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.

Der Umgang mit Forschungsdaten an der Leibniz Universität Hannover. Auswertung einer Umfrage und ergänzender Interviews 2015/16

Im Kontext des Projekts „Entwicklung eines institutionellen Konzepts zum Forschungsdatenmanagement an der Leibniz Universität Hannover“ wurden 2015/16 eine universitätsinterne Online-Umfrage und ergänzende Interviews durchgeführt. Deren Ergebnisse ermöglichen einen Einblick in den derzeitigen Umgang mit Forschungsdaten und eine Abschätzung des Bedarfs an Beratung, Schulung und technischer Infrastruktur seitens des wissenschaftlichen Personals. In diesem Bericht werden die Daten präsentiert und ausgewertet.

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. 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. At this context, it is important to examine and map the use of MI by nurses in their clinical practice with adolescents to promote health behaviors. Objetives A scoping review has been currently undertaking to find out 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. The first task was to develop a search strategy to identify relevant studies for this review. It is described here the experience in constructing a search strategy for this review. Methodology This scoping review will be informed by JBI methodology. An initial search of MEDLINE and CINAHL was undertaken. An analysis of the text words contained in the title and abstract, and of the index terms used to describe the searched articles were retrieved and these were then used to construct a search strategy for use in Medline and Cinahl. Results Analysis of the text words and the index terms generated 19 keywords: It was identified 5 synonyms for "Adolescents", 12 for "MI" and 2 for "nurse". A new research formula was designed using the text words identified. Adolescen*[Title/Abstract]) OR Younger*[Title/Abstract]) OR Youth*[Title/Abstract]) OR Teen*[Title/Abstract]) OR Adolescent[MeSH Terms])) AND (((((((((((("Motivational interview"[Title/Abstract]) OR "Motivational intervention"[Title/Abstract]) OR "Motivational interviews"[Title/Abstract]) OR "Motivational interventions"[Title/Abstract]) OR "motivational interviewing"[Title/Abstract]) OR "motivational counseling"[Title/Abstract]) OR "motivational support"[Title/Abstract]) OR "Motivational enhancement"[Title/Abstract]) OR "Brief intervention"[Title/Abstract]) OR "Brief interventions"[Title/Abstract]) OR Motivational Interviewing[MeSH Terms]) OR Directive Counseling[MeSH Terms])) AND ((nurs*[Text Word]) OR Nurses[MeSH Terms]). Limiters - Language: English, Portuguese, Spanish. In MEDLINE this research formula generated 125 results. 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. Conclusions It was presented here the initial results of this search. Next steps of this study will be to develop and refine the search strategy for use in other databases. 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 and inform opportunities for future development in nursing practice.

The effect of note taking on memory for details in investigative interviews

Across 3 experiments, the effect of different styles of note taking, summary and access to notes was examined for memory for the details contained in a witness interview. In Experiment 1, participants (N = 40) were asked to either take notes or listen as they watched a witness interview. In Experiment 2, participants (N = 84) were asked to either take notes in one of three ways (i.e., conventional, linear, spidergraph) or listen as they watched a witness interview. In Experiment 3, participants (N = 112) were asked to take notes using the conventional or spidergraph method of note taking while they watched a witness interview and were subsequently given an opportunity to review their notes or sit quietly. Participants were then either granted access to their notes during testing or were not provided with their notes. Results of the first two experiments revealed that note takers outperformed listeners. Experiment 2 showed that conventional note takers outperformed those who used organizational styles of note taking, and post-hoc analyses revealed that recall performance was associated with note quality. Experiment 3 showed that participants who had access to their notes performed the best. The implications of these findings for police training programs in investigative interviewing are discussed.

Empathy in the field: towards a taxonomy of empathic communication in information gathering interviews with suspected sex offenders

Research suggests that those suspected of sexual offending might be more willing to reveal information about their crimes if interviewers display empathic behaviour. However, the literature concerning investigative empathy is in its infancy, and so as yet is not well understood. This study explores empathy in a sample of real-life interviews conducted by police officers in England with suspected sex offenders. Using qualitative methodology, the presence and type of empathic verbal behaviours displayed was examined. Resulting categories were quantitatively analysed to investigate their occurrence overall, and across interviewer gender. We identified four distinct types of empathy, some of which were used significantly more often than others. Female interviewers displayed more empathic behaviour per se by a considerable margin.

Pedagogical interventions to overcome communication apprehension in employment interviews among career students.

Career programs in the Cegep system base their training on various learning activities, which are followed by a practicum. The objective is to achieve a certain number of competencies, deemed necessary by the Ministry of Education, for entry-level occupations in to the workforce. The Graphic Communications program offered at Champlain College Saint-Lambert is a three-year career program that leads to employment in the field of graphics. Many students have part-time jobs during their schooling period but most of those jobs do not relate to their field of study. Several graduates stated they were unable to persuade employers to hire them for an externship or stage at the end of their program. While jobs are important for their general skills, since they are not directly related to the field, these jobs may not have given the students a suitable model for the conduct of an employment interview. Practice interviews may be one of many successful training methods to lower communication apprehension (CA) levels. CA is defined as "an individual's level of fear or anxiety associated with either real or anticipated communication with another person or persons." This paper examines the literature on CA and employment interviews and evaluates whether pedagogical interventions, including monitored phone calls to employers and practice-videotaped interviews, allow students to feel more confident about interviewing for a future job. A qualitative tool was used to gather scientific measurements of the participants' levels of CA both at the beginning and at the end of the Career Planning course. Open-ended reflective journals gathered quantitative data on the impact specific instructional strategies had on the participants. The pedagogical interventions that were examined and tested were as follows: preparation of scripts, monitored phone calls, videotaped practice interviews, and inclass access to professional assistance. Results indicate that all interventions had a positive impact on lowering levels of CA. It is clear that positive conclusions were drawn by the students as to usefulness of these activities. Overall, participants who responded to the reflective journal questions felt positive about the contribution of this preparatory career course to their CA levels. The results of the quantitative tool were consistent with previous research and the analysis of the reflective journals gave additional support to the usefulness of the interventions on students' confidence levels. Recommandations for improvements to the curriculum include the need for students to be taugh formally about metacognition and how to monitor it. Students need to be exposed to videotaped interviews more often. They should be better prepared for unexpected interview questions, and they should experience formal rehearsals with one of their instructors before the actual practice interview. Some of these recommendations have already been successfully implemented in the program's curriculum.||Résumé:Le but de ce travail était de vérifier si certaines activités pédagogiques sont efficaces pour faire baisser le niveau d'anxiété lié à la communication orale lors de leurs entrevues d'embauche. L'objectif des programmes techniques au Québec est de fournir aux étudiants un certain nombre de compétences définies par le ministèe de l'Éducation, des Loisirs et du Sport afin que ces derniers puissent fournir des services de techniciens spécialisés aux entreprises. Le programme nommé Office Systems Technology (412) du collège Champlain de Saint-Lambert, a choisi la voie de la spécialisation en microédition et hypermédia en 1999 et a changé son nom pour Graphic Communications en 2005. Les programmes techniques au Cégep incluent un stage en milieu de travail à la fin d'un programme de trois ans et par le fait même, une entrevue pour obtenir un stage en entreprise. La compétence visée par cette étude est l'intégration au marché du travail et le cheminement professionnel des étudiants. Lors d'enquêtes informelles, plusieurs étudiants du programme ont fait part de leurs difficultés à trouver un stage en fin d'études. Certains auteurs suggèrent que ces étudiants n'ont pas de modèles appropriés lors de la tenue d'une entrevue d'emploi. Ils proposent de diminuer le niveau d'anxiété lié à la communication orale lors d'entrevues d'embauche en offrant des pratiques d'entrevue aux étudiants. Cette recherche a examiné la littérature au sujet de l'anxiété de communication, plus précisément lors d'entrevues. Elle avait pour mandat d'évaluer si les activités pédagogiques d'un cours de préparation à la carrière ont été efficaces pour faire baisser les taux d'anxiété en communication orale lors d'entrevues. En plus, une conseillère à l'emploi fut invitée à plusieurs reprises afin de fournir un support professionnel en classe, étant donné que les étudiants ne prennent pas nécessairement le temps de consulter des professionnels en raison de leurs activités personnelles trop nombreuses. Le type d'enseignement évalué est considéré comme stratégique, étant donné qu'il agit au niveau cognitif et métacognitif de l'étudiant. Le cours de préparation à l'emploi débute par la vérification des acquis antérieurs des étudiants et il tient compte de leur motivation scolaire et professionnelle. De plus, il est axé sur la construction du savoir en proposant des activités de plus en plus complexes, débutant par la rédaction de textes à utiliser lors d'appels aux employeurs, en passant par la préparation et la pratique d'appels et se terminant par des entrevues d'emploi qui serviront de modèle à perfectionner par chaque étudiant. Ces entrevues se font avec des employeurs qui ont déjà embauché des étudiants du programme de Graphic Communications au collège Champlain de Saint-Lambert et sont enregistrées sur bande vidéo afin de permettre une visualisation ultérieure et cohérente avec les objectifs visés. La méthodologie de cette recherche inclut deux outils, un quantitatif et un qualitatif. L'outil quantitatif permet de mesurer scientifiquement les taux d'appréhension en communication des étudiants au début et à la fin du cours de préparation à l'emploi. Cet outil est la fusion de deux outils, le Personal Report of Communication Apprehension ou PRCA-24, qui fut développé par McCroskey (1984), en tandem avec celui de Wongprasert & Ayres (2000), qui lui met l'accent sur les entrevues d'emploi. Les réponses à cet outil combiné sont évaluées sur une échelle Likert de cinq points. L'outil qualitatif est une série de questions auxquelles les étudiants ont répondu quatre fois lors de la session. Les réponses à ces questions ont été analysées et les commentaires des étudiants évalués. Il découle de cette analyse que les niveaux d'anxiété des étudiants qui ont participé (14) étaient définitivement à la baisse en fin de cours. La pratique téléphonique structurée, dans un laboratoire avec les téléphones, a été très révélatrice pour les étudiants. Ils ont appris comment utiliser un script comme piste de départ pour un appel et qu'il était possible de contourner certains obstacles de façon professionnelle. Ensuite, lors d'une visite d'une compagnie de graphisme, ils ont pu observer divers modèles d'emploi. Ils ont eu la possibilité de poser des questions sur le fonctionnement et les besoins de l'entreprise. Ceci facilita la rédaction de leur curriculum vitae en leur permettant de mieux décrire leurs acquis en fonction d'emplois recherchés. Par la suite, ils se sont préparés pour une pratique d'entrevue, filmée. Les interviewers avaient déjà travaillé avec le collège et avaient déjà embauché certains étudiants de ce programme, donc ils connaissaient leur potentiel. Une liste de questions possibles fut suggérée mais il n'en restait pas moins que les interviewers pouvaient les modifier, ceci étant représentatif du marché de l'emploi. Même si le collège fournit un enseignement en anglais, un des intervieweurs donna ses entrevues en français. Trois étudiants se sont portés volontaires, mais deux ont constaté qu'ils auraient dû pratiquer leur script en français avant l'entrevue pour mieux diminuer leur niveau d'anxiété. Finalement, les étudiants durent visionner leur segment d'entrevue : ceci leur a permis de voir si leur attitude non-verbale concordait avec ce qu'ils ressentaient en entrevue et d'emmener les correctifs appropriés. Les taux d'anxiété furent vérifiés une deuxième fois en fin de session et les résultats ont démontré une baisse des taux d'appréhension. Les résultats de cette étude concordent donc avec ceux trouvés dans la littérature et donnent de bonnes pistes pour l'amélioration de ce cours de préparation à la carrière. L'auteur recommande d'enseigner la métacognition de façon formelle et ainsi de faciliter la prise de conscience des apprentissages que les étudiants effectuent. De plus, les étudiants devraient être filmés en studio au moins une fois par année pour diminuer le facteur de stress causé par les caméras et finalement ils pourraient certainement bénéficier de pratiques formelles d'entrevue avec un instructeur avant l'entrevue filmée. L'augmentation des pratiques a déjà été mise en oeuvre dans le programme et des résultats positifs se sont ensuivis.

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

The objective of this scoping review is to examine and map the use of motivational interviews (MI) by nurses in their clinical practice with adolescents to promote health behaviors.More specifically, the review will focus on the following questions:What is the current nature and extent of use of nurse-led MI in the promotion of health behaviors in adolescents?Which adolescent populations (in terms of health status and adoption or not of health risk behaviors have been included in nurse-led MI with the aim of promoting health behaviors?What are the contexts in which nurses have used MI to promote health behaviors in adolescents?Which specific MI techniques and/or strategies have been used by nurses to promote health behaviors in adolescents?What outcomes on the promotion of health behaviors have been reported from nurse-led MI with adolescents?

The use of motivational interviews by nurses to promote health behaviors in adolescents: developing a search strategy for this review

Introduction: The developmental changes during adolescence may affect subsequent risk for diseases and health-related behaviors. 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. At this context, it is important to examine and map the use of MI by nurses in their clinical practice with adolescents to promote health behaviors. Objectives: A scoping review has been undertaking to find out what is the current extent of the use of nurse-led MI; which adolescents were included; in which contexts nurses use MI; which MI techniques/strategies are used and what outcomes have been reported. The first task was to develop a search strategy to identify relevant studies for this review. It is described here the experience in constructing the search strategy review. Methodology: This scoping review will be informed by JBI methodology. An initial search of MEDLINE and CINAHL was undertaken. An analysis of the text words contained in the title and abstract, and of the index terms used to describe the searched articles were retrieved and these were then used to construct a search strategy for use in Medline and Cinahl. Results: Analysis of the text words and the index terms generated 19 keywords: It was identified 5 synonyms for "Adolescents", 12 for "MI" and 2 for "nurse". A new research formula was designed using the text words identified. Adolescen*[Title/Abstract]) OR Younger*[Title/Abstract]) OR Youth*[Title/Abstract]) OR Teen*[Title/Abstract]) OR Adolescent[MeSH Terms])) AND (((((((((((("Motivational interview"[Title/Abstract]) OR "Motivational intervention"[Title/Abstract]) OR "Motivational interviews"[Title/Abstract]) OR "Motivational interventions"[Title/Abstract]) OR "motivational interviewing"[Title/Abstract]) OR "motivational counseling"[Title/Abstract]) OR "motivational support"[Title/Abstract]) OR "Motivational enhancement"[Title/Abstract]) OR "Brief intervention"[Title/Abstract]) OR "Brief interventions"[Title/Abstract]) OR Motivational Interviewing[MeSH Terms]) OR Directive Counseling[MeSH Terms])) AND ((nurs*[Text Word]) OR Nurses[MeSH Terms]). Limiters - Language: English, Portuguese, Spanish. In MEDLINE this research formula generated 125 results. 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. Conclusions: It was presented here the initial results of this search. Next steps of this study will be to develop and refine the search strategy for use in other databases. 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 and inform opportunities for future development in nursing practice.

Philosophy of quantum field theory: an introduction with interviews and comments

In this thesis, I address quantum theories and specifically quantum field theories in their interpretive aspects, with the aim of capturing some of the most controversial and challenging issues, also in relation to possible future developments of physics. To do so, I rely on and review some of the discussions carried on in philosophy of physics, highlighting methodologies and goals. This makes the thesis an introduction to these discussions. Based on these arguments, I built and conducted 7 face-to-face interviews with physics professors and an online survey (which received 88 responses from master's and PhD students and postdoctoral researchers in physics), with the aim of understanding how physicists make sense of concepts related to quantum theories and to find out what they can add to the discussion. Of the data collected, I report a qualitative analysis through three constructed themes.

[climacteric Syndrome In A Northeastern Brazilian City: A Household Survey].

To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically. A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms. Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint. The prevalence of CS was high among women from São Luís, Maranhão, Brazil.

[principles Of Universality, Comprehensiveness And Equity In A Hearing Health Care Service].

This article analyzed whether the practices of hearing health care were consistent with the principles of universality, comprehensiveness and equity from the standpoint of professionals. It involved qualitative research conducted at a Medium Complexity Hearing Health Care Center. A social worker, three speech therapists, a physician and a psychologist constituted the study subjects. Interviews were conducted as well as observation registered in a field diary. The thematic analysis technique was used in the analysis of the material. The analysis of interviews resulted in the construction of the following themes: Universality and access to hearing health, Comprehensive Hearing Health Care and Hearing Health and Equity. The study identified issues that interfere with the quality of service and run counter to the principles of Brazilian Unified Health System. The conclusion reached was that a relatively simple investment in training and professional qualification can bring about significant changes in order to promote a more universal, comprehensive and equitable health service.

Optical And Nonoptical Aids For Reading And Writing In Individuals With Acquired Low Vision.

To evaluate the use of optical and nonoptical aids during reading and writing activities in individuals with acquired low vision. This study was performed using descriptive and cross-sectional surveys. The data collection instrument was created with structured questions that were developed from an exploratory study and a previous test based on interviews, and it evaluated the following variables: personal characteristics, use of optical and nonoptical aids, and activities that required the use of optical and nonoptical aids. The study population included 30 subjects with acquired low vision and visual acuities of 20/200-20/400. Most subjects reported the use of some optical aids (60.0%). Of these 60.0%, the majority (83.3%) cited spectacles as the most widely used optical aid. The majority (63.3%) of subjects also reported the use of nonoptical aids, the most frequent ones being letter magnification (68.4%), followed by bringing the objects closer to the eyes (57.8%). Subjects often used more than one nonoptical aid. The majority of participants reported the use of optical and nonoptical aids during reading activities, highlighting the use of spectacles, magnifying glasses, and letter magnification; however, even after the use of these aids, we found that the subjects often needed to read the text more than once to understand it. During writing activities, all subjects reported the use of optical aids, while most stated that they did not use nonoptical aids for such activities.

[lay Agency And Healthcare: Producing Healthcare Maps].

This study aimed to characterize which regulatory logics (other than government regulation) result in healthcare output, using a two-stage qualitative study in two municipalities in the ABCD Paulista region in São Paulo State, Brazil. The first stage included interviews with strategic actors (managers and policymakers) and key health professionals. The second phase collected life histories from 18 individuals with high health-services utilization rates. An analysis of the researchers' involvement in the field allowed a better understanding of the narratives. Four regulatory systems were characterized (governmental, professional, clientelistic, and lay), indicating that regulation is a field in constant dispute, a social production. Users' action produces healthcare maps that reveal the existence of other possible health system arrangements, calling on us to test shared management of healthcare between health teams and users as a promising path to the urgent need to reinvent health.

[the Perception Of Behavior Related To Mindfulness And The Brazilian Version Of The Freiburg Mindfulness Inventory].

Mindfulness is a practice and a form of consciousness which has been the basis for innovative interventions in care and health promotion. This study presents mindfulness, describes and discusses the process of cultural adaptation of The Freiburg Mindfulness Inventory (FMI) to Brazilian Portuguese. From the original version of this pioneering instrument for assessing mindfulness two translations and two back-translations were made. These were evaluated by a committee of 14 experts (Buddhists, linguists, health professionals), who helped to create two versions for the first pre-test, based on which suggestions were made by a sample of 41 people of the population through interviews. Considering the difficulties in understanding the concepts that are unfamiliar to the Brazilian culture, a new version was prepared with additional explanations, which underwent a further evaluation of the experts and a second pre-test with 72 people. This process aimed at addressing the limitations and challenges of evaluating mindfulness in a country of western culture through a self-report instrument based on Buddhist psychology. With appropriate levels of clarity and equivalence with the original instrument, the Freiburg Mindfulness Inventory adapted for Brazil is presented.

[lean Production And Psychosocial Risks: The Case Of A Multinational Merger In A Metallurgical Company In Brazil].

This study focused on the method known as lean production as a work-related psychosocial risk factor in a Brazilian multinational auto parts company after its merger with other multinational companies. The authors conducted a qualitative analysis of two time points: the first using on-site observation and key interviews with managers and workers during implementation of lean production in 1996; the second, 16 years later, comparing data from a document search in labor inspection records from the Ministry of Labor and Employment and legal proceedings initiated by the Office of the Public Prosecutor for Labor Affairs. The merger led to layoffs, replacements, and an increase in the workday. A class action suit was filed on grounds of aggravated working conditions. The new production model led to psychosocial risks that increased the need for workers' health precautions when changes in the production process introduced new and increased risks of physical and mental illnesses.