BUSINESS ORGANIZATIONS IN KOSOVO - MANAGEMENT AND ORGANIZATIONAL AMENDMENTS

Mentor: Prof. Dr. Vjollca Hasan

Pathways to child and adolescent psychiatric clinics: a multilevel study of the significance of ethnicity and neighbourhood social characteristics on source of referral

<p>Abstract</p> <p>Background</p> <p>In the Swedish society, as in many other societies, many children and adolescents with mental health problems do not receive the help they need. As the Swedish society becomes increasingly multicultural, and as ethnic and economic residential segregation become more pronounced, this study utilises ethnicity and neighbourhood context to examine referral pathways to child and adolescent psychiatric (CAP) clinics.</p> <p>Methods</p> <p>The analysis examines four different sources of referrals: family referrals, social/legal agency referrals, school referrals and health/mental health referrals. The referrals of 2054 children aged 11-19 from the Stockholm Child-Psychiatric Database were studied using multilevel logistic regression analyses.</p> <p>Results</p> <p>Results indicate that ethnicity played an important role in how children and adolescents were referred to CAP-clinics. Family referrals were more common among children and adolescents with a Swedish background than among those with an immigrant background. Referrals by social/legal agencies were more common among children and adolescents with African and Asian backgrounds. Children with Asian or South American backgrounds were more likely to have been referred by schools or by the health/mental health care sector. A significant neighbourhood effect was found in relation to family referrals. Children and adolescents from neighbourhoods with low levels of socioeconomic deprivation were more likely to be referred to CAP-clinics by their families in comparison to children from other neighbourhoods. Such differences were not found in relation in relation to the other sources of referral.</p> <p>Conclusions</p> <p>This article reports findings that can be an important first step toward increasing knowledge on reasons behind differential referral rates and uptake of psychiatric care in an ethnically diverse Swedish sample. These findings have implications for the design and evaluation of community mental health outreach programs and should be considered when developing measures and strategies intended to reach and help children with mental health problems. This might involve providing information about the availability and accessibility of health care for children and adolescents with mental health problems to families in certain neighbourhoods and with different ethnic backgrounds.</p

Assessing the Influence of Neighbourhood Disadvantage on Violent Crime among Child Psychiatric Patients

The aim of this study is to assess the effect of neighbourhood socioeconomic disadvantage on violent crime among a group of children and adolescents who attended Psychiatric Child and Youth Clinics in Stockholm, Sweden. Data is drawn from The Stockholm Child-psychiatric database, which consists of approximately 7600 children and adolescents who consulted the Psychiatric Child and Youth Clinics (PBU) in the county of Stockholm. The children were born in 1981-1989, and finished their contacts with the Psychiatric Child and Youth Clinics between 2003 and 2005. Using multilevel techniques, incidences of violent crime in police registers were related to characteristics of the neighbourhood where the children and adolescents lived. About 7 percent of the variance in violent crime incidents is found at the neighbourhood level. Controlling for individual characteristics reduces the between-neighbourhood variance, though a significant neighbourhood effect remains. When neighbourhood-level disadvantage is added to the model, the between-neighbourhood variance in incidence of violent crime is further reduced, but still significant. This implies that neighbourhood characteristics, in addition to individual characteristics, should be considered in the design and development of psychiatric care for children, and for the development of strategies to prevent future criminality

Adolescent mental health and utilisation of psychiatric care : the role of parental country of birth and neighbourhood of residence

The studies included in this thesis aim to illustrate different aspects of mental health and the utilisation of psychiatric care among Swedish children and adolescents, with the overarching aim being to improve the existing knowledge on how the neighbourhood of residence and parental country of birth influence adolescents’ mental health and their pathways into and utilisation of psychiatric care. The first study investigates referral pathways to child and adolescent psychiatric clinics, directing a special focus at how these pathways differ on the basis of parental country of birth and neighbourhood of residence. The results show that parental country of birth plays an important role in how children and adolescents are referred to the child and adolescent psychiatric sector. Children and adolescents with Swedish-born parents appear more often to have been referred by their families, whereas by comparison with children and adolescents with Swedish-born parents, those with foreign-born parents had more often than been referred by someone outside the family, such as the social services or their school. Neighbourhood of residence was found to play a significant role in relation to family referrals; children and adolescents living in neighbourhoods with low levels of socioeconomic deprivation were more likely to have been referred by their families by comparison with those from more deprived neighbourhoods. The second study investigates how parental country of birth and individual gender are associated with the utilisation of psychiatric care. The findings from the study indicate that adolescents whose parents were born in middleor low-income countries present lower levels of psychiatric outpatient care utilisation than those with Swedish-born parents. Initially, no associations 7 were found between parental country of birth and inpatient care. Following adjustment for socio-demographic variables, it was found that adolescents whose parents were born in low-income countries were also less likely to utilise inpatient care. Girls were more likely to have utilised psychiatric care, but controlling for possible interactions revealed that this was true primarily for girls with parents born in Sweden or other high-income countries. In the third study, psychiatric care utilisation patterns are analysed in relation to the neighbourhood of residence. In part the aim was to investigate the validity of the neighbourhood when it comes to understanding variations in adolescents’ utilisation of psychiatric care, but the study also examines whether neighbourhood socioeconomic deprivation is associated with individual variations in the utilisation of psychiatric care. The results indicate that the neighbourhood of residence has little influence on the utilisation of psychiatric care, only 1.6 % of the variance was found at the neighbourhood level. No clear association between the neighbourhood level of socioeconomic deprivation and levels of psychiatric care utilisation was found in the study. The final study investigates how adolescents’ perceptions of the social characteristics of their neighbourhood are related to their self-reported mental health, while controlling for the socioeconomic structure of the neighbourhood. The results show that adolescents’ perceptions of their neighbourhood are associated with their self-reported mental health, particularly their perceptions of social disorder. However, these associations differ between girls and boys, and between adolescents with Swedish- and foreign-born parents. In conclusion, the results presented in the thesis show that parental country of birth is an important factor when it comes to understanding differences in referral patterns and in the utilisation of psychiatric care. However, the role of the neighbourhood of residence appears to be more complex

Criminal policy debate as an active learning strategy

One of the biggest challenges for criminal justice educators is to deal with the strongly held opinions and preconceived notions about criminal justice issues among students. It often takes the form of students being reluctant to ac- cept certain premises that does not comply with their own experience of the issue. The general tendency to reject information that does not confirm your own view of the world and to accept information that does confirm what you believe to be true is called confirmation bias. This paper proposes the criminal policy debate format as an active learning strategy. Based on the application in an introductory course that is part of a three-year bachelor program in criminology, findings show that the debate format facilitates learning by encouraging students to formulate arguments for and against criminal policy question

Intimate partner violence and the Nordic paradox

Survey data (FRA 2014) suggest that the lifetime rates of intimate partner violence against women (IPVAW) in the Nordic countries are among the highest in the EU, even though these countries are positioned as among the most gender equal in the world. This co-existence of high levels of gender equality and of high IPVAW rates, which has been termed the Nordic Paradox, has hitherto not been adequately understood. This presentation provides an outline of a cross-disciplinary research project aiming to explore this Nordic Paradox by (1) analyzing whether the apparent paradox reflects true differences in IPVAW prevalence, or whether they are expressions of confounding or information bias; (2) conducting multilevel analyses to increase understanding of the individual risk of IPVAW, as well as within and between country variations; and (3) performing qualitative research in two countries exemplifying the Nordic paradox: Sweden and Spain. The emphasis of the presentation lies on qualitative research (3) consisting of focus groups and interviews with 30 professionals working with IPVAW in Southern Sweden, aiming to elucidate the professionals’ thoughts and experiences surrounding the Nordic Paradox. While questioning the data underpinning the Nordic Paradox, the professionals pointed to factors potentially contributing toward, and presenting specific challenges for the handling and prevention of, IPVAW in Sweden. Notably, they suggested that despite relative gender equality, strong tendencies towards rendering IPVAW unseen remain