Body worn cameras (BWCs) are a newer piece of equipment that has been issued to police officers in efforts to increase transparency and improve relations with the community. Researchers who have just recently begun studying the effects of BWCs have observed changes in behavior of officers who wear the equipment. Some of these changes potentially have an adverse effect on citizens and the officers who wear BWCs. Lipsky's street-level bureaucracy theory was utilized to examine police officer use of discretion when conducting field activities while wearing BWCs. The research question pertained to police officers' perceptions regarding changes in behavior while being video recorded on duty. This study used generic qualitative inquiry to understand five police officers' perceptions through individual semi structured interviews complemented by the responsive interview model. Themes that emerged consisted of implementation, personal harm, privacy, and behavior modification. Notable findings under the theme of implementation included lack of initial acceptance of the equipment followed by approval of the equipment after use; and that initial training of BWCs was deemed insufficient. In the personal harm theme, participants expressed concern over functionality of BWCs and that superiors possibly would use footage for punitive reasons. Minimal privacy issues for officers were discovered; however, use of BWCs in private residences was perceived by participants as a concern for citizens. The most significant behavior modification was increased professionalism. Implications for social change include improved officer and citizen safety and the delivery of more effective police services, improving relations with the community.

In clinical trials of drug treatments for women’s sexual dysfunction, placebo responses have often been substantial. Little is known about the nature and time course of symptom reduction with placebo treatment. It is also unknown to what extent placebo responses might be associated with individual characteristics, such as demographic variables, that influence responsiveness to treatment. Finally, it is unknown how sexual behavior during placebo treatment changes and whether changes in sexual behavior account for variability in outcomes. In the present work I investigated potential between-trial, between-person, and within-person variables that might explain variability in response to placebo treatment of sexual dysfunction in women. Study 1 consisted of a systematic review of the clinical trial literature to estimate the magnitude and predictors of placebo response across previous trials. Study 2 was an analysis of a small sample of women who were randomized to receive placebo in a recent clinical trial. These preliminary studies provided evidence of a relatively large clinical response among women randomized to placebo in controlled clinical trials of sexual dysfunction treatments. In addition, I found evidence of a possible effect of psychosocial variables on placebo response. In Study 3, I further tested the nature and correlates of placebo response in a sample of 50 women with sexual arousal and desire problems. These data were drawn from a 12-week double-blind randomized controlled trial in which measurement of symptom severity took place at baseline, 4 weeks, 8 weeks, and 12 weeks, allowing for longitudinal analysis. Change in sexual function during placebo treatment peaked at 4 weeks and remained relatively stable through post-treatment. Furthermore, change in sexual function was clinically meaningful in approximately one-third of the sample. Symptom improvement appeared to be in part a function of increased frequency of satisfying sexual encounters during treatment, although there remained additional variability in outcomes that could not be explained by the available data. The findings are discussed with reference to enhancing both clinical trial design and psychological therapies in the treatment of sexual dysfunction in women. / text

Diabetes type 2 is a fast growing illness and a global health problem, often a result from less appropriate standard of living. Lifestyle changes related to diet and physical activity are important lifestyle changes regarding to get control of the self-management and to avoid vascular complications. Aim The aim of this study was to describe patient's experiences of lifestyle changes in diabetes type 2. Method A literature study was carried through based on 12 qualitative scientific articles. Results The analysis result into two main themes and eight subthemes. Main themes where barriers and motivators for lifestyle changes and the subthemes where struggle, denial, lack of knowledge, alienation, support, motivation, acceptance and knowledge. Conclusion This study shows that lifestyle changes are experienced different by patient with diabetes and nurses should therefore be aware of the unique and specific demands these patients require. This is important for providing a good diabetic healthcare and to help patients with their self-management

Es scheint in den letzten Jahren eine deutliche Veränderung in der Art der Kommunikation mit den sogenannten Neuen Kommunikationstechnologien stattgefunden zu haben, und zwar im Längsschnitt, also etwa über die letzten 10, 15 Jahre, wie auch zwischen den sich aus heutiger Sicht herausentwickelt habenden Nutzergruppen. Quantitative Erhebungen, am ausgeprägtesten die regelmäßig unternommenen und von den Medien wiedergegebenen "Internetumfragen", ebnen solche Veränderungen naturgemäß vollständig ein. Auch die vorhandenen qualitativen Arbeiten reflektieren solche Veränderungen meist nicht, da zeitliche Dimensionen üblicherweise in den Fragestellungen fehlen. Der Beitrag versucht eine Skizze dieser Entwicklungen, möchte einige Mißverständnisse im Zusammenhang mit neuer "Elektronischer Kommunikation" korrigieren helfen und kommunikationsökonomische Aspekte beisteuern.

Cette thèse s'inscrit dans le contexte actuel de remise en question de la prépondérance de la voiture particulière dans les déplacements des ménages français. Elle propose d'analyser les ruptures de comportements liées au déploiement de solutions pour mutualiser l'automobile, dans le but de prévoir l'évolution de ses modes d'usage, de son intensité d'usage, ainsi que celle de la motorisation. En premier lieu, nous identifions les nouveaux services de mobilité automobile comme les principaux vecteurs de changement de comportement, nous calculons les potentiels de développement du covoiturage (importants), de l'autopartage et de la location courte durée (restreints), et nous montrons que ces services peuvent permettre de réaliser des économies d'énergie s'ils sont utilisés en remplacement d'un équipement personnel. Dans un second temps, nous nous concentrons sur l'analyse fine des comportements de mobilité dont nous réalisons une segmentation mettant en évidence leurs principaux déterminants. A partir de ces derniers, l'estimation d'un modèle de choix modal montre que des transferts de la voiture personnelle vers les transports en commun ou encore la voiture partagée sont probables à horizon 2020, en cas de démotorisation des ménages. Enfin, nous analysons l'évolution de la motorisation des ménages et montrons des ruptures dans la dynamique générationnelle positive observée dans le passé qui se stabilisera, voire même s'inversera, à horizon 2020. Le marché automobile français sera donc davantage porté par le canal des sociétés (de service notamment) que celui des particuliers. / This thesis rises in a context where the automobile supremacy is questioned. It aims at analysing behavioural changes related to the deployment of solutions to pool car, in order to foresee evolution of its modes of use, intensity of use, as well as that of motorization. First, we identify new car mobility services as main vectors of changes in behaviours, we also measure the potential development of carpooling (important), carsharing and short-term car rental (limited), and we end up by showing that these services can achieve energy savings if used as substitute to individual equipment. In a second step, we focus on the analysis of mobility patterns from which we establish a behaviour classification highlighting their main drivers. From these, the estimation of a modal choice model shows that shifts from personal car toward public transport or shared car are likely to 2020, in the case of a decrease in households' motorization level. Thus, we finally analyse the evolution of households' motorization and emphasis a breaking point in the positive generational trends observed in the past, that will know a stagnation if not an inversion to 2020. As a consequence, the evolution of the French car market will tend to be more driven by sales to fleet and business than sales to private.

Background: Chinese immigrants (CIs) with non-insulin dependent diabetes mellitus (NIDDM) generally have poor control in their diet regimen. Due to the variation in body mass, physiology, and cultural differences as compare with the general American population, special attention must be conducted in treating diabetes in Cis, emphasizing culturally sensitive care and nutrition therapy that acknowledge the differences. Purpose: The purpose of this project was to assess cultural challenges in self-management for CIs living with non-insulin dependent diabetes mellitus and evaluate the effectiveness of a diabetic nutritional self-management guide tailored to this population. Theoretical Framework: Havelock’s theory of change is a model emphasized for understanding and intervening of the possibility that people might be resistant to behavior changes. Methods: Thirty-five foreign-born CIs were selected. The project was comprised of two phases to include pretest and posttest self-assessment questionnaires in addition to pretest and posttest A1C levels to evaluate the effectiveness of a custom meal plan. Results: Result findings were non-significant. However, female CIs were noted to have superiority for diet management as compared with male CIs. The two groups had no significant difference in age and cultural characteristics. Conclusion: The goal of the implementation of this project was to improve self-care for Chinese diabetic patients through behavior training and change in policy making. Social and cultural norms were identified that had great influence on an individual’s overall health knowledge. Increasing health care providers’ overall cultural competency was expected to promote better health outcome and ease the complexity of the acculturation process. However, the management of the diet did not have a significant change for the improvement of A1c. Future recommendations include the exploration of the immensity of change in cultural diet and acculturation.

The emerging health care culture of accountability for patient outcomes compounds problems for already overwhelmed clinicians struggling to fit everything entailed in complicated office visits into 15-minute appointments. Unprocessed frustrations tempt clinicians to use ineffective and outdated methods for trying to get their patients to comply or adhere to their care plans, undermining effective health care management. The intention of this project was to evaluate whether educating medical assistants in the health coaching method of motivational interviewing can improve the patient care approach while simultaneously assisting clinicians struggling with insufficient time. Several individual scheduling conflicts limited the target population into two primary care medical assistants and two auxiliary primary care office staff who voluntarily chose to learn the new approach. Guided by the adult learning theory, an educational lecture project was designed to capture the spirit of motivational interviewing through basic descriptions and strategies that will assist learners to focus on person-centered conversation skills, helping to balance both the needs of the patient and clinician. Following the education, participants filled out an anonymous post-lecture evaluation questionnaire to provide immediate feedback about learner understanding. Responses indicated the project met its stated objectives, and results showed the versatility of the motivational interviewing method which can be learned and effectively applied by health care workers from a wide range of professional backgrounds. Motivational interviewing is an innovative approach that utilizes therapeutic communication to promote behavior changes that lead to improved health of our communities and country.

Diabetes, a chronic disease with devastating but preventable consequences, is common in the United States, especially within African American communities. Earlier research has indicated that 21.7% of African American parents have children diagnosed with Type 1 diabetes in the Mississippi Delta Region. Researchers have examined coping, stress, and behaviors of African American parents of children diagnosed with Type 1 diabetes; however, there is a gap in literature regarding how African American parents can cope with stress and how changes in health behavior due to Type 1 diabetes impact African American families. The purpose of this qualitative phenomenological study was to explore the lived experiences of African American parents, examining how they can cope with stress and how their families are impacted by the changes in health behavior due to Type 1 diabetes. The transtheoretical model, used to evaluate a person's preparedness to pursue a new healthier behavior, was applied. Through semi-structured interviews, data collected from 13 families were recorded, transcribed, and coded into themes. Phenomenological data analysis was performed based on the descriptive technique, using a computer-based NVivo model and preset codes. In this study, African Americans are likely to accept and acknowledge the impact of denial as a coping mechanism, while accepting the behavioral changes, and this will likely alert professionals in this field of study. Also, this will lead to a positive social change in the study of Type 1 Diabetes.

A construção desta tese partiu das reflexões em torno das transformações no contexto da atividade de processamento de alimentos na agricultura familiar no Brasil. Tanto as políticas públicas como as políticas locais estão sendo formuladas com o objetivo de promover a essas famílias o acesso a recursos financeiros e a novos canais de comercialização. Ambas as políticas (locais e públicas) estão condicionadas às ideias das regras da legislação sanitária agroalimentar, que nem sempre refletem as formas como as famílias e os atores sociais locais interpretam as atividades de processamento de alimentos. Considerando esse contexto, esta tese teve como objetivo analisar o papel que as ações políticas locais, os programas e as políticas públicas - construídos para a agricultura familiar desde a década de 1990 no Brasil - exercem no processo de mudança na interpretação e conduta das famílias que desenvolvem tais atividades. Para tanto, a pesquisa foi realizada em quatro regiões do Rio Grande do Sul, as quais corresponderam aos Coredes: Hortênsias, Jacuí Centro, Sul e Vale do Rio dos Sinos. Ao total, foram entrevistadas 64 famílias (agricultores familiares) que processam alimentos oriundos da agricultura e pecuária. Para a coleta dos dados, foram utilizados um formulário composto de questões quali e quantitativas, diários de campo e observações. A análise dos dados foi desenvolvida por meio de técnica qualitativa (análise de conteúdo) e quantitativa (Escala Likert). As famílias foram divididas em 4 grupos (trajetórias), que mostram as diferenças nas formas como iniciaram e modificaram tecnicamente as suas atividades de processamento de alimentos. As diferentes formas como as políticas locais foram construídas explicam a emergência de novos hábitos nas famílias, especialmente no aspecto produtivo. Os agentes ligados aos governos locais e aos órgãos de assistência técnica destacaram-se como os principais atores sociais que influenciaram nesses processos. O regramento sanitário conduziu os agentes locais na formulação de ações visando transformar essa atividade. Nesse contexto, foram evidenciadas três formas de políticas locais: as políticas caracterizadas pela repressão, negociação e construção de ações coletivas entre as famílias envolvidas. O Programa Nacional de Alimentação Escolar é a única política pública que está provocando a transformação de hábitos, identificada pelas novas reflexões das famílias em torno das suas atividades, no ambiente da produção e da comercialização de alimentos. Essas mudanças são explicadas pelo processo de operacionalização e gestão dessa política pública, que demanda novas formas de organização social e coletiva nas atividades de processamento de alimentos. / This thesis has started from reflections on transformations in the context of processing food activities developed by family farmers in Brazil. Public and local policies have been developed to promote financial resources and new channel selling for the food produced by family farmers. Both policies reflect the ideas from agri-food hygiene standards, which may not represent the way families and other social actors have been interpreting this activity. Considering this context, this thesis aims to discuss what the role of public and local policies are – constructed for family farms in Brazil from the 90’s – in the changes of behavior and interpretation from family farmers that are processing food. The research was developed in 4 different regions in state of Rio Grande do Sul, Brazil, according to Regional Development Councils (Coredes): Corede Jacuí Centro, Corede Sul, Corede Vale do Rio dos Sinos and Corede Hortênsias. Interviews have been conducted with 64 families, which process food in the rural area, with the assistance of a semi-structured form (with qualitative and quantitative questions), field diaries and observations. In the data analysis, it was used qualitative (technique called tenor analyzis) and quantitative methods (Likert Scale). A typology has been constructed to describe the trajectories of families in the processing food activities, which represents how 4 different groups have started processing food and how they have changed the techniques over time. Different local policies have been developed by rural extension and actors from local government, which represents the main element of institutional changes. In this context, local policies have different characteristics: repressive, negociated and collective actions. Besides, these actors have been using the ideas from agrifood hygiene standards to develop local policies in order to transform processing food activities. The institutional changes were characterized by the transformations on productive and commercial aspect, especially in the local and stages of production. The National School Feeding Program (PNAE) has been influencing transformations in the family habits, which has been identified by changes in the production and selling of food. Moreover, these changes might be explained by the management process of this program, which involves new collective actions in the context of processing food activities.

A construção desta tese partiu das reflexões em torno das transformações no contexto da atividade de processamento de alimentos na agricultura familiar no Brasil. Tanto as políticas públicas como as políticas locais estão sendo formuladas com o objetivo de promover a essas famílias o acesso a recursos financeiros e a novos canais de comercialização. Ambas as políticas (locais e públicas) estão condicionadas às ideias das regras da legislação sanitária agroalimentar, que nem sempre refletem as formas como as famílias e os atores sociais locais interpretam as atividades de processamento de alimentos. Considerando esse contexto, esta tese teve como objetivo analisar o papel que as ações políticas locais, os programas e as políticas públicas - construídos para a agricultura familiar desde a década de 1990 no Brasil - exercem no processo de mudança na interpretação e conduta das famílias que desenvolvem tais atividades. Para tanto, a pesquisa foi realizada em quatro regiões do Rio Grande do Sul, as quais corresponderam aos Coredes: Hortênsias, Jacuí Centro, Sul e Vale do Rio dos Sinos. Ao total, foram entrevistadas 64 famílias (agricultores familiares) que processam alimentos oriundos da agricultura e pecuária. Para a coleta dos dados, foram utilizados um formulário composto de questões quali e quantitativas, diários de campo e observações. A análise dos dados foi desenvolvida por meio de técnica qualitativa (análise de conteúdo) e quantitativa (Escala Likert). As famílias foram divididas em 4 grupos (trajetórias), que mostram as diferenças nas formas como iniciaram e modificaram tecnicamente as suas atividades de processamento de alimentos. As diferentes formas como as políticas locais foram construídas explicam a emergência de novos hábitos nas famílias, especialmente no aspecto produtivo. Os agentes ligados aos governos locais e aos órgãos de assistência técnica destacaram-se como os principais atores sociais que influenciaram nesses processos. O regramento sanitário conduziu os agentes locais na formulação de ações visando transformar essa atividade. Nesse contexto, foram evidenciadas três formas de políticas locais: as políticas caracterizadas pela repressão, negociação e construção de ações coletivas entre as famílias envolvidas. O Programa Nacional de Alimentação Escolar é a única política pública que está provocando a transformação de hábitos, identificada pelas novas reflexões das famílias em torno das suas atividades, no ambiente da produção e da comercialização de alimentos. Essas mudanças são explicadas pelo processo de operacionalização e gestão dessa política pública, que demanda novas formas de organização social e coletiva nas atividades de processamento de alimentos. / This thesis has started from reflections on transformations in the context of processing food activities developed by family farmers in Brazil. Public and local policies have been developed to promote financial resources and new channel selling for the food produced by family farmers. Both policies reflect the ideas from agri-food hygiene standards, which may not represent the way families and other social actors have been interpreting this activity. Considering this context, this thesis aims to discuss what the role of public and local policies are – constructed for family farms in Brazil from the 90’s – in the changes of behavior and interpretation from family farmers that are processing food. The research was developed in 4 different regions in state of Rio Grande do Sul, Brazil, according to Regional Development Councils (Coredes): Corede Jacuí Centro, Corede Sul, Corede Vale do Rio dos Sinos and Corede Hortênsias. Interviews have been conducted with 64 families, which process food in the rural area, with the assistance of a semi-structured form (with qualitative and quantitative questions), field diaries and observations. In the data analysis, it was used qualitative (technique called tenor analyzis) and quantitative methods (Likert Scale). A typology has been constructed to describe the trajectories of families in the processing food activities, which represents how 4 different groups have started processing food and how they have changed the techniques over time. Different local policies have been developed by rural extension and actors from local government, which represents the main element of institutional changes. In this context, local policies have different characteristics: repressive, negociated and collective actions. Besides, these actors have been using the ideas from agrifood hygiene standards to develop local policies in order to transform processing food activities. The institutional changes were characterized by the transformations on productive and commercial aspect, especially in the local and stages of production. The National School Feeding Program (PNAE) has been influencing transformations in the family habits, which has been identified by changes in the production and selling of food. Moreover, these changes might be explained by the management process of this program, which involves new collective actions in the context of processing food activities.