The purpose of this study was to determine whether parents of children who attend childcare centers have different attitudes and behaviors toward shaping their child's eating habits than parents of children who stay at home, and whether these attitudes and behaviors affect their child's dietary intake and weight. Fifty parents of 3- to 5-year-old children who attended childcare centers and fifty parents of 3- to 5-year-old children who stayed at home in Central Texas participated in the study. Parents completed questionnaires designed to measure the factors they considered when choosing food for their child, and their perceived influence on, satisfaction with, responsibility for, and control over their child's eating habits. After receiving training and measuring utensils, parents completed 3-day dietary records for their child. A researcher recorded the children's food intake when they were at the childcare center. Children's height and weight were measured, and body mass index was plotted on the CDC BMIfor- age growth charts (2000). Twelve percent of childcare children were obese compared to 2 percent of stay-at-home children (p<0.05). Children in childcare consumed more energy, vegetables, fat, saturated fat, and sweetened beverages than stay-at-home children (p<0.05), mostly due to consumption at the center. Both groups met requirements for all food groups and nutrients except grains, vegetables, and vitamin E. Their diets were too high in fat, contributing 32 percent of total energy. There was no evidence that parents of children in childcare felt less responsible for, less influential on, more satisfied with, or exerted less control over their child's diet than stay-at-home parents. Parents of childcare children believed that they and the childcare center shared responsibility for their child's nutrition. They felt that time was a more important factor in choosing food for their child than did stay-at-home parents. Parents who perceived lack of time to be an obstacle had children who consumed less energy, iron, and fat during the evening hours. Parents of overweight children felt more influential on and were more satisfied with their child's diets than parents of normal weight children. No other parental attitudes were predictive of children's food intake or weight status. / text

Background: Patients’ recovery from surgery differs when they are in a hospital setting or at home. However, an often forgotten aspect of post-operative ambulatory care is the patients' recovery at home following ambulatory surgery.Aim: To explore and describe the patients’ experiences of recovery at home following the ambulatory surgery procedure.Method: A systematic review of 7 qualitative studies in English with pre-specified criteria was conducted. An overview of qualitative evidence derived from the 17 identified main themes across the 7 primary studies was analyzed.Result: Seven thematic analysis themes were identified as being core to the patients’ experience during recovery process at home: physical symptoms, a period of regaining pre-operative functions, psychological effects, the surgical wound, delayed recovery process, social support, and the sick-role condition.. These seven themes were described patient's experiences at home following ambulatory surgery from early stage of recovery to the time of getting back to normal life.Conclusion: Recovery at home following ambulatory surgery seemed to be challenging, a quality self-care at home was lacking in the form having full control and knowledge about symptoms; adequate information, education and medication during self-care management; sufficient support by carer and nurses; and enough time-off for recovery.

Bakgrunn Depresjon og demens er blant de to hyppigst forekommende psykiatriske sykdommene blant eldre globalt sett. Depresjon opptrer ofte sammen med demens. Sykdomene er underdiagnostisert. Pårørende kan oppleve stor belastning av å være omsorgsperson. Hensikt Studiens hensikt er a) å undersøke om det finnes en sammenheng mellom depresjon hos hjemmeboende personer som utredes for demens og ulike demografiske variabler som kjønn, sivilstand, alder, kognitiv funksjon og hjelpetilbud før og etter demensutredning, og b) å undersøke om det finnes en sammenheng mellom depresjon hos personer med mistanke demens og pårørendes belastning som omsorgsgiver. Metode Studien baserer seg på informasjon fra klinisk praksis om pasienter utredet for demens av demensteam i 33 kommuner i Norge i løpet av ett år (n=474). Anonymisert informasjon om pasientene og pårørende ble innhentet. Kun pasienter hvor en depresjonsvurdering ble gjennomført i demensutredningen ble inkludert (n=165). Resultat Depresjonsvurdering gjøres i 34.8 % av demensutredningene, og 46.1 % av de undersøkte har symtomer på depresjon (n=74). Pasientene med depresjon skiller seg ikke fra pasientene uten depresjon med hensyn til kjønn, alder, sivilstatus og kognitiv funksjon. Det er ingen sammenheng mellom forekomst av depresjon og det hjelpetilbudet som ytes av det kommunale tjenesteapparat. Det er imidlertid en sammenheng mellom depresjon ved mistanke om demens og belastning hos pårørende (r=0.44). Det er 31.6 % av de deprimerte pasientene som har en alvorlig grad av depresjon og deres pårørende oppgir at de har lett/moderat til alvorlig grad av belastning (n=24). Konklusjon Halvparten av pasientene har symptomer på depresjon. Pasientene med sympomer på depresjon skiller seg ikke ut fra de øvrige pasientene uten depresjon. Det finnes en sammenheng mellom depresjon hos pasientene og belastning hos pårørende.Depresjonsvurdering bør vektlegges mer av de som driver demensutredning i kommunene. / Background Depression and dementia are two of the most prevalent mental disorders among elderly individuals worldwide. Depression and dementia may occur simultaneously, and the disorders are often underdiagnosed. Relatives may experience great stress as caregivers. Aim This study aimed to a) examine whether depression in home-dwelling elderly assessed for dementia is associated with variables such as gender, marital status, age, cognitive function and need for assistance before and after a dementia assessment, and b) to examine if there is a association between depression in elderly undergoing dementia assessment and burden of their caregivers. Method The study is based on information about the patients treated in clinical practice for dementia assessment in 33 municipalities in Norway over the course of one year (n=474). Anonymised information was obtained from patients and their caregivers. The study included only patients who were assessed for depression as part of the dementia assessment (n=165). Results Depression assessments are conducted in 34.8 % of all dementia assessments, and 46.1 % of these patients have symptoms of depression (n=74). Patients with depression do not differ from patients without depression regarding gender, age, marital status and cognitive function.  Services from the community healthcare system do not differ, regardless of whether the patient has signs of depression. Depression is associated with caregiver burden (r = 0.44). In 31.6% of cases the patients had a severe degree of depression and their relatives reported a burden of care that ranged from easy/moderate to severe (n=24). Conclusion Half of the patients who participated in this study had symptoms of depression. Patients with depression do not differ from patients without depression. Depression is associated with caregiver burden. Dementia assessments in municipalities should place greater emphasis on assessments of depression. / <p>ISBN 978-91-86739-23-2</p>

In a recent report on the state of homelessness in Canada, it is estimated that at least 200,000 Canadians access homeless emergency services or sleep outside per year, with approximately 30, 000 homeless on any given night (Gaetz, Donaldson, Richter, Gulliver, 2013, 5). A strategy to address homelessness is Housing First. Housing First is an evidenced-based housing intervention strategy which provides homeless individuals with immediate access to housing and supports. A unique feature of this program is that participants are offered immediate housing of their choice. Prior to the introduction of Housing First, housing intervention strategies focused on “housing readiness” and often required sobriety or psychiatric treatment prior to entry. The Housing First approach has demonstrated significant recovery, cost savings and housing retention rates in The Mental Health Commission of Canada’s (MHCC) At Home/Chez Soi project—one of the world’s largest research studies utilizing a randomized control trial to study the outcomes of the Housing First approach. The At Home/Chez Soi project operated in five cities across Canada; Toronto, Montreal, Moncton, Winnipeg and Vancouver. Approximately 14% of At Home/Chez Soi participants had three or more moves and a portion of individuals in the MHCC’s study struggled to achieve stable housing. In an early findings report released by the MHCC one of the main themes that emerged from qualitative interviews conducted by At Home/Chez Soi project researchers included “changes in the social aspects of day to day life” once acquiring housing. Some of these changes were described to be negative. This finding highlights the impacts that the acquisition of housing may have on the experiences of Housing First participants. This demonstrates a need for further research to explore how social experiences relate to housing retention and mental health recovery in Housing First programming. In this research, I address this gap by focusing on understanding the social experiences of participants of Housing First programming for whom the transition into stable housing was difficult. More specifically, I ask “In relation to factors that impact housing retention, what is the experience of social connection and sense of community for a group of participants who had difficulty transitioning into housing provided through the At Home/Chez Soi Housing First program?” In this thesis, I present qualitative findings from narratives collected from 5 participants of the At Home/Chez Soi project for whom the transition to stable tenancy was difficult. Semi-structured interviews were conducted with five participants who had a range of experiences with housing retention including one participant who remained in their first apartment, and four others who had between 1-4 moves during their involvement in the At Home/Chez Soi project. In this research, I explored whether the fundamental needs of social connection and sense of community are instrumental in producing positive outcomes such as mental health recovery and housing retention in Housing First programming. Using narrative methodology and interpretive description, I further explore how the unmet needs of social connection and sense of community can assist in understanding the challenges experienced by individuals who struggle to transition into stable housing. The findings demonstrate that participants experienced a shift in social connection and sense of belonging to the “street”, to a feeling of connection to the housed community. All of the participants expressed wanting to disassociate themselves from the DTES. This was difficult because of stigmatization particularly on the part of the landlords and neighbours in their new communities. Discriminatory treatment in their housing served to reinforce negative feelings of self. The process of shifting to a sense of belonging to the housed community presented additional challenges, such as periods of isolation and/or being in the difficult position of saying “no” to friends in order to preserve their tenancy by abiding by the rules of the Residential Tenancy Act (RTA). Participants overcame these challenges by making adjustments in meeting their social needs. Some ways that participants demonstrated resilience included connecting with professionals, creating community in local shops, setting boundaries with old friends, and in some instances, cutting off from old friends. I conclude that social connection is paramount for these individuals. I also contend that the participants are resourceful in ensuring these needs are met. Recommendations for new or existing Housing First programming are made to ensure sensitivities and practices are geared to supporting these connections including offering flexibility and choice around locations and activities for weekly meetings with case managers. Other recommendations, specific to the transition into housing include incorporating a survey of important shops or services during the housing search process, and ensuring a good landlord-tenant fit during the housing selection process. / Graduate / 0617 / jynene_s@hotmail.com

In a recent report on the state of homelessness in Canada, it is estimated that at least 200,000 Canadians access homeless emergency services or sleep outside per year, with approximately 30, 000 homeless on any given night (Gaetz, Donaldson, Richter, Gulliver, 2013, 5). A strategy to address homelessness is Housing First. Housing First is an evidenced-based housing intervention strategy which provides homeless individuals with immediate access to housing and supports. A unique feature of this program is that participants are offered immediate housing of their choice. Prior to the introduction of Housing First, housing intervention strategies focused on “housing readiness” and often required sobriety or psychiatric treatment prior to entry. The Housing First approach has demonstrated significant recovery, cost savings and housing retention rates in The Mental Health Commission of Canada’s (MHCC) At Home/Chez Soi project—one of the world’s largest research studies utilizing a randomized control trial to study the outcomes of the Housing First approach. The At Home/Chez Soi project operated in five cities across Canada; Toronto, Montreal, Moncton, Winnipeg and Vancouver. Approximately 14% of At Home/Chez Soi participants had three or more moves and a portion of individuals in the MHCC’s study struggled to achieve stable housing. In an early findings report released by the MHCC one of the main themes that emerged from qualitative interviews conducted by At Home/Chez Soi project researchers included “changes in the social aspects of day to day life” once acquiring housing. Some of these changes were described to be negative. This finding highlights the impacts that the acquisition of housing may have on the experiences of Housing First participants. This demonstrates a need for further research to explore how social experiences relate to housing retention and mental health recovery in Housing First programming. In this research, I address this gap by focusing on understanding the social experiences of participants of Housing First programming for whom the transition into stable housing was difficult. More specifically, I ask “In relation to factors that impact housing retention, what is the experience of social connection and sense of community for a group of participants who had difficulty transitioning into housing provided through the At Home/Chez Soi Housing First program?” In this thesis, I present qualitative findings from narratives collected from 5 participants of the At Home/Chez Soi project for whom the transition to stable tenancy was difficult. Semi-structured interviews were conducted with five participants who had a range of experiences with housing retention including one participant who remained in their first apartment, and four others who had between 1-4 moves during their involvement in the At Home/Chez Soi project. In this research, I explored whether the fundamental needs of social connection and sense of community are instrumental in producing positive outcomes such as mental health recovery and housing retention in Housing First programming. Using narrative methodology and interpretive description, I further explore how the unmet needs of social connection and sense of community can assist in understanding the challenges experienced by individuals who struggle to transition into stable housing. The findings demonstrate that participants experienced a shift in social connection and sense of belonging to the “street”, to a feeling of connection to the housed community. All of the participants expressed wanting to disassociate themselves from the DTES. This was difficult because of stigmatization particularly on the part of the landlords and neighbours in their new communities. Discriminatory treatment in their housing served to reinforce negative feelings of self. The process of shifting to a sense of belonging to the housed community presented additional challenges, such as periods of isolation and/or being in the difficult position of saying “no” to friends in order to preserve their tenancy by abiding by the rules of the Residential Tenancy Act (RTA). Participants overcame these challenges by making adjustments in meeting their social needs. Some ways that participants demonstrated resilience included connecting with professionals, creating community in local shops, setting boundaries with old friends, and in some instances, cutting off from old friends. I conclude that social connection is paramount for these individuals. I also contend that the participants are resourceful in ensuring these needs are met. Recommendations for new or existing Housing First programming are made to ensure sensitivities and practices are geared to supporting these connections including offering flexibility and choice around locations and activities for weekly meetings with case managers. Other recommendations, specific to the transition into housing include incorporating a survey of important shops or services during the housing search process, and ensuring a good landlord-tenant fit during the housing selection process. / Graduate / 0617 / jynene_s@hotmail.com

Tyrimo tikslas – atskleisti artimųjų, slaugiusių sunkiai sergantį šeimos narį iki jo/jos mirties namuose, patirtį. Tiriamas reiškinys – slaugymas iki mirties namuose. Tyrimo klausimai. 1) Kokia yra artimųjų slaugymo namuose sunkiai sergantį šeimos narį patirtis? 2) Kokia yra artimųjų budėjimo namuose šalia mirštančio šeimos nario patirtis? Tyrimo metodai. Kokybinis tyrimas, taikant aprašomosios fenomenologijos strategiją, pagal P. Colaizzi metodą. Duomenys rinkti taikant individualųjį giluminį interviu. Tyrimo dalyviai. 5 artimieji (1 vyras, 4 moterys). Atranka – tikslinė. Atrankos kriterijai: a) artimieji, slaugę sunkiai sergantį suaugusį šeimos narį ir budėję jo/jos mirties momentu namuose; b) artimieji, slaugę šeimos narį ir budėję jo/jos mirties momentu namuose, ne anksčiau nei praėjus vieneriems metams po mirties. Tyrimo rezultatai. Tyrime išryškėjusios temos, kurios atskleidė patirčių esmę – tiriamą reiškinį: 1) Šeimos narys: nesvarbu koks, svarbu, kad tik būtų kartu?; 2) Slaugos namuose motyvai: „namai lieka namais“; 3) Artimųjų palaikymas ir pagalba – „pats svarbiausias dalykas“; 4) Pokyčiai gyvenime: nuo momentinės pagalbos iki priežiūros 24 valandas per parą; 5) Susitaikymas ir „paleidimas“; 6) Mirties akimirka: nuo „visiška ramybė“ iki „blogiausias momentas“; 7) Sveikatos priežiūros specialistai – padedantys arba apsunkinantys esamą situaciją; 8) Sugrįžimas į gyvenimą „be artimųjų slaugymo“. Išvados. Artimieji nusprendę slaugyti sunkiai sergantį šeimos narį... [toliau žr. visą tekstą] / Reseach purpose – to reveal the family caregivers’ experience of caring a seriously ill family member till his/her death at home. Studied phenomenon – caring a seriously ill family member till his/her death at home. Research questions. 1) What kind of experience have the family caregivers got of caring a seriously ill family member till his/her death at home? 2) What kind of experience have family caregivers got while caring a dying family member? Research methods. Qualitative research, with applied descriptive phenomenology strategy, on the base of P. Colaizzi method. Data has been collected by in-depth interviewing, asking two research questions. Research participants. 5 family caregivers (1 male, 4 female). Selection – target, selection criteria: a) family caregivers who took care of a seriously ill adult family member till his/her death at home; b) family caregivers who took care of a seriously ill adult family member at home, no earlier than a year after he/she had passed. Research results. The following themes have emerged: 1) Family Member: no matter how he or she is, it is important to have one beside; 2) Home care motivation: “home is home”; 3) Family members’ assistance and support – “the most important thing”; 4) Changes in care needs: from instant help to care 24 hours a day; 5) Reconciliation and acknowledging the full reality of the loss; 6) The moment of death: from “total peace” to the “worst moment”; 7) Health care professionals – whether they help or hinder... [to full text]

隨著經濟、社會結構的轉變、產業結構之調整，雇主為了精簡組織、節省成本，將非企業之核心知識以外包的方式來節省成本；而科技的發展、網際網路的發達，越來越多的人選擇在家工作，使居家工作似乎成為一種時髦的工作型態。 居家工作之運用對雇主來說似乎為一項利多，但對於居家工作者而言，可能連帶引起許多問題，居家工作者通常居於薄弱的議價地位，他們的工作條件是否能及得上從事相同工作的一般勞工？將工作帶入家庭，工作與家庭生活是否能調和？本研究以使用資訊、科技等設備的居家工作者為研究對象，探討他們可能遭遇的工作條件與生活問題。 本研究之發現如下： 一、工作條件問題： 雇主對居家工作的看法（工作內容是否為主要業務）以及僱用關係均會對居家工作者的工作條件產生影響。僱用及非僱用關係的居家工作者均有需配合趕工（無加班費，且需在週末及夜晚趕工）、缺乏職業健康安全措施之保護等問題；另外非僱用關係居家工作者與委託者大部分以口頭約定工作，使得工作內容不明確，致工作來源、工作量、工作條件不穩定，且在社會安全制度適用上困難、教育訓練機會缺乏。 二、生活問題： 工作與家庭生活結合易產生時間與空間的競合，以及角色的重疊容易將工作情緒帶入家庭，進而影響生活品質。其中居家工作者認為「時間配置」的問題，最易影響生活品質。 在家工作之後會減少與人群接觸的機會，大部分是以網路溝通取代面對面溝通，多少會與社會產生疏離。長時間工作會壓縮跟家人相處的時間，且趕工的壓力亦會影響生活品質。但居家工作者多願意配合趕工，也就是說他們的「工作投入」優先於「家庭投入」。 三、因應策略： 非僱用關係居家工作者的工作條件必須以書面記載，並詳列委託條件、雙方權益義務等。契約的格式必須統一規範，而不是由委託者片面決定。加強居家工作者自我健康管理的認知，落實居家工作者及其雇主之登記制度。政府應儘速規劃一套規範制度，避免居家工作成為雇主逃避責任的工具。 工作與生活界線之管理，工作應儘量與一般日常的活動切割，例如以不同的活動作為分隔（送小孩去保姆家後開始工作）、訂定工作時間表。而居家工作者本身必須具有良好的適應力，可以因應將工作帶入家庭產生的壓力，以及自我約束、自我激勵，不因干擾而影響工作品質。

Thesis (M.A.)--Texas State University-San Marcos, 2007. / Vita. Appendix: leaves 34-35. Includes bibliographical references (leaves 36-38).

Thesis (M.A.)--Texas State University-San Marcos, 2007. / Vita. Appendix: leaves 34-35. Includes bibliographical references (leaves 36-38).

Thesis (M.S.)--University of Michigan, 1980.