The aim of this study was to examine how social services work with home-based solution which aim to replace residential care for children and youth. Furthermore, our intention was to see how social services argue for the interventions through policy documents and interviews. The data consisted of policy documents from eleven municipalities and two interviewees with three professionals. The result of the study was processed through a qualitative content analysis and was analysed in relation to previous research, systems theory and institutional theory. The study presented that social services strive to replace placements with other alternatives at home. Interventions, such as home-based solutions and qualified home-based care and family-oriented methods was central in the study. The analysis of the collected material resulted in three approaches to the case “alterative to placements”: home care, efficiency and eclecticism. Furthermore, it showed that home-based solutions develop in order to receive more financial gains. On the other hand, there is also an uncertainty in the way the interventions should be implemented since they are under process. One conclusion is that it is ambiguous whether home-based solutions aim to replace institutional care or if they apply as supplementary intervention for children and youth. Regardless, the municipalities described that they want to develop comprehensive home-based solutions that enable the child to grow up in his or her home environment, if not for the rights of the child and for the parents, for a sustainable social service. / Syftet med fallstudien var att undersöka hur socialtjänsten i Sveriges kommuner argumenterar för öppenvårdsinsatser som ett alternativ till placeringar av barn och unga. Vidare har intentionen varit att undersöka hur socialtjänsten genom måldokument och intervjuer argumenterar för sina insatser. Som datainsamlingsmetod användes elva måldokument följt av två intervjuer med tre informanter. Studiens resultat bearbetades genom en kvalitativ innehållsanalys och analyserades i relation till tidigare forskning, systemteori samt institutionell teori. Resultatet utgörs av en fallbeskrivning bestående av tre förhållningssätt till ”alternativ till placering”: vård på hemmaplan, kostnadseffektivisering och eklektism. Studien visade att socialtjänsten har ett flertal insatser att tillgå för att minska placeringar men att insatserna varierar mellan kommunerna. Det framgick att kommuner framförallt vill tillämpa omfattande öppna insatser på hemmaplan för att ersätta placering utanför det egna hemmet. Begrepp som hemmaplanslösningar och kvalificerad vård på hemmaplan återfinns i måldokumenten där kommunerna skriver att de vill utveckla och implementera familjeorienterade metoder. Vidare beskriver kommunerna att utvecklingen av insatser på hemmaplan är kopplade till mindre kostnader för kommunerna. Dessutom framgick det att öppenvårdsinsatser är under en pågående process och att det finns en otydlighet kring hur insatserna ska genomföras. Slutsatsen är att det är tvetydigt om öppenvårdsinsatser används i syfte att ersätta institutionsvård eller om de tillämpas som kompletterande insatser till barn och unga. Oavsett fanns det i det insamlade materialet en beskrivning av att utveckla omfattande öppenvårdsinsatser som möjliggör att barnet kan växa upp i sin hemmiljö, om inte för barnets bästa, för att resurserna ska räcka till.

Afin d'exploiter les capacités des architectures parallèles telles que les grappes, les grilles, les systèmes multi-processeurs, et plus récemment les nuages et les systèmes multi-cœurs, un langage de programmation universel et facile à utiliser reste à développer. Du point de vue du programmeur, OpenMP est très facile à utiliser en grande partie grâce à sa capacité à supporter une parallélisation incrémentale, la possibilité de définir dynamiquement le nombre de fils d'exécution, et aussi grâce à ses stratégies d'ordonnancement. Cependant, comme il a été initialement conçu pour des systèmes à mémoire partagée, OpenMP est généralement très limité pour effectuer des calculs sur des systèmes à mémoire distribuée. De nombreuses solutions ont été essayées pour faire tourner OpenMP sur des systèmes à mémoire distribuée. Les approches les plus abouties se concentrent sur l’exploitation d’une architecture réseau spéciale et donc ne peuvent fournir une solution ouverte. D'autres sont basées sur une solution logicielle déjà disponible telle que DMS, MPI ou Global Array, et par conséquent rencontrent des difficultés pour fournir une implémentation d'OpenMP complètement conforme et à haute performance. CAPE — pour Checkpointing Aided Parallel Execution — est une solution alternative permettant de développer une implémentation conforme d'OpenMP pour les systèmes à mémoire distribuée. L'idée est la suivante : en arrivant à une section parallèle, l'image du thread maître est sauvegardé et est envoyée aux esclaves ; puis, chaque esclave exécute l'un des threads ; à la fin de la section parallèle, chaque threads esclaves extraient une liste de toutes modifications ayant été effectuées localement et la renvoie au thread maître ; le thread maître intègre ces modifications et reprend son exécution. Afin de prouver la faisabilité de cette approche, la première version de CAPE a été implémentée en utilisant des points de reprise complets. Cependant, une analyse préliminaire a montré que la grande quantité de données transmises entre les threads et l’extraction de la liste des modifications depuis les points de reprise complets conduit à de faibles performances. De plus, cette version est limitée à des problèmes parallèles satisfaisant les conditions de Bernstein, autrement dit, il ne permet pas de prendre en compte les données partagées. L'objectif de cette thèse est de proposer de nouvelles approches pour améliorer les performances de CAPE et dépasser les restrictions sur les données partagées. Tout d'abord, nous avons développé DICKPT (Discontinuous Incremental ChecKPoinTing), une technique points de reprise incrémentaux qui supporte la possibilité de prendre des points de reprise discontinue lors de l'exécution d'un processus. Basé sur DICKPT, la vitesse d'exécution de la nouvelle version de CAPE a été considérablement augmenté. Par exemple, le temps de calculer une grande multiplication matrice-matrice sur un cluster des ordinateurs bureaux est devenu très similaire à la durée d'exécution d'un programme MPI optimisé. En outre, l'accélération associée à cette nouvelle version pour divers nombre de threads est assez linéaire pour différentes tailles du problème. Pour des données partagées, nous avons proposé UHLRC (Updated Home-based Lazy Relaxed Consistency), une version modifiée de la HLRC (Home-based Lazy Relaxed Consistency) modèle de mémoire, pour le rendre plus adapté aux caractéristiques de CAPE. Les prototypes et les algorithmes à mettre en œuvre la synchronisation des données et des directives et clauses de données partagées sont également précisées. Ces deux travaux garantit la possibilité pour CAPE de respecter des demandes de données partagées d'OpenMP / In order to explore further the capabilities of parallel computing architectures such as grids, clusters, multi-processors and more recently, clouds and multi-cores, an easy-to-use parallel language is an important challenging issue. From the programmer's point of view, OpenMP is very easy to use with its ability to support incremental parallelization, features for dynamically setting the number of threads and scheduling strategies. However, as initially designed for shared memory systems, OpenMP is usually limited on distributed memory systems to intra-nodes' computations. Many attempts have tried to port OpenMP on distributed systems. The most emerged approaches mainly focus on exploiting the capabilities of a special network architecture and therefore cannot provide an open solution. Others are based on an already available software solution such as DMS, MPI or Global Array and, as a consequence, they meet difficulties to become a fully-compliant and high-performance implementation of OpenMP. As yet another attempt to built an OpenMP compliant implementation for distributed memory systems, CAPE − which stands for Checkpointing Aide Parallel Execution − has been developed which with the following idea: when reaching a parallel section, the master thread is dumped and its image is sent to slaves; then, each slave executes a different thread; at the end of the parallel section, slave threads extract and return to the master thread the list of all modifications that has been locally performed; the master includes these modifications and resumes its execution. In order to prove the feasibility of this paradigm, the first version of CAPE was implemented using complete checkpoints. However, preliminary analysis showed that the large amount of data transferred between threads and the extraction of the list of modifications from complete checkpoints lead to weak performance. Furthermore, this version was restricted to parallel problems satisfying the Bernstein's conditions, i.e. it did not solve the requirements of shared data. This thesis aims at presenting the approaches we proposed to improve CAPE' performance and to overcome the restrictions on shared data. First, we developed DICKPT which stands for Discontinuous Incremental Checkpointing, an incremental checkpointing technique that supports the ability to save incremental checkpoints discontinuously during the execution of a process. Based on the DICKPT, the execution speed of the new version of CAPE was significantly increased. For example, the time to compute a large matrix-matrix product on a desktop cluster has become very similar to the execution time of the same optimized MPI program. Moreover, the speedup associated with this new version for various number of threads is quite linear for different problem sizes. In the side of shared data, we proposed UHLRC, which stands for Updated Home-based Lazy Release Consistency, a modified version of the Home-based Lazy Release Consistency (HLRC) memory model, to make it more appropriate to the characteristics of CAPE. Prototypes and algorithms to implement the synchronization and OpenMP data-sharing clauses and directives are also specified. These two works ensures the ability for CAPE to respect shared-data behavior

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L’articulation du genou est particulièrement sujette aux blessures pendant l’adolescence. Ces blessures peuvent avoir des effets profonds sur la santé physique et mentale des jeunes. Selon la théorie de l’autodétermination (TAD), la satisfaction du besoin psychologique fondamental d’autonomie peut favoriser le rétablissement physique et psychologique des adolescents après une blessure au genou. L’autonomie, telle que définie par la TAD, renvoie au fonctionnement autodéterminé. Le soutien à l'autonomie (SA) peut se manifester par de l’empathie, des informations significatives et l’encouragement à participer activement à la prise de décision et à la résolution de problèmes. Des études, souvent menées auprès d’adultes et utilisant des devis transversaux, ont montré des corrélations positives entre le soutien à l’autonomie et les indicateurs de santé mentale et physique de patients dans divers domaines de la santé. Étant donné les défis uniques auxquels sont confrontés les adolescents au cours du processus de rétablissement et de rééducation, la présente thèse vise à explorer de manière prospective comment le SA perçu de la part des parents et des professionnels de la santé est liée au fonctionnement psychologique et physique d’adolescents ayant subi une blessure au genou. Dans l’article 1, les contributions uniques et additives du SA des parents et du médecin dans la prédiction du bien-être subjectif (BES) de 44 adolescents blessés au genou ont été étudiées. Le BES des patients, comprenant leurs affects positifs et négatifs ainsi que leur satisfaction de vie, a été évalué mensuellement pendant 3 mois. Nos résultats ont souligné l'importance du SA perçu de la part des parents, qui corrélait positivement avec le BES au fils du temps. Au suivi de 2 mois, ce lien était toujours présent, et ce, même lorsque le niveau de base du BES et des covariables clés étaient prises en compte (c.-à-d., le SA du médecin, l'identité athlétique et la fonction du genou). L’article 2 a examiné l'association entre la perception du SA par les spécialistes de la rééducation et la fonction du genou 3 mois plus tard, au sein d’un sous-ensemble de 24 patients adolescents ayant suivi un programme de rééducation. Dans cette étude, les liens prospectifs entre la motivation autonome, l’adhérence à la rééducation à domicile et la fonction du genou des patients ont également été explorés. Les résultats ont révélé qu’aucune de ces variables n’était déterminante pour une meilleure fonction du genou, au-delà de l’influence de son niveau de base. Cependant, les patients adolescents qui percevaient leur spécialiste en rééducation comme plus soutenant de l’autonomie étaient plus susceptibles d’avoir un niveau plus élevé de motivation autonome pour suivre ses instructions. De plus, une plus grande motivation autonome était liée à un plus grand respect des recommandations en termes d’exercices prescrits et d’abstention d'activités aggravantes. Ensemble, ces études offrent un aperçu précieux des liens entre les facteurs sociomotivationnels, le bien-être et les pratiques de rééducation, à travers le prisme de la TAD. Les associations positives entre le SA perçu des agents de socialisation clés et à la fois le bien-être subjectif et la motivation autonome, ainsi qu’entre la motivation autonome et l’adhérence à la rééducation à domicile, soulignent l’importance d’une approche qui soutienne l’autonomie des patients adolescents lors de leur rétablissement. Cette thèse discute en outre des implications théoriques et pratiques de ces résultats préliminaires et exploratoires pour le bien-être et la motivation des jeunes dans les contextes de soins de santé, tout en reconnaissant ses limites et en suggérant des pistes de recherches futures. / The knee joint is particularly prone to injury during adolescence, and such injuries can have profound effects on youth’s physical and mental health. According to the Self- Determination Theory (SDT), the satisfaction of the basic psychological need for autonomy can promote the physical and psychological recovery of adolescents following knee injuries. Autonomy, as defined by SDT, refers to volitional functioning. Autonomy support (AS) can be manifested through empathy, meaningful information, and encouragement of active involvement in decision making and problem solving. Research, often conducted with adults and employing cross-sectional designs, has demonstrated positive correlations between AS and patients’ mental and physical health outcomes across various health domains. Given the unique challenges faced by adolescents during the recovery and rehabilitation process, the present thesis aims to prospectively explore whether perceived AS from parents and healthcare providers is linked to the psychological and physical functioning of adolescents who sustained knee injuries. In Article 1, the unique and additive contributions of parental and physician AS in predicting the subjective well-being (SWB) of 44 knee-injured adolescents were investigated. Patients’ SWB, comprising positive and negative affect as well as life satisfaction, was assessed monthly for 3 months. Our findings underscored the significance of AS perceived from parents, which exhibited a positive correlation with SWB over time. At the 2-month follow-up, this link persisted even after adjusting for baseline SWB and key covariates (i.e., physician AS, athletic identity, and knee function). Article 2 examined the association between perceived AS from rehabilitation specialists and knee function 3 months later, within a subset of 24 adolescent patients who had undertaken a rehabilitation program. In this study, the prospective links between patients’ autonomous motivation, adherence to home-based rehabilitation, and knee function were also explored. Results revealed that none of these variables were determinants of better knee function, beyond the influence of its baseline level. However, adolescent patients who perceived their rehabilitation specialist as more autonomy-supportive reported higher levels of autonomous motivation for following their instructions. Moreover, greater autonomous motivation was related to a higher degree of compliance in terms of performing prescribed exercises and refraining from engaging in aggravating activities. Together, these studies offer some valuable insights into the links between sociomotivational factors, well-being, and rehabilitation practices, through the lens of SDT. The positive associations between perceived AS from key socialization agents and both SWB and autonomous motivation, as well as between autonomous motivation and home-based rehabilitation adherence, underscore the importance of an autonomy-supportive approach when aiming to facilitate adolescent patients’ recovery. This thesis further discusses the theoretical and practical implications of these preliminary and exploratory findings for youth’s well-being and motivation in healthcare contexts, while recognizing its limitations and suggesting future research directions.

The purpose of this study was to examine participants' perceptions on the effectiveness of the "Parents in Partnership" program (PIP) of the Los Angeles County Department of Children and Family Services. Parents in Partnership (PIP) is a collaborative effort between the Department of Children and Family Services (DCFS) and parent partner paraprofessionals toward facilitation of safe reunification and permanency through education, support and mentoring of birth parents. The program's sole goal is the timely and safe reunification of children and their families. Face-to-face interviews were conducted with fourteen participants in the PIP program. Both mentors and mentees were interviewed.

The aim of this research was to support new mothers in groups, so that they can function optimally as educators. During the research mothers with babies up to three months of age were used by means of a support group. This research project was done after it became evident from a literature study that new mothers suffered with unique problems during this adaption phase. In the empirical survey the researcher gave attention to the new mothers' specific needs and problems during this trimester. The researcher aimed to explore the experiences of the new mother as educator through weekly group sessions. From the results it was clear that there was a need of support from other mothers that is going through the same experiences. In this way new mothers could receive emotional support and obtain knowledge regarding relevant issues experienced during this unique life phase. / Educational Studies / M. Ed. (Guidance and Counselling)

Stigma is broadly considered as an important obstacle in HIV prevention and treatment. In Mozambique, more PLWHIV have access to treatment than ever. ART increased their QoL and created a new context for stigma production. This cross-sectional study conducted in Northern Mozambique explored a possible association between stigma and QoL. The Berger Stigma Scale and WHOQOL-BREF were used to measure levels of HIV-related stigma and perceived QoL in two groups of PLWHIV receiving ARV, with participation in a HBC programme as the independent variable. The study uncovered a weak to moderate negative correlation between stigma and QoL scores. Statistically significant differences were discovered between the groups’ scores on the Berger Stigma Scale and a higher perceived QoL for PLWHIV in the HBC group on three WHOQOL-BREF subscales and on the overall score. The scores on the social relationships subscale indicated lower perceived QoL for PLWHIV in the HBC group. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study was to determine how pain in PLHIV on community home based care programme was managed using the Roy adaptation model (RAM) as the theoretical framework. This study used a descriptive mixed method research design which allowed for the research topic to be investigated and described in terms of both narrative qualitative accounts and descriptive statistics. A sequential exploratory approach was adopted in which qualitative data collection was conducted in the initial phase followed by quantitative data collection. Ten qualitative interviews, guided by the components of the RAM were conducted in the initial phase and a structured interview schedule (questionnaire) partially based on the result of the qualitative phase and (which was also structured in accordance with the RAM) was administered to 120 respondents who met the inclusion criteria of being on CHBC. Convenience sampling was used to select study participants and respondents in both phases of the study. Peripheral neuropathy was the most common pain syndrome experienced by patients. More females suffered numbness/tingling sensation of toes, followed by chest pains than their male counterparts. Pain experienced was moderate to severe which was not treated effectively. The study findings could assist health care providers, policy makers and researchers to invest into improving pain management for PLHIV, strengthen education of patients and their primary caregivers on the causes of pain and modalities to employ for pain relief and implement palliative care guidelines for PLHIV. / Health Studies / D. Litt. et Phil. (Health Studies)

Children are being removed unnecessarily from their families and placed into substitute care because service programmes lack resources to keep families intact. There are overseas programmes, which provide home services to families, with children at risk of out of home placement. Although there has been an IFPS project there is no established intensive short-term programme in South Africa that deals with families at the brink of dissolution.The objective of the research is to investigate whether an Intensive Family Preservation Programme is feasible in South Africa. The researcher received training in the United States and met with leaders in the field, to discuss the development and implementation of the programme in South Africa. Surveys obtained the attitudes and opinions of the local social workers and commissioners of Child Welfare in Durban towards the programme. The results from opinion surveys indicate that an Intensive Family Preservation Programme is feasible in South Africa. / Social Science / M.A.(Social Work)