Stages of Change in the Trajectory of Postpartum Weight Self-Management

Objective To identify women\u27s patterns of readiness to engage in weight self-management behaviors during the postpartum period. Design Prospective, longitudinal design with repeated measures, guided by the transtheoretical model of behavior change (TTM). Setting A tertiary perinatal center in an urban setting in the midwestern United States with approximately 3,000 births annually. Participants One hundred ninety-one (191) adult postpartum women. Methods Participants were surveyed in person during their postpartum hospitalizations, and by telephone at 4 and 8 weeks postpartum using the Stages of Change for Weight Management (SOCWM) and the Decisional Balance for Weight Management (DBWM) tools. Results There was a significant effect of time on stage of change for women in the postpartum period, with women in a higher stage of change at 8 weeks than during the postpartum hospitalization. There were no significant differences in stage of change at any of the three time points by prepregnant weight category or by race. Nearly one half of the sample was in the contemplation stage during the postpartum hospitalization, and more than 80% were in action or maintenance stages by 8 weeks postpartum. Conclusions The early postpartum period is an opportune time to influence stage of change in women\u27s weight management behaviors. Assessment of readiness to engage in or continue weight management behaviors will allow providers to use stage-matched interventions guided by the TTM to facilitate women\u27s self-management of weight

From spring to summer? Revolutionary change in Tunisia, Egypt and Libya

This article offers an analysis of the early stages of the revolutions that have been taking place in Tunisia, Egypt and Libya. Here we consider the early stages of the revolutions from winter 2010-11 up until the summer of 2012 and offers a comparative study of the experiences of the early stage of the revolutions in each case study. In particular this study considers the roles of six variables on the process of regime change and transition as follows: 1) duration of the uprising up to regime change; 2) the initial outcome of the revolution/uprising; 3) the number of deaths and casualties; 4) the post-regime change status of key members of the former governing elite; 5) the existence and nature of post-regime change elections; and 6) levels of international involvement. This study finds that in all three case studies, considering these variables offers insight into the nature and effect of the early stages of the revolutions. Furthermore, in each case there are key similarities in some of these variables but significant differences in others which suggest that the processes of transition are not directly comparable with each other. This article also offers some thoughts on how the early stages of these revolutions could affect the direction and pace of change in each state

Stages of health behavior change and factors associated with physical activity in patients with intermittent claudication

OBJECTIVE: To analyze, in people with intermittent claudication, the frequency of individuals who are in each of stages of health behavior change to practice physical activity, and analyze the association of these stages with the walking capacity. METHODS: We recruited 150 patients with intermittent claudication treated at a tertiary center, being included those > 30-year-old-individuals and who had ankle-arm index < 0.90. We obtained socio-demographic information, presence of comorbidities and cardiovascular risk factors and stages of health behavior change to practice physical activity through a questionnaire, they being pre-contemplation, contemplation, preparation, action and maintenance. Moreover, the walking capacity was measured in a treadmill test (Gardner protocol). RESULTS: Most individuals were in the maintenance stage (42.7%), however, when the stages of health behavior change were categorized into active (action and maintenance) and inactive (pre-contemplation, contemplation and preparation), 51.3% of the individuals were classified as inactive behavior. There was no association between stages of health behavior change, sociodemographic factors and cardiovascular risk factors. However, patients with intermittent claudication who had lower total walking distance were three times more likely to have inactive behavior. CONCLUSION: Most patients with intermittent claudication showed an inactive behavior and, in this population, lower walking capacity was associated with this behavior

Firm development as an integrated process: with evidence from the General Motors-Fisher Body case

This paper argues that an adequate approach to the firm should be able to accommodate the complexities of actual firm development. The latter is conceptualized in terms of three general stages: prime movers or drivers of change, change processes, and change attractors. Furthermore, any "real-world" firm is both a technical and an institutional unit. To emphasize the importance of "real firm" analysis, the discussion presented here revolves around an understanding of the much considered case of General Motors and Fisher Body integration has developed over time. Generalization from this case suggests that an integrated view of the firm is necessary that combines the three stages and the two bases (technical and institutional). Six general perspectives on the firm are identified as having technical or institutional bases that are relevant in each of the three stages. This integrated approach to the firm is explored in terms of the general topic of firm development. It is concluded that, without an integrated approach to firm development, a potentially biased or incomplete analysis can result

Change in Working Length at Different Stages of Instrumentation as a Function of Canal Curvature

The aim of this study was to determine the change in working length (∆WL) before and after coronal flaring and after complete rotary instrumentation as a function of canal curvature. One mesiobuccal or mesiolingual canal from each of 43 extracted molars had coronal standardization and access performed. Once the access was completed, canal preparation was accomplished using Gates Glidden drills for coronal flaring and EndoSequence files for rotary instrumentation. WLs were obtained at 3 time points: pre-instrumentation (unflared), mid-instrumentation (flared) and post-instrumentation (concluded). Measurements were made via direct visualization (DV) and the CanalPro apex locator (EM) in triplicate by a single operator with blinding within the time points. Root curvature was measured using Schneider’s technique. The change in working length was assessed using repeated-measures ANCOVA. The direct visualization measurements were statistically larger than the electronic measurements (paired t-test difference = 0.20 mm, SE = 0.037, P \u3c .0001), although a difference this large may not be clinically important. Overall, a greater change in working length was observed in straight canals than in curved canals, and this trend was more pronounced when measured electronically than via direct visualization, especially in the unflared-concluded time points compared with unflared-flared time points. A greater change in working length was also observed in longer canals than in shorter canals.https://scholarscompass.vcu.edu/gradposters/1032/thumbnail.jp

Economic liberalization and the antecedents of top management teams: evidence from Turkish 'big' business

There has been an increased interest in the last two decades in top management teams (TMTs) of business firms. Much of the research, however, has been US-based and concerned primarily with TMT effects on organizational outcomes. The present study aims to expand this literature by examining the antecedents of top team composition in the context of macro-level economic change in a late-industrializing country. The post-1980 trade and market reforms in Turkey provided the empirical setting. Drawing upon the literatures on TMT and chief executive characteristics together with punctuated equilibrium models of change and institutional theory, the article develops the argument that which firm-level factors affect which attributes of TMT formations varies across the early and late stages of economic liberalization. Results of the empirical investigation of 71 of the largest industrial firms in Turkey broadly supported the hypotheses derived from this premise. In the early stages of economic liberalization the average age and average organizational tenure of TMTs were related to the export orientation of firms, whereas in later stages, firm performance became a major predictor of these team attributes. Educational background characteristics of teams appeared to be under stronger institutional pressures, altering in different ways in the face of macro-level change

Moving beyond 'refugeeness': problematising the 'refugee community organisation'

This paper explores processes of change and development within asylum seeker and refugee-led associations in Glasgow. I argue that adopting a life-cycle approach to association emergence and continuity (Werbner 1991a: 15) provides a more rounded and sophisticated understanding of not only the factors giving rise to such groups, but also of processes of change within groups. By problematising the ‘refugee community organisation’ label, I suggest that the focus on ‘refugeeness’ fails to attend to internal diversity, specifically relating to changing and differentiated immigration status within such associations. Exploring an externally constructed fictive unity using Werbner’s framework provides one way to challenge these effects. Rather than see this framework as made up of linear stages, I argue that groups move through and between stages of associative empowerment, ideological convergence and mobilisation simultaneously and that features differentiating stages may be co-present. This paper is relevant for policy-makers, practitioners and third sector organisations and can aid thinking about how to move beyond labels in approaching broader questions, practices and experiences of ‘settlement’, integration, belonging and social cohesion

Sensitivity of multi-product two-stage economic lotsizing models and their dependency on change-over and product cost ratio's

This study considers the production and inventory management problem of a two-stage semi-process production system. In case both production stages are physically connected it is obvious that materials are forced to flow. The economic lotsize depends on the holding cost of the end-product and the combined change-over cost of both production stages. On the other hand this 'flow shop' is forced to produce at the speed of the slowest stage. The benefit of this approach is the low amount of Work In Process inventory. When on the other hand, the involved stages are physically disconnected, a stock of intermediates acts as a decoupling point. Typically for the semi-process industry are high change-over costs for the process oriented first stage, which results in large lotsize differences for the different production stages. Using the stock of intermediates as a decoupling point avoids the complexity of synchronising operations but is an additional reason to augment the intermediate stock position. The disadvantage of this model is the high amount of Work-In-Process inventory. This paper proposes the 'synchronised planning model' realising a global optimum instead of the combination of two locally optimised settings. The mathematical model proves (for a two-stage single-product setting) that the optimal two-stage production frequency corresponds with the single EOQ solution for the first stage. A sensitivity study reveals, within these two-stage lotsizing models, the economical cost dependency on product and change-over cost ratio‟s. The purpose of this paper is to understand under which conditions the „joined setup‟ or the „two-stage individual eoq model‟ remain close to the optimal model. Numerical examples prove that the conclusions about the optimal settings remain valid when extending the model to a two-stage multi-product setting. The research reveals that two-stage individually optimized EOQ lotsizing should only be used when the end-product stage has a high added value and small change-over costs, compared to the first stage. Physically connected operations should be used when the end-product stage has a small added value and low change-over costs, or high added value and large change-over costs compared to the first production stage. The paper concludes with suggesting a practical common cycle approach to tackle a two-stage multi-product production and inventory management problem. The common cycle approach brings the benefit of a repetitive and predictable production schedule