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Background. A central role of mental health professionals within the criminal justice and forensic mental health system is the assessment, management and communication of an individual's risk of future violence (Webster & Hucker, 2007). The current methodology favoured by clinicians is the structured professional judgement (SPJ) approach (Farrington, Joliffe & Johnstone, 2008). These instruments act as guides in clinical practice in that practitioners are encouraged to apply clinical judgement on the relevance of empirically validated risk factors to each client. In this way, identified risk factors can be directly used to inform individual care and treatment, i.e. risk management. Yet, research on SPJ tools is typically based on retrospective or pseudo-prospective designs, which lack in ecological validity. Furthermore, findings are based on risk assessments completed by researchers rather than clinicians. This is an issue as risk ratings differ significantly depending on professional background (de Ruiter & de Vogel, 2004). Aims. This thesis presents five studies with the aim of examining the link between violence risk assessment and management in vivo. This includes two studies focussing on the predictive validity of SPJ tools following clinical implementation; a description of the implementation procedure; a traditional research study on the predictive power of dynamic risk factors and a pilot evaluation of a short term risk assessment tool for imminent inpatient violence. Methodology. The primary research site was the State Hospital, the high secure psychiatric facility for mentally disordered offenders in Scotland and Northern Ireland. The research population consisted of 115 male forensic patients who were followed up across different risk settings for a mean of 31 months. The SPJ instruments under investigation were the HCR-20 (Webster et al, 1997), the SVR-20 (Boer, Hart, Kropp et al, 1997) and the RSVP (Hart et al, 2003). All assessments were exclusively completed by clinicians and resulted in active risk management strategies. Additionally, the predictive validity of dynamic risk factors was examined through psychometric measures of anger, impulsivity, psychiatric symptoms, unmet needs and imagined violence. The risk of imminent violence was assessed with the Dynamic Appraisal Situational Appraisal - Inpatient Version (DASA-IV, Ogloff & Daffern, 2006). Results and Conclusions. Findings indicate that clinically implemented SPJ tools are not predictive of future violence, both within and outwith secure settings. Comparison with a previous study at the State Hospital implies that the implementation process of the HCR- 20 facilitated the knowledge transfer from assessment to management, and therefore incidents were prevented. This noted the results also highlight that clinicians may accept risk tools into practice when these have not been scientifically scrutinised. This was the case with the RSVP in that there is little published data on the psychometric properties of this tool, yet its introduction replaced the SVR-20 across the State Hospital. With regards to dynamic risk factors, the severity and chronicity of psychiatric symptoms were the strongest predictors of violence. This is further corroborated by the finding that the DASA-IV predicted violence within 24 hours of ratings provided. All findings are discussed in the context of previous research and the experienced obstacles of implementing changes within NHS settings. Clinical implications and recommendations for violence assessment and management are provided in the light of acknowledged limitations.

Auditor´s professional judgement is often discussed. The aim of this paper is to see how structure affects auditor’s professional judgement in audit planning. The empirical analysis is based on qualitative interviews with seven auditors with different experience. The study shows that there is not a trend toward less structure in audit firms, rather more. It is clear that auditor´s professional judgements are affected by the degree of structure and structure occurs in most of auditors’ work. The study shows that structure and professional judgements are not two separate things; instead they support each other. Even if auditors have access to structure when planning an audit they need to make professional judgements, especially when identify risks and decide materiality.

Titel Har granskningen påverkats?  Författare Elsa Henrysson och Johanna Löfdahl  Handledare Pernilla Broberg  Bakgrund Det senaste året har präglats av pandemin Covid-19 vilket har medfört att revisorer behövt tillämpa alternativa metoder vid inhämtandet av revisionsbevis, då arbetet övergått till att vara mer digitalt än tidigare. Covid-19 har drabbat många företag och branscher, både i positiv men främst negativ bemärkelse. Detta har bland annat resulterat i att revisorn har ställts inför att göra svårare bedömningar om exempelvis företagets fortsatta drift och vad som anses vara tillräckliga och ändamålsenliga revisionsbevis.  Syfte Syftet med denna studie är att förstå hur revisorernas tillvägagångssätt vid inhämtande av revisionsbevis har påverkats av Covid-19. Metod Studien tillämpar en kvalitativ forskningsstrategi och har sin utgångspunkt i en deduktiv forskningsansats med induktiva inslag. För datainsamlingen genomfördes 16 semistrukturerade intervjuer med revisorer från de fem största revisionsbyråerna i Sverige och som jobbat både innan och under Covid-19.  Slutsats Studiens resultat antyder att Covid-19 delvis påverkat tillvägagångssättet vid inhämtande av revisionsbevis sett till att lagerinventeringar genomförts digitalt. I annan bemärkelse har egentligen inte tillvägagångssättet påverkats avsevärt, utan har istället påverkat revisorns professionella bedömningar på grund av den osäkerhet som Covid-19 medför. Revisionskvaliteten går ännu inte att utläsa om Covid-19 haft någon inverkan på. Däremot har kvaliteten gentemot kund påverkats mer i negativ bemärkelse samt kvaliteten internt. På grund av den osäkerhet som råder kring Covid-19 anses revisorns upplevda komfort påverkats som en följd av osäkerheten men inte till följd av hur man arbetar. Vad som däremot är viktigt att poängtera är att Covid-19 upplevs ha påverkat i olika omfattning beroende på vilken bransch som revisorerna arbetar mot. / Title Has the audit been affected?  Authors Elsa Henrysson och Johanna Löfdahl  Supervisor Pernilla Broberg Introduction The past year has been characterized by Covid-19 which has affected the way auditors collect audit evidence due to new digital ways of working. Covid-19 has affected companies and businesses both in positive and foremost negative meaning. This has contributed to the auditor now needing to make more difficult judgements, especially regarding going concern and in determining what is considered to be sufficient and appropriate audit evidence. Purpose The aim of this study is to understand how the auditor's approach of collecting audit evidence has been affected by Covid-19.  Method The study is based on a qualitative research strategy where a deductive approach is applied with some inductive inputs. The collection of data consists of 16 semi-structured interviews with auditors representing the five biggest audit firms in Sweden that have worked both before and during Covid-19.  Conclusion The result indicates that Covid-19 to some extent has affected the approach to collecting audit evidence, especially considering the inventory. In other ways, the approach does not seem to have been affected drastically but has instead affected the auditors’ professional judgements due to the uncertain circumstances regarding Covid-19. The audit quality cannot yet be determined in which way it has been affected. But the customer quality and the internal quality has been affected negatively. Due to the uncertain circumstances that concerns Covid-19 is the auditors' comfort considered to be affected, but not considering in the way they work. Although, the effect of Covid-19 seems to be different depending on which business the auditor works towards.

Socialstyrelsen, i sin roll av tillsynsmyndighet för den läkemedelsassisterade opiatvården, utfärdar riktlinjer för detta arbete. Av dessa framkommer vissa skyddsfaktorer av särskild vikt, vilka har operationaliserats i en factorial survey med en randomiserad och en standardiserad vinjettkomponent. Dessa bedömdes av yrkesverksamma inom underhållsbehandling, totalt 38 personer. Materialet bearbetades genom multipel regressionsanalys. Resultatet visade att tre av variablerna - psykosocial intervention, boendesituationen samt familjen/nätverkets stöd, har ungefär lika stor påverkan på bedömningar. Variabeln för sysselsättning hade ytterst marginell påverkan. Vidare visade materialet att den arbetsplats som respondenten var yrkesverksam på var viktigare för att förstå påverkan av bedömningar än någon av ovan nämnda variabler. Detta diskuteras med hjälp av de teoretiska modellerna för återhämtningskapital, handlingsutrymme och judgement theory. / The swedish national board of health and welfare is the regulatory body for the medically assisted opiate care. As such, the board issues guidelines for this field. Theese guidelines contain several recommendations concerning salutogen factors, namely housing, the role of the family and network, work and psychosocial care. These are incorporated in vignettes using the factorial survey approach, and distributed to 38 swedish opiate care professionals. The results show that while the variables family/network, housing and psychosocial care have a relatively coherent influence on professional judement, work does not. However, the single most relevant factor is the clinicians workplace to understand influence om professional judgement. The results are discussed using a framework of recovery capital and judgement theory.

Väsentlighet utgör en viktig hörnsten i revisorns bedömning och styr hur omfattande en granskning ska vara och i vilken riktning granskningen ska gå. Syftet med uppsatsen är att undersöka vilka kvalitativa faktorer anses ha en påverkan på revisorns väsentlighetsbedömning. Kvalitativa faktorer som valts att fokusera på är revisorns erfarenhet, byråtillhörighet, revisionsklientens företagsspecifika karaktär samt klientförhållandet. En kvantitativ metod med en deduktiv ansats har använts för att undersöka studiens syfte. En modell konstruerats för att illustrera hur väsentlighetsbedömningen påverkas av de kvalitativa faktorerna. Modellen har utformats utifrån tidigare vetenskapliga artiklar som behandlar ämnet väsentlighet. Vidare har empiri insamlats genom en enkätundersökning som skickades ut till samtliga godkända och auktoriserade revisorer i Sverige varav 154 respondenter gav fullständiga svar. Resultatet visar att signifikanta skillnader i hur väsentlighetsnivån fastställs beroende på hur länge revisorn hade arbetat och även på om revisorn arbetade på en av de större byråerna. Det framkom även att skillnader fanns när hänsyn togs till positiva och negativa faktorer hänförliga till om klienten var börsnoterat eller inte, verksam i en riskfyllt eller stabil bransch samt hur så tog revisorerna även hänsyn till huruvida de arbetade med en ny klient eller en klient de haft erfarenhet av. Vår undersökning indikerar även att revisorer tenderat att reagera starkare på negativa faktorer. Med en godare förståelse för vilka faktorer som påverkar revisorns bedömning föreslår vi framtida studier som undersöker klientförhållandet och dess inverkan på väsentlighetsbedömningen då detta området gav en signifikant skillnad men är i tidigare forskning outforskat. / Materiality is an important cornerstone of the auditor's assessment that governs how extensive an audit should be and which direction the audit should go. The purpose of this paper is to investigate which qualitative factors are considered to have an impact on the auditor's materiality assessment. Qualitative factors such as focus the auditor's experience, audit firm, the audit client's company-specific character and the auditor-client relationship. A quantitative method with a deductive approach has been used where a model was designed to illustrate how materiality assessment is influenced by the qualitative factors. The model has been designed based on previous scientific articles dealing with materiality. In addition, empirical evidence has been collected through a survey sent to all authorized auditors in Sweden, of which 154 respondents gave complete answers. The results shows differences in the level of materiality are determined depending on the auditor’s experience and whether the auditor worked at one of the larger agencies. There were also differences when considering positive and negative factors related to whether the client was listed or not, active in a risky or stable industry, and the auditor’s consideration to  whether they were working with a new client. Auditors tend to react more strongly to negative factors. With a better understanding of which factors affect the auditor's assessment, we propose future studies on the client relationship and its impact on materiality judgement, as this area gave a significant difference, but has been not explored that much in earlier research.

This thesis comprises a rigorous and coherent body of work related to the use of the HCR-20 and the START to inform risk assessment and management of secure mental health inpatients. The thesis contributes significant theoretical and applied knowledge by: 1) investigating the extent to which these tools can be generalised beyond restricted validation samples to the full range of individuals in contact with secure services, 2) determining whether they can aid assessment and management of adverse outcomes beyond aggression, and 3) offering practical, empirically-derived advice for clinicians regarding management strategies that may reduce the occurrence of adverse events. This collection of papers has used considerably novel methods, such as rocreg analysis in risk assessment of behavioural outcomes, and high quality, routinely collected data to gain a more realistic representation of what occurs in clinical practice. Further, the papers draw on larger sample sizes than have previously been reported in this area, allowing for more complex statistical analysis. This thesis has helped clarify the contexts in which these instruments perform effectively and therefore has important implications for clinical risk assessment in inpatient settings. Specifically, there is evidence that the HCR-20 and the START may aid assessment and management of aggression for the majority of groups examined, and that both tools have some efficacy for predicting self-harm among female populations. However, the HCR-20 should not be used to inform prediction and management of aggression and self-harm for individuals with developmental and organic disorders and is unlikely to be beneficial at informing risk management strategies targeting self-harm among males; the START should not be used to inform prediction and management of substance abuse, victimisation, or unauthorised leave. Finally, this thesis highlights a number of directions for future research to continue advancement in this area.

Bakgrund och problem: Revisionsbranschen befinner sig i ett kritiskt skede. Detta eftersom teknikens prestanda utvecklas snabbare än vad människor gör, vilket i sin tur resulterat i att människors uppgifter har börjat bytas ut mot datorer, robotar eller annan liknande teknik. Detta går att likställa med automatisering. Tidigare studier har påvisat ett flertal fördelar med att implementera automatiserade verktyg och tekniker inom revision, såsom ökad effektivitet och kostnadsbesparingar. Det är dock relativt outforskat på svenska revisionsbyråer sett till samspelet mellan människa och teknologi för att uppnå dessa fördelar och med denna studie vill författarna bidra med mer forskning inom området. Syfte: Syftet med studien är att analysera automatisering inom revisionsbranschen och möjligheter och utmaningar det medfört revisorns professionella bedömningar. Metod: Denna studie är av kvalitativ karaktär och innefattar en deduktiv forskningsansats där det empiriska materialet har samlats in genom semistrukturerade intervjuer med auktoriserade revisorer på revisionsbyråer i Sverige. Vidare har det empiriska materialet analyserats genom en tematisk analys. Slutsats: Studien visar att automatiseringen utvecklas varje dag, vilket resulterar ett flertal möjligheter. Automatiserade verktyg och tekniker ger revisorn en helhetsbild av revisionen som resulterar i att fler avvikelser upptäcks och det finns möjlighet att revisorn gör bättre bedömningar i då större delar av populationer täcks in. Samtidigt är det emellanåt svårt att följa med i alla dess framsteg, och utmaningar uppdagas. Detta då det råder en tidsbrist för revisorer att lära sig de automatiserade verktygen och teknikerna, vilket gör att det inte anses som tidseffektivt. Dessutom kan det argumenteras för att nyexaminerade inte förbereds tillräckligt mycket inför den IT-miljö som revisionsbyråer idag kantas av, vilket skapar ett kunskapsglapp och kan ses som en utmaning för revisorns professionella bedömningar. Våra fynd och studiens teoretiska modell kan ses öppna upp möjligheter för vidare forskning inom området men även andra delar av samhället. / Background and problem: The audit industry is at a critical stage. This is because the performance of technology is evolving faster than that of humans, which in turn has resulted in human tasks being replaced by computers, robots or other similar technologies. This can be equated with automation. Previous studies have demonstrated a number of benefits of implementing automated tools and techniques in auditing, such as increased efficiency and cost savings. However, the interaction between humans and technology to achieve these benefits is relatively underexplored in Swedish audit firms, and with this study the authors want to contribute with more research in this area. Purpose: The purpose of the study is to analyze automation in the audit industry and the opportunities and challenges it has brought to the auditor's professional judgments. Method: This study is qualitative in nature and includes a deductive research approach where the empirical material has been collected through semi-structured interviews with certified public accountants at accounting firms in Sweden. Furthermore, the empirical material has been analyzed through a thematic analysis. Conclusion: The study shows that automation is evolving every day, resulting in numerous opportunities. Automated tools and techniques provide the auditor with a holistic view of the audit which generates more discrepancies to be detected and the possibility for the auditor to make better judgements as larger parts of the populations are covered. At the same time, it is sometimes difficult to keep up with all of its progress, and challenges emerge. This is because there is a lack of time for auditors to learn the automated tools and techniques, which means that it is not considered time efficient. In addition, it can be argued that new graduates are not adequately prepared for the IT environment that surrounds audit firms today, which creates a knowledge gap and can be seen as a challenge to the auditor's professional judgements. Our findings and the study’s theoretical model can be seen to open up possibilities for further research in this area but also in other parts of society.

Kommunen är huvudman för äldreomsorgen vilket innebär att organisationen är politiskt styrd. Att arbeta som första linjens chef inom äldreomsorgen är därmed ett komplext uppdrag där flera olika perspektiv konstant måste tas i beaktning. Första linjens chefer inom äldreomsorgen har krav på sig både uppifrån och nedifrån vilket kan skapa lojalitets konflikter. Förstalinjens chef står i direkt kontakt med den operativa verksamheten och dem verksamheten är till för (brukarna). Brukarnas och personalens intressen ska därmed pareras gentemot organisationens intressen och krav och det finns en relevans i att titta på hur eventuella lojalitetskonflikter hanteras och vilket handlingsutrymme första linjens chef har. Syftet med uppsatsen var att undersöka hur första linjens chefer upplever lojalitetskonflikter mellan verksamhetens uppdrag och arbetsgivaransvaret samt vilka strategier de använder i handlingsutrymmet. Studiens design var en kvalitativ intervjustudie med semistrukturerade frågor och materialet analyserades med hjälp av kvalitativ innehållsanalys. Dataanalysen resulterade i två huvudkategorier vilka var att leda genom lojalitet och att våga handla. Informanterna ansåg att deras lojalitet låg hos arbetsgivaren och att deras uppgift var att implementera politikers och lednings beslut. Informanterna var samtidigt tydliga med att brukarnas bästa kommer i första hand. De prioriterade och ignorerade vissa beslut utifrån om de kunde se ett tydligt syfte med arbetsuppgiften eller inte. Från NPM och detaljstyrning till dagens fokus på tillits- och värdebaserad styrning menar författarna att det är viktigt med chefers etiska kompetens eftersom de enligt denna studie verkar genomföra beslut baserat på om de själva finner syfte och värde i verksamheten de leder. / Swedish elderly care is a politically controlled organizationwith the municipality as principal. Working as a first-line manager in elderly care is thus a complex task where several different perspectives must constantly be taken into account. First-line managers have demands on them both from above and below, which can create loyalty conflicts. The first-line manager is in direct contact with the operational activities and those the activities are for (the users). The interests of the users and the staff must be balanced against the interests and demands of the organization and the reis a relevance in looking at how potential conflicts of loyalty are handled and what margin for manoeuvre the first-line manager has. The purpose of the essay was to investigate how first-line managers experience loyalty conflicts between the organizations mission and the employer's responsibility and which strategies they use in the margin for manoeuvre. The design of the study was a qualitative interview study with semistructured questions and the material was analyzed using qualitative content analysis. The data analysis resulted in two main categories which were leading through loyalty and daring to act. The informants believed that their loyalty lay with the employer and that their task was to implement the decisions of politicians and management. At the same time, the informants were clear that the best interests of the users come first. They prioritized and ignored certain decisions based on whether or not they could see a clear purpose for the work task. From NPM and detailed management to today's focus on trust and value-based management, the authors believe that managers' ethical competence is important because, according to this study, the managers seem to implement decisions based on whether they themselves find purpose and value for their operation unit.