A consecutive series of 149 subjects with complete or partial vocational disability due to somatic ill-health were investigated at admission for vocational rehabilitation and two years later. Subjects filled in checklists which encompassed 5 socio-demographic, 5 psycho-social and 9 life satisfaction items. Moreover, 5 dimensions of "handicap" were assessed. At admission subjects were physically examined. In this diagnostically mixed sample 80 of them had non-specific locomotor dysfunction with pain ("algia"). In this sub-sample 23 symptoms (yes/no alternatives) and 24 signs (present/not present) were registered. At the two-year follow-up actual source and level of income were registered and 126 subjects reported their levels of life satisfaction. A reference population including 163 employed subjects was used for comparisons of levels of life satisfaction.At admission satisfaction with life as a whole (level of happiness) and with 6/8 domain specific life satisfaction items were significantly lower for the vocational rehabilitation clients than for the references. Psycho-socio-demographic items formed 5 factors, two were socio-demographic and three psycho-social characteristics. Only few were "handicapped" concerning orientation, mobility and self-care, while the majority were financially and/or occupationally "handicapped". At the two-year follow-up 91% of the partly and 67% of those who at admission were completely vocationally disabled were undergoing education or were gainfully employed, giving a success rate of 77%. Moreover, return to work from unemployment resulted in significantly increased income. Successful rehabilitation resulted in normalization of the majority of life satisfaction domains. This was particularly true for overall vocational satisfaction. Level of happiness was increased but not up to the level of the references. At follow-up the level of or change in (admission/follow-up computations) vocational satisfaction were major predictors for level of or change in happiness. Hence, successful vocational rehabilitation led to increased social well-being. For the total sample major predictors of outcome were: Level of experienced health and belief in vocational return. It is suggested that these two variables arc useful instruments for vocational rehabilitation decision making. In the algic sub-sample signs and symptoms were - statistically - combined into 8 meaningful entities, characterizing regional, postural and relational syndromes. Whereas these may not necessarily be generalizable they may be of clinical descriptory value. However, only one of them contributed to outcome prediction; the major predictors for those algic subjects being belief in vocational return and sex. / <p>S. 1-48: sammanfattning, s. 49-125: 5 uppsatser</p> / digitalisering@umu

This thesis examines data and theory about how the system of law (SL) operates and evolves: it contrasts data from social workers and attorneys working in the juvenile dependency court with theories about how individuals and social systems evolve. The analysis is based on research conducted in San Diego and revolves around a theory about human development, or the "individual as a system" (HD), and a theory about social systems, such as the autopoietic theory of law and its self-reproducing system (LA). It is suggested that together, the theories of HD+LA help to examine how professionals and law operate and evolve in the legal system. Overall, the thesis rejects the autopoietic systems theory that law reproduces itself, by itself. Instead, analysis in this study supports the finding that law is defined and operates through a dialectic of the individual and the social (or the organic and the mechanistic respectively) such that each gives rise to the other. On the basis of this system connection, aspects from systems theory about legal autopoiesis are integrated into concepts from constructive-developmental theory (HDLA), thus providing a new framework through which to examine how law and its system functions. The new framework is built around an equation that emerged some time after data analysis and theoretical development: SL&equals;HDLA+DSA . The equation states that: The evolution of the system of law involves processes of human development and to some but a much lesser degree, the autopoietic nature of law. The extent of this evolution is best determined by analyzing data from a court setting. The dialectical relationship between individual and social influences in the evolution of law is facilitated by the accumulation of social action � such as activity from media and advocacy groups � and the individual meaning that professionals make about this action, which in turn has an influence on the formal and informal operations that they perform when operating law. The nature of these interacting dynamics will be shown through two interconnected tools of analysis: one is a typology of individual, professional and system self-concepts; the typology helps to show how a cycle of system change (human development giving rise to legal change and vice versa) occurs in the court; the other is the operative structure (or culture) of systems for law and social work in child abuse cases � which unite in court operations. These two interconnected tools help to show how the court operates and how social action (SA) for change contributes to professional and system change in the evolution of law.

The purpose of this PhD was to explore the psycho-social health (PSH) and well-being (WB) of Great Britain's (GB) Wheelchair Basketball (WhB) players over time, starting from when they became disabled and culminating in the London 2012 Paralympic Games. The sample comprised 16 players (8 male, 8 female) and 4 coaches. They were interviewed on three occasions - 2 years before, within a year of and a year after London. Observations spanned this period, whilst data was also collected via two visual methods: auto-photography (AP) and timelining. All data was analysed using a thematic analytical approach. First the challenges to PSH and WB of being disabled are discussed, with the diversity of experience highlighted. Secondly in exploring the role of spinal units and story-tellers in initiating players into sport, a lottery which risked their PSH and WB is exposed. Whilst copious benefits of recreational disability sport are described, being a GB WhB player is revealed as an extreme health rollercoaster. Just as being a Paralympian offers perks and privileges, so too does it risk players becoming obsessed. Performance and health are shown to be uniquely related and yet not always simultaneously achievable. Finally, from the pride of wearing the jersey and competing at a home Paralympics, to shattered dreams and unfulfilled ambitions, London 2012 is relived. The research concludes that creating a 'Healthy Paralympian' is a challenging task and yet winning formula. Recommendations are made to realise this aim, whilst those which have already been adopted by GB WhB are also shared.

Made available in DSpace on 2014-06-11T19:29:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-12-05Bitstream added on 2014-06-13T19:58:39Z : No. of bitstreams: 1 uliana_am_me_assis.pdf: 1311985 bytes, checksum: bba4997a675cb9525bbcc797d4b6520d (MD5) / O objetivo dessa pesquisa constitui em analisar as concepções do trabalhador de saúde mental em sua relação com o trabalho e a instituição e como concebe a produção de saúde mental no contexto psicossocial. Considera-se como campo social o contexto da reforma psiquiátrica e da proposta psicossocial, como sujeito da ação de mudança o trabalhador de saúde mental de um CAPS e como intermediário as forças antagônicas de desejo, motivação e sofrimento nas relações de trabalho. Levou-se em consideração como as escolhas profissionais e seus determinantes articulam-se com a relação que o sujeito estabelece com o exercício profissional e seu significado, com a concepção de saúde mental e as práticas desenvolvidas na atenção psicossocial. O referencial teórico fundamentou-se na Psicossociologia, com autores como Dejours (1992, 1994), Enriquez (2000) e Gaulejac (2001), na psicanálise com Freud (1913, 1930), Birman (1977) e Costa (2004) e na Saúde Coletiva com Amarante (1996, 1997, 1998, 1999, 2007), Rotelli (1990) e Costa Rosa, Luzio, Yasui (2001, 2003). Em termos metodológicos, foram coletados os dados por meio de entrevistas semidirigidas, com os técnicos do CAPS do interior do estado de São Paulo. Os resultados apontaram que os indícios de sofrimento dos trabalhadores não assumem um caráter patogênico, imobilizador de ações e impeditivos na realização de desejos. Os trabalhadores que tiveram uma livre escolha, considerando sua constituição subjetiva, sua historia pessoal e seus desejos, demonstram uma maior integração, afinidade, motivação e prazer nas relações de trabalho, bem como uma melhor adesão à proposta psicossocial... / This research aims to study the mental health professional.s conceptions related to his work as well as the institution and how this professional conceives the mental health production in the social context. The psychiatric reform context and the psycho-social proposal are taken as the social field; a mental health professional of a CAPS is the change action subject; and the desire, motivation and suffering adverse strength in the work relations are considered the means through which these changes are promoted. It was studied how the professional choices and their determining factors are articulated in the relation that the subject has with his work activity, and how its meaning is articulated with the mental health conception and the practices developed for psycho-social attention. The theoretical references were based on Psycho-sociology, with authors like Dejours (1992, 1994), Enriquez (2000) e Gaulejac (2001); on Psychoanalysis, with Freud (1913,1930, Birman (1977) e Costa (2204); and on the Collect Health, with Amarante (1996, 1997, 1999, 2007), Rotelli (1990) e Costa Rosa, Luzio, Yassui (2001, 2003). Method: data were collected up from semi-conducted interviews with technicians who work for CAPS in the countryside of São Paulo State. The results showed the professional.s suffering signs do not have a pathogenic character which can immobilize actions or avoid this professional to realize his own desire. The professionals who had a free choice, considering its subjective constitution, his personal life course and his own desire demonstrated a better integration, identification, motivation and pleasure to work, and it is better and easier for them to accept... (Complete abstract click electronic access below)

La compréhension des déterminants de l’activité physique (AP) et de l’activité sédentaire (AS) constitue un problème de santé public majeur en vue de promouvoir l’AP et de diminuer l’AS. Les principaux objectifs de cette recherche sont a) décrire les niveaux d'activité physique modérée à vigoureuse (APMV) et les niveaux d’AS d’adolescents des villes de Tarbes (France) et Huesca (Espagne) et b) analyser l'influence de plusieurs facteurs environnementaux, sociaux et psychologiques sur les niveaux de ces mêmes variables. Les cadres théoriques des modèles socio-écologiques et de la théorie de l’autodétermination ont été utilisées comme base à ce travail. Un total de 828 adolescents (14.32±.73 ans), dont 50,5% d'espagnols, a participé au projet. Cette thèse se compose de six études. Les résultats ont montré que les niveaux d’APMV sont plus élevés en Espagne (~ 60 minutes/jour) qu'en France (~ 47 minutes/jour). Ces différences ont été mises en évidence lors de presque tous les moments de la semaine, à l’exception du temps scolaire. Il a été également montré que la pratique de plusieurs comportements sédentaires (SB) semble excessive, aussi bien en Espagne qu’en France (plus de deux heures par jour de temps d'écran). L’analyse des déterminants montre que des températures plus élevées, des niveaux de précipitation plus faibles et l'utilisation du transport actif favorisent des niveaux plus élevés d’APMV dans les deux pays. Il apparaît également qu’une motivation plus autodéterminée, des niveaux plus élevés de satisfaction des besoins psychologiques fondamentaux (compétence et affiliation) ainsi qu’un soutien plus élevé du père conduisent à des niveaux plus élevés d’APMV. / Physical activity (PA) and its factors of influence constitute important elements of study. The main objectives of this research are a) to describe the moderate-to-vigorous physical activity (MVPA) levels and sedentary activity levels of a sample of adolescents from cities of Tarbes (France) and Huesca (Spain), and b) to analyse the influence of several environmental, social, and psychological factors on their PA levels. A total of 828 adolescents (14.32±.73 years), of which 50.5% were Spaniards, took part in the project. This dissertation is made up of six studies. Results showed that MVPA levels are higher in Spain (~ 60 minutes) than in France (~ 47 minutes). These differences were found at almost any given time of the week, except during school time. Results also showed that the practice of several sedentary behaviours (SB) seems excessive, both in Spain and France (more than two hours per day of screen time). Considering factors of influence, it can be said that warmer temperatures, lower levels of rainfall and the use of active transport all promote higher MVPA levels in both countries. It is also shown how more self-determined motivation, higher levels of basic psychological needs satisfaction (except the perception of autonomy) and greater support from the father lead to higher MVPA levels. Programmes to promote PA need to be implemented.

Le Trouble de Stress Post-Traumatique (TSPT) fait suite à l’exposition à un ou plusieurs événement(s) traumatique(s) et se caractérise par un ensemble de symptômes : flashbacks, cauchemars, comportements d’évitement, altération négative de la cognition et de l’affect, hyper-vigilance et perturbation du sommeil (American Psychiatric Association, 2013). La récente considération de ce trouble dans la sphère publique a mis en lumière l’intérêt sociétal d’agir en amont auprès des professionnels exposés à ce type d’évènements dans le cadre des fonctions de leur métier, tels que les professionnels spécialisés en milieu montagneux (lieu où les conditions sont dangereuses et imprévisibles), qui sont particulièrement exposés à des évènements traumatiques (Weinbruch & Nordby, 2010) et ont par conséquence plus de risque de développer un TSPT que la population générale.Le but visé par l'objectif de ces travaux de thèse a été d’explorer des pistes d’actions à suivre pour renforcer les capacités de résilience chez des professionnels à risques afin de prévenir au plus tôt le TSPT. A travers une approche intégrative et processuelle du développement du TSPT basée sur une perspective biopsychosociale, nous avons étudié un ensemble de facteurs impliqués dans l’apparition et/ou le maintien de ce trouble que nous avons par la suite intégrés à la construction, l’évaluation et l’implémentation d’une action de prévention.Les résultats des études menées en laboratoire et sur le terrain ont permis de dégager l’implication d’un ensemble de facteurs tant spécifiques que généraux (i.e., flexibilité du coping, mécanismes de régulations physiologiques, sens de la mission). Nous pouvons conclure que ce trouble est la résultante de processus translationnels biopsychosociaux marqués par une forte interconnexion entre la psychologie et la physiologie, et l’environnement social professionnel qui modifie l’expression et la visibilité du TSPT. Cette thèse a permis de construire de premiers éléments pour une action de prévention basée sur une vision intégrative et multifactorielle et d’en mesurer l’efficacité dans une démarche fondée sur la preuve. En conclusion, ces travaux ouvrent la voie de la prévention primaire du TSPT professionnel dans une vision intégrative. / Post-Traumatic Stress Disorder (PTSD) follows exposure to one or more traumatic events and is characterized by a set of symptoms: flashbacks, avoidance, negative cognitive and affect changes, hyper-vigilance and sleep disturbance (American Psychiatric Association, 2013). The recent consideration of this disorder in the public sphere has highlighted the societal interest in acting upstream with professionals exposed to this type of event as part of their professional duties. The Auvergne Rhône-Alpes region has populations of professionals specialized in mountain environments (dangerous and unstable with sudden changes in weather conditions), who are particularly exposed to traumatic events (Weinbruch & Nordby, 2010). As a result, they are more likely to develop PTSD than the general population.The aim of this thesis work was to provide elements to establish the lines of action to be adopted to improve the resilience capacities of at-risk professionals in order to prevent PTSD in the early stages. Through an integrative and processual approach to PTSD development focused on a biopsychosocial perspective, we studied a set of factors involved in the development and/or persistence of this disorder and coupled with the construction, evaluation and implementation of preventive action.The results of the laboratory and on-site studies revealed the involvement of a set of both specific and general factors (i.e., coping flexibility, physiological regulatory mechanisms, meaning of the mission). We can thereby conclude that this disorder is the result of a translational interaction defined by strong interconnection between psychology and physiology, and by the socio-professional environment that modifies the expression and visibility of this disorder. This thesis proposed new elements to prevent professional TSPT, based on an integral and multifactorial vision with an evidenced-based approach. In conclusion, these studies are the first to address primary prevention of PTSD with an integrative approach.

Previous research describes co-morbid substance use disorders and eating disorders as a complex issue. Research on collaboration between Swedish addiction treatment facilities and Swedish eating disorder care is scarce. The aim of this Bachelor thesis is to analyze and understand how professionals in addiction care and professionals in eating disorder care experience collaboration regarding people with comorbid substance use disorders and eating disorders. The approach of this study is hermeneutic. The bio-psycho-social model and Collaboration Theory are used for data analysis. The data consists of nine semi-structured interviews with professionals working in either regional eating disorder care or municipal addiction care or in an independent addiction treatment facility. The informants work in different Swedish municipalities and regions having varying occupations. Some work in social services, others in medical care. Our results show varying experiences of collaboration among the informants. Some informants think collaboration works well whilst others see room for improvement. Poor collaboration is described by some informants as due to organizational prestige or bureaucracy. Some informants emphasize that referrals between different care units lead to long wait times for the patients/clients during which nobody takes responsibility for the patient, whose health may worsen. The professionals use different strategies, treatments, and methods to treat and recognize comorbidity and to collaborate with other care units. Joint care planning, reaching a consensus and having a holistic viewpoint are methods that the informants use. The informants have different views on which disorder that precedes the other, and also on which treatment is best suited for this type of comorbidity. Several professionals believe that the addiction should be treated primarily. According to the professionals, prerequisites for collaboration are: established contact with other collaborative parties, the knowledge and accessibility of other professionals, patient consent and motivation. An exchange of knowledge at an organisational level is requested, regarding subjects such as collaboration and comorbidity. / Tidigare forskning visar att samsjuklighet i form av missbruk och ätstörning är ett komplext problem. Forskning om samverkan mellan missbruksvård och ätstörningsvård i Sverige är dock ett relativt outforskat område. Denna intervjustudie syftar till att analysera och förstå hur professionella inom missbruksvården och professionella inom ätstörningsvården upplever samverkan gällande personer med samsjuklighet: missbruk och ätstörning. Studien antar en hermeneutisk ansats, det biopsykosociala perspektivet samt samverkansteori används för att analysera empirin. Empirin består av nio semistrukturerade intervjuer med professionella inom regional ätstörningsvård, kommunal missbruksvård och ett fristående behandlingshem. Informanterna arbetar i olika kommuner och regioner samt har olika yrkesbakgrund inom bland annat socialtjänst eller hälso- och sjukvård. I studien framgår de professionellas samverkanupplevelse, arbets- och behandlingssätt av personer med samsjuklighet i form av missbruk och ätstörning. Därtill framgår vilka förutsättningar som enligt informanterna bör ligga till grund för att upprätta samverkan kring klientgruppen. Resultaten visar att de professionellas erfarenheter och upplevelse av samverkan varierar. Att samverkan fungerar väl respektive om samverkan behöver förbättras lyfts fram. Dålig samverkan på grund av prestige eller i form av en byråkratisk klyfta mellan kommun och region identifieras av några informanter. Vissa informanter framhåller att remisskickande mellan vårdenheter leder till långa väntetider, där klienten eller patienten ”bollas runt”. Under väntetiden kan den vårdsökande fara illa. De professionella använder olika arbetssätt och strategier för behandling, för att fånga upp samsjuklighet och för att inleda samverkan. Gemensam vårdplan, samsyn och helhetssyn är några arbetssätt de professionella utgår ifrån. Informanterna har olika syn på vilket sjukdomstillstånd som föregår det andra och ser även olika på vilken behandling som lämpar sig bäst för denna typ av samsjuklighet: flera anser att missbruket bör behandlas först. Upplevda förutsättningar för samverkan är upprättade kontakter med annan samverkanspart, professionellas kunskap, tillgänglighet samt patientens samtycke, initiativtagande och motivation. Organisatorisk kunskapsöverföring om samverkan och samsjuklighet efterfrågas.

Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag—age group: ag 1: 35–50 years, ag 2: 70–84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients’ native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.

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Each new student arriving at the university or college brings an assortment of expectations, different types and levels of academic competency, different levels of psychological well-being, a variety of attitudes, values and divergent life experiences. Each adjusts at his or her own rate and experiences life as a student in unique ways. The focus of this study is on the problems that are encountered by the first year student on arrival at the institution and throughout the course of his or her first year studies. Using both qualitative and quantitative research methods that include work-shopping many issues, a questionnaire and focus group interviews, this triangulation of data-collection techniques has helped to provide a rich and deep exploration of the perceived problem areas. The study examines various factors that are perceived as limiting the potential performance and achievement of the student, specifically academic aspects and those factors and circumstances that affect psychological well-being. The psycho-educational issues found to be perceived as problematic by both students and staff members are a lack of preparation and insufficient academic competencies that are necessary for successful tertiary education. Of critical concern with the resultant necessity of immediate intervention, are the lack of accountability and a fear of failure with concomitant anxiety. Issues other than psycho-educational problem areas are highlighted such as economic and social variables. Although not part of the study, issues such as lack of finance and the impact of HIV/AIDS cannot be ignored as they may have a possible detrimental effect on first year student achievement. As academic competency development and psychological well-being are but two areas of concern within the gestalt of student development, the study is conducted from a theoretical stance that embraces holistic student development. It is in this light of developing the student as a totality that an intervention programme is suggested, affording the new student many opportunities to develop all facets of his being. / Faculty of Education / D. Ed.