Bakgrund: Endometrios drabbar nästan var tionde kvinna i fertil ålder, ungefär 250 000 kvinnor i Sverige. Endometrios kan leda till funktionsnedsättning på grund av kronisk bäckensmärta och andra endometriosrelaterade symtom som smärtsamma menstruationer, rikliga blödningar, smärta vid samlag och infertilitet. Syfte: Syftet var att beskriva kvinnors upplevelser av endometrios. Metod: En litteraturöversikt - innehållsanalys av elva originalstudier för att beskriva kunskapsläget inom aktuell forskning. Datainsamlingen genomfördes med hjälp av två elektroniska forskningsdatabaser Cinahl Complete och PubMed och studier analyserades med hjälp av Fribergs fyrstegsmodell. Resultat: Endometrios har negativ inverkan på kvinnors liv i flera aspekter: fysiskt, psykiskt och socialt. Huvudsakligen handlar kvinnors upplevelser om smärta och dess effekter på det dagliga livet.Fastställning av diagnos kan ta lång tid för många kvinnor, detta harmed sig ofördelaktiga effekter på kvinnornas fysiska och psykiskahälsa, därför listas endometrios som en dold sjukdom i behov avmycket stöd från samhälle och familj. Sammanfattning: Litteraturöversikten har påvisat en klar bild av otillräckliga kunskap och information om endometrios både inom vården och samhället, en normalisering av symtompåverkan som har med sig ogynnsamma effekter på kvinnornas liv och välbefinnande. För att undvika normaliseringen av endometrios behövs ökade kunskapsinsatserfrämst hos sjukvårdspersonal. Trots att det finns mängder av beprövade kunskaper om endometrios, ändå hittas fortfarande brister på stöd i fokus att utforska endometrios omvårdnaden. Med den anledning tycks att endometrios ska vara ett intressant ämne för framtida forskningen. / Background: Endometriosis affects almost one in ten women of reproductive age, approximately 250,000 women in Sweden. Endometriosis can lead to disability due to chronic pelvic pain and other endometriosis related symptoms such as painful periods, heavy bleeding, pain during intercourse and infertility. Aim: The aim was to describe women's experiences of endometriosis. Method: A literature review - content analysis of eleven originalstudies to describe the state of knowledge in current research. Data collection was conducted using two electronic research databases Cinahl Complete and PubMed and studies were analysed using Friberg's four-step model. Results: Endometriosis has a negative impact on women's lives in several aspects: physical, psychological, and social. Mainly, women's experiences relate to pain and its effects on daily life. Diagnosis can take a long time for many women, which has unfavourable effects on their physical and mental health, therefore endometriosis is listed as a hidden disease in need of much support from society and family. Summary: The literature review has revealed a clear picture of inadequate knowledge and information about endometriosis in both health care and society, a normalisation of symptoms that has unfavourable effects on women's lives and well-being. In order to avoid the normalisation of endometriosis, there is a need to increase knowledge, especially among healthcare professionals. Even though there is a lot of proven knowledge about endometriosis, there is still a lack of support in the focus of exploring endometriosis care. Therefore, it seems that endometriosis should be an interesting topic for future research.

Many stories exist within the professional landscape of child weight management programming and health services. Grand narratives within these spaces story fat bodies as “unhealthy”, “risky” and in need of transformation, and often position the family and mothers in particular given gendered caregiving norms, as responsible for their children’s weight and poor health. Mothering stories and experiences are rarely told by the mothers themselves within this professional landscape. This study is a narrative inquiry that explores the in-depth experiences of two mothers who previously participated with their children in an Ontario paediatric weight management program. Given my work as a social worker within child weight management clinics I also explore my experiences alongside the participants. Clandinin and Connelly’s conceptualization of narrative inquiry and the three dimensional framework of temporality (past, present, future), sociality and place, inquiring inward, outward, backward and forward, were used in order to find meaning in mothering experiences of child weight management. Narrative beginnings share my own experiences of mothering and child weight management. Relational ethics were central as the inquiry unfolded, allowing for simultaneous exploration of experiences, continuous negotiation, awareness and re-evaluation with each mother, from recruitment, field work, to field text, interim text and the writing of the final text. Given the current social distancing restrictions related to the COVID-19 pandemic, conversations took place over zoom and telephone and were audio-recorded and transcribed verbatim. Detailed narrative accounts were written for each mother capturing individual experiences of child weight management as they intersected with many other experiences in their everyday lives. Narrative threads weaved together the mother’s experiences throughout the inquiry and focused on disrupting the grand narrative and resisting fragmentation. The inquiry contributes to the scholarship within fields of social work, social justice, mothering and health care by providing new ways of knowing about and engaging in conversations about mothering, weight, fatness and health. / Dissertation / Doctor of Philosophy (PhD) / This narrative inquiry explores the in-depth experiences of two mothers who previously participated in a child weight management program. As part of this research, I also explore my experiences in relation to the mothers, as a social worker who historically worked in the clinic. Mothers were often positioned as responsible for their children’s body weight and poor health and stories and experiences were rarely told by the mothers themselves across research and policy in the field. Clandinin and Connelly’s three-dimensional framework was used to find meaning in mothering experiences of child weight management. Conversations took place over zoom and telephone over a year. Detailed narrative accounts capture the individual mothering experiences of child weight management and come together in narrative threads that focus on disrupting the grand narrative and resisting fragmentation. The inquiry contributes to the scholarship within fields of social work and health care, providing new ways of knowing about and engaging in conversations about mothering, weight, fatness and health.

Growing evidence of the health risks associated with adverse childhood experiences (ACEs) has prompted public health and community initiatives to promote awareness, detection, and responses that are trauma informed. Nationwide programs to integrate trauma-informed care into education, health care, and child serving agencies, have thus far led to the proposal and advancement of trauma-informed policies and practices in many communities. While Mississippi agencies include trauma-specific intervention and training, statewide ACEs initiatives and relevant data are still limited. This project aimed to contribute to the larger goal of a statewide trauma-informed paradigm shift, by increasing ACEs awareness and developing recommendations for the integration of such research into programs aimed at serving vulnerable populations. Sixty-one child-serving professionals participated in adversity and resilience training (ART), a 3-hour workshop addressing childhood adversity, traumatic stress, resilience, and secondary traumatization. Outcomes measured were changes in trauma knowledge, trauma informed attitudes, attributions regarding difficult child-behaviors, and secondary trauma knowledge and self-care. Participants also provided ratings on a training evaluation survey. There were significant changes in trauma knowledge (F(1,22) = 6.418, p = .000, ηρ2 = .226) and trauma-informed attitudes (F(1,22) = 11.014, p = .003, ηρ2 = .334) between pre- and post-training. Training evaluations were generally positive (M = 4.61, SD = 0.13, on a 1 to 5 Likert scale). The current study contributes to the research an evaluation of a training intervention that offers feasible strategies for scalable training and assessment of outcomes.

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Adverse childhood experiences, known as ACEs, have been shown to negatively impact an individual’s health as an adult. While efforts to decrease children’s exposure to these traumatic experiences are beneficial, they are not able to fully eliminate these experiences and do not address how to help children who have already been exposed. Resilience, which has been defined as managing and adapting to significant sources of trauma, has been thought to be a protective factor against the toxic stress of ACEs. While the relationship between ACEs and poor health outcomes has been established, the relationship between resilience and health outcomes is largely unknown.  This study seeks to determine the association between resilience scores on a validated resilience questionnaire and health outcomes in adolescents. Looking specifically at body mass index, blood pressure, and depression scores on a validated depression screen we hypothesize that higher resilience scores will be associated with better health outcomes. In addition, we examine the relationship between ACE scores and resilience scores. If this validated resilience instrument is able to help predict health outcomes, this can direct development of intervention programs to build resilience in those living in ACE-heavy environments. / Urban Bioethics

Bakgrund: Obesitas förekommer i stort sett över hela världen. Orsakerna till en oönskad ökning av kroppsvikten är komplexa där både biologiska, miljömässiga och beteendemässiga faktorer kan ligga bakom. Tidigare studier har visat att det finns en utbredd stigmatisering i samhället av personer med obesitas, även inom sjukvården. Befintlig forskning har inte undersökt personer med obesitas upplevelser av fysioterapeutisk vård i Sverige, den kunskapsluckan ämnar denna uppsats att uppfylla.  Syfte: Syftet med denna studie är att undersöka huruvida personer med obesitas inom svensk fysioterapeutisk vård påverkas av eventuell stigmatisering eller diskriminering. Metod: En kvalitativ metod baserad på semistrukturerade intervjuer användes. Totalt deltog fem informanter, där intervjuerna skedde separat via zoom. Materialet analyserades sedan genom en kvalitativ innehållsanalys. Resultat: I resultatet framkom tre kategorier med tillhörande subkategorier. En informant beskrev upplevelser av diskriminering vid kontakt med fysioterapeuter, övriga hade haft en positiv upplevelse. Den tydligaste gemensamma faktorn var önskan om att bli bemött som en hel person, där samtliga beskrev att de ville bli sedda som en individ samt att fysioterapeuten skulle vara rak och ärlig i diskussioner  om vikt, förutsatt att det var nödvändigt att ta upp i förhållande till kontaktorsaken.   Slutsats: Resultatet är inte generaliserbart på den svenska fysioterapeutiska vården i stort. Det öppnar dock upp för en möjlighet att hitta relevanta mönster både internt inom studien samt i förhållande till andra liknande studier. / Background: Obesity is a global occurrence, the reasons behind an unwanted weight gain are complex where biological, environmental and behavioral factors all play a role. Prior research has shown that stigmatization of people with obesity is common in society and in healthcare. No prior research could be found regarding the experiences of obese people in encounters with physiotherapists in Sweden, this gap in knowledge is the focus of this paper. Objective: To investigate if people with obesity within Swedish physiotherapy care are affected by any stigmatization or discrimination. Method: This study utilized a qualitative method based on semi-structured interviews. Five participants were included in the study and were interviewed through the web based video software Zoom. The data was analyzed by way of qualitative content analysis Results: Three categories were identified with subsequent subcategories. One out of five participants described discrimination by their physiotherapist, the remaining participants described positive experiences. A common theme among the participants was the desire to be seen as an individual and that their physiotherapist should be honest and direct regarding the subject of weight as long as it is relevant to the context of their visit.  Conclusion: The results of this study cannot be generalized on Swedish physiotherapy care as a whole, however it does offer an opportunity to investigate relevant patterns internally in this study and compare them in relation to similar studies performed on the subject.