin embargo, la carente instrumentación de políticas de manejo en estos espacios geográficos hace evidente su deterioro socioambiental. Bajo este preámbulo, el objetivo de esta investigación fue identificar, ubicar y analizar espacialmente los procesos de transformación que inciden de manera directa en los cambios de uso de suelo y vegetación dentro del territorio administrativo del Parque Otomí-Mexica del Estado de México. Mediante la generación de coberturas de uso de suelo y vegetación de los años 1993 y 2018, aplicación de métodos de sobreposición, técnicas de fotointerpretación y trabajo de campo se determina que los cambios de uso de suelo y vegetación son generados por procesos de conversión, modificación y fragmentación

More and more contributions to the field of lithics are taking into consideration skill levels and learning processes in prehistory, with the aim of clarifying not only how individuals acted when they produced their tools but also of addressing the processes of change or continuity in the technocultural traditions of past societies and the participation of different social groups in the collective production. For this purpose, the demarcation of realistic categories of “experts” and “novices” in knapping, as well as a determination of what attributes differentiate each one, are essential. Nowadays, knapping experiments offer a more realistic approach for a comparative study in which skill technotypes can indicate the existence of different skill levels inside a particular assemblage. Through the typologies of these experimental technical entities and their comparison with the archeological record, we can deduce the presence of particular models of social production and learning processes during the Lower and Middle Paleolithic.

El presente trabajo trata de incorporar la historia de la escuela en el corriente de la historia cultural de la experiencia, mostrando como la cultura empírica se sustenta, además de en las prácticas que ejecutan alumnos y enseñantes, en los modos de sociabilidad que los actores de la educación formal llevan a cabo mediante las ritualidades que institucionalizan la educación formal. Analiza, bajo un enfoque esencialmente fenomenológico y antropológico, las formas que adoptan los rituales escolares de paso y de interacción, y como éstas contribuyen a asegurar la gubernamentalidad de la vida escolar. Se complementa con la nueva perspectiva de la historia de las emociones. El texto se ilustra con algunas iconografías que muestran ejemplos de algunos de los ritos más frecuentes en la cotidianidad de la experiencia escolar y sus relaciones con los mitos, los juegos y las ceremonias. También plantea las resistencias que las prácticas rituales ofrecen a los procesos de cambio en la educación formal.

Resumen: Analizamos el funcionamiento de algunas dimensiones de la organización escolar que han posibilitado que una experiencia innovadora inicialmente circunscrita a dos aulas de una escuela de Cantabria se haya ampliado progresivamente y convertido en un proyecto que implica a todo el centro educativo. Este estudio de los procesos internos de cambio en la organización escolar, llevado a cabo en el curso académico 2017/2018, se realiza a partir de un estudio etnográfico de este caso escogido por sus características diferenciales y parti¬culares, buscando responder a una cuestión fundamental: ¿cuál es la relevancia de la organización escolar en los procesos de mejora? Las técnicas de recogida de información han sido: observación participante, grupos de discusión y análisis documental. Realizamos un análisis de contenido que revela algunas claves que facilitan la innovación: la revisión de las culturas escolares a partir de procesos dialógicos que implican a los diferentes agentes de la comunidad; la creación de condiciones estructurales (tiempos y espacios) desti¬nados al intercambio; un equipo directivo que dinamiza la colaboración y genera dichas estructuras físicas desde formas de liderazgo distribuido; la recuperación de la autonomía pedagógica como clave fundamental para desarrollar cambios coherentes con la realidad educativa del centro. Abstract: We analyze the functioning of some dimensions of the school organization that have enabled that an innovative experience initially circumscribed to two classrooms of a school in Cantabria has progressively expanded and become a project that involves the whole school. This study of the internal processes of change in school organization, carried out in 2017/2018, is based on an ethnographic study of this case chosen for its differential and particular characteristics, and is aimed at answering one fundamental question: what is the relevance of the school organization in the processes of educational improvement? Our sample refers to all agents of the school and the information gathering techniques are: participant observations, focus groups and document analysis. We carry out a content analysis that reveals some keys that facilitate innovation that involve the whole school: the revision of school cultures based on dialo¬gical processes that involve the different agents of the community; the creation of structural conditions (times and spaces) destined for exchange; a leadership team that dynamizes the collaboration and generates these physical structures from distributed leadership; the recovery of pedagogical autonomy as a fundamental key to develop changes coherent with the educational reality of the school.

The purpose of this article is to serve as a guide for counseling psychologists to learn about a neuroscience methodology that can be used to study psychotherapy change processes. Event-related potential (ERP) is a specific type of electroencephalography that can be time-locked to a stimulus and thus allows researchers to examine neural responses to specific therapeutic techniques. A conceptual overview of the method and its applicability to counseling psychologists is provided. Additionally, this article contains basic guidelines for designing an ERP study, the tools necessary for setting up an ERP lab, and an overview of data-processing strategies. Common pitfalls encountered both broadly in neuroscience research and specifically in ERP research are discussed. An integrated review of relevant literature is presented here, along with suggestions for future counseling psychology research, with a focus on establishing biomarkers of successful interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The aim of this study was to gain a better understanding of the change from physical spaces to learning environments by examining how, and through which processes, learning spaces are transformed, produced and developed. For this purpose, we used a comparative ethnography approach and collected observation material from two Finnish schools at different development phases. The material was supplemented by focus-group interviews with teachers and individual interviews with principals. The results suggest that no ready-made models exist which fit into a new context. Rather, practices are constructed in physical spaces through active negotiations and meaning- making in three cyclic interaction processes (i.e., interaction between teachers, interaction between students and teachers, and interaction between students). Hence, through cyclic processes with strong support from teachers, students managed to find tools to build learning environments suited to their needs, which further enabled the expansion of learning environments inside and outside school walls. Nevertheless, changes in practices required an overall change in every aspect of the school. Focusing on the processes of change, results provide information from a systemic perspective on how schools can manage continuous change when developing physical spaces into learning environments.

BackgroundThe American and Canadian Choosing Wisely campaigns recommend against routine complete blood count (CBC) and chemistry testing in the face of clinical stability in the inpatient internal medicine setting. ProblemPatients on internal medicine units commonly have daily lab tests ordered at admission and lab testing is often bundled. Four ‘core’ lab tests (CBC, electrolytes, creatinine, and urea) account for more than half of all lab tests performed. MethodsThe Model for Improvement and the Donabedian framework was used to define the problem, evaluate the baseline state, and generate targeted improvements. A quality improvement (QI) initiative consisting of education and process change was implemented on one general internal medicine unit and multiple plan-do-study-act cycles were carried out. The outcome measure was the total number of core labs performed, and the process measure was the proportion of patients with tests ordered on a repeating daily basis. ResultsThe initiative led to an 18.9% decrease in the total number of core labs ordered and an 18.2% absolute decrease in repeating daily lab orders. ConclusionsA multifaceted QI initiative aimed at reducing unnecessary lab testing was successful at reducing the number of lab tests ordered and changing lab ordering process. ResumeContexteLes campagnes américaine et canadienne “Choisir judicieusement” recommandent de ne pas effectuer de tests de routine de numération globulaire complète (CBC) et de chimie face à la stabilité clinique des patients hospitalisés en médecine interne. ProblèmeLes patients des unités de médecine interne doivent généralement passer des examens de laboratoire quotidiens à l’admission et les analyses de laboratoire sont souvent regroupées. Quatre tests de laboratoire “de base” (NFS, électrolytes, créatinine et urée) représentent plus de la moitié de tous les tests de laboratoire effectués. MéthodesLe modèle d’amélioration et le cadre donabédien ont été utilisés pour définir le problème, évaluer l’état de référence et générer des améliorations ciblées. Une initiative d’amélioration de la qualité (AQ) consistant en un changement d’éducation et de processus a été mise en œuvre dans une unité de médecine interne générale et plusieurs cycles “planifier-faire-étudier-agir” ont été réalisés. La mesure des résultats était le nombre total de laboratoires de base effectués, et la mesure des processus était la proportion de patients dont les tests commandés se répétaient quotidiennement. RésultatsCette initiative a permis de réduire de 18,9 % le nombre total de laboratoires de base commandés et de 18,2 % en valeur absolue le nombre de commandes quotidiennes répétitives. ConclusionsUne initiative d’AQ à multiples facettes visant à réduire les tests de laboratoire inutiles a permis de réduire le nombre de tests de laboratoire commandés et de modifier le processus de commande des laboratoires.

Acceptance and Commitment Therapy (ACT) targets six core processes of change including acceptance/experiential avoidance/, mindfulness/lack of contact with the present moment, committed action/inaction, cognitive defusion/fusion, self-as-context/self-as-content, and values clarification/values problems (Hayes, Strosahl, & Wilson, 1999). Previous researchers suggested that targeting experiential avoidance, cognitive fusion, and valued living may assist with posttraumatic stress disorder (PTSD) treatment (Donahue, Khan, Huggins, & Marrow, 2017; Walser & Hayes, 2006), yet few researchers have investigated these ACT core processes in a PTSD treatment-seeking sample. Therefore, we sought to investigate the relationship between these three ACT core processes, quality of life, PTSD symptom severity, and depression symptoms. Results indicated that experiential avoidance was most strongly related to PTSD symptom severity and depression, though it was not related to quality of life. In contrast, valued living was not significantly related to PTSD symptom severity or depression and was related only to quality of life. Overall, experiential avoidance and valued living appear to be especially relevant ACT processes in a sample of people reporting elevated levels of PTSD symptoms.

The current study investigates the physical activity distribution of Korea adults, examines the differences in the TTM constructs by the stage of physical activity, and identify the relationship be...

The social innovation inclines to an emphasis on ‘systems and processes of change in social relations’ and ‘innovation is a new idea, product or process that addresses social and environmental challenges and their needs’. It is newly growing up as a field of practice that is done by people. It has occurred from the broader field of innovation studies. In this article, the System of Rice Intensification (SRI) has been taken as a case of social innovation, which helps to increase the productivity of rice and enhance the income of the farmers. The literature related to SRI suggested that the technique is sustainable and innovative because of the less use of inputs and changes in some set of principles (i.e., planting, fertilizer, water and seeds) whereas increasing output in terms of production and productivity of the crop. In this sense, aim of the article is to evaluate the impact of the SRI technique within the framework of social innovation in Patna district, Bihar, India. In a wider context, the question is not about whether it is intensifying or not, rather emphasis should be on how farmers deal with changing environmental and socio-economic factors. Moreover, there is a need to delve deeper into implantation strategies in the local context and evaluate their impact in terms of opportunities and constraints during adaptation. In addition to this, an exploratory research design was followed to study SRI. Criterion and expert sampling were employed to select the farmers, and data were collected by a personal interview method with the help of a structured schedule. However, the data indicate the production and productivity of paddy are increased through SRI, but variation exists among different blocks of the district. It is clearly evident from the data that nearly 42 per cent of farmers from all blocks have witnessed an increase in food sufficiency. In the case of income due to the sale of excess produce is 57 per cent.

OBJECTIVESMost prescribing through the electronic health record (EHR) in the NICU at St. Vincent Women's Hospital use a weight-based dosing calculator. Prescribers receive no alert if the resulting volume is unmeasurable. Study definition of measurable was a dose volume with a visible hash mark on an appropriately sized oral syringe. The primary objective was to compare the rate of unmeasurable oral liquid doses prescribed at discharge before and after implementation of educational process changes. Secondary objectives assessed patient and discharge medication characteristics in relation to the unmeasurable doses prescribed.METHODSThis study was a 2-phase retrospective analysis of patients discharged from the NICU between January 1 and June 30, 2016 (phase I), and between October 1, 2017, and March 31, 2018 (phase II). Patients were included in the analysis if they were discharged on at least 1 oral liquid medication, excluding vitamins. Demographic and discharge medication information was collected.RESULTSThere were 58 patients discharged on a total of 118 oral liquid medications in phase I and 63 patients discharged on a total of 111 oral liquid medications in phase II. Following implementation of the process change, the percentage of unmeasurable discharge prescriptions decreased from 27 (23%) to 5 (4.5%) (p < 0.001).CONCLUSIONSThe educational process change implemented in the NICU effectively reduced the rate of unmeasurable doses prescribed at discharge from 1 in 4 to 1 in 25. Additional system-level changes may result in further reductions.

While the notion of farm tourism is not new in tourism studies, it continues to evolve and take forms not previously examined. This article describes the development of this form of tourism on the outskirts of Hội An (a World Heritage Site in Vietnam) as a farming sector seeks to build on a demand being created by visitors to the United Nations Educational, Scientific and Cultural Organization gazette site. Based on 27 informants, the article examines the nature of the agritourism products and their move towards sustainable tourism in response to demand. The article highlights (a) the nature of the products, (b) the opportunity provided by proximity to a World Heritage Site and (c) the educational background of the farmers and suggests that levels of education possess importance by enabling entrepreneurs to acquire business skills not previously available to earlier generations. In identifying this, the article contributes to a literature on how tourism products evolve in developing countries, for not only does education create skill sets but also creates an awareness of the commercial and social values of traditions and the need to retain this as expressions of cultural patterns of life.

Sexual harassment is increasingly prevalent. This is a concern because most sex offenders are teenagers. Sexual harassment committed by adolescents is related to the psychological development they are undergoing. Adolescence is a transitional period between children and adults characterized by ongoing processes of change in biological, psychological and sociological terms. Adolescent students live their lives in school throughout the day, if calculated spending about 7 hours/day at school This study aims to describe the sexual abuse behavior of adolescents. The research sample consisted of 182 vocational students who were selected by the proportional random sampling technique. The instrument used was a scale of sexual harassment behavior. The research instrument was tested for validity and reliability The data analysis in this study used a quantitative approach with descriptive methods. The results showed that the acts of adolescent sexual harassment, in general, were in the high category of 76 students (42%). The implications of this study are as a basis for counselors to prevent acts of teenage sexual harassment in schools.

Using the perceptions of the actors (researchers, principals and teachers) involved in the processes of change in Swiss school improvement processes, this study aims to identify the role of researchers/ trainers in school improvement. Methodologically, it is a descriptive study in which 13 respondents from four schools with inclusive projects have participated. Based on the content analysis of semistructured interviews, the results give an account of the roles they adopt and the strategies used by researchers/ trainers to mobilize knowledge on inclusive education. Este estudio pretende conocer, desde las percepciones de los actores implicados en procesos de cambio en escuelas suizas (investigadores, directivos y profesores), cuál es el papel de los investigadores/ formadores en los procesos de mejora escolar. Metodológicamente se trata de un estudio descriptivo en el que han participado 13 informantes de cuatro escuelas con proyectos inclusivos. A partir del análisis de contenido de entrevistas semiestructuradas, los resultados dan cuenta de los roles que adoptan y las estrategias que utilizan los investigadores/formadores para movilizar el conocimiento sobre educación inclusiva.

The economic transformation of the old industrial bases is a key research topic among geographers in China. In this paper, we propose that the concept of regional economic resilience (RER) has unique theoretical value in analyzing the economic transformation of the old industrial bases. We constructed an analytical framework and an index system and applied the conceptual tools to study the evolution of RER in the old industrial base of Liaoning Province in China, which is currently subjected to not only sudden shocks but ‘slow burn’—longer term processes of change that may nevertheless affect the regional economy. There are four main findings: first, the evolution of RER in Liaoning can be divided into four stages from 2000 to 2015. Liaoning is currently in its conservation-release period, and the next stage will be a release-reorganization period. Second, the RER of the majority of the studied cities is lower than the average value for Liaoning, and this is mainly attributed to the relatively weak vulnerability-resistance and adaptability-transformation capacity of these cities. Third, the RER levels of the 14 cities in Liaoning differ significantly. At the first level is Shenyang and Dalian, at the second level is Dandong and Yingkou, and the third level comprises the remaining cities. Fourth, regional economic resilience is mainly determined by vulnerability-resistance, which indirectly reflects Liaoning’s lack of adaptability-transformation capacity, and the ability of the region to renew or create a new development path is weak.

While accounts of urban climate change governance and planning are growing, there is a need for further conceptual and empirical work to better understand processes of change and uptake across a ra...

The Zeen oak (Quercus faginea) is a forest species endemic to the western Mediterranean, very remarkable in Algeria; it is an oak with deciduous or semi-persistent leaves. Quercus faginea, is very polymorphic, especially in terms of leaf characteristics, so it would be represented in Algeria by two subspecies: Quercus faginea subsp. baetica (Webb) DC and Quercus faginea subsp. tlemcenensis (DC). The latter, which is of major taxonomic interest, is a species that still resists climatic fluctuations. This stand is a formation at the climatic stage, which covers a large part of the Moutas reserve (488 ha), appears from an altitude of 1100 m and is frequently found where humidity is high. For a decade, our attention has been drawn to its particular behaviour, linked to major processes of change in both climate and biological components. Through this study, we show the importance of this stand, which is in a regressive dynamic phase on which the incidence of disturbances is only the action of anthropogenic climatic factors. Despite its good adaptive strategy, Quercus faginea subsp. tlemcenensis is a species threatened by multiple anthropozoogenic impacts; the latter constitutes a direct threat to the preservation and renewal of biological resources as well as to the ecological balance of the area [1], but the dynamic value of Quercus faginea subsp. tlemcenensis remains appreciated with particular attention by scientists, foresters, conservators and local populations in the region.

The objectives were a) to test whether a Processes of Change (POC)-personalized Transtheoretical model (TTM)-based intervention could increase physical activity (PA) among inactive adults, and b) to examine whether the intervention increased the level of TTM theoretical constructs. The following hypotheses were formulated: 1) PA levels will be significantly higher during and after the intervention in comparison to baseline measures; 2) the level of targeted POCs will significantly increase during the intervention; 3) non targeted POCs will stay stable, and 4) self-efficacy and decisional balance levels will significantly increase during the intervention. A series of N-of-1 with A (1 to 2-week)-B(10-week)-A’(2-week) design were conducted with 12 inactive adults. Behavioral counselors used behavior change techniques to target TTM constructs and supervise PA. Interventions were individualized based on the 5 POCs with the lowest pre-intervention level. Device-based and subjective PA along with TTM measures were collected weekly online. PA data were analyzed with piecewise linear models. A visual analysis was run to examine the TTM constructs. Device, self-reported and TTM data were available for five, seven and five participants, respectively. A significant self-reported PA increase for six participants was found during the phase B and A2. A significant device-measured PA increase was observed in two participants during the study. A substantial increase of targeted POC from baseline for all participants with available data was observed. This study provides the first evidence of behavioral and psychological effects of a POC-personalized TTM-based intervention in inactive adults.

The last five decades have seen a proliferation of psychological packages designed to treat psychiatric syndromes. Despite millions of dollars invested evaluating and comparing complex interventions, progress has been limited. Increasingly, research is shifting toward evaluating evidence-based processes of change instead of packages. There is also an increasing focus away from static mediational models to understanding how processes and symptoms interrelate in dynamic network models. The Extended-Evolutionary Meta Model seeks to provide different therapeutic orientations with a common framework for discussing and understanding processes of change. We conclude the article by providing concrete examples of evidence-based processes across six dimensions- Attention, self, cognitive, affect motivation, and overt behavior--and three levels-biological, psychological, and social.