This resembles the strategy of emphasizing negotiation and consideration of many stakeholders' views and can be considered a natural first step in the initiation of change programs [ 26].
During initial development of the PAR program 83% of 255 volunteer physicians reported that their MSF feedback data stimulated contemplation of change, and 66% reported initiation of change in at least one aspect of their practice [ 4].
The literature suggests that initiation of change in academic cultures should come from leadership, such as deans and departmental chairs, and that the support of senior faculty for these changes is crucial [ 26, 27].
Other studies demonstrated that ESWT is chondroprotective in the initiation of OA changes of the knee [ 19], and induces regression or retardation of established OA changes of the knee in rats [ 20].
To compare modifications in the surgical technique of congenital aural atresia (use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal, and Merocel wicks) by examining hearing results and complications before and after initiation of these changes.
On the other hand, numerous evidences support a role of ROS in several muscle functions, such as force production [3], initiation of adaptative changes in gene expression [4], and regulation of calcium channels, calcium transporters and calcium-sensing proteins [5] [7].
A large proportion of patients (94%) had at least one follow-up visit and initiation of, or changes to, antihypertensive drug treatment took place in 72% of patients.
Maeda et al (2005) described that downregulation of E-cadherin expression in TGF- β1-treated mouse mammary NMuMG cells was much slower than the initiation of morphological changes.
In mice with perturbed epithelial gene expression, this is sufficient stimulus to induce innate smad-mediated increases in endothelin-1 synthesis and subsequently the initiation of remodeling changes.
Most patients with SHT had at least one follow-up visit and 72% had initiation of, or changes to, antihypertensive drug treatment.
