Cette étude visait à améliorer la compréhension du rôle des rapports de genre et de la sexualité dans les comportements sexuels à risque au VIH/sida chez les clients et les autres partenaires sexuels des travailleuses du sexe (TS) de Ouagadougou au Burkina Faso. Deux techniques de collectes de données ont été employées. Premièrement, des entretiens qualitatifs effectués auprès de 30 hommes (24 clients et six petits amis de TS) ont permis d'approfondir le contexte des rapports de genre, de la sexualité, de la prostitution et des comportements sexuels. L'analyse du discours des participants a fait ressortir l'existence d'une inégalité sociale et sexuelle entre les hommes et les femmes, inégalité qui, dans un contexte de précarité socio-économique, fournit une explication au phénomène de la prostitution ainsi qu'aux comportements sexuels des participants. Deuxièmement, des questionnaires administrés à 249 clients de TS visaient à vérifier le lien entre les normes sociales et sexuelles masculines (identifiées à partir de l'analyse des entretiens qualitatifs), parmi d'autres facteurs psychosociaux, et l'intention d'utiliser le condom chez ce groupe d'hommes. Les résultats ont montré que la majorité des clients (77 %) avaient une intention élevée d'utiliser le condom avec les TS. L'analyse de régression logistique a révélé que les principaux déterminants de l'intention étaient les croyances dans les rôles sociaux perçus (rapport de cote=9,2, 95% IC : 3,7-22,7), l'efficacité personnelle perçue (rapport de cote=3,9, 95%, IC : 1,9-8,0) et la perception du contrôle (rapport de cote=3,2, 95% IC : 1,3-8,0). Des analyses discriminantes ont permis de préciser les énoncés significatifs des croyances dans les rôles sociaux et de l'efficacité personnelle perçue. L'intégration des résultats qualitatifs et quantitatifs ont mis en évidence la présence d'une vulnérabilité féminine et masculine au VIH/sida propre au milieu prostitutionnel et ancrée dans les normes sociales et sexuelles de genre. Il ressort particulièrement que la difficulté chez certains hommes à contenir leurs désirs sexuels pourrait les empêcher de recourir au condom avec une TS alors qu'au contraire, ils auraient davantage l'intention de l'utiliser si la TS l'exigeait. Enfin, des recommandations sont formulées afin de développer les futures recherches et interventions dans ce milieu. / The aim of the study was to improve the understanding of the role of gender relations and sexuality on sexual behaviour at risk of HIV/AIDS among clients and other sexual partners of female sex workers (FSW) from Ouagadougou, Burkina Faso. To this end, two data collection techniques were used. First, 30 qualitative interviews were conducted among clients (24) and boyfriends (6) of FSW covering the context of gender relation, sexuality, prostitution and sexual behaviours. Participants' discourse analysis highlighted the presence of social and sexual inequality between men and women, inequality which, in a context of socio-economic precariousness, provided an explanation to prostitution phenomena and risky sexual behaviour of participants. Second, 249 questionnaires were administered to clients of FSW. These were used to examine the link between male social and sexual norms (identified by the analysis of qualitative interviews), among other psychosocial factors, and their intention to use condom. Results showed that a majority of clients (77 %) had a high intention to use condom with FSW. Logistic regression analysis showed that the principal determinants of intention to use condom were role beliefs (OR=9,2, 95% CI : 3,7-22,7), self-efficacy (OR=3,9, 95%, IC : 1,9-8,0) and perception of control (OR=3,2, 95% IC : 1,3-8,0). Discriminant analysis was used to identify significant statements of role beliefs and self efficacy. Integration of qualitative and quantitative results highlighted a female and male vulnerability to HIV/AIDS in the prostitution milieu that was embedded into social and sexual gender norms. In particular, we found that the difficulty for some men to control their sexual desire can reduce their intention to use condom with FSW while they would have a more positive intention if the FSW require them to use one. Finally, we gave some suggestions to develop further research and intervention in this prostitution milieu.

The protection of clients in their dealings with insurance advisors is very important. This is mainly because clients are not too knowledgeable about insurance products. This lack of knowledge makes vulnerable to exploitation by insurance advisors. It is the duty of the regulator of insurance to ensure adequate protection of clients in their dealings with insurance advisors. However, this may not be easily attainable in a jurisdiction like Lesotho where there is only one regulator for all financial institutions, the Central Bank of Lesotho. This more so because insurance is very complex as there are different persons and contracts involved. The client has to firstly deal with insurance advisors or intermediaries before an actual contract of insurance comes into existence. In Lesotho the insurance sector is regulated by the Insurance Act 18 of 1976. Although there are systems in place regarding the regulation of the insurance industry, they are not adequate nor guarantee effective protection of the clients. These measures are mainly focused on the relationship between the Commissioner and the insurance advisors and not the relationship between the insurance advisors and the clients. The ineffectiveness of the current regulatory framework in Lesotho was exposed by the MKM situation in 2007 which showed that clients in Lesotho are to a very large extent left unprotected against insurance advisors. Even the proposed Insurance Bill of 2013 which was meant to address problems not addressed by the Insurance Act, does not offer any assistance as it contains no provisions on the protection of clients. The problem with the legal framework in Lesotho is that does not address the most important of protection of clients in their dealings with insurance advisors. This is also due to the fact that there is only one regulator for all financial institutions and this places a very burdensome duty on the Central Bank of Lesotho. In order to find solutions to this problem, a comparative study based on literature was done between Lesotho and South Africa. This is because South Africa on the other hand is more advance. The current legal framework in South Africa ensures the protection of clients in their dealings with insurance advisors. The non-banking institutions such as insurance advisors are regulated by the Financial Services Board. There are systems in place in South Africa regulating the conduct of insurance advisors towards clients. The Financial Advisory and Intermediary Services Act is one of the measures in place meant to ensure that those who render advice are fit and proper by requiring them, amongst others, to be in possession of relevant academic qualifications and operational ability to dispose of their duties in terms of the Act. This is different from the position in Lesotho where the only piece of legislation regulating the insurance advisors is the Insurance Act. Furthermore, by virtue of section 2B of the General Proclamation of 1884, the common law of South Africa is applicable in Lesotho so it is important to examine the changes that South Africa has made to it common law on which Lesotho mostly relies. The results show that the clients in Lesotho are to a very large extent left unprotected against insurance advisors as the current legal framework offers them no protection. The legal framework in South Africa on the other hand affords clients more protection. However, economic position of Lesotho it would not be ideal to take all measures applicable in South Africa and apply them to Lesotho as they are. Based on these findings recommendations made include that the Commissioner must engage in consumer education to ensure that clients know about their rights in dealings with insurance advisors. Another recommendation made is that the current legal framework be amended to include provisions relating to the protection of clients. It is also recommended that the Central Bank of Lesotho is well equipped to deal with matters relating to the protection of clients. / LLM (Estate Law), North-West University, Potchefstroom Campus, 2015

The protection of clients in their dealings with insurance advisors is very important. This is mainly because clients are not too knowledgeable about insurance products. This lack of knowledge makes vulnerable to exploitation by insurance advisors. It is the duty of the regulator of insurance to ensure adequate protection of clients in their dealings with insurance advisors. However, this may not be easily attainable in a jurisdiction like Lesotho where there is only one regulator for all financial institutions, the Central Bank of Lesotho. This more so because insurance is very complex as there are different persons and contracts involved. The client has to firstly deal with insurance advisors or intermediaries before an actual contract of insurance comes into existence. In Lesotho the insurance sector is regulated by the Insurance Act 18 of 1976. Although there are systems in place regarding the regulation of the insurance industry, they are not adequate nor guarantee effective protection of the clients. These measures are mainly focused on the relationship between the Commissioner and the insurance advisors and not the relationship between the insurance advisors and the clients. The ineffectiveness of the current regulatory framework in Lesotho was exposed by the MKM situation in 2007 which showed that clients in Lesotho are to a very large extent left unprotected against insurance advisors. Even the proposed Insurance Bill of 2013 which was meant to address problems not addressed by the Insurance Act, does not offer any assistance as it contains no provisions on the protection of clients. The problem with the legal framework in Lesotho is that does not address the most important of protection of clients in their dealings with insurance advisors. This is also due to the fact that there is only one regulator for all financial institutions and this places a very burdensome duty on the Central Bank of Lesotho. In order to find solutions to this problem, a comparative study based on literature was done between Lesotho and South Africa. This is because South Africa on the other hand is more advance. The current legal framework in South Africa ensures the protection of clients in their dealings with insurance advisors. The non-banking institutions such as insurance advisors are regulated by the Financial Services Board. There are systems in place in South Africa regulating the conduct of insurance advisors towards clients. The Financial Advisory and Intermediary Services Act is one of the measures in place meant to ensure that those who render advice are fit and proper by requiring them, amongst others, to be in possession of relevant academic qualifications and operational ability to dispose of their duties in terms of the Act. This is different from the position in Lesotho where the only piece of legislation regulating the insurance advisors is the Insurance Act. Furthermore, by virtue of section 2B of the General Proclamation of 1884, the common law of South Africa is applicable in Lesotho so it is important to examine the changes that South Africa has made to it common law on which Lesotho mostly relies. The results show that the clients in Lesotho are to a very large extent left unprotected against insurance advisors as the current legal framework offers them no protection. The legal framework in South Africa on the other hand affords clients more protection. However, economic position of Lesotho it would not be ideal to take all measures applicable in South Africa and apply them to Lesotho as they are. Based on these findings recommendations made include that the Commissioner must engage in consumer education to ensure that clients know about their rights in dealings with insurance advisors. Another recommendation made is that the current legal framework be amended to include provisions relating to the protection of clients. It is also recommended that the Central Bank of Lesotho is well equipped to deal with matters relating to the protection of clients. / LLM (Estate Law), North-West University, Potchefstroom Campus, 2015

Bien que des interventions psychothérapeutiques efficaces aient été identifiées pour un éventail de problématiques psychologiques, un nombre considérable de clients ne bénéficient toutefois pas complètement de ces traitements, tel que l’indiquent les hauts taux d’abandon thérapeutique. La relation thérapeutique comme telle a été identifiée comme l’un des prédicteurs de l’abandon et plusieurs études ont démontré que les clients qui demeurent en thérapie évaluent leur alliance thérapeutique de manière plus positive que ceux qui abandonnent. De plus, parmi les clients qui demeurent en thérapie, c’est encore la relation thérapeutique qui joue un rôle important par sa valeur prédictive des résultats thérapeutiques. Le courant humaniste, en psychothérapie, place la relation thérapeutique au premier plan de l’intervention et a largement contribué à l’intérêt grandissant, en recherche, pour la relation thérapeutique. Malgré cette reconnaissance de l’importance de la relation thérapeutique, les études sur la nature des composantes de la relation thérapeutique et sur leur rôle dans l’efficacité de la thérapie ont surtout été menées du point de vue du psychothérapeute ou de celui d’un observateur. Le point de vue du client a été peu étudié, bien qu’il puisse être un meilleur prédicteur des résultats thérapeutiques. La présente étude avait donc pour but de recueillir les perceptions de clients adultes en psychothérapie sur la nature des composantes d’une relation thérapeutique positive ainsi que sur les composantes de la relation thérapeutique qu’ils perçoivent comme ayant un impact positif sur leur processus de changement. Un cadre théorique humaniste a été privilégié. Un devis qualitatif a été utilisé, car ce type de devis est pertinent pour explorer un phénomène peu documenté et pour décrire en profondeur l’expérience unique et complexe qui s’y rapporte. Des entrevues semi-structurées ont été réalisées auprès de clients en psychothérapie à moyen et long terme (de 15 séances à deux ans), avec des psychologues d’orientation humaniste, étant donné l’importance qui est accordée à la relation thérapeutique par cette approche. Les données ont été analysées à l’aide de la méthode d’analyse de contenu mixte, inspirée de la méthode proposée par l’Écuyer, en combinant la méthode déductive et la méthode inductive. Une grille des composantes préexistantes a été construite pour guider la collecte et l’analyse des données et comprend la Relation coopérative, la Relation transférentielle, la Relation personne-à-personne et la Relation transpersonnelle. L’analyse des données a permis de décrire en profondeur ces composantes. De plus, l’analyse à l’aide de la méthode inductive a fait se dégager un arbre des catégories émergentes, qui amène des éléments d’approfondissement quant à la perception des clients d’une relation thérapeutique positive. Une démarche d’accord inter-juges a permis d’augmenter la validité du processus de codification. En ce qui a trait aux éléments perçus comme ayant un impact positif sur le processus de changement, la confiance mutuelle et le dévoilement de soi seraient centraux dans la perception des clients de cette étude. De plus, il ressort que différents éléments de la relation plus personnelle qui s’établit entre le client et le thérapeute, tels qu’un équilibre entre intimité et distance émotionnelle ainsi que la présence d’une complicité, seraient des leviers importants dans le processus de changement, selon les clients qui ont participé à cette étude. À la lumière des résultats obtenus ainsi que des forces et des limites de l’étude, des recommandations concernant les pistes d’investigation futures pour la recherche sont formulées. Les résultats et la discussion de la présente étude pourront fournir aux psychologues cliniciens et aux institutions de formation une porte d’entrée pour amorcer ou poursuivre une réflexion quant aux composantes de la relation thérapeutique pouvant recevoir une attention particulière en psychothérapie.

The purpose of this thesis is to study how individuals with alcohol and drug problems come to treatment – who is in treatment and who is not? It further studies the goal and role of treatment according to different groups – clients, staff and politicians. How can we understand clients’ experiences in a context? The main data is from the Women and men in Swedish alcohol and drug treatment-study, with a representative sample of clients as well as complementary data on the views of staff and the general population. The thesis comprises four related papers: (1) explores who is in treatment and who is not by analysing the client and the general population samples; (2) studies reasons for coming to treatment among clients by focussing on self-choice in relation to informal, formal, and legal social pressures to seek treatment; (3) investigates alcohol and drug related events among misusers and the role of these events in treatment entry, and in relation to level of marginalization of the clients; (4) analyses motives for and conflicts surrounding changes in the treatment system on an organizational level. The thesis reveals that clients in treatment are marginalized (regarding housing, work, family, etc.). At treatment entry, clients report self-choice as well as a range of pressures to seek treatment as reasons for coming. The events are influential in treatment seeking, especially events and pressures in relation to significant others. In addition, it is shown that changes in the treatment system are not only driven with the interests of the clients in mind. Professional struggles, economic cuts, and coincidences are of importance. It is shown that different actors have competing as well as compatible and matching views on the goals of treatment. Finally, some notable changes in the treatment system are discussed.

Purpose: The purpose of this thesis is to study business clients’ technology acceptance of e-commerce within business-to-business in the work wear sector. In specific, develop and test a framework in order to analyze the antecedents of perceived usefulness and perceived ease of use behind business clients’ behavioral intention to the usage of e-commerce. Problem: There is not sufficient research regarding industries and companies that are categorized as laggards (Del Aguila-Obra & Padilla-Melendez, 2006), and furthermore regarding clients’ technology acceptance in a business-to-business context (Doherty & Ellis-Chadwick, 2010). Actors within the work wear sector conduct their businesses in the most traditional way, with physical stores (Ekberg, Fraenkel, Gustavsson, Hamsten & Hedin, 2014). The question is whether this traditional way remain due to skepticism among the business clients’ and their level of technology acceptance. Method: A proposed framework is developed by the authors, adapted from Technology Acceptance Model (Venkatesh & Davis, 2000) and Diffusion of Innovation Theory (Rogers, 1983). This framework is tested through quantitative research, and more specific a questionnaire. Subsequently, the empirical data gathering is assembled, analyzed and concluded into a final proposed framework.  Findings: The final proposed framework incorporates antecedents from the proposed framework, but also new influences that are identified in the empirical findings as relevant. These influences are Age, Gender, Experience and Compliance. Further, the antecedents presented in the final proposed framework are the following: Subjective norm/Opinion leaders, Job relevance/Compatibility, Output quality, Result demonstrability/Observability and Trialability.

The aim of this dissertation is to examine the implementation of the Addiction Severity Index (ASI) in social services and how it affects the encounter between the clients and their social workers. As structured interviews are unusual in social service based addiction care there is concern that they will have negative consequences on the relation between the social workers and their clients. The first study therefore investigates the clients’ acceptance of the ASI. The results show that 95 % of the clients accepted the ASI and that 85% viewed it in positive terms. Approximately 8% reported feeling violated by one question without this having any negative effect on the relation to the social workers or confidence in the social services. The results did not give empirical support for negative effects of the ASI. In the second study a comparison was made between a group that had participated in an assessment session using the ASI and a group with which the ASI had not been used. The results show that there is no difference in perception of “the alliance” or “negative experiences” with or without the ASI, but that the clients’ feeling of “own competence” is lower when the ASI is employed. The question of whether the reduced feeling of own competence among the clients is an expression of greater realism and reduced denial or only the negative effect of increased helplessness on the clients’ self-esteem can not be resolved in this study. In the third study, based on the same groups participating in the second study, the social workers were also asked to judge how the clients experienced such assessment sessions. The results show that the social workers’ assessment of the clients’ experiences differed from the clients’ own experiences regarding the “alliance” and “clients’ own feelings of competence”. However, the social workers made a correct assessment of the clients’ “negative experiences” of the sessions. The two different forms of session, with or without the ASI, did not influence the social workers’ assessment of the clients’ perceptions. The fourth study presents the results of a national questionnaire completed by 555 members of staff in social services, the prison service, and addiction services. The results show that supervisors and bosses take an increasingly greater responsibility for ASI training and that opportunities for using the ASI varied according to the place of work. Differences can probably be explained by different services being in different phases of implementation at the time of the study. The ASI has primarily been used in direct client work and only to a minor extent for follow-ups and evaluation. The number of ASI interviews carried out is small especially for those trained prior to 1999.

<p>The purpose of this thesis is to study how individuals with alcohol and drug problems come to treatment – who is in treatment and who is not? It further studies the goal and role of treatment according to different groups – clients, staff and politicians. How can we understand clients’ experiences in a context?</p><p>The main data is from the Women and men in Swedish alcohol and drug treatment-study, with a representative sample of clients as well as complementary data on the views of staff and the general population.</p><p>The thesis comprises four related papers: (1) explores who is in treatment and who is not by analysing the client and the general population samples; (2) studies reasons for coming to treatment among clients by focussing on self-choice in relation to informal, formal, and legal social pressures to seek treatment; (3) investigates alcohol and drug related events among misusers and the role of these events in treatment entry, and in relation to level of marginalization of the clients; (4) analyses motives for and conflicts surrounding changes in the treatment system on an organizational level.</p><p>The thesis reveals that clients in treatment are marginalized (regarding housing, work, family, etc.). At treatment entry, clients report self-choice as well as a range of pressures to seek treatment as reasons for coming. The events are influential in treatment seeking, especially events and pressures in relation to significant others. In addition, it is shown that changes in the treatment system are not only driven with the interests of the clients in mind. Professional struggles, economic cuts, and coincidences are of importance. It is shown that different actors have competing as well as compatible and matching views on the goals of treatment. Finally, some notable changes in the treatment system are discussed.</p>

There are several success factors defined for the implementation phase that should be achieved in order for an implementation project to be successful. Several studies focus on the supplier's commitment and success factors to implement a system that end users will accept. But there are identified success factors which clients themselves should implement or give attention to during the implementation phase to have the end users accepting the system and keeping the time frame of the project. How has the client's efforts and capacity affected the result of the implementation and the timing of deployment? The aim with this study is to apply and develop a model for implementation of information systems which is based of success factors from a client perspective. The aim is also to identify advice on how to successfully implement a system, that the system is deployed on time and that the users is accepting the system. Our theoretical framework is presenting eight identified success factors within the client organisation. This has been applied in a case study with semi-structured interviews. The result is a model from a client perspective which shows the connection between the success factors in the implementation phase. The model can be used by providers to inform clients about the success factors that affect the implementation project. It may then be easier for the client to see what needs to be done and how one action affects another. Further, a number of recommendations extracted from the model is presented, which affects the result, the users’ acceptance and if the information system is deployed on time. / Syftet med denna studie är att utifrån framgångsfaktorer ur ett beställarperspektiv tillämpa och vidareutveckla en modell för implementation av informationssystem. Syftet är även att identifiera råd för en lyckad implementering som innebär att systemet driftsätts efter utsatt tid samt att användarna finner acceptans för systemet. Vårt teoretiska ramverk presenterar åtta identifierade framgångsfaktorer inom beställarorganisationen och det har vi tillämpat i en fallstudie med semistrukturerade intervjuer. Resultatet blev en modell ur ett beställarperspektiv som redovisar sambandet mellan framgångsfaktorer i implementeringsfasen. Modellen kan användas av leverantörer för att informera beställare om de framgångsfaktorer som påverkar ett implementeringsprojekt. Det kan då bli tydligare och enklare för beställaren att se vad som behöver göras och hur en åtgärd påverkar en annan. Vidare redovisas ett antal rekommendationer utifrån modellen som påverkar resultatet för att driftsätta informationssystem i tid och som påverkar användarnas acceptans.

The aim of this thesis is to study whether the Swedish state’s efforts to govern the professional practice of social workers (SWs) by knowledge to achieve an evidence-based practice, address the difficulties that SWs encounter in their practice. The Swedish state’s ambition is to govern the practice of social work by ideas and methods originating from medicine. The thesis therefore compares, through four different studies, the professional practice of SWs with general practitioners (GPs) as the most comparable sub-profession in medicine. The research questions that the thesis seeks to answer are: What situations are perceived as problematic and non-problematic by SWs and GPs? How does the professionals’ relationship with clients affect the performative aspects of these occupations’ enactment of their practice? How do SW and GPs experience the state’s efforts to govern their professional practice by knowledge? What problems can arise when the Swedish state builds its knowledge governance of social work practice on a comparison with medicine, even though these professional fields exhibit a number of important differences? The empirical material in the first and second studies consists of 52 narratives, written by SWs and GPs on problematic and non-problematic situations. The third study is based on vignette-based focus group interviews with 25 SWs and GPs. And the fourth study is based on a literature review, consisting of 54 articles about SWs’ and GPs’ practice. A first finding is that professionals rarely describe lack of knowledge or difficulties with knowledge use as problematic. A second finding is that non-problematic situations are connected to professionals’ control of the intervention process. SWs gained control of the relationship with the client either by use of coercive means or by the client’s active co-operation. GPs gained control of the intervention process by the use of professional knowledge. A third finding is that an understanding of professional practice as a linear process consisting of diagnosis, inference and treatment reflects GPs’ practice but not all aspects of SWs’ practice. A fourth finding is that both professions hold ambivalent positions towards evidence-based risk reductions technologies. The responses towards organisational risk reductions technologies differ in that GPs are sceptical, whilst SWs take a more pragmatic view. A main conclusion is that the Swedish state’s efforts to govern the performative aspects of SWs’ practice by knowledge, runs the risk of becoming a insufficient strategy since they tend to exhibit two main blind spots. The first is that these efforts tend to ignore that the relationship with the client has a crucial affect on and conditions SWs’ and in problematic situations also GPs’ knowledge use. The second is that the efforts also tend to ignore that control of the intervention process is not always maintained through control of knowledge use. For SWs control of the relationship with clients represents another mode of professional control of the intervention process. / Hur använder socialarbetare och allmänläkare kunskap i praktiken?, FAS/FORTE dnr 2009-0251