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A growing body of research has emphasized the prevalent mental health problems faced by the fastest-growing demographic segment of Canada’s population, older adults, in addition to their particularly low rates of mental health service use. Research has also begun to demonstrate that although older adults express a desire to be involved in their health care decision-making, they are often not given sufficient information to participate in this process. In light of low rates of service use and generally poor mental health literacy, defined as knowledge and beliefs about the recognition, prevention, and management of mental health problems, several researchers posit that older adults experience a gap in the knowledge translation of mental health information. The present research explores older adults’ pathways to mental health information and treatment. In Study 1, individual interviews were conducted with older adults who came to seek psychological treatment for mental health problems (n = 15), and analyzed according to narrative analysis. The main storylines across participants’ narratives of treatment seeking included resistance to being labeled with mental health problems, muddling through the treatment seeking process, and interpretations of psychological treatment. Findings are discussed within the context of increasing efforts to enhance clarity in the complex process of seeking treatment for mental health problems. In Study 2, older adults’ mental health information preferences and predictors of information preferences were examined in a sample of community-dwelling older adults (n = 229). Results demonstrated that despite being unfamiliar with mental health treatment options, older adults reported a strong interest in receiving detailed information concerning a variety of mental health treatment options. Family, friends, and health care providers were highly rated informational sources; and written formats and discussions with health care providers were highly rated informational formats. The most consistent predictors of mental health information preferences included attitudes toward seeking psychological treatment and social support. Findings are contextualized within the importance of increasing the mental health literacy of older adults through knowledge translation efforts. Overall, findings of this research provide clear directions for decreasing the gap in mental health knowledge translation among older adults. / October 2016

Master of Philosophy (Medicine) / Health care evaluation serves the purpose of monitoring the quality of health care provided by Health Care Providers (HCP), so that health care services can be provided most effectively and efficiently. Patient satisfaction studies are widely used to assess the quality of outpatient care. A client satisfaction study was conducted at an HIV health care facility in Sydney, Australia during 2007-2008. There were three objectives: 1.) To validate a questionnaire for future determination of client satisfaction in HIV health care facilities. 2.) To identify the levels of satisfaction of clients, and investigate any dissatisfaction and unmet needs towards HIV health care. 3.) To provide recommendations for improving client satisfaction levels in HIV health care. This research used a mixed method approach and consisted of two phases. The first phase was a quantitative survey conducted with 166 clients (both HIV positive and negative) at Albion Street Centre (ASC) using a newly-devised questionnaire. Clients were asked to answer demographic questions, rate their levels of satisfaction with each aspect and each HCP category, and provide suggestions for improvement. Quantitative statistical analysis was conducted to obtain a general view of client satisfaction levels. Dissatisfaction and unmet needs of clients were then investigated in-depth in the second phase of the research through qualitative face-to-face semi-structured interviews. Twenty-two clients (both HIV positive and negative) at ASC were interviewed individually and asked about their attitudes, perceptions, and experiences towards their HCP and the HIV health care services received. Thematic analysis was used to categorise and interpret the qualitative data. More than 90% of the clients were satisfied with most of the aspects covered in the survey, with a mean overall satisfaction score of 84 out of 100. Clients were most iii satisfied with the “technical quality” and “interpersonal manner” of the HCP, and were least satisfied with “waiting time” and “availability of HCP”. The HCP category with which the clients has the highest level of satisfaction was “nurses” (86%), followed by “psychologists” (84%), then “doctors” (83%). Clients who were HIV negative, had a full time job, visited ASC less frequently, or did not possess any type of Health Care Card were more satisfied with the services overall. No common dissatisfaction or unmet needs towards HIV health care service were identified. “Technical quality of HCP” and “the relationship with HCP” were the two most important determinants of client satisfaction, which outweighed the inconvenience contributed by the poor availability of HCP and the location of ASC. The maintenance of “confidentiality/privacy” was shown to be fundamental in HIV health care facilities. The multi-disciplinary nature of ASC increased the degree of convenience and satisfaction level among clients. Suggestions for improvement in client satisfaction levels include increasing the attractiveness of the physical environment and the variety of educational reading materials in the waiting area; introducing beverages, and encouraging clients to be involved in their treatment decisions. Health care administrative staff in particular are reminded not to neglect the importance of the availability of HCP, accessibility, and physical environment when establishing a new HIV health care facility. The mixed method approach (quantitative survey and qualitative interviews) proved beneficial. It increased the validity of the findings by assessing client satisfaction levels using more than one method. This enabled clarification of ambiguities noted in the initial survey through probes used in the interviews, and also allowed investigation of the determinants of client satisfaction through understanding their experiences in HIV health care. Future client satisfaction studies would benefit from using this approach.

Syfte: Att studera föräldrars uppfattning om den preoperativa information de får inför sitt barns planerade operation, samt undersöka om och på vilket sätt föräldrarna anser att informationen behöver förbättras. Metod: Kvantitativ, deskreptiv enkätstudie. Enkäten innehöll främst standardiserade frågor men även några öppna frågor. Föräldrar till barn i åldrarna 0-3 år inneliggande på en barnkirurgisk vårdavdelning ombads delta i studien. Antalet insamlade enkäter var 22 stycken. Resultat: Föräldrarna var som helhet nöjda med den preoperativa informationen, majoriteten ansåg att mängden information varit lagom omfattande och att informationen från personalen oftast gavs på ett sätt så att de förstod. Några föräldrar ansåg att informationen gällande det postoperativa vårdförloppet delvis varit bristfällig. De flesta ansåg att informationen de fått stämde med vårdförloppet som följde. Dock framkom att föräldrarna önskat få mer förberedande information, såväl praktisk som medicinsk tillsammans med kallelsen. Slutsats: Resultatet visar att de flesta föräldrar som helhet var nöjda med informationen de fått inför sitt barns operation med visst undantag för innehållet i kallelsen och den properativa informationen gällande det postoperativa förloppet. / Aim: To study the parent’s perception of the preoperative information they receive for their child's scheduled surgery, and examine whether and how parents believe that the information needs to be improved. Method: Quantitative Descriptive survey study. The questionnaire contained mainly standardized questions and some open questions. Parents of children aged 0-3 years hospitalized at a children's surgical ward were asked to participate in the study. The number of collected questionnaires was 22 pieces. Results: Parents were overall satisfied with the preoperative information, the majority felt that the amount of information was extensive enough and that the information from the staff is usually given in a way that they understood. Some parents felt that the information regarding the postoperative care process had partly been inadequate. Most parents felt that the information they received matched the care process that followed. However, it was found that parents wanted more preparatory information, both practical and medical, with the invitation. Conclusion: The results show that most parents as a whole were satisfied with the information they received before their child's surgery with certain exceptions for the content of the notice and the properativa information regarding the postoperative course.

Farming relies on the ecosystem services provided by biodiversity for production. Farming has been, however, responsible for habitat degradation and destruction, and consequently, biodiversity loss. At present, efforts to increase habitat on farmland are largely confined to voluntary programs. The effectiveness of the provincially delivered Agricultural Biodiversity Conservation (ABC) program was measured using a quantitative survey. Follow-up interviews during farm tours further explored qualitatively how farmers value biodiversity and biodiversity conservation on their land. Results from the survey quantitatively link ABC program participation to increased engagement in riparian management and modified harvesting activities. Qualitative results suggest that the motivation for engagement in biodiversity conservation stems from the farmers’ interest in preserving the balance between production and 'nature', thereby preserving what they perceive to be the health of their land. These results have implications for the improvement of the ABC program and of future stewardship program design.

Master of Philosophy (Medicine) / Health care evaluation serves the purpose of monitoring the quality of health care provided by Health Care Providers (HCP), so that health care services can be provided most effectively and efficiently. Patient satisfaction studies are widely used to assess the quality of outpatient care. A client satisfaction study was conducted at an HIV health care facility in Sydney, Australia during 2007-2008. There were three objectives: 1.) To validate a questionnaire for future determination of client satisfaction in HIV health care facilities. 2.) To identify the levels of satisfaction of clients, and investigate any dissatisfaction and unmet needs towards HIV health care. 3.) To provide recommendations for improving client satisfaction levels in HIV health care. This research used a mixed method approach and consisted of two phases. The first phase was a quantitative survey conducted with 166 clients (both HIV positive and negative) at Albion Street Centre (ASC) using a newly-devised questionnaire. Clients were asked to answer demographic questions, rate their levels of satisfaction with each aspect and each HCP category, and provide suggestions for improvement. Quantitative statistical analysis was conducted to obtain a general view of client satisfaction levels. Dissatisfaction and unmet needs of clients were then investigated in-depth in the second phase of the research through qualitative face-to-face semi-structured interviews. Twenty-two clients (both HIV positive and negative) at ASC were interviewed individually and asked about their attitudes, perceptions, and experiences towards their HCP and the HIV health care services received. Thematic analysis was used to categorise and interpret the qualitative data. More than 90% of the clients were satisfied with most of the aspects covered in the survey, with a mean overall satisfaction score of 84 out of 100. Clients were most iii satisfied with the “technical quality” and “interpersonal manner” of the HCP, and were least satisfied with “waiting time” and “availability of HCP”. The HCP category with which the clients has the highest level of satisfaction was “nurses” (86%), followed by “psychologists” (84%), then “doctors” (83%). Clients who were HIV negative, had a full time job, visited ASC less frequently, or did not possess any type of Health Care Card were more satisfied with the services overall. No common dissatisfaction or unmet needs towards HIV health care service were identified. “Technical quality of HCP” and “the relationship with HCP” were the two most important determinants of client satisfaction, which outweighed the inconvenience contributed by the poor availability of HCP and the location of ASC. The maintenance of “confidentiality/privacy” was shown to be fundamental in HIV health care facilities. The multi-disciplinary nature of ASC increased the degree of convenience and satisfaction level among clients. Suggestions for improvement in client satisfaction levels include increasing the attractiveness of the physical environment and the variety of educational reading materials in the waiting area; introducing beverages, and encouraging clients to be involved in their treatment decisions. Health care administrative staff in particular are reminded not to neglect the importance of the availability of HCP, accessibility, and physical environment when establishing a new HIV health care facility. The mixed method approach (quantitative survey and qualitative interviews) proved beneficial. It increased the validity of the findings by assessing client satisfaction levels using more than one method. This enabled clarification of ambiguities noted in the initial survey through probes used in the interviews, and also allowed investigation of the determinants of client satisfaction through understanding their experiences in HIV health care. Future client satisfaction studies would benefit from using this approach.

This dissertation examines state-society relationships in Turkey through the lens of efforts to promote sustainable development at the local level. To this end, it first lays out a theoretical framework to analyze the political economy of local sustainable development, for which purpose the Gramscian state theory and its applications to the political economy of the environment are deployed. The dissertation thus situates the local social-economic-environmental processes within the making of state hegemony and the uneven impacts of state behavior on the society. The dissertation employs two case studies, each based on extensive qualitative study and quantitative data from the administration of representative surveys to operationalize this framework. At both case study sites, Sultan Sazligi and Köprülü Kanyon, the Turkish state made explicit efforts to implement sustainable development through projects funded by the Global Environmental Facility, but failed to do so. In analyzing the reasons for failure, the dissertation documents how the Turkish state's hegemonic practices, interacting with local power inequalities, undercut the implementation of sustainable development. It further reveals how inequalities are perpetuated by the failure of sustainable development and how they, in turn, prove to be impediments on sustainable development implementation at the local level. The dissertation also provides a critical lens through which community-based schemes, including co-governance and participatory management, can be examined. It highlights, in particular, the role of local inequalities and anticipations shaped by the state by conducting an econometric study. It demonstrates the different channels through which exclusion from decision-making operates, impeding the democratic functioning of these institutions and undermining efforts to promote sustainable development.

The counseling profession seeks to support and enrich the quality of life of the general public by providing effective clinical services. Many counselors struggle with practicing self-care regularly, increasing the risk of burnout. When counselors provide services while experiencing burnout, they risk harming clients being served. The conservation of resources theory suggests that there is an increased risk of maladaptive coping and burnout when there is a decrease in resources used to protect someone from experiencing stress. A quantitative survey research study using a nonprobability convenience sampling was used to explore the relationship between counselor burnout, life balance, and self-compassion among fully licensed and provisionally licensed counselors throughout the United States with at least 2 years of experience (N = 331). Two canonical correlation analyses were conducted to determine (a) if there was any significant relationship between the subscales of the Juhnke-Balkin Life Balance Inventory, measuring life balance, and the Counselor Burnout Inventory (CBI), measuring burnout, and (b) if there was a significant relationship between the subscales of the CBI, measuring burnout, and the Self-Compassion Scale, measuring self-compassion. Both canonical correlation analyses indicated a statistically significant relationship. Particularly, professional counselors are experiencing poor work-life balance, decreased attention in their personal life, decreased quality of their relationships, negative work environment, and lower levels of self-compassion. The potential social change impact from this research study is that a better understanding of how to mitigate and/or prevent experiences of burnout in counselors may improve counselor’s quality of life, mitigate turnover, counselor burnout, reduce client harm, and increase the quality of clinical services.

Youths tend to spend less and less time reading, although they still consider that they would like to read more. This dilemma is particularly interesting within the teaching of the Swedish language in school since reading fiction is a vital part of the subjects’ content. Based on the result in the already done systematic literature study and the fact that Swedish school has become highly digitalized the aim of this study is to, from a student perspective, investigate whether audio books, and audio books in combination with paper books, could to any greater extent motivate upper secondary students on various programs to read fiction. Based on the essay's purpose, four questions are formulated: I. How do students rate their general motivation for reading fiction?II. How do students see how their motivation to read fiction could be improved with the help of audio books?III. What advantages and disadvantages do students see with the use of paper books, audio books or a combination of these?IV. Can any differences be discerned between students studying on different programmes, and if so which? A quantitative method is used through a digital survey where quantitative as well as qualitative questions are asked. A total of 71 students responded to the survey distributed among five different programs, the care and social care program, the social science program, the natural science program, the economics program, and the humanities program. The result shows that student’s motivation to read fiction is relatively low, especially among students studying the natural science program. Almost half of all respondents believe that paper books are the best form of reading but many of the students believe that the use of audio books could increase their motivation to read. Many students also believe that a combination of paper book and audio book can increase the motivation to read, especially among students studying the social science program. Regarding the advantages and disadvantages of different forms of reading four themes can be distinguished, advantages and disadvantages of: concentration, reading and language training, interpretation and things that concern practical circumstances. The result indicates that the preferred way of consuming books is by personal preferences since students can use the same argument for different options. The result is analyzed based on Jack Mezirow's theory of transformative learning. This theoretical framework involves an attempt to apply ten different phases for a transformative learning to the study's results. All phases are not able to be applied to the result, but the theory is still considered suitable.

Syftet med uppsatsen är att undersöka hur lojala konsumenterna på apoteksmarknaden i Katrineholm är. Eventuella samband mellan kön och lojalitetstyp samt åldersgrupp och lojalitetstyp undersöktes även. För att uppnå syftet genomfördes en kvantitativ undersökning med hjälp av enkäter, där 240 svar samlades in. Konsumenterna delades in i de fyra lojalitetstyper som tas upp i Dick och Basus lojalitetsmodell. Analysen visar att kön inte spelar in i vilken lojalitetstyp individen tillhör. Åldersgruppstillhörighet har dock en signifikant påverkan.