This thesis aimed to explore service users’ priorities and preferences for treatment of psychosis-spectrum difficulties, and experiences of Cognitive Behavioural Therapy (CBT). A literature review (Chapter 1) summarised current understanding and treatment of psychosis. A narrative review of qualitative studies examined treatment priorities and preferences of people with experience of psychosis (Chapter 2), and found that common priorities and preferences included improving social and functional ability, reducing symptoms of psychosis, and individualised, collaborative approaches to care, including alternatives to routine psychiatric treatment. A Delphi study of priorities and preferences for treatment of psychosis was conducted (Chapter 3), and identified priorities that included improving difficult emotional and cognitive states, understanding, coping, and self-esteem, along with treatment preferences such as individualised, collaborative care, greater provision of information, and choice of treatment. Three qualitative studies were conducted. The first (Chapter 4) explored the subjective experiences of young people seen in an Early Detection (ED) for psychosis service. Findings indicated that reluctance to communicate mental health concerns delayed help-seeking for the majority of participants. Disclosure of such concerns to staff in the ED service was considered helpful, especially in the context of CBT. The second qualitative study (Chapter 5) explored subjective experiences of CBT for psychosis. CBT-specific processes were summarised as ‘structured learning’, and the most commonly perceived benefits included improved understanding of psychosis and self, and normalisation. The ‘hard work’ of CBT was also highlighted, especially the disclosure and discussion of difficult life experiences and psychological problems. The third qualitative study (Chapter 6) evaluated experiences of involvement in a randomised trial of CBT for young people at risk of developing psychosis. Having a ‘chance to talk’ about mental health concerns was consistently valued by participants in both the control and the treatment arm of the trial. Valued experiences of CBT included ‘rethinking things’, especially through psychological formulation and re-appraisal of distressing beliefs. Participants also described difficult aspects of CBT, such as personal disclosure, though these were often considered necessary for recovery. Across studies, the importance of individualised, collaborative treatment was highlighted consistently. It is also evident that along with reductions in distressing psychological problems, participants across studies also highly valued social and functional aspects of recovery. The methodological limitations and strengths of these studies, along with implications for clinical practice and future research, are discussed.

INTRODUCTION: There is uncertainty in the prevalence of chronic non-cancer pain (CNCP) in military veterans. A systematic review and meta-analysis was conducted to elucidate this issue, and examine potential effect modifiers of CNCP prevalence. Additionally, chronic pain is a pervasive and debilitating condition that disproportionately affects military veterans. We recently completed a qualitative study of Canadian veterans living with chronic pain to identify their research priorities; however, the generalizability of our findings was uncertain. METHODS: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science were searched from 2013 to January 21, 2021, for observational studies reporting “chronic pain” or pain ≥ 3 months in military veterans. The random-effects meta-analysis was used for pooling data, the Grading of Recommendations, Assessment, Development and Evaluations approach was used for rating quality of evidence, and the Instrument to Assess the Credibility of Effect Modification Analyses was used to rate credibility of the subgroup analyses. Furthermore, from January to March 2021, we emailed a 45-item cross-sectional survey to a list of Canadian veterans that asked about the relative importance of 20 research priorities regarding chronic pain. We explored for statistical significance between male and female responses for any item in which the proportion of endorsement showed a ≥10% difference. RESULTS: 41 observational studies with 5,550,375 military veterans were included. The overall pooled CNCP prevalence is 34% (95% confidence interval (CI) 25% to 45%). However, significant subgroup effect was found for type of prevalence measure (generic or specific) among military veterans (test of interaction p=0.007, moderate subgroup credibility): the pooled generic CNCP prevalence of 43%, 95% CI 29% to 57% (Low-certainty evidence) vs. the pooled specific type of CNCP prevalence of 14%, 95% CI 6.7% to 23% (Moderate-certainty evidence). A multivariable meta-regression model adjusted for proportion lost to follow-up found the type of prevalence measure to be the only significant predictor of CNCP prevalence (p < 0.0001). 313 of 699 Canadian military veterans living with chronic pain completed ≥50% of the survey (45% response rate). Respondents were predominantly male (77%) with a median age of 52 (interquartile range [IQR] 44-58). All 20 research priorities listed in the survey were endorsed as very important by ≥52% of respondents, and three received endorsement by ≥85%: (I) optimizing chronic pain management after release from the military; and (II) identifying and (III) treating mental illness among veterans living with chronic pain. Women were more likely than men to endorse research on post-surgical care for chronic pain prevention or research on holistic care for chronic pain. Men were more likely than women to endorse research on physical activity or exercise for chronic pain. Individuals with higher gross income (≥$80,000) were less likely to endorse research into physiotherapy for chronic pain, or chiropractic for chronic pain compared to those with lower gross income. Individuals with greater age are less likely to endorse research on medical cannabis for chronic pain. CONCLUSIONS: The overall prevalence of CNCP is 34% among military veterans. For generic CNCP, the prevalence is 43%; for a given subtype of CNCP, the prevalence is 11%. Methodologically robust studies are required to more precisely determine CNCP prevalence. The most salient research priorities among our respondents were optimizing chronic pain management during service and after discharge from the military, including co-morbid mental illness. Differences in gender, gross income, and age are implicated in the endorsement of therapy-related priorities, which include surgery, physical activity or exercise, chiropractic, and medical cannabis. Our findings provide insight into the research priorities of Canadian military veterans living with chronic pain. These findings should be considered by granting agencies when formulating calls for proposals, and by researchers who wish to undertake research that will address the needs of military veterans living with chronic pain. / Thesis / Master of Science (MSc)

No

none available / This thesis is concerned with the analysis of a squared-Euclidean distance location-allocation problem with balanced transportation constraints, where the costs are directly proportional to distances and the amount shipped. The problem is shown to be equivalent to maximizing a convex, quadratic function subject to transportation constraints. A branch and bound algorithm is developed that utilizes a specialized, tight, linear programming representation to compute strong upper bounds. These bounds are shown to substantially dominate several other upper bounds that are derived using standard techniques, to an extent which significantly increases the size of problems solvable within a reasonable effort. The special structure of the transportation constraints is used to derive a partitioning scheme, and this structure is further exploited via suitable logical tests which tighten the bounds implied on the transportation flows by the branching restrictions. The transportation structure is also used to generate additional cut-set inequalities based on a cycle prevention method which preserves a forest graph for any partial solution. Results of the computational experiments, and a discussion of possible extensions are also presented. / Master of Science

Yes / Global water security presents a complex problem for human societies and will become more acute as the impacts of climate change escalate. Water security connects the practical water and sanitation challenges of households to the dynamics of global hydroclimates and ecosystems in the Anthropocene. To ensure the successful deployment of attention and resources, it is necessary to identify the most pressing questions for water research. Here, we present the results of a scoping exercise conducted across the global water sector. More than 400 respondents submitted an excess of 4,000 potential questions. Drawing on expert analysis, we highlight 100 indicative research questions across six thematic domains: water and sanitation for human settlements; water and sanitation safety risk management; water security and scarcity; hydroclimate-ecosystem-Anthropocene dynamics; multi-level governance; and knowledge production. These questions offer an interdisciplinary and multi-scalar framework for guiding the nature and space of water research for the coming decades.

Bakgrund: Förvirringen kring hur den ideella sektorn och dess mångfald ska benämnas försvårar situationen gällande hur forskning om sektorn utvecklas. Fokus i denna studie är därför enbart på välgörenhetsorganisationer, som en del av den ideella sektorn. Antalet välgörenhetsorganisationer tycks ständigt öka och som följd har en slags konkurrenssituation utvecklats, vilket har ökat organisationernas medvetenhet kring styrning. Givare och allmänhet förväntar sig allt mer tydlighet och transparens vad gäller information om organisationernas prestationer och resultat. Problemdiskussion: Välgörenhetsorganisationer står inför ett antal utmaningar vad gäller deras styrning. Utmaningarna tycks bero på att beslutsfattandet uppfattas som diffust och otydligt samt att det saknas definitioner och mått av väsentliga begrepp så som prestationer och resultat. Funderingar har väckts kring hur organisationernas beslut om resursprioriteringar görs och vilken roll och påverkan ekonomistyrning har vid dessa situationer. Vidare har funderingar även väckts angående prestationsoch resultatbegreppets innebörd i välgörenhetsorganisationers specifika kontext. Syfte: Studiens första syfte är att kartlägga välgörenhetsorganisationernas beslutsprocess för att identifiera och förklara hur beslut om resursprioriteringar görs och vilken roll ekonomistyrningen har vid dessa beslutssituationer. Vidare syftar studien även till att definiera prestationsbegreppet och hur detta kan mätas samt utreda vad resultatbegreppet innebär för välgörenhetsorganisationer. Studien ska resultera i en referensram för att öka kunskapen om ekonomistyrningens roll i välgörenhetsorganisationers beslutsprocess. Metod: Forskningen antar en fallstudie med två välgörenhetsorganisationer där semi-strukturerade intervjuer och granskning av dokument har legat till grund för insamling av empiriskt material. Resultat och analys: Ekonomistyrningen tycks inte ha den roll eller det genomslag i de studerade organisationerna som den beskrivs kan eller till och med borde ha, detta tycks vidare kunna bero på ett antal identifierade gap. Besluten i organisationerna tycks istället påverkas och styras av en rad andra faktorer, där medlemmarnas tolkning av dessa faktorer uppfattas som utbredd. I dagsläget använder sig organisationerna inte av begreppet prestation utan talar istället i andra termer när de syftar på vad de utför. Resultatbegreppet tycks vidare ha två innebörder beroende på situationen. Slutsats: Utifrån studien som genomförts kan det konstateras att ekonomistyrningen inte har en speciellt utbredd roll i välgörenhetsorganisationernas verksamhet och inte heller i deras beslutsprocess. Besluten tenderar istället att baseras på medlemmarnas känslor, interna diskussioner, extern information, tillströmningen av medel och vad som är publikt för tillfället. Organisationerna talar i termer av output, aktivitet och verksamhet när de syftar till begreppet prestation. Vidare innebär prestationsbegreppet att något utförts, vanligen gentemot mottagaren i utsatthet. Det har dock uppdagats att organisationerna utför prestationer av både social och ekonomisk karaktär. Resultatbegreppet tycks vidare avgöra värdeaspekten i det som organisationerna utför. Resultatbegreppet i organisationerna syftar därmed som följd både till ekonomiska och sociala resultat. / Background: The confusion around how the nonprofit sector and its diversity will be named complicates the situation regarding how research about the sector develops. Focus of this study is therefore solely on charities, as a part of the nonprofit sector. The amounts of charities are constantly increasing and as a consequence a competitive situation has occurred, which has increased the organizations awareness about management control. Donors and the public are expecting even more clarity and transparency regarding information about the organizations performance and results. Problem discussion: Charities face a number of challenges regarding their management control. The challenges seem to be related to the fact that the decision-making is perceived as diffuse and unclear. Also lacks of definitions and measures around significant concepts like performance and results. Concerns have been raised about how the organizations' decisions on resource prioritizations are done and what role and impact management control has in these situations. Furthermore, concerns have also been raised regarding the concepts of performance and results and their signification in the charities specific context. Purpose: The first objective of the study is to map the charitable organization's decision-making process. This in order to identify and explain how decisions about resource priorities are made and what role the management control has on these decision-making situations. Secondly, the study aims to define the concept of performance and how the concept of performance can be measured and also examine what the concept of result means for charities. The study will result in a framework for increasing knowledge about the role of management control in the decision-making process of charities. Method: This research adopts a case study methodology with two charities in which semi-structured interviews and reviews of documents have been the basis for collecting empirical data. Results and analysis: The management control does not appear to have the role or the impact of the studied organizations that it is described can or even should have, which seem to depend on a number of identified gaps. The decisions of the organizations seem rather to be influenced and controlled by a number of other factors, where the members' interpretation of these factors is perceived as widespread. In the current situation the organisations are not using the concept of performance, instead they are talking in other terms when they refer to what they do. The concept of result seems furthermore have two meanings depending on the situation. Conclusion: Based on the study conducted, it can be stated that the management control does not have a particularly prevalent role in the charitable organizations and not either in their decision-making process. Instead, the decisions tend to depend on the members' feelings, internal discussions, external information, the inflow of funds and what is currently of public interest. The organizations are talking in terms of output, activity, and operation when they refer to the concept of performance. Furthermore, the concept of performance means that something has been done, usually against the receiver in distress. However, it has been revealed that the organizations are undertaking performance of both social and economic character. The concept of result also seems to determine the value of what the organizations accomplish. The concept of result, as a consequence, therefore aims both to economic and social results.

What are the factors that shape views and attitudes toward the family, and how are these views and attitudes influenced in changing cultures? Do culture, social change/economic development, childhood experiences, and gender influence family centredness and democratisation? Are there different levels of factors that impact on family centredness and democratisation? If so, how are these factors interlinked? The studies discussed in detail in this thesis investigated family perceptions across cultures and generations, looking closely into specific aspects of family views and attitudes and various factors that impact on them. This thesis attempts to answer these questions by conducting three experiments. Study I (described in Chapter 3), which was conducted in Hungary, South Korea, and Canada (total N=403), tested a hypothesised model based on the literature review (Chapter 2). The study looked at cultural differences in family centredness and democratisation, and the impact of cultural orientation, gender, economic growth (national-level), Postmodernist Values, and political beliefs on perceptions of family centredness and democratisation. Study II (described in Chapter 4), conducted in the US and South Korea amongst young individuals in their late teens or early twenties, and their parents' generations, mostly in their forties and fifties (total N= 230). It expanded on the model by adding Schwartz' value dimensions, self-beliefs, and broader aspects of family perceptions. Furthermore, Study II investigated the intergenerational differences and the impact of childhood experiences by comparing data from two generational groups. Study III (Chapter 5) was conducted in four cultures, Canada, Britain, South Korea, and Japan on 539 university students, in order to ascertain cultural influences on values, beliefs, and family centredness and democratisation. Study III also investigated the interlinks between the factors in each culture more specifically using multi-group analysis method in SEM (Structural Equation Modelling). The final chapter summarises and discusses the implications of the major findings from these studies, and makes note of possible methodological issues. Overall, cross-cultural differences in value priorities, self-beliefs, political beliefs, and perceptions of family centredness and democratisation were found. Generation/age, country-level economic growth and gender were significant predictors for values, beliefs and family views and attitudes discussed in this work. Women and younger generations were more likely to endorse the Autonomous-Related Self-belief, believe in the importance of family democratisation. Stronger belief in the Autonomous-Related self led to higher emphases on family centredness and democratisation. Significant relationship was also found between family centredness and democratisation and individual-level values and beliefs, where stronger democratic beliefs led to stronger belief in the importance of family democratisation, higher endorsement of Self-Transcendence values predicted higher levels of family centredness and democratisation, and stronger Consevation Values predicted higher level of family centredness. By investigating factors influencing family centredness and democratisation, the current work probed into the family in the contemporary world. In line with Kagitcibasi's new model of family change, this thesis demonstrates that certain features of family views and relationship, including perceptions of family centredness, are likely to persist, and contends the individualisation theorists' (e.g., Beck, 1997; Giddens, 1992) negative predictions for the future of the family.

Bakgrund I svensk hälso- och sjukvård skall prioriteringar utgå från de tre principerna i den etiska plattformen. Habiliteringen i Västra Götaland har utvecklat ett beslutstöd för prioriteringar med utgångspunkt från den nationella modellen för öppna prioriteringar vars syfte är att omsätta den etiska plattformen till praktiken.   Syfte Syftet med förbättringsarbetet var att börja använda beslutsstöd vid val av behandlingsmetoder, och hypotesen var att om beslut tas strukturerat ökar förutsättningarna för en mer likvärdig vård. Studiens syfte var att beskriva medarbetarnas upplevelser av förbättringsarbetet.   Metod I det pågående förbättringsarbetet har Nolans förbättringsmodell använts. Studien genomfördes som en deskriptiv kvalitativ studie och fokusgrupper genomfördes i två omgångar med deltagande team.   Resultat Medarbetarna upplever att arbete utifrån prioriteringsriktlinjer är viktigt men är beroende av beslutsstödet utformning och yttre faktorer. Att prioritera blir enklare om åtgärderna på väntelistan är rangordnade. Det går än inte att utläsa att mer likvärdig vård uppnåtts men när medarbetarna får styra över förbättringsarbetet minskar väntetiden från beslut till behandlingsstart.   Slutsatser Nolans förbättringsmodell fungerar vid införande av beslutsstöd för prioritering. Det återstår att se om beslutsstödet bidrar till en mer likvärdig vård. / Background In Swedish health care priorities shall be based on the principles in the ethics platform. Habilitation Services in Västra Götaland has developed a decision support for priorities on basis of the national model of priorities aimed to translate the ethical platform to practice.   Purpose Improvement work aimed to start using decision support in the selection of treatment. The hypothesis was, if decisions are structured increases the prospects of a more equitable care. The purpose was to describe employees’ experiences of improvement work.   Method The ongoing improvement work have used Nolan's model of improvement. The study was conducted as a descriptive qualitative study with focus groups in two rounds.   Results Employees feel that work on the basis of priority guidelines are important, but are dependent on decision support design and external factors. Prioritizing becomes easier if the waiting list are ranked. It is not yet possible to say that a more equitable care has been achieved but when employees get control over the improvement work the waiting time from decision to treatment reduces.   Conclusions Nolan's model of improvement works at the introduction of decision support for priority. It remains to be seen whether decision support contributes to more equitable care.

The purpose of this research was to determine if a relationship exists between quality of the therapeutic working alliance and counselors' and clients' Adlerian personality priorities. Variables included counselors' and clients' Adlerian personality priorities and ratings of working alliance. Information for counselors' and clients' Adlerian personality priorities was obtained on the Allen Assessment for Adlerian Personality Priorities (AAAPP; Allen, 2005). Working alliance was measured with the Working Alliance Inventory- short revised (WAI-SR; Hatcher & Gillaspy, 2006). Participants included 14 counselors and 31 clients from a community counseling clinic on a university campus in the southwest United States. Results suggested that match between counselors' and clients' Adlerian personality priorities is related to counselors' perceptions of quality of the therapeutic working alliance. Statistically significant values were found on one hypothesis, as well as large effect sizes.

The intent of the study was to ascertain the importance faculty at Historically Black Private Colleges and Universities in Texas place upon academic activities of research, teaching and service. A survey of faculty at 4 historically black private colleges and universities in Texas (HBCUs) was conducted to collect data from 158 faculty members; 107 usable questionnaires were returned. A response rate of 67.7 percent was achieved. The pattern that emerged from the data indicates the HBCU faculty in this study lean toward teaching and service as being a viable measure for tenure and promotion. The HBCU faculty in this study should remain cognizant that they are an intricate element within the higher education discipline. According to the perceptions of the HBCU faculty, several indicated that their college/university is important; however, they indicated that their academic discipline is less important in comparison. According to the perceptions of the HBCU faculty, many respondents indicated that their job is a source of considerable personal strain. A comparison with the findings of the 1989 Carnegie Foundation for the Advancement of Teaching reveals more similarities than differences.