Tutoring services have experienced exponential increases in enrollment in Canada, with Ontario alone witnessing a 60% increase in enrollment from 1996 to 2000 (see Aurini & Davies, 2004). While Canadian research has documented organizational changes (Aurini & Davies, 2004; Aurini, 2006) and parents’ motives to enroll in tutoring services (Davies, 2004; Gale, 2016), the lived experiences of students with tutoring services are notably absent from the literature to date. In response, the current study investigates the experiences of high school students receiving math tutoring services (n =3) and their parents (n =2). The extent to which their participation in tutoring demonstrates “transboundary learning” (Kim & Jung, 2019b) is also examined in response to claims that tutoring services represent mainly peripheral learning environments as opposed to a core part of students’ learning (Aurini & Davies, 2013). Guided by a poststructuralism theoretical framework, the study employs qualitative methods to respond to three questions: (1) What are the lived experiences of high school students receiving math tutoring from a private tutoring service in Ottawa (Ontario, Canada)? (2) What are parents’ motives for seeking private tutoring services? and (3) How do participants perceive the learning taking place in different environments (e.g., tutoring vs. school)? Data from semi-structured interviews with high school students and their parents are analyzed using thematic analysis and interpreted using a Transboundary Learning framework (Kim & Jung, 2019b). Findings reveal key characteristics of transboundary learning in participants’ math tutoring contexts, suggesting a shift in the relationship between tutoring and schooling from peripheral to transboundary learning, whereby, tutoring is not regarded as peripheral as it has been in the literature to date. These findings are discussed in light of the noteworthy influence of tutoring over students' learning and schooling, and the potential for more inequalities in education.

Bakgrund: Den äldre befolkningen ökar i rask takt och bor i större utsträckning hemma längre. Människan är beroende av gemenskap och de äldre är en utsatt grupp som löper större risk att drabbas av ensamhet. Ensamhet kan idag ses som en folksjukdom och kan bidra till flertalet somatiska sjukdomar, psykisk ohälsa och en känsla av utanförskap. Syfte: Syftet med denna kvalitativa litteraturstudie var att beskriva äldres erfarenheter av ofrivillig ensamhet. Metod: En kvalitativ artikelöversikt har tillämpats för att genomföra denna litteraturstudie. Sökningar genomfördes i tre olika databaser och artiklar valdes utifrån inklusions- och exklusionskriterier samt efter genomgången kvalitetsgranskning. Nio kvalitativa studier som svarade mot studiens syfte valdes ut, analyserades och sammanställdes till ett resultat. Resultat: I resultatsammanställningen identifierades tre huvudkategorier och åtta subkategorier. Huvudkategorierna var: Orsaker till ensamhet, konsekvenser av ensamhet och faktorer som lindrar ensamhet. Konklusion: Ensamhet är komplext och en högst individuell upplevelse. Många äldre upplever ensamhet som något plågsamt och ett hinder som skapar en barriär mellan dem och den sociala världen. En åldrande kropp och förlust av relationer samt en känsla av utanförskap var vanligt förekommande teman i samtliga valda studier. Sjuksköterskan kan med enkla medel eventuellt lindra lidande, förebygga ohälsa och stärka de äldres känsla av sammanhang. / Background: The elderly population is increasing rapidly and are living at home longer. The human being is dependent on solidarity and the elderly are a vulnerable group who are at greater risk of suffering from loneliness. Loneliness can today be seen as an public health disease and can contribute to a lot of different somatic diseases, mental illnes and a feeling of exclusion. Aim: The aim of this qualitative literature study was to describe older persons experiences of involuntary loneliness. Methods: A qualitative article review has been applied to this litteraturestudy. The search was conducted in three different databases and the articles were selected based on the inclusion- and exclusioncriteria and a quality review. Nine qualitative studies that answered to the authors purpose were selected, analyzed and compiled into a result. Results: In the compilation of the results, three different main categories and eight subcategories emerged. The main categories were: Causes of loneliness, experiences of loneliness and factors the alleviate loneliness. Conclusion: Loneliness is a complex and highly individual experience. Many older persons experience loneliness as something painful, and an obstacle that created a barrier between them and the social world. An aging body and loss of relationships as well as a feeling of exclusion were common themes in all selected studies. The reg. nurse can with simple means possible alleviate suffering, prevent ill health and strengthen the elderly’s sense of coherence.

Background: Endometriosis is a gynecological disease caused by endometrium, or cells similar to the endometrium, that grows outside the uterus and creates a chronic inflammation. The most commonly reported symptoms are dysmenorrhoea, dyspareunia, severe or irregular bleedings and pelvic pain. The underlying cause of the disease is not yet established and 5,726,6% of women in fertile age are estimated to be affected. Health care professionals has an important role in nursing care, as it might affect quality of life in women with endometriosis. Purpose: The aim of the study is to describe women's experiences of living with endometriosis. Method: Literature study based on an analysis of 18 scientific articles with qualitative and quantitative content. Results: Four main themes are represented in the result; Experiences of health care, Physical consequences, Mental pain and Endometriosis controls women’s social lives. Conclusion: The literature study shows that endometriosis has a major impact on women's lives, which affects relationships, life opportunities and quality of life. The majority have experienced negative meetings with health care and a lack of knowledge. This leads to a long wait for diagnosis and insufficient treatment options. Further research should focus on results-oriented treatments and symptomatic therapies for endometriosis patients. Studies should also include transgender patients and patients that has undergone gender reassignment surgery, that is seeking health care for endometriosis-related symptoms.

Bakgrund: Cancer är en sjukdom som drabbar många människor. Var tredje svensk beräknas drabbas av sjukdomen. Cancerbehandlingen har utvecklats och fler överlever, däremot är behandlingen aggressiv och ger biverkningar som bland annat förändrar nutritionen. En av förutsättningarna för hälsa är tillräcklig nutrition. Vid bristande näringsintag påverkas individens immunsystem, risken för sjukdomar ökar och välbefinnandet kan minska. Personens välbefinnande är en förutsättning till god livskvalité. Syfte: Syftet var att beskriva erfarenheter av nutritionens betydelse för hälsa hos personer med cancer. Metod: En beskrivande litteraturstudie som identifierat 12 studier via databasen MEDLINE via PubMed. Litteraturstudien bygger på en tematisk analys. Resultat: Det framkommer att personer med cancer får nutritionsrelaterade problem (NRP) vid behandling. Det skapar svårigheter för ett tillräckligt näringsintag. Den förändrade situationen ger negativa känslor och begränsar individen socialt. En förutsättning för att hantera NRP och bevara hälsan är att hitta egenvårdsstrategier. Slutsats: Nutritionsrelaterade problem medför påfrestningar fysiskt, psykiskt och socialt hos personen med cancer. Sjuksköterskan har en betydande roll för att uppmärksamma individuella behov hos personer med cancer och anpassa omvårdnaden efter individen. Det är betydelsefullt ur ett omvårdnadsperspektiv att motivera personer till egenvårdsstrategier för att främja hälsa. / Background: Cancer is a disease that affects a lot of people. A third of the Swedish population is estimated to be affected of the disease. The cancer treatment has evolved and more and more of the affected people survive, on the other hand the treatment is aggressive and gives side effects where altered nutrition is one of them. For a good health, a good nutrition is necessary. When there is a lack of nutrition the individual’s immune system is affected, the risk for diseases increases and the wellbeing of a person decreases. A person’s wellbeing is a requirement for quality of life. Aim: The aim was to describe experiences of the importance of nutrition for the health of people with cancer. Method: A descriptive review that identified 12 studies through the database MEDLINE through PubMed. The literature study builds on a thematic analysis. Results: in the present result it occurs that people with cancer get nutrition related problems (NRP) in connection with the treatment. Which creates a problem with a good nutrition intake. The altered situation gives negative emotions and limits the individual socially. A basis to handle NRP and preserve the health is to find self-care strategies. Conclusion: Nutrition related problems are common on people with cancer and causing straining physically, psychological and socially. The nurse has an important role to pay attention to individual needs of people with cancer and adapt the care to the individual. It is significant from a care perspective to motivate people to self-care strategies to promote health.

Abstract Background There is limited research and guidelines regarding physiotherapy as a treatment approach      for post-traumatic stress (PTS). Refugee experience of physiotherapy interventions is hoped                      to contribute to awareness of the subject and to give insight into this developing field of the         profession. Purpose The purpose of the study was to investigate and describe refugees experience of post-             traumatic stress physiotherapy. The study was interested in both refugee experience of          treatment itself and of possible effects. Design and Method Qualitative explorative design. The study was based on five semi-structured interviews. A        qualitative, content analysis was used to process the data. Results          The analysis showed that the refugees faced many physical and psychological barriers to         treatment, especially relating to pain and somatisation, however they were able to                    experience increased bodily comfort during treatment itself. The relationship to         physiotherapist, the psychological impact of the treatment environment and other social      factors were also described as important to experience. Physiotherapy was described as positively affecting patient outcomes both in physical and mental health, despite certain uncontrollable/unmanageable symptoms making this difficult. The refugees were able to achieve generalisation of physiotherapy into their day-to-                     day life enabling them to self-manage to some extent and feel liberated from PTS symptoms. Conclusion The study agrees with the available literature on the effectiveness of treating refugee              patients suffering from post-traumatic stress with physiotherapy, not just to improve            physical health outcomes but even to give holistic improvements.  Keywords Post-traumatic stress, refugee, physiotherapy, experiences / Abstrakt Bakgrund Det finns begränsad forskning och riktlinjer gällande fysioterapeutisk behandling mot post-traumatisk stress (PTS). Flyktingars upplevelse av fysioterapeutisk behandling förväntas sprida kunskap och bidra till insikt i denna del av det fysioterapeutiska området som fortfarande är under utveckling. Syfte Syftet av studien var att utforska och beskriva flyktingars upplevelse av posttraumatisk stress-fysioterapi. Studiens intresse var av flyktingars upplevelse och effekt av den fysioterapeutiska behandlingen. Design och Metod Studien är av kvalitativ utforskande design baserat på användandet av 5 semi-strukturerade intervjuer. En kvalitativ innehållsanalys användes för att bearbeta informationen. Resultat Analysen visade att flyktingar möter många fysiska och psykiska hinder i behandlingen, mest gällande smärta och somatisering men att de kunde uppleva en viss grad av bekvämlighet under behandlingen ändå. Förhållandet till fysioterapeuten, den psykologiska effekten av behandlingsmiljön och andra sociala faktorer var också viktiga. Fysioterapi beskrevs ge positiv påverkan i resultatet av patienternas fysiska och mentala hälsa efter behandling trots utmaning från icke-hanterbara symptom. Flyktingarna kunde uppnå generalisering av deras fysioterapi till det dagliga livet som gjorde att de kunde hantera situationen själva till en viss grad och känna frihet från sina PTS symptom. Konklusion Studiens resultat går i samma linje som den tillgängliga litteraturen på effekten av att behandla flyktingar som lider av posttraumatisk stress med fysioterapi, inte bara för att öka den fysiska hälsan utan även för att ge mer vidgående holistiska förbättringar och livskvalitet. Nyckelord Post-traumatic stress, refugee, physiotherapy, experiences

Pregnancy is a unique developmental period in a woman’s life, characterized by numerous psychological, behavioural, and biological changes. How a biologically female woman experiences her pregnancy is impacted by her previous life experiences, including early experiences of adversity. In particular, maternal history of Adverse Childhood Experiences (ACEs) before age 18, has been shown to exert distal effects on mental health and behaviour in pregnancy. The current study explored the associations between ACEs and mental health symptoms in pregnancy via structural equation modelling within a sample of 330 Canadian women. This statistical approach permitted the use of a latent ACE variable comprised of abuse, neglect, and household dysfunction as indicator variables, as well as a latent mental health variable comprised of symptoms of depression, anxiety, and fear of childbirth. A direct effect emerged whereby maternal ACEs predicted mental health symptoms. This permitted subsequent testing of the following mediating pathways: sleep, health-risk behaviours, resilience, and social support. In the mediation analyses, further support emerged for the total indirect effect of maternal ACEs on mental health symptoms in pregnancy, once mediation pathways were added. In reviewing individual indirect pathways, sleep and social support mediated the association between ACEs and mental health symptoms in pregnancy. However, health risk behaviours and resilience did not. In addition, social support mediated the relationship between resilience and mental health symptoms in pregnancy. This study contributes to the existing research on maternal ACEs and their relationship with mental health symptoms during pregnancy. The concurrent testing of several pathways in the structural model served to characterize possible mechanisms through which early adversity relates to current mental health symptoms in pregnancy. Implications of these findings include identification of possible targets for intervention in pregnancy, in order to lessen the burden of ACEs on maternal mental health. / Graduate

Current statistics show an alarming number of children entering the South African children’s court system annually. Yet little to no research has been conducted involving children who actually attend children’s court within the South African context, specifically since the promulgation of the new Children’s Act 38 of 2005. Consequently, very little knowledge regarding these children’s experiences and where the court system may be failing them exists. Statutory intervention with children in the middle-childhood phase is based on the premise that such intervention is in the best interest of the child. The process begins with the assignment of a social worker who is tasked with conducting a comprehensive investigation into the child’s life. Once this investigation has been finalised, the child and all relevant parties will attend children’s court where a final decision will be made regarding the child’s future care. The question arises how children experience children’s court procedures and whether there are areas where improvement would be warranted, especially since heavy caseloads often result in postponements which could exacerbate any negative experiences. With a view to gaining insight into middle-childhood children’s experience of children’s court procedures, the researcher conducted a qualitative, applied study using a collective case study design. Two literature studies form the knowledge base of the study, where the first explores the various areas of development in middle childhood and the second the children’s court process, with specific reference to the relevant legislation and polices underlying this process. In-depth interviews with nine children in the middle-childhood phase who had been exposed to children’s court procedures allowed the researcher to gather data from the children’s perspectives, rather than from the perspective of professionals as is the case in the majority of other studies. This empirical study contributed to the knowledge base by providing evidence that children are not by any means adequately prepared for children’s court and do not meaningfully participate in the process. Furthermore, empirical evidence revealed that children in middle childhood often associate negative emotions – notably fear, sadness and anger – with children’s court procedures. From this empirical study, it was concluded that social workers need to take responsibility for ensuring that children are comprehensively prepared for court procedures. Furthermore, steps need to be taken to enhance children’s level of participation throughout the entire process. / Dissertation (MSW)--University of Pretoria, 2013. / lmchunu2014 / Social Work and Criminology / unrestricted

There are millions of adult male offenders currently involved with U.S. corrections system, many of which report a wide range of mental health difficulties and a history of traumatic experiences. Mental health and trauma-related difficulties are important considerations in the treatment and rehabilitation of adult male offenders. The relationship between adverse childhood experiences (ACEs), attachment style, and PTSD symptoms were studied in a sample of adult male participants in a court-ordered diversion program. The sample consisted of 59 men, ranging in age from 19 to 68-years-old, who endorsed a history of at least one prior arrest. Data were collected during a psychoeducational group-therapy class offered at a post-arrest diversion program. Primary study measures included the use of the ACEs questionnaire, Attachment Style Questionnaire (ASQ-40), and the Posttraumatic Stress Disorder Checklist-5 (PCL-5). A priori hypotheses proposed, 1) there is a significant correlation among ACEs, ASQ subscales, and PTSD symptoms, and 2) insecure attachment subscales mediate the relationship between ACEs and PTSD symptoms. Correlation, regression, and mediation analyses evaluated the relationship among ACEs, ASQ subscales and PCL-5 scores. As predicted, ACEs and PTSD symptoms were negatively correlated with secure attachment and positively correlated with insecure attachment. Also as predicted, insecure attachment style (i.e. discomfort from closeness) mediated the relationship between ACEs and PTSD symptoms. Results suggested that the confidence and discomfort with closeness attachment scales shared a significant relationship between and ACEs and PTSD symptoms. These findings suggest that the relationship between ACEs, attachment style, and PTSD symptomatology can further inform conceptualizations and treatments oriented toward improving outcomes for adult male offenders and successful reintegration into their communities.

Master of Public Health - MPH / The HIV incidence among young people aged 15 to 24 years remains a global health concern. Sub-Saharan Africa (SSA) is the home of approximately four million young people living with HIV, and young people in the region account for about 70% of new infections annually. Over 85% of HIV infections among young people in SSA is sexually transmitted. Therefore, the aim of the study was to understand young people’s experiences and perspectives on HIV prevention in four communities in Zambia.

Bakgrund: Kommunikation är en viktig del av omvårdnadsarbetet. Humor möjliggör för kommunikation, hantering av känslor och främjande av relationer mellan sjuksköterskan och patienten. Patienter anser oftast att det är positivt att sjuksköterskor använder sig av humor om det används i rätt kontext. Syfte: Syftet är att beskriva sjuksköterskors erfarenheter av humor i kommunikationen med patienter. Metod: En litteraturstudie baserad på åtta empiriska kvalitativa studier. Studierna hittades i fyra databaser, Cinahl, PubMed, Scopus och APA PsycInfo.  Resultat: Resultatet presenteras i tre teman och sju subteman. Temana är ‘Stärker den egna utvecklingen’, ‘Möjliggör ett samspel’ och ‘Reflekterar möjligheter och begränsningar’. Slutsats: Sjuksköterskor använder humor som ett sätt att etablera relationer till sina patienter. Humorn ses som ett effektivt kommunikationsverktyg för sjuksköterskan. Sjuksköterskor använder humor som en strategi i omvårdnadsarbetet och samtidigt som ett sätt att hantera ilska, stress och frustrerande känslor, en coping-strategi, ett sätt för sjuksköterskor att få mental vila och ro. Humorn bör anpassas till situationen och personerna. Sjuksköterskor tycker oftast att det är positivt när patienter använder humor. / Background: Communication is an important part of nursing. Humor enables communication, helps with dealing with emotions and building a relationship between nurse and patient. Patients usually think that it is positive that the nurse uses humor if it is used in the right context. Aim: The aim is to illustrate nurses’ experiences of humor in communication with patients.  Method: A literature study based on eight empirical qualitative studies. The studies were collected from four databases: Cinahl, PubMed, Scopus and APA PsycInfo.  Results: The result is presented in three themes and seven subthemes. The themes are ‘Strengthens own development’, ‘Enables an interaction’ and ‘Reflects opportunities and limitations’.  Conclusion: Nurses use humor as a way to establish relationships with patients. Humor is viewed as an effective communication tool for the nurse. Nurses use humor as a strategy in nursing and as a way to deal with anger, stress and frustrating emotions. Furthermore, the nurses use humor as a coping strategy and as a way for them to get mental rest. Humor should be adjusted to the situation and the people. Nurses usually think it is positive when patients use humor.