This thesis describes and analyses in three substudies how home-based measures for children are expanding and why an open care idea are established as part of the Swedish child welfare. The first substudy describes the national increment of what today can be considered as a treatment policy – non-institutional care in child welfare. The results are analysed with Kingdon's agenda setting theory and shows that the factors of what Kingdon describes as problems-, politics- and policyflow influenced the national increment. Significant mechanisms have primarily been, the profession, the society's concerns for socially disadvantaged children, negative experiences of institutionalisation and a political position to deinstitutionalise all care. The second substudy focuses on how knowledge and research contributes to ideological, professional, and organizational change in child welfare by analysis of Research & Developments reports and articles from the professional journal Socionomen. Based on the neo-institutional concepts of organisational fields and isoformism the study's results shows that a consequence of adaptation strategies and "rationalized myths" are a number of similarities in how home-based measures are organized and which measures that are used. The third substudy, a case study, analyses how we can understand a local development of ideas in social services for children with concepts from neo institutional theory. Interviews and municipal documents are analysed and shows that the local translation of an open care idea is characterized by discretion, personal preferences and action and affects the choice of method and organization. The study also shows a political mistrust of institutional care while there is at the same time political confidence in the individual social worker's ability to find solutions that allow non-institutional measures to be an alternative to institutional care. An overall conclusion of the thesis is that there is now a treatment policy in social services for the children, which involves extensive efforts at home and it has led to that more children receive support from social services. One result of non-institutional care increment is that it led to increased costs for municipalities for intervention for children and young people when out-of-home care has not decreased. Another general conclusion is that translation and adaptation of ideas to local contexts is something that generally fits street-level bureaucrats need for discretion.

This dissertation consists of four separate papers. Paper 1: Will Privatization Reduce Costs? I develop a model of public sector contracting. In this model, an agent can put effort into increasing the quality of a service or reducing costs. Being residual claimants, private owners have stronger incentives to cut costs than public employees. However, if quality cannot be perfectly measured, providing a private firm with incentives to improve quality forces the owner of the firm to bear risk. As a result, private firms will always be cheaper for low levels of quality but might be more expensive for high levels of quality. Paper 2: When Does Privatization Reduce Costs and Improve Quality? Theory and Evidence from Service Contracting I develop and test a model of service contracting in residential youth care. I find that private facilities have lower per-day cost of treatment for low levels of quality, but higher per-day cost for high levels of quality. Though public facilities generally have a higher level of quality, private facilities are relatively better at treating troublesome teenagers. Treatment periods are much longer under private provision, implying that the average total cost of treatment is twice as high in the private sector. Paper 3: Identity and Redistribution (co-author Robert Östling) This paper models the interaction between individuals' identity choices and redistribution. Both redistributive polices and identity choices are endogenous, and there might be multiple equilibria. The model is applied to ethnicity and social class. Paper 4: Political Polarization and Economic Performance (co-author Robert Östling) We study the effect of political polarization on economic performance using the dispersion of self-reported political preferences as our measure of polarization. We find that politically polarized countries are poorer and have smaller and inferior governments. / <p>Diss. Stockholm : Handelshögskolan, 2007 viii, s. 3-9: sammanfattning, s. 13-203: 4 uppsatser</p>

In the last two decades, increasingly more research has been conducted on the process of participation as a children’s right both nationally and internationally. This includes research on children’s participation within the family environment as well as with children who are placed into alternative care. Children’s participation within the field of child protection continues to demonstrate challenges for both children and those adults working with children in this environment. A child and youth care centre forms part of the broader field of child protection and represents a bounded system of dynamics especially with regard to the process of children’s participation. There continues to be various barriers with regard to children’s participation in general but especially for children who have been found in need of care and protection. This is largely linked to the emphasis being put on the vulnerabilities and needs of children who have been placed into alternative care. The general aim of the study was to qualitatively, through a case study design, explore and describe the nature of participation as a children’s right in the context of a child and youth care centre in the Western Cape. The case study was utilised in order to gain more insight into the nature of participation as a children’s right, based on the perceptions of the children, child care workers, social workers and professionals within the system. Thirteen semi structured individual interviews were held with the child participations. Prior to the interviews, a session was held with the children to discuss the purpose of the research and to allow them to become more aware of the concept of children’s participation. The children were asked to create a collage of their perception of children’s participation as a right. Two separate focus groups were held for the adult participants; one for the child care workers and the other for the social workers and professionals. Based on the findings of this qualitative study about the nature of children’s participation as perceived by both children and adults in a child and youth care centre, the article in Section B aims at highlighting those critical elements needed for the realisation of children’s participation within a context of child protection. / MSW (Child Protection), North-West University, Potchefstroom Campus, 2014

This study is concerned with the inter-subjectively co-constructed narratives of experience, for Child and Youth Care practitioners, in an agency-based school program which focuses on treatment of DSM diagnosed children. This school-based program is formally committed to a strength-based practice for treatment of mental disorder. A Diagnostic and Statistical Manual (DSM) diagnosis is required for admission to this program. This agency-based practice exists at the intersection of dissonant discourses of understanding, in the treatment of children’s mental disorder. In this study, a narrative methodology of inquiry, situated in a post-modern epistemology of understanding, was utilized to investigate the narratives of experience of four Child and Youth Care practitioners. Narratives are distinctive units of speech that are typically employed by the narrator to convey evaluative meaning in context. Narratives inquiry represents a useful means for understanding questions of experience, as people use narratives to organize and evaluate their knowledge and transactions with the social world. The narrative, as a reflection of intersubjective constructs of meaning, provides a means of understanding the individual or group through its conveyance of lived experience. The results of this study include four narratives, written in the first person, communicating the subjective experiences of Child and Youth Care practitioners in this unique practice setting. Each of these narratives suggests the importance of, and methods towards, finding ways for strength-based practitioners to practice in harmony in landscapes of deficit-focused understandings.

This thesis is based on Project Artemis, a critical, girl-centred participatory action research (PAR) project designed as part of an evaluation of Artemis Place, an alternative education program serving “at-risk” girls in Victoria, BC. Nine Artemis Place students between the ages of 15 and 18 worked alongside me as co-researchers to investigate how Artemis Place has affected their lives. Our research also explored girl co-researchers' schooling experiences more broadly and the structural inequities they experience across the multiple contexts of their lives. Our process was rooted in a critical, participatory, collaborative framework, which aimed to investigate, problematize, and address (through social action) the complex forces shaping girls' experiences of marginalization. We used arts-based methods such as photovoice, graffiti walls, journaling and participatory video to cycle through the iterative phases of PAR: exploration/data collection, critical reflection/analysis, and action. We produced a documentary film as our primary research dissemination tool. In this thesis, I undertake my own analysis of our collective research to do a deep reading of girls' resistances to “at-risk” constructions of girlhood, in order to understand their negotiations of the complex forces shaping their daily realities. I complicate the concept of resistance using a hybridized feminist-poststructural (Davies, 2000) and desire-based (Tuck, 2010) framework to explore the ways girls' resistances are produced through flows of desire – creative and productive force – that disrupt, exceed, (re)configure, and/or (re)code “girl” and “risk.” I argue that tracing the “desire flows” (Deleuze & Guattari, 1987) and reconfigurations produced in/through our critical research process, is an important, political move toward sustaining alternative figurations of girlhood. As such, this thesis contributes promising, ethical/affirmative/political possibilities for understanding the complexities of girls' lives and for engaging alongside them in feminist research, praxis, and activism for social justice. / Graduate

This thesis describes and analyses in three substudies how home-based measures for children are expanding and why an open care idea are established as part of the Swedish child welfare. The first substudy describes the national increment of what today can be considered as a treatment policy – non-institutional care in child welfare. The results are analysed with Kingdon's agenda setting theory and shows that the factors of what Kingdon describes as problems-, politics- and policyflow influenced the national increment. Significant mechanisms have primarily been, the profession, the society's concerns for socially disadvantaged children, negative experiences of institutionalisation and a political position to deinstitutionalise all care. The second substudy focuses on how knowledge and research contributes to ideological, professional, and organizational change in child welfare by analysis of Research &amp; Developments reports and articles from the professional journal Socionomen. Based on the neo-institutional concepts of organisational fields and isoformism the study's results shows that a consequence of adaptation strategies and "rationalized myths" are a number of similarities in how home-based measures are organized and which measures that are used. The third substudy, a case study, analyses how we can understand a local development of ideas in social services for children with concepts from neo institutional theory. Interviews and municipal documents are analysed and shows that the local translation of an open care idea is characterized by discretion, personal preferences and action and affects the choice of method and organization. The study also shows a political mistrust of institutional care while there is at the same time political confidence in the individual social worker's ability to find solutions that allow non-institutional measures to be an alternative to institutional care. An overall conclusion of the thesis is that there is now a treatment policy in social services for the children, which involves extensive efforts at home and it has led to that more children receive support from social services. One result of non-institutional care increment is that it led to increased costs for municipalities for intervention for children and young people when out-of-home care has not decreased. Another general conclusion is that translation and adaptation of ideas to local contexts is something that generally fits street-level bureaucrats need for discretion.

Thesis (MSc (Nursing))--Cape Peninsula University of Technology, 2018 / Primary health care (PHC) is a frontline health care approach. It is the point of contact where people are kept well and where their quality of life is improved. All people diagnosed as HIV- positive are retested prior to antiretroviral therapy (ART) initiation to verify their serostatus. ART initiation is seen as a non-emergency treatment that provides many benefits if its initiation is accelerated, for example following up pregnant women after being diagnosed with HIV. However, accelerated initiation may lead clients to start treatment before they are ready to adhere to treatment outcomes. The purpose of this study was to describe the nurse support for young adults during a first antiretroviral therapy visit at an urban primary health care clinic in Malawi. A descriptive phenomenological design was followed at an urban setup in Zomba city, Malawi. The sample was selected through purposive sampling until data saturation was obtained. Individual semi- structured interviews were conducted with young adults aged 19 25 who have visited the clinic for their first ART according to an interview schedule and field notes for around 30 minutes in a private room. The data was analysed using distinctive process and a consensus meeting was held between the researcher and independent coder. The findings of the study could help the PHC services to retain and re-engage the young adults in HIV care and aid the Government of Malawi in achieving its Sustainable Development Goal (SDG) 3. Principles of trustworthiness and ethics were adhered to throughout the research process. Six themes, each with separate categories, emerged from the data analysis on the experience of young adults during their first visit for ART at an urban PHC clinic in Malawi. The results indicated the need for an environment that enhances a client-orientated approach with a focus on holistic well-being. Knowledge management should be used to provide relevant and sufficient information to a newcomer while maintaining ethics under difficult circumstances. The legal environment should have a focus on supporting clients that need comprehensive ART treatment. Motivation of the patient regarding taking antiretroviral treatment (ART) is thus essential. Young adults express the need to be supported by nurses with relevant information, privacy and confidentiality and the trusting client/nurse relationship which could help them to retain in ART care. Recommendations of this study was that nurses should be offered in-service training on youthfriendly programmes which focuses on the health care of young adults during their HIV/ART services. Nurses need to create trusting relationship for the young adults and providing in door game at the waiting area to keep them busy as they are waiting for the services. Nursing managers to lobby for funding to extend the clinic and be role models in providing relevant information to young adults. It was concluded that a first visit was both positive and challenging to the participant s; however, they experienced the health providers on the first visit to be caring and supportive.

Under flera år har svenska medier kantats av debatter kring vården på statens institutionsstyrelse där behandlingspersonal missbrukar makten och inte givit ungdomarna den vård som krävs för att de ska motiveras mot en bättre livsstil. Denna studie har som utgångspunkt att studera relationerna mellan behandlingspersonal och ungdomar som har tvångsvård enligt 3 § LVU. Studien riktar även sitt fokus på ungdomar som har NPF diagnoser samt svårigheter kring skapandet av relationer. Undersökningen mynnar ut i följande frågeställningar; Hur upplever behandlingspersonalen relationer med brukare på Statens institutionsstyrelse? samt Vilka faktorer påverkar relationen mellan brukare med funktionsnedsättning och behandlingspersonal? Undersökningen genomfördes med en kvalitativ ansats där vi genomförde semistrukturerade intervjuer med respondenter som arbetade som behandlingspersonal på statens institutionsstyrelse. Resultatet visade på att skapa relationer på sis är något komplicerat och kräver olika faktorer för att en relation ska fungera. Resultatet visade att personligheten är central faktor i arbetet, men även tidigare kunskaper och erfarenheter vid arbetet, speciellt inom avdelningar där ungdomar har en funktionsnedsättning. Vidare har resultat även påvisat att personal måste visa tillit och agera som rollmodeller för att ungdomarna ska få motivation att skapa relationer och lyckas med sin behandling. / For several years, Swedish media have been lined with debates about care at the state department board where treatment assistants abuse power and have not given young people the care needed to be motivated towards a better lifestyle. This study is based on studying the relationships between treatment assistants and young people who have compulsory care according to § 3 LVU. The study also focuses on young people who have NPF diagnoses and difficulties in creating relationships. The survey results in the following issues; How do treatment assistants experience relationships with users at the Swedish National Board of Institutional Care? and What factors affect the relationship between users with disabilities and treatment assistants? The survey was conducted with a qualitative approach where we conducted semi-structured interviews with respondents who worked as treatment assistants at the State Department Board. The result showed that creating relationships on sis is somewhat complicated and requires different factors for a relationship to work. The results showed that personality is a central factor in the work, but also previous knowledge and experience at work, especially in departments where young people have a disability. Furthermore, results have also shown that staff must show trust and act as role models for young people to be motivated to create relationships and succeed in their treatment.

The study was carried out at the Mogale Child and Youth Care Centre (MCYCC) a privately run institution by Bosasa Operations in partnership with the Gauteng Provincial Departments of Social Development and Health and Social Welfare Department. The facility caters for boys in conflict with law aged 14–18 years, who have been legally placed in the facility as a place of safety by court order. It is expected that the findings and recommendations from this study will be useful in improving the food service standards for such institutions. At the time of this study there were 200 adolescents, 137 were awaiting trial, 55 on the diversion programmes and 8 were serving court sentence at the centre. The cross sectional study evaluated the food service offered at the MCYCC to establish the nutritional adequacy of the food served. Both qualitative and quantitative research methods were used to collect and analyse data. Out of the 200, 144 answered the customer satisfaction questionnaire and 167 took the BMI test. Observations were done in the kitchen to determine the compliance level to the food and safety regulations. The analytical results of the responses from the self-administered questionnaire on the customer service satisfaction generated by the SAS software revealed reliable results. The probability, (p-value) from the Chi-square (χ2) test showed that there was a significant difference in response the parameters tested including the overall satisfaction. Body Mass Index (BMI) calculations established different anthropometric patterns of which 1.3% adolescents were found to be obese, 28.2% were overweight, 57% had normal weight while 13.5% were found to be underweight. The Foodfinder 3 software used to evaluate the nutrient composition in a 2-week cycle menu revealed that in most cases both the macronutrients and micronutrients in the menus exceeded the recommended daily allowance (RDA) for the adolescent boys. Food safety and hygiene standards results showed that the unit is compliant with the required standards as it scored 86%; it was colour coded Silver and rated as very good. All the parameters evaluated scored above average percentage rating the customer satisfaction level for the services offered at the MCYCC are as good. Both underweight and overweight adolescents exist among the adolescents at the centre. The weights from the sample food plates exceeded the RDA of the adolescent boys. The centre’s compliance to health and safety regulations was rated as very good. The authorities in the Gauteng Provincial Departments of Social Development and Health and Social Welfare and Bosasa operation management should make use of this evident information to further improve the food service standards for other such institutions. / Dissertation (MSc)--University of Pretoria, 2014. / gm2015 / School of Health Systems and Public Health (SHSPH) / MSc / Unrestricted

Most children born HIV positive live longer and have more healthy lives since the advent of Anti-Retroviral Therapy (ART), together with the accessibility of Anti-Retroviral Drugs (ARV) to persons living with HIV. However, some of those children find themselves in need of care due to abandonment, orphanhood and / or neglect. In South Africa such children may enter the formal Child and Youth Care System and be placed in centres such as Epworth Child and Youth Care Centre. Due to the complex nature of the consequences of such disclosure or non-disclosure of HIV positive children’s status to them, social service workers are posed with a dilemma. In the absence of clear guidelines and policy around such disclosure, the children concerned may be unaware of their HIV positive status, despite being on a medication regime. The aim of the study was to explore the perceptions of social service workers regarding disclosure of HIV status to children born HIV positive living at Epworth Child and Youth Care Centre in Lambton, Ekurhuleni, South Africa. The study was located within a qualitative research paradigm, and utilised a purposive stratified sample of 15 social service workers form various occupational groupings recruited from Epworth Child and Youth Care Centre. A semi-structured interview schedule was employed as the research tool, with in-depth one-on-one interviews being adopted as a method of data collection. Thematic content analysis was used to analyse the data collected during the interviews. The main findings of the study were that HIV status disclosure is viewed as a complex but essential process as it reinforces children’s ability to adhere to medication regimes and to dispel anxiety and suspicion within themselves and around their status; that non-disclosure may lead to poor or coerced adherence and strains the relationship between the children and the social service workers. Disclosure of children’s HIV positive status can be viewed as complex as it presents both positive and the negative. Recommendations relate to community educative and awareness programmes, policy and practice changes regarding disclosure and none disclosure of children’s HIV positive status, as well as future research.