A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

Funding for this study was received from the Chief Scientist Office for Scotland. We would like to thank Asthma UK and Asthma UK Scotland for facilitating the advertisement of the study pilot and consultative user group. Thanks to Dr Mark Grindle for his helpful discussions concerning narrative. Thanks also to Mr Mark Haldane who designed the characters, backgrounds, and user interface used within the 3D computer animation. Particular thanks to the participants of the consultative user group for their enthusiasm, comments, and suggestions at all stages of the intervention design.

Signalling changes to individuals who show resistance to change can reduce challenging behaviour

Background & objectives Several neurodevelopmental disorders are associated with resistance to change and challenging behaviours – including temper outbursts – that ensue following changes to routines, plans or expectations (here, collectively: expectations). Here, a change signalling intervention was tested for proof of concept and potential practical effectiveness. Methods Twelve individuals with Prader-Willi syndrome participated in researcher- and caregiver-led pairing of a distinctive visual-verbal signal with subsequent changes to expectations. Specific expectations for a planned subset of five participants were systematically observed in minimally manipulated natural environments. Nine caregivers completed a temper outburst diary during a four week baseline period and a two week signalling evaluation period. Results Participants demonstrated consistently less temper outburst behaviour in the systematic observations when changes imposed to expectations were signalled, compared to when changes were not signalled. Four of the nine participants whose caregivers completed the behaviour diary demonstrated reliable reductions in temper outbursts between baseline and signalling evaluation. Limitations An active control group for the present initial evaluation of the signalling strategy using evidence from caregiver behaviour diaries was outside the scope of the present pilot study. Thus, findings cannot support the clinical efficacy of the present signalling approach. Conclusions Proof of concept evidence that reliable pairing of a distinctive cue with a subsequent change to expectation can reduce associated challenging behaviour is provided. Data provide additional support for the importance of specific practical steps in further evaluations of the change signalling approach.

Technology is Set to Change Real Estate Forever

Major developments in the technological environment can become commonplace very quickly. They are now impacting upon a broad range of information-based service sectors, as high growth Internet-based firms, such as Google, Amazon, Facebook and Airbnb, and financial technology (Fintech) start-ups expand their product portfolios into new markets. Real estate is one of the information-based service sectors that is currently being impacted by this new type of competitor and the broad range of disruptive digital technologies that have emerged. Due to the vast troves of data that these Internet firms have at their disposal and their asset-light (cloud-based) structures, they are able to offer highly-targeted products at much lower costs than conventional brick-and-mortar companies.

Adapting to change in contemporary Irish and Scottish culture: fiction to film

Abstract available: p. [ii]-[iii].

Experiences of care and adjustment to change in caregivers of children with autoimmune encephalitis: an interpretative phenomenological analysis

Background: Autoimmune encephalitis (AE) occurs in response to an antibody-mediated central nervous system disease and can lead to significant neurodisability. Prior research on family adjustment has described a reciprocal relationship between caregiver functioning, distress and clinical outcome in parents and children with encephalitis. There has been no previous research exploring the experiences of caregivers with a child with AE. Aims: To explore the perspectives of parents and/or caregivers with a child diagnosed with AE regarding (i) their own adjustment from hospital admission to post-discharge, and (ii) their experiences of care and service provision. Methods: A purposive sampling approach was used. Five parents of children with AE participated in a semi-structured interview exploring their experiences of caring for their child and service provision during acute care and post-discharge. Interpretative Phenomenological Analysis (IPA) was used to analyse the transcripts. Main findings and conclusions: Four shared super-ordinate themes with related subthemes emerged: (a) uncertainty, (b) managing our recovery, (c) changes in my child, (d) experiences of service provision. Participants reported emotional distress, often underpinned by recurrent experiences of uncertainty, and ‘loss’ of the previous child, and mediated by coping strategies and social support. While an overall positive experience of inpatient services was reported, parents often perceived post-discharge services as lacking in co-ordination, communication and formal follow-up, resulting in unmet support needs. Implications and recommendations for services, practitioners and future research are discussed.

The importance of organizational commitment to knowledge management

In recent years, Knowledge Management (KM) has assumed great importance in the literature on business and management. However, we still have so little understanding of the human issues in KM processes. Thus, this research aims to contribute to analysing the importance of Organizational Commitment (OC) to KM. First, we used the Cardoso (2003) Knowledge Management Questionnaire (QGC) that embraces all organizational activities around knowledge processes and distinguishes four dimensions of KM. Secondly we applied the Quijano, Masip, Navarro and Aubert (1997) questionnaire (ASH-ICI) that distinguishes two types of commitment (personal and instrumental) into four dimensions. These two questionnaires were applied with 300 employees in the Portuguese industrial ceramics sector. Through multiple regression analysis we found that levels of organizational commitment are statistically important to KM dimensions. Furthermore, our analysis indicates that personal commitment is more important than need commitment. These results are discussed and Organizational Behaviour specialists and Work and Organizational psychologists are challenged to assume more responsibility and an active role in KM studies and practices and to explore human issues in this field.

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.

Behavioural outcomes of next-generation family members’ commitment to their firm

Are there variations in behaviours and leadership styles of next-generation family members or descendants who join their family business due to different forms of commitment? Evidence from a dual respondent study of 109 Canadian and Swiss family firms suggests that descendants with affective commitment to their family firms are more likely to engage in discretionary activities going beyond the job description, thereby contributing to organizational performance. Next-generation members with normative commitment are more likely to engage in transformational leadership behaviours. Both affectively and normatively motivated next-generation members use contingent reward forms of leadership. A surprising finding of this study is the binding force of normative commitment on positive leadership behaviours of next-generation members. This study empirically tests the generalizability of the three-component model of commitment to family businesses, a context in which different forms of commitment may play a unique role.

Conservative management in very elderly patients with severe aortic stenosis: Time to change?

Despite current recommendations, a high percentage of patients with severe symptomatic aortic stenosis are managed conservatively. The aim of this study was to study symptomatic patients undergoing conservative management from the IDEAS registry, describing their baseline clinical characteristics, mortality, and the causes according to the reason for conservative management. Consecutive patients with severe aortic stenosis diagnosed at 48 centers during January 2014 were included. Baseline clinical characteristics, echocardiographic data, Charlson index, and EuroSCORE-II were registered, including vital status and performance of valve intervention during one-year follow-up. For the purpose of this substudy we assessed symptomatic patients undergoing conservative management, including them in 5 groups according to the reason for performing conservative management [I: comorbidity/frailty (128, 43.8%); II: dementia 18 (6.2%); III: advanced age 34 (11.6%); IV: patients’ refusal 62 (21.2%); and V: other reasons 50 (17.1%)]. We included 292 patients aged 81.5 ± 9 years. Patients from group I had higher Charlson index (4 ± 2.3), higher EuroSCORE-II (7.5 ± 6), and a higher overall (42.2%) and non-cardiac mortality (16.4%) than the other groups. In contrast, patients from group III had fewer comorbidities, lower EuroSCORE-II (4 ± 2.5), and low overall (20.6%) and non-cardiac mortality (5.9%). Patients with severe symptomatic aortic stenosis managed conservatively have different baseline characteristics and clinical course according to the reason for performing conservative management. A prospective assessment of comorbidity and other geriatric syndromes might contribute to improve therapeutic strategy in this clinical setting.

Sensitization and Disposition to Change Facing the Challenges of the New Educational Circumstances

This article is about the necessity of an up to date vision in teachers’ training. It starts with the latest studies and advances surrounding learning-along-life term. It presents a set of topics inspired in the contributions of new fields of study connected to learning. Such contributions, as neuroscience, should be considered in the decisions related to future teachers’ training, thus favoring the transformation of the pedagogical practice. Awareness and disposition to change are essential requirements for teacher trainers who will drive investigative processes and pedagogical proposals generation; all of this according to the new and dynamic knowledge society.

Factors associated with favorable drinking outcome 12 months after hospitalization in a prospective cohort study of inpatients with unhealthy alcohol use.

BACKGROUND: Prevalence of unhealthy alcohol use among medical inpatients is high. OBJECTIVE: To characterize the course and outcomes of unhealthy alcohol use, and factors associated with these outcomes. DESIGN: Prospective cohort study. PARTICIPANTS: A total of 287 medical inpatients with unhealthy alcohol use. MAIN MEASURES: At baseline and 12 months later, consumption and alcohol-related consequences were assessed. The outcome of interest was a favorable drinking outcome at 12 months (abstinence or drinking "moderate" amounts without consequences). The independent variables evaluated included demographics, physical/sexual abuse, drug use, depressive symptoms, alcohol dependence, commitment to change (Taking Action), spending time with heavy-drinking friends and receipt of alcohol treatment (after hospitalization). Adjusted regression models were used to evaluate factors associated with a favorable outcome. KEY RESULTS: Thirty-three percent had a favorable drinking outcome 1 year later. Not spending time with heavy-drinking friends [adjusted odds ratio (AOR) 2.14, 95% CI: 1.14-4.00] and receipt of alcohol treatment [AOR (95% CI): 2.16(1.20-3.87)] were associated with a favorable outcome. Compared to the first quartile (lowest level) of Taking Action, subjects in the second, third and highest quartiles had higher odds of a favorable outcome [AOR (95% CI): 3.65 (1.47, 9.02), 3.39 (1.38, 8.31) and 6.76 (2.74, 16.67)]. CONCLUSIONS: Although most medical inpatients with unhealthy alcohol use continue drinking at-risk amounts and/or have alcohol-related consequences, one third are abstinent or drink "moderate" amounts without consequences 1 year later. Not spending time with heavy-drinking friends, receipt of alcohol treatment and commitment to change are associated with this favorable outcome. This can inform efforts to address unhealthy alcohol use among patients who often do not seek specialty treatment.

TYÖPROSESSIN JA TOIMINNANOHJAUSSOVELLUKSEN KÄYTTÖÖNOTTO

Työn tavoitteena oli tutkia uuden tuotannonohjausjärjestelmän ja työprosessin käyttöönottoa maantieteellisesti hajautetussa organisaatiossa. Tavoitteena oli myös laatia malli kuinka mittavat järjestelmäkäyttöönotot tulisi viedä läpi hallitusti. Tutkimuksen teoriaosuus on tehty kirjallisuustukimuksena ja asiantuntijahaastatteluiden pohjalta. Teoriaosuudessa käydään läpi mitkä seikat uuden tuotannonohjausjärjestelmän käyttöönotossa ovat tärkeitä onnistumisen kannalta ja kuinka käyttöönottoprojekti tulisi viedä läpi. Työn empiirisessä osuudessa on analysoitu kuinka järjestelmä otettiin käyttöön kohdeyrityksessä. Empiirinen osa on tehty tarkastelemalla käyttöönottoa ja onnistumista on pohdittu suorittamalla käyttäjäkysely. Järjestelmien käyttöönotot epäonnistuvat useassa tapauksessa. Nämä epäonnistumiset johtuvat usein käyttöönotto-organisaation kokemattomuudesta viedä läpi monimutkaisia projekteja, suunnittelun puutteesta, huonosta sitoutumisesta muutokseen tai riittämättömästä resurssien allokoinnista. Ennalta suunnittelu, suunnitelmien pitävyyden tarkastaminen ja mahdollisesti muuttaminen käyttöönoton edetessä ovat avaimia onnistumiseen. Kohdeyrityksessä otetaan erilaisia järjestelmiä käyttöön ajoittain. Nämä käyttöönotot eivät ole kuitenkaan aina sujuneet halutulla tavalla. Tutkimus pyrkii luomaan vaiheittaisen mallin muutokseen valmistautumisesta, suunnittelusta, muutoksen kouluttamisesta, järjestelmän integroimisesta muihin järjestelmiin, muutoksen läpivientiin ja käyttöönoton onnistumisen mittaamisesta. Tutkimuksessa käsitellään uuden projektinhallintajärjestelmän käyttöönoton problematiikan lisäksi uuden työprosessin käyttöönottoa.

Olipa kerran muutos - Narratiivinen tutkimus organisaatiosta sisäisten ja ulkoisten muutospaineiden keskellä

Tutkimus kuvaa tarinallisuuden kautta organisaation sisäistä muutosta organisaation toimiessa muuttuvassa toimintaympäristössä. Teoriaosan keskeisinä käsitteinä ovat sosiaalinen identiteetti organisaatiossa sekä muutosjohtaminen. Tutkimus selvittää, miten jatkuva organisatorinen ja toimintaympäristöllinen muutos vaikuttivat organisaation muutoskykyyn ja sen jäseniin, minkälaista muutosjohtamista organisaatio muutostilanteessa tarvitsee ja millaisia vaikutuksia muutoksilla oli organisaation sisällä esiintyviin sosiaalisiin identiteetteihin. Organisaatiomuutos ilmeni organisaation työntekijöissä erilaisina reaktioina: osa menetti uskonsa organisaatioon, toiset turhautuivat ja kaipasivat vahvistusta toiminnalleen ja kolmansilla työn sujuminen nousi keskiöön. Muutospaineiden keskellä organisaatiossa tarvitaan uskottavaa muutosviestintää ja johtavaa identiteettiä, johon kaikki organisaation jäsenet voivat samaistua. Tämän sosiaalisen identiteetin synnyn mahdollistaa organisaation johdon aktiivinen muutosprosessin johtaminen. Myös keskijohdon rooli johdon muutosviestin vahvistamisessa on tärkeä muutosprosessin onnistumiselle ja sisäistämiselle. Muutoksen johtamisessa on oleellista ottaa ihmisten johtaminen osaksi päivittäistä toimintaa. Organisaation jäsenten tunnepohjaisen sitouttamisen kautta saavutetaan mahdollisuus toteuttaa onnistunut muutosprosessi. Keskijohdon tehtävänä on viestiä ylimmän johdon visio työntekijätasolle uskottavasti, jotta muutokseen sitoudutaan. Muutosprosessin onnistumista tulee seurata ja tukea organisaation johdon taholta.

Henkilöstön sitoutuminen muutoksessa - Case: Etelä-Karjalan sosiaali- ja terveyspiiri

Tutkimuksen tarkoituksena oli selvittää, mitkä tekijät vaikuttavat henkilöstön sitoutumiseen muutoksessa. Tutkimuksen teoriaosiossa käsitellään ensiksi muutossitoutumista vahvistavia ja siinä huomioitavia tekijöitä muutosprosessissa onnistuneen muutosjohtamisen kautta, jonka jälkeen syvennytään niihin tekijöihin jotka erityisesti vaikuttavat henkilöstön muutossitoutumiseen. Tutkimuksen empiirisen aineiston muodostivat Etelä-Karjalan sosiaali- ja terveyspiirin ikäihmisten palveluiden kolmentoista henkilön haastattelut. Henkilöistä kymmenen toimi työntekijätehtävissä, kaksi lähiesimiestehtävissä sekä yksi johtoryhmässä. Haastatteluaineisto kerättiin sekä analysoitiin laadullisella tutkimusmenetelmällä. Tutkimustulokset osoittavat, että henkilöstön muutossitoutumiseen vaikuttivat eniten viestintä sekä sen ilmeneminen case-organisaation muutosprosessissa. Kaikki puutteet ja onnistuneisuudet muutosjohtamisessa kiteytyivät viestintään; henkilöstön muutossitoutumisen kannalta erityisesti esimiehen hallitsemaan viestintään ja muutosjohtajuuteen. Muutosviestinnän ollessa onnistunutta se vahvisti selkeästi henkilöstön luottamusta muutosprosessin vaiheissa ja näin lisäsi muutokseen sitoutumista.