Text in English / Interactive health communication between the health-care professional (HCP) and patient relationship for diabetes health-care positively contributes to patient-centred care. Hence individual patient concerns are addressed and catered for in the medical system. The purpose of this study was to analyse in-depth how HCP-patient relationships and HCP-HCP teamwork dynamics positively contribute to effective diabetes patient care and treatment adherence. Different health communication models and theories were reviewed and a conceptual framework was developed from the literature. A qualitative case study approach was used to collect data at Stanger Hospital’s diabetes clinic. Data was collected using three different methods, namely in-depth interviews with HCPs and patients individually, observations conducted at the clinic analysing both the HCPs and patients, and finally, documentation that emerged as a third data collection method where patient files and diabetes educational material were analysed at the clinic. Triangulation by means of the three methods ensured that reliable, valid and credible data was collected in the field. Diabetes health-care and treatment management are affected by the social context/social system which includes family and culture. These social factors are acknowledged as core in the literature. However, a single comprehensive health communication model did not exist solely in this regard. The data indicated that at the Stanger Hospital’s diabetes clinic, patient-centred (individual tailor-made treatment plans) care was only implemented after patients had defaulted treatment for reasons linked to their social circumstances. The findings of the study indicate that teamwork was favoured in the HCP-HCP relationship at the diabetes clinic, and that this made a positive contribution to effective diabetes patient care. HCPs were overburdened at the clinic since patient numbers were high and there were staff shortages. The patients’ empirical data indicated that interactive communication positively contributed to their medical concerns being catered for at the diabetes clinic, but this tended to occur only after non-adherence. Patients required care and support from HCPs in order to learn to accept diabetes and manage their illness. / Sociology / D. Litt. et Phil. (Sociology)

Thesis (MA)--Stellenbosch University, 2012. / Includes bibliography / ENGLISH ABSTRACT: As a wave of political uprisings swept across North Africa since January 2011, ridding the region of longstanding autocratic leaders, presidents in Sub-Saharan Africa were still imprisoning opposition leaders, deploying military and police to clamp down on protest, and promising their citizens change - all this in a bid to avoid being ousted by their own people. Leadership has long been the main constraint on political and economic progress in Africa. This study analyses African leadership and especially the role of the presidency as a cause of conflict and instability in Africa. The modern-day African president might no longer be the absolute autocrat from yesteryear, but he still rules with awesome power and vast state resources at his disposal. African leaders have assumed an imperial character; many regard themselves as largely above the law; accountable to no one and entitled to remain in power or to pass the sceptre to their offspring. Due to this rather imperial character, conflict has been inevitable in Africa. As a theoretical basis the study proposes a framework for analysing leaders’ behavioural patterns that contribute to conflict and instability domestically as well as regionally. Six relevant behavioural patterns are identified: political deprivation, patronage and clientelism, personalisation of power, use of the military, staying to office, underdevelopment and conflict. Additionally, and as a case study, this framework is applied to Uganda’s president Yoweri Museveni. Each of the six behavioural patterns are analysed and evaluated in relation to Museveni’s rule of the past 25 years. Applying the framework demonstrates how Museveni contributed to conflict across the region in Somalia, Sudan, Kenya and the Democratic Republic of the Congo (DRC). Museveni is found to be a power point man in the region and his imperial nature is likely to contribute to future instability and conflict in Uganda and the Great Lakes region. The study also addresses the genesis of the imperial African leader and investigates why, despite waves of democratisation and the expulsion of a few autocratic rulers in Africa in the late 1990s, the imperial character still persist today. Constitutional limitations are found to be one of the major reasons why absolute powers end up being vested in the hands of the president. Lack of proper separation of powers, and a culture conducive to suppressing the legislature and parliamentary role, provides additional reasons for this phenomenon. Furthermore, both internationally and locally, the leadership deficit in Africa is drawing continuing attention and even funding. However, in order for Africa to make progress in eradicating poor and unaccountable leadership, local initiatives should be further encouraged. The African Union Peer Review Mechanism and the African Charter on Elections, Democracy and Governance are discussed as two African initiatives; also the Mo Ibrahim Index and Prize are evaluated. Although all three these initiatives are admirable in theory, they have failed to deliver because real commitment to action is lacking in most African countries. A speedy and conclusive solution to the problem seems unlikely because of the complex nature of humans and their environment. Thus, the aim of this study is to make a contribution to the scholarly body of work regarding the causes of African conflict, focusing on the African presidency as one cause of such conflict in Africa. / AFRIKAANSE OPSOMMING: Vanaf Januarie 2011 het ’n vlaag politieke opstande Noord-Afrika getref waartydens weggedoen is met langdurige outokratiese leiers. In Afrika Suid van die Sahara het heersers egter steeds opposisieleiers opgesluit en militêre- en polisiemagte ontplooi om opstande die hoof te bied, terwyl vae beloftes aan die bevolking gemaak word oor moontlike veranderinge. Swak Afrika-leierskap word dikwels beskou as ‘n belangrike faktor wat politieke en ekonomiese vooruitgang op die vasteland strem. Hierdie studie analiseer leierskap in Afrika, veral die rol wat die president speel in die skepping van konflik en onstabiliteit. Die hedendaagse Afrika-leier mag dalk nie meer voorkom as die absolutistiese outokraat van die verlede nie, maar hy regeer steeds met oorweldigende mag en ekstensiewe staatshulpbronne tot sy beskikking. Dit is duidelik dat die Afrika-leier dikwels ‘n imperiale karakter aanneem en homself verhewe ag bo die wet. In welke geval hy dus geen verantwoording hoef te doen aan enige ander party nie. Die hoofdoelwit blyk dikwels te wees om beheer te behou. Die gevolgtrekking wat gemaak kan word, is dat die imperiale karakter van die Afrika-president tot konflik kan lei. Die teoretiese basis van hierdie studie bied ’n raamwerk om die leiers van Afrika se gedragspatrone te bestudeer wat aanleiding kon gee tot onstabilitiet asook interne-en streekskonflik. Ses gedragspatrone is geïdentifiseer om hierdie proefskrif te illustreer: politieke vervreemding; beskermheerskap en kliëntilisme; personalisering van mag; gebruik van militêre mag om aan bewind te bly; gebrek aan ontwikkeling en konflik. In besonder word hierdie raamwerk toegepas op die president van Uganda, Yoweri Museveni, as ‘n gevallestudie. Hierdeur word aangedui hoe Museveni bygedra het tot konflik, nie net in Uganda nie, maar inderwaarheid ook in Somalië, Sudan, Kenia en die Demokratiese Republiek van die Kongo (DRK) tydens sy bewind van die afgelope 25 jaar. Museveni word allerweë beskou as die “sterkman” in die streek en sy imperiale karakter sal heel waarskynlik ook in die toekoms bydra tot onstabiliteit en konflik in Uganda en die Groot- Merestreek. Hierdie studie spreek ook die oorsprong van die imperiale Afrika-leier aan en ondersoek waarom, ten spyte van die sterk strewe na demokrasie en die omverwerping van outokratiese leiers in Afrika in die laat 1990s, die imperiale karakter van sodanige leiers steeds kan voortbestaan. Konstitusionele beperkings word beskou as een van die hoofredes waarom totale mag in die hande van ‘n president beland. Gebrek aan behoorlike verdeling van mag en ‘n kultuur bevorderlik vir die onderdrukking van die wetgewende en parlementêre funksies, is bydraende redes vir hierdie verskynsel. Verder ontlok die tekortkominge van Afrikaleierskap plaaslik en internasionaal heelwat aandag en selfs befondsing. Die ideaal sou egter wees dat Afrika aangemoedig moet word om tot ‘n groter hoogte plaaslike inisiatiewe te gebruik om swak en onbevoegde leierskap te verwerp. Die African Union Peer Review Mechanism en die African Charter on Elections, Democracy and Governance word gesien as twee nuttige Afrikainisiatiewe. Ook die Mo Ibrahim Index and Prize word geëvalueer. Alhoewel al drie inisiatiewe in teorie goed blyk te wees, het dit misluk as gevolg daarvan dat ‘n verbintenis tot aksie ontbreek in die meeste Afrika lande. Waarskynlik is geen spoedige of permanente oplossing vir die konflik moontlik nie – grotendeels weens die kompleksiteit van mense en hulle omgewing. Dus is die doel van hierdie studie om ‘n bydrae te maak tot akademiese navorsing betreffende die oorsake van konflik in Afrika en dan spesifiek hoe die institusionele aard van leierskap in Afrika fungeer as ‘n bydraende oorsaak.

Freshwater resources play an important role in the integrity of natural ecosystems as well as livelihoods of communities. However, South Africa has limited freshwater resources and many of this country’s inland water streams are polluted as a result of human activities. Various legislations such as the National Water Act (Act No. 36 of 1998) were promulgated in order to address the issue of sustainable management of these resources. In this study, the Driver-Pressure-State-Impact-Response (DPSIR) model was applied to determine water quality challenges and threats in and around the Mapungubwe National Park and Heritage Site (MNPHS). This study area was declared as a heritage site by the United Nations Educational, Scientific and Cultural Organisation (UNESCO) and is also a national park. Several research objectives were formulated and various methodologies were used to address the research aim. In determining land uses around the study area, site visits, visual inspections, literature reviews as well as the analysis of the national land use data were undertaken. Various land uses that have potential to negatively impact water quality were identified. In order to determine the status of water quality in the study area, water samples were analysed in-situ and in the laboratory. The results obtained showed that water quality was generally compliant with a few exceptions. For example, the concentrations of nitrates, microbes, and few metals such as mercury and beryllium were not complying with water quality guidelines and standards. Finally, in formulating the DPSIR framework for the MNPHS, a participatory approach was used where stakeholders were interviewed by means of a questionnaire. One of the most salient finding of the DPSIR modelling in this study was institutional weaknesses associated with the poor implementation of existing water related laws and regulations. The study also highlighted a few recommendations for further action and research. / Environmental Sciences / M.Sc. (Environmental Management)

Genom denna avhandling undergår vi som speldesigners en dokumenterad process där vi utvecklar ett spel från koncept till funktionell prototyp. Målet är att kunna bygga vidare på våra egna samt andras metoder för utvecklingen av mekaniker som kompletterar övrigt gameplay. Undersökningsområdet för denna process utgörs av hur vi kan framställa en dödsmekanik som passar i kontext till vårt valda spelkoncept och dess förutsättningar. Detta inriktningsområde grundas i vår vilja att skapa dödsmekaniker som upplevs inge betydelsefulla konsekvenser både på spelarkaraktären och spelupplevelsen i sin helhet vilket stämmer överens med konceptets designmål. Genom ett speltest där en testgrupp genomför ett antal kvalitativa prototyptester av dödsmekaniker kan vi sedan jämföra resultaten och etablera slutsatser kring hur väl varje prototyp lyckas uppfylla konceptets designmål och inge tydliga konsekvenser för spelaren som förstärker resterande gameplay. / Through this thesis we as game designers undergo a documented process in which we develop a game from concept to functional prototype. The end goal is to allow us to further our own as well as others’ methodology for the development of mechanics that complement existing gameplay. The field of inquiry for this process consists of how we can establish a death mechanic that fits in context to our chosen game concept and its parameters. This focal point originates from a desire on our part to create death mechanics that strive to instill meaningful consequences affecting the player as well as the game experience itself which correspond with the design goals of the concept. By performing a playtest where a number of qualitative prototypes of death mechanics are carried out by a test group we can compare the results and establish conclusions concerning how well each prototype manages to fulfill the concept’s design goals and convey clear consequences for the player, reinforcing surrounding gameplay.

This study discusses the case of modernising the Southern African Development Community (SADC) regional payments system facilitated by the SADC Payment System Project. The long-term objective is to have harmonised cross-border and inter-bank settlement systems to facilitate the economic activity such as supporting the flow of trade within the SADC region. The SADC Payment System Project purports to have adopted a strategic management process to achieve its mandate. The modernisation process is in line with the Regional Indicative Strategic Development Plan (RISDP). The aim of the RISDP is to provide strategic direction with respect to various SADC programmes and activities and to align the strategic objectives and priorities of SADC with the policies and strategies for achieving its long-term goals. The concept of payment, clearing and settlement system is explained to provide the context within which the national payment system fits in the economic system and its role towards economic development. The first objective of the study is to discuss the strategic management process. The objective of the discussion is to reflect how the strategic management theoretical constructs were translated into practice. The second objective of the study is to explore the environmental and country internal factors that are likely to impact on and delay the fully harmonised regional cross-border and inter-bank settlement systems. Although not exhaustive, the identified factors include; - The structural arrangements of country- specific teams that support the modernisation initiatives, - The availability of skills and capacity to harness the implemented systems within each member country in the SADC region. iii - The influence of foreign fund donors, as a result of a possible duplication of efforts, - The repair state of power supply and communication networks, - The supporting legal and regulatory regimes, - The forms of economic systems, - The influence and the extent of trade flows with the SADC region, and - The resilience banking networks in the facilitation of financial information flows within each member country and externally (internationally). The target population of central bank officials who also take an active role in the modernisation of SADC regional payments systems were requested to provide feedback on the prepared questionnaire to address the above factors. The responses provided are summarised in Chapter 5. It was clear from the responses that the identified factors appeared to pose little challenge for respective member countries. However, additional comments by respondents indicated that there is still a lot of groundwork to be covered. There was an evidence of the need for on-going training in payment systems and to improve communication networks and power supply within each member country, especially on the remote country areas/rural areas. Some members also hinted a warning on developing systems, which would have a potential to become white elephants if other sectors are not developed in parallel to the regional payment systems. / Graduate School of Business Leadership / M.B.L.

This study discusses the case of modernising the Southern African Development Community (SADC) regional payments system facilitated by the SADC Payment System Project. The long-term objective is to have harmonised cross-border and inter-bank settlement systems to facilitate the economic activity such as supporting the flow of trade within the SADC region. The SADC Payment System Project purports to have adopted a strategic management process to achieve its mandate. The modernisation process is in line with the Regional Indicative Strategic Development Plan (RISDP). The aim of the RISDP is to provide strategic direction with respect to various SADC programmes and activities and to align the strategic objectives and priorities of SADC with the policies and strategies for achieving its long-term goals. The concept of payment, clearing and settlement system is explained to provide the context within which the national payment system fits in the economic system and its role towards economic development. The first objective of the study is to discuss the strategic management process. The objective of the discussion is to reflect how the strategic management theoretical constructs were translated into practice. The second objective of the study is to explore the environmental and country internal factors that are likely to impact on and delay the fully harmonised regional cross-border and inter-bank settlement systems. Although not exhaustive, the identified factors include; - The structural arrangements of country- specific teams that support the modernisation initiatives, - The availability of skills and capacity to harness the implemented systems within each member country in the SADC region. iii - The influence of foreign fund donors, as a result of a possible duplication of efforts, - The repair state of power supply and communication networks, - The supporting legal and regulatory regimes, - The forms of economic systems, - The influence and the extent of trade flows with the SADC region, and - The resilience banking networks in the facilitation of financial information flows within each member country and externally (internationally). The target population of central bank officials who also take an active role in the modernisation of SADC regional payments systems were requested to provide feedback on the prepared questionnaire to address the above factors. The responses provided are summarised in Chapter 5. It was clear from the responses that the identified factors appeared to pose little challenge for respective member countries. However, additional comments by respondents indicated that there is still a lot of groundwork to be covered. There was an evidence of the need for on-going training in payment systems and to improve communication networks and power supply within each member country, especially on the remote country areas/rural areas. Some members also hinted a warning on developing systems, which would have a potential to become white elephants if other sectors are not developed in parallel to the regional payment systems. / Graduate School of Business Leadership / M.B.L.

This multi-sited case study aims to explore spatial capacity through pen-and-paper and hands-on activity tests, and explore world view perceptions of space in an attempt to show that spatial conceptualisation is a rich and complex blend of spatial capacity and world view. This study is oriented in a interpretive-naturalistic paradigm and characterised by multi-dimensional quantitative and qualitative methods. The research, set in five secondary schools in the Eastern Cape, was carried out with 32 Grade 11 learners and was designed around seven stages. This study attempts to understand spatial conceptualisation by recognising that all learners have epistemological macrostructures (world views) that shape their perceptions of the world in general and of space in particular. The main contention of this study is that spatial conceptualisation cannot be understood in isolation, through studying achievements on traditional pen-and-paper tests only. A comprehensive understanding of an individual's spatial conceptualisation involves the recognition of hands-on skills and world views as well. Spatial capacity, defined here in terms of spatial visualisation and orientation constructs, was explored through a pen-and-paper and a hands-on activity test. The results show only a weak to moderate correlation between the two tests, suggesting that performance in a traditional pen-and-paper test was not necessarily a good predictor for performance in a hands-on activity-based test. The investigation of world views was underpinned by a logico-structuralist process centred in conversations around nine bi-polar themes. Through a process of content- and meta- analyses involving the participation of a validation team, world-view profiles were established. / In terms of the applied pen-and-paper test which explored spatial capacity, this study confirms males' dominance in all spatial tasks, particularly in three-dimensional problems. This was also found to be true for learners from the participating rural school and for those from disadvantaged socio-economic backgrounds. In the hands-on activity test, however, the study revealed no observable gender difference in favour of the males, except for items that were characterised by the spatial orientation construct. Both the participating rural and township schools performed poorly in items characterized by the spatial visualisation and orientation construct compared to the other participating schools. Although participants from the rural and township schools found it difficult to articulate their world views in depth, the world-view perspectives of space of this sample reveal rich and complex profiles that are similar across all the schools. Despite leaning towards a Newtonian division of absolute and relative space and containing strong religious elements, this sample generally views space as mysterious, infinite and somewhat obscure. It often refers to space in Kantian ideas and related space in terms of subjective feelings. Females in particular, refer to their own `space bubble', for example. Out of the world-view profile analysis, a meta-analysis was conducted which explored thinking skills in terms of capacity to abstract, to be insightful, deal with complex issues, engage critically, and be imaginative. / This reveals that for this case, females were rated on a higher level than their male counterparts for their capacity to abstract and be complex (the capacity to identify related parts and to deal with composites), whereas males rated higher for showing insight, being imaginative, and being critical. Although there appear to be high correlations between the various tests, meta-levels and school performance for some of the participants, the same cannot be said for the sample as a whole. The world-view aspect of this study reveals a rich, often complex, understanding of space, strengthening the notion that world views are integral to a learner's cognition process.

I takt med att de globala klimatförändringarna fortsätter kommer konsekvenserna bli allt mer ödesdigra. Vissa av dessa konsekvenser förbises ofta i den globala debatten och i världspolitikens inflytelserika kretsar. Uppskattningar gör gällande att så många som 200 miljoner människor blivit förskjutna som en konsekvens av klimatförändringarna. Detta aktualiserar frågan om klimatflyktingar. Syftet med denna uppsats är att studera varför det internationella samarbetet gällande klimatflyktingar kan betraktas som begränsat. För att närmre studera denna fråga har jag gjort en case study, en tolkande kvalitativ textanalys. Liberalism och realism används som teoretiskt ramverk, som redskap för analysen. De centrala slutsatserna är främst att det för närvarande existerar ett definitionsproblem vad gäller klimatflyktingar, det finns ekonomiska hinder för samarbete och frågan betraktas som ett problem begränsat till låginkomstländer känsliga för klimatförändringar. / As the global climate changes continue the consequences will increase. Some of these consequences are often overlooked in the global debate and influential circles of world politics. Estimations speak of as many as 200 million displaced persons as a consequence of climate change. This brings to the fore the question of climate refugees. The aim of this paper is to study why the international cooperation regarding climate refugees can be seen as limited. To closer look upon this issue I am doing a case study, an interpretative qualitative text analysis. Liberalism and realism are used as theoretical frame, as tools in the analysis. The central conclusions are that it currently exists a problem of definition regarding climate refugees, there are economic obstacles for cooperation and the question is perceived as a problem limited to low income countries fragile for climate change.

Objective: To understand the use of evidence-informed decision-making within an interorganizational network, and identify the facilitators and barriers to achieving network goals. Design: Case study. Setting: Rural health district in Nova Scotia, Canada (2006 to 2011). Participants: Members from 4 organizations representing community and hospital groups participating in a regional Baby Friendly Initiative network. Methods: A descriptive mixed methods study using focus group and questionnaire methodology. Data were analyzed using framework analysis and social network analysis (SNA). Results: The SNA results highlighted the role that relationships have on the sharing of knowledge among network members. The findings highlight the need for leadership at multiple levels (community, network members, primary organizations, and the provincial government). A lack of resources to achieve the network’s goals was a key barrier. Conclusions: The role of multi-level leadership is important for future network development and community consideration. The case study methodology facilitated momentum towards the network’s goals.

Bakgrunn: Det er avdekket at pasienter med komplekse behov og kroniske lidelser har behov for mer integrerte helsetjenester en de har fått. Samhandlingsreformen fremmer at dagens helsevesen må desentraliseres for å gi integrerte tjenester til denne pasientgruppen. Hensikt: Formålet med denne studien var å avdekke hva som er avgjørende for en bærekraftigbehandlingskjede til personer med komplekse og langvarige lidelser. Metode: Forskningen er et multiple case study med to case; diagnosegruppene Schizofreni ogKOLS. Undersøkelsen ble gjennomført i to middels store norske kommuner og deres respektive regionale sykehus. Det ble gjenomført 10 semi-strukturerte intervju med påfølgende innholdsanalyse. Funn fra intervjuene og dokumentanalysen ble triangulert. Resultat: Avgjørende for bærekraftige behandlingskjeder er: Organisasjonsstruktur: Interorganisatorisk behandlingskjede, med minimum nivå av lenket interaksjon, fundamentert på samarbeidsavtale. Interaksjonsnivået og bruk av IP var høyest innen for psykisk helse sektoren. Ingen av behandlingskjedene har multidisiplinære team som har myndighet til situasjonstilpasning avtjenestene; Organisasjonskultur: Det var ett multidisiplinært grenseoverskridende team, som var utenlederstøtte relatert til felles målsetninger og felles styrende idéer og løsning på samhandlingsutfordringer eller fokus på utvikling av helhetlige behandlingskjeder, spesielt fellesoppgavene; Utviklingsmulighet gjennom støttende nasjonal policy og statlige virkemidler; og Utviklingsfokus Det manglet avklaring på lederansvar for utvikling av behandlingskjeder og prioritering av ressurser til utvikling i form av personell, økonomi og tid. Konklusjon: Studien viser at det er avgjørende med adekvat organisasjonsstruktur med samhandlingssoner for både multidisiplinære grenseoverskridende team med tilstrekkelig interaksjonog myndighet til å gi situasjonstilpassede tjenester, og et ledernivå med fokus på lederstøtte for de multidisiplinære teamene. En altruistisk holdning i lederskapet kan bidra til støttende strukturer somfelles styrende ideer og målsetninger. Det er nødvendig med et tydelig fokus på utvikling av tjenester der det er tjenestetomme rom, og spesielt på fellesoppgaver og løsing av samhandlingsutfordringer,.Det er også viktig for behandlingskjedens bærekraft at ledere prioriterer tilstrekkelig ressurser til utviklingen av behandlingskjeder og bruker mulighetene gjennom de statlige virkemidlene.En integrert helsetjeneste er ennå ikke et faktum i de undersøkte behandlingskjedene, men viktige steg er tatt i retning av å oppfylle Samarbeidsreformens målsetning. / Background: Evidence shows that patients with complex and chronic illnesses need greater coordination of their healthcare services. The Coordination Reform claims that health care services must be decentralized to give integrated care to these patients Purpose: This study aimed to determine the crucial factors for sustainable chains of care for persons with complex and chronic diseases. Method: This study was organized as a multiple case study involving two diagnosis groups for schizophrenia and chronic obstructive pulmonary disease. Research was conducted in two mid-sized Norwegian municipalities, each connected to separate regional hospitals. It was conducted 10 semistructured interviews. Findings from interviews and document analysis were triangulated. Result: Integrated chains of care depend on four factors. Organizational structure needed organizational chains of treatment with a minimum level of linked interaction, based on contracts.The level of interaction was higher, and the use of Individual Plans was more common within the mental health sector. In our study, neither chain of care had a mandate to adjust services according tochanging needs. In organizational culture, we identified one inter-organizational team, which lacked necessary leadership support to identify common goals, and lacked governing ideas or leadership to solve the challenges or focus on developing integrated chains of care. Supporting policies andgovernmental incentives enabled development opportunities. Finally, we identified a lack of development focus (i.e., appointed responsibility for the development of integrated health care and the allocation and management of resources for personnel, time, and economy). Conclusion: We determined that an adequate organizational structure for interaction is crucial to creating zones of interaction for multi-disciplinary teams with adequate interaction and authority to adjust health services according to need. We also determined a need for leadership to focus on supporting multidisciplinary teams. Leadership with altruistic attitudes may inspire and strengthen supporting structures such as common governing ideas and goals. When voids exist in the chain of care, clearly focused service development and problem solving is crucial, especially for interorganizational treatment. Sustainability of the chain of care requires leaders prioritize development regarding the allocation of adequate resources, using the possibilities within the national regulations and incentives. An integrated chain of care was not yet in place for the cases studied here, butimportant steps have been taken towards fulfilling the goals of the Norwegian Coordination reform. / <p>ISBN 978-91-982282-1-2</p>