This study focuses on how leadership is constructed in the Social Service of Sweden. The aim is to study how first line managers experience expectations on themselves as leaders and how they handle these as well as how they perceive their possibility to live up to these expectations. The study is based on eight interviews with first line managers in the fields of Social Service. Even though the result show that first line managers experience a lot of, sometimes conflicting, expectations, both from within the organisation but also external expectations from society, they feel that they can handle the pressure. The managers appear to have developed strategies to handle these expectations by re-formulating them into new expectations that is easier to live up to. Also, they believe that they have good opportunities as they feel supported in their work and they have a good self-esteem. Overall the interviewed first line managers don’t describe themselves as stressed or overworked, troubled with meeting up to expectations on them, which somewhat contradicts the result of previous research.

L'objet de cette thèse est double. Elle a tout d'abord pour finalité d'enrichir la compréhension des pratiques dans leurs rapports aux normes en dépassant une vision binaire en termes d'opposition ou non. Elle entend par ailleurs approfondir la connaissance sur les pratiques, encore peu explorées mais pourtant fondamentales, des managers de première ligne en matière de gestion des mobilités internes. Adoptant une approche« HRM-in-practice » et abductive, cette thèse repose sur l'étude d'une grande entreprise publique qui souhaite faire de ses managers de « véritables acteurs » d'une politique dite « d'activation des mobilités internes». Cette recherche met alors en évidence une diversité des pratiques RH des managers de première ligne alors même qu'ils font face à des normes identiques émanant de la Direction qui restreignent fortement leurs marges de manœuvre formelles. En introduisant les concepts de transgression et de bricolage dans le cadre d'analyse de la perspective de la pratique, nous montrons que derrière cette diversité se dissimulent quatre manières différentes de se comporter face aux normes : les pratiques peuvent non seulement s'opposer ou non aux normes, mais également prendre de la distance ou non avec ces dernières. Cette distinction des pratiques en fonction de leurs rapports de transgression et de bricolage vis-à-vis des normes permet tout d'abord de mettre en évidence les caractéristiques en termes de moyens mobilisés et de logiques d'action qui les différencient. Ces diverses pratiques apparaissent par ailleurs comme des réponses locales à des tensions qui peuvent être considérées relativement aux normes en vigueur ou au système de gestion des mobilités internes. Nous montrons enfin que les différents types de pratiques identifiés participent diversement à la fabrique des mobilités internes. / The purpose of this thesis is twofold. It first aims to enrich the understanding of practices considering how they are related to norms without restricting our view to a binary approach of opposition or not. It also intends to deepen the knowledge about first-line managers' practices in the internal mobility management process. While fundamental, these practices still remain poorly explored. Adopting a « HRM-in-practice » and an abductive perspective, this thesis relies on the study of a large public company that intends to give its managers a key role in internal mobility process. This study reveals a diversity of first-line managers' HR practices even though they are faced with the same top management's norms that severely restrict their formal leeway. By introducing the concepts of deviance and bricolage into the Practice Perspective's analysis framework, we show that this diversity conceals four different ways of behaving towards norms: in addition to opposition or not to norms, practices can also apply them with more or Jess distance. The distinction of these practices regarding the consideration of norms with or without deviance and bricolage first highlights the differentiation in used resources and action logics. These practices can also be considered as local adaptations to tensions related either to current norms or to the internal mobility management system. We finally show that the different practices that have been identified contribute to the construction of internal mobility in different ways.

First-line supervisors in U.S. retail organizations are unable to resolve nearly 34% of typical daily customer problems for their organizations. The purpose of this single case study was to explore the strategies retail supermarket managers have used to improve 1st line supervisor problem solving abilities within a retail supermarket company in Winston-Salem, North Carolina. The conceptual framework for this study was the skills-based leadership model. Data were collected from semistructured interviews with 4 retail store manager participants with a successful record of improving first-line supervisor problem solving abilities. Additionally, the review of company documents including training guides, training checklists, job descriptions, annual goal setting templates, and company website postings supplemented the semistructured interviews. Data analysis entailed coding, conceptualizing concepts and ideas, identifying themes, and member-checking to ensure the trustworthiness of interpretations. Based on the methodological triangulation of the data collected, 4 themes emerged after the data analysis: (a) the importance of communicating expectations with first-line supervisors, (b) coaching first-line supervisors on performance, (c) first-line supervisor learning and development, and (d) measuring first-line supervisor performance. Findings from this study may contribute to social change by providing insights and strategies that retail store managers can use to improve 1st-line supervisor problem-solving abilities. Improvement in problem-solving abilities may improve employees' lives, communities, and organizational performance.

<p>Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of &gt / 80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence.</p>

<p>Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of &gt / 80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence.</p>

Po Lietuvos neprikausomybės atkūrimo, šalies politinis ir ekonominis vystymąsis atskleidė daugybę, neišspręstų ar naujai iškilusių, socialinių problemų (klausimų), todėl iškilo socialinių darbuotojų poreikis įvairiose visuomenės gyvenimo srityse, tame tarpe ir sveikatos priežiūroje. Sparčiai didėjo supratingumas, kad sveikatos priežiūra yra ne tik ligų diagnozavimas, gydymas, prevencija. Labai svarbi visuomenės sveikatos sudėtinė dalis yra pačio paciento slauga. Šiandien socialinių paslaugų pasiūla pacientams yra nepakankama Lietuvoje. Savarankiškumą praradę ar sunkiai sergantys ligoniai turi gauti kvalifikuotas socialines paslaugas. / After Lithuania regained its independence, many of the country's unsolved social problems soon became apparent. These problems illustrated the need for a properly trained labor force of social workers equipped to deal with them, particularly in the field of health care. It soon became clear that effective health care prevention was every bit as important as diagnosing and curing disease. A very important component of such health care is the nursing care and social support that patients receive, but the provision of such care is still insufficient in Lithuania . Patients that have lost their independence and are seriously ill must receive adequate care and support.

I arbetslivet har första linjens chefer haft stora inslag av direkt ledarskap med en traditionellt hög närvaro hos de underställda. Studier visar på en ökad andel administrativa, ekonomiska och personalledande uppgifter för första linjens chefer som får till följd en minskad delaktighet i den dagliga verksamheten men också sämre möjligheter att motivera sin underställda, vilket negativt påverkar verksamheten. I Försvarsmakten har administrativa uppgifter som tidigare genomfördes högre upp i organisationen flyttats till en lägre nivå. Uppsatsens syfte är att öka förståelsen för och kunskapen om plutonchefens arbetssituation efter införandet av anställda soldater och den delegerade arbetsgivarrollen till plutonchefen. Studiens fokus är på plutonchefens avvägning mellan deltagandet i underställdas verksamhet för att utöva direkt ledarskap kontra att genomföra bl.a. personaladministration. I studien används rollteori från socialpsykologin som analysmodell, med utgångspunkt i tidigare forskning och litteratur om första linjens chefer och Försvarsmaktens ledarskapsmodell. Inledningsvis beskrivs Försvarsmaktens ”utsända” rollförväntning, därefter inhämtas plutonchefens upplevda arbetssituation och rollförväntning med en enkät till 141 plutonchefer (90 svar). Slutligen jämförs rollförväntningarna med varandra samt med teorin.  I empirin framkommer att plutonchefernas situation är pressad där upplevda tvingande administrativa arbetsuppgifter prioriteras före direkt ledarskap. Hälften (48 %) av plutoncheferna deltar i underställdas verksamhet mindre än 20 % av sin arbetstid och endast 20 % av plutoncheferna använder mindre än 20 % av arbetstiden till administration av underställda. Resultatet antyder att det finns en skillnad i rollförväntningar på plutonchefen mellan Försvarsmakten och plutoncheferna själva, främst kopplat till faktorn överbelastning av arbetsuppgifter samt yrkesrollidentiteten.

Depuis les années 2000, la France a mis en place d'importantes politiques de réformes de l'Etat. Ayant pour ambition affichée de moderniser la gestion de l'Etat en le recentrant sur ses missions prioritaires comme améliorer le service rendu à l'usager et réduire les dépenses publiques, ces réformes ont des répercussions sur l'ensemble des acteurs, et notamment sur les cadres de proximité. Pris en tenaille entre leur hiérarchie qui fixe des objectifs de performance et leur équipe qui « fait » le travail, ces cadres traduisent au quotidien les objectifs en missions concrètes.Dans le but de mieux comprendre cette posture d'équilibriste et ses conséquences sur l'activité et la santé des cadres, cette thèse s'intéresse à l'activité des cadres de proximité de la Direction Générale des Finances Publiques (DGFiP), créée en 2008 et qui s'inscrit dans la ligne du New Public Management. Ces cadres A encadrants sont issus des deux anciennes filières distinguées avant la fusion, et dont les cultures respectives diffèrent au niveau de l'approche du pilotage par la performance et de la relation aux agents. Dans une administration en changement permanent, ils sont tiraillés par des injonctions contradictoires, qui remettent continuellement en question leur positionnement vis-à-vis de la hiérarchie versus équipe encadrée, des objectifs de performance versus conditions de vie au travail, des logiques managériales versus logiques de technicité du métier. Un détour par la littérature pluridisciplinaire (sciences de gestion, sociologie, psychologie), abondante notamment sur le rôle et le positionnement des cadres de proximité, pointe pourtant un creux sur le contenu-même de ce travail. En ergonomie, les quelques recherches sur le travail des cadres de proximité s'intéressent plutôt à l'analyse des situations de travail. Nous proposons pour notre part d'analyser cette activité sous le prisme des parcours professionnels au sens de Gaudart & Ledoux (2013), c'est-à-dire comme une succession d'emplois ou de fonctions d'une part, et d'autre part un parcours de travail entendu comme un accroissement du temps vécu (Molinié, Gaudart & Pueyo, 2012) pointant les rôles de l'expérience. Notre objectif est de comprendre à la fois comment les transformations du travail impactent l'activité des cadres de proximité et en quoi l'expérience peut être une ressource dans la réalisation de cette activité, notamment vis-à-vis de la régulation du couple distances/proximités par ces cadres.Notre stratégie de recherche combine cinq méthodes : l'analyse d'un dispositif existant dénommé « espace de dialogue » et de ses contenus ; des entretiens notamment de reconstitution des parcours professionnels et sur le dialogue de gestion ; des observations de l'activité de 14 cadres de proximité ; des auto-confrontations à partir des traces de l'activité ; et l'organisation d'ateliers réflexifs. / Since the 2000s, France set up important policies of State reforms. The aim of these reforms is to modernize the French State management by refocusing this one on its missions' priority as to improve the service provided to the user and to reduce the public spending. These reforms have repercussions on all the actors, in particular on the first-line managers. Between their hierarchy which sets goals of performance and their teams which “do” the work, these first-line managers translate day-to-day the objectives into concrete missions.In order to understand this balanced posture and its consequences on the activity and on the health of managers, this thesis is interested in the activity of the Head office of the Public finances' first-line managers. This administration was created in 2008 and joins in the line of New Public Management. This kind of managers is from the two former sectors which existed before the merger: the respective cultures differ in the approach of performance-based management and the relation to the agents. In an administration in permanent change, the first-line managers are pulled by contradictory orders. This kind of orders questions constantly the positioning towards the hierarchy and supervised team, towards objectives of performance and living conditions at work, towards logics of technical skill and managerial logics. Although the multidisciplinary literature – sciences of management, sociology, psychology – is extensive in particular on the role and the positioning of the first-line managers, the contents of their work are few approached. In ergonomics, some researches on the work of the first-line managers are rather interested in the analysis of working situations. For our part, we suggest analyzing this activity under the prism of the careers (Gaudart & Ledoux, 2013). These careers represent a succession of jobs or functions and a working course with an increase of real-life time (Molinié, Gaudart & Pueyo, 2012) which points at the experience's roles. Our two objectives are to understand how the work transformations impact on the first-line managers' activity and how the experience can be a resource to realize this activity, in particular to regulate the couple closeness / distances by these managers.Our strategy of research combines five methods: the analysis of an existing “space of dialogue” plan and its contents, interviews of the careers' reconstruction, observations of the 14 managers' activity, auto-confrontations from the tracks of the activity, and the organization of reflexive workshops.

Magister Public Health - MPH / Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of &gt;80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence. / South Africa

Bakgrund: Första linjens chefers stöd och förståelse för distriktssköterskor är viktigt för att befrämja en god arbetsmiljö och tillfredsställelse på arbetsplatsen. Faktorer som kan påverka: resurser, att känna sig delaktig, att veta vad som händer, utvecklingsmöjligheter. Syfte: Syftet var att beskriva erfarenheter och reflektioner första linjens chefer vid hälsocentraler hade kring sitt arbete med strukturella förutsättningar till distriktssköterskor. Metod: Studien hade en kvalitativ ansats med beskrivande design. Semistrukturerade intervjuer, med åtta första linjens chefer inom primärvården, utfördes och bearbetades genom kvalitativ innehållsanalys utifrån en induktiv ansats. Resultat: Information framhölls som svårt. Vanligast sättet att föra ut information på var mail. Vikten av att distriktssköterskorna gavs förutsättningar att själva söka information påtalades. Cheferna höll olika möten, vilket tog mycket tid. Cheferna gjorde sitt yttersta för att det skulle finnas tillräckligt med personal. Cheferna litade på distriktssköterskornas bedömningar vad gällde material, utrustning och att planera sin tid. Cheferna uttryckte att distriktssköterskornas tid var knapp. Cheferna kände att de hade en hög närvaro och tillgänglighet. Feedback gavs på olika sätt, flera chefer ville förbättra sig på detta. Cheferna var positiva till utbildning och ansåg att möjligheter till utveckling fanns. Slutsats: Första linjens chefer inom primärvård upplevde att de var ett gott stöd till distriktssköterskor och avsikterna var att ge möjlighet till strukturella förutsättningar. De upplevde ibland att de var styrda uppifrån. De upplevde att vissa distriktssköterskor inte hade samma intresse som organisationen, vilket kunde försvåra anpassning av exempelvis utbildning på individuell nivå. / Background: First line managers' support and understanding for district nurses is important to promote good work environment and satisfaction at the workplace. Factors that may affect: resources, feeling involved, knowing what's happening, development opportunities. Aim: The aim of this study was to describe experiences and reflections first-line managers’ had concerning their work on structural empowerment for district nurses in primary care. Method: The study had a qualitative approach with descriptive design. Semi-structured interviews, with eight first-line primary care managers, were performed and analyzed through qualitative content analysis based on an inductive approach. Result: Information was highlighted as difficult. Most common way to convey information were by mail. It was important to give district nurses opportunity of seeking information themselves. The managers held different meetings, which took a lot of time. The managers did their utmost to ensure that there were enough staff. The managers trusted the district nurses' assessments regarding materials, equipment and planning their time. The managers expressed that the time of district nurses was scarce. The managers felt they’d high attendance and availability. Feedback was given in different ways, managers would like to improve on this. The managers were positive about education and felt that opportunities for development were available. Conclusion: First-line managers in primary care experienced themselves as good support to district nurses and their intentions were to provide opportunities for structural empowerment. Sometimes they experienced being controlled from top. They found that some district nurses didn’t share the same interest as the organization, which may make it difficult to adjust at individual level.