INTRODUCTION: While research indicates that Motivational Interviewing (MI) is effective for reducing substance use, little is known about whether brief MI-based interventions reduce drug use in a primary care setting, or what processes impact outcomes. Mixed findings in MI process studies have led investigators to call for research exploring alternative process variables that may predict outcomes. The current study is a secondary data analysis using coded audio-recordings from a randomized controlled trial that tested the efficacy of two brief MI-based interventions as part of the `Assessing Screening Plus brief Intervention's Resulting Efficacy to stop drug use' (ASPIRE) trial. It was hypothesized that skill in affirming clients and enhancing self-efficacy (also assessed as a composite self-enhancement variable) would be associated with lower frequency of drug use at 6 weeks and 6 months after controlling for baseline drug use and indicators of general MI proficiency. METHODS: Audio-recordings from two intervention conditions [Enhanced Motivational Intervention (EMI; N=176) and Brief Negotiated Interview (BNI; N=174)] were coded with behavior counts and global interventionist skill ratings using an established coding system for MI and a study-specific coding manual. A series of negative binomial regression models were conducted that were stratified by intervention due to the different goals and characteristics of the two interventions. Secondary and tertiary analyses examined moderators including MI Spirit and patient baseline ratings of self-efficacy. RESULTS: There were no significant findings for the main effects models (Incidence Rate Ratio range .71-1.29). Only patient self-efficacy moderated the relationship between self-enhancement composite and 6 week outcome in the BNI condition; Self-enhancement composite was associated with lower frequency of drug use at 6 weeks in the BNI condition for those with low self-efficacy at baseline. Discussion: Overall, the results provided little support for the view that therapist skill in affirmation or enhancing self-efficacy was predictive of drug use outcomes in one-session interventions in primary care. The restricted range of interventionist skill ratings may account, in part, for these intervention process findings. Future work should explore the role of these interventionist variables on proximal indicators of change (i.e., intention) and drug use in MI-based interventions with demonstrated efficacy.

A cada dia novos modelos de Veículos Aéreos Não Tripulados (VANTs) estão sendo lançados no mercado para serem utilizados em diversas aplicações, tais como mapeamento de ambientes e vigilância. Geralmente, estes robôs utilizam um sensor GPS como fonte de estimativa de localização. Contudo, para um bom funcionamento, este sensor depende de um número mínimo de satélites sincronizados com ele e que o sinal emitido pelos satélites seja recebido com boa qualidade, o que pode ser considerado um fator negativo. Uma forma de contornar este problema é empregar um sistema de localização baseado em visão computacional utilizando a câmera que já está embarcada no robô e imagens de satélite como mapa. Este sistema estima a localização do VANT através de comparações entre as imagens capturadas por ele e uma imagem de satélite, buscando encontrar a sua posição nesta imagem de satélite. Neste contexto, apresentamos uma variação do descritor BRIEF, o abBRIEF, para ser utilizado em um novo modelo de observação que também está sendo proposto. O modelo de observação é responsável por medir quão parecidas são as leituras do robô com diversas partes do mapa, para estimar a sua localização correta. Devido ao grande número de comparações necessárias, é importante que o descritor utilizado no processo seja rápido, não consuma muitos recursos computacionais e seja robusto para lidar com as várias diferenças entre as imagens. O modelo proposto foi utilizado no algoritmo de Monte Carlo (Monte Carlo Localization, MCL) para realizar a localização de VANTs e apresentou resultados satisfatórios que corroboram a eficácia do modelo e do descritor. / New models of Unnamed Aerial Vehicles (UAVs) are developed on a daily basis and applied to several tasks, such as mapping terrains and surveillance. GPS sensors are usually the main source of information to estimate the robot position, however, a downside of these sensors is that a minimum number of satellites must be available and emitting high quality signals. A vision-based system can be used to overcome this problem by using a robot embedded camera and satellite images as maps. Computational vision systems estimate the UAV localization through the comparison between the robot extracted image and several parts of the satellite image. These comparisons are performed in order to localize the part of the map which is most similar to the robot perspective. Taking into account all this information, we propose BRIEF descriptor variation, called abBRIEF, to be used on a novel observation model, also proposed in this master thesis. An observation model is responsible for evaluate how similar the robot measurements and the different map parts are. The used descriptor must run fast, consume low computational resources and be robust regarding image changes, all to compensate the large number of necessary comparisons. The proposed model is applied with Monte Carlo Localization (MCL) method to the auto localization of UAVs and presented solid results that corroborate the model and descriptor efficiency.

O câncer de mama tem motivado pesquisas de avaliação e intervenção psicológica pelos altos índices de mulheres acometidas pela doença, por ser o segundo tipo de câncer mais comum entre as mulheres no mundo e também responsável pelo maior número de mortes. As pacientes com câncer de mama enfrentam o sofrimento psíquico com o diagnóstico e as vicissitudes do tratamento oncológico, necessitando de ajuda psicológica urgente. Definiu-se como objetivo geral desta pesquisa investigar os efeitos terapêuticos da Psicoterapia Breve Operacionalizada (PBO) no atendimento de mulheres diagnosticadas com câncer de mama e em tratamento oncológico. Como objetivos específicos este estudo pretende averiguar os efeitos da técnica da PBO nas situações-problema localizadas nos setores adaptativos e verificar a eficiência da PBO nas situações de crise adaptativa. A pesquisa foi delineada pelo método misto e as participantes foram 17 mulheres, com idade entre 30 e 65 anos, que estavam em tratamento num ambulatório de oncologia do Grande ABC Paulista. Os instrumentos utilizados foram: entrevista clínica preventiva; Escala Diagnóstica Adaptativa Operacionalizada (EDAO) para avaliação da adaptação, antes e após a intervenção psicológica breve e no follow-up; e a PBO. Os resultados mostraram na avaliação inicial que 17,5% das participantes estavam com adaptação ineficaz grave (grupo 5), 53% estavam com adaptação ineficaz severa (grupo 4), 17,5% com adaptação ineficaz moderada (grupo 3) e 13% com adaptação ineficaz leve (grupo 2), sendo que 41,2% estavam em crise adaptativa por perda; o setor Orgânico foi o mais comprometido, seguido do Afetivo-Relacional com soluções pouquíssimo adequadas. A situação-problema da maior parte das participantes estava relacionada ao câncer de mama, o que na compreensão psicodinâmica mostrou-se associada ao intenso desamparo egóico diante do adoecimento e tratamento oncológico. Na avaliação adaptativa final e follow-up, 82,4% das participantes apresentaram evolução de grupo adaptativo. Concluímos que a PBO se mostrou eficiente em todas as idades, estado civil, escolaridade, tempo de diagnóstico, fase de tratamento oncológico e tipo de cirurgia (mastectomia radical ou parcial) e a técnica da interpretação teorizada mostrou-se eficiente para a solução das situações-problema e da crise adaptativa por perda. A motivação, a aliança terapêutica e a transferência positiva foram fundamentais para as participantes no aproveitamento das sessões / Breast cancer has motivated research of evaluation and psychological intervention by the high rates of women affected by the disease, because it is the second most common cancer among women worldwide and also responsible for more deaths. Patients with breast cancer face the psychological suffering with diagnosis and the events of cancer treatment, requiring urgent psychological help. Thus this research had as a general objective investigate the therapeutic effects of Brief Psychotherapy Operationalized (PBO) in the care of women diagnosed with breast cancer and cancer treatment. And the specific objectives were to investigate the effects of PBOs technique in problem-situations located in adaptive sectors and verify the efficiency of the PBO in situations of adaptive crisis. The research was outlined by the mixed method and the participants were 17 women aged 30 to 65, who were being treated in an oncology outpatients clinic in São Paulo. The instruments used were: preventive clinical interview, Adaptative Operational Diagnostic Scale (EDAO) for evaluation of adaptation before and after the brief psychological intervention and follow-up; and the PBO. The results showed in the initial evaluation that 17,5% of participants were in ineffective adaptation serious (group 5), 53% were in ineffective adaptation severe, 17,5% ineffective adaptation moderate and 13% ineffective adaptation light, whereas 41,2% were in the adaptative crisis by loss; the Organic sector was the most committed, followed by the Affective-Relational with solutions very little adequate. The problem-situation of most participants was related to breast cancer, which in psychodynamic understanding was associated to the intense helplessness ego in the face of illness and cancer treatment. In the final adaptive evaluation and follow-up, 82,4% of participants presented evolution of adaptive group. We concluded that the PBO was efficient at all ages, marital status, scholarity, time of diagnosis, cancer treatment stage and type of surgery (radical and partial mastectomy) and the technique of interpretation theorized proved efficient for the solution of problem- situations and adaptive crisis by loss. The motivation, the therapeutic alliance and positive transference were crucial for the participants in harnessing of the sessions

Philosophiae Doctor - PhD / The importance of health enhancing physical activity participation (HEPA) has always been emphasized globally, as one of the means to reduce the risk of Non-Communicable Diseases (NCDs) occurrence. In Africa, it is more relevant currently, due to the growing burden of NCDs that is coupled with the existing encumbrance of communicable diseases. In Rwanda, specifically, there are limited national strategies to promote health-enhancing physical activity. Consequently, the level of physical activity among Rwandans, especially government office workers, is likely to diminish, which could possibly be attributed to the rapid urbanization that comes with lifestyle changes. Basically, most people tend to abandon the traditional labour-intensive activities, which are associated with high energy expenditure, to more sedentary activities. Therefore, the need to promote health enhancing physical activity participation is crucial. Physical activity participation is an intricate and multifaceted behaviour that may not be viewed from a linear perspective. This current study adopted a socio-ecological framework to assess the factors that influence Leisure Time Physical Activity (LTPA) among government employees in Kigali City. The study used an exploratory, sequential, mixed methods of qualitative and quantitative designs, in order to comprehensively explore and understand the research problem. Qualitatively, a Case study and exploratory design was used to collect data, specifically from the Rwanda Sport Policy and its implementing stakeholders. Quantitatively, a cross-sectional, descriptive design was used to assess and describe the levels of LTPA among government workers in Kigali City, as well as highlight the various factors that influence, or limit, their participation.

O uso de álcool na gestação traz sérios riscos à saúde da mãe e do bebê. As prevalências do uso de risco de álcool entre gestantes encontradas em estudos nacionais giram em torno de 20%. Nos EUA, estudos sobre avaliação das intervenções breves têm mostrado uma na redução do uso de álcool em gestantes. O objetivo deste estudo foi elaborar um protocolo de intervenção breve (IB) para gestantes e avaliar sua eficácia na redução do consumo de álcool comparativamente ao recebimento de um folheto informativo sobre os riscos do uso de álcool na gestação. Foi realizado um ensaio clínico, cego, comparativo e prospectivo, com distribuição randômica das participantes em dois grupos (IB e folheto), com dois tempos de coleta de dados (T1 e T2). Foram recrutadas 86 gestantes em serviços de saúde de Ribeirão Preto e Araraquara com uso de risco de álcool utilizando o instrumento T-ACE (pontuação maior ou igual a dois). As gestantes eram maiores de 18 anos e possuíam até 16 semanas de gestação. Todas responderam a um questionário incluindo avaliação do padrão de uso de álcool e receberam IB ou um folheto informativo sobre os riscos do uso de álcool na gestação. Foram excluídas gestantes com diagnóstico prévio de dependência de álcool ou drogas, as que pontuaram acima de 20 no instrumento AUDIT, as que declararam uso, nos últimos três meses, de outras drogas, exceto tabaco e aquelas incapazes de compreender e fornecer informações aos pesquisadores. No segundo tempo da pesquisa (a partir da 25ª semana gestacional) compuseram a amostra 80 gestantes, sendo 39 do grupo folheto e 41 do grupo IB. As gestantes do grupo IB apresentaram menor média de doses consumidas e maior prevalência de abstinentes. Contudo, não foram observadas diferenças estatisticamente significativas entre os grupos em relação ao padrão de consumo de álcool. A avaliação intra-grupos também não detectou diferenças no padrão de consumo de álcool entre T1 e T2 seja para o grupo folheto ou para o grupo IB. Apesar disso, a autoavaliação das gestantes tanto no grupo folheto quanto no grupo IB sobre a mudança no comportamento de consumo de bebidas alcoólicas indicou uma diminuição estatisticamente significativa do consumo (Grupo folheto, Wilcoxon, Z=-2,74; p<0,01; r=0,31) (Grupo IB, Wilcoxon, Z=-4,43; p<0,001; r=0,49). / Alcohol use during pregnancy causes serious health risks to the mother and baby. National studies indicate prevalence around 20% of risky drinking by pregnant women. In the U.S., researches on evaluation of brief interventions have shown a reduction in alcohol consumption among pregnants. A prospective, blind and randomized clinical trial was developed to evaluate the efficacy of a brief intervention (BI) protocol in reducing alcohol use among pregnant women. Participants were randomized by opaque and sealed envelopes in two groups (IB and brochure), with two periods of data collection (T1 and T2). We recruited 86 risky drinking and pregnant women in health care services using T-ACE (score more than two points). Women were older than 18 years and had up to 16 weeks of gestation. All completed a questionnaire including evaluation of standard alcohol and received IB (IB group) or information leaflet about the risks of alcohol use during pregnancy (brochure group). We excluded women with (1) a previous diagnosis of alcohol or drugs dependence, (2) those scored above 20 points in AUDIT instrument, (3) those reported drugs use (except tobacco) in the past three months, and (4) those unable to understand and provide information to researchers. In T2 period (up 24 weeks gestation), 80 participants remained in the study (39 brochure group and 41 IB group). IB group presented a lower average doses consumed and a higher prevalence of abstinent. However, there were no statistically significant differences between the groups in relation to the pattern of alcohol consumption. Intra-group evaluation also did not detect differences in the pattern of alcohol consumption between T1 and T2 in both groups. Nevertheless, self-assessment of pregnant women about the change in drinking behavior indicated a statistically significant decrease of alcohol consumption in brochure group (Wilcoxon, Z= -2.74, p <0, 01, r = 0.31) and IB group (Wilcoxon, Z= -4.43, p <0.001, r = 0.49).

INTRODUÇÃO: As Estratégias de Diagnóstico e Intervenções Breves (EDIB) propostas pela Organização Mundial de Saúde são consideradas efetivas para o diagnóstico e prevenção dos agravos decorrentes do uso do álcool. Atitudes, crenças e expectativas dos profissionais de saúde em relação ao uso de álcool influenciam o efeito destas novas propostas. OBJETIVO: Este trabalho propõe a avaliação do efeito do treinamento em EDIB sobre as crenças e expectativas a respeito do uso de álcool. MÉTODOS: O estudo é do tipo observacional, transversal, comparativo, sobre uma amostra de 88 profissionais da atenção primária à saúde, provenientes de Ribeirão Preto e região, que concordaram em participar da pesquisa conforme os procedimentos éticos recomendados, treinados pelo Programa de Ações Integradas para Prevenção e Atenção ao Uso de Álcool e Drogas na Comunidade (PAIPAD) no período de 2003 a 2006. Os dados foram coletados através de questionários individuais aplicados antes do treinamento e no período de 4 a 6 meses depois. Os questionários incluíram um formulário sócio-demográfico, o Teste de Conhecimento sobre álcool e Intervenções Breves (IB), o Inventário de Expectativas e Crenças Pessoais acerca do Álcool (IECPA) e um formulário de estimativas sobre o uso do AUDIT (Alcohol Use Disorder Identification Test) e das IB. A amostra foi caracterizada quanto à prática e preparação profissional na atenção primária, papel, atitudes e crenças dos profissionais em relação aos problemas relacionados ao uso de álcool ou outras drogas pelos seus pacientes. RESULTADOS: No Teste de Conhecimento sobre álcool e Intervenções Breves, a pontuação média foi maior após o treinamento, passando de 4,1 para 5,57(Wilcoxon Test: z= -4,936; p 0,001). Os resultados médios do IECPA passaram de 93,45 pontos na fase pré para 78,74 pontos na fase pós-treinamento (Wilcoxon, z=-4,138; p 0,001). Através do teste de Spearman observou-se tendência à correlação positiva entre a aquisição de conhecimento e as variações no IECPA (p=0,095); o nível de conhecimento pré-treinamento e as estimativas de realização de EDIB(p=0,082); as estimativas de aplicação de AUDITS e o intervalo de tempo(p=0,009). As variações do IECPA se correlacionaram positivamente com as expectativas de aplicação de EDIB (Nonparametric Chi-Square: p=0,053). No Teste de Conhecimento, o nível médio (incompleto e completo) apresentou menor nível de aproveitamento que os outros níveis de escolaridade. As maiores variações no IECPA foram observadas entre os profissionais de nível de escolaridade superior (incompleto e completo). Os profissionais com ocupações de nível superior apresentaram maiores variações positivas quanto ao conhecimento que os de nível técnico, e maior redução na pontuação do IECPA. CONCLUSÕES: A estratégia de formação oferecida pelo PAIPAD foi efetiva, promovendo mudanças nas crenças e expectativas da equipe sobre uso de álcool, interferindo positivamente na conduta preventiva dos profissionais treinados junto aos pacientes. / BACKGROUND: The Strategies of Screening, Brief Intervention and Referral to Treatment (SBIRT) proposed by World Health Organization (WHO) are considered effective to perform the diagnosis and the prevention of damage caused by alcohol. Attitudes, beliefs and expectations of health professionals in relation to alcohol use have influence over the effect of these new proposals. OBJECTIVE: This study aimed at evaluating the effect of training in SBIRTs on the beliefs and expectations of professionals about the alcohol use. METHODS: The study is observational, cross-sectional and comparative, with a sample of 88 professionals of primary care, from Ribeirão Preto and region, who agreed to participate following ethical procedures, trained by Program of Integrated Action for Prevention and Attention to Alcohol and Drug Use in the Community (PAIPAD), in period from 2003 to 2006. Data were collected through individual questionnaires applied before the training and in the period from 4 to 6 months later. The questionnaires included a socio-demographic inventory, the Test of Knowledge about alcohol and brief interventions (IB), the Inventory of Positive Expectations and Beliefs about Alcohol (IECPA) and an inventory of estimates on the use of the AUDIT (Alcohol Use Disorder Identification Test) and brief interventions. The sample was characterized in relation to the practice and professional preparation in primary care, the professional role in primary care and attitudes and beliefs of professionals about problems related to alcohol or other drugs for their patients. RESULTS: In the Test of Knowledge about alcohol and brief interventions, the average score was higher after the training, increasing from 4.1 to 5.57 (Wilcoxon test: z =- 4.936, p0001). The IECPA average changed from 93.45 points to 78.74 points after intervention, in the post-training (Wilcoxon, z =- 4.138, p0001). A trend toward positive correlation between the acquisition of knowledge and changes in IECPA (p = 0,095) was found (Spearman test), as well the level of pre-training knowledge and estimates of conducting SBIRTs (p = 0,082), estimates of implementing AUDIT and the time (p = 0,009). In the Test of Knowledge, the intermediate level of schooling (complete and incomplete) showed lower score than the others. Variations of IECPA correlated positively with the expectations of applying SBIRTs (Nonparametric Chi-Square: p = 0,053). The highest changes in IECPA were seen among higher level professionals (complete and incomplete). The professionals of higher-level occupations showed bigger positive changes in knowledge than workers of technical level and higher reduction in scores of IECPA. CONCLUSIONS: The strategy of training offered by PAIPAD was effective, promoting changes in beliefs and expectations of the team about alcohol use, interfering positively in the preventive attitudes of trained professionals with the patients.

This article concentrates on two models of therapy, one Gestalt and the other Adlerian, that were presented at a Brief Therapy Conference and involved demonstrations with parents. Both sessions focused on the needs of individual parents who sought help with their relationships with a daughter and a son, respectively. Typescripts of each session are provided along with an assessment of purpose, awareness, contact, and experience (P.A.C.E.) as these relate to the flow and rhythms of therapy.

This paper explores the process of individual short-term ego-supportive psychotherapy with mentally deficient adults. The literature on clinical research, case studies, process research, short-term psychotherapy, and therapy with the mentally retarded is selectively reviewed. Four case studies are presented with clients at the Portland Habilitation Center, a sheltered workshop which trains mentally deficient adults in socialization, practical living, and job skills. Finally, the case studies are discussed in terms of the selected literature.

Difficulties experienced at work can cause feelings of burnout that become prolonged and intensified without acts of self-care. The intense nature of mental health workers' jobs may make them, more vulnerable to burnout than other professionals. Because mental health professionals' mental and emotional wellness can significantly affect their work, adequate self-care is critical to both their well-being and that of their clients. Previous researchers have investigated the self-care behaviors of mental health professionals, but little was known about how gender affected the use of these behaviors in burnout prevention among mental health professionals. The purpose of this quantitative study was to examine the relationship between self-care behaviors and burnout among a sample of 325 mental health professionals working in New York. Differences in the ways male and female mental health professionals practiced self-care behaviors were also investigated. Burnout and gender role theories were used as the theoretical framework. Study instruments included the MBI-HSS and the Brief COPE. Multiple regression analysis and independent sample t tests were employed to analyze survey data. Analysis revealed levels of self-care behaviors were significantly predictive of depersonalization, emotional exhaustion, and reduced personal accomplishment. Gender differences in self-care behaviors were indicated for substance use, self-blame, depersonalization, emotional exhaustion, and reduced personal accomplishment. Since burnout is a significant problem for many mental health professionals, understanding how self-care affects burnout is critical to promoting behavioral changes among these professionals. Self-care among mental health professionals may improve their professional and personal lives.

The purpose of this study was to examine the utility of a brief assessment for the selection of an effective instruction to increase fluency performance on computation math problems. Participants were four general education third-grade students who performed below the median score on a classwide administered multiple math skills probe. Students first participated in a brief assessment within a mini-withdrawal design to compare the relative effects of a contingent reward (CR) condition to a baseline condition on math fluency performance using a multiple skills probe. All four students increased performance when given an opportunity to earn an incentive for meeting a performance goal. Increased performance indicated a performance deficit to explain low math performance and that the students would positively respond to a contingent reward intervention on single math skills. To validate this hypothesis, the effects of baseline, CR, and instruction plus CR on fluency performance over time was assessed using a multiple baseline design across three single target skills for each student. Of the 12 skills assessed, results from the extended analysis demonstrated that the CR was effective on one skill, instruction plus CR was effective on five skills, and performance improved during baseline on six skills. Post results showed improved performance on the multiple probe for all students but performance was retained over 2 to 4 weeks on 5 of the 12 skills mastered during the study. Discussion focuses on considerations of the utility of a brief assessment approach in the application decision making and for future research