Introduction: Multiple studies have shown the symptoms of Parkinson's disease (PD) can impair driving performance. Studies have also found elevated crash rates in drivers with PD, however, none have controlled for exposure or amount of driving. Although a few studies have suggested that drivers with PD may self-regulate (e.g., by reducing exposure or avoiding challenging situations), findings were based on self-report data. Studies with healthy older drivers have shown that objective driving data is more accurate than self-estimates. Purposes: The primary objectives of this study were to examine whether drivers with PD restrict their driving (exposure and patterns) relative to an age-matched control group and explore possible reasons for such restrictions: trip purposes, perceptions of driving comfort and abilities, as well as depression, disease severity and symptoms associated with PD. Methods: A convenience sample of 27 drivers with PD (mean 71.6±6.6, range 57 to 82, 78% men) and 20 age-matched control drivers from the same region (70.6±7.9, range 57 to 84, 80% men) were assessed between October 2009 and August 2010. Driving data was collected for two weeks using two electronic devices (one with GPS) installed in each person‟s vehicle. Participants completed trip logs, questionnaires on background and usual driving habits, and measures of cognitive functioning, depression, quality of life, daytime sleepiness, driving comfort and abilities. Contrast sensitivity and brake response time were also assessed. Severity of PD was assessed using the Unified Parkinson‟s Disease Rating Scale (UPDRS) motor scores. An interview was conducted at the end of the second assessment to examine influence of the devices, driving problems and any departures from usual patterns over the monitoring period. Results: Of the 128 PD patients screened for possible study participation, 35% had already stopped driving. Former drivers were older, more likely to be women and had poorer UPDRS motor scores. Only 48% of those who were eligible for the study agreed to participate. Compared to controls, the PD group had significantly slower brake response times, higher depression and quality of life scores, less comfort driving at night and poorer perceptions of their driving abilities. The PD group also had significantly lower cognitive functioning scores than controls, and a significantly greater proportion (74% versus 45%) were classified as having mild cognitive impairment. Compared to vehicle recordings, both groups mis-estimated the amount they drove over two weeks (measurement error was 94 km for the PD group and 210 km for the controls). The PD group drove significantly less overall (days, trips, distance and duration), at night, on week-ends and in bad weather and for different purposes. Four of the PD drivers had minor accidents over the two weeks, while one lost his license. Conclusions: Self-estimates of exposure were inaccurate warranting the continued use of objective driving data. Overall, the findings suggest that drivers with PD appear to restrict their driving exposure and patterns relative to controls. The PD group were more likely to combine several activities into one trip, possibly due to fatigue. Moreover, they were more likely than controls to drive for medical appointments and less likely to drive for leisure activities and make out of town trips. The findings need to be replicated with larger samples and longer monitoring periods to examine changes in self-regulatory practices associated with disease progression and symptomatology. Other researchers are also likely to have similar difficulty in recruiting drivers with PD as this group may quit driving at an earlier age and those who are still driving are fearful of being reported to licensing authorities. Future studies also need to screen for cognitive impairment which often goes undetected, particularly in otherwise healthy drivers.

A qualitative study was conducted to identify perceptions of high-risk pregnant Aboriginal women during pregnancy. Five women were interviewed by the researcher who is also Aboriginal. Each woman was a client of the Healthy Mother Healthy Baby pregnancy outreach program in Saskatoon, and was considered to be at high-risk for poor pregnancy outcomes. Interviews were conducted utilizing a phenomenologically-based model of research, from which emerged themes or commonalities of thought between each woman during this time of their lives. The themes were discussed with Aboriginal women elders who worked with Aboriginal families in Saskatoon, for further insight and discussion of the findings. The themes were collated under one general theme called `hopes and dreams.' Each theme included the interest of these women to `want to' move ahead with their lives in the area of improving their relationships with their offspring, their partners, and within themselves. Though each women talked about these areas as being important, all except one did not manifest them in their lives.<p> The implications for the delivery of health care services include the need for health care workers to gain further understanding of the positive motivational factors of high-risk pregnant Aboriginal women that work towards achieving long-term positive behavioural changes, and thus reduce the risks of poor pregnancy outcomes. Other recommendations from this research for health promotion programs include the development of a partnership with the urban Aboriginal community in delivering culturally-based services and teachings to complement the educative and supportive model of program delivery.

Various research reports and articles in the popular press have highlighted the obstacles and negative conditions that learners experience at some farm schools in South Africa. These obstacles and conditions are not conducive to the health and well-being of farm schools and violate farm school learners' rights to receive a high quality of education. The aim of this research was to establish how parents of farm school learners perceive the health and well-being of farm schools. A literature study and a qualitative investigation were undertaken to achieve the aim of the research. The literature study focused on the health and well-being of schools with specific reference to farm schools. In the qualitative part of the research, focus group interviews were conducted with 38 parents of learners who attend farm schools in the Mopani District of the Department of Education in the Limpopo Province. The qualitative data analysis revealed the following findings: • Parents who participated in the research have negative perceptions of the health and well-being of the farm schools that their children attend. • Their negative perceptions can be ascribed to various health-related problems/issues that prevail at these schools. Based on the research findings, various recommendations were made with a view to improve the health and well-being of these farm schools. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2008.

Various research reports and articles in the popular press have highlighted the obstacles and negative conditions that learners experience at some farm schools in South Africa. These obstacles and conditions are not conducive to the health and well-being of farm schools and violate farm school learners' rights to receive a high quality of education. The aim of this research was to establish how parents of farm school learners perceive the health and well-being of farm schools. A literature study and a qualitative investigation were undertaken to achieve the aim of the research. The literature study focused on the health and well-being of schools with specific reference to farm schools. In the qualitative part of the research, focus group interviews were conducted with 38 parents of learners who attend farm schools in the Mopani District of the Department of Education in the Limpopo Province. The qualitative data analysis revealed the following findings: • Parents who participated in the research have negative perceptions of the health and well-being of the farm schools that their children attend. • Their negative perceptions can be ascribed to various health-related problems/issues that prevail at these schools. Based on the research findings, various recommendations were made with a view to improve the health and well-being of these farm schools. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2008.

Introduction: Multiple studies have shown the symptoms of Parkinson's disease (PD) can impair driving performance. Studies have also found elevated crash rates in drivers with PD, however, none have controlled for exposure or amount of driving. Although a few studies have suggested that drivers with PD may self-regulate (e.g., by reducing exposure or avoiding challenging situations), findings were based on self-report data. Studies with healthy older drivers have shown that objective driving data is more accurate than self-estimates. Purposes: The primary objectives of this study were to examine whether drivers with PD restrict their driving (exposure and patterns) relative to an age-matched control group and explore possible reasons for such restrictions: trip purposes, perceptions of driving comfort and abilities, as well as depression, disease severity and symptoms associated with PD. Methods: A convenience sample of 27 drivers with PD (mean 71.6±6.6, range 57 to 82, 78% men) and 20 age-matched control drivers from the same region (70.6±7.9, range 57 to 84, 80% men) were assessed between October 2009 and August 2010. Driving data was collected for two weeks using two electronic devices (one with GPS) installed in each person‟s vehicle. Participants completed trip logs, questionnaires on background and usual driving habits, and measures of cognitive functioning, depression, quality of life, daytime sleepiness, driving comfort and abilities. Contrast sensitivity and brake response time were also assessed. Severity of PD was assessed using the Unified Parkinson‟s Disease Rating Scale (UPDRS) motor scores. An interview was conducted at the end of the second assessment to examine influence of the devices, driving problems and any departures from usual patterns over the monitoring period. Results: Of the 128 PD patients screened for possible study participation, 35% had already stopped driving. Former drivers were older, more likely to be women and had poorer UPDRS motor scores. Only 48% of those who were eligible for the study agreed to participate. Compared to controls, the PD group had significantly slower brake response times, higher depression and quality of life scores, less comfort driving at night and poorer perceptions of their driving abilities. The PD group also had significantly lower cognitive functioning scores than controls, and a significantly greater proportion (74% versus 45%) were classified as having mild cognitive impairment. Compared to vehicle recordings, both groups mis-estimated the amount they drove over two weeks (measurement error was 94 km for the PD group and 210 km for the controls). The PD group drove significantly less overall (days, trips, distance and duration), at night, on week-ends and in bad weather and for different purposes. Four of the PD drivers had minor accidents over the two weeks, while one lost his license. Conclusions: Self-estimates of exposure were inaccurate warranting the continued use of objective driving data. Overall, the findings suggest that drivers with PD appear to restrict their driving exposure and patterns relative to controls. The PD group were more likely to combine several activities into one trip, possibly due to fatigue. Moreover, they were more likely than controls to drive for medical appointments and less likely to drive for leisure activities and make out of town trips. The findings need to be replicated with larger samples and longer monitoring periods to examine changes in self-regulatory practices associated with disease progression and symptomatology. Other researchers are also likely to have similar difficulty in recruiting drivers with PD as this group may quit driving at an earlier age and those who are still driving are fearful of being reported to licensing authorities. Future studies also need to screen for cognitive impairment which often goes undetected, particularly in otherwise healthy drivers.

Objective Objective of this study was to investigate the impact of the recent economic crisis of 2007/2008 on the subjective well-being and health status in thirteen European countries. Methods The European Social Survey (ESS) database was searched for individual health and wellbeing indicators and the database of the European Commission Eurostat for economic indicators. Data representing social determinants like education, housing and employment status and others before, during and after the crisis were retrieved. Eurostat data were used to analyse economic indicators and health outcomes on country level. Descriptive statistics were used to describe the changes in the different parameters over time. Regression analysis was performed to demonstrate relations between subjective well-being and different social determinants. Results Between 2006 and 2012 all countries experienced changes in their populations' subjective well-being. From 2006 to 2010 (crisis) the number of people with good or very good subjective well-being increased in France, Ireland, Belgium and Portugal by 0.6%, 1.0%, 1.2% and 6.5%, respectively. In Denmark and Spain this number remained basically stable. In Sweden, the United Kingdom, Finland and Germany the percentage of the population with good or very good subjective well-being decreased by 1.1%, 2.7%, 1.7% and 2.8%, respectively. Regression analysis demonstrated a significant relation between good and very good subjective well-being and level of education, main activity during the last 7 days, satisfaction with life, satisfaction with household income, main source of household income, gender and age. This relation differed for various factors and countries. In none of the countries satisfaction with national health services and satisfaction with current state of economy within the country was found significantly related to subjective well-being. The main amendable determinant correlating with a higher degree of subjective well-being is good education. The correlation between education and subjective well-being got stronger after the crisis than before or during the crisis. Conclusion Economic development does not have a uniform impact on subjective well-being. Education is a major amendable determinant influencing individual well-being. We could not find evidence for any significant impact of the organization of the healthcare services or social system on the subjective well-being.

Bakgrund: Cancer är den största dödsorsaken för individer under 80 år i världen. År 2018 vårdades cirka 40 miljoner individer med palliativ vård, därför är det viktigt att sjuksköterskor har vetskap kring vad en god palliativ vård innebär. Cancer har både fysisk och psykisk påverkan på individernas liv vilket kan orsaka ett lidande. Syfte: Syftet med studien är att beskriva yngre vuxna individers upplevelser av att leva och vårdas med en obotlig cancersjukdom. Metod: Metoden var en kvalitativ innehållsanalys där datainsamlingen gjordes genom fyra narrativa berättelser i självbiografier. Resultat: Resultatet presenteras i fyra teman samt elva subteman. Människor i omgivningen hade en stor betydelse för individerna då de utgjorde ett stöd. Sjukdomen medförde fysisk påverkan genom biverkningar, symtom och en förändrad självbild medan psykisk påverkan kunde innefatta stark emotionell påverkan och existentiella tankar. Slutsats: Livet vändes upp och ner vid cancerbeskedet och individerna var tvungna att börja identifiera sig med sjukdomen. Cancer bidrog till lidande men genom acceptans kunde välbefinnande trots sjukdom uppnås. Det var viktigt att vårdgivare kunde bemöta unika tankar och behov för att skapa möjlighet till en god relation. / Background: Cancer is the leading cause of death for individuals under 80 in the world. In 2018 about 40 million individuals were in need of palliative care, therefore it`s important that nurses have knowledge of what good palliative care means. Cancer has both physical and mental impact on individuals’ lives, which can cause suffering. Aim: The aim of the study is to describe younger adults’ experiences of living and being cared for with terminal cancer. Method: The method was a qualitative content analysis in which data collection was done through four narrative stories in autobiographies. Results: The results were presented in four themes and eleven sub-themes. People in the surroundings were of great importance to the individuals as they provided support. The illness led to physical impact through side effects, symptoms and a changed self-image, while psychological impact could include strong emotional impact and existential thoughts. Conclusion: Life was turned upside down by the cancer diagnosis and the individuals hadto start identifying themselves with the disease. Cancer contributed to suffering but through acceptance, well-being despite disease could be achieved. It was important for caregivers to respond to unique thoughts and needs to create opportunities for a good relationship.

Magister Scientiae (Occupational Therapy) - MSc(OT) / Street gangs have become a permanent feature of the social landscape in the Western Cape, South Africa. Various strategies have been developed to address the issue of gangsterism. The study focused on one strategy, disengagement. Disengagement is regarded as the process in which active gang members withdraw from their affiliated gangs and re-integrate into society. Much of the research that has been conducted in the area of disengagement has been done internationally, and there is very little research that explores how youth leave gangs within the South African context. Therefore, the current study explored young men’s perceptions and experiences of disengaging from gangs and how occupations facilitate and sustain the disengagement process. In the present study, occupation is defined as activities and tasks of everyday living that give meaning or value to one’s life. Occupation is associated with health and well-being, but occupations can also be unhealthy and dangerous. A qualitative approach, using an explorative research design, was adopted in order to explore the topic within a South African context, namely the townships of Nyanga and Langa, which are located on the Cape Flats. Through the use of purposive and convenience sampling, ten members of two groups, namely, the Peace Team and Project Playground, were invited to participate in the study. The Peace Team was established in 2013 by former gang members in response to the conflict amongst the youth of Nyanga and to encourage gang members to leave gangs. Project Playground is a Non-Governmental Organisation that services the areas of Langa and Gugulethu through a variety of community development projects and after school programmes. An initial focus group was conducted with some of the participants. Thereafter, semi structured interviews were conducted with each of the ten participants (until data saturation was reached). After the individual interviews were completed, a second focus group was conducted with some of the participants to discuss and explore issues that were uncovered during the individual interviews. All focus groups and interviews were voice recorded and transcribed verbatim, and transcriptions were then compared to the recordings to assure accurate reflections thereof. Thematic analysis was used to identify codes, categories and themes. Once transcription was completed coding was commenced. Through the use of codes, the researcher was able to reorganize data in a way that facilitated the interpretation and enabled the researcher to organize data into categories that were analytically useful to the study. Categories were then grouped in sub-themes and finally themes, based on similarities and patterns. Rigor and trustworthiness was ensured through various means including triangulation of data sources (multiple participants), data gathering methods (focus groups and individual interviews), member checking, keeping an audit trail and reflexivity. Ethical clearance was obtained from the Senate Research Committee of the University of the Western Cape, registration number 15/7/86. From the data five themes emerged to form the findings. These themes were: (1) The reason why, (2) The price of gang life… the fine print, (3) Time to get out… I didn’t sign up for this, (4) Getting out and staying out, and (5) The price of my freedom. The study contributed to current knowledge in occupational therapy and occupational science regarding how engagement in meaningful occupations promotes health and well-being. In understanding these occupations and what meaning they hold, it assists occupational therapists in planning, implementing and evaluating appropriate interventions to help gang members to disengage from gangs and engage in meaningful and healthy occupations that support their reintegration into the community in pro-social ways.

This thesis will explore the possible obstacles among Region Stockholm municipalities in promoting adolescents’ mental health and well-being through experimental governance. The thesis will examine the municipal and non-municipal points of view on specifically promoting adolescents’ mental health and well-being through experimental governance in the Swedish context with the use of urban sustainability transitions and transition management frameworks. The urban sustainability transitions will help us understand the role of cities in creating new modes of urban governing processes. In addition, the use of a transition management framework will help us to understand the importance of shifting from traditional management approaches by rather placing greater focus on innovative and design-oriented methods. This approach highlights the importance of learning by doing process rather than a reaching specific destination. In addition, I will use a qualitative research design that uses the methods of semi- structured interviews. The empirical findings are analysed with the help of thematic analysis through the theoretical frameworks and concepts. It has been demonstrated an observable slow- paced adoption of experimental governance, insufficient specific promotion of adolescents’ mental health and well-being, and distant relationship between experimental governance and promotion specifically adolescents’ mental health and well-being in the urban planning process.

Well-being is fundamental for health. However, health and well-being are under threat by increased prevalence of depression and physical inactivity. Interaction with the natural environment may prevent these critical health issues, as research has shown that walking outdoors contributes to better well-being than walking indoors. The aim of this thesis was to investigate outdoor group walks as a potential public health intervention to enhance positive mental and emotional well-being, reduce stress, and foster resilience. This thesis evaluated Walking for Health, a national group walking programme in England using a nonexperimental, longitudinal design. Individuals who did (Group Walkers) and did not (Non-Group Walkers) take part in outdoor group walks completed two online questionnaires about their mental and emotional well-being, and covariates. To gain a broader understanding of how outdoor group walks may contribute to positive well-being, integrations were proposed between the Attention Restoration Theory and the psycho-evolutionary model, and the theories of coping and resilience. Findings show that Group Walkers had greater mental well-being and positive affect, and less negative affect, depression and perceived stress than Non-Group Walkers. Group walking had no affect on social well-being, connectedness to nature or resiliency. Outdoor group walk participation affected positive well-being through a decrease in perceived stress, and an increase in physical activity. Group Walkers demonstrated resilience against adversity on negative affect. No evidence of resilience from outdoor group walks was found for mental well-being, positive affect or depression. Group walks in farmland and green corridor environments may further boost mental well-being, and reduce negative affect and perceived stress, when compared to group walks in the urban environment. This research suggests that outdoor group walks are effective at improving mental and emotional well-being, and could be a useful public health intervention to reduce stress and foster resilience. Implications for theory are discussed.