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.

A percepção dos trabalhadores da enfermagem acerca da avaliação de desempenho do servidor público

A concepção de avaliação de desempenho dos trabalhadores da enfermagem, na maioria das vezes, é a de um ato de julgamento entre o certo e o errado, relacionado às ações e posturas desenvolvidas no contexto do seu trabalho. A avaliação de desempenho, no entanto, pode ser visualizada pelos trabalhadores como um importante instrumento que favorece o feedback do fazer profissional, desafiando-os a olharem para si mesmos, para o desenvolvimento de suas atribuições profissionais, proporcionando um real entendimento de sua importância na sociedade. Assim tem-se como objetivo geral conhecer a percepção dos trabalhadores da enfermagem de um Hospital Universitário localizado no extremo sul do Rio Grande do Sul (HU) acerca da sistemática da avaliação dos servidores públicos vivenciada na instituição e como objetivo específico conhecer a percepção dos trabalhadores da enfermagem do HU acerca da sistemática da avaliação dos servidores públicos no período do estágio probatório, adotada na instituição. Trata-se de uma pesquisa com abordagem qualitativa do tipo exploratória, desenvolvida com 70 trabalhadores de enfermagem. Para a coleta de dados utilizou-se a técnica de entrevista. Mediante a análise textual discursiva, construíram-se duas categorias: A avaliação do desempenho na concepção de trabalhadores da enfermagem e Serviço público: representatividade para o serviço da enfermagem. A avaliação do desempenho do servidor público pode ser influenciada pelo período de estágio probatório, pela sua vulnerabilidade na instituição, com possibilidade de conquistar a estabilidade ou perdê-la. Decorrido o período probatório, alguns trabalhadores modificam seu comportamento, demonstrando, por vezes, falta de comprometimento com seu fazer. No entanto, tal mudança pode estar relacionada com a cultura organizacional existente na instituição pública e, ainda, com um aparente descontentamento dos trabalhadores na realização da avaliação de desempenho, por não receberem um retorno significativo de cada avaliação. Pensar a sistemática de avaliação de desempenho com os trabalhadores da enfermagem significou a possibilidade de desencadear um processo de discussão e de reflexão sobre os diferentes modos de ser e fazer a enfermagem.

Submission Fees - A Tool in the Transition to Open Access?

Knowledge Exchange examined different routes in achieving the vision of 'having a layer of scholarly and scientific content openly available in the internet'. One of these routes involves exploring new developments in the future of publishing. Work is being undertaken investigating interesting alternative business models which could contribute to the transition to open access. In this light KE has commissioned a study investigating whether submission fees could play a role in a business model for Open Access journals. The general conclusion of the report bearing the title ‘Submission Fees a tool in the transition to open access?', written by Mark Ware, is that there are benefits to publishers in certain cases to switch to a model in which an author pays a fee when submitting an article. Especially journals with a high rejection rate might be interested in combining submission fees with article processing charges in order to make the transition to open access easier. In certain disciplines, notably economic and finance journals and in some areas of the experimental life sciences, submission fees are already common. Overall there seems to be an interest in the model but the risks, particularly those involved in any transition, are seen by the publishers to outweigh the perceived benefits. There is also a problem in that the advantages offered by submission fees are often general benefits that might improve the system but do not provide publishers and authors with direct incentives to change to open access. To support transition funders, institutions and publication funds could make it clear that submission fees would be an allowable cost. At present this is often unclear in their policies. Author acceptance of submission fees is critical to its success. It is an observable fact that authors will accept them in some circumstances. Author acceptance would require further study though. Based on the interviews and the modelling in the study one model in particular is regarded as the most suitable way to meet the current requirements (i.e. to strengthen open access to research publications). In this model authors pay a submission fee plus an Article Processing Fee and the article is subsequently made available in open access. Both fees are set at levels that balance acceptability with the author community with securing a meaningful mix of revenues for the Publisher.

On dangers to rational exploitation and development of the resources of the great lakes of Africa

The major dangers facing the resources of the Great Lakes of Africa include over exploitation, falling species diversity, accumulating pollution, and a probable decline in fishery productivity. These dangers may be viewed as accentuated by: i) Inadequate scientific knowledge on the exploited resources ii) Reluctance to apply even the limited scientific information available, by fishery administrators iii) Constant increase in the demand for fish and other aquatic resources. iv) Lack of commitment to active collaboration and co-operation by riparian states regarding development and management of the shared resources. This paper discusses the above factors in relation to the dangerous trends facing the resources of the Great Lakes of Africa. The discussion is intended to contribute to the promotion of rational and sustainable utilisation of the aquatic resources of these lakes.

Adapting to a team of host culture domination: Experiences of Finnish and British expatriates

International teams are permanent features of the global market, and multinational companies cannot ignore them. This thesis discusses an individual’s adaptation to a team of host culture domination by looking at the experiences of Finnish and British expatriates. The research question is: How does a foreigner adapt to a Finnish-British team where all the other members are from the local culture? The theoretical framework of this thesis consists of theories on multicultural teamwork and Finnish and British cultures. Based on theories, the impact of diversity on teamwork and whether it improves or deteriorates a team’s performance is unclear but the idea of multicultural teams is not just to live with cultural differences but to use and benefit of them. The main differences between Finnish and British cultures are in management styles and level of hierarchy. Still, these two cultures seem to be very similar. This is a qualitative study and expert interviews were used as a method for data collection. The results of the empirical research showed that Finns and Brits have differences in decision-making, level of hierarchy and communication. None of the informants saw the challenges that they have faced to result from being the only representative of a foreign culture – they only perceived them resulting from the characteristics of the host culture. In addition, all the informants had to change their habits and behaviour in the host culture in order to fit into the new culture and to become a part of the team. However, all the informants saw advantages in cross-cultural teams. Based on this thesis, team members from the host culture do not value cultural differences and they seem to be an issue only for the team member from the minority culture. It seems that a Finn or a Brit adapts to a Finnish-British team where the host culture dominates by changing their own behaviour in order to become a part of the team – even though people often see their own culture’s methods and habits as the right ones. Finnish and British cultures seem to be similar in fundamental issues like views and attitudes, which could mean that it is fairly easy for a Finn to get used to working in a British team and vice versa. Even though there are many challenges in cross-cultural and bi-cultural teams, there are even more advantages.

Serviços dos ecossistemas prestados pelos estuários : especiação e capacidade de retenção do fósforo

O fator nutricional presente nos sapais não é só importante para os organismos que nele habitam como também apresenta uma importância ecológica a uma maior escala. Exemplifica-se este fato com a capacidade de retenção do Fósforo (P) por parte das plantas podendo estas competir como produto químicos para sua imobilização através da incorporação da sua fração biodisponível para cumprimento dos mecanismos básicos de sobrevivência. O rizosedimento dessas plantas é uma importante fonte de nutrientes necessários para garantia básica da perpetuação de todos os serviços (regulação, provisão, cultural) gerados pelo ambiente. A perda de áreas de sapal foi o motivo principal para a elaboração desta tese visto a preocupação em relação aos impactes que a perda de serviços associados à área de estudo escolhida, o sistema lagunar da Ria de Aveiro, poderá vir sofrer caso aconteçam alterações hídricas (naturais ou antrópicas) mais acentuadas no futuro. Essa tese assume como compromisso chamar a atenção para essa questão como também investigar os mecanismos do ciclo do P este importante nutriente considerado essencial para a manutenção da vida em nosso planeta. Para este estudo foram escolhidas 3 espécies de plantas halófitas representantes do sapal amostral, são elas: Bolbochenous maritimus, Spartina maritima e de Juncus maritimus. As questões levantadas buscam compreender o papel do P nas transformações que ocorrem no rizosedimento das halófitas em 3 diferentes contextos: (i) quando comparados os valores da biomassa de P associado às halófitas estudadas (estudo realizado nos sapais povoados por Spartina maritima e Juncus maritimus) em toda extensão da Ria de Aveiro (ii) quando da disponibilidade de P perante a presença de poluentes inorgânicos no Largo do Laranjo, que corresponde a uma zona historicamente contaminada por metais (estudo realizado no rizosedimento das espécies Bolbochenous maritimus e Juncus maritimus) e (iii) quanto à intrusão superficial da água salgada da laguna (estudo focado na avaliação da perda do P próximo às raízes das halófitas que habitam a zona externa do dique do Baixo Vouga Lagunar (BVL) que corresponde à zona de confluência do Rio Vouga com a Ria de Aveiro). Por meio da análise do rizosedimento e da biomassa das diferentes halófitas predominantes do sapal foi possível verificar que, em relação à carga nutritiva fosfática, de Norte (Canal de São Jacinto/Ovar) a Sul (Canal de Mira) da Ria de Aveiro, a cota do sapal é mais importante do que a natureza espacial do sistema. Esta informação é primordial para a assertividade de futuras medidas de criação e reabilitação das áreas de sapal na Ria de Aveiro. Os estudos realizados nas áreas impactadas (Largo do Laranjo e BVL) incidiram na análise do perfil vertical rizosedimentar das halófitas pertencentes ao sapal médio-alto. Estes estudos revelaram que o rizosedimento dessas halófitas possui características peculiares que definem a dinâmica do ciclo do P de forma bastante característica. O rizosedimento das halófitas presentes no Largo do Laranjo apresentaram teores biodisponíveis de P equivalentes àqueles presentes no rizosedimento de área mais afastada da fonte pontual de contaminação para as mesmas espécies. Numa visão otimista, os resultados revelam que ambos sapais, Largo de Laranjo e Cais do Bico, apresentam condições equiparável para perpetuação dos serviços por eles gerados, que nesse caso se tornam ainda mais valiosos devido a garantia da fitoestabilização dos contaminantes (prevenção da entrada de contaminantes na coluna d’água e na cadeia alimentar). No Baixo Vouga Lagunar a análise espacial do sapal na zona exterior ao dique revelou a perda da diversidade das espécies bem como o aumento da área de vasa e consequentemente a perda dos teores de P associados ao rizosedimento das halófitas mais expostas aos efeitos da compressão costeira intensificados pelas ações naturais e antrópicas a que a Ria está sujeita. Em geral, a degradação dessa área de sapal devido aos fenômenos de assoreamento ou de erosão não pode ser separada dos processos sedimentares na área envolvente, principalmente no caso da Ria de Aveiro que tem sofrido constantes mudanças para atender às necessidades das atividades humanas. Essa tendência provavelmente não mudará no futuro próximo. Consequentemente, a evolução da laguna será principalmente dependente do resultado direto das ações humanas que deverão sempre encontrar formas de compensar os danos causados no âmbito de intervenções de reabilitação do sistema hídrico. A recriação de áreas de sapal pode ter lugar como medida mitigadora no âmbito de intervenções de reabilitação de áreas degradadas e ainda poderá servir como forma de captura de P para programas de utilização de fertilizantes naturais (componente desejável para a agricultura moderna o que é particularmente importante para as regiões altamente dependentes do mercado de importação). Deste modo, recomenda-se que a recuperação das áreas de sapal seja enquadrada no âmbito de intervenções mais amplas de valorização dos sistemas estuarinos e lagunares.

Beyond hope: Rhetorics of mobility, possibility, and literacy

When writing teachers enter the classroom, they often bring with them a deep faith in the power of literacy to rectify social inequalities and improve their students’ social and economic standing. It is this faith—this hope for change—that draws some writing teachers to locations of social and economic hardship. I am interested in how teachers and theorists construct their own narratives of social mobility, possibility, and literacy. My dissertation analyzes the production and expression of beliefs about literacy in the narratives of a diverse group of writing teachers and theorists, from those beginning their careers to those who are published and widely read. The central questions guiding this study are: How do teachers’ and theorists’ narratives of becoming literate intersect with literacy theories? and How do such literacy narratives intersect with beliefs in the power of literacy to improve individuals’ lives socially, economically, and personally? I contend that the professional literature needs to address more fully how teachers’ and theorists’ personal histories with literacy shape what they see as possible (and desirable) for students, especially those from marginalized communities. A central focus of the dissertation is on how teachers and theorists attempt to resolve a paradox they are likely to encounter in narratives about literacy. On one hand, they are immersed in a popular culture that cherishes narrative links between literacy and economic advancement (and, further, between such advancement and a “good life”). On the other hand, in professional discourse and in teacher preparation courses, they are likely to encounter narratives that complicate an assumed causal relationship between literacy and economic progress. Understanding, through literacy narratives, how teachers and theorists chart a practical path through or around this paradox can be beneficial to literacy education in three ways. First, it can offer direction in professional development and teacher education, addressing how teachers negotiate the boundaries between personal experience, theory, and pedagogy. Second, it can help teachers create spaces wherein students can explore the impact of paradoxical views about the role of literacy on their own lives. Finally, it can offer direction in public policy discourse, extending awareness of what we want—and need—from English language arts education in the twenty-first century. To explore these issues, I draw on case studies and ethnographic observation as well as narrative inquiry into teachers’ and theorists’ published literacy narratives. I situate my findings within three interrelated frames: 1) the narratives of new teachers, 2) the published works of literacy educators and theorists, and 3) my own literacy narrative. My first chapter, “Beyond Hope,” explores the tenuous connections between hope and critique in literacy studies and provides a methodological overview of the study. I argue that scholarship must move beyond a singular focus on either hope or critique in order to identify the transformative potential of literacy in particular circumstances. Analyzing literacy narratives provides a way of locating a critically informed sense of possibility. My second chapter, “Making Teachers, Making Literacy,” explores the intersection between teachers’ lives and the theories they study, based on qualitative analysis of a preservice course for secondary education English teachers. I examine how these preservice English teachers understood literacy, how their narratives of becoming literate and teaching English connected—and did not connect—with theoretical and pedagogical positions, and how these stories might inform their future work as practitioners. Centering primarily on preservice teachers who resisted Nancie Atwell’s pedagogy of possibility because they found it too good to be true, this research concentrates on moments of disjuncture, as expressed in class discussion and in one-on-one interviews, when literacy theories failed to align with aspiring teachers’ understandings of their own experiences and also with what they imagined as possible in disadvantaged educational settings. In my third and fourth chapters, I analyze the narratives of celebrated teachers and theorists who put forth an agenda that emphasizes possibilities through literacy, examining how they negotiate the relationship between their own literacy stories and literacy theories. Specifically, I investigate the narratives of three proponents of critical literacy: Mike Rose, Paulo Freire, and Myles Horton, all highly respected literacy teachers whose working-class backgrounds influenced their commitment to teaching in disenfranchised communities. In chapter 3, “Reading Lives on the Boundary,” I demonstrate how Mike Rose’s 1989 autobiographical text, Lives on the Boundary, juxtaposes rhetorics of mobility with critiques of such possibility. Through an analysis of work published in professional journals, I offer a reception history of Rose’s narrative, focusing specifically on how teachers have negotiated the tension between hope and critique. I follow this analysis with three case studies, drawn from a larger sampling, that inquire into the personal connections that writing teachers make with Lives on the Boundary. The teachers in this study, who provided written responses and participated in audio-recorded follow-up interviews, were asked to compare Rose’s story to their own stories, considering how their personal literacy histories influenced their teaching. My findings illustrate how a group of teachers and theorists have projected their own assessments of what literacy and higher education can and cannot accomplish onto this influential text. In my fourth chapter, “Horton and Freire’s Road as Literacy Narrative,” I concentrate on Myles Horton and Paulo Freire’s 1990 collaborative spoken book, We Make the Road by Walking. Central to my analysis are the educators’ stories about their formative years, including their own primary and secondary education experiences. I argue that We Make the Road by Walking demonstrates how theories of literacy cannot be divorced from personal histories. I begin by examining the spoken book as a literacy narrative that fuses personal and theoretical knowledge, focusing specifically on its authors’ ideas on theory. Drawing on Bakhtin’s notion of the chronotope—the intersection of time and space within narrative—I then explore the literacy narratives emerging from the production process of the book, in a video production about Horton and Freire’s meeting, and ultimately in the two men’s reflections on their childhood years (Dialogic). Interspersed with these accounts is archival material on the book’s editorial production that illustrates the value of increased dialogue between personal history and theories of literacy. My fifth chapter is both a reflective analysis and a qualitative study of my work at a men’s medium-high security prison in Illinois, where I conducted research and served as the instructor of an upper-level writing course, “Writing for a Change,” in the spring of 2009. Entitled “Doing Time with Literacy Narratives,” this chapter explores the complex ways in which literacy and incarceration are configured in students’ narratives as well as my own. With and against students’ stories, I juxtapose my own experiences with literacy, particularly in relation to being the son of an imprisoned father. In exploring the intersections between such stories, I demonstrate how literacy narratives can function as a heuristic for exploring beliefs about literacy between teachers and students both inside and outside of the prison-industrial complex. My conclusion pulls together the various themes that emerged in the three frames, from the making of new teachers to the published literacy narratives of teachers and theorists to my own literacy narrative. Writing teachers encounter considerable pressure to align their curricula with one or another theory of literacy, which has the effect of negating the authority of knowledge about literacy gleaned from experience as readers and writers. My dissertation contends that there is much to be gained by finding ways of articulating theories of literacy that encompass teachers’ knowledge of reading and writing as expressed in personal narratives of literacy. While powerful cultural rhetorics of upward social mobility often neutralize the critical potential of teachers’ own narratives of literacy—potential that has been documented by scholars in writing studies and allied disciplines—this is not always the case. The chapters in this dissertation offer evidence that hopeful and critical positions on the transformational possibilities of literacy are not mutually exclusive.

Osuuskunnan edustajiston rooli ja tehtävät

Tutkimuksen tarkoituksena ja tavoitteena on ymmärtää osuuskunnan ja erityisesti osuuskaupan edustajiston tehtäviä ja roolia. Tutkimuksessa halutaan tunnistaa osuuskunnan edustajiston tehtävät ja rooli siten, että ne parhaalla mahdollisella tavalla lisäisivät edustajiston jäsenten vaikuttavuutta ja vaikuttavuuden tunnetta. Tarkoituksena on kehittää toimintaa sellaiseksi, että edustajiston jäsenet kokevat osuuskunnan omakseen ja roolinsa siellä tärkeäksi, ja tätä kautta sitoutuvat tehtäviinsä ja ottavat vastuuta. Tutkimuksessa selvitetään, kuinka edustajisto voi tulevaisuudessa toteuttaa edustuksellista rooliaan parhaalla mahdollisella tavalla huomioiden jäsenten osuuskuntatoimintaa koskevat arvot, tavoitteet sekä odotukset. Tutkimus suoritettiin laadullisena haastattelututkimuksena, johon kuului kuusi puolistrukturoitua haastattelua huhtikuussa 2016. Esimerkkiorganisaationa tässä tutkimuksessa käytettiin Helsingin Osuuskauppa Elannon edustajistoa. Tutkimuksen tulokset osoittavat, että edustajiston jäsenet tuntevat roolinsa ja tehtävänsä vaikuttavaksi, mutta ongelma näyttäisi olevan, että tätä mielikuvaa ei ole pystytty siirtämään eteenpäin jäsenistölle. Jotta mielikuva ja tieto välittyisi ulospäin pitäisi tutkimusta tehdä vielä lisää sekä lisätä mainontaa, koulutusta ja valistusta edustajiston tehtävien ja roolin tiimoilta. Edustajat kokevat tulosten mukaan roolinsa tärkeäksi, mutta parannettavaa löytyi osuuskunnan omaksi tuntemisessa sekä sitä kautta sitoutumisessa. Omistuksen tunteen kehittyminen auttaisi sitoutumisessa työhön. Kollektiivisena tällainen omistamisen tunne palvelisi myös osuuskunnan etuja edustajien paremman työpanoksen ja yhteisten päämäärien kautta. Tällainen vahvemman siteen syntyminen edesauttaisi myös mielikuvien ja ennakkoluulojen muuttamista, joita osuuskunnan jäsenillä näyttäisi olevan edustajistosta ei kollektiivisena yhteisönä.

MSW: from pollution/degradation source to resource

Municipal Solid Waste is one of the biggest challenges that cities are facing: MSW is considered of the main sources of energy consumption, urban degradation and pollution. This paper defines the major negative effects of MSW on cities and proposes new solutions to guide waste policies. Most contemporary waste management efforts are focused at regional government level and based on high tech waste disposal by methods such as landfill and incineration. However, these methods are becoming increasingly expensive, energy inefficient and pollutant: waste disposal is not sustainable and will have negative implications for future generations. In this paper are proposed all the principle solutions that could be undertaken. New policy instruments are presented updating and adapting policies and encouraging innovation for less wasteful systems. Waste management plans are fundamental to increase the ability of urban areas effectively to adapt to waste challenges. These plans have to give an outline of waste streams and treatment options and provide a scenario for the following years that significantly reduce landfills and incinerators in favor of prevention, reuse and recycling. The key aim of an urban waste management plan is to set out the work towards a zero waste economy as part of the transition to a sustainable economy. Other questions remain still opened: How to change people’s behavior? What is the role of environmental education and risk perception? It is sure that the involvement of the various stakeholders and the wider public in the planning process should aim at ensuring acceptance of the waste policy.

A film director’s challenge : To manage – to manage? – The creative process in a film project

The aim of this text is to discuss how it is possible to manage the art creating process in a film project, where the circumstances are often turbulent. In normative project management literature one proceeds from the idea that a project is realised in a stable world from a clear goal. In a film project there is often a need to change your plans, to improvise both in front of the camera as well as behind the camera. In the theoretical cinematic literature the responsibility for the final film text is more and more being viewed as a product of not only the director, but of the whole team’s work. Consequently, the narrative of leadership/management in a film team can be viewed from a relational perspective where the director and those s/he interacts with, are responsible for the action, relations and social situations they construe jointly in the process of filmmaking. The organization of a film project is a temporary one. The members of a team are seldom the same from one production to another, as well as the creative process always being unique. According to process thinking, organizing can be seen as the ongoing creative activity where we structure and stabilize the chaotic, moving reality. As concerns a film project, the process of becoming of the filmic expression; careful plans, on the one hand, and improvisation and flexibility in action, on the other hand, are a precondition for its realisation. The director when setting a linguistic formulation to what is to be done, can be considered as a practical author.

Investigation on water and sediment quality variation from coast to off shore and its relation to bent hoses biodiversity: case study Bandar tahery

This paper deals with the qualification of water and sediment particularly those of benthos, as well as their interaction results, through careful laboratory researches within 24 experimental sites around the bank of Bandar Taheri, Persian Gulf water of Iranian borders, under 13th phase south Pars project. Samples were carried to the laboratories and careful experimental tests such as physical chemical, heavy metal, nitrate ammoniac, toc and other biologic tests including various type of benthos count were performed. Data gained through Shanon and Dankan statistical analyses were also studied to determine the water, sediment and pollution rate. Resulted information would classify the area as less polluted area which is rather away from critical environmental zone, another word the area could be liable to change to an undesired one while the density rates of principal metals follows the Fe>Mn>Zn>Cu>Pb>Cd>N pattern.

New Ways of Working in Acute Care: A Case for Change

This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users a quality of care that meets their needs and expectations.

HOLDING HANDS WHILE PARTING WAYS: EXAMINING ALLIANCE TREATY RENEGOTIATION

This study investigates the renegotiation of security alliances, specifically the structural conditions surrounding their revision. Although the field of international relations offers a rich discussion of the formation and violation of alliance treaties, few scholars have addressed the reasons why alliance members amend security obligations. After the formation of an alliance, a member may become dissatisfied owing to changes in the external and domestic security environments. A failure to address this discontent increases the risk of alliance breakdown. Members manage their alliance relationship through a negotiation process or intra-alliance bargaining in the search for a new arrangement that can endure. Factors that help to show commitment to the alliance and communicate a set of feasible solutions are crucial if members are to find a mutually acceptable arrangement. By taking these factors into account, allies are more likely to revise an existing treaty. Examining a set of bilateral alliances dating from 1945 to 2001, this research demonstrates that public requests for renegotiation compel allies to change the status quo. It is found that alliance-related fixed assets and the formation of external alliances increase the likelihood of treaty revision, though institutionalization of an alliance does not help to resolve interest divergence. In addition, this study examines the strategy of delay in intra-alliance bargaining. Allies may postpone a dispute by ignoring it while working to maintain the alliance. Tension among allies thus increases, but the alliance endures. I examine three alliances in order to illustrate this renegotiation process. Among these, the Anglo-Japanese alliance demonstrates two successful renegotiations that prolonged a wavering alliance relationship; the Sino-Soviet alliance is an example of failure owing to the lack of substantive cooperation; and the US-Taiwan alliance during the 1970s demonstrates successful use of a strategy of delay that appeases a dissatisfied member.

Satisfação/motivação dos enfermeiros profissão, serviço e hierarquia

Apesar de décadas de estudos, as opiniões são controversas. Não existe uma opinião comum entre os pesquisadores sobre o que é e como ocorre a motivação, a satisfação e a insatisfação no trabalho. As condições físicas dos serviços são um factor primordial para a motivação, satisfação ou insatisfação do trabalhador, assim como o tipo de liderança existente no mesmo. Ao longo da nossa história tem-se assistido a muitos exemplos de liderança, uns mais, outros menos eficazes. A satisfação no trabalho é um estado afectivo resultante da apreciação das características percebidas do trabalho e da organização. Neste contexto de mudanças na administração pública em geral e na área da saúde em particular, surge este estudo em contexto hospitalar, motivado pela necessidade de conhecer a satisfação dos enfermeiros de um Centro Hospitalar de Lisboa e a relação com algumas variáveis sócio demográficas. Optou-se pelo paradigma quantitativo, numa amostra de 122 inquiridos pertencentes a um grupo de profissionais de enfermagem de um Hospital Central de Lisboa. Para a elaboração da parte empírica utilizou-se o método por questionário de escolha múltipla. Os objectivos definidos: Objectivo Geral: perceber o nível de motivação/ satisfação dos enfermeiros relativamente à profissão ao serviço e à hierarquia. Objectivos específicos: Identificar o nível de satisfação/motivação dos enfermeiros dos serviços estudados relativamente à profissão, em função das variáveis sociodemográficas. - Caracterizar os aspectos com os quais os enfermeiros têm maior e menor satisfação relacionados com a profissão, serviço e hierarquia. - Identificar se existe relação entre o nível de motivação/satisfação e os sintomas físicos sentidos. Os participantes da amostra são, maioritariamente do sexo feminino, a média de idades é de 32 anos, grande percentagem já tem como habilitações profissionais a licenciatura, têm entre 1 e 28 anos de profissão e 1 e 28 anos no serviço actual, 17,2% exercem funções de chefia. Grande percentagem da amostra tem como horário semanal de trabalho 35 horas e trabalham em horário rotativo. Os enfermeiros são profissionais que mostram insatisfação relativamente à profissão e hierarquia e moderada satisfação relativamente aos serviços. A satisfação dos enfermeiros quanto à profissão altera-se de acordo com o horário de trabalho, vínculo à instituição e os sentimentos que os mesmos têm relativamente ao trabalho. A satisfação dos enfermeiros relativamente ao serviço altera-se consoante o tempo de profissão e com os sentimentos que os profissionais apresentam relativamente ao trabalho. Quanto à satisfação dos enfermeiros relativamente à hierarquia altera-se dependendo da idade dos profissionais, do tempo de profissão e do serviço onde desempenham. Relativamente à satisfação geral com o trabalho, esta pode alterar dependendo da idade, do tempo de profissão, do serviço onde desempenham funções e dos sentimentos dos profissionais relativamente ao trabalho. De salientar que ao analisarmos os serviços estudados separadamente concluímos que os enfermeiros do serviço de urgência são profissionais muito insatisfeitos com a hierarquia e os enfermeiros da Unidade de Urgência Médica são profissionais pouco satisfeitos, mas apesar de tudo satisfeitos com a hierarquia. ABSTRACT; Behind decades of studies, the opinions are controversial. There is a common opinion among researchers about what is and how is the motivation, satisfaction and dissatisfaction at work. The physical conditions of services are a major factor in motivation, satisfaction or dissatisfaction of the worker and the type of leadership exists in it. Throughout our history have seen many examples of leadership, some more, some less effective. Job satisfaction is an affective state resulting from the assessment of the perceived characteristics of work and organization. ln this context of changes in public administration in general and in health in particular, this study appears in the hospital setting, motivated by the need to know the satisfaction of nurses in a Hospital in Lisbon and the relationship with sociodemographic variables. We chose the quantitative paradigm in a sample of 122 respondents belonging to a group of nursing professionals in a central hospital in Lisbon. ln developing the empirical part we used the method for multiple-choice test. The objectives: General Objective: To understand the level of motivation I satisfaction of nurses for the profession and the service hierarchy. Specific objectives: To identify the level of satisfaction I motivation of nursing service studied for the profession, according to the socio-demographic variables. - Characterize the points with which nurses have the highest and lowest satisfaction related to the profession, service and hierarchy. - To identify if there is a relationship between the level of motivation I satisfaction and physical symptoms felt. The sample participants are mostly female, average age is 32 years, a large percentage already has the professional qualifications of the degree, are between and 28 years of occupation and 1 and 28 in the current service, 17.2 % hold positions of leadership. A great percentage of the sample has the working week and working 35 hours on rotating schedule. Nurses are professionals who show dissatisfaction with the profession and the hierarchy and moderately satisfied for the services, the latter fact can be justified by what is possible when the organization professionals are available and perform functions in service to their liking and they like to work. The satisfaction of nurses as the profession changes according to working hours, commitment to the institution and the feelings they have for the work. The satisfaction of nurses for the service changes depending on the length of service and with the feelings that professionals are on the job. The satisfaction of nurses from the hierarchy will change depending on the age of professionals, time and professional service where they play. For the overall satisfaction with the work, this may change depending on age, length of employment, where the service functions and the feelings of the professionals for the job. Note that when analyzing the services studied separately concluded that the nurses in the emergency department professionals are very unhappy with the hierarchy and the nurses of the Unit of Emergency Medical professionals are somewhat satisfied but still happy

Extended use of gamma irradiation in wild mushrooms conservation: validation of 2 kGy dose to preserve their chemical characteristics

Irradiation is recognized by international organizations as a conservation technology, and its application to wild mushrooms has been tested in some species. Our research group evaluated the effectiveness of gamma irradiation to conserve different samples of highly appreciated species, particularly, Lactarius deliciosus, Macrolepiota procera, Boletus edulis and Hydnum repandum. From those results and considering also international recommendations on this subject, the 2 kGy dose was chosen for further studies. Therefore, the application of gamma irradiation at 2 kGy dose was extended to Boletus pinophilus Pilát & Dermek and Clitocybe subconnexa Murrill to validate the proposed technology. Considering the obtained results, some of the analysed chemical parameters (specially sugars and fatty acids), as well as the antioxidant activity, showed significant changes after irradiation treatment, particularly in B. pinophillus, probably due to its higher water content. Nevertheless, the obtained differences did not seem to be sufficient to change the organoleptic characteristics of these mushrooms. Furthermore, the antioxidant activity was generally higher in irradiated samples. In conclusion, the detected chemical changes might be considered as acceptable, when considering the high advantages of gamma irradiation at decontamination and/or disinfestation level.