Suchergebnisse

BACKGROUND AND AIMS: Increasingly, efforts to counteract perceived problems in drug treatment at residential rehabilitation centres have come to rely on measures drawing on evidence-based practice (EBP). However, the Swedish media, government inquiries, and international research have identified a number of problems regarding both residential rehabilitation and EBP. This suggests that caution should be exercised when placing expectations on EBP. The aim of this study is to investigate how the responsible authorities have handled increasing demands for EBP with administrative control while facing critical evaluations of their steering and implementation efforts. The study examines the maturation of a widespread treatment ideology, which aims to be based on evidence, in a country known for its restrictive drug policy and its goal of becoming a drug-free society. METHODS: Through a qualitative textual analysis of 17 years (2000–2016) of inquiries, directives, and authority archives we have traced the interplay between problem descriptions, intended goals, and implemented solutions. FINDINGS: The analysis shows that the ambition to provide care and welfare based on EBP is still an ambition. Also, the authorities' control over the care actually provided still leaves room for improvement. Recurring criticism and the empirical material indicate that the expectations have not been met. CONCLUSIONS: We would like to suggest that continued frustration can be traced to the misconception that EBP is the opposite of values and ideology, and hence preferable. As drug treatment strives for scientific credibility to give it legitimacy, some types of "evidence" are preferred above others. We would like to suggest that we need to bring ideology to the fore, and openly discuss our restrictive policy goals and choices of "evidence".

In this article we describe and diagnose ailments suffered by the so-called 'medical insurance decision-making support tool' that was published in 2007 as part of a major reform of the Swedish social insurance. Through document studies and interviews the guideline is analysed and compared with a reference case, a guideline within cardiology. Particular attention is paid to different types of objectivity and how they relate to the sick-listing guidelines and their uncertain, multi-professional, high-stakes or 'post-normal' character. Conflicting concerns and probably unavoidable choices are found in the ambitions, formats, implementation mode and experts of the guidelines.

The object of the present study was to see whether there are tendencies towards reactive arson, measured as a relation between frustration, intoxication and a disposition to start fires. One hundred individuals, 50 men and 50 women, participated. All were students and they were randomly
assigned to each of five experimental groups, namely a Control Group, a Placebo Group, a Frustration Group, an Alcohol Group and an Alcohol + Frustration Group. A projective test was devised which required the participant to complete a short story where the content involved a person who
had suffered humiliation and persecution and who was fingering a box of matches in his/her pocket. Results indicated that frustration increases the probability of starting fires, but, in this study, alcohol did not increase the degree of relation to fire. Results also suggest that there
are strong cognitive barriers in a population of university students against fantasizing about starting fires.