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| 2. |
- Almqvist, Anna-Lena, et al.
(author)
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Placements and ‘complex needs’. : An interview-study with Swedish young people
- 2021
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Conference paper (peer-reviewed)abstract
- Increasing mental ill-health among youth and young people sent back and forth between different welfare state actors have been subjects of concern in Sweden in recent years. These young people are often labelled as having ‘complex needs’, with a placement as the social services’ possible intervention. What do young people stress as positive as well as negative experiences with placements? How can the concept ‘complex needs’ be understood in relation to placements? Semi-structured interviews were made in 2018, in two municipalities, with 9 young people between 15-22 years. They have received support from social services and psychiatric care, often related to substance abuse. The young people’s history is often a long-term process of different forms of placements, both in families as well as in residential care. Too short-term interventions may lead to discontinuity in care. Residential care is often perceived of as more storage than treatment and care. Implications are that the young person’s placement need to be more carefully monitored. Treatment introduced at the placement need to be better coordinated and evaluated jointly by social services and psychiatric care. It is important that professionals have more interventions to suggest and are working proactively to avoid future placements.
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| 3. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Social Work Practices for Young People with Complex Needs : An Integrative Review
- 2018
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In: Child and Adolescent Social Work Journal. - : SPRINGER. - 0738-0151 .- 1573-2797. ; 35:3, s. 207-219
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Research review (peer-reviewed)abstract
- The aim of this integrative review is to investigate research of social work practices for adolescents and young adults with complex needs. The research questions are: What are the major themes in studies of practices for young people with complex needs? How do studies suggest that complex needs can be met in ways that are beneficial for young people? A young person with complex needs is in this review defined as an adolescent or young adult who, due to mental ill-health in combination with different types of social vulnerabilities, is receiving assistance from multiple welfare services. Searches were conducted in seven databases. These searches resulted in a sample of 1677 records, published 2007-2016, which in the screening process were reduced to 24 publications, all peer-reviewed articles. The participants in the studies in the articles consisted of young people, parents and professionals from mainly Anglo-Saxon countries. The articles were analyzed with qualitative summative content analysis. Three empirically generated themes were found in studies of work practices targeting young people with complex needs: collaboration-, relationship- and empowerment-oriented practices. In conclusion, the practices contain a wide variety of features, but with the joint aim of acknowledging young people's needs. The results can be used by practitioners and policymakers to further the development of services for youth with mental ill-health and social vulnerabilities, who use multiple welfare services.
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| 4. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Tensions and change in liminal spaces – Young people in Swedish out-of-home care
- 2024
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In: Children and youth services review. - : Elsevier Ltd. - 0190-7409 .- 1873-7765. ; 157
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Journal article (peer-reviewed)abstract
- The objective of this paper is to further the understanding of young people's experiences of out-of-home care (OHC). The focus will be on the tension between negative and positive experiences of OHC, refracted through the concept of liminality. The study is based on semi-structured interviews with 10 young people aged 15–22 (7 women, 3 men) with long-term contact with social services and psychiatric care. OHC can be experienced as a liminal space in both a negative and a positive sense. It is negative when perceived as containment rather than meaningful treatment. It can also be a negative experience when connected to fear, a lack of influence, and uncertainty in terms of being in between the social services and psychiatric care. It is positive when it is perceived as a turning point that enables positive change. It is then connected to feelings of meaningfulness, being respected, hope, and empowerment. The young people participating in the study also connect their experiences of OHC to a context of greater austerity in the welfare state. They reflect upon the benfits of OHC in terms of costs for society, but also the costs for the young person if the OHC is not perceived as meaningful support leading towards positive change. The participants have complex, interrelated needs and problems, and they also experience institutional gaps between psychiatric care and social services. It is important to overcome these gaps, so that young people are not located in ‘in-between spaces’ in terms of service provision.
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| 5. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Understanding complex needs through the concept of recognition : A qualitative study with Swedish young people about their encounters with welfare state actors
- 2022
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In: Nordic Social Work Research. - 2156-857X .- 2156-8588. ; 12:5, s. 716-727
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Journal article (peer-reviewed)abstract
- The paper uses the concept of recognition to investigate how young people labelled as having ‘complex needs’ experience their encounters with welfare state actors. Semi-structured interviews were held in 2018 with 14 young people, aged 15–22 years, in two Swedish municipalities. The participants have received multiple, long-term interventions from social services and psychiatric care. Research questions are: What aspects in the encounters between welfare state actors and young people may contribute to complexity in their life situations? How can Honneth’s concept of recognition illuminate this complexity? Aspects that have contributed to complexity in young people’s life situations are related to acts of dismissal. These dismissals by welfare state actors are interpreted as forms of disrespect as regards affection, rights or solidarity. Barriers to recognition are also related to the participants’ young age and position as children, and what this implies in a particular society. Our findings show that the difficulties young people face in their encounters with welfare state actors are partly due to the high level of specialization which contributes to an increased organizational complexity. Implications include that, when encountering young people in complex life situations, welfare state actors need to consider the importance of recognition as regards affection, rights, and solidarity. Recognition is central to achieving a positive outcome in working with young people in complex life situations and is expressed in social interactions. Therefore, building relationships needs to be more highly prioritized in welfare state organizations. young people in complex life situations and is expressed in social interactions. Therefore, building relationships needs to be more highly prioritized in welfare state organizations.
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| 6. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Where Lies the Complexity? : Interviews with Swedish Young People who Receive Support from Social Services and Psychiatric Care.
- 2018
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Conference paper (peer-reviewed)abstract
- Mental ill-health among young people has increased in the past decades in Sweden as well as in other western countries. When mental ill-health is connected with social vulnerability such as difficulties in completing education, unemployment or substance abuse you may be considered to have “complex needs”. This paper presents findings from a project (2016-2018) in two municipalities. The data consists of semi-structured interviews from two sub studies. One with 13 young persons (15-25 years) who have been or are recipients of long-term support from social services as well as psychiatric care, and one with 24 professionals from social services and psychiatric care. The aim is to investigate young people’s and professionals’ experiences of work practices aiming at increased well-being for young people labelled as having complex needs. The research questions are: What barriers for work practices for sustainable support are there from the young people’s perspective? How to overcome work practice barriers for giving sustainable support, from the professionals’ perspective? The questions are reflected in three themes; empowerment, relationships and collaboration. Barriers mentioned by the young people are high employee turnover as well as too many professionals involved in activities. Professionals might have their own ideas about what should be done, not taking the wishes of the young person into consideration to a satisfying level. In collaboration between different organizations, the professionals consider it important with at least one person who has the influence in several of them. To take the young person seriously as well as staying on in difficult times are considered important. We argue that the expression complex needs, when used as a way to categorize young people, may obscure that the problem also lies with highly specialized and complex welfare state organizations. They do not always succeed in catering for the interconnected needs of their clients.
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| 7. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Young people meet complex organisations : An interview study with Swedish service providers
- 2018
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Conference paper (peer-reviewed)abstract
- This paper presents findings from a Swedish interview study from 2016-2017 with 20 professionals working with young people, who suffer from a combination of mental ill-health and social vulnerability. They have been recipients of long-term support from multiple welfare service actors with the aim of promoting the young people’s wellbeing. The aim of the study is to investigate professionals’ experiences of work practices aiming at increased wellbeing for this group of young people. Mental ill-health among young people has increased in the past decades in Sweden as well as in many other western countries. Mental ill-health has also been connected with social vulnerability such as difficulties in completing education, unemployment, out-of-home care or substance abuse. This group of young people are sometimes referred to as youth with complex needs. Complex needs is a concept used to categorize people that have multiple interconnected needs that span medical and social issues, people that are considered as especially disadvantaged, or presenting challenges to welfare services. Categorizations of people and needs are prerequisites for legal, bureaucratic and professional systems within the welfare state. Welfare organizations construct knowledge and strategies regarding specific target groups according to these categorizations. In the paper we argue that the expression complex needs, when used as a way to categorize young people, not necessarily take into consideration that the problem instead may be the complex organizations that young people meet. These organizations may not always succeed in catering for the needs of young people.
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| 8. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Young people with complex needs meet complex organizations : an interview study with Swedish professionals about sustainable work practices
- 2018
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In: Community, Work and Family. - : Routledge. - 1366-8803 .- 1469-3615. ; 21:5, s. 620-635
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Journal article (peer-reviewed)abstract
- This paper concerns preconditions for the well-being of young people with mental ill-health combined with social vulnerabilities, also referred to as youth with complex needs. Research questions are: What barriers to sustainable work practices for young people labelled as having complex needs do professionals encounter? What do professionals identify as possible ways to overcome these barriers? Sustainable work practices are reflected in three themes: empowerment, relationships and collaboration. The findings are based on semi-structured interviews with 24 professionals, 3 men and 21 women, working in psychiatric care and the social services in two Swedish municipalities in 2016 and 2017. Major barriers are lack of continuity and co-ordination in staff and support, and fragmentation of work practices. As a consequence of the increased specialization of human service organizations, young people have to interact with many different professionals which could cause disparate interventions. Possible ways mentioned to overcome these barriers are supported through good interactional skills, using keyworkers as well therapeutic alliances, wrap-around services and case management. Complexity is linked to organizations and work practices rather than to young people. An often dysfunctional service delivery system in organizations with rigid boundaries may also affect professionals’ aim for sustainable support.
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| 9. |
- Bergvall-Kåreborn, Birgitta, et al.
(author)
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User toolkits for citizen-centric mobild service innovation
- 2012
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In: eChallenges e-2012 Conference Proceedings. - : IIMC International Information Management Corporation. - 9781905824359
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Conference paper (peer-reviewed)abstract
- Around the world, there is an ongoing shift from en economy focusing on product development to an economy with focus on digital service development. An ongoing initiative in Europe to support this shift is the Internet of Services (IoS) which strives for a situation where everything that is needed to use a software is available as a service. The aim of this paper is to present a toolkit that non-programmers can use develop their own innovative mobile services. This environment strives to put forth a situation where technologies are made available as components that easily can be composed into a mobile services by just about anyone. This has tremendous impact on the feasibility of citizen-centric services where citizens create apps based on their current needs in their contemporary situation.
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| 10. |
- Edmark, Lennart, et al.
(author)
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A ventilation strategy during general anaesthesia to reduce postoperative atelectasis
- 2014
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In: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 119:3, s. 242-250
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Journal article (peer-reviewed)abstract
- Background:Atelectasis is common during and after general anaesthesia. We hypothesized that a ventilation strategy, without recruitment manoeuvres, using a combination of continuous positive airway pressure (CPAP) or positive end-expiratory pressure (PEEP) and a reduced end-expiratory oxygen fraction (FETO2) before ending mask ventilation with CPAP after extubation would reduce the area of postoperative atelectasis.Methods:Thirty patients were randomized into three groups. During induction and emergence, inspiratory oxygen fractions (FIO2) were 1.0 in the control group and 1.0 or 0.8 in the intervention groups. No CPAP/PEEP was used in the control group, whereas CPAP/PEEP of 6 cmH2O was used in the intervention groups. After extubation, FIO2 was set to 0.30 in the intervention groups and CPAP was applied, aiming at FETO2 < 0.30. Atelectasis was studied by computed tomography 25 min postoperatively.Results:The median area of atelectasis was 5.2 cm(2) (range 1.6-12.2 cm(2)) and 8.5 cm(2) (3-23.1 cm(2)) in the groups given FIO2 1.0 with or without CPAP/PEEP, respectively. After correction for body mass index the difference between medians (2.9 cm(2)) was statistically significant (confidence interval 0.2-7.6 cm(2), p = 0.04). In the group given FIO2 0.8, in which seven patients were ex- or current smokers, the median area of atelectasis was 8.2 cm(2) (1.8-14.7 cm(2)).Conclusion:Compared with conventional ventilation, after correction for obesity, this ventilation strategy reduced the area of postoperative atelectasis in one of the intervention groups but not in the other group, which included a higher proportion of smokers.
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