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Change Mechanisms (change + mechanism)
Selected AbstractsRedox-Based Resistive Switching Memories , Nanoionic Mechanisms, Prospects, and ChallengesADVANCED MATERIALS, Issue 25-26 2009Rainer Waser This review article introduces resistive switching processes that are being considered for nanoelectronic nonvolatile memories. The three main classes are based on an electrochemical metallization mechanism, a valence change mechanism, and a thermochemical mechanism, respectively. The current understanding of the microscopic mechanisms is discussed and the scaling potential is outlined.. [source] Effect of an In-Home Occupational and Physical Therapy Intervention on Reducing Mortality in Functionally Vulnerable Older People: Preliminary FindingsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2006Laura N. Gitlin PhD OBJECTIVES: To evaluate the effect of a multicomponent intervention on mortality and the role of control-oriented strategy use as the change mechanism. DESIGN: Two-group randomized design with survivorship followed for 14 months. Participants were randomized to intervention or a no-treatment control group. SETTING: Urban, community-living older people. PARTICIPANTS: Three hundred nineteen people aged 70 and older with functional difficulties. INTERVENTION: Occupational therapy and physical therapy sessions involving home modifications, problem solving, and training in energy conservation, safe performance, balance, muscle strength, and fall recovery techniques. MEASUREMENTS: Survival time was number of days between baseline interview and date of death or final interview if date unknown. Control-oriented strategy use was measured using eight items. RESULTS: Intervention participants exhibited a 1% rate of mortality, compared with a 10% rate for no-treatment control participants (P=.003, 95% confidence interval=2.4,15.04%). At baseline, those who subsequently died had more days hospitalized and lower control-oriented strategy use 6 months before study enrollment than survivors. No intervention participants with previous days hospitalized (n=31) died, whereas 21% of control group counterparts did (n=35; P=.001). Although intervention participants with low and high baseline control strategy use had lower mortality risk than control participants, mortality risk was lower for intervention participants with low strategy use at baseline (P=.007). CONCLUSION: An occupational and physical therapy intervention to ameliorate functional difficulties may reduce mortality risk in community-dwelling older people overall and benefit those most compromised. Instruction in control-oriented strategies may account for the intervention's protective effects on survivorship. [source] Chinese inpatients' subjective experiences of the helping process as viewed through examination of a nurses' focused, structured therapy groupJOURNAL OF CLINICAL NURSING, Issue 7 2004Fei-Hsiu Hsiao RN Aims and objectives., This study examined Chinese inpatients' views on what aspects of a nurses' focused, structured therapy group worked to help their psychological and interpersonal problems and what traditional Chinese cultural values influenced their viewpoints. Methods., Nine Chinese inpatients with mental illness participated in the four-session nurses' focused, structured therapy group. After they completed the last session of therapy, they were invited to participate in a structured interview and a semi-structured interview regarding their perceptions of the change mechanisms in nurses' focused, structured group therapy. The semi-structured interviews were recorded and transcribed to be further analysed according to the principal of content analysis. Results., The results indicate that (i) all patients believed that a nurses' focused, structured group psychotherapy enhanced their interpersonal learning and improved the quality of their lives, (ii) traditional Chinese cultural values , those emphasizing the importance of maintaining harmonious interpersonal relationships , influenced the Chinese inpatients' expression of negative emotions in the group and their motivation on interpersonal learning. Conclusion., In conclusion, we found that transcultural modification for applying Western group psychotherapy in Chinese culture was needed. The modification included establishing a ,pseudo-kin' or ,own people' relationship among group members and the therapists, organizing warm-up exercises and structured activities, applying projective methods and focusing on the issues of interpersonal relationships and interpersonal problems. Relevance to clinical practice., The small sample size of the present study raises questions regarding how representative the views of the sample are with respect to the majority of Chinese inpatients. Nevertheless, this preliminary study revealed a cultural aspect in nursing training that requires significant consideration in order to work effectively with Chinese patients. [source] Conceptual and Design Essentials for Evaluating Mechanisms of ChangeALCOHOLISM, Issue 2007Matthew K. Nock Background:, Considerable progress has been made toward the development of evidence-based treatments for a wide range of psychological disorders; however, little is known about the mechanisms through which these treatments actually lead to clinical change. Although the use of traditional randomized controlled treatment designs and tests of statistical mediation have significantly advanced understanding of psychological treatments, they are insufficient to test mechanisms of change. Method:, This article outlines the conceptual and methodological requirements for evaluating mechanisms of change, highlights the importance of such a focus, and offers specific recommendations for research aimed at elucidating change mechanisms. Results and Conclusions:, Conceptualizing and conducting studies that test mechanisms of change requires substantial modifications to traditional research designs, but doing so will significantly enhance scientific understanding as well as the efficiency and effectiveness of clinical interventions. [source] Models for the development of graduate entry medical courses: two case studiesMEDICAL EDUCATION, Issue 11 2004David Prideaux Introduction, The introduction of graduate entry medical courses requires attention to models of decision-making and change. Much of the educational literature describes change as either centralised or decentralised with the latter claimed to be more effective. Recently Fullan has argued for the importance of an ongoing culture of change. This paper examines the change culture of two medical schools adopting graduate entry courses; Flinders University in South Australia and St George's Hospital Medical School, London. Method, Comparative case study was used. Key informants were interviewed and documents and records analysed. Data were cross-checked and categorised to generate models of change. Results, There were four components of the change culture at Flinders but they were not sufficient on their own to generate change. The process was triggered by a significant external event. The nature of the change was also important. The descriptive model developed suggested a complex interplay of factors rather than attributing the success of the change to the change mechanisms adopted alone. The model was tested for explanatory potential at St George's. The culture there was described as both ,macro-innovative' and ,micro-conservative'. External events were also important but they exerted a positive force. A more centralised approach was adopted. Discussion, The models developed represent change as ,dynamic, complex and open' rather than a simple centralised or decentralised dichotomy. While some of the elements of a change culture were evident at both schools there were longer term questions of sustainability. This has implications for development of all programmes but particularly for graduate entry schools. [source] Facilitating effective health promotion practice in a public health unit: lessons from the fieldAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2007Jessica Berentson-Shaw Objectives: Health promotion is a core function of public health services and improving the effectiveness of health promotion services is an essential part of public health service development. This report describes the rationale, the process and the outcomes of a realignment designed to improve the effectiveness of health promotion activities in a public health unit (PHU) in New Zealand. Methods: A practice environment analysis revealed several factors that were hindering the effectiveness of the health promotion unit's (HPU) activities. Two primary change mechanisms were implemented. The first was an outcomes-focused model of planning and service delivery (to support evidenced-based practice), the second was the reorganisation of the HPU from a topicsbased structure to an integrated one based on a multi-risk factor paradigm of population health. Results: During the realignment barriers were encountered on multiple levels. At the individual level, unfavourable attitudes to changes occurred because of a lack of information and knowledge about the benefits of evidence and research. At higher levels, barriers included resourcing concerns, a lack of organisational commitment and understanding, and tensions between the political need for expedient change and research and development need for timely consideration of the impact of different models of practice. Conclusions and Implications: This realignment took place within the context of a changing public health environment, which is significantly altering the delivery of public health and health promotion. Realignments designed to facilitate more effective health promotion and public health practice will continue, but need to do so in the light of others' experience and debate. [source] Treatment fidelity as a predictor of behaviour change in parents attending group-based parent trainingCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2009C. Eames Abstract Background Change in parenting skills, particularly increased positive parenting, has been identified as the key component of successful evidence-based parent training (PT), playing a causal role in subsequent child behaviour change for both prevention and treatment of Conduct Disorder. The amount of change in parenting skills observed after PT varies and may be accounted for by both the content of the programme and by the level of PT implementer process skills. Such variation in implementer skills is an important component in the assessment of treatment fidelity, itself an essential factor in successful intervention outcome. Aims To establish whether the Leader Observation Tool, a reliable and valid process skills fidelity measure, can predict change in parenting skills after attendance on the Incredible Years PT programme. Results Positive leader skills categories of the Leader Observation Tool significantly predicted change in both parent-reported and independently observed parenting skills behaviour, which in turn, predicted change in child behaviour outcome. Conclusions Delivering an intervention with a high level of treatment fidelity not only preserves the behaviour change mechanisms of the intervention, but can also predict parental behaviour change, which itself predicts child behaviour change as a result of treatment. [source] | ||||||||||