This qualitative study was designed to explore the perceptions of Aboriginal professionals in various work sectors as they reflect on their educational experiences in high school and the nature of success. Questions guiding this research were: What is Aboriginal student success? What factors affect success? To what or whom do professionals attribute their successfulness? What can make others successful?<p> Prompting this study was the latest statistics about Aboriginal people released on September 24, 2003. The Aboriginal Peoples Survey was compiled by Statistics Canada in 2001. The survey stated that the number of off reserve Canadian Aboriginal students who are dropping out of school is 52%. In comparison to the Non-Aboriginal population, the overall high school dropout rate is 26%. What is alarming is that the drop out rate has not changed since the previous study in 1996.<p> Some of the research conducted has focused on finding barriers to Aboriginal students dropping out of school. Although this research assumed that if barriers can be identified, and removed they have only insignificantly decreased the dropout rate. This study gives voice to aboriginal professionals' success experiences by having them share their stories through in-depth interviews. Rather than focus on barriers, this study emphasizes positive high school experiences of Aboriginal professionals and factors that led to their success.<p> In-depth interviews were conducted initially with professionals in various work sectors that include human service sectors. A second interview was held with these professionals to clarify and further develop ideas emerging from the initial sets of interviews. Descriptive memos and reflective notes were kept throughout the process with the analysis of data following traditions of qualitative methods. The results of the study showed that the nature of success was complex, intricate, and idiosyncratic. Each participant had their own unique definition of success based upon distinct factors including a mindset, cultural orientation, spiritual connections, marginalization, and colonization. The definitions of success varied with changing variables of the participants.<p> Not surprisingly, the study related student success to the biological, social, physical and spiritual factors including Aboriginal spirituality; to external factors including culture, curriculum, instructional approaches, role models, relevant education, and relationships; and to the internal factors attitude, goal setting, motivation and inquiry.<p> In their suggestions of how others can be successful, each participant shared words of wisdom about education, stability, balance and a work ethic. The study offers teachers, parents, and students practical suggestions for increased student success and provides a list of implications produced by the study.

This study presents an account of experiences of recent immigrant women professionals in negotiating labour market opportunities after arriving in Canada. The purpose of this research is to bring in immigrant women’s perspectives on immigration and employment study. Six immigrant women professionals from different cultural backgrounds were interviewed within the framework of qualitative research. Informed by feminist theories, this study intended to make women’s experience in post-arrival integration and settlement more visible and prominent. Research findings indicate both labour market and household factors contributed to shape the labour market experience of immigrant women professionals of recent years. Their experiences reveal the complicated social relations of their doubly burdened and triply oppressed location.

Mindfulness-based wellness education (MBWE) is an 8-week program teaching formal mindfulness practices as a foundation for cultivating an awareness of one’s health or ill-health in the physical, social, emotional, ecological, vocational, mental and spiritual domains of human existence. It is designed as a health promotion intervention for individuals who are at risk of developing stress related problems, such as is the case of human services professionals. This dissertation focuses on teachers-in-training. Two groups of teacher trainees completed MBWE as part of an elective course focusing on stress and burnout. In comparison to control participants, who completed other optional courses, MBWE participants experienced improvements in mindfulness, health, and teaching self-efficacy. In one group, the intervention was also effective in reducing psychological distress and augmenting satisfaction with life. Interviews with participants after graduation revealed that although they struggled with independent mindfulness practice, they benefited from their participation in the class, which led to specific health behavior changes such as increased physical activity. Some participants reported that they relied on their mindfulness practices in times of crisis; others shared the knowledge they learned with their students and observed that this was an effective and beneficial response to the needs of their classrooms. Ideas for future inquiries include the need to explore factors influencing participants’ responses to the MBWE program and how to support on-going practice.

According to the Crohn’s and Colitis Foundation of Canada, there is approximately 1 in every 200 individuals who is living with inflammatory bowel disease (IBD). Many of those living with IBD also need to have an ostomy. The literature on the effects IBD and an ostomy has on adolescents and young adults lacks consensus. Therefore, the purpose of this phenomenological study was to try to understand the lived experiences of adolescents and young adults (N=6) living with IBD and an ostomy. Sociodemographic information was collected, and the participants were interviewed in person using a semi-structured interview guide. The work of van Manen (1990) was used as a guide for data collection, analysis and interpretation of this study. Analysis revealed the essence of the adolescents’ and young adults’ lived experience as being “Concealing and Revealing the Self”. Three themes communicate the essence of their lived experience: (a) Uneasy feelings, (b) “It’s hard…”, and (c) A renewed sense of self. The needs of the adolescents and young adults, along with their recommendations to health care providers, are addressed. The study findings inform nurses in the areas of practice, education and research. Practice recommendations include being cognizant that these individuals need holistic care that addresses their psychological, psychosocial and physical needs. This study forms the basis for future research to explore some of the themes in greater detail, as well as a recommendation for a longitudinal study. / February 2008

Aquesta tesi és un estudi al voltant de la formació MIR i l'adquisició de les competències professionals en aquest procés. Aquest model formatiu té interès pedagògic perquè encaixa perfectament amb els actuals models de formació per competències al combinar formació i treball.Es plantegen dos grans objectius: es pretén analitzar i contrastar les percepcions de tutors i residents de Catalunya al voltant de l'adquisició de competències professionals en el procés MIR dins l'especialitat de Medicina de Família i Comunitària; posteriorment, la informació obtinguda donarà pistes per suggerir propostes de millora en relació a l'adquisició de competències.Prenent com a punt de partida la hipòtesi que hi ha diferencies entre tutors i residents en les seves percepcions al voltant de l'adquisició de competències es dissenya la recerca. Es tracta d'un estudi descriptiu que combina informació quantitativa i qualitativa. Primerament es treballa amb qüestionaris per obtenir una primera opinió de tots els tutors i residents R3 de Catalunya i posteriorment amb grups focals per poder aprofundir i interpretar les dades obtingudes quantitativament. Aquest procés es fa de forma paral·lela amb tutors i residents. El qüestionari té de dues parts. La primera, consta d'una escala de 42 competències, agrupades en 10 àrees competencials (habilitats clíniques, habilitats instrumentals i habilitats de maneig, comunicació, atenció a la família, atenció a la comunitat, activitat preventiva, docència, aspectes organitzatius i recerca) sobre les que tutors i residents han d'avaluar el grau de capacitació d'aquests últims. La segona part, consta d'altres preguntes sobre la formació MIR en connexió amb aquesta adquisició de competències.Entre les dades obtingudes de forma estadística, entenent que les dades qualitatives no sempre les subscriuen, destaca que les percepcions dels tutors sobre el grau de capacitació per àrees són o molt similars o per sobre de les dels residents i en general força positives llevat de la comunitat que queda clarament "suspesa" i la docència i recerca on els residents els queda molt poc per arribar a "aprovar-se". Com a més valorades destaquen les àrees de clínica, maneig, comunicació i preventiva, mantenint-se la resta en una posició més intermèdia.En quant al model formatiu (estratègies metodològiques, avaluació formativa...) la percepció dels tutors també és més positiva que la dels residents.Per concloure , de tots els resultats obtinguts globalment i de la seva discussió, es destrien del treball algunes aportacions: - L'eix de la formació segueix sent l'assistència individual.- Les àrees competencials vinculades a una medicina més integral (família i comunitat) estan menys consolidades.- Encara s'observen dificultats per practicar una medicina centrada en la persona.- La recerca segueix sent un punt feble.- Hi ha sensibilitat vers la comunicació i el treball en equip.- Les competències es consoliden realment quan es posen en pràctica. El context té un paper fonamental. - Tutorització, autoaprenentatge i modelatge són l'eix metodològic bàsic.- Hi ha poca cultura avaluativa.- La pressió assistencial i la manca de temps entorpeixen el procés formatiu. A partir d'aquí, algunes de les propostes de millora de la formació MIR que es suggereixen són:- Millorar la qualitat docent: formació, espai per docència, reconeixement, criteris d'acreditació amb eines diverses.- Millorar la Tutorització Activa Contínua: centrar-la en el resident i augmentar-ne la freqüència a R1 i R2.- Rotar per diversos tutors de primària.- Potenciar l'aprenentatge cooperatiu.- Desenvolupar mecanismes d'avaluació contínua amb instruments senzills i manejables.- Estimular aquelles àrees que donen un caràcter diferenciador a la primària (família, comunitat, preventiva...).- Buscar el consens en zones frontereres d'actuació. / This thesis is a study of postgraduate medical training and the acquisition of professional competences in this process. This formative model is of pedagogic interest because it fits perfectly well with present training models since it combines education and work. Two great objectives are proposed. Firstly, the objective is to analyse and contrast tutors' and residents' perceptions on the acquisition of professional competences in the postgraduate training process within Family and Community Medicine; secondly, the information obtained will provide clues to suggest proposals for the improvement of acquisition of competences.Research is designed taking as starting point the hypothesis that there are differences between tutors and residents in their perceptions on the acquisition of competences. It is a descriptive study that combines quantitative and qualitative information.Firstly, work is carried out with the help of questionnaires to obtain a first opinion from all tutors and trainees in 3rd year in Catalonia, followed later on by focus groups in order to be able to deepen our understanding and to interpret the data obtained quantitatively. This process is carried out in a parallel way with tutors and residents.The questionnaire consists of two parts. First, it has a scale of 42 competencies, grouped in 10 competency areas (clinical expertise, instrumental abilities and handling abilities, communication, consideration for the family, regard for the community, preventive activity, teaching, management aspects and research) in which tutors and residents have to evaluate the degree of capacitation of the latter ones. The second part consists of other questions regarding postgraduate training in relation to this acquisition of competencies.Among the data obtained statistically, with the prior understanding that qualitative data cannot always be subscribed, we must emphasize that tutors' perceptions on the degree of capacitation in each area are either very similar to or above those of the residents, and generally quite positive except with regards to regard for the community, which is clearly "failed", and to teaching and research skills where residents are close to achieving a "pass". The most valued competency areas are clinical expertise, handling abilities, communications and preventive activity, with the other competency areas maintaining a more intermediate position. With regards to the formative model (methodological strategies, formative evaluation...), tutors' perception is also more positive than the residents' one.To conclude, of all the results obtained globally and from their discussion, some contributions are extracted:- The foundation of the formation continues to be individual attendance. - Competency areas linked to a more global medicine (family and community) are less consolidated.- Difficulties are still observed for practicing a medicine centred on the person.- Research remains a weak point.- There is sensitivity for communication and teamwork.- Competencies really consolidate themselves where they are put into practice. Context plays a crucial role.- Tutorials, self-learning and modelling constitute the basic methodological axis.- There is little evaluative culture.- The pressure on the social security system and the lack of time interrupt the formative process.The following are some of the proposals suggested to improve the postgraduate medical training: - Improve the quality of teaching: formation, teaching space, recognition, accreditation criteria with various tools.- Improve Continuous Active Tutorials: focus them on the resident and increase their frequency for R1 and R2.- Rotate between various primary health care tutors.- Enhance cooperative learning.- Develop continuous evaluation mechanisms with simple tools that are easy to handle.- Enhance those areas which give primary health care a differentiating character (family, community, preventive...).- Seek consensus in border action areas.

El naixement d'un infant és un temps de grans canvis per als pares i la família. L'impacte emocional que es produeix és gran i les reaccions emocionals dels nous pares són diverses. Neix un fill i, a la vegada, neixen uns pares. Però… els pares estan realment preparats per a començar a exercir com a tals? I què succeeix quan el nen que neix no és com esperàvem? Què passa si presenta un alteració en el desenvolupament o té risc de patir-la? Tot allò construït es trenca davant una situació inesperada i desconeguda. És per això que és fa necessària una atenció a aquests pares amb la finalitat de poder-los ajudar a iniciar-se en aquest nou rol i, conseqüentment, afavorir el desenvolupament del nen. Un nou rol que porta implícit una amalgama de sentiments, de vegades contradictoris, que cal aprendre a identificar i gestionar. En el cas de nounats que presenten algun tipus d'alteració en el seu desenvolupament o tenen risc de patir-la, sovint els pares es troben davant un abisme (per un costat hi ha el nen somiat i per l'altra, el nen real), se senten sols, desorientats, plens d'angoixa i culpabilitzant-se de la situació del seu fill. Considerem imprescindible conèixer els sentiments i emocions d‟aquests pares per tal de comprendre les seves vivències dins la unitat. D‟altra banda, esbrinar el seu grau de satisfacció permet poder introduir canvis en el funcionament i organització de la unitat per tal d‟oferir una atenció de qualitat. Creiem en la important tasca preventiva de l‟atenció neonatal i és per aquest motiu que el nostre estudi s'ubica al servei de neonatologia de l'Hospital Arnau de Vilanova de Lleida. / El nacimiento de un niño es un tiempo de grandes cambios para los padres y la familia. El impacto emocional que se produce es grande y las reacciones emocionales de los nuevos padres son varias. Nace un hijo y, a su vez, nacen unos padres. Pero… ¿los padres están realmente preparados para empezar a ejercer como tales? Y ¿qué sucede cuando el niño que nace no es como esperábamos? ¿Qué pasa si presenta una alteración en el desarrollo o tiene el riesgo de padecerla? Todo aquello construido se rompe ante una situación inesperada y desconocida. Por ello es tan necesaria una atención a estos padres con la finalidad de poderlos ayudar a iniciarse en este nuevo rol y, en consecuencia, favorecer el desarrollo del niño. Un nuevo rol que lleva implícito una mezcla de sentimientos, a veces contradictorios, que hay que aprender a identificar y gestionar. En el caso de neonatos que presentan algún tipo de alteración en su desarrollo o tienen riesgo de padecerla, a menudo los padres se encuentran ante un abismo (por un lado está el niño soñado y por el otro, el niño real), se sienten solos, desorientados, llenos de angustia y culpabilizándose de la situación de su hijo. Consideramos imprescindible conocer los sentimientos y emociones de estos padres para poder comprender sus vivencias dentro de la unidad. Por otro lado, saber su grado de satisfacción permite poder introducir cambios en el funcionamiento y la organización de la unidad con el fin de ofrecer una atención de calidad. Creemos en la importante tasca preventiva de la atención neonatal y es peor ello que nuestro estudio se ubica en el servicio de neonatología del Hospital Arnau de Vilanova de Lleida. / The birth of a child is a moment of big changes for parents and family. The emotional impact that is produced is big and the emotional reactions of new parents are diverse. A son is born and, at the same time, parents are born. But... are parents enough prepared to start exercising as such? And what does happen when the born baby is not such as we expected? What does happen if he/she presents an alteration in his/her development or he/she has a risk of suffering it? All that was built breaks in front of an unexpected and unknown situation. That‟s why an attention to these parents is needed in order to help them to start in this new role and, consequently, favour the child development. A new role that involves an amalgam of feelings, sometimes mixed, that need to learn to identify and manage. In the case of newborn babies that present some type of alteration in their development or have a risk of suffering it, usually parents face an abyss (on the one hand there is the dreamt child and, on the other hand, the real child), usually they feel lonely, disorientated and anxious and they blame on themselves for the situation of their child. We consider necessary to know these parents‟ feeling and their emotions in order to understand their experience in the unit. Otherwise, knowing their grade of satisfaction allows to introduce changes in the operation and organisation of the unit to offer a quality care. We believe in the important preventive task of neonatal attention and that is why our study is placed in the neonatal unit of Arnau de Vilanova Hospital from Lleida.

This thesis uses a critical medical anthropology approach to explore healthcare professionals’ perspectives of Hansen’s disease (HD) patients’ treatment-seeking experiences in the United States. During semi-structured interviews my eight informants discussed challenges patients face when seeking treatment. The number one challenge discussed was that of knowledge gaps among healthcare professionals which influence misconceptions of HD being highly contagious and dangerous. Such misconceptions negatively influence patients’ treatment from start to finish. My informants discussed their understandings of, and roles in minimizing challenges for their patients.

Yrkeslärare har som uppgift att arbeta med att förmedla sin kunskap om branschen så att elever ges möjlighet att utföra hantverket. De har också en pedagogisk roll för att kunna lära ut och undervisa i hantverket. Programmålen betonar aspekter som handlar om förmåga att kunna utföra yrket. Hur hanterar yrkeslärarna sina dubbla yrkesroller, upplever de att de har dubbla yrkesroller? Studiens syfte är att undersöka vilka kompetenser yrkeslärare i Hotell – och restaurangprogrammet upplever betydelsefulla för att bli en professionell yrkeslärare. Detta är en intervjustudie där jag valt att intervjua tre yrkeslärare inom Hotell – och restaurangprogrammet. Resultatet pekar på att vara yrkeslärare innebär att ha kompetens inom två yrkesområden, dels branschkompetens, dels den pedagogiska yrkeskompetensen. De tre första aspekterna som lärarna betonar har koppling till branschen, och handlar om vikten av grundkunskaper och yrkeslivserfarenhet, att vara stresstålig problemlösare samt nyfikenhet och intresse för egen utveckling inom yrket. De två övriga är mer relaterade till den pedagogiska uppgiften och handlar om att vara flexibel och väl förberedd samt betydelsen av god elev- och föräldrakontakt. Samtidigt kan konstateras att dessa kompetenser också överlappar varandra, enligt analysen av deras utsagor. De upplever inte att de har dubbla roller, de upplever att det är en roll att vara yrkeslärare med dubbla och breda kompetensområden. / Instructors who have to deal with sharing her knowledge of the industry so that students are enabled to perform the craft. They also have an educational role to teach and instruct in the craft. Program goals emphasize aspects is the ability to carry out the profession. How to deal with professional teachers of their dual roles, they feel that they have dual roles? Purpose of this study is to examine what skills trainers in the hotel - and restaurant program is experiencing significant to become a professional instructors. This is an interview where I chose to interview three instructors in the hotel - and restaurant program. The results indicate that as instructors is to have expertise in two professions, and industry expertise, and teaching vocational skills. The first three aspects of teacher stress has been linked to the industry, and about the importance of basic skills and work experience, to be stress problem solver as well as curiosity and interest in own professional development. The other two are more related to the educational challenge and about being flexible and well-prepared and the importance of good student and parental contact. At the same time be noted that these competencies also overlap, according to the analysis of their evidence. They do not feel that they have dual roles, they feel that there is a role to be instructors of dual and wide areas of expertise.

Bakgrund: Cirka 70 % av alla kvinnor i världen har någon gång blivit utsatta för våld. Forskning visade att det fanns en rädsla hos vårdpersonalen för att ta upp problemet med kvinnorna. Vårdpersonal har ett ansvar när det gäller att upptäcka och identifiera våldet som kvinnan upplevt. Syfte: Syftet var att belysa fysiskt våldsutsatta kvinnors upplevelser av vad som kännetecknar en god vårdrelation. Metod: Studien genomfördes som en allmän litteraturstudie, detta med hjälp av 11 vetenskapliga artiklar. Resultat: Huvudfynden var en bekräftande dialog, en förtroende och tillitskapande relation och ett professionellt bemötande. Slutsats: Vårdpersonal bör visa respekt för de våldsutsatta kvinnorna och även vara goda lyssnare. Kroppsspråket kan visa om en person verkligen tycker det den säger. Som vårdpersonal är det därför viktigt att tänka ut vart man själv står i frågan om våldsproblemet, så att man kan lägga det åt sidan och ge sin patient den optimala vård som behövs. Varje möte med en patient ger möjlighet att lära känna denne bättre, på så vis kan individuell omvårdnad ges. / Background: About 70% of all women in the world have sometimes been the victims of violence. Research has shown that health professionals are afraid of asking about the violence. Health professionals have a responsibility when it comes to detecting and identifying violence against the women. Aim: The aim of this study was to illustrate physically battered women's experiences of what characterizes a good health care relationship. Method: The study was conducted as a general literature review, this with the help of 11 scientific articles. Result: The main findings were a confirmation dialog, a confidence and trust-building relationship and a professional approach. Conclusion: Clinicians should show respect for battered women and also be good listeners. Body language can show if a person really mean what he/she says. As health professionals, it is important to figure out where you self stands on the issue of violence, so you can put it aside and give the patient the optimal care that is needed. Every meeting with a patient creates an opportunity to get to know her better. In this way an individual care can be given.

Syftet med denna studie var att undersöka vårdpersonals (N=108) attityder gentemot personer med psykisk ohälsa samt se om skillnader i attityder fanns beroende på respondenternas utbildningsnivå och tidigare erfarenhet av psykisk ohälsa. Studien är en delstudie ur projekt Psykisk Ohälsa som har en prospektiv longitudinell design. För att beskriva attityder gentemot personer med psykisk ohälsa användes frågeformuläret Community Attitudes Towards Mental Illness (CAMI-s). Rekrytering av vårdpersonal skedde via enhetscheferna på ett 70-tal psykiatriska avdelningar och vårdpersonal som dagligen arbetar med människor med psykisk ohälsa tillfrågades om att delta. Resultatet visar inga signifikanta skillnader i attityder mellan olika (yrkesgrupper) utbildningsnivåer och statistisk signifikans återfanns endast vid ett påstående, där respondenterna tog ställning till om det bästa sättet att omhänderta människor med psykisk sjukdom var att låsa in dem. Inga skillnader i attityd upptäcktes beroende på erfarenhet av psykisk ohälsa. Slutsatsen av denna studie visar en övervägande positiv attityd bland vårdpersonal gentemot personer med psykisk ohälsa. Studien visar även, om än i mindre utsträckning än i de artiklar vi jämfört med, att det fortfarande finns tendenser till stigmatiserande och diskriminerande attityder till personer med psykisk ohälsa kvar bland vårdpersonal. / The aim of this study was to examine health professionals’ (N=108) attitudes towards people with mental illness as well as differences in attitudes depending on the respondents level of education and previously experiences of mental illness. The study is a part of the project “Psykisk Ohälsa” that has a prospective longitudinal design. To measure attitudes towards people with mental illness the questionnaire Community Attitudes Towards Mental Illness (CAMI-s) was used. Recruitment of health professionals was made with help from the unit directors on 70 different psychiatric wards and health professionals that worked with people with mental illness on a daily basis was asked to participate. The result shows only minor differences in attitudes towards people with mental illness between different education levels.  Statistical significance differences between education level groups, was only found in one claim, where the respondents took a standpoint if the best way to manage people with mental illness was to keep them locked in. Results showed no differences in attitudes depending on experiences of mental illness. The conclusion of this study shows a predominantly positive attitude among health professionals towards people with mental illness. The study also shows, though to a lesser extent, that there are still tendencies to stigmatization and discriminating attitudes towards people with mental illness among health professionals.