Introduction The NHS emphasises programme approaches to commissioning (Health Improvement Programmes and National Service Frameworks) but research is limited. I evaluated the Health Care Programme Approach (HCPA) for stroke whose individual elements are: a co-ordinating group; a co-ordinator; a technical document; and agreement of priorities. Methods 1 Four rounds of interviews with managers and clinicians; observation at meetings; analysis of documentary sources. 2 Quantitative indicators of progress measured at two time points. 3 Estimation of the Programme Budget and Transaction Costs from published sources and local data. 4 Interviews with Directors of Public Health from nine comparator districts. Results 1A structured process led to a set of priorities, which were widely accepted across all agencies, allowing the co-ordinating group to focus on facilitating change. This group took two years to reach a stage where it could change services. Most peoples upportedth e approachb ut were not alwaysc lear aboutt he process. 2 The indicators showed improvements in some aspects of care. 3 The programme budget was £IOm, mostly in long-term care (£5.5m) and hospital care (£3m). The transaction costs amounted to 0.25% of the programme budget. Preface 4 All comparator districts reported changes to commissioning and improvements in stroke services, but I found more widespread change in the study district. Discussion The detailed description of process, and use of multiple methods, gives strength to the findings. A collaborative approach has developed across the NHS during the period of this study making the findings highly relevant. There were important lessons for multiagency groups including: the time needed to function effectively; the need for individuals to clarify whether they represent an organisation or their own perspective; the need to review the group remit and the group's routes of communication; and the ability to adapt to changes in national policy while focusing on improving the health of the patients who fall within the programme. Keywords Planning, Purchasing, Commissioning, Stroke Services, Health Care Programme Approach, Evidence-Based, Multiagency Collaboration, Triangulation, Evaluation, Case Study.

The aftermath of the 9/11 attacks on the United States resulted in the introduction of the National Fusion Center Network. This effort seeks to empower National Security by effectively sharing information between various law enforcement organizations. Since the establishment of the Network, information that addresses the Networks' standard operating procedures and existing barriers to share information effectively has been lacking. This caused many criticisms as to whether the network is in fact effective in fulfilling its mandate to effectively share information between the various law enforcement agencies. Utilizing Bandura's cognitive theory of behavioral change, this phenomenological study identifies the strategies utilized by the Fusion center Network to share information while addressing the barriers that arise during the process. Qualitative data consists of interviews conducted with a purposive sample of N=8 employees at two Fusion Centers in the Network. Data were inductively coded, analyzed, and summarized to answer the research questions and illustrate relevance to the framework. Findings made it clear that staff respondents believe that the Fusion Center Network has a tangible impact on Information Sharing between law enforcement, government, and non-government agencies. This expanded the field of knowledge regarding the Fusion Center Network and made room for future researchers to expound on. Recommendations offered by this study are geared towards assisting policy makers, partner organizations and the public at large to make better decisions toward protecting the Homeland from future acts of terror. This study carries implications for creating positive social change by providing recommendations to assist legislators develop effective policies and to increase national security measures of the United States.

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This article describes the Division of Career Development and Transition’s (DCDT) position regarding Career Technical Education (CTE) and provides recommendations regarding more intense collaboration to improve access to and persistence in CTE for students with disabilities. Professional groups, such as the DCDT and the Association for Career and Technical Education, as well as policy makers, should strengthen collaboration in this area. This position paper: (a) explores CTE’s effectiveness as a secondary special education and transition service; (b) summarizes relevant federal legislation; and (c) presents key recommendations for policy, practice, personnel preparation and professional development, and research. Policy and practice recommendations emphasize access and equity, personnel preparation and professional development recommendations promote an understanding of related legislation and instructional practices, and research recommendations emphasize collaborative high-quality research.

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Syftet med studien var att undersöka hur olika brottsförebyggande aktörer ser på det 364 dagar långa uppehållet av skjutningar som varade i Linköping mellan 28 januari 2022 och 27 januari 2023. Syftet var även att studera hur aktörerna ser på förebyggande arbete mot skjutningar i Linköping på ett övergripande plan. För att studera detta har kvalitativa intervjuer genomförts med sex relevanta brottsförebyggande aktörer i kommunen. Resultatet visade att uppehållet utifrån informanternas beskrivning till stor del berodde på tillfälligheter som lett till avhållsamhet hos de som annars genomför skjutningar. Aktörerna hade dock tilltro till det egna och andra aktörers arbete på området, både preventivt och ingripande, och menade att samverkan mellan aktörerna är fundamentalt i arbetet mot skjutningar. De viktigaste slutsatserna var att det inte går att säkerställa varför uppehållet uppstod, men att aktörernas bilder av uppehållet och vilka åtgärder som fungerar var samstämmiga. Dessa åtgärder avser främst samverkan och närvaro. / The purpose of this study was to examine the perspectives of crime prevention actors regarding the 364-day absence of shootings in Linköping between January 28, 2022, and January 27, 2023. Additionally, the study aims to investigate how these actors perceive preventive efforts against shootings in Linköping. Qualitative interviews were conducted with six relevant crime prevention actors in Linköping to examine these aspects. The findings revealed that, according to the informants' descriptions, the absence of shootings during this period was largely due to coincidental factors that abstained potential perpetrators. Nevertheless, the actors expressed confidence in the effectiveness of their own and other actors' preventive and intervention initiatives, emphasizing the fundamental role of interagency collaboration in preventing shootings. The study concludes that while specific reasons for the absence cannot be determined, actors' perceptions and the importance of interagency collaboration was consistent. The findings highlight interagency collaboration and active presence in crime prevention.

Homelessness is a pressing social and health concern that affects Māori disproportionately. This research explores the provision of mental health services to Māori who are homeless. The thesis has two primary aims. First, to document the experiences of Māori homeless people who live with mental health concerns and their relationships with mental health professionals. Second, to document the experiences of mental health professionals and how they interact with, provide care for, and build relationships with Māori Homeless. The skills of, and the difficulties faced by these professionals in provisions of quality of care are also considered. Three male and three female homeless participants were recruited from the Waikato and Auckland regions. All participants had received care from Non Governmental Organisations (NGOs) and/or District Health Board services (DHB). Participating mental health professionals included one female and five males. Mental health professionals included counsellors, therapists, psychologists, social workers, crisis team coordinator, and a cultural advisor. All participants took part in individual semi-structured interviews conducted in an open and conversational manner. Key themes for homeless participants included their general life histories of mental illness, mental health service use, relationship with professionals, cultural issues, and concerns that Māori homeless wanted to discuss. Key themes for mental health professionals included their approaches when working with homeless people, relationship building, barriers to working with this group and possible solutions, linking with other professionals or organisations, and issues mental health professionals wanted to discuss. Findings highlight the importance of strong therapeutic relationships between homeless clients and mental health professionals, the need for more joined up (multi-level agency) approach to service delivery, and the importance of Māori ideology in restoring wellbeing and dignity. Findings suggest that the effectiveness of mental health service delivery relies in part on information provided by stakeholders. Information provided by homeless people and mental health professionals informs both service delivery and the ways in which practitioners can best support the needs of homeless people.

Introduction Not all children seeking asylum without parents or other relatives are entitled to residence permits. In the last few years, more than one in four unaccompanied asylum-seeking refugee children have been forced to repatriate, either to their home country or to a transit country. Mostly the children refuse to leave the country voluntarily, and it becomes a forced repatriation. Five actors collaborate in the Swedish child forced repatriation process: social workers, staff at care homes, police officers, Swedish Migration Board officers and legal guardians. When a child is forced to repatriate, the Swedish workers involved must consider two different demands. The first demand requires dignified repatriation, which is incorporated from the European Union’s (EU’s) Return Directive into Swedish Aliens Act. The second demand requires that the repatriation process be conducted efficiently, which means that a higher number of repatriation cases must be processed. The fact that the same professionals have different and seemingly contradictory requirements places high demands on the involved collaborators. Two professionals have a legal responsibility for the children until the last minute before they leave Sweden: social workers and police officers. That makes them key actors in forced repatriation, as they carry most of the responsibility in the process. Further, they often work with children who are afraid what will happen when they return to their home country and often express their fear through powerful emotions. Being responsible and obliged to carry out the government’s decision, despite forcing children to leave a safe country, may evoke negative emotional and mental stress for the professionals involved in forced repatriation. Aim The overall aim of this study is to explore and analyse forced repatriation workers’ collaboration and perceived mental health, with special focus on social workers and police officers in the Swedish context. Materials and methods The study combines a qualitative and quantitative research design in order to shed light at both a deep and general level on forced repatriation. In qualitative substudy I, a qualitative case study methodology was used in one municipality in a middle-sized city in Sweden. The municipality had a contract regarding the reception of unaccompanied asylum-seeking refugee children iv with the Swedish Migration Board. The municipality in focus has a population of more than 100,000 inhabitants. The city in which the data were collected has developed a refugee reception system where unaccompanied asylumseeking refugee children are resettled and await a final decision regarding their permit applications. This situation made it possible to recruit participants who had worked with unaccompanied refugee children without a permit. Semi-structured interviews were conducted with a total of 20 social workers, staff at care homes, police officers, Swedish Migration Board officers and legal guardians. A thematic approach was used to analyse the data. In quantitative substudies II, III and IV, a national survey of social workers (n = 380) and police officers (n = 714), with and without experience of forced repatriation, was conducted. The questionnaires included sociodemographic characteristics, the Swedish Demand-Control Questionnaire, Interview Schedule for Social Interaction, Ways of Coping Questionnaire and the 12- item General Mental Health Questionnaire. Factor analysis, correlational analysis, and univariate and multivariable regression models were used to analyse the data. Results The qualitative results in substudy I showed low levels of collaboration among the actors (social workers, staff at care homes, police officers, Swedish Migration Board officers and legal guardians) and the use of different strategies to manage their work tasks. Some of them used a teamwork pattern, showing an understanding of the different roles in forced repatriation, and were willing to compromise for the sake of collaboration. Others tended to isolate themselves from interaction and acted on the basis of personal preference, and some tended to behave sensitively, withdraw and become passive observers rather than active partners in the forced repatriation. The quantitative results in substudy II showed that poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for mental health among social workers, while psychological job demand, decision latitude and marital status were predictors among police officers. Substudy III showed that both social workers and police officers reported relatively high access to social support. Furthermore, police officers working in forced repatriation with low levels of satisfaction with social interaction and close emotional support increased the odds of psychological disturbances. In substudy IV, social workers used more escape avoidance, distancing and positive-reappraisal coping, whereas police officers used more planful problem solving and self-controlling coping. Additionally, social workers with experience in forced repatriation used more planful problem solving than those without experience. Conclusions In order to create the most dignified forced repatriation, based on human dignity, for unaccompanied asylum-seeking refugee children and with healthy actors, a forced repatriation system needs: overall statutory national guidance, interagency collaboration, actors working within a teamworking pattern, forced repatriation workers with reasonable job demands and decision latitude, with a high level of social support and adaptive coping strategies. The point of departure for an interagency model is that it is impossible to change the circumstances of the asylum process, but it is possible to make the system more functional and better adapted to both the children’s needs and those of the professionals who are set to handle the children. A centre for unaccompanied asylum-seeking refugee children, consisting of all actors involved in the children’s asylum process sitting under the same roof, at the governmental level (Swedish Migration Board, the police authority) and municipality level (social services, board of legal guardians), can meet all requirements.