Two studies were performed to detect aetiology of acute diarrhoea in hospitalized children aged under five years in Tripoli, Libya. In the first study, two hundred and thirty-six stool samples were obtained. Of these, 118 were from patients admitted for acute diarrhoeal disease, and 118 age and sex-matched concurrent controls were admitted for other reasons. In the second study, eight hundred and ten stool specimens were collected 405 from patients and the same number from controls. All were admitted to the AIjala Children’s Hospital, Tripoli, Libya. The first study was conducted between August 1st 1997 and 31st October 1997 and the second study was conducted between January 1st 2003 and 31st December 2003. One or more enteric pathogens were isolated from 55.9% of patients and 13.6% of controls in the first study and 68.1 % of patients and 12.6% of controls in the second study. In the first study, the organisms were identified from stool of patients; Escherichia coli 22.9%, rotavirus 15.3%, Campylobacter 7.6%, Proteus 7.6%, Klebsiella 4.2%, Entamoeba histolytica 4.2%, Cryptosporidium 2.5% and Giardia lamblia 1.7%, Salmonella was not isolated in both studies, because not growth on ordinary media were used (MacConkey agar and Blood agar) but usually growth on Salmonella-Shigella medium where not used. In the second study, enteropathogens identified were: rotavirus 30.4%, Escherichia coli 16.5%, Entamoeba histolytica 12.5%, Campylobacter 6.7%, Giardia lamblia 3.7%, Cryptosporidium 3.2%, Klebsiella 2.9%, Proteus 2.2%. Libyan children under six months of age were the most susceptible to acute diarrhoea requiring admission to the hospital. This was remarked in 46.6% of patients in the first study and 43.2% in the second. Exclusive breast feeding in Libyan children was of a very low percentage. In the first study it was 19.5% and in the second 29.1%. Children use dummies were about 3 times more at risk of diarrhoea than the non users in the first study (OD: 5.95,95%, CI: 1.120-2.37, p<0.001) and RR: 3.1 and (0: : 2.986ý 95%. Cl: 2.13-4.16, P<0.001) and RR: 23 in the second, this fell to children being twice as much at risk of contracting diarrhoea. Watery stool was the most common stool consistency of patients in both studies. Fever was the most common clinical feature associated with acute diarrhoea in the two studies (72.9% and 71.6% respectively). Vomiting was present in 51.7% of patients among the first study and 58.3% among the second. Moderate and isotonic dehydration were the most common degree and type of dehydration across both studies. In the second study, Rotavirus peaked during the winter (cold season) while bacteria and parasites peaked during the summer and autumn seasons. API 20E and API Campy were used to identify bacterial isolated by cultures and the number of confirmed cases decreased from 142 to 112 samples. Polymerase Chain Reaction was adopted in the second study to confirm detection of Campylobacter spp. these were identified by API Campy technique, where all Campylobacter spp. were identified as the same as detected by API Campy and for 24 samples.

Bakgrund: Hjärtsvikt är en kronisk sjukdom som ökar med stigande ålder över hela världen. Personer med hjärtsvikt har en hög symtombörda och det leder till begränsningar såväl psykiskt som fysiskt och socialt. Syfte: Att beskriva upplevelser i livets slutskede hos personer som lever med svår hjärtsvikt. Metod: Litteraturöversikt baserad på 13 kvalitativa vetenskapliga artiklar som analyserades enligt Fribergs modell. Resultat: Analysen resulterade i fem kategorier; Begränsningar i det dagliga livet, En förändrad identitet, Att uppleva trygghet, Att leva mellan hopp och förtvivlan och att planera för livets slut. Slutsats: Personer som lever med hjärtsvikt i livets slutskede upplever att de blir påverkade fysiskt, psykiskt, socialt och existentiellt i det dagliga livet. Personerna upplever en förlust av identitet. Att känna trygghet och kontinuitet upplevdes som viktiga komponenter för att hantera sjukdomens oförutsägbara natur. / Background: Heart failure is a chronic disease, increasing in the world as the population gets older. Persons living with heart failure has high symtom burden and that leads to limitations in a physical, psychological and social way. Aim: To describe experiences in the end of life among person´s living with advanced heart failure. Method: A literature study based on 13 scientific qualitative articles that was analyzed according to Friberg´s model. Results: The analysis resulted in five categories; Limitations in the daily life, a changed identity, sense of security, Living between hope and despair and Planning for the end of life. Conclusion: Persons living with advanced heart failure in the end of life experience that they become affected in their daily life in a physical, psychological, social and existential way. They experience a loss of their identity. To feel secure and continuity are important factors in dealing with the uncertainty of the disease.

En enkätundersökning genomfördes vars syfte var att undersöka om det fanns en relation mellan grundskolelärares arbetsbetsrelaterade krav, kontroll, socialt stöd och subjektivt välmående. Syftet var också att undersöka om det fanns någon relation mellan arbetsbetsrelaterade krav, kontroll, socialt stöd och upplevelse av stress. Urvalet bestod av 365 grundskolelärare. Enkäten besvarades via en länk som med mail skickades ut till de grundskolor som valde att delta i undersökningen. En länk lades också ut på olika Facebook grupper för att öka stickprovets storlek. Prediktorerna krav, kontroll och socialt stöd mättes med General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic-34+). Beroendevariabeln subjektivt välmående mättes med The Satisfaction with Life Scale (SWLS). Beroendevariabeln stress mättes med QPS Nordic-34+. Data analyserades i dataprogrammet SPSS med hjälp av en multipel regressionsanalys. Resultatet visade att krav, kontroll och socialt stöd signifikant predicerade grundskolelärarnas välmående. Vidare visade resultatet att krav och kontroll signifikant predicerade upplevelsen av stress. Socialt stöd predicerade inte upplevelsen av stress signifikant. Trots vissa begränsningar i undersökningen har slutsatsen gjorts att krav, kontroll och socialt stöd är av betydelse för lärares välmående. Arbetsrelaterade krav och kontroll kan förklara deltagarnas upplevelse av stress. Resultatet diskuterades i relation till tidigare genomförda studier. För vidare forskning gavs förslag om att använda en skala som också mäter externa krav som kopplas ihop med grundskolelärares sociala interaktion med elever och deras vårdnadshavare. / A survey was constructed whose purpose was to examine if there was a relationship between the primary school teacher work-related demands, control, social support and subjective well-being. The aim was also to examine whether there was any relationship between work-related demands, control, social support and experience of stress. The sample consisted of 365 primary school teacher. The questionnaire was answered by a link as with email was sent out to the schools that chose to participate in the survey. A link was also posted on various Facebookgroups to increase the sample size. The predictors demands, control and social support was measured with the General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic-34 +). Dependent variable subjective well-being was measured with The Satisfaction with Life Scale (SWLS). Dependent variable stress was measured with QPS Nordic-34 +. Data were analyzed in the computer program SPSS using a multiple regression analysis. The results showed that demands, control and social support significantly predicted primary school teachers' well-being. The results also showed that demand and control significantly predicted the experience of stress. Social support predicted no experience of stress significantly. Despite some limitations in the study the conclusion has been made that the demands, control and social support are important for teachers' well-being. Work-related demands and control can explain participant’s experience of stress. The results were discussed in relation to previous studies. For further research a suggestion was to use a scale that also measures the external requirements linked with primary school teachers' social interaction with the pupils and their guardian.

Socioemotional selectivity theory posits that as people age, they become motivated and successful at maximizing positive emotions and minimizing negative ones. Yet, 70% of older adults report physical pain, which is associated with negative affect. The strategies and resources that older adults use to maintain positive affect in the face of pain remain largely unknown. Specific positivity-enhancing strategies include recalling, recognizing, and responding to positive stimuli and prioritizing close over knowledgeable social partners. Executive functions (EF, i.e., task-switching, working memory, and inhibition) and heart rate variability (HRV) may be important resources for coping with pain. The current project used two studies to test whether older adults used positivityenhancing strategies and maintained emotional wellbeing following pain more than younger adults; associations with EF and HRV were also investigated. In Study 1, 50 older and 50 younger adults experienced a control and a pain condition, were given the chance to employ positivity-enhancing strategies, and provided EF and HRV data. Study 2 used longitudinal data from community-dwelling older adults (n =150) to test whether task-switching moderated the within-person relationship between pain and wellbeing. In Study 1, after the pain condition, younger adults demonstrated lesser preference toward knowledgeable social partners than older adults (γ = -0.15, p = .016). No other age group x pain condition x valence interactions were found. Older and younger adults did not differ in changes in positive or negative affect following pain. Task-switching and HRV were both associated with reduced preference for knowledgeable social partners following pain, but no other significant EF or HRV interactions were found. Study 2 failed to support the hypothesis that task-switching protected against pain-related declines in wellbeing. Future research on strategies that older adults use to maintain emotional wellbeing in the face of pain is needed.

Cirka 200 000 personer i Sverige lever med hjärtsvikt. Tidiga symtom är andfåddhet, trötthet och mindre ork i vardagen. Oro, sömnsvårigheter och depression drabbar ofta patienten när sjukdomen förvärras, med sämre livskvalitet som följd. Det finns en korrelation mellan upplevelsen av fysiska begränsningar och upplevd livskvalitet. Många patienter med hjärtsvikt undviker att träna på grund av osäkerhet. Sjuksköterskans roll är att förmedla kunskap om fysisk aktivitet för att göra patienten trygg. Det är också viktigt att kunna identifiera en lämplig nivå och form på träningen, som ska vara individanpassad. Syftet med litteraturöversikten var att beskriva vilka effekter fysisk aktivitet har på livskvaliteten för patienter med hjärtsvikt. 16 kvantitativa artiklar valdes ut och analyserades. Resultatet visar att det finns god vetenskaplig evidens för att fysisk träning påverkar livskvaliteten positivt hos patienter med hjärtsvikt. Graden av deltagande har större betydelse för effekten än typen av träning. Övervakad träning har visat sig öka deltagandet, liksom social gemenskap. Genom att sjuksköterskan förmedlar individanpassad information och lyckas identifiera en träningsform som passar patientens intressen, resurser och behov ökar chansen till högt deltagande i fysisk aktivitet, vilket i sin tur kan leda till förbättrad livskvalitet. / Approximately 200 000 persons in Sweden are living with heart failure. Early symptoms are dyspnea, fatigue and difficulties in daily activities due to lack of energy. As the heart failure proceeds the patients are often facing anxiety, sleep deprivation and depression. Perceived physical limitations has shown to correlate well with perceived quality of life. Many patients with heart failure avoids physical activity due to feelings of uncertainty. The role of the nurse is to make the patient feel comfortable and safe to engage in physical training, by providing knowledge. It is important to identify a suitable level and form of individually tailored training. The purpose of the literary review was to describe how various forms of physical activities affects quality of life in patients with heart failure. 16 quantitative articles were chosen and analyzed. The result shows that physical training affects quality of life in a positive manner in heart failure patients. Level of participation is of greater importance than the form of training. Supervised training has shown to increase participation, as well as social interaction. By providing individually adjusted information and by identifying a form of training suitable to the patient, the nurse is able to influence the patient towards an increased engagement in physical activities, presumably leading to improved quality of life.

During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.

Although economic growth has brought significant improvements in the standard of living in the UK over recent decades, there are still individuals living in poverty. Furthermore poverty in the UK is expected to rise. Although monetary poverty has wide ranging impacts such as poor health, low educational attainment and employability and reduced life expectancy, it does not (in the form of a poverty line at 60% of the median equivalised household income) appear to have an impact on wellbeing when the threshold was tested. Instead, multidimensional poverty – that purported by the Capabilities Approach – is a more individually relevant measure of poverty. Using a list, developed by Nussbaum, of core capabilities seen as essential for human life, capability measures were taken from the British Household Panel Survey. In analysis, some are found to be significant determinants of wellbeing, individually and in sum. Furthermore, individuals within the dataset experience loss aversion to capabilities. This thesis concludes that poverty measurement should be meaningful at the individual level, and to that aim, the Capabilities Approach provides a richer and more relevant evaluation of what poverty really means.

Adolescence is challenging time for youth with autism spectrum disorder (ASD), who generally exhibit a myriad of psychosocial difficulties. While this developmental period represents an important window for intervention, few evidence-based programs exist. Recent research suggests that interventions targeting emotion regulation (ER) skill deficits in ASD may represent a promising approach to promoting more favourable outcomes for these youth (Mazefsky et al., 2014). Nurturing mindfulness has been shown to be an effective means of improving ER and wellbeing in diverse child and adult populations, although research in ASD is limited. This pilot study evaluated the impact of a 9-week mindfulness intervention on the ER and socioemotional functioning of 14 adolescents (13-17 years) with high functioning ASD using a pre-test post-test design. Parents reported statistically significant changes of small to medium effect size in adolescents’ overall problem behaviours and social skills, ER, adaptability, hyperactivity, and withdrawal behaviours. Additionally, parents reported changes of small effect size that approached significance for adolescents’ anxiety symptoms and atypicality. Adolescents reported changes of small effect size that were statistically significant for anxiety symptoms and interpersonal functioning, and non-significant for depression and social stress symptoms. Changes in many parent-reported outcome variables showed moderate to strong correlations with home practice adherence and parent-reported changes in ER. Qualitative observations of program impact and social acceptability were positive and supported the quantitative findings. The results provide promising evidence for mindfulness training with youth with ASD. Implications for assessment, intervention, and future research are discussed. / October 2016

Objective—To explore the experience of psychological distress and wellbeing in emergency medicine (EM) consultants. Methods— A qualitative, Interpretative Phenomenological Analysis (IPA) study based on interviews with EM consultants working in emergency departments (EDs) across South West England. 18 EM consultants were interviewed, representing a response rate of 54.55% across 5 EDs. The mean (SD) age of participants was 43.17 (5.8) years. All participants worked full-time as EM consultants, with the average years-in-role being 7.64 (5.76). The personal meanings that participants attached to their experiences were inductively analysed and explored alongside their perceived psychological health. Results— The analysis formed three super-ordinate themes: systemic pressures, physical and mental strain, and managing the challenges. Pressures within the ED and healthcare system contributed to participants feeling undervalued and unsatisfied when working in an increasingly uncontrollable environment. Participants described working intensely to meet systemic demands, which inadvertently contributed to a diminishing sense of achievement and self-worth. Consultants perceived their experience of physical and emotional strain as unsustainable, as it negatively impacted: functioning at work, relationships, personal wellbeing and the EM profession. Sustainability was promoted by the presence of social support and through evolving with the consultant role. Conclusions— EM consultants experience considerable physical and mental strain. This strain is dynamically related to consultants' experiences of diminishing self-worth and satisfaction, alongside current socio-political demands on EM services. Recognising the psychological experience and needs of EM consultants through promoting a sustainable EM consultant role could have wide-reaching benefits for the delivery of emergency care and physician wellbeing.

This paper uses data from The Survey on Income and Living Conditions (SILC) for year 2013 to estimate the effect of family size on parent's wellbeing. To address the possible endogeneity in family size we use "multiple births" as exogenous origin of variation in family size. First finding shows insignificant effect of the additional child on parent's wellbeing. However, when we examine if the effect of number of children is significantly different for men and for women, we receive significant results. The number of children positively influences mother's wellbeing, but for fathers, there do not exist clear result. Finally, we examine if big family is poor family and our finding reveals, that number of children positively increases income of household. JEL Classification D31, I31, J13 Keywords wellbeing, family size, instrumental variable, income Author's e-mail andrea.havrilova@gmail.com Supervisor's e-mail gebicka@fsv.cuni.cz