“I know, therefore I adapt?” Complexities of individual adaptation to climate-induced forest dieback in Alaska

Individual actions to avoid, benefit from, or cope with climate change impacts partly shape adaptation; much research on adaptation has focused at the systems level, overlooking drivers of individual responses. Theoretical frameworks and empirical studies of environmental behavior identify a complex web of cognitive, affective, and evaluative factors that motivate stewardship. We explore the relationship between knowledge of, and adaptation to, widespread, climate-induced tree mortality to understand the cognitive (i.e., knowledge and learning), affective (i.e., attitudes and place attachment), and evaluative (i.e., use values) factors that influence how individuals respond to climate-change impacts. From 43 semistructured interviews with forest managers and users in a temperate forest, we identified distinct responses to local, climate-induced environmental changes that we then categorized as either behavioral or psychological adaptations. Interviewees developed a depth of knowledge about the dieback through a combination of direct, place-based experiences and indirect, mediated learning through social interactions. Knowing that the dieback was associated with climate change led to different adaptive responses among the interviewees, although knowledge alone did not explain this variation. Forest users reported psychological adaptations to process negative attitudes; these adaptations were spurred by knowledge of the causes, losses of intangible values, and impacts to a species to which they held attachment. Behavioral adaptations exclusive to a high level of knowledge included actions such as using the forests to educate others or changing transportation behaviors to reduce personal energy consumption. Managers integrated awareness of the dieback and its dynamics across spatial scales into current management objectives. Our findings suggest that adaptive management may occur from the bottom up, as individual managers implement new practices in advance of policies. As knowledge of climate-change impacts in local environments increases, resource users may benefit from programs and educational interventions that facilitate coping strategies.

Using social network analysis to identify key stakeholders in agricultural biodiversity governance and related land-use decisions at regional and local level

In 2013 the European Commission launched its new green infrastructure strategy to make another attempt to stop and possibly reverse the loss of biodiversity until 2020, by connecting habitats in the wider landscape. This means that conservation would go beyond current practices to include landscapes that are dominated by conventional agriculture, where biodiversity conservation plays a minor role at best. The green infrastructure strategy aims at bottom-up rather than top-down implementation, and suggests including local and regional stakeholders. Therefore, it is important to know which stakeholders influence land-use decisions concerning green infrastructure at the local and regional level. The research presented in this paper served to select stakeholders in preparation for a participatory scenario development process to analyze consequences of different implementation options of the European green infrastructure strategy. We used a mix of qualitative and quantitative social network analysis (SNA) methods to combine actors’ attributes, especially concerning their perceived influence, with structural and relational measures. Further, our analysis provides information on institutional backgrounds and governance settings for green infrastructure and agricultural policy. The investigation started with key informant interviews at the regional level in administrative units responsible for relevant policies and procedures such as regional planners, representatives of federal ministries, and continued at the local level with farmers and other members of the community. The analysis revealed the importance of information flows and regulations but also of social pressure, considerably influencing biodiversity governance with respect to green infrastructure and biodiversity.

Capacity Management in Healthcare Services

The level of demand for healthcare services can fluctuate widely and this can place pressure on the capacity of service providers. This article examines some of the approaches used to influence the level of available capacity in the healthcare services sector. A number of strategies designed to flex capacity are discussed, including the development of flexible approaches to human resources; rapid responses to changes in demand; the use of self-service technology and self-care; and the use of temporary additional facilities.

Energy efficient measures to reduce electrical energy use in commercial buildings in New York City

GEA Consulting Engineers, acting as the design engineers, was hired by the owner, East Village 207 Residential LLC2 for energy modeling for compliance with LEED NC V3 -- This report details the results of the energy simulation done with the 100% construction documents -- This report only refers to entities within the LEED3 project boundary -- The project consists of a new eight-story high-end residential condominium building with 81 units, as shown in illustration 1, and approximately 117,905 GSF, equivalent to 10,953.73 m2, is located at 211 E 13th Street in New York, NY -- The residential portion of the building will function 24-7 -- The design goal is to utilize energy efficient measures to reduce electrical energy use and aims to achieve LEED certification -- LEED EA Credit 14 requires a building to demonstrate a percentage improvement in the proposed building performance compared with the baseline building -- The Credit rewards 1 point for achieving 12% reduction in energy costs -- Additionally, the Credit rewards another point for each subsequent reduction of 2% in the building’s energy cost

The use of motivational interviews by nurses to promote health behaviors in adolescents: A scoping review protocol

Abstract The developmental changes during adolescence may affect subsequent risk for diseases and health-related behaviors. Traditionally, professionals assume that knowledge is sufficient for behavioral changes; however adolescents continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge". Motivational Interview (MI) may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects. Objectives The objective of this scoping is to examine and map the use of MI by nurses in their clinical practice with adolescents to promote health behaviors. The review will focus on knowing what is the current extent of the use of nurse-led MI; which adolescent populations were included; in which contexts nurses use MI; which MI techniques/strategies have been used and what outcomes on health behaviors promotion have been reported. Methodology This scoping review will be informed by JBI methodology. The population of this study is adolescents aged 10 to 19 years participating in nurse-led MI. The concept of MI include MI done by personal or telephone call, with any number of sessions, brief interventions and other motivational interventions grounded but not limited to the principles described by Miller & Rollnick (2008). All geographical and all clinical practice contexts where nurses' undertake MI with adolescents such as hospitals, primary health care, health care centers, community or schools will be contemplated. English, Spanish and Portuguese published studies will be considered for inclusion. Results An initial limited search of MEDLINE and CINAHL was undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe the concepts, synonyms (with truncations), MeSH Terms and Cinhal headings of this study. It was identified 5 synonyms for "Adolescents", 7 for "MI" and 2 for "nurse". A first search using the all 14 identified keywords and index terms was made at Medline (Title/Abstract) and brought up 125 articles. Other 16 databases referenced at the protocol will be searched to identify additional studies. Articles identified from the final search will be assessed for relevance to the review, based on information provided in the title and abstract. The full article will be retrieved for all studies that meet the inclusion criteria of the review. It is expected that findings from this Scoping Review provide needed information to nurses related to the use of MI to promote health behaviors in adolescents. Conclusions There is little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to nurse-led MI. There is a need for scoping or mapping the nurse-led MI with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. Moreover, information regarding implemented and evaluated interventions, techniques used, contexts of application and adolescents groups is dispersed in the literature which impedes the formulation of questions about the outcomes and effectiveness of those interventions. The practical implication of this mapping will be clarifying all these aspects.

The use of motivational interviews by nurses to promote health behaviors in adolescents: a scoping review protocol

Adolescents - defined as young people between 10 and 19 years of age1 - are, in general, a relatively healthy segment of the population.2 However, the developmental changes that take place during adolescence may affect their subsequent risk for diseases and for a variety of health-related behaviors. In fact, early onset of preventable health problems (e.g. obesity, malnutrition, STDs) and the engagement in health risk behaviors (e.g., sedentary life style, excessive alcohol consumption, unprotected sex) during adolescence, are likely to put them at greater risk for physical and mental health problems at a later stage in life. Moreover, health related problems and health risk behaviors may disrupt adolescents' physical and cognitive development and therefore may affect their ability to think and act in relation to decisions about their health in the future.1 In summary, health-related behaviors in adolescence, apart from their influence on the continuum of "health-disease", they also have the potential to influence future behaviors. In fact, several studies have shown that past behaviors are good predictors of future behaviors .3,4 Thus, promoting healthy practices during adolescence and taking measures to better protect young people from health risks are essential for the prevention of health problems in adulthood.5 According to the World Health Organization, the main problems affecting young people include mental health problems (such as behavioral disorders, eating disorders, suicide, anxiety or depression), the use of substances (illegal substances, alcohol and tobacco), interpersonal violence, nutrition (a proper nutrition consists of healthy eating habits and physical exercise), unintentional injuries (which are a leading cause of death and disability among young people, with road traffic injuries accounting for about 700 deaths per day), sexual and reproductive health (for example, risky sexual behaviors, early pregnancy and childbirth) and HIV (resulting from sexual transmission and drug injection).5,6 On the other hand, the number of children and youth with chronic health conditions has increased dramatically in the past four decades7 as larger numbers of chronically ill children survive beyond the age of 10.8 Despite the lack of data on adolescents' health making it difficult to determine the prevalence of chronic illnesses in this age group9, it is known that one in ten adolescents suffers from a chronic condition worldwide.10 In fact, national population based studies from Western countries show that 20-30% of teenagers have a chronic illness, defined as one that lasts longer than six months.8 The most prevalent chronic illness among adolescents is asthma and the one with the highest incidence is diabetes mellitus, particularly type II.9 Traditionally, healthcare professionals have been mainly investing in health education activities, through the transmission of knowledge with a view to creating habits, customs and behaviors, and promoting healthy lifestyles. However, empowering people does not only consist of giving them the right information11 , i.e. good information is not enough to cause people to make changes.12 The motivation or desire to change unhealthy behaviors and habits depends on many factors, namely intrinsic motivation, control over personal decisions, self-confidence and perception of effectiveness, personal ambivalence, and individualized assistance.12 Many professionals assume that supplying knowledge is sufficient for behavioral changes; however, even very good advice often fails to generate behavioral change. After all, people continue to engage in unhealthy behaviors despite clearly knowing what they should do and how to change. "What is lacking is the motivation to apply that knowledge".13, p.1233 In fact, behavioral change is a complex phenomenon with multiple determinants that also includes motivational variables. It is associated with ambivalent processes expressed in the dilemma between keeping the current status and moving on to new ways of acting. For example, telling adolescents that if they keep on engaging in a certain behavior, they are increasing the risk of developing a long-term condition such as cardiovascular disease, stroke or diabetes is rarely enough to trigger the desired behavioral change; people are more likely to change when they believe that the change is really effective and that they are able to implement it.12 Therefore, it is essential to provide specific training for "healthcare professionals to master motivational techniques, avoid confrontation with the users, and facilitate behavioral changes".14 In this context, motivating patients to make behavioral changes is also an important nursing task where change in lifestyle is a major element of patients' treatment and preventive interventions.15 One of the nurse's goals is to help improve a patient's health or help them to manage existing health conditions. Once nurses are in a position where they have to focus on accomplishing tasks and telling patients what needs to be accomplished16, the role of the nurse is expanding even more into the use of motivational strategies.17 MI is bringing nurses back to therapeutic communication and moving them closer to successful health promotion and disease management, by promoting behavior change and empowering their patients. As the nursing profession evolves, MI is seen as a challenge and the basis of nurse's interactions with individuals, families and communities.16, 17 In the same way, MI may be taken as an essential tool in the provision of nursing care to adolescents, being itself a workspace with possible therapeutic effects regarding problems, clarification of doubts, and development of skills.18 In fact, MI may be particularly applicable in work with adolescents because of their specific developmental stage. Adolescents attempt to establish their own autonomy and identity while struggling with social interactions and moral issues, which leads to ambivalence.19 Consistent with the developmental challenges during adolescence, "MI explicitly honors autonomy, people's right and irrevocable ability to decide about their own behavior"20 while allowing the person to explore possibilities for change of risky or maladaptive behaviours.19 MI can be defined as a directive, client-centred counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style of interpersonal relationship.21 It is a set of strategies and techniques widely used in clinical practice based on the transtheoretical model of change. The Stages of Change model describes five stages of readiness—precontemplation, contemplation, preparation, action, and maintenance—and provides a framework for understanding behavior change.22 The MI has been widely tested and applied in different areas, such as modification of addictive behaviors, interventions with offenders in the context of justice, eating disorders, promotion of therapeutic adherence among chronic patients, promotion of learning in school settings or intervention with adolescents at risk.18,23 In general, clinical practice has been adopting the perspective of motivation as something relatively immutable, i.e., the adolescent is either motivated for change/treatment and, in these conditions, the professional's role is to help him/her, or the adolescent is not motivated and then change/treatment is not feasible. Alternatively the theoretical model underlying the MI technique postulates that the individual's adherence to change/treatment depends on his/her motivation, which can change throughout the therapeutic intervention. As several studies found positive results for effects of MI24-26 and its use by health professionals is encouraged23,27 nurses may play an important role in patients' process of change. As nurses have a crucial role in clinical contexts, they can facilitate the process of ending risk behaviors and/or adopting positive health behaviors through some motivational techniques, namely with adolescents. A considerable number of systematic reviews about MI already exist pointing to some benefits of its use in the treatment of a broad range of behavioral problems and diseases.13,28,29 Some of the current reviews focus on examining the effectiveness of MI for adolescents with diverse health risks/problems 30-32. However, to date there are no reviews that present and assess the evidence for the use of nurse-led MI in adolescents. Therefore, we have little knowledge of what works for whom (which adolescent subpopulation) under what circumstances (in which setting, for what problem) in relation to motivational interviewing by nurses. There is a clear need for scoping or mapping the use of MI by nurses with adolescents to identify evidence gaps and to inform opportunities for future development in nursing practice. On the other hand, information regarding nurse-led implemented and evaluated interventions, techniques and/or strategies used, contexts of application and adolescents subpopulation groups is dispersed in the literature33-36 which impedes the formulation of precise questions about the effectiveness of those interventions conducted by nurses and therefore the realization of a systematic review. In other words, it is known that different kind of motivational interventions have been implemented in different contexts by nurses, however does not exist a map about all the motivational techniques and/or strategies used. Furthermore the literature does not clarify which is the role of nurses at cross professional motivational intervention implemented programs and finally the outcomes and evaluation of interventions are unclear. Thus, the practical implication of this mapping will be clarifying all these aspects. Without this clarification is not possible to proceed to the realization of a systematic review about the effectiveness of the use of motivational interviews by nurses to promote health behaviors in adolescents, in a particular context and/or health risk behavior; or regarding the effectiveness of certain technique and/or strategy of MI. Consequently, there are important questions about the nature of the evidence in this area that need to be answered before formulating a precise question of effectiveness. This scoping review aims to respond to these questions. An initial search of the JBI Database of Systematic Reviews & Implementation Reports, Cochrane Database of Systematic Reviews, , Database of promoting health effectiveness reviews (DoPHER), The Campbell Library, Medline and CINAHL, has revealed that currently there is no Scoping Review (published or in progress) on the subject. In this context, this scoping review will examine and map the published and unpublished research around the use of MI by nurses implemented and evaluated to promote health behaviors in adolescents; to establish its current extent, range and nature and identify its feasibility, outcomes and gaps in the evidence defining research priorities in this field. This scoping review will be informed by the JBI methodology37 that suggests a five stage methodological framework for conducting scoping reviews which includes: identifying the research question, searching for relevant studies, selecting studies, charting data, collating, summarizing and reporting the results.

Health-related quality of life in portuguese SLE patients: an outcome measure independent of disease activity and cumulative damage

PURPOSE: To evaluate quality of life in Portuguese patients with Systemic Lupus Erithematosus (SLE) and its correlation with disease activity and cumulative damage. METHODS: We included consecutive SLE patients, fulfilling the 1997 ACR Classification Criteria for SLE and followed at the Rheumatology Department of the University Hospital of Coimbra, Portugal at time of visit to the outpatient clinic. Quality of life was evaluated using the patient self-assessment questionnaire Medical Outcomes Survey Short Form-36 (SF-36) (validated Portuguese version). The consulting rheumatologist fulfilled the SLE associated indexes for cumulative damage (Systemic Lupus International Collaborating Clinics- Damage Index: SLICC/ACR-DI) and disease activity (Systemic Lupus Erythematosus Disease Activity Index: SLEDAI 2000). Correlation between SLEDAI and SLICC and SF-36 was tested with the Spearman Coefficient. Significant level considered was 0.05. RESULTS: The study included 133 SLE patients (90.2% female, mean age - 40.7 years, mean disease duration - 8.7 years). Most patients presented low disease activity (mean SLEDAI = 4.23) and limited cumulative damage (mean SLICC = 0.76). Despite that, SF-36 mean scores were below 70% in all eight domains of the index. Physical function domains showed lower scores than mental function domains. The QoL in this group of patients is significantly impaired when compared with the reference Portuguese population (p<0.05 in all domains). There was no correlation between clinical activity or cumulative damage and quality of life. CONCLUSION: QoL is significantly compromised in this group of SLE patients, but not related with disease activity or damage. These findings suggest that disease activity, cumulative damage and QoL are independent outcome measures and should all be used to assess the full impact of disease in SLE patients.

Advanced Adhesion Strength Testing Methods of Thin Film Multilayers in Electronic Packaging Systems

With the continued miniaturization and increasing performance of electronic devices, new technical challenges have arisen. One such issue is delamination occurring at critical interfaces inside the device. This major reliability issue can occur during the manufacturing process or during normal use of the device. Proper evaluation of the adhesion strength of critical interfaces early in the product development cycle can help reduce reliability issues and time-to-market of the product. However, conventional adhesion strength testing is inherently limited in the face of package miniaturization, which brings about further technical challenges to quantify design integrity and reliability. Although there are many different interfaces in today's advanced electronic packages, they can be generalized into two main categories: 1) rigid to rigid connections with a thin flexible polymeric layer in between, or 2) a thin film membrane on a rigid structure. Knowing that every technique has its own advantages and disadvantages, multiple testing methods must be enhanced and developed to be able to accommodate all the interfaces encountered for emerging electronic packaging technologies. For evaluating the adhesion strength of high adhesion strength interfaces in thin multilayer structures a novel adhesion test configuration called “single cantilever adhesion test (SCAT)” is proposed and implemented for an epoxy molding compound (EMC) and photo solder resist (PSR) interface. The test method is then shown to be capable of comparing and selecting the stronger of two potential EMC/PSR material sets. Additionally, a theoretical approach for establishing the applicable testing domain for a four-point bending test method was presented. For evaluating polymeric films on rigid substrates, major testing challenges are encountered for reducing testing scatter and for factoring in the potentially degrading effect of environmental conditioning on the material properties of the film. An advanced blister test with predefined area test method was developed that considers an elasto-plastic analytical solution and implemented for a conformal coating used to prevent tin whisker growth. The advanced blister testing with predefined area test method was then extended by employing a numerical method for evaluating the adhesion strength when the polymer’s film properties are unknown.

Óbidos, literary village: innovation in the creative industries?

The village of Óbidos was recognized in 2015 as a creative city in the area of literature, becoming a member of the UNESCO Creative Cities Network. The attribution of the title depends on the fulfillment of a number of criteria the regions have to integrate. In addition to Óbidos, UNESCO attributed the same title in the same year to other European cities, including Barcelona, Nottingham, Ljubljana, Tartu and Lviv. This article intends to co nduct a case study to the cultural and artistic offer, as well as the cultural and literary legacy that different cities provide to be able to inquire the innovation of the proposals. The study aims to assess how much Óbidos, compared to other cities with the same title, is creative. Knowing that the concept of creative city (Landry and Bianchini, 1995) results from the emergence of new technologies and a new type of economy based on creativity and innovation and that creativity implies removing economic or social value of the creative work or talent, the study aims to determine to what extent the processes generated gave rise to new ideas (creativity) and what processes led to its implementation (innovation). Being innovation in the creative industries asso ciated with product, process, positioning, paradigmatic and social innovation (Storsul and Krumsvik, 2013), it is concluded that, in Óbidos, the entrepreneurship initiatives are more focused on tourists who occasionally visit the village and the business o pportunities that are generated there. New innovative and creative spaces were created, promoting literature and adding value and quality to urban space. This urban intervention resulted in the attraction of individuals who streamlined new habits of being and acting in the village

Relational and reproductive trajectories leading to adolescent pregnancy in Portugal: a national and regional characterization

INTRODUCTION: The current study aimed to describe the relational and reproductive trajectories leading to adolescent pregnancy in Portugal, and to explore whether there were differences in this process according to adolescents' place of residence. MATERIAL AND METHODS: Data were collected between 2008 and 2013 in 42 public health services using a self-report questionnaire developed by the researchers. The sample consisted of a nationally representative group of pregnant adolescents (n = 459). RESULTS: Regardless of having had one (59.91%) or multiple sexual partners (40.09%), the majority of adolescents became pregnant in a romantic relationship, using contraception at the time of the conception and knowing the contraceptive failure which led to pregnancy (39.22%). In some regions other trajectories were highly prevalent, reflecting options such as planning the pregnancy (Alentejo Region/ Azores Islands), not using contraception (Centro Region/Madeira Islands) or using it incorrectly, without identifying the contraceptive failure (Madeira Islands). On average, romantic relationships were longer than 19 months and adolescents' partners were older than themselves (> 4 years) and no longer in school (75.16%); these results were particularly significant when the pregnancy was planned. DISCUSSION: The knowledge gained in this study shows that prevention efforts must be targeted according to the adolescents' needs in each region and should include high-risk male groups. CONCLUSION: Our results may enable more efficient health policies to prevent adolescent pregnancy in different country regions and support educators and health care providers on sexual education and family planning efforts.

“He who plants a tree – Plants a hope.” Reforestation possibilities in Tingana, Peru

Tropical forests have decreased drastically especially in the Peruvian Amazon. In Peru deforestation is caused especially by migrant people; building of houses and infrastructure, clearing land for agricultural purposes and illegal logging and mining. Deforestation results in hindering ecosystem vitality, boosting climate change and decreasing livelihood possibilities. As a counterpoint to cutting down trees there is reforestation, which refers to re-establishment of forest cover. Deforestation and reforestation can be analysed in the light of Forest Transition theory. According to it, due to economic growth, the amount forest cover first diminishes but then starts to increase as the economy in general strengthens. Thus, the research framework is set to this theory. In this study the focus is on analysing socioeconomically sustainable reforestation possibilities in the community of Tingana, Peru. It is situated in a municipal conservation area around which deforestation has been heavy. Land cover change is analysed from LandsatTM satellite images covering a 15 year time period, 1995–2010, in the surroundings of the study area. Semi-structured interviews have been done with a sample size of 25 people and shed light on the perspectives on forests, reforestation and economical activities. The synthesis created from the two methods gives information about the possibilities to enforce reforestation in Tingana and the phase of forest transition in the area. The results show that forest cover has decreased around the surroundings of Tingana leaving the conservation area isolated from larger forest areas. Knowing that forest cover has also decreased inside the conservation area due to agricultural expansion it is certain that fragmentation harms biodiversity causing changes in local climate, which can have knock-on effects for farming and local livelihoods. Therefore reforestation is welcomed when it ensures both conservation and financial benefits and when carried out on locals’ terms. Regarding conservation and incomes the best option would be to plant native timber species together with fruit production species to create agroforestry systems. Economically the community should aim towards an economy that relies on ecotourism as it already practiced in the area. Reforestation could increase ecotourism, which then could in turn increase reforestation via revenues. Regarding forest transition it is likely that forest re-establishment will occur if reforestation along with ecotourism is implemented on long time scale.

FEEDING AND DIABETES MELLITUS: PERCEPTION AND FOOD CONSUMPTION BY ELDERLY PEOPLE IN THE HINTERLANDS OF PERNAMBUCO

Objective: To evaluate the knowledge of diabetes diet and identify factors that may interfere with the adherence to nutritional therapy and food choices of participants in a Community Center for the Elderly in Sairé, PE. Methods: A quantitative, descriptive and cross-sectional study, which evaluated 39 attendees of that center, from July to August 2014, with or without diabetes mellitus. Two questionnaires were applied to assess socioeconomic data, nutrition knowledge and cultural factors, and check the consumption of food with high and low glycemic index. Data was analyzed using the Assistat Program 7.0 Beta version. Results: The majority of the respondents have knowledge about types of foods that may influence the treatment of diabetes mellitus, as 51.2% (n=20) reported knowing some food that can reduce the risk for diabetes onset or assist in its treatment. Most of the participants reported having acquired such knowledge through the television 35% (n=7) and conversation with peers 35% (n=7). Evaluation of the food intake evidenced higher consumption of foods with high glycemic index. However, among diabetic patients, foods with low glycemic index are consumed more times per week. Conclusion: The knowledge about nutrition and diabetes mellitus was considered adequate, but socioeconomic and cultural factors may interfere in the adherence to diet therapy for diabetes or in the food choices made by the individuals. However, food consumption was considered appropriate among diabetics.

Intercultural musical learning in the era of technology

Foreign students abroad need to feel integrated in the new community, which includes complex learning processes in multicultural environments. The fact that we have experienced these processes ourselves was certainly a motivation for this research, especially knowing that we could contribute to help our fellow Portuguese brass players undergoing the same experience. From the singularity of music performance in the style of playing and communication emerge many cultural aspects, which have been developed through centuries of orchestral practice. As the new students are confronted with the aesthetic musical concepts and both professional and social practices of the country they arrive in, they strive to understand these concepts and adapt themselves to the values promoted by the new music practice. The aim of this on-going research is the study of the integration of brass music students in German universities and in the German society. Notably, through the understanding of intercultural processes experienced by the students, professors can become more aware of the challenges that concern music education. In this research all ten Portuguese brass students enrolled in any German music university in the last five years were interviewed in order to deeply understand this process. With a growing importance of the technological facilities, students are able to gather more information, to prepare themselves for the new concepts they try to embrace and to better deal with a different culture.

Guided portfolio writing as a scaffold for reflective learning in in-service contexts: a case study

Language is widely recognized as an inescapable mediating tool for professional learning, and with this text we want to contribute to a better understanding of the particular role that guided writing can play in in-service professional reflective learning. We analysed one pre-school teacher’s written portfolio, the construction of which was guided to scaffold deep thinking about (and the transference of theory into) practice during participation in an in-service program about language education. Our case study shows that the writing process sustained robust learning about professional knowing, doing and learning itself: The teacher elaborated an integrative ethical understanding of the discussed theory, fully experienced newly informed practices and assessed her own learning by using theory to confront her previous knowledge and practices. Throughout the portfolio, the learning stance revealed by her voice varied accordingly. The study illustrates the potential of guided writing to scaffold reflective learning in in-service contexts.

Psychosocial Risk Factors, Interventions, and Comorbidity in Patients with Non-Specific Low Back Pain in Primary Care: Need for Comprehensive and Patient-Centered Care

International audience