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Desenvolvimento e validação da sexta versão da Addiction Severity Index (ASI6) para o Brasil e outras análises em uma amostra multicêntrica de usuários de drogas que buscam tratamento no paísKessler, Felix Henrique Paim January 2011 (has links)
Conforme revisão da literatura, existem poucos instrumentos de pesquisa no Brasil que avaliam de forma mais ampla os problemas relacionados ao álcool e outras drogas. Neste contexto, a sexta versão do Addiction Severity Index (ASI6) foi escolhida para ser validada no Brasil. Trata-se de uma entrevista semi-estruturada que foi planejada de forma multidimensional para obter informações sobre os problemas de abuso de substância e outros aspectos da vida como: médico, ocupacional, aspectos legais, sócio-familiar e psiquiátrico. Essa tese descreve na sua introdução as modificações dessa versão do instrumento, que foi desenvolvida para aprimorar seu conteúdo e corrigir as principais limitações das versões anteriores. A tese contém 5 manuscritos e teve como objetivos principais: adaptar a escala traduzida como Escala de Gravidade de Dependência (ASI6) para a cultura brasileira (carta ao editor anexada), apresentar o instrumento através de um caso clínico (artigo 1), além de testar algumas de suas propriedades psicométricas em uma população clínica (artigo 2). Para isso, um estudo transversal multicêntrico foi conduzido em 4 capitais de estados brasileiros, e as características da amostra foram descritas (artigo 3) e comparadas entre os cinco centros de pesquisa que coordenaram o estudo. Foram entrevistados por cinco centros de pesquisa 150 pacientes adultos internados ou em tratamento ambulatorial que buscaram tratamento em centros especializados em dependência química. Um total de 740 abusadores ou dependentes de substâncias foi selecionado. A qualidade dos dados coletados foi assegurada pelo treinamento e supervisão dos entrevistadores. A maioria dos pacientes entrevistados era do sexo masculino (78%) e a média de idade foi de 36 anos, e as drogas mais consumidas nos últimos 30 dias foram: álcool (82%), cocaína/crack (51%) e maconha (41%). No geral, não houve grandes diferenças significativas entre os centros no que tange aos escores de gravidade do ASI6. Na análise psicométrica, a maioria das áreas da ASI demonstrou boa confiabilidade, sem diferenças estatisticamente significativas entre os Escores Sumários de Funcionamento Recente (SS-Rs) da ASI-6 no teste-reteste e entre entrevistadores. O alfa de Cronbach para as subescalas da ASI-6 variou de 0,64 a 0,95. Correlações entre os escores da área Álcool e Drogas da ASI-6 e o instrumento concorrente (ASSIST) foram altas (0,72 e 0,89, respectivamente). Encontrou-se também uma correlação negativa, estatisticamente significativa entre os escores nas áreas psiquiátrica, médica e drogas, e os escores da WHOQOL. Esses primeiros resultados apontam para uma boa confiabilidade e validade da Escala de Gravidade de Dependência para a cultura brasileira. Além dos aspectos acima mencionados, a tese também inclui outras análises relacionadas a essa amostra na forma de artigos científicos. O primeiro deles (artigo 4), compara 293 usuários de crack com 126 usuários de cocaína e 324 pacientes que apresentaram uso de álcool e outras drogas, e demonstrou que o grupo de usuários de crack apresentou mais indivíduos (25%) com personalidade antissocial do que usuários de cocaína (9%) e usuários de outras drogas (9%), mesmo depois de ajuste para idade e gênero, com uma Razão de Prevalência de 2,6 (IC 95%: 1,10-6,40). Através dos escores de gravidade do ASI, os usuários de crack também demonstraram significativamente mais problemas ocupacionais, familiares e legais, principalmente devido ao envolvimento em atividades ilegais como tráfico de drogas e outros crimes, quando comparados a outros usuários de substâncias psicoativas. Por fim, um outro estudo (artigo 5) avaliou a qualidade de vida (QV), através do WHOQOL-BREF, de 174 sujeitos que consideraram o álcool como causador de sérios problemas em suas vidas e os fez buscar tratamento especializado para esse problema. Quando comparados os SS-Rs entre tercis de gravidade de problemas de álcool, encontraram-se diferenças significativas (p=0,002) nos domínios físicos e psicológicos que eram mais baixos no grupo com mais problemas relacionados ao álcool. Além disso, o aumento da gravidade dos problemas desses pacientes, especialmente nas áreas médica e psiquiátrica, avaliados pelos SS-Rs do ASI6 também apresentou uma correlação negativa com os escores do WHOQOL-BREF. Através dos achados dessa tese, conclui-se que o ASI6 poderá ser incorporado ao arsenal diagnóstico de pacientes usuários de drogas que buscam tratamento, a fim de auxiliar a avaliar a sua problemática, e melhorar as estratégias de abordagem e intervenção relacionadas às necessidades específicas dessa população. Sem dúvida, serão necessários novos estudos de avaliação psicométrica com outras amostras de consumidores de substâncias psicoativas. Os resultados da tese também sugerem que os usuários de crack devem ser melhor avaliados com o ASI6 ou com outros instrumentos que abordam sintomas psiquiátricos, especialmente quanto a comportamentos antissociais, que provavelmente estão relacionados aos inúmeros problemas legais, familiares e sociais dessa população. Ademais, os achados finais indicam que alcoolistas que buscam tratamento devem ser avaliados quanto aos seus sintomas psiquiátricos e que a diminuição da gravidade dos problemas relacionados ao álcool poderá melhorar a qualidade de vida psicológica desses pacientes. / A review of the literature demonstrated that there are few instruments in Brazil to assess the problems related to alcohol and other drugs in a more general manner. In this context, the sixth version of the Addiction Severity Index (ASI-6) was chosen to be validated in Brazil. This instrument consists of a semi-structured interview that was designed in a multidimensional way to collect data about problems related to substance abuse and other aspects of life in the medical, occupational, legal, social relations and family, and psychiatric domains. This version of the instrument was modified with the purpose of improving its content and solving the major limitations of the previous versions. The present dissertation includes five manuscripts and its main objectives were: to adapt the ASI-6 to the Brazilian culture (letter to the editor attached); to present this instrument based on a clinical case (manuscript 1); and to test some of its psychometric properties in a clinical population (manuscript 2). In order to reach these objectives, a multicenter study was conducted in four Brazilian state capitals. The characteristics of the sample were described (manuscript 3) and compared between the five research centers that coordinated the study. A total of 150 adult inpatients or outpatients who sought treatment at five specialized centers for substance abuse were interviewed. A total of 740 substance dependent or abusers were selected. Interviewers were trained and supervised to ensure the quality of the data collected. Most patients were male (78%) and their mean age was 36 years. The most abused drugs in the previous 30 days were: alcohol (82%), cocaine/crack (51%), and marijuana (41%). Overall, there were no major differences between the research centers regarding the ASI-6 severity scores. According to the psychometric analysis, most areas of the ASI demonstrated good reliability, with no statistically significant differences between the ASI-6 Summary Scores for Recent Functioning (SS-Rs) in the test-retest and between interviewers. The Cronbach's alpha for the ASI-6 subscales ranged from 0.64 to 0.95. The correlations between the ASI-6 and the other instrument (ASSIST) scores for the alcohol and drugs area were high (0.72 and 0.89, respectively). There was also a negative statistically significant correlation between the scores of the psychiatric, medical and drugs areas and the scores of the WHOQOL. These initial results suggest a good reliability and validity of the ASI for the Brazilian culture. In addition to the above mentioned aspects, this dissertation also includes additional analyses related to this sample presented in two other scientific papers. The first study (manuscript 4) compared 293 crack users with 126 cocaine users and 324 patients who used alcohol and other drugs. The results demonstrated that the group of crack users had more individuals (25%) with antisocial personality than the group of cocaine users (9%) and the users of other drugs (9%) even after adjusting for age and gender, with a Prevalence Ratio of 2.6 (CI95%: 1.10 to 6.40). Based on the ASI severity scores, crack users also showed significantly more occupational, family and legal problems, mainly in terms of involvement in illegal activities such as drug dealing and other crimes, when compared with other drug users of psychoactive substances. Finally, another study (manuscript 5) used the WHOQOL-BREF to evaluate the quality of life (QoL) of 174 subjects who considered that alcohol was causing serious problems in their lives and led them to seek specialized treatment. When the SS-Rs between the severity tertiles of alcohol problems were compared, there were significant differences (p = 0.002) in the physical and psychological domains, which were lower in the group with more alcohol-related problems. Furthermore, the increased severity of these patients' problems, especially in the medical and psychiatric areas assessed by the ASI-6 SS-Rs, also showed a negative correlation with the WHOQOL-BREF scores. Based on these findings, it is possible to conclude that the ASI-6 may be included in the set of diagnostic instruments of drug users seeking treatment to help assess their problems and improve the approach and intervention strategies related to the specific needs of this population. Indeed, further psychometric assessment studies involving other samples of psychoactive substance users are needed. The results of this dissertation also suggest that crack users should be better evaluated using the ASI- 6 or other instruments dealing with psychiatric symptoms, especially regarding antisocial behaviors, which are probably related to the high rate of legal, family and social problems of this population. In addition, the final findings indicate that alcoholics who seek treatment should have their psychiatric symptoms assessed and that a decrease in the severity of alcohol-related problems may improve the psychological quality of life of these patients.
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OPTIMIZING INDIVIDUAL FIRST-AID KIT PLACEMENT IN K-12 SCHOOL ENVIRONMENTSCollin N Knolhoff (17586267) 12 December 2023 (has links)
<p dir="ltr">With increasing frequency, American schools have been plagued with mass casualty events perpetrated by offenders using various types of firearms. In recent years, several studies have used AnyLogic®, an agent-based computer modeling software, to model some of these mass shooting events. More specifically, researchers have modeled mass shooting events and how changes in police response and victim response affect casualty rates in these scenarios. Another model has used the same agent-based software to model mass-casualty events of various venues. The model goes further by integrating what will be known throughout this paper as “the bleed-out model”. The bleed-out model uses known data from these mass casualty events to model types of injuries and their related probability of resulting in a fatality. The model also uses known data about traumatic wound interventions from mass casualty scenarios, as well as law enforcement and military applications, to model life-saving measures to counteract traumatic injuries and decrease the probability of a victim becoming a fatality. This research used AnyLogic® software to integrate agent-based school shooting models with an agent-based bleed-out model. Once combined, individual first aid kits (IFAKs) geared toward traumatic wound/hemorrhaging care were introduced into the environment and their placement was arranged in several different ways. AnyLogic® software and quantitative analysis were used to make recommendations about best practices for implementing IFAKS in schools. This research specifically examines whether the placement distance for IFAKS in schools during an active shooter incident could have a statistically significant impact on the survivability of active shooter victims. Different scenarios are assessed in the AnyLogic® model varying the placement of a fixed number of IFAKS throughout the school during an incident.</p>
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Bedömningsinstrument : En studie om hur bedömningsinstrument används inom socialtjänstens arbete med missbruks- och beroendevårdArdesjö, Lillemor, Lazarevic, Monika, Sjögren, Åsa January 2009 (has links)
<p> </p><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><p><!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --></p><!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --><p> </p><!--[endif]--><p>Vilka bedömningsinstrument som används inom missbruks- och beroendevården och hur Sveriges kommuner använder instrumenten är ett outforskat område. Socialstyrelsen publicerade år 2007 nationella riktlinjer för missbruks- och beroendevård där man förespråkar användandet av bedömningsinstrument. Studien har granskat i vilken utsträckning och i vilket syfte bedömningsinstrument används och hur förutsättningarna ser ut för användningen av bedömningsinstrument inom socialtjänstens arbete med missbruks- och beroendevård. Hur frekvent är användningen av bedömningsinstrument och vilka för- och nackdelar framkommer i bruket av dessa? Uppsatsen har en kvantitativansats med kvalitativa inslag och utgår från telefonintervjuer med tio respondenter. Dessa arbetar som handläggare inom missbruks- och beroendevården för vuxna och har tillgång till bedömningsinstrument. Studien visade att åtta av tio arbetsplatser (80 %) som har tillgång till olika bedömningsinstrument använder dem. Främsta syftet är att tydliggöra klientens problematik, se insatsbehovet, få ett helhetsperspektiv och att skapa ett aktivt deltagande från klienten. Förutsättningarna för att använda bedömningsinstrument finns i form av utbildning och stöd från organisationen, men det saknas tid, kunskap och utrustning för att använda dessa fullt ut. Den statliga intentionen med en evidensbaserad praktik är att skapa en evidensbaserad kunskapsbank. Trots detta visar undersökningen att utvärdering och statistik är två eftersatta områden gällande hanteringen av bedömningsinstrument.</p> / <p><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif]--></p><p>What assessment instruments used in drug and dependent care, and the extent to which the Swedish municipalities are using these instruments is an unexplored area. Socialstyrelsen published in 2007, national guidelines for drug and dependent care which advocates the use of assessment instruments. The study aim is to examine the extent to which, for what purpose and how conditions look for the use of assessment instruments in the social service work with drug and dependent care. How frequent is the use of assessment instruments and the advantages and disadvantages apparent in the use of these? The essay has a rate of quantitative and qualitative elements based on telephone interviews with ten respondents. Those working as administrators in the drug and dependent care for adults and have access to assessment instruments. The results showed that eight out of ten sites (80%) use different assessment instruments. Main purpose is to clarify the client's problem, see the effort need, have a global perspective and to create the active participation of the client. The conditions for the use of assessment instruments are in the form of training and support from the organization, but the absence still time, knowledge and equipment to use them fully. The government intends to evidence-based practice is to create an evidence-based knowledge. Although this study shows that the evaluation and statistics are two areas in the existing management of the assessment instrument.<strong></strong></p><p> </p>
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Images of Kabir : As described by Yadav in Assi and Nagwa, and Julaha in Shivala and Saket NagarNiemi, Kristian January 2008 (has links)
<p>In his own time, the nirguna poet-saint Kabir was a controversial figure. He spoke ill of Islam and Hinduism alike, yet, in the end, both groups claimed him as their own. In this essay, various images of Kabir are discussed. Kabir as he appears in legends; Kabir as he appears in his poems; Kabir as a historical figure. But more importantly, Kabir as he is perceived as today. The image of Kabir, as it were. The question of ‘who Kabir was’ is posed to members of two groups in the city of Banaras, India — one group Muslim (Julaha), the other Hindu (Yadav).</p> / <p>Under sin egen tid var nirguna helgonpoeten Kabir, en kontroversiell figur. Han pratade illa som såväl Islam som Hinduism --- men till slut kom ändå båda grupperna att anamma honom som sin egen. I den här uppsatsen diskuteras olika bilder av Kabir. Kabir som han beskrivs i legender; Kabir som han träder fram i sina dikter; Kabir som en historisk figur. Men kanske viktigast av allt, bilden av Kabir idag. Frågan om "vem Kabir var" ställs till personer ur två grupper i staden Banaras, Indien --- en grupp Muslimer (Julaha), den andra gruppen Hinduer (Yadav).</p>
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Images of Kabir : As described by Yadav in Assi and Nagwa, and Julaha in Shivala and Saket NagarNiemi, Kristian January 2008 (has links)
In his own time, the nirguna poet-saint Kabir was a controversial figure. He spoke ill of Islam and Hinduism alike, yet, in the end, both groups claimed him as their own. In this essay, various images of Kabir are discussed. Kabir as he appears in legends; Kabir as he appears in his poems; Kabir as a historical figure. But more importantly, Kabir as he is perceived as today. The image of Kabir, as it were. The question of ‘who Kabir was’ is posed to members of two groups in the city of Banaras, India — one group Muslim (Julaha), the other Hindu (Yadav). / Under sin egen tid var nirguna helgonpoeten Kabir, en kontroversiell figur. Han pratade illa som såväl Islam som Hinduism --- men till slut kom ändå båda grupperna att anamma honom som sin egen. I den här uppsatsen diskuteras olika bilder av Kabir. Kabir som han beskrivs i legender; Kabir som han träder fram i sina dikter; Kabir som en historisk figur. Men kanske viktigast av allt, bilden av Kabir idag. Frågan om "vem Kabir var" ställs till personer ur två grupper i staden Banaras, Indien --- en grupp Muslimer (Julaha), den andra gruppen Hinduer (Yadav).
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Bedömningsinstrument : En studie om hur bedömningsinstrument används inom socialtjänstens arbete med missbruks- och beroendevårdArdesjö, Lillemor, Lazarevic, Monika, Sjögren, Åsa January 2009 (has links)
<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif]-->Vilka bedömningsinstrument som används inom missbruks- och beroendevården och hur Sveriges kommuner använder instrumenten är ett outforskat område. Socialstyrelsen publicerade år 2007 nationella riktlinjer för missbruks- och beroendevård där man förespråkar användandet av bedömningsinstrument. Studien har granskat i vilken utsträckning och i vilket syfte bedömningsinstrument används och hur förutsättningarna ser ut för användningen av bedömningsinstrument inom socialtjänstens arbete med missbruks- och beroendevård. Hur frekvent är användningen av bedömningsinstrument och vilka för- och nackdelar framkommer i bruket av dessa? Uppsatsen har en kvantitativansats med kvalitativa inslag och utgår från telefonintervjuer med tio respondenter. Dessa arbetar som handläggare inom missbruks- och beroendevården för vuxna och har tillgång till bedömningsinstrument. Studien visade att åtta av tio arbetsplatser (80 %) som har tillgång till olika bedömningsinstrument använder dem. Främsta syftet är att tydliggöra klientens problematik, se insatsbehovet, få ett helhetsperspektiv och att skapa ett aktivt deltagande från klienten. Förutsättningarna för att använda bedömningsinstrument finns i form av utbildning och stöd från organisationen, men det saknas tid, kunskap och utrustning för att använda dessa fullt ut. Den statliga intentionen med en evidensbaserad praktik är att skapa en evidensbaserad kunskapsbank. Trots detta visar undersökningen att utvärdering och statistik är två eftersatta områden gällande hanteringen av bedömningsinstrument. / <!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:HyphenationZone>21</w:HyphenationZone> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-name:"Normal\,Normal1\,Normal11\,Normal111\,Normal1111\, webb2"; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:612.0pt 792.0pt; margin:70.85pt 70.85pt 70.85pt 70.85pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!--[if gte mso 10]> <mce:style><! /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Normal tabell"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} --> <!--[endif]--> What assessment instruments used in drug and dependent care, and the extent to which the Swedish municipalities are using these instruments is an unexplored area. Socialstyrelsen published in 2007, national guidelines for drug and dependent care which advocates the use of assessment instruments. The study aim is to examine the extent to which, for what purpose and how conditions look for the use of assessment instruments in the social service work with drug and dependent care. How frequent is the use of assessment instruments and the advantages and disadvantages apparent in the use of these? The essay has a rate of quantitative and qualitative elements based on telephone interviews with ten respondents. Those working as administrators in the drug and dependent care for adults and have access to assessment instruments. The results showed that eight out of ten sites (80%) use different assessment instruments. Main purpose is to clarify the client's problem, see the effort need, have a global perspective and to create the active participation of the client. The conditions for the use of assessment instruments are in the form of training and support from the organization, but the absence still time, knowledge and equipment to use them fully. The government intends to evidence-based practice is to create an evidence-based knowledge. Although this study shows that the evaluation and statistics are two areas in the existing management of the assessment instrument.
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The revival of Sphoṭa in early modern Benares : Śeṣakṛṣṇa's SphoṭattvanirūpaṇaSeneviratne, Rohana Pushpakumara January 2015 (has links)
This thesis examines the revival of the sphoṭa doctrine in early modern Benares and Śeṣakṛṣṇa's Sphoṭattvanirūpaṇa as an influential work in that revival. The sphoṭa doctrine is the richest contribution of the grammarians to the philosophy of language, but its semantic significance was not highlighted until late, because its theological implication was stronger. Śeṣakṛṣṇa was a renowned Sanskrit grammarian who flourished in sixteenth-century Benares. He also wrote poetry and Dharmasastric works, and played an important role as a juridical authority. Despite his illustrious career, Śeṣakṛṣṇa encountered criticism for his works from contemporary critics. The only work he wrote solely on the philosophy of language was the Sphoṭattvanirūpaṇa. As the first discrete work on sphoṭa by a grammarian, the Sphoṭattvanirūpaṇa represented an important landmark in the later expositions of the doctrine of sphoṭa particularly because it renewed the later grammarians' interest in sphoṭa, which then resulted in a series of individual works of a similar sort. The revival of the sphoṭa doctrine in early modern Benares coincided with that of the philosophy of language, which was caused by a number of social and intellectual factors in different proportions and phases. Śeṣakṛṣṇa's Sphoṭattvanirūpaṇa emerged on the eve of that revival, and can be recognized as a pioneer work in terms of its revitalization of the grammarians' interpretation of sphoṭa after a period of dormancy, and its influence on later works on sphoṭa.
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När kunskap ska styra : Om organisatoriska och professionella villkor för kunskapsstyrning inom missbruksvården / When knowledge is the ruling force : On organizational and professional conditions for knowledge governance in substance abuse treatmentAlm, Maria January 2015 (has links)
This thesis focuses on the changed governance of the public sector and what it can entail for professional work in substance abuse treatment. The point of departure is one of these new forms of governing, namely ‘knowledge governance’, which refers to a policy-driven process for promoting the use of evidence-based practice. The overall aim is to contribute to understanding and knowledge of the meaning and the conditions for knowledge governance in substance abuse treatment. The thesis studies how knowledge is interpreted by professionals and adapted to local practice in relation to organizational and professional conditions. The thesis also highlights the implications that these conditions may have for knowledge development on a professional and organizational level. The empirical material comprises three studies. Study 1 included a document analysis and a literature review. The document analysis examines how knowledge governance is described in official documents, while the focus of the literature review is on the concept of knowledge management. In Studies 2 and 3 focus group interviews were conducted with professionals who participated in a specific project, and professionals who use structured interview methods in their work (Addiction Severity Index, ASI, or Documentation of clients, DOC). The theoretical perspectives used in the thesis are neo-institutional theory, professional theory and perspectives on workplace learning. The results of Study 1 showed that knowledge governance embodies a steering of organizations, in comparison with knowledge management as a means for steering in organizations. The analyses from the focus group interviews demonstrate that knowledge governance becomes the subject of translations and edits to a local context. This process was affected by both organizational and professional conditions. The thesis is concluded with a discussion of the conditions that must be present if knowledge governance can lead to development of knowledge. The main result is that strategies must be tailored to each organization's specific condition and must be anchored throughout the organization.
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Trauma and Mental Health Symptoms among Clients in Residential Treatment for Substance Use DisordersJohnson, Pam L. January 2020 (has links)
No description available.
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Caractérisation de nouveaux modes de maintien en charge pour batteries stationnaires de secoursDillenseger, Guillaume 14 December 2004 (has links) (PDF)
Les accumulateurs au plomb de secours sont traditionnellement maintenus à l'état chargé par floating, i.e. tension de charge constante.<br />Nous avons mené différentes études sur les batteries de démarrage, les moins chères du marché : cinétiques d'autodécharge des électrodes, influence des surtensions sur les états de charge et la corrosion, aptitude à la recharge.<br />Il en résulte des considérations sur les notions mêmes de fem d'un accumulateur au plomb, de charge complète, et un modèle de perte de capacité des matériaux actifs dans le temps. Une nouvelle technique de maintien en charge est proposée, réduisant au moins d'un facteur deux les quantités d'électricité fournies. Cette technique associe de longues périodes sous faibles courants de maintien, inférieurs d'un ordre de grandeur aux courants de floating habituels, et des phases courtes à régime plus élevé. Elle vise à réduire les coûts de service en conjuguant : batteries bon marché, peu ou pas d'entretien et durée de vie élevée.
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