Historiskt har den medicinska professionen sökt exklusiva rättigheter att praktisera i en miljö där många olika yrkesgrupper fanns. I Sverige har detta lett till att komplementär och alternativ medicin (CAM) hamnade utanför den etablerade sjukvården, vilket inneburit en bristfällig kunskap om hur bl.a. CAM terapeuter arbetar. Användning av alternativ medicin har ökat i Sverige vilket motiverar att studier genomförs för att få bättre kunskap om yrkets utövande. Syftet med uppsatsen är att beskriva CAM terapeuters praktikmönster och inställning till samarbete med traditionell skolmedicin. Utifrån en litteraturstudie utarbetades en enkät som skickades till 102 CAM terapeuter i Sverige för att undersöka deras praktikmönster och sociodemografiska egenskaper. 63 terapeuter (62 %) svarade, varav 59 uppfyllde forskningskriterierna och kunde delta i de fördjupande telefonintervjuer som följde efter enkätstudien och som syftade till att ta reda på deras syn på samarbete med den skolmedicinska sjukvården. Resultaten av undersökningen visade att 55 %, av de 59 intervjuade var kvinnor, 10 % hade legitimation i andra sjukvårdsyrken, 69 % arbetade ensamma med i snitt 24 patienter i veckan. 79 % var positiva till samarbete med skolmedicinen och 37 % hade redan regelbunden kontakt med läkare. Intervjuerna visade att CAM terapeuter generellt ansåg att det var viktigast att patienters behov och önskemål beaktades i utformningen av den vård som erbjöds. Patienternas kostnad för behandling, respekt för CAM terapeuter, legitimation, konkurrens, samarbete med och kunskap om de olika yrken var andra viktiga faktorer som belystes ur olika perspektiv. Studien ger ny kunskap om CAM i Sverige och avslöjar många hinder som gör samarbete mellan skolmedicin och CAM till en utmaning för CAM terapeuter. Resultaten från denna studie kan hjälpa till att utveckla en sjukvård som omfattar olika utövare av läkekonsten / This study aims to describe the practice patterns of complementary and alternative medicine (CAM) practitioners and their collaboration with traditional medical professionals in Sweden. Historically, the medical profession has dominated medical practice in an environment of different healing professions. This domination placed CAM professionals outside the established medical system. Consequently, information about CAM is inadequate. Since today’s patients increasingly seek consultations with CAM practitioners, the need for a better understanding of these professions has grown.       To investigate the practice patterns and sociodemographic characteristics of CAM practitioners, we developed a literature-based questionnaire and sent it to 102 CAM practitioners. Among the 63 practitioners (62%) who replied, only 59 matched our research criteria for participating in further telephone interviews that allowed them to state their opinions on collaborating with conventional medical professionals.       Fifty-five percent of the telephone interviewees were women, 10% were licensed in other medical professions, and 69% worked in solo practices, seeing 24 patients per week on average. Furthermore, 79% felt collaboration would be positive, and 37% had already established regular contacts with medical doctors. CAM practitioners generally considered patients’ needs and desires to be an essential component of healthcare provision. They also elucidated the importance of treatment costs, respect for CAM professionals, licensing, competition, collaboration, and knowledge of a variety of professions.  This study provides new information about the challenges faced by CAM profession in Sweden and reveals many obstacles to collaboration. Our results can assist in the development of a health care system that includes a variety of different professions. / <p>ISBN 978-91-85721-79-5</p>

Syftet med denna studie var att undersöka klienters uppfattningar av samverkan inom socialtjänsten samt mellan socialtjänsten och andra aktörer inom det människobehandlande området. Detta gjordes med en kvalitativ metod där sex stycken halvstrukturerade intervjuer genomfördes med klienter vars barn var aktuella inom individ och familjeomsorgen hos socialtjänsten i en mellanstor kommun. Resultaten belyser att informanterna uppmärksammar andra faktorer av betydelse i samverkansprocesser än vad professionella gör. Informanterna berättar att samverkan behövs men att det upplevs svårt och tidskrävande ju fler aktörer som är inblandade. Informanterna i studien har i huvudsak beskrivit sig som drivande och hjälpsökande. Studiens resultat visar att de har många viktiga roller i samverkansprocesserna vilket ofta förbises av både dem själva och av professionella. Socialsekreteraren och dennes relation till informanten upplevdes spela en viktig roll och de kunde avlasta klienten genom att fungera som exempelvis informationsspridare. För framtida forskning vore det intressant att undersöka andra klientgruppers erfarenheter av samverkansprocesser. / The purpose of this study was to investigate clients' perceptions of collaboration within the social service and between social services and other actors in human service organizations. A qualitative method was used and six semi-structured interviews were conducted with clients whose children were involved with social services. The results highlight that clients pay attention to other factors in the collaborative processes than professionals do. The interviewed clients expressed that collaboration is needed, but becomes difficult and time consuming the more actors involved. They described themselves as having a strong driving force and being help-seeking, as well as having many important roles in the collaborative processes that are often overlooked by both themselves and professionals. The results show that the relationship between social workers and clients play an important role where the social worker can relieve the client by acting as a disseminator of information.

The Occupational Therapist's Intervention for Adult Patients with Neurogenic Dysphagia Abstract of the Thesis: Dysphagia is a serious disorder, often caused by a cerebrovascular accident; in many cases it may be its only or primary symptom, and even the cause of death. The main objective of this thesis is to raise awareness of swallowing disorders among occupational therapists. Despite the fact that the occupational therapist's intervention for patients with swallowing disorder is common practice among occupational therapists abroad, this issue still is not well known among occupational therapists in the Czech Republic. There is also a considerable lack of Czech literature dealing with swallowing disorders from the occupational therapy point of view. This thesis therefore not only presents theoretical findings in this field but also recommends practical procedures for occupational therapists. The theoretical part of the thesis describes functional anatomy of the swallowing structures and swallowing physiology and pathophysiology. It analyses different causes of dysphagia with a focus on neurological disorders, defines the term dysphagia and other related terms, and briefly explains several classification methods of dysphagia. While the first part of the thesis looks primarily into the diagnostics and...

No description available.

Trata-se de um estudo de caso, de abordagem qualitativa, do tipo exploratÃrio. O referencial teÃrico que orientou a criaÃÃo, o desenho e o processo de coleta dos dados, a criaÃÃo dos instrumentos de pesquisa e a posterior anÃlise do corpus de dados integralizado no trabalho de campo foi o conceito de colaboraÃÃo interprofissional e a Tipologia da ColaboraÃÃo Interprofissional de DâAMOUR et al.(2008). O estudo ocorreu no municÃpio de Juazeiro do Norte ondefoi investigado o processo de colaboraÃÃo de gestores e docentes de trÃs IES privadas que adotam a EstratÃgia SaÃde da FamÃlia (ESF) como campo de estÃgio curricular para os seus discentes, e gestores e profissionais das equipes da ESF. A coleta de dados ocorreu durante o mÃs de agosto de 2011 e em outubro de 2012, tendo-seutilizadoas seguintes tÃcnicas: diÃrio de campo, entrevista aberta e revisÃo e anÃlise de documentos comregistro de acordos e parcerias entre a Secretaria Municipal de SaÃde e as IES. Analisou-se cada instituiÃÃo separadamente, discutindo o processo de colaboraÃÃo interprofissional entre docentes e profissionais de saÃde, considerando quatro dimensÃes: governanÃa, objetivos e visÃo compartilhadas, formalizaÃÃo e internalizaÃÃo, e dez indicadores do modelo, reproduzido de forma esquemÃtica no grÃfico de Kiviat. Para a construÃÃo do grÃfico de cada IES, analisou-se as falas dos entrevistados, buscando promover a transversalidade das entrevistas dos profissionais do sistema municipal de saÃde, o que permitiu visualizar o nÃvel de colaboraÃÃo entre as organizaÃÃes. O estudo foi submetido ao Comità de Ãtica em Pesquisa da Universidade Estadual Vale do Acaraà (UVA), protocolo n 911. Desta forma, considerando a questÃo proposta, as inferÃncias quanto à colaboraÃÃo interprofissional entre as IES investigadas e a ESF contribuem de forma bastante incipiente para a qualidade da formaÃÃo de graduandos e a educaÃÃo permanente dos profissionais da ESF, apresenta muitas fragilidades. O espaÃo de trabalho das unidades de saÃde parece nÃo ser visto como campo comum para professores, estudantes e profissionais de saÃde e isso resulta provavelmente da falta de lideranÃas que induzam a integraÃÃo, objetivando o fortalecimento de prÃticas qualificadas de saÃde à comunidade. Ademais a investigaÃÃo revelou a importÃncia da articulaÃÃo interinstitucional e interprofissional para a promoÃÃo de atividades, como as de educaÃÃo em saÃde, que acabam sendo deixadas em segundo plano pela burocratizaÃÃo dos processos de trabalho e pela demanda imediata que precisa ser atendida nas unidades da ESF. Seria fundamental uma aproximaÃÃo dos profissionais de saÃde à literatura que trata da integraÃÃo ensino-serviÃo para que haja clareza do que significa e do que propÃe. Apesar das limitaÃÃes da pesquisa, que nÃo avaliou, por exemplo, os resultados deste processo na formaÃÃo profissional, esta pode contribuir para despertar nos gestores de IES e de sistemas e serviÃos de saÃde a necessidade de estreitar laÃos para contribuir com o fortalecimento da qualidade da atenÃÃo, da promoÃÃo e da educaÃÃo permanente em saÃde.

The professionals active in the Swedish health and welfare system have in recent years become less holistic and more specialised in their professions. This has resulted in complications due to the complex nature of some cases they work on. The focus on expertise the individual professional possesses has a tendency to blind them of relevant aspects of the clients case outside their own field of expertise. Due to this there has been a noted tendency of clients” falling between the cracks” and not receiving the help they are entitled to. By performing a directed qualitative content analysis, the authors of this paper aim to investigate aspects of the interprofessional collaboration that either benefit or harm the work they do. To do this the authors of this paper analyse different evaluation reports made by Swedish municipalities and regions on their interprofessional collaborations through what is known as a coordinated individual plan, and compare these reports to previous research and also analyse these results with the aid of Domain theory. In this paper we discover that boundaries set up between professionals both benefit and harm the work that is done in Swedish welfare organisations. We also discover how the Swedish social works professional identity affect their relations with other organisations and professionals.

Previous research describes co-morbid substance use disorders and eating disorders as a complex issue. Research on collaboration between Swedish addiction treatment facilities and Swedish eating disorder care is scarce. The aim of this Bachelor thesis is to analyze and understand how professionals in addiction care and professionals in eating disorder care experience collaboration regarding people with comorbid substance use disorders and eating disorders. The approach of this study is hermeneutic. The bio-psycho-social model and Collaboration Theory are used for data analysis. The data consists of nine semi-structured interviews with professionals working in either regional eating disorder care or municipal addiction care or in an independent addiction treatment facility. The informants work in different Swedish municipalities and regions having varying occupations. Some work in social services, others in medical care. Our results show varying experiences of collaboration among the informants. Some informants think collaboration works well whilst others see room for improvement. Poor collaboration is described by some informants as due to organizational prestige or bureaucracy. Some informants emphasize that referrals between different care units lead to long wait times for the patients/clients during which nobody takes responsibility for the patient, whose health may worsen. The professionals use different strategies, treatments, and methods to treat and recognize comorbidity and to collaborate with other care units. Joint care planning, reaching a consensus and having a holistic viewpoint are methods that the informants use. The informants have different views on which disorder that precedes the other, and also on which treatment is best suited for this type of comorbidity. Several professionals believe that the addiction should be treated primarily. According to the professionals, prerequisites for collaboration are: established contact with other collaborative parties, the knowledge and accessibility of other professionals, patient consent and motivation. An exchange of knowledge at an organisational level is requested, regarding subjects such as collaboration and comorbidity. / Tidigare forskning visar att samsjuklighet i form av missbruk och ätstörning är ett komplext problem. Forskning om samverkan mellan missbruksvård och ätstörningsvård i Sverige är dock ett relativt outforskat område. Denna intervjustudie syftar till att analysera och förstå hur professionella inom missbruksvården och professionella inom ätstörningsvården upplever samverkan gällande personer med samsjuklighet: missbruk och ätstörning. Studien antar en hermeneutisk ansats, det biopsykosociala perspektivet samt samverkansteori används för att analysera empirin. Empirin består av nio semistrukturerade intervjuer med professionella inom regional ätstörningsvård, kommunal missbruksvård och ett fristående behandlingshem. Informanterna arbetar i olika kommuner och regioner samt har olika yrkesbakgrund inom bland annat socialtjänst eller hälso- och sjukvård. I studien framgår de professionellas samverkanupplevelse, arbets- och behandlingssätt av personer med samsjuklighet i form av missbruk och ätstörning. Därtill framgår vilka förutsättningar som enligt informanterna bör ligga till grund för att upprätta samverkan kring klientgruppen. Resultaten visar att de professionellas erfarenheter och upplevelse av samverkan varierar. Att samverkan fungerar väl respektive om samverkan behöver förbättras lyfts fram. Dålig samverkan på grund av prestige eller i form av en byråkratisk klyfta mellan kommun och region identifieras av några informanter. Vissa informanter framhåller att remisskickande mellan vårdenheter leder till långa väntetider, där klienten eller patienten ”bollas runt”. Under väntetiden kan den vårdsökande fara illa. De professionella använder olika arbetssätt och strategier för behandling, för att fånga upp samsjuklighet och för att inleda samverkan. Gemensam vårdplan, samsyn och helhetssyn är några arbetssätt de professionella utgår ifrån. Informanterna har olika syn på vilket sjukdomstillstånd som föregår det andra och ser även olika på vilken behandling som lämpar sig bäst för denna typ av samsjuklighet: flera anser att missbruket bör behandlas först. Upplevda förutsättningar för samverkan är upprättade kontakter med annan samverkanspart, professionellas kunskap, tillgänglighet samt patientens samtycke, initiativtagande och motivation. Organisatorisk kunskapsöverföring om samverkan och samsjuklighet efterfrågas.

Construction research brings attention to the persistent efficiency and productivity issues in the industry which often are related to a lack of innovation in the sector. To tackle these issues, considerable research has been focused on improved procurement practices, as it is seen that choosing the optimum procurement strategy can promote the development of innovative solutions, thereby resulting in improved efficiency and productivity in the sector. Moreover, research and numerous policy initiatives highlight that public clients play an important role in promoting innovation and improving the overall efficiency and productivity level in the sector through improved procurement practices. Still, this is an area in need of continued improvement since many public clients still frequently rely on traditional and rigid procurement practices which inhibit the potential for innovation to take place. Furthermore, promoting innovation in the procurement of civil works requires interprofessional collaboration between construction project managers and procurers, which can be difficult to achieve since research has shown that interprofessional tensions between these professional groups may occur.  Considering the relevance and importance of the subject the research aims to study how technical functions and procurement functions are organized in the procurement of civil works and how project managers and procurers collaborate during the process. The study has also investigated the perceived conditions for promoting innovation in the procurement of civil works by project managers and procurers. The aim was achieved through a case study of four Swedish municipalities where the empirical data was gathered through semi-structured interviews with project managers and procurers in the municipalities. The findings showed that the studied municipalities largely lacked organizational resources conducive for innovation-oriented procurement of civil works. The findings suggested that the support and commitment for innovation within the civil engineering field was modest in the municipalities, however, there existed strong support for innovation in other areas such as within IT. Still, there exists a willingness among project managers to promote innovation and increase the efficiency in the civil works contract and the findings indicated that the project managers and procurers were better equipped for focusing on incremental innovations rather than radical innovations. Furthermore, opportunities for promoting innovations were discussed and identified. For example, setting higher and more project-specific environmental requirements in projects could improve the potential of increased efficiency and development of innovative solutions in the civil works. / Byggrelaterad forskning tyder på att branschen präglas av effektivitets- och produktivitetsproblem som många menar beror på en låg innovationsnivå inom sektorn. Mycket forskning har därför riktats mot förbättringar inom upphandling då man anser att valet av en optimal upphandlingsstrategi kan främja innovation, vilket i sin tur kan resultera i ökar effektivitet och produktivitet inom sektorn. Dessutom, tyder mycket forskning på att offentliga beställare utgör en stor roll i att främja innovation och effektivitet inom sektorn, något som stödjs genom flera politiska direktiv. Detta är dock ett område som behöver förbättras då många offentliga beställare fortfarande tillförlitar sig på traditionella och stelbenta upphandlingsmetoder som hämmar innovationspotentialen. För att främja innovation inom upphandling av anläggningsentreprenader krävs det inter-professionellt samarbete mellan byggprojektledare och upphandlare, något som kan vara svåruppnått då forskning har visat att spänningar kan uppstå dessa två yrkesgrupper emellan. I betraktande av ämnets vikt och relevans är arbetets syfte att studera hur byggförvaltningar och upphandlingsfunktioner i kommuner organiseras vid upphandling av anläggningsentreprenader samt hur projektledare och upphandlare samarbetar under processen. Studien har även undersökt de upplevda förutsättningarna av projektledare och upphandlare för att främja innovation vid upphandling av anläggningsentreprenader. En fallstudie av fyra svenska kommuner genomfördes för att uppnå studiens syfte, där empirin framställdes genom semi-strukturerade intervjuer med projektledare och upphandlare i kommunerna. Empirin visade att de studerade kommunerna till stor del saknade organisatoriska resurser för att främja innovation vid upphandling av anläggningsentreprenader. Resultaten indikerade att stödet och engagemanget för innovation inom anläggningsområdet var måttligt i kommunerna, men att det fanns ett starkt stöd för innovation inom andra områden exempelvis inom IT. Likväl, finns det fortfarande en vilja bland projektledare att främja innovation och öka effektiviteten i anläggningsentreprenaderna, och resultaten visade att projektledare och upphandlare var bättre rustade för att fokusera på inkrementella innovationer snarare än radikala innovationer. Möjligheter att främja innovation diskuterades och analyserades. Till exempel bedömde man att högre och mer projektspecifika miljökriterier i projekt kunde förbättra potentialen för ökad effektivitet och utveckling av innovativa lösningar i anläggningsentreprenaderna.

INTRODUCTION: Children’s Oral Health (OH) is a vital part of their general health. Since many OH problems begin during early childhood, prevention of these problems can be achieved through early and routine preventive dental care. The dental community alone cannot adequately address all oral health care needs. The establishment of an interprofessional oral health primary care workforce team can help provide holistic health care services that can improve children’s OH, particularly among under-served populations. OBJECTIVE: The aim of our study was to assess the effect of Interprofessional Education (IPE) on the level of OH knowledge among pediatricians, nurses, speech-language pathologists, nutritionists, and social workers. MATERIALS AND METHODS: Questionnaires assessing participants’ oral-health knowledge were collected from pediatricians, nurses, speech-language pathologists, nutritionists and social workers who are working or studying in Boston, Massachusetts. Pre-test questionnaires were used to evaluate baseline oral-health knowledge and attitude towards IPE. Post-test survey immediately after the IPE training and a follow-up survey after 6-12 months were used to evaluate immediate and long-term retention of knowledge. Pre-, post- and follow-up scores were assigned based on the participants’ responses. Univariate parametric analysis methods such as T-test and non-parametric tests such as Kruskal-Wallis and Wilcoxon rank-sum tests were used to assess retention of knowledge and attitude towards IPE. Fisher’s Exact test was used to evaluate differences in the number of high scores. Multiple linear regression models were used to adjust for potential confounders. Statistical significance was reported when p-value <0.05. RESULTS: Among the 557 participants, the immediate post-test scores showed significant improvement when compared to the baseline knowledge scores across different professions (p<0.01). The long-term follow-up scores was lower than the immediate post-test scores (statistical significance was not detected across all professions), however, still significantly higher when compared to the pre-test scores (p<0.01). Among all the participants, the attitude towards collaboration was high (100%). CONCLUSION: Our results highlight the need for collaboration between dental and non-dental healthcare workforce by incorporating IPE into existing curriculum to enhance the retention of knowledge and increase collaboration after graduation. Continuing education programs can significantly contribute towards long-term retention of knowledge. / 2022-07-29T00:00:00Z

Thesis (MCurr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: see full text for abstract / AFRIKAANSE OPSOMMING: sien volteks vir die opsomming