822 resultados para Stages Of Change
Resumo:
Motorcyclists in Australia have been found to be 30 times more likely to be killed per kilometre travelled than car occupants and 40 times more likely to be seriously injured. One approach to preventing motorcycle-related injury is through training and education. While there is traditionally a major focus on developing riding skills during training for motorcyclists, there is also a need for training to promote safe riding to reduce subsequent risk taking. The Transtheoretical Model, commonly known as the ‘Stages of Change’ model, provides a rationale to support incremental behaviour change for risky riding that may be facilitated through motorcycle rider training and education. A sample of 438 learner motorcyclists attended a rider training program in Queensland, Australia, with the stages of change to adopt a safe riding mindset and safe riding practices being measured upon commencement of the course (Time 1) and then again upon completion (Time 2). A small subset of the original sample (n=45) responded at follow up 24 months post training (Time 3). Consistent with the aims of training, results showed a significant shift from the contemplation stage to the subsequent stages of change for participants between Time 1 and Time 2. Progression to the later stages in the model was found for the subset of participants that responded at the Time 3 follow up. Issues of questionnaire design and the utility of the Transtheoretical Model for motorcycle rider training are discussed.
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Objective. To evaluate the perception of eating practices and the stages of change among adolescents. Methods. Cross-sectional study involving a representative sample of 390 adolescents from 11 public schools in the city of Piracicaba, Brazil, in 2004. Food consumption was identified by a food frequency questionnaire and the perception of eating practices evaluation was conducted by comparing food consumption and individual classification of healthy aspects of the diet. The participants were classified within stages of change by means of a specific algorithm. A reclassification within new stages of change was proposed to identify adolescents with similar characteristics regarding food consumption and perception. Results. Low consumption of fruit and vegetables and high consumption of sweets and fats were identified. More than 44% of the adolescents had a mistaken perception of their diet. A significant relationship between the stages of change and food consumption was observed. The reclassification among stages of change, through including the pseudo-maintenance and non-reflective action stages was necessary, considering the high proportion of adolescents who erroneously classified their diets as healthy. Conclusion. Classification of the adolescents into stages of change, together with consumption and perception data, enabled identification of groups at risk, in accordance with their inadequate dietary habits and non-recognition of such habits. (C) 2009 Elsevier Inc. All rights reserved.
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Domestic violence is a major public health problem, yet most physicians do not effectively identify patients at risk. Medical students and residents are not routinely educated on this topic and little is known about the factors that influence their decisions to include screening for domestic violence in their subsequent practice. In order to assess the readiness of primary care residents to screen all patients for domestic violence, this study utilized a survey incorporating constructs from the Transtheoretical Model, including Stages of Change, Decisional Balance (Pros and Cons) and Self-Efficacy. The survey was distributed to residents at the University of Texas Health Science Center Medical School in Houston in: Internal Medicine, Medicine/Pediatrics, Pediatrics, Family Medicine, and Obstetrics and Gynecology. Data from the survey was analyzed to test the hypothesis that residents in the earlier Stages of Change report more costs and fewer benefits with regards to screening for domestic violence, and that those in the later stages exhibit higher Self-Efficacy scores. The findings from this study were consistent with the model in that benefits to screening (Pros) and Self-Efficacy were correlated with later Stages of Change, however reporting fewer costs (Cons) was not. Very few residents were ready to screen all of their patients.^
Resumo:
Understanding a population's dietary behavior is important to promote behaviors which have the most beneficial impact on health. The most recent Dietary Guidelines for Americans (2005) identifies carotenoids as a key nutrient to be consumed through increased intake of fruits and vegetables (FV). While some studies have included or focused on the Hispanic population, few have focused only on Mexican-American populations and staged its intake of FV. Stage of change behavior theory has been used to understand the adoption and promotion of healthy behaviors such as increased intake of FV. It has been shown to effectively aid interventionists' understanding of dietary behavior. Intake patterns of FV of older women, rural residents, and adolescents of Mexican American descent have been conducted but not by stages of change. This study aimed to determine the relationship between stages of change for fruits and vegetables (SOC-FV) and total carotene intake to assess the quality of SOC-FV as a surrogate measure of total carotene. ^ Data from the 2000 Qué Sabrosa Vida Community Nutrition Survey (QSV-CNS) were analyzed to identify the SOC-FV and sources of carotenes in a Mexican American population 18-60 yrs. of the Paso del Norte region. A 107 item interviewer administered food frequency questionnaire (FFQ) specifically calibrated for a Mexican American population was used to collect usual intake of total carotene. The QSV survey study population included 963 participants, 590 (61.3%) women and 373 (38.7%) men. A statistically significant mean difference in caloric intake between men and women was found (p-value = <0.01). When total carotene intake was adjusted for energy, there were significant differences between men and women (p-value = <0.0001) with women consuming a higher amount of total carotene (406 RE/kcal 1,000) than men (332 RE/kcal 1000). The food sources of total carotene for both genders included many items found in a traditional Mexican American diet. Chile, after carrots, was the highest contributor of dietary carotene. Total carotene intake was not associated with stages of change among women or men and their distributions were not linear. Mean differences of total carotene by stages of change were significant for women for pre-contemplation/contemplation (p-value = 0.04) and preparation (p-value = 0.0004) but not for men. ^ SOC-FV may serve as a surrogate measure for dietary carotene intake. This study's Mexican American population had a high carotene quality diet derived from traditional food items irrespective of their stage of change for fruits and vegetables. To better understand this population's dietary intake a measure for acculturation should be included. Interventions aimed at Mexican American populations should aim to promote traditional diets consistent with cultural practices.^ ^
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Parent-mediated early intervention programs depend on the willingness and ability of parents to complete prescribed activities with their children. In other contexts, internal factors, such as stages of change, and external factors, such as barriers to treatment, have been shown to correlate with adherence to service. This researcher modified the Stages of Change Questionnaire as well as the Barriers to Treatment Participation Scale (BTPS) to use with this population. Despite initial interest, twenty-three parent participants were referred to the researcher over the course of three years, with only five parents taking part in the study. A population base ten times that of the current sample would be required recruit enough participants (fifty-one) to provide sufficient power. This feasibility study discusses the results of the five parent participants. Findings suggest that the modified Stages of Change Questionnaire may not be sensitive enough for use with the current sample, while the modified BTPS may yield useful information for service providers.
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Next generation ATM systems cannot be implemented in a technological vacuum. The further ahead we look, the greater the likely impact of societal factors on such changes, and how they are prioritised and promoted. The equitable sustainability of travel behaviour is rising on the political agenda in Europe in an unprecedented manner. This paper examines pilot and controller attitudes towards Continuous Descent Approaches (CDAs). It aims to promote a better understanding of acceptance of change in ATM. The focus is on the psychosocial context and the relationships between perceived societal and system benefits. Behavioural change appeared more correlated with such benefit perceptions in the case of the pilots. For the first time in the study of ATM implementation, and acceptance of change, this paper incorporates the Seven Stages of Change model, based on the constructs of the Theory of Planned Behaviour. It employs a principal components (factor) analysis, and further explores the intercorrelations of benefit perceptions, known in psychology as the ‘halo effect’. Disbenefit perceptions may break down this effect, it appears. For implementers of change, this evidence suggests an approach in terms of reinforcing the dominant benefit(s) perceived, for sub-groups within which a halo effect is evident. In the absence of such an effect, perceived disbenefits, such as with respect to workload and capacity, should be off-set against specific, perceived benefits of the change, as far as possible. This methodology could be equally applied to other stakeholders, from strategic planners to the public. The set of three case studies will be extended beyond CDA trials. A set of concise guidelines will be published with a strong focus on practical advice, in addition to continued work enabling a better understanding of the expected, increasing psychosocial contributions to successful and unsuccessful efforts at ATM innovation and change.
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The aim was to analyze the prevalence of the stages of behavior change (BCS) and the perceived barriers to physical activity in older people residents in a medium size city of São Paulo state, Brazil. Seventy-nine older people participated of the study. The BCS was assessed by the Questionnaire of Behavior Chance Stages and those on perception of barriers by the Questionnaire on Barriers to the Practice of Physical Activity in Older People (QBPPAE). Statistical analyses was comprised by the Chi-square test (p<0.05). Data showed that: a) 64,6% of the older people do not practice physical activity and only 22,8% of them have been practicing it on a regular basis for more than 6 months; b) The most perceived barriers were: "Active enough", "Too old"; "Need to rest" and; "Disease or injury"; c) The BCS seems modulate significantly the perception of barriers (p<0.05). We can conclude that: a) most of the older people are in the pre-contemplation, contemplation and preparation stages of the BCS, yet; b) gender influences almost nothing with perception of barriers and; c) the BCS interferes with the type of perceived barriers. Such conclusions support the suggestions that it is necessary to develop specific strategies for different stages of behavior change if it is to minimize the barriers. This may help to find the most effective way to change to more active lifestyle in the elderly.
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A low rate of physical activity (PA) participation is observed worldwide. The identification of feasible and reliable instruments able to accurately measuring PA and help in the development of interventions to promote PA are necessary. This study aimed to analyze the concordance between the Stages of Behavior Change Questionnaire (SBCQ) and the International Physical Activity Questionnaire (IPAQ long-version) in assessing adult leisure-time physical activity (LTPA). A total of 1.588 adults completed the IPAQ to assess LTPA and the participants who performed more than 10 min/week were classified in active individuals. Using the SBCQ, active individuals were those classified in the action or maintenance stage and inactive individuals were those classified in the precontemplation, contemplation or preparation stage. The concordance between SBCQ and IPAQ was found to be 0.80. Separated by gender, it was observed a concordance between the two instruments of 0.82 for women, and 0.77 for men. Regarding age group, it was found to be 0.81 for young and middle-aged adults, and 0.77 for older people. The SBCQ presented a very good concordance with IPAQ to assess LTPA.
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Adiponectin, one of the most abundant adipokines in circulation, is known for its role in regulation of body metabolism. The aim of this study was to evaluate the effects of a negative energy balance (NEB) at 2 stages of lactation (lactational NEB at the onset of lactation and an induced NEB by feed restriction near 100 d of lactation) on circulating adiponectin concentrations. We also investigated the effect of feed restriction on adiponectin concentrations in milk and the relationships of blood and milk adiponectin with selected plasma or milk variables and with measures of body condition. Plasma adiponectin was measured in 50 multiparous Holstein dairy cows throughout 3 experimental periods [i.e., period 1=3 wk antepartum up to 12 wk postpartum, period 2=3 wk of feed restriction starting at around 100 d in milk with a control (n=25) and feed-restricted group (50% of energy requirements; n=25), and period 3=subsequent realimentation period for 8 wk]. Milk adiponectin was investigated among 21 multiparous cows at wk 2 and wk 12 of period 1 and wk 2 of period 2. Adiponectin concentrations in plasma and skim milk were measured using an in-house ELISA specific for bovine adiponectin. Major changes in circulating adiponectin concentrations were observed during the periparturient period, whereas energy deficiency during established lactation at around 100 d in milk and subsequent refeeding did not affect plasma adiponectin. Together with lower adiponectin concentrations in milk (µg/mL), the reduction in milk yield led to decreased adiponectin secretion via milk (mg/d) at the second week of feed restriction. Irrespective of time and treatment, milk adiponectin represented about 0.002% of total milk protein. Mean adiponectin concentrations in milk (0.61 ± 0.03 µg/mL) were about 92% lower than the mean plasma adiponectin concentrations (32.1 ± 1.0 µg/mL). The proportion of the steady-state plasma adiponectin pool secreted daily via milk was 2.7%. In view of the similar extent of NEB in both periods of energy deficiency, decreasing adiponectin concentrations seems important for accomplishing the adaptation to the rapidly increasing metabolic rates in early lactation, whereas the lipolytic reaction toward feed restriction-induced NEB during established lactation seems to occur largely independent of changes in circulating adiponectin.
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Climate change is one of the most important issues confronting the sustainable supply of seafood, with projections suggesting major effects on wild and farmed fisheries worldwide. While climate change has been a consideration for Australian fisheries and aquaculture management, emphasis in both research and adaptation effort has been at the production end of supply chains—impacts further along the chain have been overlooked to date. A holistic biophysical and socio-economic system view of seafood industries, as represented by end-to-end supply chains, may lead to an additional set of options in the face of climate change, thus maximizing opportunities for improved fishery profitability, while also reducing the potential for maladaptation. In this paper, we explore Australian seafood industry stakeholder perspectives on potential options for adaptation along seafood supply chains based on future potential scenarios. Stakeholders, representing wild capture and aquaculture industries, provided a range of actions targeting different stages of the supply chain. Overall, proposed strategies were predominantly related to the production end of the supply chain, suggesting that greater attention in developing adaptation options is needed at post-production stages. However, there are chain-wide adaptation strategies that can present win–win scenarios, where commercial objectives beyond adaptation can also be addressed alongside direct or indirect impacts of climate. Likewise, certain adaptation strategies in place at one stage of the chain may have varying implications on other stages of the chain. These findings represent an important step in understanding the role of supply chains in effective adaptation of fisheries and aquaculture industries to climate change.
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New stars form in dense interstellar clouds of gas and dust called molecular clouds. The actual sites where the process of star formation takes place are the dense clumps and cores deeply embedded in molecular clouds. The details of the star formation process are complex and not completely understood. Thus, determining the physical and chemical properties of molecular cloud cores is necessary for a better understanding of how stars are formed. Some of the main features of the origin of low-mass stars, like the Sun, are already relatively well-known, though many details of the process are still under debate. The mechanism through which high-mass stars form, on the other hand, is poorly understood. Although it is likely that the formation of high-mass stars shares many properties similar to those of low-mass stars, the very first steps of the evolutionary sequence are unclear. Observational studies of star formation are carried out particularly at infrared, submillimetre, millimetre, and radio wavelengths. Much of our knowledge about the early stages of star formation in our Milky Way galaxy is obtained through molecular spectral line and dust continuum observations. The continuum emission of cold dust is one of the best tracers of the column density of molecular hydrogen, the main constituent of molecular clouds. Consequently, dust continuum observations provide a powerful tool to map large portions across molecular clouds, and to identify the dense star-forming sites within them. Molecular line observations, on the other hand, provide information on the gas kinematics and temperature. Together, these two observational tools provide an efficient way to study the dense interstellar gas and the associated dust that form new stars. The properties of highly obscured young stars can be further examined through radio continuum observations at centimetre wavelengths. For example, radio continuum emission carries useful information on conditions in the protostar+disk interaction region where protostellar jets are launched. In this PhD thesis, we study the physical and chemical properties of dense clumps and cores in both low- and high-mass star-forming regions. The sources are mainly studied in a statistical sense, but also in more detail. In this way, we are able to examine the general characteristics of the early stages of star formation, cloud properties on large scales (such as fragmentation), and some of the initial conditions of the collapse process that leads to the formation of a star. The studies presented in this thesis are mainly based on molecular line and dust continuum observations. These are combined with archival observations at infrared wavelengths in order to study the protostellar content of the cloud cores. In addition, centimetre radio continuum emission from young stellar objects (YSOs; i.e., protostars and pre-main sequence stars) is studied in this thesis to determine their evolutionary stages. The main results of this thesis are as follows: i) filamentary and sheet-like molecular cloud structures, such as infrared dark clouds (IRDCs), are likely to be caused by supersonic turbulence but their fragmentation at the scale of cores could be due to gravo-thermal instability; ii) the core evolution in the Orion B9 star-forming region appears to be dynamic and the role played by slow ambipolar diffusion in the formation and collapse of the cores may not be significant; iii) the study of the R CrA star-forming region suggests that the centimetre radio emission properties of a YSO are likely to change with its evolutionary stage; iv) the IRDC G304.74+01.32 contains candidate high-mass starless cores which may represent the very first steps of high-mass star and star cluster formation; v) SiO outflow signatures are seen in several high-mass star-forming regions which suggest that high-mass stars form in a similar way as their low-mass counterparts, i.e., via disk accretion. The results presented in this thesis provide constraints on the initial conditions and early stages of both low- and high-mass star formation. In particular, this thesis presents several observational results on the early stages of clustered star formation, which is the dominant mode of star formation in our Galaxy.