Children are among those most directly affected by food insecurity, a condition in which households lack access to adequate food because of money or other resources (Gundersen & Ziliak, 2015). According to the latest United States Department of Agriculture (2016) reporting, 1 in 5 children experiences hunger on a daily basis. That ratio increases for African American and Latino children whom experience 1 in 3 ratios. While many programs exist to address this growing problem among youth and impoverished families, the efficacy of those programs is yet to be determined and the problem of hunger in America persists. This qualitative research study utilized an innovative methodological approach to explore youth food justice narratives from two cross-town middle schools in Kentucky. Through the use of photos, students identified several factors that influence their ability to meet their food needs and areas of inequity within their community. Strategies were provided for policymakers and educators to address these issues.

Public school educators strive to address a variety of student needs. Factors such as poverty, trauma, Limited English Proficiency, and the presence or risk of disabilities contribute to students' learning profiles and require educators to rely on the best practices of an interwoven network of specialists so that they can meet these needs. Utilizing a Participatory Action Research (PAR) approach, aimed at fostering school improvement and collaborative research, this study paints an in-depth, holistic cultural portrait of a diverse PreK-5 elementary school in the mountains of northern New England. The lead researcher collaborated with the leadership of the school with the goal of creating a more inclusive learning environment. The school studied is unique in that the arts are used as a vehicle for instruction and inclusion of students from diverse backgrounds, including students with disabilities. The study weaves together feminism, ethnography, arts integration, and disability studies to explore the potential multiple benefits of arts-based instruction and a social skills curriculum for meeting the needs of diverse learners. Through interviews, observations, document review, and reflective journaling, the study collaboratively explores the beliefs and practices of three interrelated micro-cultures within the school: school leaders, classroom teachers, and parents. This study -- conducted over the course of one school year -- provides a snapshot of how one unique school community worked to create an inclusive learning environment through arts integration and a social skills curriculum. Additionally, it documents the benefits and challenges of a PAR approach to supporting and sustaining school-wide change.

The present study aimed to investigate a locally-driven action research project to improve connections between Spanish-speaking Latinx parents and the high school that their children attend. Using Participatory Action Research (PAR), the study sought to create a collaborative research agenda that would empower the participants to study their own culture and practices at the school, and how the two combined to create a home-school partnership. Six parents and two members of the school’s bilingual staff comprised the PAR team, with a total of nine members including the principal investigator. The project began with the creation of a public sphere in which all members of the PAR team were encouraged to freely contribute to the design and implementation of the research project. Focus group recordings were reviewed and interpreted by two members of the PAR team in the original language of Spanish, and Spanish documents and resources were made to provide easy access to information requested by the team. In this study, I did not attempt to create generalizable knowledge about any culture. Results indicated that the parent participants’ priorities differed from those initially defined before recruitment, and that parents were comfortable enough to express differing views in the public sphere. The project was reported to be helpful to the parents, and the school administration agreed to incorporate the results of the project into a parent outreach project for the coming year. Implications for research and practice are discussed.

<p><strong>Bakgrund:</strong> Demens är ett sjukdomstillstånd som innebär en bestående nedsättning av kognitiva funktioner. Därför behöver personer med demenssjukdom och närstående stöd för att klara vardagen bättre. <strong>Syfte:</strong> Syftet var att tillsammans med en personalgrupp vid en dagsjukvårdsenhet utarbeta ett underlag för en kommande utvärdering av ett projekt vars syfte var att ge stöd i relationen mellan personer med demenssjukdom och deras närstående. <strong>Metod:</strong> Studien genomfördes med deltagarbaserad aktionsforskning med en fokusgruppsintervju och en enskild intervju. Deltagarna var en personalgrupp på en dagsjukvårdsenhet. <strong>Resultat:</strong> Dagsjukvårdsenheten önskade stödja relationen mellan personer med demenssjukdom och deras närstående. Stödet planeras genomföras vid fem tillfällen under fem veckor. Dessa fem tillfällen har olika teman som handlar om hur paren kan hantera vardagen på ett annat sätt. Genom dessa tillfällen har dagsjukvårdsenheten som mål att exempelvis underlätta vardagen för paren. <strong>Diskussion:</strong> Ett av de centrala fynden var att personer med demenssjukdom och deras närstående behöver både individuellt och gemensamt stöd i relationen. Ett annat fynd var att personalguppen är av den åsikten att vardagen kan underlättas om paren får ta del av andras erfarenheter. En samordnad stödform mellan kommun och landsting kan underlätta för att kunna ge bästa stöd till personer med demenssjukdom tillsammans med närstående.</p> / <p><strong>Background:</strong> Dementia is a disease which involves a permanent reduction of cognitive functions. Therefore people with dementia and their relatives need support to cope with problems in the daily life. <strong>Aim:</strong> The aim was to work with personnel at a day care unit to prepare a basis for a future evaluation of a project which purpose was to provide support in the relationship between people with dementia and their relatives. <strong>Method:</strong> The study was conducted as participatory action research with a focus group interview and an individual interview. Participants were personnel at the day care unit. <strong>Results:</strong> The day care unit wished to support the relationship between people with dementia and their relatives. The support was planned to be done at five occasions during five weeks. These five occasions have different themes which are about how the couples could handle the everyday life in a different way. Through these occasions the day care unit has as a goal for example to simplify everyday life for the couples. <strong>Discussion:</strong> One of the key findings was that people with dementia and their relatives need, both individually and jointly, support in the relationship. Another finding was that the personnel group is of the opinion that life can be facilitated if the couples may take part of other’s experiences. A coordinated assistance between municipalities and county councils can help to provide the best support for people with dementia together with their relatives.</p>

Forskningsresultat når inte alltid ut i vården till patienter och kliniskt verksam personal. Detta kan leda till att den vetenskapliga grund, som vården enligt svensk lagstiftning ska vila på, inte erbjuds. Anledningen till att vetenskapligt belagd kunskap inte når ut kan vara til lexempel avsaknad av kunskap om hur forskningsresultat sprids och om hur resultat kan omsättas till den egna verksamheten. Ett omfattande forskningsfält inom omvårdnad rör samtal, kommunikation och reflektion kopplat till relationen mellan vårdpersonal och patient. Reflektion bör ses som en central företeelse inom vården dels för att förstå patienten dels för att förändring skall komma till stånd. Reflektioner inom ramen för ett aktionsforskningsprojekt torde leda till förändringar i relation till vårdpersonals förståelse och attityder till patienten. Syftet med studien var att undersöka om förändringar sker i personals syn på sig själv och på patienten i samband med att de deltog i ett aktionsforskningsbaseratutvecklingsarbete. Fokus för utvecklingsarbetet var bedömning av patienters smärta. Studien är kvalitativ. Data har inhämtats i samband med fokusgruppsamtal, transkriberats och analyserats utifrån en hermeneutisk analysmetod. Följande tre huvudteman framkom vid analysarbetet; patienten blir en person; professionell identitet blir tydligare; teamanda förstärks. Innebörderna i dessa tre teman tolkas i relation till teorier om personcentrerad vård och transition. Deltagarbaserad aktionsforskning kan vara ett sätt att öka användning av forskning och omsätta den nya kunskapen till egen handling. I studien gav deltagarna uttryck för att deras arbete resulterade i ett förändrat arbete med smärta och smärtbedömning mot en patientnärmre vård. / Research results do not always reach out in care to patients and clinically active personnel. This can lead to the result that the scientific basis, as health care, according to Swedish law must rest upon are not offered. The reason that scientifically knowledge does not reach out can be such a lack of knowledge about how research is disseminated and how the results can be translated into its own practice. An extensive field of research in nursing relates conversation, communication and reflection related to the relationship between health professionals and patients. Reflection should be seen as a central phenomenon in health care to gain new understanding and lead to develop and change. Reflection in the context of anaction research project should lead to changes in relation to health professionals understanding and attitudes to the patient. The purpose of this study was to investigate whether changes occur in the staff´s view of oneself and the patient in an action research basedproject. Focus of the development project was the assessment of patients' pain. The study is qualitative. Data have been collected during focusgroup, transcribed and analyzed based on a hermeneutic method of analysis. Three main themes emerged from the analysis:the patient becomes a person, professional identity becomes clearer, team spirit is strengthened. Meanings of these three themes interpreted in relation to theories of personcentered care and transition. Participatory action research can be a way to increase the use of research and translate new knowledge to its own practice. In the study, participants expressed that their work resulted in a changed work with pain and pain assessment.

Therapeutic relationships were explored using participatory action research in recreation therapy at Sunnybrook Health Sciences Centre (SHSC). The 22 recreation therapists at SHSC comprised the research team and were actively involved throughout the research process; they determined the research questions, the research process, and engaged in data collection and data analysis. This study explored how recreation therapists understood their therapeutic relationships, how different waves of influences were negotiated and philosophies of care that emerged in their therapeutic relationships. At first glance, therapeutic relationships were understood as meaningful connections and shared experiences that developed over time between a recreation therapist and individual receiving care. Later on, therapeutic relationships emerged as a complex process with welcoming, continuing and closing phases. Positive therapeutic relationships were defined by qualities such as caring, trust, respect, and non-judgment for everyone involved. Therapeutic relationships were also influenced by the organizational context, unit specific cultures, family, and staff members and recreation therapists continually negotiated the expectations, power and boundaries of these influences within their therapeutic relationships. The recreation therapists also discussed the different roles, they and the individuals receiving care could engage in during their therapeutic relationships ranging from the traditional, contemporary or controversial. Findings revealed that recreation therapists’ practices were predominantly influenced by person-centered care philosophies, although the biomedical model and relationship-centred care philosophies were also apparent. The practice of being in the moment emerged as a means of enhancing therapeutic relationships, whereas self-reflective practice assisted the recreation therapists to negotiate different waves of influence on their therapeutic relationships.

With the aging of our population and the higher risk of chronic illness and disability with age, more and more family members may be faced with the experience of having a relative transition into a long-term care (LTC) home. This reality necessitates greater understanding of family care partner needs to ensure wellness throughout their caring career. Using participatory action research, notions of wellness were explored for family partners in care with relatives residing in LTC homes. Using two LTC homes from a privately owned company called Specialty Care, ten family members were interviewed, followed by one focus group at each of the two LTC homes. Three major themes were revealed, each with several sub themes: (1) understanding wellness amidst challenges to keep a sense of wellness in life; (2) self-appraisal: becoming aware of personal beliefs and perceptions that influence wellness; and (3) assessing LTC homes and their influence on the experience of wellness. We not only revealed more about wellness and how it is experienced in the caring context, we also discovered leisure’s role in maintaining wellness and how embedded leisure’s influence is on the various aspects of wellness that family partners in care experience. Relationship-centred care is a framework we used to guide this study. It highlights the importance of family member needs, along with the needs of the residents and staff. With our enhanced understanding of family care partner needs, recommendations were made to the Specialty Care communities so they can work together to ensure optimal wellness is maintained for all parties, including family partners in care.

Bakgrund: Demens är ett sjukdomstillstånd som innebär en bestående nedsättning av kognitiva funktioner. Därför behöver personer med demenssjukdom och närstående stöd för att klara vardagen bättre. Syfte: Syftet var att tillsammans med en personalgrupp vid en dagsjukvårdsenhet utarbeta ett underlag för en kommande utvärdering av ett projekt vars syfte var att ge stöd i relationen mellan personer med demenssjukdom och deras närstående. Metod: Studien genomfördes med deltagarbaserad aktionsforskning med en fokusgruppsintervju och en enskild intervju. Deltagarna var en personalgrupp på en dagsjukvårdsenhet. Resultat: Dagsjukvårdsenheten önskade stödja relationen mellan personer med demenssjukdom och deras närstående. Stödet planeras genomföras vid fem tillfällen under fem veckor. Dessa fem tillfällen har olika teman som handlar om hur paren kan hantera vardagen på ett annat sätt. Genom dessa tillfällen har dagsjukvårdsenheten som mål att exempelvis underlätta vardagen för paren. Diskussion: Ett av de centrala fynden var att personer med demenssjukdom och deras närstående behöver både individuellt och gemensamt stöd i relationen. Ett annat fynd var att personalguppen är av den åsikten att vardagen kan underlättas om paren får ta del av andras erfarenheter. En samordnad stödform mellan kommun och landsting kan underlätta för att kunna ge bästa stöd till personer med demenssjukdom tillsammans med närstående. / Background: Dementia is a disease which involves a permanent reduction of cognitive functions. Therefore people with dementia and their relatives need support to cope with problems in the daily life. Aim: The aim was to work with personnel at a day care unit to prepare a basis for a future evaluation of a project which purpose was to provide support in the relationship between people with dementia and their relatives. Method: The study was conducted as participatory action research with a focus group interview and an individual interview. Participants were personnel at the day care unit. Results: The day care unit wished to support the relationship between people with dementia and their relatives. The support was planned to be done at five occasions during five weeks. These five occasions have different themes which are about how the couples could handle the everyday life in a different way. Through these occasions the day care unit has as a goal for example to simplify everyday life for the couples. Discussion: One of the key findings was that people with dementia and their relatives need, both individually and jointly, support in the relationship. Another finding was that the personnel group is of the opinion that life can be facilitated if the couples may take part of other’s experiences. A coordinated assistance between municipalities and county councils can help to provide the best support for people with dementia together with their relatives.

This thesis examines maternal decision-making regarding prenatal care and childbirth in the rural, north-central Andes in the province of Carhuaz. Semi-structured interviews (n=30) and participatory action research workshops (n=7) were conducted with local women to elucidate how they conceptualize, experience, and negotiate the shifting landscape of prenatal care and childbirth practices and providers. Semi-structured interviews with obstetricians, midwives, and social workers (n=9) were also conducted to compare perspectives and identify disconnects in knowledge and practices existing between these two groups in order to facilitate an open conversation on how to jointly improve the maternal experience and reduce maternal mortality and morbidity in rural Peru, where these risks are significantly higher than in urbanized, coastal areas. In the face of changing practices and the influx of biomedical ideologies, women are faced with competing and conflicting bodies of knowledge as well as varying concrete and symbolic values and consequences of their decisions, which they must navigate and evaluate in a dynamic environment. Issues of ethnic and gender discrimination and financial and social coercion arose as prominent forces structuring risks and constraining maternal agency. However, women also found ways to both resist and accommodate these challenges, demonstrating the intricate and on-going negotiations that occur throughout gestation and the maternal experience. The results of this investigation illustrate the various and nuanced ways in which macro-level maternal health policies are manifesting on the local level and impacting the lived realities of rural, Andean women.

Therapeutic relationships were explored using participatory action research in recreation therapy at Sunnybrook Health Sciences Centre (SHSC). The 22 recreation therapists at SHSC comprised the research team and were actively involved throughout the research process; they determined the research questions, the research process, and engaged in data collection and data analysis. This study explored how recreation therapists understood their therapeutic relationships, how different waves of influences were negotiated and philosophies of care that emerged in their therapeutic relationships. At first glance, therapeutic relationships were understood as meaningful connections and shared experiences that developed over time between a recreation therapist and individual receiving care. Later on, therapeutic relationships emerged as a complex process with welcoming, continuing and closing phases. Positive therapeutic relationships were defined by qualities such as caring, trust, respect, and non-judgment for everyone involved. Therapeutic relationships were also influenced by the organizational context, unit specific cultures, family, and staff members and recreation therapists continually negotiated the expectations, power and boundaries of these influences within their therapeutic relationships. The recreation therapists also discussed the different roles, they and the individuals receiving care could engage in during their therapeutic relationships ranging from the traditional, contemporary or controversial. Findings revealed that recreation therapists’ practices were predominantly influenced by person-centered care philosophies, although the biomedical model and relationship-centred care philosophies were also apparent. The practice of being in the moment emerged as a means of enhancing therapeutic relationships, whereas self-reflective practice assisted the recreation therapists to negotiate different waves of influence on their therapeutic relationships.