<p>There are great expectations that collaboration among professions and various sectors will further develop health care and thus lead to improved public health. In the World Health Organization’s declaration “Health 21” the designated goal for health professions in the member nations in Europe by the year 2010 is to have developed health promotional competence, including teamwork and cooperation based on mutual respect for the expertise of various professions. The challenges faced by the interprofessional teams are, however, multifaceted, and these challenges place demands upon society, which, in turn, determines the fundamental conditions for collaboration among the health professions within the health care organizations.</p><p>This licentiate dissertation contains discourse and content analyses of interprofessional teamwork in health care. The major objective of this dissertation is to study and describe how the team members construct and create the content and significance of teams and teamwork among health professions. One specific goal has been to study how the members of a multi-professional health care team refer to their team, especially the discursive patterns that emerge and the function that these patterns has (I). The second specific goal has been to identify and describe the difficulties that the health professionals have experienced within their interprofessional teamwork. One purpose has been to enable discussions of the implications for interprofessional learning (II).</p><p>Focused group interviews with team members (n=32) from six teams were studied using discursive social psychological research approach. The analysis concentrated on the use of the pronouns “I”, “we” and “them”. The results were then analyzed in relation to theories on discursive membership and discursive communities (I). Individual semi-structured interviews with team members (n=18) from four of the six teams were carried out using critical incident techniques. The interviews were analysed via latent qualitative content analysis and the results were interpreted in the light of theories on sociology of professions and learning at work (II).</p><p>The findings showed that two discursive patterns emerged in the team members’ constructions of “we the team”. These patterns were designated knowledge synergy and trustful support (I). The following three themes that touched upon the difficulties of interprofessional teamwork were identified in the personal interviews: (A) difficulties concerning the teams’ dynamics that arose when the team members acted as representatives for their respective professions; (B) difficulties when the various contributions of knowledge interacted in the team; and (C) difficulties that were related to the surrounding organisation’s influence on the team (II).</p><p>The conclusion was reached that the discursive pattern provided rhetorical resources for the team members, both in order to reaffirm membership in the team and to promote their views with other care providers, but also to deal with difficulties regarding, for example, lack of unity in outlook. The conclusion was also drawn that, in addition to the individual consequences, one outcome of the perceived difficulties was that they caused limitations of the use of collaborative resources to arrive at a holistic view of the patient’s problems. Thus the patients could not be met in the desired manner.</p><p>The practical implications of the research project concern the development of teams in which various forms of interprofessional learning can influence the continued development of the team and the management of health care in regard to the importance of implementation processes and organisational learning.</p> / <p>Stora förväntningar ställs på att samarbete mellan yrkesgrupper och mellan sektorer ska utveckla hälso- och sjukvården och leda till en förbättrad folkhälsa. I Världshälsoorganisationens policydokument “Health21” anges exempelvis målsättningen att hälsoprofessionerna i de europeiska medlemsländerna till år 2010 ska ha utvecklat en hälsofrämjande kompetens som bland annat innefattar teamarbete och samarbete på basis av ömsesidig respekt för de olika professionernas expertis. Det interprofessionella teamets utmaningar är dock mångfacetterade och kräver uppmärksamhet från det samhälle som skapar villkoren för hälsoprofessionernas samarbete inom hälso- och sjukvårdens organisationer.</p><p>Denna licentiatavhandling innehåller diskurs- och innehållsanalytiska studier om interprofessionellt teamarbete i vården. Avhandlingens övergripandet syfte var att undersöka och beskriva hur teammedlemmar konstruerar och skapar innebörder av team och teamarbete mellan flera hälsoprofessioner. Det ena specifika syftet var att undersöka hur medlemmar i multiprofessionella vårdteam talar om sitt team, särskilt avseende de diskursiva mönster som framträdde och vilken funktion dessa mönster hade (studie I). Det andra specifika syftet var att identifiera och beskriva svårigheter som hälsoprofessioner har uppfattat vid interprofessionellt teamarbete, där avsikten även var att möjliggöra en diskussion om implikationer för interprofessionellt lärande (studie II).</p><p>Fokusgruppintervjuer med teammedlemmar (n=32) från sex team analyserades utifrån en diskursiv socialpsykologisk forskningsansats och fokuserade på användningen av pronomina ”jag”, ”vi” och ”de”. Fynden relaterades sedan till teorier om diskursivt medlemskap och diskursiva samhällen (studie I). Individuella semistrukturerade intervjuer med teammedlemmar (n=18) från fyra av de sex teamen genomfördes med critical incident-teknik. Intervjuerna analyserades via latent kvalitativ innehållsanalys och fynden tolkades utifrån teorier om professionssociologi och lärande i arbetet (studie II).</p><p>Resultaten visade att två diskursiva mönster framträdde i teammedlemmarnas konstruktioner av ”vi-som-team”. Dessa mönster benämndes kunskapssynergi och tillitsfullt stöd (studie I). Vid individuella intervjuer med teammedlemmar identifierades följande tre teman som rörde svårigheter vid interprofessionellt teamarbete; (i) svårigheter som gällde den teamdynamik som uppstod när teammedlemmarna agerade som företrädare för sina professioner i relation till teamet, (ii) svårigheter när medlemmarnas olika kunskapsbidrag interagerade i teamet och (iii) svårigheter som rörde den omgivande organisationens påverkan på teamet (studie II).</p><p>Konklusionen gjordes att de diskursiva mönstren utgjorde retoriska resurser för teammedlemmarna, både för att bekräfta medlemskapet i teamet, för att hävda sina åsikter i kontakter med andra vårdgivare (”de andra”) och även för att hantera uppfattade svårigheter beträffande exempelvis bristande samsyn. Vidare drogs slutsatsen att en konsekvens av de uppfattade svårigheterna var, förutom individuella konsekvenser, begränsningar i användandet av de gemensamma resurserna för att nå en helhetssyn på patientens problem och att patienterna inte kunde bemötas på det sätt som önskades.</p><p>Forskningsprojektets praktiska implikationer rörde teamutveckling där olika former av interprofessionellt lärande påverkar teamets fortsatta utveckling, samt ledning av hälso- och sjukvården avseende betydelsen av imple-menteringsprocesser och organisatoriskt lärande.</p>

<p>The relationship between the Swedish state’s welfare political commitments and the emergence and development of three female-dominated welfare state occupational groups - nurses, home relief helpers and occupational therapists - is at the heart of this thesis. The primary aim is to study the professional possibilities and limitations created by the state’s welfare political commitments in health care, family policy and rehabilitation.</p><p>The thesis emphasises the importance of regarding the state as a historically conditioned actor and as an organisation of organisations. The state is not a unified and static actor and this makes it difficult to speak of the state’s relationship to different welfare occupations in general terms. Nurses, home relief helpers and occupational therapists have encountered the state in different historical contexts and established ties to different parts of the state. Abbott’s (1988) term jurisdiction is used to characterise the area within welfare politics that nurses, home relief helpers and occupational therapists have made claims on or been allotted. The struggle for jurisdiction takes place on three, analytically separate but in reality interconnected arenas. These arenas are the workplace, the media arena and the legal arena. The thesis limits itself to the legal arena, that is, the state’s administrative, planning and legislative structures. At the centre of the analysis of the legal arena are the Swedish Government Commission and the welfare political reform work that to a large degree has been formed by these institutions’ function and work.</p><p>An important conclusion from these three case studies is that the state’s welfare political commitments have been central for the emergence of nurses, home relief helpers and occupational therapists and their development into welfare state occupational groups. The state’s welfare political ambitions have contributed considerably to the transformation of nurse, home relief helpers and occupational therapists into modern occupational groups. Dependency on the state has not always been easy to handle however. The state’s welfare political interests have often contradicted the wishes of the professions regarding the content, length and organisation of training programmes, as well as regarding continuing education and licensing. The state has been unwilling to provide more training than deemed necessary from a welfare political perspective. An important conclusion from this study is that it is difficult for welfare state occupational groups to steer their professional project in a direction that falls outside of the state’s welfare political commitments.</p>

The relationship between the Swedish state’s welfare political commitments and the emergence and development of three female-dominated welfare state occupational groups - nurses, home relief helpers and occupational therapists - is at the heart of this thesis. The primary aim is to study the professional possibilities and limitations created by the state’s welfare political commitments in health care, family policy and rehabilitation. The thesis emphasises the importance of regarding the state as a historically conditioned actor and as an organisation of organisations. The state is not a unified and static actor and this makes it difficult to speak of the state’s relationship to different welfare occupations in general terms. Nurses, home relief helpers and occupational therapists have encountered the state in different historical contexts and established ties to different parts of the state. Abbott’s (1988) term jurisdiction is used to characterise the area within welfare politics that nurses, home relief helpers and occupational therapists have made claims on or been allotted. The struggle for jurisdiction takes place on three, analytically separate but in reality interconnected arenas. These arenas are the workplace, the media arena and the legal arena. The thesis limits itself to the legal arena, that is, the state’s administrative, planning and legislative structures. At the centre of the analysis of the legal arena are the Swedish Government Commission and the welfare political reform work that to a large degree has been formed by these institutions’ function and work. An important conclusion from these three case studies is that the state’s welfare political commitments have been central for the emergence of nurses, home relief helpers and occupational therapists and their development into welfare state occupational groups. The state’s welfare political ambitions have contributed considerably to the transformation of nurse, home relief helpers and occupational therapists into modern occupational groups. Dependency on the state has not always been easy to handle however. The state’s welfare political interests have often contradicted the wishes of the professions regarding the content, length and organisation of training programmes, as well as regarding continuing education and licensing. The state has been unwilling to provide more training than deemed necessary from a welfare political perspective. An important conclusion from this study is that it is difficult for welfare state occupational groups to steer their professional project in a direction that falls outside of the state’s welfare political commitments.

Engagée à l'occasion de l'introduction en France de contrats de commande publique de type "partenariat public-privé" [PPP] - elle fut initiée peu après la promulgation de l'Ordonnance du 17 juin 2004 créant les " Contrats de Partenariat " - notre recherche explore les PPP, modalités de commande publique complexe à caractéristiques financières, en tant qu'ils constituent un marché émergent pour des acteurs financiers, fournisseurs de capitaux et de techniques de financement, potentiellement porteurs de valeurs, modes de raisonnement, et logiques économiques, exogènes au monde de la commande publique. Aiguillonné par notre désir de participer aux débats disciplinaires des mondes de la sociologie économique, des études sociales de la finance, et d'autres approches hétérodoxes des phénomènes économiques, par notre souci de contribuer à la compréhension des formes d'organisation des services publics et des infrastructures urbaines, stimulé également par notre curiosité à l'égard des mutations des économies occidentales, interpellé évidemment par l'actualité incontournable de la grande crise financière, puis économique, entamée en 2007-08, notre travail prend prétexte de ce "phénomène" - l'immixtion, par l'entremise des PPP, de nouveaux acteurs financiers dans une partie de la commande publique de grands équipements - pour nous inscrire dans le programme de recherche qui vise à caractériser le mouvement socio-économique plus large parfois qualifié de "financiarisation". Ce terme recouvre, sans grande précision ni définition consacrée et indiscutable, un ensemble d'évolutions liées à l'extension du domaine de la finance, que ce soit au niveau macroéconomique, sectoriel, ou cognitif, dans l'ordre de la connexion de pans entiers de la vie économique et sociale aux "marchés" financiers et à leurs exigences. Notre ambition est donc, à partir d'un sujet particulier et technique, non réductible à sa seule dimension financière4, de considérer la valeur heuristique du cas des PPP pour interroger plusieurs dimensions caractéristiques de ce mouvement de "financiarisation" - voire essayer d'en identifier les principaux éléments constitutifs. Ce dessein passe par une analyse en termes de sociologie économique menée à plusieurs niveaux

L'objectif de cette thèse est de proposer une méthode de repérage empirique robuste du travailleur indépendant français. En effet, l'absence de norme homogène atténue la portée des travaux économétriques et statistiques. Dans un premier chapitre, les fondements de l'indépendance professionnelle sont mis en avant par une approche historique. Le deuxième chapitre permet de formuler des hypothèses typologiques consécutivement à l'examen des normes juridiques et du corpus empirique.Un idéaltype empirique est proposé dans le troisième chapitre. Il est formulé en opposant les hypothèses à l'analyse des résultats de classifications ascendantes hiérarchiques effectuées sur différents échantillons de travailleurs. La norme ainsi proposée permet de repérer objectivement les indépendants français au regard de critères inhérents au métier effectivement exercé, aux statuts entrepreneuriaux, à la taille de l'entreprise et au secteur d'activité. Cet idéaltype empirique permet un repérage robuste des indépendants au sein de la population des travailleurs non-salariés.

La naturaleza potencialmente anticompetitiva de las prácticas impartidas desde las organizaciones de profesionales ha sido racionalizada por la literatura económica y ha ocupado un lugar no menor en la agenda de los organismos de defensa de la competencia. Sin embargo, la economía empírica carece de estudios sobre el ejercicio profesional autorregulado. Este trabajo relaciona los mercados de servicios profesionales con los modelos de diferenciación vertical y emplea un modelo Logit Mixto para evaluar la conducta del desempeño médico en Argentina. La evidencia hallada sugiere la existencia de algún acuerdo de precios. / The potentially anticompetitive nature of some practices driven by professional organizations has been approached in economic literature and appears as an important issue in the antitrust organism's agenda. However, empirical economics lacks of a self-regulated professionals analysis. This work relates the market for professional services with vertical product differentiation models and uses a Mixed Logit model to assess the medical profession behavior in Argentina. The evidence suggests the existence of a price arrangement. / Tesis de la Maestría en Economía, bajo la dirección de Fernando Navajas, de la Facultad de Ciencias Económicas de la Universidad Nacional de La Plata.

The profession of psychology in South Africa has not always been regulated by a statutory body such as the Health Professions Council of South Africa (HPCSA). Currently, the profession of psychology is regulated by the HPCSA and psychologists and the HPCSA find themselves in a lawful and interminable relationship. The HPCSA’s motto is to protect the public and to guide the profession, but it was questioned whether psychologists actually experience guidance from the HPCSA. In response to this problem, this study aimed to explore the subjective experiences of a group of South African psychologists regarding the HPCSA as well as the ethical code which serves as a guideline for the conduct of psychologists. This study made use of a sequential mixed method design, which comprised of a qualitative phase followed by a quantitative phase. All participants in this study were qualified psychologists. Seven participants took part in the qualitative phase and 74 participants took part in the quantitative phase. The data from the qualitative phase was grouped into broad categories and served as the basis for compiling a questionnaire for the quantitative phase. After collecting the completed questionnaires, the data was read into SPSS (Statistical Package for the Social Sciences), which was used for the statistical analysis of the data. The data was analysed by means of frequency distributions and mean scores. During the analysis of the data, six themes where identified: five regarding the HPCSA as the regulator of psychology and one regarding the ethical code that guides the conduct of psychologists. The themes include “guidance and mentorship”, “the HPCSA as a watchdog”, “the HPCSA’s motive”, “reverence that psychologists have for the HPCSA”, “the competence of the HPCSA” and “psychologists’ view on the ethical code”. The results indicated that an ambiguous relationship exists between this group of psychologists and the HPCSA, as these two entities seem to function separately. Generally, psychologists who took part in this research have a negative view towards the HPCSA, although they realise the necessity for the HPCSA as a regulating body for psychology. The recognition of this need is a platform for a workable relationship between psychologists and the HPCSA. The participants provided less detail and responded more neutral regarding their views on the ethical code, and it is concerning that quite a number of psychologists indicated that they did not know the code. This study concludes with recommendations for the HPCSA to be more approachable and to provide psychologists with more support. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

While striving for excellence in an increasingly market-dominated, multicultural, multilingual, service-oriented, and globalised society, language practitioners – translators, text editors, interpreters, audio describers, sign language interpreters and subtitlers – in South Africa and Flanders find themselves under increasing pressure to defend the professional status of their work, and to justify the conception of their different occupations as a homogenous profession. Given the cultural and mediatory role of the language practitioner in this decentralised, dynamic, complex, and virtual market, the professionalization of language practitioners is rapidly developing into a matter that needs urgent academic consideration. Scientific and multidisciplinary research on the occupations collectively and colloquially referred to as the “language professions”, or more academic, language practice, is therefore currently of the utmost importance and relevance to ensure market-related expert language services. Unquestionably, without such research language practice cannot become a bona fide profession. From the point of view of the sociology of professions, language practitioners are an extreme example of an understudied professional occupation (Sela-Sheffy & Schlesinger, 2011). By focusing attention on the marginal status of the language occupations (which persists despite the ever-increasing need for professionalized expert language services in a globalised multilingual and multicultural world), this research project aims to identify the perceived impediments to desired professional status for language practice, thereby creating a more systematic basis for future professionalization endeavour. The sociological literature on the professions as manifest in the functional, interactional and conflict approaches of Émile Durkheim, Max Weber, and Karl Marx, as well as a critical, postmodern approach offers a body of history and theory of the development of modern professions and their attributes. The service ideal; a viable income congruous with expert status; occupational autonomy and monopoly; career oriented training and continuing education; professional training institutions; professional bodies; ethics, and jurisdiction (see for example Abbott, 1988; Barber, 1963; Freidson, 1983, 1994; Goode, 1969; Hughes, 1963; Larson, 1977; Macdonald, 1995; Torstendahl & Burrage, 1990; Wilensky, 1964) are attributes unique to the “true profession”. These characteristics served as the matrix to establish a framework for the prototypical profession whereby the current professional status of language practitioners in South Africa and Flanders could be ascertained, and a formal language practice “professional project” initiated. Using the “professional project” (Larson, 1977) as a conceptual tool advantageously establishes the concrete, historically bounded character of the professions as empirical entities (Witz, 1992:64) within the context of three different approaches to categorisation as described in this project: the classical model, the critical model, and the prototype model. The identification of perceived obstacles to the professionalization of language practice as per the literature provided the context for a comparative appraisal of the current professional state of affairs of language practitioners in South Africa and Flanders. An objective investigation into the character of these obstacles revealed the catalyst opportunities inherent in the alleged barriers to professionalization. This perspective provides a rational framework for the implementation of essential measures to augment a viable professional project of language practitioners in general. / Thesis (PhD (Afrikaans and Dutch))--North-West University, Potchefstroom Campus, 2012

While striving for excellence in an increasingly market-dominated, multicultural, multilingual, service-oriented, and globalised society, language practitioners – translators, text editors, interpreters, audio describers, sign language interpreters and subtitlers – in South Africa and Flanders find themselves under increasing pressure to defend the professional status of their work, and to justify the conception of their different occupations as a homogenous profession. Given the cultural and mediatory role of the language practitioner in this decentralised, dynamic, complex, and virtual market, the professionalization of language practitioners is rapidly developing into a matter that needs urgent academic consideration. Scientific and multidisciplinary research on the occupations collectively and colloquially referred to as the “language professions”, or more academic, language practice, is therefore currently of the utmost importance and relevance to ensure market-related expert language services. Unquestionably, without such research language practice cannot become a bona fide profession. From the point of view of the sociology of professions, language practitioners are an extreme example of an understudied professional occupation (Sela-Sheffy & Schlesinger, 2011). By focusing attention on the marginal status of the language occupations (which persists despite the ever-increasing need for professionalized expert language services in a globalised multilingual and multicultural world), this research project aims to identify the perceived impediments to desired professional status for language practice, thereby creating a more systematic basis for future professionalization endeavour. The sociological literature on the professions as manifest in the functional, interactional and conflict approaches of Émile Durkheim, Max Weber, and Karl Marx, as well as a critical, postmodern approach offers a body of history and theory of the development of modern professions and their attributes. The service ideal; a viable income congruous with expert status; occupational autonomy and monopoly; career oriented training and continuing education; professional training institutions; professional bodies; ethics, and jurisdiction (see for example Abbott, 1988; Barber, 1963; Freidson, 1983, 1994; Goode, 1969; Hughes, 1963; Larson, 1977; Macdonald, 1995; Torstendahl & Burrage, 1990; Wilensky, 1964) are attributes unique to the “true profession”. These characteristics served as the matrix to establish a framework for the prototypical profession whereby the current professional status of language practitioners in South Africa and Flanders could be ascertained, and a formal language practice “professional project” initiated. Using the “professional project” (Larson, 1977) as a conceptual tool advantageously establishes the concrete, historically bounded character of the professions as empirical entities (Witz, 1992:64) within the context of three different approaches to categorisation as described in this project: the classical model, the critical model, and the prototype model. The identification of perceived obstacles to the professionalization of language practice as per the literature provided the context for a comparative appraisal of the current professional state of affairs of language practitioners in South Africa and Flanders. An objective investigation into the character of these obstacles revealed the catalyst opportunities inherent in the alleged barriers to professionalization. This perspective provides a rational framework for the implementation of essential measures to augment a viable professional project of language practitioners in general. / Thesis (PhD (Afrikaans and Dutch))--North-West University, Potchefstroom Campus, 2012

The profession of psychology in South Africa has not always been regulated by a statutory body such as the Health Professions Council of South Africa (HPCSA). Currently, the profession of psychology is regulated by the HPCSA and psychologists and the HPCSA find themselves in a lawful and interminable relationship. The HPCSA’s motto is to protect the public and to guide the profession, but it was questioned whether psychologists actually experience guidance from the HPCSA. In response to this problem, this study aimed to explore the subjective experiences of a group of South African psychologists regarding the HPCSA as well as the ethical code which serves as a guideline for the conduct of psychologists. This study made use of a sequential mixed method design, which comprised of a qualitative phase followed by a quantitative phase. All participants in this study were qualified psychologists. Seven participants took part in the qualitative phase and 74 participants took part in the quantitative phase. The data from the qualitative phase was grouped into broad categories and served as the basis for compiling a questionnaire for the quantitative phase. After collecting the completed questionnaires, the data was read into SPSS (Statistical Package for the Social Sciences), which was used for the statistical analysis of the data. The data was analysed by means of frequency distributions and mean scores. During the analysis of the data, six themes where identified: five regarding the HPCSA as the regulator of psychology and one regarding the ethical code that guides the conduct of psychologists. The themes include “guidance and mentorship”, “the HPCSA as a watchdog”, “the HPCSA’s motive”, “reverence that psychologists have for the HPCSA”, “the competence of the HPCSA” and “psychologists’ view on the ethical code”. The results indicated that an ambiguous relationship exists between this group of psychologists and the HPCSA, as these two entities seem to function separately. Generally, psychologists who took part in this research have a negative view towards the HPCSA, although they realise the necessity for the HPCSA as a regulating body for psychology. The recognition of this need is a platform for a workable relationship between psychologists and the HPCSA. The participants provided less detail and responded more neutral regarding their views on the ethical code, and it is concerning that quite a number of psychologists indicated that they did not know the code. This study concludes with recommendations for the HPCSA to be more approachable and to provide psychologists with more support. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.