No description available.

I Sverige är det ovanligt med barnmorskeledda kontinuitetsmodeller inom mödra- och förlossningsvård. Studier har visat att ungefär hälften av gravida kvinnor i Sverige skulle vilja ha kontinuitet med samma barnmorska genom hela graviditeten eller en för dem känd barnmorska med under förlossningen. Kontinuitetsmodeller har använts i olika delar av världen och det har visat sig vara fördelaktigt för den gravida kvinnan med bland annat färre komplikationer under förlossningen och har fler medicinska fördelar. Vårdkontinuitetsmodellen främjar även relationen mellan barnmorskan och kvinnan vilket ökar möjligheten för kvinnan att berätta om symtom och oro för sin barnmorska.  Syftet med denna litteraturöversikt var att belysa kvinnors upplevelse av barnmorskeledd kontinuitet under graviditet, förlossning- och eftervård. En litteraturöversikt genomfördes utifrån studiens syfte. Litteraturöversikten inkluderade kvalitativa samt kvantitativa forskningsartiklar. Artikelsökning gjordes i databaserna CINAHL och PubMed. Totalt inkluderades 17 vetenskapliga artiklar. Datamaterialet analyserades med integrerad analysmetod och tre teman med tillhörande subteman identifierades.  Teman var: Relationen till barnmorskan, Kontinuitetens påverkan på vården under graviditet och postpartum och Faktorer som påverkar kvinnans förlossningsupplevelse. Resultatet visade att majoriteten av kvinnorna var positiva till barnmorskeledd kontinuitetsvård. Relationen som kvinnan och barnmorskan skapade bidrog till en trygghet hos kvinnan med ökad självtillit. Vårdmodellen gav kvinnan tid för att beskriva sina önskemål inför förlossningen. Tydlig information och kunskap var en betydande faktor för kvinnorna, då de erhöll en större förståelse om graviditet och förlossning. Detta gjorde att de var väl förberedda inför förlossningen. Att ha sin barnmorska närvarande gav kvinnor ett ökat självförtroende att ta sig igenom förlossningsprocessen, eftersom barnmorskan kände till kvinnans önskemål redan innan. Slutsatsen är att kvinnorna upplevde kontinuitetsvården som tillgänglig, stöttande och säker. Barnmorskeledd kontinuitetsvård under graviditet, förlossning och eftervård kan bidra till en nära relation till barnmorskan, öka tillgängligheten till barnmorskan under graviditet och eftervård och förbättra förlossningsupplevelsen. / In Sweden midwife-led continuity models of care during pregnancy, childbirth and postpartum care is unusual. Studies have shown that about half of the pregnant women in Sweden would like to have continuity with the same midwife throughout pregnancy and childbirth. Continuity models of midwifery care have been tested and implemented in different parts of the world and has proven to be beneficial for the pregnant woman as there are fewer complications during childbirth and has more medical benefits. The continuity model promotes the relationship between the midwife and the woman, which enhance the possibility for the woman to talk about symptoms and worries with her midwife.  The purpose of the literature review was to highlight women´s experience of midwife-led continuity during pregnancy, childbirth- and postpartum care.  A literature review was conducted based on the purpose of the study. The literature review included qualitative and quantitative research articles. The search for articles was done in the databases CINAHL and PubMed. A total of 17 scientific articles were included. The data material was analyzed with an integrated analysis method. Following a compilation of the included articles, three themes were identified with associated subthemes.    The themes were: The relationship with a midwife, The impact of continuity of care during pregnancy and postpartum and Factors affecting woman’s childbirth experience. The results showed that a majority of all women were positive towards midwife-led continuity of care. The midwife-woman relationship brought a sense of security for the woman with increased self-confidence. With the continuity model of care the woman had more time to describe her wishes facing the birth. Clear information and knowledge were a significant factor for the women, as they gained a greater understanding of pregnancy and childbirth. This meant that they were well prepared for the birth. Having a known midwife present gave women an increased self-confidence to go through the process of childbirth because the midwife already knew the woman´s wishes. The woman felt that the continuous midwife-led care was accessible, supportive and safe.   Midwife-led continuity of care during pregnancy, childbirth and postpartum care can contribute to a close relationship with the midwife, increase the accessibility of the midwife during pregnancy and postpartum care and improve the childbirth experience.

Perceived quality of care and burnout affects psychiatric care workers profession-ally and physically. Psychiatric caregivers working in forensic facilities encounter negative changes with perceived quality of care and burnout when working with offender patients. Recognizing the variables that lead to burnout and perceived quality of care may assist professionals and organizations with the information needed to prevent burnout and poor perceived quality of care among psychiatric caregivers. Using self-efficacy theory as a framework, this correlational design examined whether years of experience, self-efficacy, and caseload complexity predict burnout and perceived quality of care. A total of 148 psychiatric caregiver participants completed questionnaires comprised of the Maslach Burnout Inventory-HSS, General Self-efficacy Scale, and Quality of Care Measures (staff-form), along with demographic questions. Multiple regression determined that self-efficacy and years of experience significantly predicted personal accomplishment, which is a subscale of burnout. However, self-efficacy did not predict of depersonalization or emotional exhaustion the other 2 subscales of burnout. Self-efficacy was also found to be a positive predictor of perceived quality of care. The research findings have the potential to influence social change by providing professionals and organizations a better under-standing of the factors that influence burnout and perceived quality of care when work-ing with offender patients. In relation, improvements in trainings, interventions, and strat-egies for positive employee well-being and increased patient care could possibly reduce burnout and increase perceived quality of care.

No

This study used an explanatory research model that determined the effect on caseworker time and therefore workload caused by specific characteristics of cases assigned after the child abuse investigation is complete. The purpose of this study was to explain the relationship between child protection case characteristics and the time an assigned caseworker devotes to a case. With this knowledge an informed methodology to assess the current workload of a caseworker could be used to assure that the caseworker is able to successfully complete the tasks required for each child assigned. Further, the knowledge of the amount of time spent on a case with specific characteristics allows supervisors to assess and properly assign cases. Utilizing focus groups and a secondary data analysis of the Florida State Automated Child Welfare Service Information System (SACWSIS) the case characteristics of race/ethnicity, living arrangement, placement, removal and prior removal were found to significantly affect caseworker time spent on a case. Additionally, the case characteristics of gender, age, type of maltreatment, and disability were not found to affect caseworker time spent on a case.

Patient influence for women giving birth in Caseload midwifery Background: According to the Patent Safety Act, a patient must be provided with expert and caring health care that meets certain requirements. The patient must be shown care and respect and the care is designed with and carried out in consultation with the patient, in that the patient has influence over their care. Person-centered, here women-centered, is about meeting the patient's need for coordination, continuity and with the participation of the patient. Motive: There are no studies done regarding patient-influence in caseload midwifery, which is so far the most women-centered model this author has found.Aim: To, based on previous research, describe and interpret women's experience of patient influence when they give birth to children in Caseload midwifery. Method: A search for qualitative articles using the PubMed and CINAHL databases was performed to make a metasynthesis. Inclusion criteria was articles were published from 2010 onwards in English and peer reviewed. Quality review was performed using SBU's protocol for review of qualitative studies, which resulted in sex articles. Results: Five themes that all showed that Caseload contributed to an increased patient influence. Continuity in the relationship, Consent to and be inclusive of, Empowerment and decision-making, Ownership and being in the moment and Alteration and normality.Conclusion: Continuity in the relationship by being remembered helped the woman to focus, on things that were important to her. This increased the woman's self-confidence, she got a sense of context and felt prepared for the birth. Participation in informed decisions about her pregnancy and childbirth, gave her empowerment. The woman experienced control and got an active role in the birth, they owned their birth. Childbirth as a philosophy gave women additional perspectives on childbirth as a normal phenomenon but at the same time as a transforming process of becoming a mother. The summary of this meta-synthesis is that all experiences flow together and are interdependent of each other, patient influence is complex. The synthesis of the six qualitative studies showed that Caseload midwifery contributed to an increased patient influence.

This study examined factors contributing to Utah's critical shortage of school-based speech-language pathologists. Specifically, this study focused on the following three constructs: (a) stress levels among professionals currently in the field, (b) attrition and the reasons professionals leave their positions, and (c) factors at the university level. Stress among Utah's speech-language pathologists was assessed using the Speech-Language Pathologist Stress Inventory (Fimian, Lieberman, & Fasteneau, 1991). Of the 230 potential participants, 97 completed and returned questionnaires. Results indicated that Utah's school-based speech-language pathologists experience less overall stress than a normative sample of speech-language pathologists throughout the United States; however, Utah's professionals reported significantly greater stress related to caseload, salary, and use of prescription drugs. However, overall stress was not related to caseload size or the number of service delivery sites. In regard to how various aspects of burnout were related, a weak positive relationship was found between years of experience and Time and Workload Management. Overall, Total Stress appeared to be most strongly related to Lack of Professional Supports. Attrition was investigated by distributing an existing survey to the special education directors of Utah's 40 school districts, who reported the status of speech-language pathologists employed in their respective districts. All 40 of the directors responded to the survey. Based on their report, 67 of the speech-language pathologists left their positions during the 2004-2005 school year, representing 14.5% of Utah's school-based speech-language pathologists. The top reasons indicated for speech-language pathologists leaving their positions were (a) moved, (b) children/pregnancy, (c) changed district within state, (d) retired, and (e) left education. Finally, the directors of Utah's three university graduate-level speech-language pathology programs were surveyed to assess factors at the university level that may be contributing to the shortage. All three directors responded to the survey. The mean number of applicants over the three-year period in question was 186 per year, and of these, an average of 111.3 or 60.0% was accepted. From these three combined programs, an average of 67 students graduated each year, and approximately 30 to 40% of these graduates initiated practice in Utah's schools. Data from one of the three programs, Utah State University, indicated that the addition of an outreach program significantly increased their number of graduates.

Proceedings before the European Court of Human Rights and their reform The purpose of this thesis is to analyse and evaluate the proceedings before the European Court of Human Rights. This Court that exists within the Council of Europe is the guardian of guaranteed human rights and fundamental freedoms defined in the European Convention on Human Rights. Under this Convention an individual is entitled to submit an application to the Court and seek for the protection of his rights that were violated by one of the Member states. One of the conditions that ensure this protection is an effective and adequate proceedings before the Court. At present, the Court has to face many problems that are able to put this human rights protection in danger. Therefore the Member states decided to initiate a reform of the Court and its proceedings. The basic goal of this reform process is to ensure the long-term efficiency of the proceedings. This thesis analyzes the outcomes of this reform and how it affects the current proceedings. Key words: the European Court of Human Rights, proceedings, reform, workload, caseload

The thesis examines the effect of the number of judges on court output in the Czech Republic. It is based on the theory of a rational judge and the hypothesis that after the appointment of new judges, the incumbent judges face lower caseload pressure and they can decrease their effort. It follows that the change in the court output is very small or non-existent. I develop a model that specifies court output as a function of judicial staffing, caseload and other variables. I employ OLS, FE and 2SLS estimation methods. The estimation results suggest that the number of judges does not affect court output in the case of district courts. In the case of regional courts, a 10% growth in the number of judges leads approximately to a 5% growth in the number of resolved cases. Furthermore, estimates suggest that all courts strongly react on changes in the caseload. I also show that the quantity-quality trade-off is not present at courts in the Czech Republic. The thesis contributes to thin empirical literature on the effect of judicial staffing on court output mainly by controlling for the case difficulty and by using panel data from the Czech Republic.

Healthcare professionals such as speech and language therapists are expected to change their practice throughout their career. However, from a practice perspective, there is a lack of knowledge around what practice change is, what it really takes, and why there are different trajectories. Consequently, therapists, managers and commissioners lack empirical evidence on which to base decisions about enabling practice change. In addition, intervention researchers lack basic sociological research around implementation that could inform their research designs, reporting and impact. This case-based sociological inquiry, underpinned by critical realist assumptions, was designed to address this knowledge gap. It includes a two-stage qualitative synthesis of 53 (then 16) studies where speech and language therapists explained the work of their practice in depth, and a primary qualitative study focused on one professional jurisdiction, children with speech sound difficulties (SSD). Forty two speech and language therapists from three NHS areas and independent practice in Scotland participated in individual interviews or self-organised pairs or focus groups to discuss in depth how and why they had changed their practice with these children. A variety of comparative methods were used to detail, understand and explain this particular aspect of the social world. The resulting theory of SSD practice change comprises six configured cases of practice change (Transforming; Redistributing; Venturing; Personalising; Delegating; Refining) emerging from an evolving and modifiable practice context. The work that had happened across four key aspects of this context (Intervention; Candidacy; Caseload; Service) explained what made each case possible, and how practice had come to be one way rather than another. Among its practical applications, the theory could help services plan more realistic practice change. In addition, the inductively developed layered model of SSD intervention change has the potential to contribute to speech and language therapy education as well as methodological discussions around complex interventions.