The current study set out to explore the affect and significance of differing parental conditions on the experiences commonly reported by young carers. Previous studies on young caring have reflected on the impacts of caring for parents with particular `types' of conditions (normally physical disability or mental health problems) or a specific diagnosis. However, these have not contrasted or discriminated young carers' experiences according to different parental conditions. To address this gap in knowledge, the current study considered the experiences of young carers supporting parents with different `types' of conditions, namely physical disability, mental health problems and substance misuse. The participants discussed the impact of caring on a range of areas such as their education, social life, health, spatial transitions, relationships and role reversals. Additionally, definitional issues were considered. This included young carers own understanding and subscription to the term `young carer' and the significance of this to their identification. In terms of methodology, the study was firmly grounded within the qualitative domain and influenced by a constructive-interpretive paradigm, specifically symbolic interactionism. Within this, the grounded theory approach was used insofar as it provided a method to conduct the study. A range of data-collection techniques were employed. Semi-structured interviewing was the principal method used, with additional data gathered through a self-esteem tool, observations and diaries. The sample consisted of 30 young carers. The results showed firstly that the participants did not necessarily comprehend the term `young carer' or apply it to their own caring roles at home. Arguably, this contributed to their `hidden-ness' (i. e. invisibility) and as a result their needs were overlooked. The need for a new definition which embraces their understandings, together with appropriate awareness-raising programmes within schools and for key social care and health professionals was evidenced and called for. Secondly, whilst the participants shared common experiences regardless of the nature of the parental condition, other issues reported were specific to particular situations. Those most adversely affected were caring in the contexts of parental substance misuse or parental mental health problems. Such young carers were dually disadvantaged, as they experienced the most extreme difficulties, yet their caring roles and needs were least likely to be addressed. The experiential differences reported by young carers in different caring contexts have important practice implications. Nevertheless, the extent to which the experiences reported could be wholly attributed to the caring role, rather than other structural and socio-economic factors was questionable.

Asystematic review of health problems following tsunamis Introduction: Tsunamis are sudden onset disasters with substantial impact on human health. Toidentify the relationship between tsunamis and health problems, the evidence must besystematically reviewed. Through this, health care response can be planned accordingly. Aim: To identify the health problems following tsunamis in order to guide medical response.Methods and materials: Four databases (Medline, Global Health, Web of Science CoreCollection and Embase) were searched using an inclusive search strategy in September 2018.The inclusion criteria were published, peer-reviewed articles on morbidity with data frommedical health facilities following tsunamis, where a control or comparison group was used toanalyze the tsunami outcome. Studies on mental health problems were excluded. The studieswere analyzed through narrative synthesis. Results: Eleven articles were included in the review. There was an increase in non-traumaticconditions reported in the immediate aftermath of tsunamis. Long-term health problems on thetsunami-affected population were seen up to three years after a tsunami. There is a lack of highqualityarticles on health problems after tsunamis. Conclusions: Medical response should prepare for trauma and non-trauma care shortly after atsunami and expect an increase in certain health problems several years post-tsunami. Existing,high-quality research is limited, and this review could not capture all tsunami-related healthproblems. Future studies that identify available evidence on health care needs after tsunamisshould consider using scoping reviews to cover a broader base of literature.

<p><strong>Abstrakt </strong>Tobak har varit den mest lönsamma konsumentprodukten i världen under mycket lång tid. Nikotinet medför att människor blir beroende både fysiologiskt och psykologiskt. Rökning har relaterats till olika sjukdomstillstånd och är idag den enskilt största orsaken till för tidig död. I Sverige leder rökningen varje år till ett betydande antal för tidiga dödsfall. Rökning är ett stort folkhälsoproblem. De flesta har dock en vilja att sluta röka. Motivation och vilja har visat sig vara nödvändigt för att nå ett rökstopp. <em>Syftet</em> var att beskriva före detta rökares tankar om motivation för att göra rökstopp och att sedan vidmakthålla detta rökstopp<em>. Metoden</em> som användes var en kvalitativ intervjustudie. Tio före detta rökare intervjuades och en ostrukturerad intervjumetod valdes.<strong> </strong>Intervjuerna analyserades med kvalitativ innehållsanalys. <em>Resultatet</em> visade att rökstoppet var en process där motivationen sågs i tre olika faser. De olika faserna var motivation för att förebereda beslut om rökstopp, motivation för att ta beslut om rökstopp samt motivation för att vidmakthålla rökstopp. I de olika faserna identifierades känslor som osäkerhet där exempelvis behovet av stöd framkom. Egenmakt handlade om att bestämma sig och frihetskänslor visade bland annat stolthet och oberoende. <em>Slutsatsen </em>blev att motivationen för att nå ett rökstopp grundades på flera olika faktorer och varierade från individ till individ och över tid.</p><p><strong>         Nyckelord: </strong>folkhälsoproblem, motivation, rökstopp, tobak. <strong></strong></p><p><strong>         </strong></p> / <p><strong>Abstract</strong> Tobacco has been the most profitable consumer product in the world for a very long time. Nicotine makes people addicted, both physiologically and psychologically. Smoking has been related to various diseases and is today the single largest cause of premature death. In Sweden, a significant number of premature deaths are caused each year due to smoking. Smoking is a major public health problem. Most people have a desire to stop smoking. Motivation and willingness have been shown to be necessary to reach a smoking cessation. <em>The aim </em>was to describe the former smokers' views on motivation to quit and then maintain that smoking cessation. <em>The method</em> used was a qualitative interview study. Ten former smokers were interviewed and an unstructured interview method was chosen. The interviews were analyzed with qualitative content analysis. <em>The results</em> showed that smoking cessation was a process in which motivation was seen in three different phases. The different phases were motivation to prepare a decision on quitting smoking, motivation to make decisions about smoking cessation, and motivation for maintaining smoking cessation. The various phases were identified feelings of uncertainty, where for example the need for support was found. Empowering was about how to determine their freedom and how feelings were revealed and among other things, pride and independence. <em>Conclusion </em>was<em> </em>that the motivation to reach a smoking cessation was based on several factors, varying from individual to individual and over time.<strong></strong></p><p><strong>Keywords: </strong>motivation, public health problem, smoking cessation, tobacco.</p>

Abstrakt Tobak har varit den mest lönsamma konsumentprodukten i världen under mycket lång tid. Nikotinet medför att människor blir beroende både fysiologiskt och psykologiskt. Rökning har relaterats till olika sjukdomstillstånd och är idag den enskilt största orsaken till för tidig död. I Sverige leder rökningen varje år till ett betydande antal för tidiga dödsfall. Rökning är ett stort folkhälsoproblem. De flesta har dock en vilja att sluta röka. Motivation och vilja har visat sig vara nödvändigt för att nå ett rökstopp. Syftet var att beskriva före detta rökares tankar om motivation för att göra rökstopp och att sedan vidmakthålla detta rökstopp. Metoden som användes var en kvalitativ intervjustudie. Tio före detta rökare intervjuades och en ostrukturerad intervjumetod valdes. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultatet visade att rökstoppet var en process där motivationen sågs i tre olika faser. De olika faserna var motivation för att förebereda beslut om rökstopp, motivation för att ta beslut om rökstopp samt motivation för att vidmakthålla rökstopp. I de olika faserna identifierades känslor som osäkerhet där exempelvis behovet av stöd framkom. Egenmakt handlade om att bestämma sig och frihetskänslor visade bland annat stolthet och oberoende. Slutsatsen blev att motivationen för att nå ett rökstopp grundades på flera olika faktorer och varierade från individ till individ och över tid.          Nyckelord: folkhälsoproblem, motivation, rökstopp, tobak. / Abstract Tobacco has been the most profitable consumer product in the world for a very long time. Nicotine makes people addicted, both physiologically and psychologically. Smoking has been related to various diseases and is today the single largest cause of premature death. In Sweden, a significant number of premature deaths are caused each year due to smoking. Smoking is a major public health problem. Most people have a desire to stop smoking. Motivation and willingness have been shown to be necessary to reach a smoking cessation. The aim was to describe the former smokers' views on motivation to quit and then maintain that smoking cessation. The method used was a qualitative interview study. Ten former smokers were interviewed and an unstructured interview method was chosen. The interviews were analyzed with qualitative content analysis. The results showed that smoking cessation was a process in which motivation was seen in three different phases. The different phases were motivation to prepare a decision on quitting smoking, motivation to make decisions about smoking cessation, and motivation for maintaining smoking cessation. The various phases were identified feelings of uncertainty, where for example the need for support was found. Empowering was about how to determine their freedom and how feelings were revealed and among other things, pride and independence. Conclusion was that the motivation to reach a smoking cessation was based on several factors, varying from individual to individual and over time. Keywords: motivation, public health problem, smoking cessation, tobacco.

Worldwide there is concern about the increase in the level of deaths due to coronary heart disease. In accordance with this global picture, coronary heart disease in South Africa signifies a key health problem. Type D Personality (or distressed personality) was developed as an emerging psychological risk factor in coronary heart disease. It is associated with an adverse prognosis, impaired health status, and a wide range of emotional distress symptoms, such as depression. Type D is defined as the tendency to experience increased negative distress such as anxiety, paired with the inhibition of these emotions in social interactions. Hence this exploratory pilot study aimed to determine the relationship between Type D Personality and coronary heart disease. In addition, this research aimed to observe prevalence rates of Type D Personality and coronary heart disease in a group of patients at the Steve Biko Academic Hospital diabetic clinic. A non-probability convenience sample of 104 Caucasian and Black, Afrikaans and English speaking diabetic patients were approached to be participants. Their ages ranged from 55 to 87 and their socio-economic status ranged from low to high. The Type D Scale–14 and a demographic questionnaire were used to assess for Type D Personality and coronary heart disease, respectively. Due to under reporting of coronary heart disease patients and the added possible confounding variable of a diagnosis of diabetes, the findings from this research indicate that no statistically significant results were found. However, 41.4% of participants could be classified as Type D. Interestingly, although 41.4% of participants were classified as Type D, 68.9% were classified as positive for Negative Affectivity. Of the total sample of 104 respondents, 35.6% tested positive for coronary heart disease and 92.3% for hypertension. Only 18.3% of the 104 respondents tested positive for both coronary heart disease and Type D. A total of 38.5% of the participants tested positive for hypertension and Type D. / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

Magister Curationis - MCur / Psychiatric nurses are known for their person-centred care approach that offers help through a therapeutic communication approach. In South African nursing, a Professional Nurse is a nurse whose role include but not limited to conducting a comprehensive and holistic health assessment on clients of all age groups, with complex health problems, determines the health needs of the community, early detection, diagnosis, treatment and appropriate referral to higher levels of care.

In the past decades, Sweden’s asylum policy known for its humanitarianism has taken a significant turn toward restrictiveness. In 2016 a temporary law was introduced in Sweden to restrict asylum seekers in reaction to the refugee crisis 2015. The group that has been hit hard by this law is the unaccompanied young refugees. In 2018 another temporary law referred to as the Upper Secondary School Act was enforced to allow certain unaccompanied young refugees to complete their upper secondary education studies. Those young refugees who received temporary resident permits may only extend his or her resident permit if he or she finds a permanent employment within six months after graduation from the second upper school. The purpose of this study is to gain an understanding of how the Upper Secondary School Act affects the lives of those young refugees, and how those young people orientate themselves in their everyday lives to live up to the law’s requirement. The study’s data has been gathered through a qualitative research method and six interviews are conducted with six young refugees affected by the Upper Secondary School Act. The study’s theoretical approach is based on orientation/disorientation, deserving, SOC(a sense of  Coherence) and human capital theory. The study shows that the Upper secondary school Act has led to negative consequences for those unaccompanied young refugees due to the law’s difficult requirement. It causes stress, mental problems and disorientation for the young refugees. The study also shows that the young refugees worked very hard to navigate the uncertainty in their lives, to fulfil the law’s requirement and claim for belonging in Sweden.  The study concludes that the political context shapes the lives of young refugees.

Protein Energy Malnutrition (PEM) due to under nutrition is a major public health problem among children in Africa and other developing countries. Sorghum and bread wheat, which are important dietary staples in the semi-arid tropics of Africa, are suitable vehicles for delivering proteins to alleviate PEM. Formulation of foods from these low-lysine staples fortified with legumes is a sustainable approach to improve the protein nutritional quality of foods for young children. Biscuits offer a valuable vehicle for fortification as they are nutrient dense, ready-to-eat, have a long shelf-life and are popular. Therefore, this study investigated the effect of complementing sorghum and bread wheat with defatted soy flour on the nutritional and sensory quality and consumer acceptability of biscuits. Biscuits were formulated and developed by compositing sorghum and bread wheat flours with defatted soy flour at different ratios. To establish the nutritional characteristics of biscuits, proximate composition, lysine and reactive lysine contents and in vitro protein digestibility were determined. Protein Efficiency Ratio (PER), Food Efficiency Ratio (FER) True Digestibility and Biological Value (BV) of sorghum biscuits were determined using Sprague Dowley weanling male rats. The sensory characteristics of biscuits were evaluated using a descriptive panel and instrumental texture analysis. Acceptability was evaluated using eight to nine year old school children. Compared to the 100% cereal biscuits, sorghum-soy and bread wheat-soy composite biscuits in a 1:1 ratio had at least double the protein, mineral and crude fibre contents. The lysine contents of biscuits increased by 500-700%. For the sorghum-soy biscuits, in vitro protein digestibility increased by 170% and Protein Digestibility Corrected Amino Acid Score (PDCAAS) was 8 times higher. Two such biscuits of 28 g each could provide 50% of the recommended daily protein intake for 3 to 10 year olds. In the animal study, PER and FER for sorghum-soy biscuits were equivalent to the reference casein. True Digestibility was high for all diets, 85 to 95% and BV of sorghum biscuits was higher than sorghum-soy diet by 20%. Principal Component Analysis (PCA) revealed that 61% and a further 33% of the variation in sensory properties was due to the type of cereal and concentration of soy in biscuits, respectively. Maximum stress increased by 39% and 34% in sorghum-soy and bread wheat-soy biscuits, respectively at 1:1 ratio. Spread factor of biscuits increased by 7 to 32%. Biscuits were darker in colour (reduced L* value) by 14 to 56% and hardness increased by 84% in sorghum biscuits. Positive hedonic scores by 8 to 9 year old school children for fortified biscuits were sustained above 80% through 8 consumption occasions. This data shows that fortifying with defatted soy flour imparts positive sensory characteristics associated with biscuits to sorghum and bread wheat biscuits and the acceptance of such biscuits may be sustained over an extended period of time. This study indicates that soy fortified sorghum and bread wheat biscuits have high nutrient density, protein quality, positive sensory properties and high acceptability if consumed over an extended period. Hence, the biscuits have great potential as protein-rich supplementary foods to alleviate PEM among children and to provide an income to small holder farmers in rural African communities through purchase of grain for the Home Grown School Feeding Programme. / Thesis (PhD)--University of Pretoria, 2010. / Food Science / unrestricted

Introduction Violence against women is one of the major social problems of our time and a violation of women's human rights. Globally, it is estimated that one out of three women are exposed to some type of violence. Extensive, consequential health problems lead women subjected to violence to seek medical treatment more frequently than women who are not subjected to violence.   Aim The aim was to describe abused women's experiences of the healthcare providers’ encounter in contact with the health and medical services. Method General literature study with an inductive approach and descriptive design. Result The women were reluctant to start conversations about violence on their own initiative, why healthcare providers became a crucial actor in violence disclosure and could, in some cases, be the only chance in identifying violence. Several women had never been asked about violence, instead they described negative experiences of medical services where healthcare providers had acted in a manner which left them feeling humiliated and insulted. A minority of the women experienced that the disclosure of violence had led to better medical care and that the healthcare providers subsequently were also able to support the women through following vulnerable medical procedures. Healthcare providers who showed understanding and empathy could contribute to a comfortable and trusting experience. The women preferred to speak to healthcare providers of their own sex, particularly nurses and midwives. Healthcare providers’ validation and terminological explanations of abuse and violence were also important to help women disclose violence. Conclusion This literature study demonstrates substantial challenges in healthcare services’ response to the patient group of women subjected to violence, in a person-centered manner.The healthcare provider plays an important role in the response of these women. More knowledge and competence is required to develop the healthcare’s response to women subjected to violence. / Introduktion Våld mot kvinnor är ett av vår tids stora samhällsproblem samt en kränkning av kvinnors mänskliga rättigheter. Globalt estimeras att en av tre kvinnor utsatts för någon typ av våld. Hälsoproblemen är omfattande vilket gör att våldsutsatta kvinnor söker vård mer frekvent än icke våldsutsatta. Syfte Syftet var att beskriva våldsutsatta kvinnors erfarenheter av vårdpersonalens bemötande i kontakt med hälso- och sjukvården. Metod  Litteraturöversikt med induktiv ansats samt deskriptiv design. Resultat Kvinnorna ville sällan själva ta initiativ till samtal om våld. Sjukvården blev därför en viktig resurs vid avslöjandet om våld och kunde i vissa fall vara den enda chansen att identifiera våld. Flertalet kvinnorna hade inte blivit tillfrågade om våld, utan beskrev istället negativa vårderfarenheter där sjukvårdspersonal agerat på ett sådant sätt att de känt sig förnedrade och kränkta. En minoritet av kvinnor tyckte att avslöjandet lett till bättre vård samt att vårdpersonal därefter kunnat hjälpa kvinnorna igenom svåra vårdsituationer. Vårdpersonal som försökt förstå och visat empati kunde skapa en bekväm och tillitsfull situation. Kvinnorna föredrog att prata med sjukvårdspersonal av samma kön, företrädelsevis sjuksköterskor samt barnmorskor. Sjukvårdspersonalens validering samt begreppsförklaring av övergrepp och våld var likaså viktiga för att hjälpa kvinnornas avslöjande. Slutsats  Av litteraturöversikten framgår att hälso- och sjukvården haft framstående svårigheter med att bemöta gruppen våldsutsatta kvinnor på ett personcentrerat sätt.Vårdpersonalen har en betydelsefull roll vid bemötande av dessa kvinnor. Ökad kunskap och kompetens behövs för att utveckla vårdpersonalens bemötande av våldsutsatta kvinnor.

BAKGRUND:  Skattepolitiken kan bidra till att människors villkor förbättras eller försämras. Detta har sällan belysts i folkhälsovetenskapen. Skattereformen 1990/91 finansierades delvis med höjda indirekta skatter. De dynamiska effekter, som utlovades inför skattereformen 1990/91, uteblev. Snart efter reformens införande visade SCB:s undersökning av levnadsförhållanden en ökad oro för familjens ekonomi hos befolkningen. SYFTE: En jämförande analys före och efter skattereformen av lättare psykisk ohälsa med en beskrivning av skattereformens effekter på typfamiljer samt reformens effekter på samhällsnivå. METOD: Litteraturstudie och analys av tillgänglig statistik från SCB. RESULTAT: Under 90-talet ökade den lättare psykiska ohälsan bland såväl yngre som medelålders. Familjer med barn med ett stort basbehov har fått ett synnerligen lågt positivt utfall av skattereformen, medan familjer utan barn, vars basbehov är ringa har fått betydligt större utfall. Åtstramningarna har gett arbetslöshet och nedskärningar framför allt i den offentliga sektorn. SLUTSATSER: Denna genomgång tyder på att det som får samhällsekonomin att fungera med många arbetstillfällen är att alla gruppers basbehov blir tillgodosedda genom skattesystemets utformning och de transferereringar som det möjliggör. I annat fall stagnerar ekonomin med arbetslöshet som följd, vilket bidrar till psykisk ohälsa. Skattepolitiken och dess konsekvenser behöver tydliggöras genom en handlingsplan för hälsa, där skattesatsen på överskottet presenteras, när basbehoven är täckta för olika grupper. Vidare behövs forskning inom området om basbehov för olika grupper i samhället och dess effekter på samhällsnivå. En åtgärd för framtiden är även att införa hälsokonsekvensbedömning inför större skatteförändringar / BACKGROUND:  Tax policy can contribute to the improvement or deteroriation of citizens'  conditions. This has rarely been the object of investigation in public health science. The tax reform of 1990/91 was financed partly by the increasing of indirect tax. Those dynamic effects of the reform, promised before its introduction, did not occur. Soon after the introduction of the reform, an investigation carried out by the Council for Official Statistics´ (SCB) reported that anxiety amongst families had increased in the matter of home economics. AIMS: An analysis comparing prior to and following the tax reform of mental health problems describing the effects on a number of family types and the effects on a civic level. METHOD: Literature study and statistics from SCB. RESULT: During the 1990ties the mental health problems of younger and middle-aged people have increased. Families with children, which have substantial basic requirements have received an extremely low positive result of the tax reform, while families without children, whose basic requirements are less substantial have received a considerably high result. As a result of the tightening, there has been increased unemployment, which has resulted in decreased expenditure particularly in the public sector. CONCLUSIONS: This investigation indicates that a functioning civic economy with low unemployment needs the basic requirements of all groups to be met. This is achieved by continuing shaping of the tax system. Otherwise economic growth decreases, unemployment increases, which in turn leads to mental health problems. Tax policy and its consequences should be included in a public health plan, in which tax percentage on the surplus are presented, when the basic requirements for all socio-groups are covered. Furthermore there is a need for further research of the basic requirements of socio-groups and their effect on a civic level. A further measure would be to include health impact assessment before the introduction of major tax reforms. / <p>ISBN 978-91-85721-46-7</p>