The Common Assessment Framework (CAF) is an important part of the procedures envisaged in the government¿s Every Child Matters: Change for Children (ECM: CFC) programme. Implementation of CAF, in particular, raises many important questions, not least those arising from the inconsistencies apparent between government rhetoric around the development of multi-agency services provided to all children with `additional¿ needs and the actual experiences of children, young people, parents/carers and practitioners in `real world¿ situations. This paper explores the extent to which the actions of practitioners and the experiences of service users with regard to CAF mirror or differ from those which would be expected in view of the content of government guidance and policy documents.The data used is taken from an evaluation of CAF processes in two locations in northern England over a period of 6 months. It concludes that very small numbers of children and young people actually received the service; that, despite genuine enthusiasm from practitioners for them to be so, the processes observed could not yet be described as fully `child centred¿; that fathers were insufficiently involved; and that CAF was, in reality, another service `rationed¿ according to resources available and according to agencies¿ priorities.

There are distinctions noted in mental healthcare service uptake based on immigration status among racialized immigrants in Canada. Research focused on understanding mental healthcare disparities in accessing care within this broad population group often attends to individual-level drivers, which detracts from how systemic factors play a role in producing disparities. Through a three project study, this dissertation aims to explore how access to mental healthcare services among this broad population is influenced by different factors. First, a scoping review aimed to identify barriers and facilitators encountered by racialized immigrants when accessing mental healthcare services across Canada. Second, a qualitative descriptive study explored 16 racialized immigrants’ experiences of accessing mental health services in Ontario, Canada. Third, a qualitative descriptive study centred on the perspectives of both 16 service users and 10 mental healthcare service providers to explore how the immigration and mental healthcare systems coalesce together and play a role in shaping access to services. The findings from all three studies demonstrate how individual and systemic-level factors produce certain inequities for racialized immigrants when accessing mental healthcare services in Ontario. Improving access to mental healthcare services for this broad population group requires attention to how service delivery exists and is shaped by macro-level factors. By highlighting legal status as a starting point for interrogation related to understanding disparities in access, a more nuanced understanding can be gained to pinpoint drivers contributing to the issue. There also needs to be an emphasis on situating how the existing mental healthcare infrastructure plays a role, specifically how access is mediated through one’s legal status. Racialized immigrants are not a monolithic group and therefore, development of equitable policies, programs, and service delivery related to mental health should account this complexity rather than a one-size-fits-all approach. / Dissertation / Doctor of Philosophy (PhD) / Racialized immigrants in Canada experience barriers when accessing mental healthcare services. While there is research that documents these barriers, there is a lack of focus on understanding how this large population’s experiences can be shaped by their legal status. The goal of this dissertation was to understand factors that influence racialized immigrants’ access to mental healthcare services in Ontario, Canada. To explore this issue, this was done through a scoping review and interviews with 16 service users and 10 mental healthcare providers. The findings point to gaps in mental healthcare services that are driven by both system and individual level factors. Meaning changes to improve services must start at the top, specifically changes to policies that limit access to care. However, it is important to not use a blanket approach in developing solutions for this broad population because it will limit how services can be adapted to their unique needs.

Yes / Involving patients and the public in all stages of research has been the focus of the SHARED study. Patient and public involvement (PPI) is an important strategic priority for the Department of Health and funders such as the National Institute for Health Research. The aim of this paper is to describe the benefits, challenges and costs involved in setting up the research study with lay members as part of the research team. The study focused on developing service user-led recommendations for people with memory loss and their carers, on discharge from acute hospital to the community. Methods: This began with a discussion of an initial research idea with a lay group of carers and people living with dementia. Once funded, approval was sought from the Research Ethics Committee and NHS Trusts to conduct the research including the active involvement of lay co-researchers. Finally, to recruit, train and pay lay co-researchers in their role. Results: The benefits of PPI have included developing ideas which are important to people living with memory loss; support for PPI received from the funders and research ethics committee, high levels of interest from volunteer groups, and lasting enthusiasm from many of the co-researchers. Organisational challenges were met in the requirement for research passports and with payment methods for the co-researchers. Training was beneficial but incurred extra costs for repeated training days. Discussion: Overall the benefits outweighed the challenges which were overcome to varying degrees. The lay co-researchers gained membership of a study group and a beneficial partnership developed with the third sector. The biggest challenge was in overcoming the differences in approach to lay co-researchers between NHS Trusts. Organisational culture has been slow to incorporate PPI and this has not yet been fully addressed. It has the potential to delay the start of projects, affect recruitment time, incur extra research costs and disadvantage PPI.

Yes / The qualitative study presented in this paper explored the perspectives of serviceusers, family members and staff about the impact of travel issues on the lives of mental health in-patients and carers. This topic was chosen because it was prioritised by members of Xplore, a service-user and carer research group, and has received little research attention. Travel problems were a significant issue for many service-users and carers, bound-up with mental health issues and the recovery experience. Travel facilitation through the funding of taxis and the provision of guides was greatly appreciated. A few service-users and carers positively valued distancing from their previous home environment. The meaning of travel issues could only be understood in the context of individuals’ wider lives and relationships. The significance of the findings is discussed in relation to the social model of disability. / This work was supported by a grant from The West Yorkshire Mental Health Research and Development Consortium.

Paper 1 - Consultation is a widely used model of practice amongst Educational Psychology Services (EPS) in the United Kingdom (UK) as evidenced in the amount of research carried out on this practice (Leadbetter, 2006, p. 246). This paper attempts to supplement the limited evidence on how and why consultation is used. This paper provides an account of Educational Psychologists (EPs) perceptions of using consultation in a Welsh Educational Psychology Service (EPS). The study uses a thematic analysis of interviews with EPs and 3 accounts of the practice of consultation are provided as examples of how consultation is used. Data analysis revealed that EPs’ practice is dominated by the influence of Wagner’s model of consultation, which is a result of both university, and service based training and not because they feel it is necessarily the best way of working and were vague about their reasons for using this approach. Evidence emerged to suggest EPs were only aware of one model of consultation, which is the Wagner model. Evidence also emerged to suggest that EPs confused service delivery models with models of consultation and that EPs are unclear about their unique skills and role when using consultation and feel that schools do not understand the work they are trying to achieve when working in this way. EPs also considered that schools want more time with them, but burdensome bureaucracy hinders this. These findings are discussed in more detail at the end of Paper 2 where the overall findings suggest there is a systemic problem in Pantysgawn EPS, where the dominance of the EP role to provide statutory assessments prevents EPs from working in a truly consultative way. The paper ends by discussing the key element of the EP’s role, whether a consistent and rigid adherence to one practice model is practicable or desirable, and the various ways that EP services can monitor outcomes to alleviate some of the bureaucratic processes. Paper 2 - Paper 1 of this study looked at EPs’ perceptions of using consultation. Very few studies have looked at service users experiences in consultation based EP services. Paper 2 therefore looks at schools’ perceptions of the EP service and considers the benefits and barriers to effective service delivery using a thematic analysis of interviews with staff from 5 primary and 3 secondary schools. Findings suggest that schools continue to regard the expertise of the EP as being a provider of individual assessments, but they also revealed an awareness of the wider systemic role that EPs can provide. This traditional view of the role of the EP is discussed in terms of a wider systemic pressure for schools to seek this kind of EP intervention due to the Local Authority’s (LA) focus on statutory assessments. Schools appreciated a greater continuity of EPS staff as this helped them to develop more productive working relationships and they wanted more time with the EP. The findings suggest that the level of bureaucracy and the statutory assessment requirements to gain access to targeted resources were a barrier to working more effectively with schools. The paper ends by integrating these findings with the paper 1 findings and discussing the key element of the EP’s role, whether a consistent and rigid adherence to one practice model is practicable or desirable, and the various ways that EP services can monitor outcomes to alleviate some of the bureaucratic processes.

The subject of this diploma paper is Inclusion of Mentally Ill People in Some Chosen Parts of Vysočina Region. It is focused not only on service providers, who deal with people suffering from some mental disorders, but also on service users, it means on people with illnesses from the domain of psychoses, above all schizophrenia and affective disorder (according to MKN-10, F20 {--} F29, F30 {--} F39). It is about people, whose social roles have been disrupted because of their illness and they are in danger of isolation and also social exclusion. The aim of this paper is to find out whether and in what way the inclusion is carried into effect in some chosen parts of Vysočina Region. In the theoretical part of this diploma paper the writer deals in a complex way with the problems of inclusion of disordered people from medical, social and juridical point of view. In the introduction the author qualifies the current situation of these problems. The first subchapter is focused on mental disorders, from the domain of psychoses, their description, their social importance, precaution and therapy. The second chapter covers inclusion and its importance. In the following part full rehabilitation and its partial parts are described. The fourth chapter deals with social work, which is focused on helping people with mental disorders and in the last chapter the author writes about problems of rights of mental ill people. The research part is based on qualitative analysis, which examines the above mentioned aim. To examine the results at the service providers it was used a method of semi-standard dialogue, which is done not only on the base of fixed questions but also on the possibility of expressing their own opinions. The case reports were worked out at the service providers. These case reports were based on the method of concerned supervision. According to the results it is obvious, that inclusion of users is carried into effect in given institutions, because 55% of respondents answered yes and 39% of respondents answered more likely yes. The result is above all the cooperation of partial parts of full rehabilitation, whose aim is to contribute mainly to inclusion. The conclusion of this paper is benefit of this knowledge, that during planning of service, intervention, analyses of needs, it is necessary to consider individuality of every client as much as possible and always emphasize individual approach. In this procedure it is also important trained staff. The author has experience of several years, which she can rely on, and she believes, that in the future community centers will be still founded and they will mostly replace big hospitals. This will be a next important step to re-socialization and to following inclusion of mental ill people.

The services for handicapped people and their transformation after 2007 The present graduation thesis deals with screening the situation in the area of social services for persons with different handicap, especially regarding the transformation of social services after 2007. In the theoretical part, I am describing particularly the characteristics of the previous and the current systems of social services. When characterising the previous system of social services, I concentrate on the legislation, governing this system. Further I am presenting the characteristics and status of the consulting services, and socially activating service, as in the further chapters I am dealing with the latter when presenting the services of the KONÍČEK, o. s. association. When presenting the new system of social services, I am describing in particular the basic principles of this system, changes it brings to the users, legislation and quality standards of the social services. A big chapter is devoted to the Social Services Act. Further chapters describe the financing of social services, education of workers in social services, and work of volunteers in social services. The practical part presents my hypothesis and the aims of the present work. Further chapters present the target group and describe the data collection. Data was collected in the form a guided interview, the questions were answered by the representatives of the given non-profit organization. This chapter includes also a presentation of the activities of the KONÍČEK, o. s. association before 2007, when the services were not registered. Further I am presenting the activities of the association in 2008, when the association was already a registered provider of social services. I am presenting, in the Discussion chapter, the screening of the transformation of social services after 2007, the obtained data, and I am offering their comparison with the outputs found out in the KONÍČEK, o. s. association, or with literature data.

Användningen av molntjänster är utbredd bland företag idag, där den flexibilitet och tillgänglighet som erbjuds i molntjänster har påskyndat övergången från lokal datalagring och mjukvara. Tillämpningen av en tredjepartsleverantör för datalagring och användning av tjänster i molnet har skapat vissa farhågor om säkerhet och tillhörande risker. Därför syftar denna uppsats till att öka kunskapen om cybersäkerhet och tillhörande risker i molntjänster för användare och tjänsteleverantörer. För att uppnå det uttalade målet ställdes följande forskningsfråga: Vilka är säkerhetsriskerna i molntjänster idag, är det skillnad mellan molntjänstanvändare och molntjänstleverantörer i upplevda säkerhetsrisker? För att besvara forskningsfrågan har avhandlingen framför allt använt sig av tematisk analys av data som samlats in via semistrukturerade intervjuer och mailintervjuer. Intervjuerna har genomförts på ett urval av molntjänstleverantörer (två företag) och slutanvändare av molntjänster (två företag). Utifrån analysen av den insamlade empiriska datan fann avhandlingen att användare och leverantörer av molntjänster uppfattar insiderrisk som den mest kritiska säkerhetsrisken. För användare av molntjänster ansågs dataläckage, särskilt relaterat till kunddata, vara den högsta risken. Detta skiljer sig från molntjänstleverantörer, de är oroliga för konsekvenserna av ett dataläckage. För molntjänstleverantörer handlar det om att kunna visa att man tar en insider attack som en stor säkerhetsrisk och motarbetar den på ett förebyggande sätt för att öka förtroendet hos de företag som väljer att använda molntjänster. Samtidigt behövs fortsatt fokus på utvecklingen av säkerheten mot olika typer av hackerattacker och intrångsförsök som tas upp i studien för att inte försumma de säkerhetsrisker som ändå bör tas på allvar. / The use of cloud services is widespread among companies today, where the flexibility and availability offered in cloud services has sped up the transition from local data storage and software. The application of a third-party provider for data storage and the use of services in the cloud has created some concerns about security and associated risks. Therefore, this thesis aims to increase knowledge about cyber security and associated risks in cloud services for users and service providers. To achieve the stated aim the following research question was raised: What are the security risks in cloud services today, is there a difference between cloud service users and cloud service providers in perceived security risks? To answer the research question, the thesis predominantly made use of thematic analysis of data collected via semi-structured interviews and email-interviews. The interviews were conducted on a sample of cloud service providers (two companies) and end-users of cloud services (two companies). From the analysis of the collected empirical data, the thesis found out that cloud service users and providers perceive insider risk as the most critical security risk. For cloud service users, data leakage, particularly related to customer data, was considered to be the highest risk. This differs from cloud service providers; they are worried about the consequences of a data leakage.For cloud service providers, it is about being able to demonstrate that you take an insider attack as a major security risk and work against it in a preventive way in order to increase the trust of the companies that choose to use cloud services. At the same time, continued focus is needed on the development of security against various types of hacker attacks and intrusion attempts addressed in the study in order not to neglect the security risks that should still be taken seriously.

There has been a surge in the involvement of service users and carers in health and social care education, research, and practice in the last three decades within the United Kingdom. However, there are few studies that have evaluated the impact of Involvement in health and social care students' education. This study explored the impact of active involvement in Adult Nursing and Social Work pre-registration education. It provided a tripartite perspective from the perceptions of the three main stakeholders involved: students, academic staff and service users/carers in a specific Higher Education setting in the United Kingdom. A concurrent embedded mixed-methods approach was employed in this study. The study sample was drawn from the three participating stakeholder groups. A total of 38 participants took part in this study. Qualitative information was gathered using semi-structured interviews and focus groups, which explored participants' perspectives of the impact of active involvement in Adult Nursing and Social Work pre-registration degrees. Questionnaires was the data collection tool for the quantitative information required in this study. Questionnaire was helpful in obtaining contextual information about the participants and service users and carers' involvement at the research site. It was used to gather factual information about the participants and the current nature of the involvement in Adult Nursing and Social Work pre-registration degree as it was being practiced at the time of data collection and characteristics that may influence or affect the impact of involvement Qualitative data was analysed thematically from the semi-structured interviews and focus groups. Additionally, descriptive and cross-tab analysis of quantitative data was carried out. Then, a side-by-side comparison was used to identify aspects of the qualitative and quantitative findings that were convergent and conflicting. Findings of this study indicated that the scope and integration of service users and carers in educational activities varied greatly within and between subjects even within the same university. Social Work degree reported a wider scope and greater inclusion than the Adult nursing degree. Two main factors account for this notable differences between the two degrees. These are: the duration of involvement being a regulatory requirement by the Professional Regulatory and Statutory Bodies as well as the duration of conducting involvement. Furthermore, this study revealed that involvement influences all three main stakeholders in Higher Education. Some beneficial outcomes of involvement were similar in the academic staff and students' participant groups. Academic staff and service users/carers raised similar concerns. Overall, the participants indicated that service users and carers' involvement is generally positive and makes an important and unique contribution to the education of nurses and Social Workers supporting the delivery of patient/client-centred care. This study contributed to new knowledge about involvement in Adult Nursing and Social Work pre-registration degrees by generating a holistic view of its impact. This was achieved by exploring these impacts from a tripartite perspective of the three main stakeholders in Higher Education. This study also developed a modified six rung model that helps to involvement is active and meaningful. A partnership framework was proposed to inform future involvement practices and research about ways of optimising the beneficial outcomes and limiting the inhibitory factors of service users and carers' involvement in students' education. Overall, this study provided insights into best practices and pitfalls to avoid, which may be of value to HE providers, education commissioners as well as Professional Statutory and Regulatory Bodies regarding the practices of service users and carers' involvement in Higher Education.

Background: The past two decades have witnessed transition from in-patient hospital settings to Community and Home Based Care in Zimbabwe. This is because of an increase in the number of people developing chronic health conditions such as diabetes, hypertension and cancers, and thus needing longer treatment durations. The increase in chronic conditions has mainly been attributed to the increase in incidence and prevalence of Human Immunodeficiency Virus and Acquired Immune-deficiency Syndrome in Sub-Saharan Africa. Many Governments, including that of Zimbabwe, endorsed and promoted community and home based care to provide a continuum of care to the chronically ill. Despite the implementation of Community and Home Based Care programmes, no studies known to the researcher have been done to investigate the congruency of service users’ needs and the programme goals. Purpose: The purpose of the study is twofold; firstly to explore whether Community and Home Based Care interventions provide services that effectively meet users’ goals in a dynamic social environment and secondly, to develop guidelines for enhancing care provision as well as congruency of service users’ needs and programme goals. Methods: A mixed-method approach combining qualitative and quantitative data collection and analysis was used. Concurrent collection of data with equal status was placed on both qualitative and quantitative data. For qualitative data interviews and focus groups were used with home based care service users, family care givers, and health providers. Structured questionnaires were used for the quantitative data. Framework: Imogene King’s Interacting Systems Framework and Theory of Goal Attainment were adopted to guide the study. These were utilised because of the assumption that mutual agreement on goals for effective care can be achieved through nurse-client interactions and communication Research findings: Community and Home Based Care programme in Zimbabwe does not comprehensively meet the needs of its service users. Service users have diverse needs and goals depending on the specific condition and symptoms they experience. They perceive access to medication for symptom management and pain control, food and financial stability, as priority needs. The study found that nursing services provided in Community and Home Based Care generally align with the physical needs of service users and was deficient in addressing the socio-economic and psycho-social needs of service users. Conclusion: No single sector can achieve the users’ and the programme`s goals of quality health on its own. The goals may only be realised when other stakeholders and relevant sectors contribute to the Community and Home Based Care programme, which requires diverse resources. Guidelines to enhance integration of Community and Home Based Care with social services were developed. / Health Studies / D.Litt. et Phil. (Health Studies)