Background: To date, little is known about the perspectives of healthcare and social service providers on the acceptability of long-term home visiting programs serving low-income, first-time mothers within a community. The present study reports on the experiences and perspectives of community professionals who participate in program referrals or deliver auxiliary services to these mothers who are enrolled in the Nurse-Family Partnership (NFP), a targeted nurse home visitation program. Methods: The present study comprised two phases. In phase one, a secondary qualitative data analysis was conducted to analyze a purposeful sample of 24 individual interviews with healthcare and social service providers, which was part of a larger qualitative case study examining adaptations required to increase the acceptability of NFP for families and service providers in Hamilton, Ontario, Canada. In phase two, identified themes from phase one were further explored and confirmed through individual, semi-structured interviews with service providers using a qualitative descriptive approach. Findings: Healthcare and social service providers recognized the added value of NFP to existing community services for low-income, first-time mothers. The public health nurses (PHNs) who delivered the NFP intervention were perceived as playing a crucial role in connecting the first-time mothers to community services, preparing them for motherhood, and for preventing or ending the involvement of child protection services. NFP services were not perceived as interfering with the logistics of existing services being delivered; they were viewed as addressing an important service gap. Discussion: This is the first qualitative study to examine the acceptability of a home visiting intervention from the perspectives of healthcare and social service providers in a community context. The study findings have relevance for policymakers by informing the general understanding of how a new early childhood prevention program is integrated among existing community-based supports servicing low-income, first-time mothers. / Thesis / Master of Health Sciences (MSc)

The purpose of this essay is to examine how same-sex couples experience the second-parent adoption process. To assist us, we have used our questions: how do the couples describe their experiences of the adoption process? Which are the couples’ stories about the experience of contact with the involved professionals? What are the opportunities and barriers for same-sex couples to start a family? How do the couples describe their experience of reactions from the community and society, and how do they think the future will look like for same-sex couples? This study has been achieved through a qualitative approach. The empirical data is based on seven semi-structured interviews with same-sex couples or pair members that want to or have had a second-parent adoption. The theory we have used for analyzing the results is phenomenology with focus on queer theory, heteronormativity, and power. We conclude that the couples’ experiences of the second-parent adoption process is that it is a long, time-consuming, and emotionally consuming process. They question why they have to go through with an adoption process. The couples think of it only as a legal security to their child. They have experienced varying treatment in the contact with professionals. The course of action has been different for all our seven couples: home insemination in Sweden, insemination at clinic in Denmark, and surrogacy in India. One clear result is that it is more difficult for gay men to start a family than for lesbians. The couples have mostly received positive responses and a lot of support from their surroundings. Despite that, they are worried about the negative view of homosexuality that is increasing in the world.

AIM This research attempts to understand the life of the medical professionals who play a pivotal role in the Swedish healthcare system. The main aim is to assess their burnout rates and workplace environment for understanding its direct or indirect effect on their performance and society. This research also includes suggestions and ideas for improvement and solutions to certain recurring problems that were highlighted by the professionals themselves during the research questionnaire. METHOD Questionnaire responses and the qualitative method of analysis are used for this study. Proper ethics for conducting a research questionnaire were followed. The demographic questionnaires took place with the help of google forms online, where doctors and medical professionals from different parts of Sweden who were willing to volunteer participated with full consent and were given the option to only answer questions that they were most comfortable with answering.RESULTSPromising results were established after the questionnaire, where the volunteering doctors were more than willing to express their working conditions, positive outcomes, and drawbacks. The final results can be divided into the following themes: work schedule, staff shortage, transport, session limitations, personal life, stress, self-accomplishment, job satisfaction, patient-care and areas of improvement. CONCLUSION This research’s findings show that there is a correlation between burnout rates and the performance of healthcare professionals, which in turn has a minor and indirect effect on society

Masters in Public Administration - MPA / The nurse qualified in the area of administration occupies a position with immense scope and potential in the profession and in society. The task of senior nursing management is a matter of balancing and reconciling the values and aims of the organisation with the values, aims and professional aspirations of the nursing staff, and of related and interdependent groups of health professionals, while creating and gaining commitment to a wider concept of the service and of the nurses role in it. The balancing and reconciling of organisational, occupational, service and educational demands with individual aspirations and expectations are delicate but essential if all available resources are to be optimally deployed. Success in the latter marks out an effective manager though it is difficult to measure this success. I believe this many sided accomplishment is vital, for surely all philosophy, education and research within nursing is valid ultimately only in its actual application to clinical practice. Professional nurses, fulfilling various degrees of administrative functions, are to be found in all areas and levels of nursing. It is upon the role of the upper echelons of Nurse Administrators (Matrons) in large, general teaching hospitals that this thesis will be focused. Acceptance of nurse leadership and thus of nurses occupying the most senior administrative posts (in nursing) generally has been the norm in South Africa. Unfortunately, this approach is not universal. In some countries such posts are held by physicians or other non-nurses. In others, nurses hold the title but do not wield the power. According to Searle this has arisen because •••• role change to meet contemporary political, socio-economic and health care strategies has not kept pace with the changing demands and activities of the Health Care system2 ••••thus leaving nurses in such cases in historically limited rather than contemporary relevant roles. The discussion and appraisal of nurse leadership has resulted in various national and international bodies affirming the importance of the development of such leadership in ·order to ensure the continuing role of nurses in administration. The World Health Organisation has, in numerous documents, emphasised the need for nurse leadership3, and, together with the International labour Organisation (1977) and the International Council of Nurses, published a statement on conditions of work and life of nursing personnel. Recommendation 1Q states •••• There should be programmes of higher nursing education to prepare nursing personnel for the highest responsibilities in direct and supportive nursing care, in the administration of nursing services, in nursing education and in research and development of the field of nursing 4

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Bakgrund: Kvinnlig könsstympning innebär helt eller delvist avlägsnade av de externa genitalierna. Detta är ett globalt hälsoproblem och omkring 200 miljoner flickor/kvinnor i världen beräknas vara könsstympade. Varje år riskerar ytterligare 3,9 miljoner flickor att utsättas för könsstympning. Ingreppet anses vara ett sätt att kontrollera sexualitet och heder hos kvinnor. Kvinnlig könsstympning kan ge allvarliga akuta och långsiktiga komplikationer och konsekvenser för individen. Syfte: Att undersöka vårdpersonals kunskap och attityder till kvinnlig könsstympning. Metod: Totalt åtta empiriska artiklar med kvantitativ metod inkluderades i denna litteraturstudie. Dessa granskades och analyserades för att sedan sammanställas. Sökningarna av artiklarna utfördes i databaserna PubMed och Cinahl. Resultat: Resultatet av litteraturstudien presenteras i tre huvudkategorier (kunskap, utbildning och attityder) varav två av dessa även har underkategorier. Kunskaps- och utbildningsnivån hos vårdpersonal visade sig vara låg och attityderna varierade. Konklusion: Vårdpersonal behöver mer kunskap och utbildning om kvinnlig könsstympning och även en förändring gällande attityder. För att dra ytterligare slutsatser behövs mer och djupare forskning om ämnet.Nyckelord: Attityd, kunskap, kvinnlig könsstympning, vårdpersonal. / Background: Female genital mutilation involves complete or partial removal of theexternal genitalia. This is a global health problem and around 200 million girls/women inthe world are estimated to be genitally mutilated. Every year another 3,9 million girls areat risk of genital mutilation. The procedure is considered a way to control women's sexuality and honor. Female genital mutilation can have serious acute and long-termcomplications and consequences for the individual. Aim: The aim was to examine the knowledge and attitudes of healthcare professionalstowards female genital mutilation. Methods: A total of eight empirical articles with quantitative method was included in thisliterature study. These were quality checked, analyzed and then compiled. The searches forthe articles were performed in the databases PubMed and Cinahl. Results: The results of the literature study are presented in three main categories(knowledge, education and attitudes), two of these also have subcategories. The level ofknowledge and education turned out to be low and the attitudes varied. Conclusion: Healthcare professionals need more knowledge and education about femalegenital mutilation and a change in attitudes is requierd. In order to be able to draw furtherconclusions, more and deeper research on the subject is needed.

Excerpt: Last fall, I sat through an uncomfortable board meeting. I was charged to work with a Clinical Social Worker, Licensed Practicing Counselor, a Counseling Psychologist, and a Licensed Nurse Practitioner to develop an integrated care training program as part of a rural workforce development project.

Suicide is the third leading cause of death among youth and young adults ages 10--24. In 2001 the U.S. Surgeon General laid out a national strategic plan to more effectively address suicide prevention (United States Public Health Service, 2001). In 2008, Gene Cash, then president of The National Association of School Psychologists, made a "call to action" to prevent suicide. Although suicide prevention has been repeatedly identified as a priority in mental health care, the vast majority of interventions with suicidal youth are not evidence based due to a lack of research utilizing controlled studies (Daniel & Goldston, 2009). Unfortunately this leaves mental health professionals (MHPs) to routinely implement interventions that are not research based and not proven effective in deterring suicidal thoughts and actions. No-suicide contracts (NSCs), commonly used in clinical and medical settings, solicit a commitment from a suicidal individual, a promise not to complete suicide. The prevalence of school-based MHPs' use of NSCs with suicidal youth (SY) is unknown. Additionally, minimal feedback is available regarding MHPs' perceptions of and current practice regarding implementation of NSCs. Likewise, school policy directing MHPs' intervention when working with SY is neither well described nor understood. A brief survey was created to access these perceptions and practices. Of 326 MHPs attending a Utah Youth Suicide Prevention Conference, 243 completed a survey (74.5% participation rate). Half of participants intervening with SY reported using NSCs. Only 27 of the 243 participants indicated that their school's policy encouraged or required a NSC. Only 8 participants reported knowledge of a formal written school policy that specifically guided their intervention with SY. Reasoning underlying decisions to use or not to use NSCs were explored. Common explanations included attending to individual student needs, following perceived guidelines, building trust with SY and adapting contracts to fit student needs, and opening discussion about suicide. Several participants expressed a need for additional training with no-suicide contracting. A few participants called for either renaming NSCs or implementing a similar, but more positive, "commitment to treatment" strategy. Participants did not mention a need for additional research to explore the efficacy of NSCs. In fact, research was not mentioned. This reflects the gap between research and practice and the dependency on personal experience and going along with the status quo versus depending on research findings to dictate improvement and change in practice.

This study aimed to examine power among professionals in preschools who work with children with Autism Spectrum Disorder (ASD). Furthermore, the study examined divisions of labor between different professionals, as well as professionals’ experiences and competence in relation to working with children with ASD. According to previous research, there are different forms of power and division of labor between different professionals working with children with ASD suggesting that the professionals who have education, competence, and knowledge in the field of ASD have the ultimate responsibility and power over the design of the work. Qualitative semi-structured interviews were used in the current study to investigate the perspectives of professionals. Eight professionals working in pre-schools were interviewed. The interviews were analyzed with interpretive phenomenological analysis to understand the participants’ individual thoughts and reflections. To interpret and discuss the results, theories of power and jurisdiction were used. The phenomenological analysis resulted in five themes: Diagnosis of ASD and professionals, Power over the identification of children with a diagnosis of ASD, Power over the design of work with children with ASD, Collaboration and division of labor, Challenges in working with children with ASD. Based on the results, the conclusions emerged that special knowledge about ASD was needed among professionals, for the children to receive a good education in preschool. Such knowledge was not acquired through preschool teacher or childcare training, but the participants gained it through courses that were specifically aimed at the area of ASD. All professionals in the present study described different positions of power in relation to working with children with ASD, and how power was manifested in preschool activities, in a way that was largely consistent with previous research. The majority of the participants in this study described that even though they had a lot of knowledge, different professionals had different amounts of power and, thus, the participants’ knowledge was not experienced as equally valuable. Especially professionals who did not have a preschool teacher diploma described that they had less power. Most believed that there were hierarchies of power based on knowledge and education; the person who was most competent and held a preschool teacher diploma was felt to be entitled to more power over the design of the work with children with ASD than other professionals were. The present study contributed with knowledge about how power is exercised by professionals, in relation to the work with children with ASD, and with knowledge about collaboration and division of labor between professionals in the work with the children.

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