The membership numbers of most of the Protestant denominations in the United States have been decreasing for a number of years. Much of the research studying this phenomenon has used demographic data and surveys of former members to understand reasons for leaving. This qualitative study uses a phenomenological perspective to understand the lived experience of eight former members of the Sunrise Mennonite Church. One former leader and three current church leaders from the Sunrise Mennonite Church were also interviewed for their perspective of the costs and benefits of church membership. The findings of this study were consistent with the literature across two main themes. First, a significant attraction and benefit of church membership is the support and fellowship experienced from close friendships within the church. Relationships as a whole are important, and negative interactions within the church can serve to damage one's satisfaction with a church as a whole. A second factor affecting church membership is the change experienced by church members and the change that occurs in the culture of the surrounding community. These changes lead to new and different preferences of the church members, and if these can not be incorporated into their churches, these members may leave their church. / Master of Science

Yes / Medicines are often suboptimally managed for heart failure patients across the transition from hospital to home, potentially leading to poor patient outcomes. The Improving the Safety and Continuity Of Medicines management at Transitions of care programme included: understanding the problems faced by patients and healthcare professionals; developing and co-designing the Medicines at Transitions of care Intervention (MaTI); a cluster randomized controlled trial testing the effectiveness of a complex behavioural MaTI aimed at improving medicines management at the interface between hospitals discharge and community care for patients with heart failure; and a process evaluation. The MaTI included a patient-held My Medicines Toolkit; enhanced communication between the hospital and the patient's community pharmacist and increased engagement of the community pharmacist postdischarge. This paper reports on the patients' experiences of the MaTI and its implementation from the process evaluation. Twenty one-to-one semi-structured patient interviews from six intervention sites were conducted between November 2018 and January 2020. Data were analysed using the Framework method, involving patients as co-analysts. Interview data were triangulated with routine trial data, the Consolidated Framework for Implementation Research and a logic model. Within the hospital setting patients engaged with the toolkit according to whether staff raised awareness of the My Medicines Toolkit's importance and the time and place of its introduction. Patients' engagement with community pharmacy depended on their awareness of the community pharmacist's role, support sources and perceptions of involvement in medicines management. The toolkit's impact on patients' medicines management at home included reassurance during gaps in care, increased knowledge of medicines, enhanced ability to monitor health and seek support and supporting sharing medicines management between formal and informal care networks. Many patients perceived that the MaTI offered them support in their medicines management when transitioning from hospital into the community. Importantly, it can be incorporated into and built upon patients' lived experiences of heart failure. Key to its successful implementation is the quality of engagement of healthcare professionals in introducing the intervention. Patients were involved in the study design, as qualitative data co-analysts and as co-authors. / Programme Grants for Applied Research. Grant Number: RP-PG-0514-20009.

In der vorliegenden Arbeit wird der Frage nachgegangen wie sich der Lerntransfer in der Medizindidaktik gestaltet und welche Aspekte diesen beeinflussen können. Als Untersuchungskontext dient die medizindidaktische Qualifizierung der Grundstufe, die am Institut für Medizinische Lehre und Ausbildungsforschung in Würzburg durchgeführt wurde. Diese kann als eine berufliche Weiterbildung für die in dieser Studie interviewten Ärzt*innen angesehen werden. Lerntransfer stellt eine erwünschte und mögliche Wirkung einer Weiterbildung dar, wobei auch nicht intendierte Transferprozesse berücksichtig werden. Zur Bearbeitung der Forschungsfrage wurde eine qualitative Panelerhebung zu zwei Erhebungszeitpunkten durchgeführt. Basierend auf fokussierten Interviews wurde eine qualitative Inhaltsanalyse in Anlehnung an Gläser und Laudel sowie Kuckartz mit einem deduktiven-induktiven Vorgehen anhand eines 9-Schritte Plans angewandt. Lerntransfer kann unter anderem als eine Identifikation von Weiterentwicklungspotentialen in der Lehre, Veränderungen im Verhalten der Teilnehmenden sowie eine Reflexion der Lehre nach der Weiterbildungsteilnahme angesehen werden. In diesem Zusammenhang können die Lehre im Krankenhaus, die Eigenverantwortlichkeit in der Lehrgestaltung und der Handlungsmodus der Ärzt*innen als beeinflussende Aspekte herausgearbeitet werden. Die Erkenntnisse dieser Arbeit können bei zukünftiger Ausgestaltung, Angebots- und Programmplanung berücksichtigt werden sowie dazu beitragen neues Wissen zu dem spezifischen Feld der medizindidaktischen Qualifizierungen und den Bedingungen der medizinischen Lehre zu generieren. / This thesis investigates the question of how the learning transfer in medical education is structured and which aspects can influence it. The medical education qualification of the basic level, which was carried out at the Institute for Medical Education and Research in Würzburg, serves as the context of the investigation. This can be seen as professional training for the doctors interviewed in this study. Learning transfer represents a desired and possible effect of further training, whereby unintended transfer processes are also taken into account. To process the research question, a qualitative panel survey was carried out at two survey times. Based on focused interviews, a qualitative content analysis based on Gläser and Laudel as well as Kuckartz was applied with a deductive-inductive approach based on a 9-step plan. Learning transfer can be seen, among other things, as an identification of potential for further development in teaching, changes in the behavior of the participants and a reflection on teaching after participation in further education. In this context, teaching in the hospital, personal responsibility in the design of teaching and the mode of action of the doctors can be worked out as influencing aspects. The findings of this work can be taken into account in future design, offer and program planning and contribute to generating new knowledge about the specific field of medical education qualifications and the conditions of medical teaching.

Die Masterarbeit beleuchtet die Entstehung emotionaler Abhängigkeitsverhältnisse zwischen Fachkräften der Sozialen Arbeit im Bereich der Suchtkrankenhilfe und ihren Adressaten. Besonders im Suchthilfebereich sind (anderweitige) Abhängigkeiten als höchst vulnerabel anzusehen, da sie das „Prinzip“ Hilfe zur Selbsthilfe massiv stören und den „Suchtkreislauf“ nicht durchbrechen, sondern (auf anderer Ebene) erhalten können. Ziel der Arbeit ist es, durch Befragung von Fachkräften in unterschiedlichen Einrichtungen das professionsbezogene Bewusstsein menschlicher und kontextueller Abhängigkeiten zu ergründen und Perspektiven wie Möglichkeiten zu sammeln, wie diese Abhängigkeitsverhältnisse abgebaut oder verhindert werden können.:Vorwort 2 Tabellenverzeichnis 5 Einleitung 6 1 Vorangegangenes Praxisforschungsprojekt 8 1.1 Kurzvorstellung 8 1.2 Reaktionen aus der Praxis 10 2 Der theoretische Raum – Zentrale Begriffe 12 2.1 Die (professionelle) Beziehung 12 2.2 Nähe und Distanz 19 2.3 Emotionen und emotionale Abhängigkeit 21 2.4 Empowerment und Ressourcen 25 3 Der praktische Raum – Kontexte Sozialer Arbeit in der Suchthilfe 29 3.1 Das Fachkrankenhaus für Psychiatrie und Psychotherapie 29 3.2 Die Rehabilitationsklinik 33 3.3 Die Adaption/Nachsorge 36 3.4 Die suchtmedizinische Tagesklinik 37 3.5 Die Suchtberatungs- und Behandlungsstelle 39 4 Forschungsdesign 42 4.1 Forschungsfrage, Zielgruppe und Ziel 42 4.2 Aktueller Forschungsstand, Methodik und Feldzugang 43 4.3 Entwicklung des Erhebungsinstruments 45 5 Forschungsdurchführung 49 5.1 Pretest 49 5.2 Durchführung der Interviews 50 5.2.1 Adaption/Nachsorge 50 5.2.2 Psychiatrisches Fachkrankenhaus 51 5.2.3 Rehabilitationsklinik 51 5.2.4 Suchtberatungs- und Behandlungsstelle 52 5.2.5 Suchtmedizinische Tagesklinik 53 5.3 Nachbereitung und Transkription der Interviews 54 5.4 Ressourcen und Herausforderungen 55 6 Der Auswertungsprozess 57 6.1 Vorstellung der Auswertungsmethode 57 6.2 Auswertung der Interviews 58 6.2.1 Interview I: Adaption/Nachsorge 58 6.2.2 Interview II: Psychiatrisches Fachkrankenhaus 66 6.2.3 Interview III: Rehabilitationsklinik 75 6.2.4 Interview IV: Suchtberatungs- und Behandlungsstelle I 82 6.2.5 Interview V: Suchtberatungs- und Behandlungsstelle II 89 6.2.6 (schriftliches) Interview VI: stationäre Entzugsbehandlung 99 6.3 Diskussion der Ergebnisse mit Rückbezug auf die Praxis 101 7 Abschluss 110 7.1 Offene Forschungsfragen mit Ausblick 110 7.2 Zusammenfassung und Fazit 112 Eidesstattliche Erklärung 113 Literaturverzeichnis 114 Anlagenverzeichnis 121

As a historically and currently marginalized population, members of LGBTQ+ communities have traditionally needed to find one another and build relationships without their queer identities being discovered. This need has resulted in the development of codes and signals used by queer people to identify one another while remaining hidden, causing a unique culture of covert, in-group communication to form. In this study, I explore the modern culture of codes being used by LGBTQ+ communities through 14 interviews with LGBTQ+ people. From these interviews, I developed two broad themes: conveying and concealing identity. When discussing how they convey their identity, participants discuss not only the behaviors they use themselves but also those used by others. Some of these behaviors are general associations they hold between various cultural phenomena and queer identity, but often they are factors that allow them to make inferences about the identities of others despite the simultaneous importance they place on disclosure when it comes to truly knowing another’s queer identity. When on the topic of concealing identity, participants generally focused on themselves, discussing where, why, and how they concealed their identity. From these results, it is clear that developing the ability to convey or conceal one’s identity is an important skill within queer communities, as it allows individuals to live authentically and safely. However, these abilities are not without negative side effects, as the balancing act between conveying and concealing one’s identity requires queer individuals to live in a state of constant identity-based behavioral micro-management. In the end, these behaviors are not just culture – they are a form of survival when it has been, is, and will continue to be dangerous on some level to be queer.

Ensuring that women have timely access to safe, effective and affordable emergency contraception (EC) is of critical importance. There are four primary modalities of EC available in Canada: the levonorgestrel emergency contraceptive pill (LNg-ECP), the copper-T intrauterine device (IUD), ulipristal acetate (UPA) and the Yupze method (combined oral contraceptive pills). This is a mixed methods study dedicated to exploring women’s knowledge of, access to and experiences with EC in New Brunswick (NB). This study consisted of a two-part mystery client study, a community-based survey, and in-depth, semi-structured interviews with women in NB. The results of the mystery-client study indicate that 180 (87%) pharmacies had at least one brand of LNG-ECPs in stock. Although availability and knowledge of LNG-ECPs among NB pharmacists is relatively high, some are still providing incorrect medical and regulatory information. The findings of this study illustrate where improvement in pharmacy provision of LNG-ECPs in NB is required. Knowledge of EC among women in NB is relatively low, especially with respect to the IUD and UPA. Continuation of education efforts among pharmacists and sexual education teachers concerning ECPs in NB appears warranted. Exploring the barriers that NB women face in obtaining ECPs is not only imperative for improving access, but also yielding better quality reproductive health services in the province.

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