The aim with this study is to investigate how social agencies work with children that are whitnessing physical violence against their mother by a man they have a close relationship with. The study is focusing on what kind of interventions that are directed to those children, in some cases also the whole family, and what effects these have on them. The study is also focusing on the cooperation between different social agencies that are working with the target group and what effects a wellworking cooperation may have. A qualitative method has been used for the study, based on semi-structured interviews with different kind of social workers that work with the target group in question. The selection of social workers consisted on five different interviewees within four different departments.The results of the study shows what interventions are the most common ones and what effects these are having on the children and their families according to previous research and according to the interviewed social workers. It also shows the importance of having a wellworking cooperation between relevant social agencies according to previous research and how the cooperation is working in practical social work according to the interviewed social workers. Eventually the results have been analysed by the three theories: attachment theory, Antonovsky’s KASAM and risk- and protection factors. The study shows the importance of aiming the right interventions to those who are exposed and how important it is with a good cooperation between different social agencies so that the interventions are far-reaching enough to support the exposed in every part of their life and to meet their every need of support. This also so those who are exposed suffer from less symptoms followed by witnessing physical violence and provide good conditions to have a healthy physical, social and psychological development.

Domestic violence does not disappear with age. In Sweden, domestic violence is as common in relationships between elderly as it is younger people, however, statistically elderly are underrepresented. Cases of domestic violence in elderly couples are more rarely reported and one reason is that elderly themselves do not report being victims of abuse. Another is a lack of legislation such as mandated reporting for professionals working with elderly. Sweden has an aging population and the fact that the amount of elderly is increasing may lead to new challenges for professions specialized in elderly care and for society at large. Two professions that work with the care and health of the elderly is care managers and homecare staff and have been chosen to study, and how these two identify domestic abuse involving elderly. The purpose of this research has been to study what efforts are made by the care managers and homecare staff at the management of health and care in Sweden, to help the elderly who are victims of domestic violence. Earlier research shows a lack of knowledge by professionals and staff on how to address the elderly's needs. One reason for this is because of ageism where it is presumed that the elderly are not in need of help or involved in, or victims of, domestic violence. Studies show how the elderly might feel ashamed talking about their experience of violence as the subject is more considered taboo for persons of their generation. Research also shows how Sweden lacks laws to deal with violence at the elderly’s homes.A qualitative research method was used when writing this study and three care managers and three home care staff have been interviewed. The results of our study conclude a strong need for better knowledge of how to identify signs of domestic violence within elderly couples, especially regarding staff working as homecare staff. The results also show that no specific measures are made to meet the elderly's needs and this study concludes that more measures need to be enforced, focusing on elderly victims of physical violence.

Adult immunizations effectively reduce morbidity, mortality, and transmission rates of multiple diseases; however, outpatient providers often a struggle to convince patients to accept vaccinations. This project’s aim is to address vaccination rates in our adult population, focusing first on the influenza vaccine in year one (2016), and then on pneumococcal vaccine in year two (2017), by 1) using a strong quality improvement strategy (known as a Champion Team) and 2) implementing a clinic program consisting of provider training, improved documentation, and informative posters targeted at patients. A quality improvement strategy known as a “Champion Team” provided a strong mechanism through which we developed and implemented the interventions across both years. Specifically, the Champion Team consisted of key stakeholders (nurses, residents, physician faculty, and informatics expert) who identified, developed, and evaluated the program. Programming included an annual health care professional training session for each vaccine (early fall of 2016 and 2017 for flu, spring 2017 for pneumococcal), improved documentation strategies and nursing uptake, and informative posters in the clinic. We assayed data from our patient electronic health record to evaluate: the percentage of our patient population for whom an immunization was documented relative to the number of unique patients seen in our clinic during that time frame. This approach in year one showed a marked increase in influenza vaccination rates in our clinic. During the 2014/2015 and 2015/2016 flu seasons our clinic vaccination rates were 39.98% and 42.05% respectively. After implementation of our champion team and clinic wide program to increase rates in 2016 our vaccination rates for the 2016/2017 flu seasons was 50.88%. Pneumonia data for a full year are under analyses and will be included in this presentation. We anticipate a similar increase in rates for our pneumococcal vaccinations. Our Champion Team and clinic wide program were perceived as relatively low-effort interventions yet appeared to increase vaccinations over the course of this study. The replication of these findings across pneumonia data (pending) and, in future work, with the herpes zoster vaccine (planned for Year 3), will increase our confidence that increases in rates were attributable to these very accessible interventions.

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Background: Migrant farm workers are exposed to job hazards in Tennessee, which is among the top five tomato-producing states. Objectives: This project sought to cultivate and evaluate a partnership to marshal greater resources to address migrants’ concerns and to better prepare future health professionals to address occupational issues. Methods: In the spring of 2008, an interprofessional student–faculty team at a regional university catalyzed a partnership with a clinic for migrants and a national network caring for the itinerant underserved. Results: Several community-based participatory research (CBPR) activities are underway. The partnership has resulted in the following projects: Use of the Rapid Entire Body Assessment (REBA) method to identify job tasks likely to be injurious, development and use of a health screening questionnaire to capture more information about occupational health, and continuing education seminars for providers and a case-based curriculum module for third-year medical students. Conclusions: Interprofessional service learning about migrant occupational health issues may have its greatest impact as participating students enter the regional workforce, caring for patients employed in slow-to-change agricultural operations.

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Contexte. En Haïti, entre 2007 et 2013, l’Agence des États-Unis pour le développement international (USAID) a financé le Multi-Year Assistance program (MYAP) avec pour objectif principal la réduction de l’insécurité alimentaire dans les communautés les plus vulnérables. L’autonomisation économique des femmes constituait l’un des piliers du MYAP. En effet, les études ont montré qu’une croissance des revenus des femmes avait des retombées positives sur la nutrition et sur la santé du ménage. De façon générale, la participation économique des femmes est considérée comme un facteur indispensable au développement durable. Le Catholic Relief Services (CRS) implantait le MYAP dans les zones rurales du sud d’Haïti. Le CRS, étant une entité de l’Église catholique, avait mis l’équité, un principe phare qui guide sa mission et sa vision, au cœur des stratégies de mise en œuvre du MYAP. Cependant, des évaluations menées durant l’implantation et à la fin du MYAP ont suggéré que les femmes les plus défavorisées des communautés rurales étaient restées en marge des interventions. Méthodologie. Pour identifier les obstacles à l’équité durant le MYAP et explorer les meilleures stratégies qui favoriseraient l’implantation d’interventions dont l’accès est équitable, la démarche adoptée a été une étude de cas. Deux sites (2) ont été sélectionnés sur la côte sud d’Haïti, Nan kanpech et les Anglais. Nous avons utilisé une combinaison de méthodes de collecte de données, dont une analyse documentaire, 13 entrevues individuelles et trois (3) groupes de discussions avec différentes parties prenantes du MYAP. Résultats. Le lieu de résidence, la culture, l’occupation, la religion, la scolarité, le statut socio-économique, le capital social et la présence d’un handicap physique ou mental sont parmis les facteurs qui ont entravé la participation des femmes les plus vulnérables aux interventions. L’étude a identifié plusieurs obstacles catégorisés en quatre (4) dimensions interconnectés qui ont compromis l’application des principes d’équité par le CRS : 1. barrières opérationnelles : manque de données sur la pauvreté, focalisation sur l’efficacité et l’efficience au préjudice de l’équité; 2. barrières organisationnelles : manque d’autonomie et manque de redevabilité du CRS à l’égard des bénéficiaires; 3. barrières communautaires : vision divergente des acteurs sur l’équité, laxisme des parties prenantes pour exiger la reddition de comptes; difficultés pour les femmes les plus vulnérables de s’organiser alors que les plus aisées dominaient l’arène; 4. barrière systémique : la corruption. Discussion. L’application des principes d’équité verticale et horizontale est nécessaire pour parvenir à une participation équitable des femmes dans les interventions d’autonomisation économique. Les implications pour les décideurs et les meilleures pratiques pour concevoir des interventions équitables incluent : le renforcement des institutions statistiques nationales pour collecter et rendre disponible des données fiables et actualisées sur la pauvreté, la participation active des cibles dans l’identification des besoins, l’équilibre entre les objectifs d’efficacité, d’efficience et d’équité dans la mise en œuvre des interventions, une modification des procédures qui lient le CRS aux donateurs, la priorisation des interventions à long terme, le développement des outils de suivis et d’évaluation pour surveiller l’équité, le renforcement du leadership des femmes et de la cohésion communautaire et finalement, la consolidation de la politique nationale de lutte contre la corruption. Conclusion. Notre recherche est la première à notre connaissance à s’intéresser aux facteurs qui influencent l’application des principes d’équité dans une intervention implantée par une ONG en Haïti. Les résultats mettent en évidence la nécessité d’une synergie d’action entre tous les acteurs pour évincer les obstacles à l’équité qui sont complexes.