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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
101

Perceived Fairness of a Child-care Subsidy in a Temporary Agency: An Equity Theory Approach

Bermudez, Pamela 01 December 1995 (has links)
The purpose of this study was to extend research findings on perceived equity into the context of the contingent workforce by examining employees' perceived fairness of a child-care subsidy (i.e., distributive justice perception) in a temporary employment agency. The variables of interest to the study were perceived fairness, comparison other, input importance, organizational responsibility and family-friendliness. The variables were examined on three levels of subsidy status (i.e., subsidy group, parents/no-subsidy group, and nonparents group). A cover letter and a questionnaire regarding perceived fairness of the child-care subsidy were mailed to all employees who had worked for the temporary agency in the last three years. In addition, a stamped self addressed envelope was attached, so respondents could mail the questionnaire directly to the researcher within 2 weeks. Respondents were instructed to anonymously answer the entire questionnaire, and to indicate the degree of their agreement or disagreement with respect to each of the statements in the questionnaire. Findings are based on 64 survey responses, which represented a return rate of 9.5%. The data were analyzed using separate analyses of variance and regression analyses. Results indicated significant differences among parents with subsidy, parents without subsidy and non-parents on their perceived importance of inputs such as level of education, hours per week and "other'' inputs (i.e., client satisfaction and work environment). Specifically, parents without subsidy perceived the level of education and the number of hours worked per week as more important inputs than did either the non-parents and the parents with subsidy. However, non-parents perceived the level of education and the number of hours worked per week as more important inputs than did the parents with subsidy. Furthermore, non-parents and parents without the subsidy perceived "other'' inputs as more important input than did the parents with subsidy. Significant differences were also found between the subsidy group and no-subsidy group and perceived fairness. Specifically, the subsidy group perceived the child care subsidy as more fair than the no-subsidy group (i.e., parents without subsidy and non-parents). A significant interaction of the effect of family-friendliness on the relationship between subsidy status and perceived fairness was also found.
102

Synthesis and applications of polystyrene-supported phosphine and arsine reagents

He, Song, Helen, January 2006 (has links)
Thesis (Ph. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.
103

Nanostructured Catalyst for Deoxygenation of Fatty Acid and Derivatives into Diesel-like hydrocarbons

Siswati Lestari Unknown Date (has links)
No description available.
104

Framgångsfaktorer i arbetsträning

Kinnunen, Peter January 2007 (has links)
<p>Att personer med psykisk sjukdom riskerar att hamna i ett utanförskap då de saknar arbete är ett problem. Att integrera psykiskt funktionshindrade personerna i samhället kan bland annat ske genom arbetsträning. Att ta ett riktigt arbete är oftast ett för stort steg att ta när personer med psykiska funktionshinder skall komma åter till arbetslivet.</p><p>Syftet med min studie är att undersöka vad arbetsträningen betyder för människor med psykiska funktionshinder. För att ta reda på detta har jag använt mig av kvalitativ metod. Jag har intervjuat fem personer med psykiska funktionshinder som arbetstränar på olika platser ute i arbetslivet bland friska personer. Arbetsträningsmodellen har inspirerats av supported employment. I den tidigare forskningen kring supported employment redovisar jag kunskaper och framgångsfaktorer som jag funnit. Studiens teoretiska utgångspunkter utgörs av KASAM känsla av sammanhang, krav - kontroll - socialt stöd, samt Stigma. Utifrån mitt intresse av att söka efter framgångsfaktorer för individerna i arbetsträning, valde jag KASAM. När jag har tittat på vilken delaktighet och egen kontroll deltagarna själva har på arbetsträningen och hur det sociala stödet ser ut lämpade sig krav – kontroll - socialt stöd väl. Med hjälp av Stigma har jag fått in utanförskapsprocessen och vad som motverkar stigmatiseringen.</p><p>Studiens resultat visar att arbetsträning bland friska personer har stor betydelse för att nå framgång i arbetsträningen och integrering i samhället. Att vara motiverad i arbetsträningen och att matcha arbetsplatser efter individens önskemål är andra framgångsfaktorer i arbetsträning. Att ha anpassade arbetstider, som att arbeta tre, fyra timmar per dag till en början, är även det en framgångsfaktor. Det som jag föreslår för framtida forskning, är att göra en studie som undersöker hur många personer som faktiskt kommer ut i arbetslivet efter arbetsträning. Med hjälp av denna typ av kunskaper kan framgångsrika arbetsträningsplatser vidareutvecklas.</p>
105

Extended stroke unit service and early supported discharge. : Short and long-term effects

Fjærtoft, Hild January 2005 (has links)
<p>Effekter av utvidet slagbehandling og samarbeid på tvers av forvaltningsnivå.</p><p>Hjerneslag er en av de hyppigste årsaker til alvorlig funksjonshemming og død i Norge, i tillegg at sykdommen medfører betydelige samfunnsmessige kostnader. Forekomsten er ca. 14 000 hjerneslag pr. år, og antallet forventes å øke betraktelig i årene fremover da antall eldre over 65 år vil øke sterkt.</p><p>Det er en stor utfordring å organisere helsetjenesten slik at behandlingstilbudet for denne pasientgruppen blir best mulig. Akuttbehandling i slagenhet er i dag det best dokumenterte behandlingstiltak, men effekten av videre rehabilitering og oppfølging har vært et lite prioritert område for forskning.</p><p>Hovedhensikten med denne avhandlingen har vært å framskaffe mer kunnskap om hva som kan oppnås for slagpasienter ved en systematisk organisering og samarbeid mellom sykehus og primærhelsetjeneste når det gjelder behandling og rehabilitering etter akuttbehandling i slagenhet. Studien som ligger til grunn for avhandlingen ble gjennomført ved Seksjon for hjerneslag, Medisinsk avdeling, St. Olavs Hospital i perioden 1995-1998.</p><p>Intervensjonen var å konstruere en ny behandlingskjede for slagpasienter hvor fokus på bedre samarbeid med primærhelsetjenesten, oppfølging av et ambulerende team, tidlig utreise fra sykehus og rehabilitering med utgangspunkt i hjemmet ble sterkt vektlagt. Den konstruerte behandlingskjeden ble evaluert med tanke på helsegevinst for den enkelte og bedre ressursutnytting sammenlignet med det tradisjonelle behandlingstilbudet.</p><p>Studien ble gjennomført som en klinisk randomisert kontrollert studie der 320 pasienter med akutt hjerneslag ble inkludert. 160 pasienter fikk ordinær slagenhet behandling med videre institusjonsrehabilitering og/eller oppfølging av primærhelsetjenesten, mens de øvrige 160 pasienter fikk oppfølging av et ambulerende team i henhold til den nye og konstruerte behandlingskjeden.</p><p>I de fire arbeidene som inngår i avhandlingen er det sett på risiko for alvorlig funksjonshemning og død, endring i funksjonsnivå og livskvalitet, samt kostnadsanalyser og ressursforbruk av helsetjenester. Pasientene i de to gruppene ble undersøkt og sammenlignet 6 og 12 måneder etter sykdomsdebut.</p><p>Resultatene av studien viste at sammenlignet med tradisjonell behandling oppnådde pasientene i intervensjonsgruppen signifikant bedre funksjonsnivå (p=0.017) og redusert risiko for alvorlig funksjonshemning og død (p=0.044) etter ett år. De viste også tendens til bedret livskvalitet samtidig som initial liggetid i institusjon ble redusert med 40 % (p=0.032). Det var ingen økning i totalt ressursforbruk eller kostnader i intervensjonsgruppen.</p><p>Oppsummert viser avhandlingen at en slagbehandlingskjede med fokus på samarbeid på tvers av forvaltningsnivå, oppfølging av et ambulerende team og rehabilitering mens pasientene bor hjemme gir meget positiv effekt.</p><p>Den kliniske betydning av disse resultater er at en oppfølging i form av en slagbehandlingskjede i tillegg til akutt behandling i slagenhet bør inngå som en integrert del av behandlingstilbudet for denne pasientgruppen.</p><p>Arbeidene er utført ved INM og ISM, Det medisinske fakultet, NTNU. 1.amanuensis, dr.med Bent Indredavik har vært hovedveileder og Professor dr.med Roar Johnsen biveileder.</p> / <p>Extended Stroke Unit Service and Early Supported Discharge. Short and Long-term Effects.</p><p><i>Background and purpose</i></p><p>Stroke imposes a considerable burden for patients, their caregivers and the society worldwide. It is a challenge to organise the healthcare service that can provide effective management of patients who have suffered from stroke. Several trials have shown that stroke unit care improves the outcome for stroke patients. More limited information exists about the most effective way to organise the follow-up care after the acute care in a stroke unit. Stroke patients conventionally receive a substantial part of their rehabilitation in hospital or in other institutions that offer 24 hours-stay.</p><p>The primary aim of this thesis was to increase knowledge about the organising of follow-up care for stroke patients after the acute care in a stroke unit. To achieve this we performed a trial to evaluate the short and long-term effects of an extended stroke unit service (ESUS), with early supported discharge from hospital, co-operation with the primary health care, and more emphasize on rehabilitation at home as essential elements.</p><p><i>Methods</i></p><p>We performed a randomized controlled trial in which 320 acute stroke patients admitted to the Stroke Unit at St. Olavs Hospital, Trondheim University Hospital were included and allocated either to ordinary stroke unit care (OSUS) (160 patients) with further in-patient rehabilitation or follow-up from the primary healthcare service, or to stroke unit care with early supported discharge (160 patients). The ESUS consisted of a mobile team which co-ordinate early supported discharge and further rehabilitation.</p><p>Included in this thesis are 4 papers based on data from this study population of acute stroke patients followed in one year after the onset of stroke. We wanted to compare the groups in relation to independency, quality of life (QoL) and resource use and costs.</p><p>• Functional outcome were measured as the proportion of patients who were independent as assessed by modified Rankin Scale (RS)(RS<2 =global independence) and Barthel Index (BI)(BI>95 = independent in ADL) at 26 weeks and 52 weeks, the differences in final residence and analyses to identify patients who benefited most of an early supported discharge service (paper I and II). All assessments were blinded.</p><p>• The outcome of QoL was measured by the Nottingham Health Profile (NHP) at 52 weeks. Other outcomes measured at 52 weeks were differences between the groups according to social activity, depression, cognitive function and the burden for carers’. (paper III).</p><p>• The use of all health services during the first 52 weeks was recorded prospectively in both groups; its costs were measured as service costs and represent a combination of calculated average costs and tariffs. Hospital expenses were measured as costs per inpatient day. The secondary objectives were to explore differences in costs between the groups with respect to different types of services, time of service delivery and stroke severity (paper IV).</p><p><i>Results</i></p><p>• Extended stroke unit service with early supported discharge and co-ordination by a mobile team improves functional outcome 6 months and 12 months after stroke. The Odds Ratio for independence at one year was 1.56 (95% C.I, 1.01-to 2.44). It was most beneficial for patients with moderate stroke (papers I and II).</p><p>• Extended stroke unit service with early supported discharge can improve long-term quality of life measured by global NHP. The ESUS group had a significant better QoL after one year than the OSUS group (p = 0.048). There were no significant differences between the groups in the secondary outcomes social activity, depression and cognitive function. The caregivers who got their patients early at home did not report an increased burden compared to caregivers whose patients became ordinary stroke unit care (paper III).</p><p>• The length of initial institutional stay (hospital and rehab.clinic) were reduced with 40 % for the patients offered extended stroke unit service (18.6 days in the ESUS versus 31.1 days in the OSUS) (p=0.032). There was also a reduction in average number of total inpatient days during the first year in favour of the ESD group (p = 0.012) (paper IV).</p><p>• The total health services costs for ESUS was equal or less than costs for ordinary care during the first year after stroke. There was a non-significant reduction in total mean service costs in the ESUS group (EUR 18937 / EUR 21824). The service seemed to be most cost effective for patients with moderate severity of stroke (23% lower mean costs compared to OSUS). The important cost savings caused by reduced length of institutional stay did not lead to an increase in costs for home-based rehabilitation (paper IV).</p><p><i>Conclusion</i></p><p>An extended stroke unit service with early supported discharge improved functional outcome and reduced the length of stay in institutions compared to traditional stroke unit care. It also seems that this service can improve long-term quality of life. The costs are equal or less than costs for ordinary care.</p><p>An early, well organised discharge from hospital co-ordinated by a mobile team seems to be an important contribution in the treatment of stroke patients and should be considered, in addition to organised in-patient stroke unit care, as a part of a comprehensive stroke care.</p>
106

Public trust / private interest : practical and philosophical issues for community colleges and their contract education programs

Lindstrom, Eric L. 21 March 2002 (has links)
Community colleges are being pressured to increase their direct support of the economic development agendas of their communities, their states, and even the nation. These pressures develop both externally and internally, and are exacerbated when increased demands for access to community college education must be met with chronically flat-lined or underfunded community college budgets. In order to deal effectively with these pressures, community colleges may have to increase the considerable degree to which they already collaborate with the private interests within their communities. Contract education programs are one of the more powerful collaborative devices available to community colleges. But increasing their emphasis on contract education presents practical and philosophical issues for community colleges, and may even put their traditionally comprehensive missions at risk. This study suggests that the degree to which a community college is able to resolve those issues and maintain a comprehensive mission is heavily dependent upon the ability of the top leadership to balance the values and interests of the multiple organizational cultures that make up the community college and its immediate environment. / Graduation date: 2002
107

Physiology of load-carrying in Nepalese porters

Bastien, Guillaume 29 August 2005 (has links)
In the Everest valley of Nepal, because of the rugged mountain terrain, the ‘roads' are nothing more than dirt mountain footpaths. Most of the material is conveyed over long distances by professional porters who carry impressive burdens in a wicker basket supported by a strap looped over their head. We measured the body weight and loads carried by the Himalayan porters passing along the busy footpath to Namche Bazaar, the main market place of the Everest region. On average, the porters were carrying loads equivalent to 90% of their body weight on the last day of a 7-9 day trip covering a horizontal distance of ~100 km with >8000 m of total ascents and >6300 m of total descents. Interestingly, these porters adopt a specific rhythm of walking: they generally walk slowly and make very frequent rest stops using a T-stick or stone-platforms built along the trail to support the load during the pause. It has been shown that African women could carry head-supported loads more economically than Western subjects because they have developed a mechanical energy-saving strategy. Similarly, Nepalese porters could also have developed a mechanism to carry economically their very heavy loads. To test this hypothesis, we measured the energy consumption and the mechanical work done during level walking under different loading and speed conditions in the Nepali porters and in Western subjects. We compared these results to those of the African women. Nepalese porters carry loads at a lower cost than either the control subjects or the African women. For example, for a load equivalent to 60% of body weight, western Caucasian subjects increases their metabolic rate by 60%, the African women by 40% and the Nepalese porters by only 30%. Contrary to the African women who are taking advantage of the load to reduce the work performed, Nepalese porters do not modify their gait while carrying a load. Consequently, the mechanical work performed is not reduced as compared to control subjects walking at same speed-load combinations. Yet the Nepalese porters are the most economical load-carriers measured to date, particularly while carrying heavy loads at walking speeds slower than 1.4 m/s, but the exact mechanisms by which they save energy are still unknown. G. J. Bastien et al. Eur J Appl Physiol 94, 76 (2005); G. J. Bastien et al. Science 308, 1755 (2005); G. J. Bastien et al. J Exp Biol submitted.
108

Micro/nano-patterning of supported lipid bilayers: biophysical studies and membrane-associated species separation

Shi, Jinjun 15 May 2009 (has links)
Micro/nano-patterning of supported lipid bilayers (SLBs) has shown considerable potential for addressing fundamental biophysical questions about cell membrane behavior and the creation of a new generation of biosensors. Herein are presented several novel lithographic methods for the size-controlled patterning of SLBs from the microscale to the nanoscale. Using these methods, chemically distinct types of phospholipid bilayers and/or Escherichia Coli (E. Coli) membranes can be spatially addressed on a single microchip. These arrays can, in turn, be employed in the studies of multivalent ligand-receptor interactions, enzyme kinetics, SLBs size limitation, and membrane-associated species separation. The investigations performed in the Laboratory for Biological Surface Science include the following projects. Chapters II and III describe the creation of lab-on-a-chip based platforms by patterning SLBs in microfluidic devices, which were employed in high throughput binding assays for multivalent ligand-receptor interactions between cholera toxin B subunits (CTB) and ganglioside GM1. The studies on the effect of ligand density for multivalent CTB-GM1 interactions revealed that the CTB-GM1 binding weakened with increasing GM1 density. Such a result can be explained by the clustering of GM1 on the supported phospholipid membranes, which in turn inhibits the binding of CTB. Chapter IV characterizes the enzymatic activity of phosphatase tethered to SLBs in a microfluidic device. Higher turnover rate and catalytic efficiency were observed at low enzyme surface densities, ascribing to the low steric crowding hindrance and high enzyme fluidity, as well as the resulting improvement of substrate accessibility and affinity of enzyme catalytic sites. Chapter V presents sub-100 nm patterning of supported biomembranes by atomic force microscopy (AFM) based nanoshaving lithography. Stable SLBs formed by this method have a lower size limit of ~ 55 nm in width. This size limit stems from a balance between a favorable bilayer adhesion energy and an unfavorable bilayer edge energy. Finally, chapter VI demonstrates the electrophoretic separation of membrane-associated fluorophores in polymer-cushioned lipid bilayers. This electrophoretic method was applied to the separation of membrane proteins in E. Coli ghost membranes.
109

Extended stroke unit service and early supported discharge. : Short and long-term effects

Fjærtoft, Hild January 2005 (has links)
Effekter av utvidet slagbehandling og samarbeid på tvers av forvaltningsnivå. Hjerneslag er en av de hyppigste årsaker til alvorlig funksjonshemming og død i Norge, i tillegg at sykdommen medfører betydelige samfunnsmessige kostnader. Forekomsten er ca. 14 000 hjerneslag pr. år, og antallet forventes å øke betraktelig i årene fremover da antall eldre over 65 år vil øke sterkt. Det er en stor utfordring å organisere helsetjenesten slik at behandlingstilbudet for denne pasientgruppen blir best mulig. Akuttbehandling i slagenhet er i dag det best dokumenterte behandlingstiltak, men effekten av videre rehabilitering og oppfølging har vært et lite prioritert område for forskning. Hovedhensikten med denne avhandlingen har vært å framskaffe mer kunnskap om hva som kan oppnås for slagpasienter ved en systematisk organisering og samarbeid mellom sykehus og primærhelsetjeneste når det gjelder behandling og rehabilitering etter akuttbehandling i slagenhet. Studien som ligger til grunn for avhandlingen ble gjennomført ved Seksjon for hjerneslag, Medisinsk avdeling, St. Olavs Hospital i perioden 1995-1998. Intervensjonen var å konstruere en ny behandlingskjede for slagpasienter hvor fokus på bedre samarbeid med primærhelsetjenesten, oppfølging av et ambulerende team, tidlig utreise fra sykehus og rehabilitering med utgangspunkt i hjemmet ble sterkt vektlagt. Den konstruerte behandlingskjeden ble evaluert med tanke på helsegevinst for den enkelte og bedre ressursutnytting sammenlignet med det tradisjonelle behandlingstilbudet. Studien ble gjennomført som en klinisk randomisert kontrollert studie der 320 pasienter med akutt hjerneslag ble inkludert. 160 pasienter fikk ordinær slagenhet behandling med videre institusjonsrehabilitering og/eller oppfølging av primærhelsetjenesten, mens de øvrige 160 pasienter fikk oppfølging av et ambulerende team i henhold til den nye og konstruerte behandlingskjeden. I de fire arbeidene som inngår i avhandlingen er det sett på risiko for alvorlig funksjonshemning og død, endring i funksjonsnivå og livskvalitet, samt kostnadsanalyser og ressursforbruk av helsetjenester. Pasientene i de to gruppene ble undersøkt og sammenlignet 6 og 12 måneder etter sykdomsdebut. Resultatene av studien viste at sammenlignet med tradisjonell behandling oppnådde pasientene i intervensjonsgruppen signifikant bedre funksjonsnivå (p=0.017) og redusert risiko for alvorlig funksjonshemning og død (p=0.044) etter ett år. De viste også tendens til bedret livskvalitet samtidig som initial liggetid i institusjon ble redusert med 40 % (p=0.032). Det var ingen økning i totalt ressursforbruk eller kostnader i intervensjonsgruppen. Oppsummert viser avhandlingen at en slagbehandlingskjede med fokus på samarbeid på tvers av forvaltningsnivå, oppfølging av et ambulerende team og rehabilitering mens pasientene bor hjemme gir meget positiv effekt. Den kliniske betydning av disse resultater er at en oppfølging i form av en slagbehandlingskjede i tillegg til akutt behandling i slagenhet bør inngå som en integrert del av behandlingstilbudet for denne pasientgruppen. Arbeidene er utført ved INM og ISM, Det medisinske fakultet, NTNU. 1.amanuensis, dr.med Bent Indredavik har vært hovedveileder og Professor dr.med Roar Johnsen biveileder. / Extended Stroke Unit Service and Early Supported Discharge. Short and Long-term Effects. Background and purpose Stroke imposes a considerable burden for patients, their caregivers and the society worldwide. It is a challenge to organise the healthcare service that can provide effective management of patients who have suffered from stroke. Several trials have shown that stroke unit care improves the outcome for stroke patients. More limited information exists about the most effective way to organise the follow-up care after the acute care in a stroke unit. Stroke patients conventionally receive a substantial part of their rehabilitation in hospital or in other institutions that offer 24 hours-stay. The primary aim of this thesis was to increase knowledge about the organising of follow-up care for stroke patients after the acute care in a stroke unit. To achieve this we performed a trial to evaluate the short and long-term effects of an extended stroke unit service (ESUS), with early supported discharge from hospital, co-operation with the primary health care, and more emphasize on rehabilitation at home as essential elements. Methods We performed a randomized controlled trial in which 320 acute stroke patients admitted to the Stroke Unit at St. Olavs Hospital, Trondheim University Hospital were included and allocated either to ordinary stroke unit care (OSUS) (160 patients) with further in-patient rehabilitation or follow-up from the primary healthcare service, or to stroke unit care with early supported discharge (160 patients). The ESUS consisted of a mobile team which co-ordinate early supported discharge and further rehabilitation. Included in this thesis are 4 papers based on data from this study population of acute stroke patients followed in one year after the onset of stroke. We wanted to compare the groups in relation to independency, quality of life (QoL) and resource use and costs. • Functional outcome were measured as the proportion of patients who were independent as assessed by modified Rankin Scale (RS)(RS&lt;2 =global independence) and Barthel Index (BI)(BI&gt;95 = independent in ADL) at 26 weeks and 52 weeks, the differences in final residence and analyses to identify patients who benefited most of an early supported discharge service (paper I and II). All assessments were blinded. • The outcome of QoL was measured by the Nottingham Health Profile (NHP) at 52 weeks. Other outcomes measured at 52 weeks were differences between the groups according to social activity, depression, cognitive function and the burden for carers’. (paper III). • The use of all health services during the first 52 weeks was recorded prospectively in both groups; its costs were measured as service costs and represent a combination of calculated average costs and tariffs. Hospital expenses were measured as costs per inpatient day. The secondary objectives were to explore differences in costs between the groups with respect to different types of services, time of service delivery and stroke severity (paper IV). Results • Extended stroke unit service with early supported discharge and co-ordination by a mobile team improves functional outcome 6 months and 12 months after stroke. The Odds Ratio for independence at one year was 1.56 (95% C.I, 1.01-to 2.44). It was most beneficial for patients with moderate stroke (papers I and II). • Extended stroke unit service with early supported discharge can improve long-term quality of life measured by global NHP. The ESUS group had a significant better QoL after one year than the OSUS group (p = 0.048). There were no significant differences between the groups in the secondary outcomes social activity, depression and cognitive function. The caregivers who got their patients early at home did not report an increased burden compared to caregivers whose patients became ordinary stroke unit care (paper III). • The length of initial institutional stay (hospital and rehab.clinic) were reduced with 40 % for the patients offered extended stroke unit service (18.6 days in the ESUS versus 31.1 days in the OSUS) (p=0.032). There was also a reduction in average number of total inpatient days during the first year in favour of the ESD group (p = 0.012) (paper IV). • The total health services costs for ESUS was equal or less than costs for ordinary care during the first year after stroke. There was a non-significant reduction in total mean service costs in the ESUS group (EUR 18937 / EUR 21824). The service seemed to be most cost effective for patients with moderate severity of stroke (23% lower mean costs compared to OSUS). The important cost savings caused by reduced length of institutional stay did not lead to an increase in costs for home-based rehabilitation (paper IV). Conclusion An extended stroke unit service with early supported discharge improved functional outcome and reduced the length of stay in institutions compared to traditional stroke unit care. It also seems that this service can improve long-term quality of life. The costs are equal or less than costs for ordinary care. An early, well organised discharge from hospital co-ordinated by a mobile team seems to be an important contribution in the treatment of stroke patients and should be considered, in addition to organised in-patient stroke unit care, as a part of a comprehensive stroke care.
110

Framgångsfaktorer i arbetsträning

Kinnunen, Peter January 2007 (has links)
Att personer med psykisk sjukdom riskerar att hamna i ett utanförskap då de saknar arbete är ett problem. Att integrera psykiskt funktionshindrade personerna i samhället kan bland annat ske genom arbetsträning. Att ta ett riktigt arbete är oftast ett för stort steg att ta när personer med psykiska funktionshinder skall komma åter till arbetslivet. Syftet med min studie är att undersöka vad arbetsträningen betyder för människor med psykiska funktionshinder. För att ta reda på detta har jag använt mig av kvalitativ metod. Jag har intervjuat fem personer med psykiska funktionshinder som arbetstränar på olika platser ute i arbetslivet bland friska personer. Arbetsträningsmodellen har inspirerats av supported employment. I den tidigare forskningen kring supported employment redovisar jag kunskaper och framgångsfaktorer som jag funnit. Studiens teoretiska utgångspunkter utgörs av KASAM känsla av sammanhang, krav - kontroll - socialt stöd, samt Stigma. Utifrån mitt intresse av att söka efter framgångsfaktorer för individerna i arbetsträning, valde jag KASAM. När jag har tittat på vilken delaktighet och egen kontroll deltagarna själva har på arbetsträningen och hur det sociala stödet ser ut lämpade sig krav – kontroll - socialt stöd väl. Med hjälp av Stigma har jag fått in utanförskapsprocessen och vad som motverkar stigmatiseringen. Studiens resultat visar att arbetsträning bland friska personer har stor betydelse för att nå framgång i arbetsträningen och integrering i samhället. Att vara motiverad i arbetsträningen och att matcha arbetsplatser efter individens önskemål är andra framgångsfaktorer i arbetsträning. Att ha anpassade arbetstider, som att arbeta tre, fyra timmar per dag till en början, är även det en framgångsfaktor. Det som jag föreslår för framtida forskning, är att göra en studie som undersöker hur många personer som faktiskt kommer ut i arbetslivet efter arbetsträning. Med hjälp av denna typ av kunskaper kan framgångsrika arbetsträningsplatser vidareutvecklas.

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