Clinical Evidence, Triangulation of Perspectives and Contextualization. Part 1: The Beginning of Carla's Treatment.

We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM). We analyze the case of a patient treated with transference-focused psychotherapy (TFP), making explicit the theoretical-clinical agreements and disagreements of the authors. We discuss the strengths and limitations of triangulation and contextualization, concluding that they make clinical work and psychoanalytic writing more reliable, transparent, auditable, and replicable.

Talking about death and dying: Findings from deliberative discussion groups with members of the public.

Talking about death and dying is promoted in UK health policy and practice, from a perception that to do so encourages people to plan for their end of life and so increase their likelihood of experiencing a good death. This encouragement occurs alongside a belief that members of the public are reluctant to talk about death, although surveys suggest this is not the case. This paper describes findings from a research study in which people participated in deliberative discussion groups during which they talked about a range of topics related to death, including talking about death, the good death, choice and planning and compassionate communities. Here we report what they had to say in relation to talking about death and dying. We identified three themes: 1. The difference between talking about death as an abstract concept and confronting the certainty of death, 2. how death and dying presents issues for planning and responsibility, and 3. approaches to normalising death within society. For our participants, planning was considered most appropriate in relation to wills and funerals, while dying was considered too unpredictable to be easy to plan for; they had complex ideas about the value of talking about death and dying.

Psychoanalytic identity in vivo: Permanence and change.

Psychoanalytic identity "in vivo" means psychoanalysis as an authentic, lived experience, socially and historically situated. What we have inherited from the psychoanalytic tradition now needs to be collectively and individually updated and shaped as therapy, as research and as theory. The focus of this paper is on developing a more critical and realistic sense of psychoanalytic identity, grounded in our clinical experience. We need to recognise our identity in what we actually do and achieve with our patients in our daily practice and avoid idealisations or devaluations arising from theoretical speculation. The important role of the Three Level Model (3-LM) and similar working parties is discussed. Psychoanalysts need a pluralistic professional identity, which implies triangulating our clinical perspectives with those of other colleagues, as happens in 3-LM clinical discussion groups, and contextualizing our knowledge from a broad perspective, including extra-clinical research and interdisciplinary dialogue with both health sciences and hermeneutic disciplines. A psychoanalytic identity that is open to the future requires an acknowledgement of the different positions that exist within our discipline and neighbouring fields, and a willingness to critically examine and discuss these differences.

Farmer Discussion Groups Create Space for Peer Learning about Safety and Health.

Objectives: Occupational safety and health (OSH) interventions emphasizing regulation or education have had limited success in reducing agricultural accidents and fatalities. There is a growing interest in sociocultural approaches to OSH promotion amongst farmers, such as peer learning groups (PLGs). The level of OSH engagement within farmer PLGs (e.g. dairy discussion groups (DDGs)) is unknown. This study evaluates Irish DDG engagement with OSH in 2016 to better understand how DDGs contribute to OSH promotion.Methods: A mixed-mode (online, postal, and telephone) retrospective survey of 121 DDG representatives (i.e. chairperson or long-term member) assessed voluntary OSH engagement in 2016, including the location, frequency, duration, and content of OSH discussions.Results: Representatives of 96 DDGs participated in the survey and met the survey criteria. Most DDGs discussed OSH to some extent in 2016 (96%), including sharing personal experiences of accidents and illnesses (89%) and close calls (82%). For 76 DDGs, at least one meeting in 2016 addressed specific hazard and risk management topics. Groups were diverse with respect to discussion frequency, duration, and topics discussed.Conclusion: Farmers actively engaged with OSH in most DDGs surveyed, suggesting dairy farmers value OSH discussions. The findings illustrate the role of DDGs in OSH promotion, as a space for farmer-led, peer-to-peer knowledge-sharing. Farm advisory (extension) services and OSH professionals can strengthen OSH engagement through tailored resources that reflect contemporary OSH knowledge and popular discussion approaches (e.g. experience-sharing).

Caminhos da autonomia: grupo reflexivo com ex-moradores de rua / Paths to autonomy: discussion groups with former homeless people / Caminos hacia la autonomía: grupo reflexivo con ex sin techos

Este artigo é resultado do projeto de iniciação científica Os Caminhos da Autonomia que, através da realização de um grupo reflexivo, pretendeu promover a interação entre ex-moradores de rua abrigados em um projeto social, membros de uma parcela da população em situação de vulnerabilidade, para que esses indivíduos despertassem para suas realidades pessoais a partir desse trabalho conjunto, de modo a se tornarem agentes transformadores de si mesmos na construção de sua autonomia. Para tanto, a metodologia aplicada de grupos reflexivos teve por finalidade a escuta e as identificações dos seus integrantes dentro de uma mesma problemática, buscando alternativas para suas resoluções. Realizaram-se quinze encontros programados e direcionados por temas de interesses comuns, nos quais foram relatadas suas histórias de vida de forma que se pudesse descobrir as singularidades de cada uma dessas narrativas. Os resultados alcançados apontam para o amadurecimento emocional do grupo, a descoberta de possibilidades reais de conscientização, que viabilizem caminhos de autonomia, sendo objetivo maior o de reconhecer a motivação para as mudanças de sua realidade através da sua história...(AU)

This article is based on a scientific research named "Paths to Autonomy", an initiative to promote interactivity among persons currently participating in a Social Project focused on assisting groups exposed to social vulnerability. Through interactive activities developed in a Reflexive Group environment, the members of this group were stimulated to share personal life experiences to develop a sense of self perception, becoming agents able to transform themselves in order to build their own autonomy. The discussion group allowed to hear and identify participants facing troubling situations and looking for alternative solutions. Throughout 15 programmed encounters, considering common interests pointed out by the group, each member could expose their life history, stimulating the search for the singularity from each narrative. The main outcome were the improved emotional maturity of the group and the identification of real possibilities of individual awareness, leading to autonomy via inspiration provided by their own life experiences to change their life conditions...(AU)

Este artículo es el resultado del proyecto de iniciación científica "Los Caminos hacia la Autonomía" que, por medio de la formación de un grupo reflexivo, pretendió promover la interacción entre ex sin techos abrigados por un proyecto social, miembros de una parte de la población en situación de vulnerabilidad, para que, a partir de ese trabajo conjunto, esos individuos pudieran despertar para sus realidades personales y convertirse en agentes transformadores de sí mismos en la construcción de su autonomía. Para ello, la metodología aplicada de grupos reflexivos tuvo por finalidad la escucha y las identificaciones de sus integrantes dentro de una misma problemática, buscando alternativas para sus resoluciones. Se realizaron 15 encuentros programados y dirigidos por temas de intereses comunes, en los cuales relataron sus historias de vida para que se pudiera descubrir las singularidades de cada una de esas narrativas. Los resultados alcanzados apuntan la maduración emocional del grupo, la descubierta de posibilidades reales de concientización, que hacen posibles caminos hacia la autonomía, siendo el mayor objetivo reconocer, por medio de su historia, la motivación para cambiar su realidad...(AU)

Proposal for the User-Centered Design Approach for Health Apps Based on Successful Experiences: Integrative Review.

BACKGROUND: Different strategies encompassed within mHealth have shown themselves to be effective for maintaining good health or controlling certain diseases. However, there is usually a very high rate of abandonment of health apps. Therefore, it would seem obvious that there is a need for involving the end users (whether they are health professionals, patients, or both) in the design process from the early stages in order to enable their needs and characteristics to be identified. In this sense, it is common knowledge that focusing on the user permits the consideration of valuable details aimed at making the correct adjustment between the patient, the technology, and the organization of attention. OBJECTIVE: The goal of the research was to propose a methodology based on the review of previous successful user experiences in setting up health apps by using qualitative techniques (focus groups and discussion groups) that includes the participation of information technology and health professionals and the patients themselves. METHODS: An integrative review was made of studies in which a qualitative methodology was employed mainly through focus and/or discussion groups for the design and development of health apps, consulting diverse databases (PubMed, Scopus, and Proquest) with the following search strategy: "mHealth AND apps AND focus group OR discussion group." A total of 69 papers were included in the review. RESULTS: A proposal structured in 4 sessions of variable duration was made in which information technology and health professionals and patients take part: composing, preparing, and organizing contents (session 1); testing structure and usability (session 2); does the app fit the needs of end users? (session 3); and last testing-keep on improving (session 4). Throughout the sessions, we propose studying aspects like previous user experiences in mHealth, barriers to the adoption of mHealth, interface contents, management and browsability, usability, perceived quality, security and privacy, capacity to self-manage disease with the app, ergonomics, and glanceability, etc. Specific tools that have proved useful in previous research for measuring these aspects are presented. CONCLUSIONS: These work sessions would be based on predominantly qualitative methodologies although, as they evolve, validated questionnaires permitting the assessment of the objectivity of certain technical aspects could be incorporated. With this proposal, a project centered on end users could be effected, responding to their needs. However, this requires validation that will be made via implementation in the development of health apps, with the subsequent measurement of results in terms of adherence and improvement in the clinical variables of the end users.

An evaluation of virtual ethics discussion groups as a method of learning on a pharmacist Independent Prescribing (IP) programme.

BACKGROUND AND PURPOSE: A postgraduate body within Queen's University Belfast (QUB) has offered a pharmacist Independent Prescribing (IP) programme to pharmacists living locally in Northern Ireland (NI) since 2006. In 2016, this course was modified and delivered by the School of Pharmacy within QUB for a non-local population of pharmacists from Great Britain (GB). In order to substitute face-to-face, live training in NI, distance learning methods were employed for one of the modules that involved studying ethical dilemmas. The purpose of this study was to assess participant acceptance and perceived effectiveness of the utilized distance learning methods. EDUCATIONAL ACTIVITY AND SETTING: All participants within Cohort 2 of the IP programme offered to GB pharmacists viewed an online recorded lecture on dealing with ethical dilemmas. This involved being taught about a professional decision-making model. Participants then applied this model to four ethical case studies via virtual discussion groups and were invited to complete a questionnaire regarding their views on these teaching methods. FINDINGS: Twenty participants viewed the online recorded lecture, and 19 attended the virtual discussion groups. Eighteen participants (90%) responded to the survey. Participants reacted positively to the e-learning format. Following the training, all participants felt confident applying the professional decision-making model and only one did not intend to apply the model to their practice. SUMMARY: The utilized e-learning format was well received and effective in producing pharmacists who felt confident approaching and resolving ethical dilemmas in their new roles as pharmacist prescribers.

Albertans for Health Research Network: Form, Fit, and Function.

The patient engagement (PE) platform staff of Alberta Strategy for Patient Oriented Research Support for People and Patient Oriented Research Trials Unit developed a patient-powered PE network called Albertans for Health Research Network (AB4HR); an enhanced tool to better connect patient partners and researchers online. AB4HR was developed in response to an identified need-a user-friendly online forum for both patient partners and researchers to access, so that they can better work together, as partners, in health research. We codesigned AB4HR and identified ways to improve the form, fit, and function of an existing registry through discussion groups with patient partners and researchers. We found 3 main themes derived from the perspective shared by patient partners and researchers. Patient partners and researchers agreed that the existing registry provides a forum to connect with one another in an easy, low-barrier way. However, there were opportunities for improvement with AB4HR, including possibilities for greater interaction between patient partners and researchers to promote more collaborative partnerships.

Nonlinear models of distribution of talking in small groups.

This paper develops a mathematical model of the distribution over time of talking in discussion groups. Researchers of small group processes and social inequality have long recognized that interaction in small discussion groups is usually not equally distributed and that being a person who talks more than others is associated with having higher status outside the group and greater prestige and influence within the group. There is also a history of mathematical approaches to describing this phenomenon. As an addition to this literature, here a nonlinear dynamical system model is presented and used to develop computer simulations that are compared with data from a laboratory study of real four-person discussion groups. The model is based on theoretical assumptions about group processes including individual differences in volubility, status generalization, deference hierarchies and norms of taking turns and of fairness. While none of these alone make predictions that match the data, when they are all combined simulations are produced that closely match the data in both changes over time and differentiation among members. The dynamical system using the parameters as estimated for these data reaches a fixed point, which may help understand how groups structures become stable under some conditions but not others.

Carbohydrate Knowledge and Expectations of Nutritional Support among Five Ethnic Groups Living in New Zealand with Pre- and Type 2 Diabetes: A Qualitative Study.

Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Maori, European, Pacific Island, Indian and East Asian people living in New Zealand with a focus on carbohydrate-containing foods. A registered diabetes dietitian led ethnic-specific discussions in groups involving 29 people with pre- or type 2 diabetes. Discussions were audio-recorded, fully transcribed and coded independently by two investigators. Themes were developed using deductive and inductive techniques. Five themes emerged: knowledge, concerns, achievements, simplicity and self-determination. Nutritional knowledge was lacking and a greater awareness of trustworthy dietary resources was needed. There were concerns about diabetes complications and appropriate carbohydrate-containing foods and portions. Contrary to this, people felt proud when achieving dietary goals and grateful for support from health care providers and family. Participants were willing to engage in self-care if advice from health professionals was given in plain language, and in a culturally appropriate manner. Given the desire to take an active role in diabetes self-management and willingness to use electronic devices, an ethnic-specific nutrition education resource could be a valuable tool.

Sharpening the focus: differentiating between focus groups for patient engagement vs. qualitative research.

PLAIN ENGLISH SUMMARY: Patient engagement is an opportunity for people with experience of a health-related issue to contribute to research on that issue. The Canadian Strategy for Patient-Oriented Research (SPOR) highlights patient engagement as an important part of health research. Patient engagement, however, is a new concept for many researchers and research ethics boards, and it can be difficult to understand the differences between patient engagement activities and research activities. Focus groups are one example of how research and patient engagement activities are often confused.We distinguish these two types of activities by using different terms for each. We use focus groups to refer to research activities, and discussion groups to refer to patient engagement activities. In focus groups, researchers collect data by speaking with a group of research subjects about their experiences. Researchers use this information to answer research questions and share their findings in academic journals and gatherings. In patient engagement, discussion groups are a way for patients to help plan research projects. Their contributions are not treated as research data, but instead they help make decisions that shape the research process. We have found that using different language to refer to each type of activity has led to improved clarity in research planning and research ethics submissions. ABSTRACT: Background In patient-oriented research (POR), focus groups can be used as a method in both qualitative research and in patient engagement. Canadian health systems researchers and research ethics boards (REBs), however, are often unaware of the key differences to consider when using focus groups for these two distinct purposes. Furthermore, no one has clearly established how using focus groups for these two purposes should be differentiated in the context of Canada's Strategy for Patient-Oriented Research (SPOR), which emphasizes appropriate patient engagement as a fundamental component of POR. Body Researchers and staff in the Maritime SPOR SUPPORT Unit refer to focus groups in patient engagement as discussion groups for clarity, and have developed internal guidelines to encourage their appropriate use. In this paper, the guidelines comparing and contrasting the design and conduct of focus groups and of discussion groups is described, including: the theoretical framework for each; the need for research ethics board review approval; identifying participants; collecting and analyzing data; ensuring rigour; and disseminating results. Conclusion The MSSU guidelines address an important and current methodological challenge in patient-oriented research, which will benefit Canadian and international health systems researchers, patients, and institutional REBs.

Discussion group networks in occupational medicine: A tool for continuing education to promote the integration of workers with disabilities.

BACKGROUND: Despite their legal rights, individuals with disabilities face numerous obstacles to integration in the workplace which can result in their discharge from the labor force. Currently occupational physicians have few resources to help decide whether to integrate disabled workers in pre-placement, or in cases of return-to-work. METHODS: A network of 13 discussion groups comprised of the occupational physicians of each regional clinic of a large Health Maintenance Organization (HMO) in Israel was created to deal with disability management dilemmas. A moderator compiles and shares the physicians' opinions and experiences with all network members thus assisting the consulting physician in decision-making. RESULTS: Successful management of three representative cases is described to illustrate real-life implementations of this network. CONCLUSION: The network enables both the consulting and other physicians to tap a large knowledge base and decision-making experience concerning cases of occupational disability management, contributing to professional development and improved service delivery.

Utilization of social media and web forums by HIV patients - A cross-sectional study on adherence and reported anxiety level.

Due to the high stigma surrounding the Human Immunodeficiency Virus (HIV), people living with HIV (PLWH) often reach out peers over the Internet for emotional and social support. The purpose of this study was to assess the characteristics of PLWH who use HIV internet forums. A cross-sectional study was conducted using an online survey investigating demographic characteristics of PLWH, level of satisfaction of the HIV Internet forums, time living with HIV, forum users' anxiety levels, self-reported adherence to antiretroviral treatment (ART), and reasons for missing pills (n = 222). Logistic regression models were constructed to compare the use of general HIV forums with social networking sites, general HIV forums with group emails, and social networking sites with group emails. Two hundred and twenty-two patients responded to the survey. Social networking sites were used by recently diagnosed PLWH who were on antiretroviral treatment (ART) > 1 year. Young patients (≤ 40 years) and those diagnosed < 1 year before, tended to use social networking sites, while older patients (> 40 years), those diagnosed > 5 years, and from low- and middle-income countries, were more likely to use emailing lists. There was no significant difference between PLWH's adherence to treatment and anxiety levels and the usage of different Internet forums. PLWH's Internet resource choice varied depending on the availability of Internet and illness duration. Different segments of the population could be reached via social networking sites versus group emails to provide HIV information.

Training Genetic Counsellors to Deliver an Innovative Therapeutic Intervention: their Views and Experience of Facilitating Multi-Family Discussion Groups.

Innovations in clinical genetics have increased diagnosis, treatment and prognosis of inherited genetic conditions (IGCs). This has led to an increased number of families seeking genetic testing and / or genetic counselling and increased the clinical load for genetic counsellors (GCs). Keeping pace with biomedical discoveries, interventions are required to support families to understand, communicate and cope with their Inherited Genetic Condition. The Socio-Psychological Research in Genomics (SPRinG) collaborative have developed a new intervention, based on multi-family discussion groups (MFDGs), to support families affected by IGCs and train GCs in its delivery. A potential challenge to implementing the intervention was whether GCs were willing and able to undergo the training to deliver the MFDG. In analysing three multi-perspective interviews with GCs, this paper evaluates the training received. Findings suggests that MFDGs are a potential valuable resource in supporting families to communicate genetic risk information and can enhance family function and emotional well-being. Furthermore, we demonstrate that it is feasible to train GCs in the delivery of the intervention and that it has the potential to be integrated into clinical practice. Its longer term implementation into routine clinical practice however relies on changes in both organisation of clinical genetics services and genetic counsellors' professional development.

A Thematic Analysis of Online Discussion Boards for Brachial Plexus Injury.

PURPOSE: Patients with brachial plexus injury (BPI) and their family members contribute to Internet discussion groups dedicated to BPI. We hypothesized that a thematic analysis of posts from BPI Internet discussion groups would reveal common themes related to the BPI patient experience, providing topics for patient education and counseling. METHODS: Internet discussion boards were identified using the search term "brachial plexus injury support group" in Google, Bing, and Yahoo! search engines. Two discussion boards had substantially more posts than other Web sites and were chosen for analyses. Posts from January 1, 2015, through January 1, 2016, were examined. Using an iterative and established process, 2 investigators (M.T.M. and C.J.D) independently analyzed each post using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. In this process, each post was reviewed 3 times. RESULTS: A total of 328 posts from the 2 leading discussion boards were analyzed. Investigators reached a consensus on themes for all posts. One central theme focused on emotional aspects of BPI. Four other central themes regarding information support were identified: BPI disease, BPI treatment, recovery after BPI treatment, and process of seeking care for BPI. CONCLUSIONS: Examination of posts on Internet support groups for BPI revealed recurring concerns, questions, and opinions of patients and their family members. The most common themes related to disease information, treatment, recovery, and the emotional element of BPI. CLINICAL RELEVANCE: These findings provide a helpful starting point in refining topics for patient education and support that are targeted on patients' interests and concerns.

Exploring the relation between online case-based discussions and learning outcomes in dental education.

Online case-based discussions, parallel to theoretical dental education, have been highly valued by students and supervisors. This study investigated the relation between variables of online group discussions and learning outcomes. At Ghent University in Belgium, undergraduate dental students (years two and three) are required to participate in online case-based discussion groups (five students/group) in conjunction with two theoretical courses on basic periodontics and related therapy. Each week, a patient case is discussed under supervision of a periodontist, who authored the case and performed the treatment. Each case includes treatment history and demand, intra- and extraoral images, and full diagnostic information with periodontal and radiographic status. For this retrospective study, data were obtained for all 252 students in forty-three discussion groups between 2009 and 2012. Spearman's rank correlations were calculated to investigate the relation among group dynamics (number of group posts and views), individual student contributions (number of individual posts, newly introduced elements, questions, and reactions to other posts), supervisors' interventions (number of posts and posed questions), and learning outcomes (examination result). The results showed that learning outcomes were significantly related to the number of student posts (Spearman's rho (ρ)=0.19), newly introduced elements (ρ=0.21), reactions to other posts (ρ=0.14), number of supervisors' interventions (ρ=0.12), and supervisors' questions (ρ=0.20). These results suggest that individual student contributions during online case-based discussions and the provided supervision were related to learning outcomes.

Tissue viability nurses' experiences of managing wound exudate.

Wound exudate presents several challenges for patients and nurses. The description of exudate volume, colour and viscosity varies greatly, often depending on the personal preference of the nurse. When the nature and volume of exudate has been described, management of exudate presents its own issues in terms of ensuring that the appropriate dressing or intervention is selected and used effectively. This article reports on the outcomes of a series of discussion groups held to explore the difficulties tissue viability nurse specialists experience in relation to advising non-specialist nurses about wound exudate in the practice setting.

"Safe Harbor": evaluation of a professionalism case discussion intervention for the gross anatomy course.

Medical professionalism is a multifaceted paradigm and is an essential component of medical education. Gross anatomy is a laboratory to teach professionalism, and promoting critical reflection in medical students is a prerequisite to furthering professionalism. The aim of this study was to determine if professionalism case discussions during a Gross Anatomy course improve students' reflections using a validated reflection instrument (12 items; five-point Likert scale where 1 = Disagree, 2 = Disagree with reservation, 3 = Neutral, 4 = Agree with reservation, 5 = Agree). Four facilitated reflection sessions were aimed at fostering reflective capacity through reflection on elements of professionalism. Results did not show a significant change between pre-and postintervention reflection scores (3.45 ± 0.61 vs. 3.48 ± 0.51; P = 0.82). Historical control students were found to have significantly higher reflection scores when compared with postintervention students (3.91 ± 0.53 vs. 3.48 ± 0.51; P < 0.001). However, the historical control students were found to have significantly higher professionalism scores (P = 0.001) as compared with the intervention students. Student satisfaction was high, with 25 of 28 (89.2%) students reporting that the sessions should be included as a component of future anatomy courses. While reflection scores were not significantly increased as a result of the intervention, students expressed appreciation for the opportunity to discuss professionalism issues related to the dissection of cadavers. Additionally, the intervention students had both lower professionalism scores and lower reflection scores, which supports the idea that highly professional students are more capable of reflecting on professionalism. Future studies should determine whether this case discussion intervention improves objective measures of professionalism.

Estudio cualitativo de las conductas de salud en la primera adolescencia / Qualitative study of health behaviours in the first adolescence

El objetivo del presente estudio de casos, de corte cualitativo, es múltiple: (1) conocer qué piensan los jóvenes al principio de la adolescencia respecto a las conductas asociadas a la salud; (2) explorar si realizan estas conductas; (3) averiguar cuáles son los motivos para llevarlas a cabo, y (4) detectar sus predicciones de futuro respecto a las mismas. Para tratar estos temas, ocho chicos y ocho chicas de entre 11 y 12 años de edad participaron en dos grupos de discusión, uno de chicos y otro de chicas, durante sesiones de una hora. Una vez analizadas las transcripciones por parte de tres investigadores, y codificadas utilizando el programa informático Nudist Vivo, versión 2.0.163, los resultados informaron que los principales temas identificados fueron las conductas de salud "clásicas", los contextos en los que realizaban las conductas, y el patrón conductual relacionado con la salud. Las interrelaciones entre estos tres temas indicaron diferencias por género, tanto en las opiniones sobre lo que significa estar sano, como en sus conductas presentes y sus predicciones conductuales para el futuro.

The goal of the current qualitative case study is multiple: (1) to know what young people thought at the beginning of adolescence with regard to health related behaviours; (2) to explore if they followed these behaviours; (3) to find out what their motives were for following them; and (4) to detect their future predictions with regard to those behaviours. Eight boys and eight girls between the ages of 11 and 12 years-old participated in two discussion groups (one for boys and one for girls). Each session lasted one hour. The transcriptions of these discussions were analyzed by three researchers and were codified using the computer programme, Nudist Vivo, version 2.0.163. The main topics identified were the "classical" health behaviours, the contexts where the behaviours took place, and the health-related behavioural patterns. The relationships among these three topics indicated that there were differences between girls and boys, specifically on what it meant to be healthy, their current behaviours, and their predicted future behaviours.

Des groupes de parole avec les adolescents: une parole subjectivée dans l'institution scolaire / Discussion groups with teenagers: a speech subjectivised in the school

Cet article présente un fragment d'une recherche "Co-psy enfant" sur la construction identitaire chez l'adolescent dans les repères de genre et de générations (identité sexuée, relations intergénérationnelles) telles qu'elle se manifeste à l'école. Elle s'est déroulée dans un collège et un lycée, situés dans des zones urbaines considérées comme très défavorisées. Nous évoquerons un temps fort de notre approche clinique avec la constitution de 7 groupes de parole d'adolescents. En résorbant en partie le clivage existant entre le statut d'élève et le Sujet adolescent, ces groupes ont montré l'intérêt d'instituer un espace pour la parole adolescente. Le moteur de sa création a été la demande des jeunes eux-mêmes, véritable force instituante d'ordinaire négligée dans l'institution scolaire. Nous évoquerons la structuration de cet espace clinique des groupes de parole, leur fonction active de contenant pour les individus et leur mise en pratique d'un lien social habituellement impossible.(AU)

In connection with "Copsy-enfant" (French National Agency for Research, 2006-2009), our recent research on the construction of gender and generational identity among teenagers, we set up seven discussion groups for middle and high school students in a working-class neighborhood of metropolitan Paris. The purpose of this article is to situate our research within the context of today's interrogations on adolescence. Such groups provided for the teenagers who requested them, a space within the school reducing the gap between their pupil's status and their teenager's being Subject. In this paper, we speak about the structuration of these groups whose orientation was psychoanalytic. We address the containing function and the social bonds that such groups provided for the teenagers.(AU)