The aim of this research was to develop guidelines for after-care services for rehabilitated alcoholics, in order to render a more effective support service towards the rehabilitated alcoholic on his way to full recovery. The necessity of the research project originated on account of a lack of knowledge among social workers on the need of the rehabilitated alcoholic towards after-care service and the specific nature that after-care services have to contain. A literature overview of after-care services was given to the alcoholic, as a background for the empirical study of the project. The literature study showed that after-care services as an integral part of the total rehabilitation of the alcoholic is conceptualized. Further out of the literature came to light that social workers have a resistance against the delivering of after-care services and that they experience feelings of discourage regarding the alcoholic. The empirical study confirmed that social workers experience resistance against giving after-care services to rehabilitated alcoholics. Further they don't consider this as part of their task and they give a low priority towards the rendering of after-care services. In spite of this, the necessity of after-care services is being realized by the social workers. Alcoholics who are standing on the point of being discharged from the rehabilitation center have a need for after-care services to help them adapt in the community. They especially have a need for individual contact with a professional person and do not want to be part of only a self-help group. Among the alcoholics who are already functioning in the community after treatment, the particular need of the female alcoholic came forward. This group feels that their family and spouse do not truly have an idea of their needs. Further there was a need among the rehabilitated alcoholics to know who will be responsible for their after-care services. This group would have wanted to be prepared on possible risky situations and ways of handling these situations. The research showed that there is a shortcoming in the practice concerning the rendering of aftercare service. Guidelines were formulated from which more effective after-care services could be given to rehabilitated alcoholics. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2004.

The aim of this research was to develop guidelines for after-care services for rehabilitated alcoholics, in order to render a more effective support service towards the rehabilitated alcoholic on his way to full recovery. The necessity of the research project originated on account of a lack of knowledge among social workers on the need of the rehabilitated alcoholic towards after-care service and the specific nature that after-care services have to contain. A literature overview of after-care services was given to the alcoholic, as a background for the empirical study of the project. The literature study showed that after-care services as an integral part of the total rehabilitation of the alcoholic is conceptualized. Further out of the literature came to light that social workers have a resistance against the delivering of after-care services and that they experience feelings of discourage regarding the alcoholic. The empirical study confirmed that social workers experience resistance against giving after-care services to rehabilitated alcoholics. Further they don't consider this as part of their task and they give a low priority towards the rendering of after-care services. In spite of this, the necessity of after-care services is being realized by the social workers. Alcoholics who are standing on the point of being discharged from the rehabilitation center have a need for after-care services to help them adapt in the community. They especially have a need for individual contact with a professional person and do not want to be part of only a self-help group. Among the alcoholics who are already functioning in the community after treatment, the particular need of the female alcoholic came forward. This group feels that their family and spouse do not truly have an idea of their needs. Further there was a need among the rehabilitated alcoholics to know who will be responsible for their after-care services. This group would have wanted to be prepared on possible risky situations and ways of handling these situations. The research showed that there is a shortcoming in the practice concerning the rendering of aftercare service. Guidelines were formulated from which more effective after-care services could be given to rehabilitated alcoholics. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2004.

No description available.

This is an exploratory follow-up study of the clientele of the Psychiatric Crisis Unit, a short-term, crisis-oriented inpatient psychiatric ward. The main objective of the research was to test the following null hypothesis: there are no significant differences between those individuals who attempt to gain aftercare treatment as opposed to those individuals who do not following discharge from the Crisis Unit. A sample of fifty-one voluntary patients who consented to participate in the study was used in testing this hypothesis. Each subject completed the Minnesota Multiphasic Personality Inventory (M.M.P.I.) and a sociological questionnaire while in the Crisis Unit, and a follow-up questionnaire was administered via telephone or personal contact approximately one month after discharge. The follow-up information was used to determine whether the subject fell into the "aftercare” or “no-aftercare” group. Data collection lasted from July 1, 1970 to December 15, 1970. The data revealed that there were significant differences between the groups and, thus, the null hypothesis was rejected. The ten M.M.P.I. scales revealed no significant differences between the groups on the individual scales. However, when examined collectively, the aftercare group scored higher than the no-aftercare group on all scales except Self-Sufficiency (which is scored in the opposite direction, corroborating the tendency in the other scales). A discriminant function correctly classified seventy-three percent of the subjects. These results indicate that the aftercare subjects probably viewed themselves as “needing” more help. The significant predictor variables found included prior familial and personal experiences similar to those bringing the subject to the Unit, employment status, age, diagnostic designation, length of hospitalization, referral planning, and self-ratings on a mood scale which was administered upon discharge from the Crisis Unit. These variables were obtained with less effort than the psychological test data. It was found that the aftercare group (compared to the other group) was younger, had a higher rate of unemployment, and had a higher rate of familial and prior personal experiences. They were also diagnosed more frequently as psychotic, with depression ranking second, and rated themselves lower on the mood scale scores. However, the difference between the before and after mood scale scores revealed that these subjects felt they had “gained” more than the no-aftercare subjects. The no-aftercare group was diagnosed more frequently as depressed, with behavior/character disorders ranking second. They tended to rate themselves higher on the mood scale scores. However, the differences between the before and after mood scale scores revealed that they had not “progressed” as much as the aftercare subjects. Although not statistically significant, it was found that the aftercare subjects were hospitalized two days longer than the subjects of the no-aftercare group. More significant is the fact that the aftercare group had a higher rate of rehospitalization than the no-aftercare group. Data collected concerning the referral process revealed that aftercare subjects were more frequently referred for treatment than were subjects of the no-aftercare group. It was speculated that those subjects who perceived themselves and/or were perceived as being "sicker" would seek further help after discharge from the Crisis Unit. The findings also suggested that not all patients need or perceived themselves as needing further help.

Amidst growing concerns about a rise in girls entering the Youth Justice System and official data highlighting increases in girls violent offending this doctoral thesis focuses on girls in the Youth Justice System. Drawing on case files and in depth interviews with a cohort of girls supervised by a Home Counties Youth Offending Team (YOT), and interviews with YOT practitioners it explores their needs and offending patterns and examines contemporary system responses to them. It aims to contribute to practice knowledge and understanding about girls offending, and to identify approaches and interventions most likely to be effective with them. Findings point to girls having multiple and interrelated needs and troubled backgrounds. Exclusion from school and non attendance, experience of severe family conflict and violence, heavy alcohol use and poverty and disadvantage are all cited as key risk factors for girls’ involvement in offending and other types of behaviour which can lead to social exclusion. Minor assault and the influence of alcohol emerge as key features in girls offending patterns. Assaults commonly arise from disputes with friends or family members, or occur whilst girls are in a mixed peer group where assaults are perpetrated against another young person or a Police Officer. The impact of more formal responses by Police and YOTS are evident and show that the highly regulated and male oriented Youth Justice System hampers the likelihood of successful interventions with girls. This study cites the importance of gender specific responses and interventions which are holistic, informal and flexible to meet the distinct needs and offending patterns of girls in the Youth Justice System. More widely early identification of girls at risk, information sharing across children, health and adult services, and the provision of a range of support and positive opportunities to girls which extend beyond the life of a Court Order are identified as key aspects of strategies aimed at improving future outcomes for girls.

For a brief moment in the 1980s, a number of local authorities across England and Wales declared themselves ‘custody free zones’ (Rutherford, 2002), symbolising an intent that children should not be incarcerated for their offending behaviour within the local authority boundary. While this lofty aspiration was not always fulfilled, on occasion it was. More importantly, such declarations can be seen as manifestations of a widespread commitment, extending well beyond those ‘zones’, to the idea that the use of custody for children should be avoided wherever possible. During the course of the decade, that commitment found expression in an unprecedented fall in the number of young people deprived of their liberty by the criminal courts. The 1990s proved to be very different. A sea-change in the treatment of children in conflict with the law led to an escalation in custody every bit as sharp as the decline that had preceded it. This thesis seeks to explain that shift in order to understand the implications for practice if the imprisonment of children is to be reduced. The explanatory account is set against a longer term background of social, economic and political change that yielded what Garland (2002) has characterised as the ‘crisis of penal modernism’. It invokes what Foucault (1991) calls a ‘history of the present’ in which patterns of incarceration since the late 1960s are analysed to shed light on the systemic determinants of the current high level of youth custody. Local variations in the use of child imprisonment are also interrogated in the context of the historical experience to ascertain the nature of political, systemic and cultural factors that are consistent with lower rates of detention. The thesis concludes that the recent rise in custody cannot be understood in isolation: the same underlying dynamic that fuelled the carceral explosion impacted equally on other aspects of the youth justice system; and necessitated a significant cultural shift on the part of the those who might previously have been expected to resist the use of detention. Without an understanding of these corresponding changes, strategies for custody reduction that rely heavily on the provision of ‘robust’ community based alternatives, or those that seek to reduce the population of the secure estate simply by ‘nipping in the bud’ (Straw, 1997) children’s offending, are unlikely to lead to the desired outcome.

“Although they make up only 11 per cent of the population above the age of criminal responsibility (in England and Wales), in 2009, people in this age group were responsible for 17 per cent of all proven offending” (NAO, 2010:5). Sadly, 56 per cent of these young people are likely to re-offend within one year (NAO, 2010). These trends are not unique; they are common to many countries worldwide (e.g. De Gusti et al, 2009). Arguably then, current government strategies that aim to reduce recidivism including custodial sentences, are not working (Clarke, 2011). However, terms such as ‘criminal offence’ and the age criteria for criminal responsibility vary widely in their definitions between and within countries. Furthermore, reasons why young people re-offend emerge from complex and multi-dimensional needs and risk factors, which themselves vary over time. Attempts at correlations and comparisons are therefore inevitably contentious. Interventions perceived as most effective at reducing recidivism focus on multi-systemic approaches to changing behaviours (e.g. DfES, 2006). This research and its findings, contributes towards a better understanding of these multi-dimensional factors. This report presents outcomes from a mixed-methods, ethnographic, comparative research project in relation to a four-day intensive outdoor experiential education programme. For the purposes of this report, the programme is called ‘Bee Inspired’ and is specifically for young people defined as ‘at risk’ of offending or re-offending. Bee Inspired is unique because it involves the participants’ immersion in learning the practical skills of beekeeping. The research was based in three countries: the Azores islands (Portuguese-governed), Prince Edward Island, Canada and England, United Kingdom. During the programme, the participants were observed closely and their behaviour, experiences and comments recorded. Additional data were collected through written questionnaires and focus group sessions during and at the completion of the programme. The outcomes are presented using a method of written ‘vignettes’. This gives voices to the participants, whose perspectives, within research data, are often absent. This report provides evidence of their positive experiences of cognitive, social and emotional development during the Bee Inspired programme; these being intrinsically linked to the programme’s objectives and the researcher’s theoretical and ontological perspectives. The findings were triangulated; qualitative and quantitative data support previous educational research and produces some new insights. The research tracked the progress of the participants twelve and eighteen months after the completion of the Bee Inspired programme. Out of 45 participants, only three participants re-offended within eighteen months; well below average and expected norms as defined in similar research. In addition to the low re-offending rates, many participants continued their beekeeping practices which in itself may contribute to the perceived success of the programme. In conclusion, although small-scale and limited in terms of scope and generalizability, this research illuminates the experiences of young people ‘at risk’ involved in experiential education. The complex and multi-dimensional nature of these experiences relate to individuals’ diverse needs. Further research into experiential education programmes is therefore required, in particular, investigations into why factors specific to beekeeping could provide a way of reducing recidivism amongst some young people at risk.

No description available.

Bakgrund: Sepsis är ett globalt hälsoproblem ibland jordens befolkning. 49 miljoner drabbas runt om i världen och de patienter som överlevt riskerar att få komplicerade komplikationer som följd. Det innebär att de drabbade är i behov av hjälp och stöd för att kunna ta sig tillbaka till det vardagliga livet. Syfte: Syftet är att belysa hur eftervården upplevs av individer som drabbats av sepsis. Metod: Studien är en empirisk enkätstudie som analyserades med kvalitativ innehållsanalys. Informanterna kontaktades via ett sepsisforum på Facebook och även kontakter via sepsisfonden. Informanterna besvarade fyra frågor som berörde upplevelsen av eftervården. Resultat: Resultatet består av fyra olika teman: Frånvaro av uppföljning, försummad av vården, kunskapsbrist i vården och god vårdkontakt. Utifrån informanternas egna ord i studien, som beskriver individernas egen upplevelse av eftervården, kunna få en ökad förståelse om det finns positiva eller negativa erfarenheter om eftervården. Slutsats: Vården har ett ansvar att guida, informera och följa upp patienterna på bästa sätt. / Background: Sepsis has become a global health problem among the population in the world, about 49 million people are affected around the world. The patients who have survived are at risk of getting complications. This means that some people need care and support to be able to go back to their normal life. Aim: The purpose of the study is to illustrate how the aftercare is experienced by individuals affected by sepsis. Method: The study is made of a qualitative content analysis with a questionnaire. Participants were contacted on a sepsis-forum on Facebook and sepsis foundation. Participants answered four questions that concerned the experience of aftercare. Choice of method and analysis produced four themes that form the basis for the results. Result: The result is made of four different themes: Lack of follow-up, neglected by care, lack of knowledge care and god care. The study is based on the informant’s own words, which describe the people's own experience of aftercare, to gain an increased understanding of whether there are positive or negative experiences about aftercare. Conclusion: The healthcare system has a responsibility to educate, guide and follow up this group.

Indiana University-Purdue University Indianapolis (IUPUI) / Postdischarge follow-up appointments are widely thought to improve the safety of transition for patients moving from the hospital to home. They provide an opportunity for outpatient primary care providers to detect problems or failures of postdischarge care. Readmissions can be used to reflect the quality of postdischarge or transitional care. This study evaluated whether patients with an outpatient follow-up appointment scheduled with their primary care provider within five calendar days of discharge had fewer 30-day readmissions than those patients who had appointments scheduled six days or longer from discharge. No difference in readmission rate was detected between the two groups.