Thesis (MA)--Stellenbosch University, 2015 / ENGLISH ABSTRACT : It has been suggested that the complex needs of children with neurodevelopmental disorders are best addressed with a family-centred approach. As this approach has been increasingly incorporated into healthcare systems over recent years, most children with disabilities are now able to remain at home as opposed to living in institutions or group homes. Many parents have thus been forced to adopt the role of a primary caregiver for their child that has been diagnosed with a disability or chronic condition. This study aimed to investigate the experiences of caregivers for children with cerebral palsy in rural communities of the Western Cape, with a specific focus on the barriers and facilitators that they encounter. An exploratory qualitative design was employed and 15 individuals (aged 27-62), who were identified as caregivers for a child with cerebral palsy through purposive sampling were interviewed. Thematic analysis was used to analyse and generate themes from the semi-structured interviews that were conducted with participants. A number of barriers to caring emerged including the personal consequences of caregiving, difficulty adjusting to caregiving duties, environmental conditions, lack of access to healthcare services, lack of respite services, and negative perceptions towards disability. Various facilitators to caring were also identified, namely personal coping methods, personal transformation, social support, relationship with one’s child, community resources, child’s crèche, and financial assistance. The five levels of the Social Ecological Model were used to conceptualise the discussion of these findings and links were made to the existing literature on the caregiver experience in the developing context. In this process it was found that participants often encountered similar barriers and facilitators to caregivers for individuals with other types of conditions, such as HIV/AIDS, autism, mental illness, cancer, and neurological disorders. This could suggest that caregivers residing in developing countries share similar experiences, regardless of the condition of the care receiver. Although participants received support from a number of sources that aided them with their caregiving duties, it is evident that they still encountered gaps in the provision of a number of important services, including lack of information from healthcare professionals, lack of community programs to reduce stress and promote empowerment, and lack of disability-friendly facilities. It is vital that caregivers have access to these services to ensure their child’s well-being as well as their own. There is thus a need to explore how these services can be made more accessible to caregivers in rural communities. / AFRIKAANSE OPSOMMING : Daar word voorgestel dat die komplekse behoeftes van kinders met neuro-ontwikkelingsversteurings die beste aangespreek word deur ‘n familie-gefokusde benadering. Aangesien hierdie benadering meer geredelik geïnkorporeer is in die gesondheidsorg sisteem oor die afgelope paar jaar is meeste kinders met gestremdhede nou in staat om by die huis te kan bly in plaas daarvan om in inrigtings of groepshuise te woon. Baie ouers is dus geforseer om die rol as primêre versorger aan te neem vir hulle kind wat gediagnoseer is met ‘n gestremdheid of kroniese toestand. Hierdie studie se doel was om die ervarings van versorgers van kinders met serebrale gestremdheid in landelike gemeenskappe van die Wes-Kaap, te ondersoek, met ‘n spesifieke fokus op die hindernisse en fasiliteerders wat hulle ondervind. ‘n Ondersoekende kwalitatiewe ontwerp is gebruik en onderhoude is gevoer met 15 individue (ouderdomme 27-62) wat deur doelgerigte steekproefneming geïdentifiseer is as versorgers van ‘n kind met serebrale gestremdheid. Tematiese analise is gebruik om die semi-gestruktureerde onderhoude wat met die deelnemers gevoer is te analiseer en temas te genereer. ‘n Aantal van die hindernisse tot versorging het na vore gekom en sluit die persoonlike gevolge van versorging, probleme om aan te pas by die versorgingspligte, omgewingstoestande, tekort aan toegang tot gesondheidsorg dienste, tekort aan verligting dienste en negatiewe persepsies teenoor gestremdhede in. Verskeie fasiliteerders tot versorging is ook geïdentifiseer, naamlik persoonlike hanteringsmetodes, persoonlike transformasie, sosiale ondersteuning, verhouding met hulle kind, gemeenskapsfasiliteerders, kind se speelskool en finansiële hulp. Die vyf vlakke van die Sosiale Ekologiese Model is gebruik om die bespreking van hierdie bevindinge te konseptualiseer en verbintenisse is gemaak met bestaande literatuur wat handel oor die versorger se ervaring in die ontwikkellende konteks. In hierdie proses is gevind dat deelnemers dikwels dieselfde hindernisse en fasiliteerders ondervind as versorgers van individue met ander tipe toestande, soos MIV/VIGS, outisme, geestesiektes, kanker en neurologiese versteurings. Dit kan moontlik beteken dat versorgers wat in ontwikkellende lande woord dieselfde ervarings deel, ten spyte van die toestand van die persoon wat die versorging ontvang. Alhoewel deelnemers ondersteuning van ʼn aantal bronne ontvang het wat hulle help met hulle versorgingspligte, is dit duidelik dat hulle steeds gapings ervaar in die voorsiening van ʼn aantal belangrike dienste, insluitende ʼn tekort aan inligting van gesondheidsorg werkers, ʼn tekort aan gemeenskapsprogramme om stres verligting en bemagtiging te bevorder en ʼn tekort aan gestremdheid-vriendelike fasiliteite. Dit is baie belangrik dat versorgers toegang het tot hierdie dienste om die welstand van hulle kind en hulself te verseker. Daar is dus ʼn behoefte om te ondersoek hoe hierdie dienste meer toegangklik gemaak kan word vir versorgers in landelike gemeenskappe.

Svenskarnas matkonsumtion är inte hållbar utifrån ett klimatperspektiv. För en mer hållbar konsumtion krävs en minskning av animaliska livsmedel. Tidigare studier visar att det är möjligt att äta klimatsmart och fortfarande nå upp till näringsrekommendationerna. Syftet med studien är att undersöka vilken klimatpåverkan och näringsinnehåll studenters matvanor har och skillnader mellan olika kosthållningar och kön. Studien har genomförts utifrån en kvantitativ ansats med en tvärsnittsdesign genom semistrukturerade intervjuer. Urvalet bestod av 21 högskolestudenter, elva män och tio kvinnor med en fördelning på sju deltagare inom varje kosthållning. Metoden som använts är retrospektiva 24-timmarsintervjuer för att få en bild av en grupps matvanor. Resultatet visar att lunch är den måltidsform med högst klimatpåverkan och näringsinnehåll. Lunch har närmare tre gånger så hög klimatpåverkan jämfört med frukost. Allätare har högst klimatpåverkan och proteinintag, medan veganer har högre kolhydrats- och energiintag samt lägst klimatpåverkan. Vegetarianer och veganer har högst intag av vitamin C. Mäns måltider bidrar med högst klimatpåverkan och de har högst intag av protein, energi och kolhydrater, medan kvinnor har ett högre intag av vitamin C. Det teoretiska perspektivet som användes för att diskutera resultatet är social-ekologiska modellen. / The food consumption of Swedish people is not sustainable from a climate perspective. For more sustainable consumption it requires a reduction of meat and dairy products. Previous studies show that it is possible to eat climate smart but still reach nutrition recommendations. The aim of this study is to investigate the students´ eating habits, nutritional content, impact on the climate, and study if there are differences between diets and between men and women. The study is based on quantitative approach with a cross sectional study through semi-structured interviews. The used method is retrospective 24-hour recall interviews to get at picture of the groups eating habits. The participants comprised of 21 students from Mälardalen University, eleven men and ten women with a distribution of seven participants in each diet. The result shows that lunch is the meal with the highest climate impact and nutritional content and that lunch has almost three times higher climate impact compared to breakfast. Individuals who eat both meat and dairy have the highest climate impact and protein intake, while vegans have the lowest climate impact and highest carbohydrate and energy intake. Vegetarians and vegans have the highest intake of vitamin C. Mens´ meals have the highest climate impact and nutritional content of protein, energy and carbohydrate, while women have a higher intake of vitamin C. The social ecological model is the theoretical perspective used to discuss the result.

This qualitative study explored the experiences of individuals living with a sibling diagnosed with Autism Spectrum Disorder (ASD) and how these individuals make meaning of this experience. The data for this study was collected from five (5) individuals between the ages of 12 and 19, who shared their experience of living with siblings diagnosed with ASD. The data was analysed using the interpretative phenomenological analysis method (IPA). I conclude that although living with a sibling diagnosed with ASD is a challenging experience, the way one makes meaning from the experience contributes greatly to their interpretation of their experience thereof; and therefore, making it a positive experience. The participants in this study showed great maturity and resilience. The findings of this study will be useful to parents, professionals and those who engage with individuals living with a sibling diagnosed with ASD. / Psychology / M.A. (Psychology in Research Consultation)

Inledning: Mäns våld mot kvinnor i nära relationer är ett utbrett folkhälsoproblem vilket hindrar utvecklingen av ett jämställt samhälle och bidrar till allvarliga hälsoproblem för många kvinnor i form av både kort- och långsiktig fysisk och psykisk ohälsa. Våldet påverkar även våldsutsatta kvinnors möjlighet till delaktighet och inflytande i samhället, vilket ytterligare gör det till en viktig folkhälsofråga. Syfte: Syftet med litteraturstudien var att beskriva riskfaktorer för mäns våld mot kvinnor nära relationer. Metod: Utifrån tjugofem vetenskapliga artiklar vilka analyserades med en tematisk analysmetod identifierades fem huvudsakliga teman: ”Uppväxtvillkor”, ”Individuella faktorer hos mannen”, ”Förhållandekontext”, ”Socioekonomiska och demografiska faktorer” samt ”Normer”. Även fyra subteman identifierades: ”Personlighetsdrag”, ”Alkohol och droger”, ”Konflikter” samt ”Graviditet och barn”. Resultat: Resultatets nyckelfynd var negativa barndomsupplevelser, impulskontroll, alkoholpåverkan, ekonomiska resurser och maskulinitetsnormer. Diskussion: Resultaten har delvis diskuterats utifrån en ekologisk modell och avslutas med implikationer och förslag på utveckling av ämnet. Litteraturstudien belyser vikten av att utveckla förebyggande och behandlande strategier på flera olika nivåer för att motverka mäns våld mot kvinnor i nära relationer. / Introduction: Men’s perpetration of intimate partner violence against women is a widespread public health problem that prevents the development of an equal society and contributes to serious health problems for many women in terms of both short and long term physical and mental health. The violence also affects the victimized women's opportunity for participation and influence in the society, which further makes it an important public health issue. Aim: The aim of the literature review was to describe risk factors for men’s perpetration of intimate partner violence against women. Methods: Based on twenty-five scientific articles analyzed by a thematic analysis method, five main themes were identified: "Conditions during childhood”, "Individual factors of the man", "Relationship context", "Socio-economic and Demographic factors" and "Standards." Four sub-themes were also identified: "Personality traits", "Alcohol and drugs", "Conflicts" and "Pregnancy and children". Results: The key findings of the results were negative childhood experiences, impulse control, alcohol impact, financial resources and masculinity standards. Discussion: The results have been discussed partly based on an ecological model and concluded with implications and suggestions on the development of the subject. The literature study highlights the importance of developing prevention and treatment strategies at several levels to counter men’s perpetration of intimate partner violence against women

Thesis (Ph. D.)--Miami University, Dept. of Botany, 2004. / Title from second page of PDF document. Includes bibliographical references.

Background: On 1 January 2020, the UNCRC was incorporated into the Swedish national law. The Convention argues that all children have the right to health, life, survival and development. The Articles of the UNCRC require higher authorities, health facilities and parents to act in the best interest of children, and to do everything to secure children’s rights. Interpreting the Convention, it is possible to conclude that all children have the right to safe and effective vaccines. Even though vaccines are accessible and free of charge to all children in Sweden, vaccination coverage for multiple vaccine-preventable diseases in Sweden has dropped. As one of the reasons for this drop in vaccination coverage is proposed vaccination hesitancy. To fulfil children’s rights as proposed in the UNCRC, vaccination hesitancy needs to be understood and addressed.  Aim: The objective of the study is to understand causes of vaccination hesitancy among parents living in Stockholm, Sweden and to examine how healthcare professionals in Stockholm County are working to eliminate vaccination hesitancy, in goal to promote children’s rights to health, life, survival and development after the UNCRC became a Swedish law on 1 January 2020. Additionally, to analyze if strategies applied by Stockholm County are truly addressing identified causes of vaccination hesitancy among parents living in Stockholm, Sweden and in that way increasing vaccination rates this year. Method: This study used a qualitative research strategy. Vaccination hesitancy in Sweden was studied using 20 semi-structured interviews with parents living in Stockholm, while effect of the UNCRC incorporation into Swedish law on vaccination hesitancy was studied using a semi-structured interview with one health professional working in Stockholm County. The gathered data was summarized, categorized and analyzed according to the proposed themes of two theories. The theoretical framework consisted of the Health Belief Model and Social-Ecological Model. Conclusion: It was possible to conclude that the choice of immunization among parents is shaped by; 1) sources and type of the received information on vaccines, vaccination and vaccine-preventable diseases included in the general Swedish child vaccination program, 2) their views on vaccine quality, safety, effectiveness and necessity for satisfying children’s rights to health, life, survival and development, 3) the level of knowledge of epidemiological concepts, mechanisms, infectious diseases and vaccines included in the vaccination program, and 4) the level of trust in the Swedish Government and healthcare, and belief if they are acting in the best interest of children. After the UNCRC incorporation into Swedish law, there have not been observed any changes in the strategic work of Stockholm County against vaccination hesitancy. For the past ten years, they are applying methods at the individual- and interpersonal level, which are not quite reaching vaccine hesitant parents living in Stockholm. Other methods at the community- and public policy level are needed. Due to unclear implications of the UNCRC entrance as a national law and COVID-19 pandemic, it is not possible to estimate if there are any changes in the vaccination rates this year.

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A higher level of education increases the chances of getting work, therefore, this can improve the socio-economic status and social position. Besides, higher education ensures improved health by providing fundamental health knowledge. Completing high school even with low grades increases the chances of getting a job, whereas, unemployment is three times more common among the students with incomplete high school education which leads to low socio-economic status and an unhealthy lifestyle in the long run. This study aims to gain a better understanding of high school students’ perspectives living in Västerås and Eskilstuna regarding meaningful leisure activities and perceived quality of education from their school which may lead to complete high school education. This study will also investigate whether there are any associations between membership in sports and perceived quality of education by adolescents at different gender and socio-economic levels. A cross-sectional study design was applied in this study. The result shows there are many available outdoor activities where the adolescents live to spend their leisure, among them parks are the most reported (314, 58%); walking and cycling paths, running track, outdoor gym and soccer field are the second most reported available opportunity (309, 56.8%) followed by the free sports activities (295, 55.9%). The most popular activities to adolescents are free sports (71, 13.2%) together with homework help at school (70, 13.1%); and more adolescents have membership in sports associations compared to other associations. Also, the study finds that adolescents who either have membership in sports or not do not make any change to the perceived quality of education by students whether they get a very good education, good education, and less than good education in high schools at different gender and self-reported socioeconomic levels. / ACTION: Actions for sustainable education and health among youth

Syftet med denna studie var att undersöka hur artiklar från två välkända svenskakvällstidningar beskriver det våld som män brukar mot kvinnor i nära relationer. Vidare har det undersökts vilka orsaksförklaringar tidningsartiklar använder för att beskriva mäns våld mot kvinnor. En kvalitativ textanalys har genomförts där resultatet har tematiserats med teoretisk ansats genom socioekologiska modellen och Socialstyrelsens definition av våld i nära relationer. Media har visat sig ha en betydande roll för människors förståelse av sociala problem. Det som beskrivs i media blir ofta människors verklighet, därför är det av betydelse att media ger en rättvis och korrekt bild av det stora och utbredda fenomen som våld i nära relationer utgör. Resultatet indikerar att fysiskt våld är den vanligast förekommande typ av våld som beskrivs av tidningsartiklar. Vidare skildrar studien att flest tidningsartiklar beskriver orsaker till mäns våld mot kvinnor med ett strukturellt perspektiv. Endast en av alla inkluderade tidningsartiklar beskriver mäns våld mot kvinnor i nära relationer genom den socioekologiska modellens alla fyra perspektiv. Modellen som i enlighet med Socialstyrelsen är av stor vikt för att få en helhetsbeskrivning av mäns våld mot kvinnor i nära relationer. / The aim of this study was to investigate how articles from two well-known Swedish evening newspapers describe the violence that men use against women in close relationships. Furthermore, the study examined which causal explanations the newspaper articles use in the descriptions of the violence. This is done through a qualitative text analysis of newspaper articles' descriptions of violence. The results of the study have been thematized with a theoretical approach through the socio-ecological model and the National Board of Health and Welfare's definition of violence in close relationships. The media has proven to play a significant role in helping people understand social issues as what is described in the media often becomes people's reality. Therefore, it is important that the media provide a fair and correct picture of the large and widespread phenomenon that violence in close relationships constitutes. The results show that physical violence is the most described violence of newspaper articles. Furthermore, most causes of men's violence against women are described by newspaper articles with a structural perspective. Only one of all included newspaper articles describes men's violence against women in close relationships through all four perspectives of the socioecological model. The model which, in accordance with the National Board of Health and Welfare, is of great importance for obtaining a comprehensive description of men's violence against women in close relationships.

<p><b>Background:</b> Shared decision-making (SDM) increases patients’ involvement in their healthcare, extending the goal of patient-centered care provision. However, SDM is underexplored in women’s reproductive health, where choices about contraception and pregnancy are frequently value and lifestyle-dependent. Furthermore, limited research exists on SDM outside of the patient-physician dyad, preventing insight into how non-physician community-based healthcare professionals (HCPs) engage women in practice. Finally, little research takes a social-ecological approach to SDM, despite interaction of multiple levels of influence in women’s reproductive healthcare decision-making. Therefore, the purpose of this study was to explore women’s and HCPs’ experiences with SDM, including the various factors associated with how women make their reproductive healthcare choices.</p><p> </p><p><b>Methods: </b>This study consisted of three distinct, but interconnected phases. Phase 1 consisted of 6 focus groups (Sept-Dec, 2019) with women aged 18-45 living in Indiana who sought community-based or private healthcare for women’s reproductive healthcare needs. Phase 2 included 20 key-informant interviews with non-physician HCPs (i.e., NP, RN, CNM, doula, pharmacist, chiropractor) living in Indiana (September 2019-May 2020) who provided community-based women’s reproductive healthcare. Focus groups and interviews were audio-recorded, transcribed, and analyzed using an expanded grounded theory framework. Constant comparative analysis identified emergent themes in both phases. Phase 3 consisted of an online survey. Women (18-45 years) living in Indiana who sought reproductive healthcare completed the survey (N=432). Multiple linear regression, chi-square analyses, and structural equation modeling were utilized to identify ecological factors associated with pregnancy and contraceptive shared decision-making.</p><p> </p><p><b>Results:</b><i> Phase 1)</i> Participants (n=22) wanted to be invited into healthcare discussions. Additionally, they wanted conversations to proceed organically, where HCPs listened to their needs, and supported and validated their choices. Though these behaviors did not always occur, they provided recommendations to enhance these experiences. Additionally, participants described quality of time was more important than quantity of time during appointments. Prior negative healthcare experiences specifically tied to HCP-interactions decreased women’s healthcare engagement. Additionally, social support system experiences were influential on women’s choices. Race also emerged as impactful toward decision-making, including Black women feeling less respected in care and making choices about their reproductive healthcare to ensure their voices were heard, such as enlisting Black doulas. <i>Phase 2)</i> HCPs noted patient-centered care was important to community-based care. They also noted the importance of contextualized decision-making approaches to ensure they could meet women’s varied needs. Results identified that outcome-oriented SDM concepts, including patient buy-in and investigative listening, were important for increasing SDM. HCPs suggested SDM improved healthcare experience beyond one visit. <i>Phase 3) </i>Structural equation modeling revealed access, social support, and patient-HCP relationship had significant relationships with contraceptive and pregnancy SDM. These models demonstrated good global and component fit, suggesting the importance of context in women’s health choices. Further, regression results demonstrated SDM was associated with higher reproductive healthcare quality. Additionally, utilizing community-based healthcare for reproductive health was associated with decreased contraceptive SDM scores.</p><p> </p><p><b>Conclusion: </b>Findings from this study provide practical considerations for extending SDM work in women’s reproductive health. In particular, results supported shifting SDM beyond the patient-physician dyad to include non-physician HCPs and HCPs in community-based healthcare settings. Women frequently access these services when seeking reproductive healthcare; thus, findings improve our understanding of the practical considerations researchers, policy-makers, and HCPs must make when promoting SDM in these settings. Furthermore, results revealed SDM use across multiple touchpoints, including community-based services, is imperative for women to achieve partnership in their healthcare. Thus, SDM provides a broader opportunity to enhance patient involvement across the spectrum of women’s reproductive healthcare. Incorporating women’s contextual needs and preferences improves HCPs’ insight into women’s experiences to further personalize care. Findings emphasize the importance of decisional space that include the various factors, agents, healthcare settings, and options that exist in reproductive health decision-making as these can shape women’s choices, and, subsequently, their SDM experiences. This mixed methods study allowed thorough insight into multiple stakeholder groups engaged in healthcare decision-making; thus, the results offer guidance on the verbiage, resources, and strategies to engage in SDM and strengthen patient involvement reflective of women’s lifestyle needs and HCPs’ existing workflow. Findings drive SDM practice into community-based healthcare and position it as the standard of care across healthcare settings.</p><br>