<p>The aim of this study is to analyse conditions that either promote or hamper the implementation of methods for systematic documentation, follow-up and evaluation in social-work services with individuals and families. The theoretical framework consists of organization theories. Human Service Organizations (HSO) theory is complemented with concepts from the new institutionalism, domain theory, implementation theory, and theory about interventions.</p><p>A concrete case, a project has been studied. The purpose of project was to implement methods for systematic documentation in public social services. With the notation “integrated” is meant that the methods should be built in and adjusted to the social-work practice. The methods were ASI (Addiction Severity Index) and IUS (a locally based model for integrated evaluation by inspiration from Göran Sandell).</p><p>Data has been captured in a pretest/ posttest design (Marlow 2000). This means that “state of things” has been described before the intervention and after. The methods used were surveys and interviews (individual and group). The process has been documented through research notes proceeding records, protocols and some diaries written by social workers. Four municipalities from the middle of Sweden took part with five working groups. Two groups contained social workers acting with children and families and three groups were working with drug abusers. The population consisted of the social workers, the managers responsible for the individual and family entities, the politicians and the clients who were affected during the time of the project.</p><p>The implementation of ASI and IUS has not occurred in the extent that was stated in the intervention theory. This means that ASI and IUS were not used in all new cases that occurred during the time of the project. The interviews supposed to be done in the beginning of the clients contact with the agency tended to be done more often than the follow-up interviews. After the project ended, three of five working groups decided to continue to use ASI (one group) and IUS (two groups). The overall impression is that the respondents comprehend, they have the willingness but they do not have the capability of using ASI and IUS. The organization does not seem to have the capacity of imposing requirements and giving resources. The outcomes do not seem to be the most important issue for the social services. These conditions are discussed in the study by means of the theoretical concepts. In the end, there is an effort to adjust the implementation theory to human service organizations.</p>

Psychosocial variables such as attachment style, depression and the working alliance were examined as predictors of treatment outcomes in the context of chronic pain patients receiving physical therapy. Four treatment outcomes were examined: change in pain severity, change in pain interference, patient satisfaction with physical therapy services and patient compliance with treatment recommendations. A model of the interplay between depression and chronic illness presented by Katon (2003) was used as a framework for the current model. Two main hypotheses were suggested. (1) The working alliance is positively related to treatment outcomes. (2) Depression is negatively associated with treatment outcomes. Data were gathered at three outpatient rehabilitation clinics and the physical therapy unit of a multidisciplinary pain clinic in two Midwestern cities. A total of 59 subjects participated and regression analyses found evidence supporting both main hypotheses. The working alliance was found to be positively correlated to the change in pain severity, the change in pain interference, patient satisfaction and patient compliance. Depression was found to be negatively correlated to the change in pain interference, patient satisfaction and patient compliance. Implications for physical therapists working with chronic pain patients include clinical recommendations for developing a good working alliance and screening for depression.

Cette recherche vise à analyser le rôle des référentiels de compétences sur le pilotage de la formation à l’université et sur les pratiques d’enseignement et d’évaluation des enseignants. Cette analyse cherche également à explorer les liens entre le rôle joué par un référentiel (son usage, ses effets) et les conditions qui ont présidé à sa réalisation : motivation de départ, méthode d’élaboration et de diffusion. La méthodologie utilisée est double. D’une part, nous avons mené une étude croisée reprenant 10 cas, soit 10 équipes d’enseignants ayant élaboré un référentiel en Belgique, en France, aux Pays-Bas et au Canada. D’autre part, nous avons suivi, durant trois années, l’élaboration du référentiel de formation de l’Ecole polytechnique de l’ULB. Entretiens semi-dirigés et observation participante ont été les deux outils respectifs de cette double méthodologie. Nous avons pu montrer que dans la plupart des cas, les référentiels ont joué un rôle dans le pilotage de la formation et dans les pratiques d’enseignement et d’évaluation mais nous avons également identifié d’autres rôles joués par les référentiels tels un rôle de gestion des ressources humaines (outil d’engagement et d’intégration de nouveaux engagés, outil de construction d’une identité collective, outil de communication interne) ou encore de communication à caractère promotionnel. Nous pouvons également formuler des hypothèses quant aux conditions susceptibles de favoriser l’usage du référentiel dans le pilotage et dans les pratiques d’enseignement et d’évaluation. Par contre, nous n’avons pas identifié l’impact de la forme du référentiel (concept de référence ou modèle théorique) sur son usage, l’usage du référentiel étant davantage lié à une politique qui l’englobe et dont il est sans doute l’un des rouages. Enfin, en regard de nos résultats et de notre échantillon, le référentiel ne semble pas constituer un levier pour accroître la professionnalisation de la formation mais se trouve au contraire en équilibre entre professionnalisation et académisation, en ce qui concerne les formations initiales de deux cycles dans un contexte universitaire ou assimilé.

The subject of this thesis is migrants’ motives and the outcomes of interregional migration, as well as how the propensity for interregional migration has changed for different groups over the past three decades. The background consists of a discussion on the role of the labour market in long-distance migration decisions and a discussion on how social and economic change affect the context in which migration decisions are made. The thesis consists of four empirical studies presented in four separate papers. The studies derive from two sources of data. Papers I and II are based on a Nordic survey, while Papers III and IV draw from Swedish population register data. Paper I focuses on migrants’ perceptions of the migration decision, motives, voluntariness, attitudes and values, based on a survey. The conclusion of this paper is that employment is by no means a dominating motive from the migrant’s perspective. Additionally, very few migrants explicitly express a sense of being forced to migrate against their will. Paper II is also based on the survey and examines the migrants’ perceptions of the outcome of migration in economic and non-economic terms. This paper further supports the view that employment and income gain are in most cases subordinate in the migration decision from the individual migrants’ point of view. Paper III is a register study comparing the composition of interregional migrants in Sweden during the period 1970-2001. In this study, it becomes evident that the increase in migration rates in the 1990’s was an effect of increased migration among young people. Compared to 1970, increasingly more people migrated during a time in life when they were not yet established on the labour market and had no family. Paper IV is also a register study comparing the effect of commuting potential on migration propensity in Sweden during the period 1970-2001. This paper concludes that increased commuting should be interpreted as a result of, rather than an explanation for, long-distance migration reluctance. Migration literature suggests that long-distance migration is primarily labour-market induced. This is evident in the sense that long-distance migration requires a new job in a new locality for those who are in the labour force, but this study show that this does not necessarily mean that employment is the main motive in the migrant’s mind; the trigger is usually something else, often related to social relationships. The pattern of interregional migration has changed over time. Compared to the 1970’s, more people now migrate at a time when they are not established on the labour market, and other considerations besides employment are thus more relevant. An important explanation for the current immobility among families and employed persons is attributed to the increase in dual-career households during the period studied. This has changed the aggregated migration behaviour everywhere, regardless of commuting potential, but enhanced constraints for interregional migration in this group could be seen as an explanation for the observed increase in commuting.

The purpose of this literature study was to describe how patients experience their quality of life while undergoing a pacemaker implantation. Searches were carried out in the databases Academic Search Elite, Ebsco Host, Pub Med, Pub Med Central, Science Direct and manually. Keywords used were quality of life, treatment outcomes, emotions, pacing and life. This resulted in nineteen peer rewieved articles that were selected for the study results. The results showed that patients undergoing a pacemaker implantation experienced an improvement in their physical health with increased functional status, more energy and strength. From a psychological perspective, some patients experienced an improvement in quality of life while others felt worried and depressed. A common factor among the patients was anxiety and insecurity concerning daily routine activities. The amount of time passed after the pacemaker implantation was also a common factor that had impact on how patients experienced their physical and psychological health. To get a deeper knowledge and understanding when meeting patients undergoing a pacemaker implantation it is important that more research, especially qualitative, is carried out.

D. C. Strubler och K. M. York (2007) har skapat en modell, Team Characteristics Model. Denna modell ligger till grund för och används som metod i den här undersökningen. Två studier utförs, en kvalitativ studie där produktions- och teamledare intervjuas om sina erfarenheter  av teamarbete. Dessutom tillfrågas de om teamets sammansättning har positiva effekter på medlemmarnas arbetsutfall. I den andra studien som är kvantitativ och utförs på industriarbetare, studeras om empowerment samt delaktighet påverkar arbetstillfredsställelsen för team. Den kvalitativa undersökningen visar att teamets sammansättning och arbete anses ha positiva effekter på utfallet, effekter som arbetsglädje och social gemenskap. Det kvantitativa resultatet påvisar ett samband mellan delaktighet och arbetstillfredsställelse men inte mellan empowerment och arbetstillfredsställelse

Language skills developed in early childhood are important for literacy and communication in childhood as well as future adult literacy skills and health. Certain demographic characteristics and parent-child interaction skills have been identified through previous research as being influential in child language development. Parental stress has also been associated with child language outcomes. This study aims to explore whether parents’ interactive relational skills, measured by an observational method, are significantly related to children’s verbal outcome, while controlling for demographic variables and parental stress. Participants included mothers of children aged 4-6 who completed measures of parental interaction quality, parental stress, and demographic characteristics. Their children competed a language skill measure. Results indicated that even when controlling for demographic variables and parental stress, the relationship between parent-child interaction quality and child language outcomes remained significant. These findings suggest that increasing positive parent-child interaction skills may be beneficial for increasing children’s language skills.

Background: Nosocomial pneumonia (NP) is a significant cause of morbidity and mortality in hospitalized patients. Objective: The objectives of this study were to describe the epidemiology of NP in adult patients hospitalized in Canadian acute care facilities and identify prognostic indicators for death. Methods: A retrospective cohort study was conducted in 114 patients with NP admitted to hospitals that participated in a 2002 Canadian point prevalence survey. Results: A high proportion of NP patients had a rapidly or ultimately fatal underlying illness. NP in non-intensive care unit (ICU) patients accounted for the larger proportion of these infections.There was no mortality difference between patients with and without ventilator-associated NP, or with and without ICU-acquired NP. Delayed initiation of appropriate antimicrobial therapy was associated with a poorer outcome. Discussion: Strategies that result in the timely administration of appropriate antimicrobial therapy should be investigated in an effort to reduce NP-associated mortality.

Background: Nosocomial pneumonia (NP) is a significant cause of morbidity and mortality in hospitalized patients. Objective: The objectives of this study were to describe the epidemiology of NP in adult patients hospitalized in Canadian acute care facilities and identify prognostic indicators for death. Methods: A retrospective cohort study was conducted in 114 patients with NP admitted to hospitals that participated in a 2002 Canadian point prevalence survey. Results: A high proportion of NP patients had a rapidly or ultimately fatal underlying illness. NP in non-intensive care unit (ICU) patients accounted for the larger proportion of these infections.There was no mortality difference between patients with and without ventilator-associated NP, or with and without ICU-acquired NP. Delayed initiation of appropriate antimicrobial therapy was associated with a poorer outcome. Discussion: Strategies that result in the timely administration of appropriate antimicrobial therapy should be investigated in an effort to reduce NP-associated mortality.

Although the concept of quality of life (QOL) has become increasingly popular in the past few decades in a number of fields of research, few studies have specifically examined QOL for high-functioning individuals with autism spectrum disorders. Several studies have found that objectively measured outcomes for adults with high-functioning autism (HFA) and Asperger's syndrome (AS) tend to be poor in terms of employment, relationships, mental health, and independence. However, it has been recently suggested that in order to obtain a more accurate depiction of overall QOL, subjective impressions must be examined as well. Recent research has found that the most significant predictor variable of QOL for high-functioning individuals with autism spectrum disorders is the discrepancy between support needed and formal support provided. The current study examined 15 formal support variables and their relationships to subjective QOL scores on the WHOQOL-BREF, in 4 domains (physical health, psychological health, environment, and social relationships) as well as overall QOL. A total of 33 participants completed a questionnaire that included items designed to obtain information on demographics and formal support. Participants also completed the WHOQOL-BREF in order to obtain overall QOL scores along with QOL domain scores. Significant negative correlations were found between Environmental QOL scores and the accessing of a social worker as well as the accessing of social groups. Significant negative correlations were also found between Social QOL scores and the accessing of a psychiatrist and a single-item overall QOL score and the accessing of counselling or psychotherapy. All correlations between formal support factors and QOL scores showed lower QOL scores for those individuals who accessed the supports. The results of standard multiple regression analyses revealed a significant model that accounted for 49% of the total variance in the amount of total supports accessed as well as two other significant models predicting Social QOL and Environmental QOL.