<p>The aim of this qualitative study was to explore experiences of malaria and attitudes to malaria prevention among nurses from Tanzania. Eleven nurses from three hospitals in northern Tanzania were interviewed. The analysis resulted in following categories: <em>The m</em><em>alaria situation was so severe at that time, Being both nurse and parent, Hindrances in the battle, Sharing knowledge </em>and<em> There is a change. </em>Ten out of eleven nurses had had malaria and all of them had been treated with anti-malarial drugs and many of them still had malaria regularly. They remembered times when the malaria situation was worse and the disease killed many more people. Having children resulted in constant worry. Being a nurse had advantages because they lived close to the hospitals so they could initiate early treatment and because they could afford to take preventive measures. Hindrances in the battle against malaria were other people’s lack of knowledge, poverty and difficulty to change lifestyle and environmental conditions. They were proud to be nurses and knowledge was their strength. There were geographical differences in how much hope they had for the future. The nurses in Zanzibar were the most optimistic. The nurses supported the governmental actions against malaria.</p> / <p>Syftet med denna kvalitativa studie var att undersöka vilka upplevelser sjuksköterskor från Tanzania hade av malaria och deras attityder till malariaförebyggande åtgärder. Elva sjuksköterskor från tre sjukhus i norra Tanzania intervjuades. Analysen resulterade i följande kategorier: <em>Malariasituationen var så allvarlig på den tiden, Att vara sjuksköterska och förälder, Hinder i kampen, Att dela kunskap </em>och<em> Det har blivit en förändring.</em> Tio av de elva sjuksköterskorna hade haft malaria och alla hade fått malariabehandling och flera av dem hade fortfarande malaria regelbundet. De hade minnen från när malariasituationen var värre och många fler människor dog av sjukdomen. Att vara förälder innebar konstant oro. Att vara sjuksköterska hade fördelar eftersom de bodde nära sjukhusen och därför kunde inleda snabb behandling och för att de hade råd att genomföra förebyggande åtgärder. Hinder i kampen mot malaria var andra människors okunskap, fattigdom och svårigheter att förändra livsstil. De var stolta över att vara sjuksköterskor och kunskap var deras styrka. Det fanns geografiska skillnader när det gällde deras framtidstro. Sjuksköterskorna på Zanzibar var de mest hoppfulla. Sjuksköterskorna stödde de statliga insatserna mot malaria.</p>

The aim of this qualitative study was to explore experiences of malaria and attitudes to malaria prevention among nurses from Tanzania. Eleven nurses from three hospitals in northern Tanzania were interviewed. The analysis resulted in following categories: The malaria situation was so severe at that time, Being both nurse and parent, Hindrances in the battle, Sharing knowledge and There is a change. Ten out of eleven nurses had had malaria and all of them had been treated with anti-malarial drugs and many of them still had malaria regularly. They remembered times when the malaria situation was worse and the disease killed many more people. Having children resulted in constant worry. Being a nurse had advantages because they lived close to the hospitals so they could initiate early treatment and because they could afford to take preventive measures. Hindrances in the battle against malaria were other people’s lack of knowledge, poverty and difficulty to change lifestyle and environmental conditions. They were proud to be nurses and knowledge was their strength. There were geographical differences in how much hope they had for the future. The nurses in Zanzibar were the most optimistic. The nurses supported the governmental actions against malaria. / Syftet med denna kvalitativa studie var att undersöka vilka upplevelser sjuksköterskor från Tanzania hade av malaria och deras attityder till malariaförebyggande åtgärder. Elva sjuksköterskor från tre sjukhus i norra Tanzania intervjuades. Analysen resulterade i följande kategorier: Malariasituationen var så allvarlig på den tiden, Att vara sjuksköterska och förälder, Hinder i kampen, Att dela kunskap och Det har blivit en förändring. Tio av de elva sjuksköterskorna hade haft malaria och alla hade fått malariabehandling och flera av dem hade fortfarande malaria regelbundet. De hade minnen från när malariasituationen var värre och många fler människor dog av sjukdomen. Att vara förälder innebar konstant oro. Att vara sjuksköterska hade fördelar eftersom de bodde nära sjukhusen och därför kunde inleda snabb behandling och för att de hade råd att genomföra förebyggande åtgärder. Hinder i kampen mot malaria var andra människors okunskap, fattigdom och svårigheter att förändra livsstil. De var stolta över att vara sjuksköterskor och kunskap var deras styrka. Det fanns geografiska skillnader när det gällde deras framtidstro. Sjuksköterskorna på Zanzibar var de mest hoppfulla. Sjuksköterskorna stödde de statliga insatserna mot malaria.

The ubiquitous roadblocks to university graduation have been investigated, identified, and interrogated for 7 decades, yet the mystery of retaining students to graduation continues to elude even the most prestigious universities. This researcher’s approach to increasing graduation began with the concession that increasingly, students may leave school at some point due to one or more of the retention issues that we recognize all too well—finances, illness, family problems, pregnancies, and other educational obstacles. However, leaving school does not mean that there is no going back. Student’s dropout status changes when they re-enroll in school; they take on new identities as stop-out students who forge their own nontraditional path to graduation. This work explored the lived experiences of this often-overlooked subset of university students—students who begin courses in higher education but then forgo their studies for a time before returning. These students are known in the literature as stop-out students, a cohort seldom acknowledged, studied, or desegregated from dropout statistics. An online survey was used to determine the demographics of the stop-out participants, and face-to-face, semi-structured interviews were then conducted to allow students to relate their experiences, in and out of school, in their own voices. Of particular interest was the effect of students’ perceived connections to faculty, staff, and/or administration as an influence in their decisions to return to school. The study was analyzed through the lens of care theory as a way to investigate how students’ persistence was affected by feelings of connection or caring. Only one of twelve interviewees had formed a relationship with a professor before he left school, and this relationship was maintained during his absence and renewed when he returned. The other interviewees acknowledged that they felt no specific connections to any person, office, or administration when they left. The stop-out population is one that higher education needs to acknowledge and support with targeted services. In many cases, they are only a few semesters from graduation. Rather than blocking their way when they run for the hills, we should be lighting their path back to success.

The overall aim of the thesis is to explore the determinants of General Practitioner (GP) referrals to specialist mental health services, in particular psychological therapy. Paper 1 is intended to contribute to this literature by providing a systematic review of GP and organisational factors identified as impacting on referral in previous research. According to this literature, referral to a mental health specialist was more likely if the GP does not feel that they have the 'capacity to help' and perceives 'time constraints' on how long they can spend with the patient. Referral also appeared more likely if the GP felt they had acceptable 'access to services' and if they had a close 'consultation/liaison' relationship with specialists. The theoretical and clinical implications of these findings are discussed, and gaps in the current literature identified for further research. Paper 2 describes an empirical study aimed at exploring the determinants of GP referral for psychological interventions within Primary Care Mental Health Services (PCMHS). 132 GPs completed questionnaires, including demographic information, attitudes towards mental health and its treatment and responses to short fictional case vignettes indicating their likelihood of referral to the PCMHS. Qualitative results suggested that GPs consider a range of factors in their referral decisions, including patient preference, severity of the problem, access to services and the effectiveness of the service. Alternative options considered included signposting to other services, reviewing, medication and providing advice and support. Quantitative results suggested that younger GPs reported a higher likelihood of referral, and were more likely to refer in line with guidelines. Psychological factors were not associated with referral likelihood or referral in agreement with guidelines. In line with previous research on clinician behaviour, findings of papers 1 and 2 are considered primarily in the context of the Theory of Planned Behaviour, and the utility of this model in predicting referral behaviour is evaluated throughout. A greater understanding of predictors of referral is thought to be valuable in designing clinician and service level interventions to improve the proportion of those in need who are able to access psychological therapy. Paper 3 provides a critical evaluation of the research process as a whole, including the processes involved in the literature review and empirical study. The strengths and weaknesses of both of these elements are discussed, along with an evaluation of the overall approach taken throughout the thesis. The findings of both studies are integrated and discussed in the context of current policy and proposed changes to healthcare provision. Implications for theory, clinical practice and further research are discussed.

Depuis une quarantaine d'années la place des animaux est devenue problématique et a été re-problématisée dans les sociétés occidentales contemporaines. La montée de la prise en compte sociale des intérêts des animaux, de la bienveillance à leur égard, recompose les représentations << traditionnelles » et « modernes » du monde animal. A travers l'exemple du développement des pratiques de soin par le contact animalier (Zoothérapie, Thérapie Assistée par l'Animal, Médiation Animale ... ), j'analyse les mécanismes de revalorisation de la présence animale auprès des humains. Ces pratiques contribuent à l'avènement d'un nouveau régime de compagnonnage anthropozoologique, dans lequel la bienveillance vis,à-vis de l'animal occupe une grande place. L'hypothèse de ce travail est que la reconnaissance d'une valeur thérapeutique au contact avec l'animal permet de rendre cette bienveillance légitime et d'enrôler tout un réseau d'acteurs autorisant le développement à grande échelle de ce nouveau régime relationnel. Ainsi, j'ai suivi comment la conviction selon laquelle l'interaction avec l'animal améliore une relation de soin "classique", a pu naître, être diffusée, mise à l'épreuve du travail scientifique, et s'actualiser dans des pratiques concrètes. La première partie aborde la constitution d'un champ de savoir autonome autour des questions de l'interaction avec l'animal à but thérapeutique, à travers une analyse bibliographique. La deuxième partie traite des réseaux d'acteurs qui ont promu le soin par le contact animalier,son développement, sa professionnalisation et sa standardisation. Enfin, une troisième partie décrit plus particulièrement les pratiques, en situation, à travers l'analyse d'observations ethnographiques et d'entretiens. / Since forty years, place of the animals become problematic in the contemporary western societies. The ascent of the social consideration of the interests of animals, benevolence towards them, recomposes the "traditional " and "modem" representations of the animal kingdom. Through the exemple of the development of the practices of care using animal contact (Zootherapy, Animal-Assisted Therapy) I analyze the mechanisms of revalorization of the animal presence with the buman beings. These practices contribute to the advent of a new regime of anthrozoological companionship, in which the benevolence towards the animal plays a big role. The hypothesis of this work is that the recognition of a therapeutic value in the contact with animais allows to return thisjustifiable benevolence and to enlist a whole actors' network authorizing the large-scale development of this new "relational regime." I followed how the conviction tbat interaction with the animal improves a "classic" relation of care, was born, spread, put to the test of the scientific work, and became accomplished in concrete practices. The first part approaches the constitution of a field of autonomous knowledge about interactions with animals with therapeutic purpose, through a bibliographical analysis. The second part deals with actors' networks whichh promoted the care by the animal contact, its development, its professionalization and its standardization. Finally, the third part describes more particularly the situated practices, through the analysis of ethnographicalobservations and interviews.

Educational and public narratives on the achievement outcomes of Black boys in mathematics are too often negative. Contrary to these negative narratives, however, research affirms positive outcomes for students, including Black boys, when engaged in caring teacher–student relationships (see, e.g., Bartell, 2011; Roberts, 2009; Steele, 1992). Considering the growing importance of mathematics both nationally and globally, an investigation into the benefits of such caring relationship is important. But literature specific to caring teacher−student relationships, African American male students, and mathematics teaching and learning is all but nonexistent. For this reason, I sought to uncover the definition that African American male students had of teacher care, and how, if at all, an African American male teacher might influence their perceptions of teacher care. Additionally, I was intrigued with and wished to uncover any influence an African American male teacher might have on African American male students’ attitudes toward mathematics. The purpose of this qualitative study, therefore, was to explore the influence a “successful” African American male teacher had on three African American male students’ perceptions of teacher care and their attitudes toward mathematics. This critical ethnography was guided by an intersection of an eclectic array of theoretical traditions (Stinson, 2009), including care theory (e.g., Gilligan, 1982; Noddings, 1992), critical race theory (e.g., Ladson-Billings, 1998), and culturally relevant pedagogy (e.g., Ladson-Billings, 1992). This eclectic array aligned with both the philosophical foundations of the project and the methodological procedures employed. The project used ethnographic methods—specifically, participant observations and semi-structured interviews—during data collection. Data analysis identified six overarching themes that the participants used to describe teacher care: (a) motivation, (b) culture, (c) confidence, (d) discipline, (e) concern for futures, and (f) environment. The findings of this study suggest that teachers should reconsider the ways they care for African American male students, specifically, in the mathematics classroom, and that a caring teacher–student relationship has a positive influence on African American male students’ attitudes toward mathematics as well as their descriptions and perceptions of teacher care.

Bakgrund: Den psykiatriska vården har under de senaste 100 åren utvecklats, däremot har synen på psykisk ohälsa inte följt samma process. Allmänheten ochsjukvården har idag en negativ attityd gentemot personer med psykisk ohälsa på grund av okunskap som resulterar i stigmatisering. Att dettaexisterar i sjukvården är ett problem eftersom det är det största forum dit personer med psykisk ohälsa kan vända sig för hjälp. Syfte: Attbeskriva sjuksköterskestudenters syn på patienter med psykisk ohälsa. Metod: Kvalitativ empirisk studie med semistrukturerade enkätfrågor. Datan analyserades genom kvalitativ innehållsanalys. Resultat: Det framkom två kategorieravstudenternas svar: hinder för ett gott bemötande och förutsättningar för ett gott bemötande. Det framkomattstudenterna hadeen okunskapom psykisk ohälsaoch en stigmatiserad syn som resulteradei en ojämlik vård. Slutsats: Sjuksköterskestudenterna har en idealisk bild av hur patienter med psykisk ohälsa ska bemötas men är ändå osäkra i mötet med dessa. Osäkerhetenspeglas i en otrygghet i yrkesrollen och grundas i studenternas upplevelser av okunskap kring psykisk ohälsa. Upplevelsen av otrygghet i yrkesrollen skapar brister i omvårdnaden eftersom det då hålls ett störreavstånd gentemot patienter. / Background: Over thelast 100 years the psychiatric care has been developed, but the attitudetowards mental illness has not. The public and the health care system today hasa negative attitude towards people with mental illness caused by ignorance resulting in stigma. The existence of stigma in the health caresystem is a problem because it isthe main forum where people with mental illness can turn to for help. Aim:Todescribe nursing students attitudes towards patients with mental illness. Method:Qualitative study with semi-structured questionnaires. The data was analyzed withcontent analysis. Results:The students answers resulted in two categories: Obstacles against good careand conditions for good care. It was revealed that the students had a lack of knowledge about mental illness and a stigmatized attitude which resulted in unequal care. Conclusion:The nursing students have an ideal image of how the patients with mental illness should be cared forbut they still feel insecure. This insecurity is reflected in their profession and is based on the lack of knowledge about mental illness. The feeling of insecurity is causing deficienciesin the caregiving because it creates a bigger distance towards the patients.

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Bakgrund: Hjärtsvikt är en diagnos som ökar i takt med att populationen i världen blir äldre. Patienter med hjärtsvikt kan via egenvård uppnå symtomlindring. Kommunikationen från sjukvården kring hur patienten ska uppnå en god egenvård är bristfällig.  Syfte: Syftet var att beskriva upplevelser av egenvård vid hjärtsvikt för vuxna patienter inom öppenvården. Metod: En kvalitativ litteraturöversikt med en induktiv ansats.  Resultat: I resultatet framkom fyra huvudkategorier, “Förståelse och kunskap kring egenvård”, “Behov av stöd för att utföra egenvård”, “Behov av att känna sig delaktig” och “Begränsningar i det vardagliga livet” med tillhörande subkategorier.  Slutsats: För att uppnå en god egenvård krävdes stöd från hälso-sjukvården samt anhöriga. Patienten behövde få känna sig delaktig i egenvården. Informationen kring egenvård från sjukvården ansågs bristande. / Background: Heart failure is a diagnosis that increases as the world's population ages. Patients with heart failure can achieve symptom relief through self-care. Communication from the healthcare system regarding how the patient should achieve good self-care is deficient.  Aim: The aim was to describe experiences of self-care in heart failure for adult patients in outpatient care.  Method: A qualitative literature review with an inductive approach.  Results: The result was four main categories, "Understanding and knowledge of self-care", “Need for support to carry out self-care", "Need to feel involved" and "Limitations in everyday life" with associated subheadings.  Conclusion: In order to achieve good self-care, support from health care and relatives was required. The patient needed to feel involved in self-care. Information about self-care from the healthcare system was considered insufficient.