Evaluation In Sweden Research Articles

Psychopathic Traits in a Swedish Court-Ordered Forensic Sample: Preferential Associations of Boldness, Meanness, and Disinhibition.

The construct validity of the triarchic psychopathy model has yet to be evaluated in the Swedish forensic psychiatric context. We examined associations between the three phenotypic constructs of the triarchic model of psychopathy (i.e., boldness, meanness, disinhibition), self-assessed empathy and anxiety, and clinical variables in 91 individuals undergoing pretrial forensic psychiatric evaluation in Sweden. Participants completed the Triarchic Psychopathy Measure (TriPM) and self-report measures of empathy and anxiety. Clinical variables, including psychiatric diagnoses and criminal behavior, were collected from the forensic psychiatric evaluations (FPE). All three subscales of the TriPM displayed significant and predominantly anticipated correlations with empathy and trait anxiety measures. TriPM Disinhibition was the only subscale with significant associations with the clinical variables collected from the FPEs. The results provide evidence for the reliability and construct validity of the Swedish translation of the TriPM in a pretrial forensic setting.

Effects of Forestry Intensification and Conservation on Green Infrastructures: A Spatio-Temporal Evaluation in Sweden

There is a rivalry between policies on intensification of forest management to meet the demands of a growing bioeconomy, and policies on green infrastructure functionality. Evaluation of the net effects of different policy instruments on real-world outcomes is crucial. First, we present data on final felling rates in wood production landscapes and stand age distribution dynamic in two case study regions, and changes in dead wood amounts in Sweden. Second, the growth of formally protected areas was compiled and changes in functional connectivity analysed in these regions, and the development of dead wood and green tree retention in Sweden was described. The case studies were the counties Dalarna and Jämtland (77,000 km2) representing an expanding frontier of boreal forest transformation. In the wood production landscape, official final felling rates averaged 0.84%/year, extending the regional timber frontier. The amount of forest <60 years old increased from 27–34% in 1955 to 60–65% in 2017. The amounts of dead wood, a key forest naturalness indicator, declined from 1994 to 2016 in north Sweden, and increased in the south, albeit both at levels far below evidence-based biodiversity targets. Formal forest protection grew rapidly in the two counties from 1968 to 2020 but reached only 4% of productive forests. From 2000 to 2019, habitat network functionality for old Scots pine declined by 15–41%, and Norway spruce by 15–88%. There were mixed trends for dead wood and tree retention at the stand scale. The net result of the continued transformation of near-natural forest remnants and conservation efforts was negative at the regional and landscape levels, but partly positive at the stand scale. However, at all three scales, habitat amounts were far below critical thresholds for the maintenance of viable populations of species, let alone ecological integrity. Collaboration among stakeholder categories should reject opinionated narratives, and instead rely on evidence-based knowledge about green infrastructure pressures, responses, and states.

Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

ObjectiveInternet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated...

School evaluation in Sweden in a local perspective: A synthesis

This article synthesises the role of evaluation at the municipal, school, classroom and parental levels of governance, and discusses the results of the articles appearing in this special issue. The discussion concerns the role of evaluation in school governance, the value of evaluation for local school development, the constitutive effects of evaluation, what explains the present results, how knowledge produced by evaluation can be used, and methodological issues. The results indicate that evaluation systems legitimise and support governance by objectives and results, parental school choice, and accountability for fairness and performance. Evaluation systems emphasise measurable aspects of curricula and foster a performance-oriented school culture. The most important evaluations for improving teaching and schools are teachers’ own evaluations. The article suggests two explanations for the actual roles of evaluation in local school governance. First, both the governance structure and applied governance model delimit and partly shape the role of evaluation at local governance levels. Second, how local school actors use their discretion and interpret their role in the education system, including how they respond to accountability pressure, explains how their roles are realised and the fact that actors at the same level of governance can develop partly different roles.

Health-related quality of life and emotional well-being in parents of children with epilepsy referred for presurgical evaluation in Sweden.

The purpose of this study was to assess and compare health-related quality of life (HRQoL) and emotional well-being in mothers and fathers of children with drug-resistant epilepsy, referred for presurgical evaluation in Sweden. Mothers (n=117) and fathers (n=102) of 122 children (0-18 years) completed the generic 36-item Short Form Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Mothers' and fathers' SF-36 scores were compared with age-adjusted Swedish population values using the independent t-tests. Differences in the proportions of mothers vs. fathers classified as 'noncases' or 'possible/probable' clinical cases of anxiety (HADS-A) and depression (HADS-D), respectively, were assessed with the chi-square test. Parents' HADS scores were also compared using independent t-tests. Mothers had significantly lower scores compared with norms on 6 of the 8 SF-36 domains (p<0.01), while fathers had significantly lower scores on 4 of the domains (p<0.01). Mothers had significantly lower scores than fathers on 4 of the SF-36 domains (p<0.05). Significantly more mothers than fathers scored below the population mean for the SF-36 Mental Component Summary score. A significantly larger proportion of mothers than fathers had 'possible/probable' anxiety (52% vs. 38%) but not depression (30% vs. 22%). Mothers had significantly worse scores than fathers on HADS-A (p<0.01) but not on HADS-D. Mothers and fathers of children with drug-resistant epilepsy have diminished HRQoL compared with population norms. Symptoms of anxiety appear to be more common than symptoms of depression. Mothers experienced higher levels of anxiety, but not depression, than fathers and scored lower than fathers on vitality, mental health, and Mental Component Summary of the SF-36. There is a need to identify contributory factors and interventions to ameliorate these difficulties.

The Oral History of Evaluation

In the vast evaluation literature, there are numerous accounts describing the emergence of the field of evaluation. However, texts on evaluation history often describe how structural conditions for conducting evaluation have changed over time, often from an American perspective. Inspired by the Oral History Team, the purpose of this article is to provide an oral history description of the professional development of a person who has contributed to the emergence of evaluation in Sweden. The article concerns Evert Vedung, undoubtedly Sweden’s most well-known evaluation researcher. Vedung is intellectually distinct from many other prominent evaluation researchers, given his background in political science. He believes that evaluation is closely connected to representative democracy, which affects his view on what value criteria are to be used in evaluation. This article presents an edited conversation with Evert Vedung on his research trajectory. The article aims to describe how serendipities have shaped Vedung’s professional development.

Offenders with mental health problems and substance misuse: cluster analysis based on the Addiction Severity Index version 6 (ASI-6)

There is an urgent need to improve assessment and treatment among offenders with mental health problems and substance misuse (the “triply troubled”). An examination of the usefulness of the recently published Addiction Severity Index version 6 (ASI-6; Cacciola, J.S., Alterman, A.I., Habing, B., & McLellan, A.T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6). Addiction, 106, 1588–1602) in classifying offenders with mental health problems and substance misuse was undertaken. A total of 207 offenders with suspect mental disorder and substance misuse about to go through a forensic psychiatric evaluation in Sweden were interviewed with the ASI-6. Data were cluster analyzed. Four distinct clusters emerged: (1) “less troubled” (n = 35), (2) “severely triply troubled” (n = 30), (3) “triply troubled with medical problems (n = 52) and (4) “working triply troubled” (n = 87). The ASI-6 proved useful in the classification of offenders with mental health problems and substance misuse...

Cost-Effectiveness Evaluation in Sweden of Escitalopram Compared with Venlafaxine Extended-Release as First-Line Treatment in Major Depressive Disorder

ObjectivesMajor depressive disorder (MDD) is a major public health concern associated with a high burden to society, the health-care system, and patients and an estimated cost of €3.5 billion in Sweden. The objective of this study was to assess the cost-effectiveness of escitalopram versus generic venlafaxine extended-release (XR) in MDD, accounting for the full clinical profile of each, adopting the Swedish societal perspective, and identifying major cost drivers. MethodsCost-effectiveness of escitalopram versus venlafaxine XR was analyzed over a 6-month time frame, on the basis of a decision tree, for patients with MDD seeking primary care treatment in Sweden. Effectiveness outcomes for the model were quality-adjusted life-years and probability of sustained remission after acute treatment (first 8 weeks) and sustained for 6 months. Cost outcomes included direct treatment costs and indirect costs associated with sick leave. ResultsCompared with generic venlafaxine XR, escitalopram was less costly and more effective in terms of quality-adjusted life-years (expected gain 0.00865) and expected 6-month sustained remission probability (incremental gain 0.0374). The better tolerability profile of escitalopram contributed to higher expected quality-adjusted life-years and lower health-care resource utilization in terms of pharmacological treatment of adverse events (though only a minor component of treatment costs). Expected per-patient saving was €169.15 for escitalopram versus venlafaxine. Cost from sick leave constituted about 85% of total costs. ConclusionsEscitalopram was estimated as more effective and cost saving than generic venlafaxine XR in first-line MDD treatment in Sweden, driven by the effectiveness and tolerability advantages of escitalopram. The study findings are robust and in line with similar pharmacoeconomic analyses.

Examining outcomes‐based educational evaluation through a critical theory lens

AbstractContemporary educational evaluation policy and practice can be challenged by applying critical theory and hermeneutics perspectives in evaluation and by asking whose interests are being served through evaluation. Using educational evaluation in Sweden as the context, the author argues for an explanation‐oriented evaluation approach that assumes education is complex, multilayered, and infused with conflicting interests and intentions. The author concludes that evaluations that attend to this complexity have the potential to influence educational policy significantly. © Wiley Periodicals, Inc., and the American Evaluation Association.

Economic evaluation in Sweden of epoetin beta with intravenous iron supplementation in anaemic patients with lymphoproliferative malignancies not receiving chemotherapy

Functional iron deficiency is one reason for lack of response to erythropoietin treatment. Concomitant intravenous (IV) iron supplementation has the potential to improve response to erythropoietin, allowing a decrease in erythropoietin dose requirements. In a recent study of anaemic, iron-replete patients with lymphoproliferative malignancies (Leukemia, 21, 2007, 627), the haemoglobin (Hb) increase and response rate were significantly greater in patients receiving epoetin beta with concomitant IV iron compared with patients receiving epoetin beta without IV iron (P < 0.05). The present analysis aimed to investigate whether a combination of epoetin beta and IV iron is cost-effective compared with epoetin beta without IV iron. This analysis was performed from a Swedish societal perspective as a within-trial evaluation of overall costs (based on differences in drug costs and resource use between groups) and effect (differences in Hb increases) during 16 weeks' treatment with epoetin beta with or without concomitant IV iron. There was an improved response to epoetin beta with IV iron therapy and an almost 2-fold greater increase in Hb levels. Overall mean cost per patient in the epoetin beta with IV iron group was euro5558 and in the epoetin beta without IV iron group was euro6228. Thus, treatment with epoetin beta with IV iron resulted in overall cost savings of about 11% compared with epoetin beta without iron, mainly due to reduced erythropoietin dosages. Epoetin beta with concomitant IV iron in anaemic patients with lymphoproliferative malignancies not receiving chemotherapy resulted in better outcomes at lower cost compared with epoetin beta without iron. This suggests that epoetin beta with IV iron is a dominant therapy from a Swedish perspective.

Do Violent Offenders With Schizophrenia Who Attack Family Members Differ From Those With Other Victims?

Do violent offenders with schizophrenia who attack family members differ from those with other victims? Data on individual background factors were collected on all male offenders of violent crimes who for their first time were subject to forensic psychiatric evaluation in Sweden between 1992 and 2000 and were diagnosed with schizophrenia. In addition to descriptive data for the whole sample, analyses were made in order to identify possible characteristic factors for offenders who targeted family members. In comparison to offenders with other victims, the findings indicate an earlier onset of mental illness, in terms of that they were more likely to have interrupted their schooling at an earlier stage, were more likely to have had psychiatric contacts in childhood, to be younger when first compulsorily admitted to psychiatric inpatient treatment, and they were also younger when they committed the index crime. The findings suggest the need to address the possibility of violent behavior within the family when managing patients with major mental disorders.

Self-reported personality traits and disorders (DSM-IV) and risk of criminal recidivism: a prospective study.

Assessment and management of criminal offenders require valid methods to recognize personality psychopathology and other risk and protective factors for recidivism. We prospectively explored the association between dimensional and categorical measures of personality disorder (PD) measured with the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q, Ottosson et al., 1995) and registered reconvictions in adult offenders. One hundred and sixty-eight offenders consecutively referred for pre-sentencing forensic psychiatric evaluation in Sweden during 1995-1996 completed DIP-Q self-reports. The subjects received different types of sanctions and were followed for an average of 36 months after release from prison, discharge from a forensic psychiatric hospital, or onset of nondetaining sentences. Age-adjusted odds ratios revealed a 4.8 times higher risk for any recidivism and a 3.7 times higher risk for violent recidivism among subjects whose self-reports suggested a categorical diagnosis of antisocial PD as compared to offenders without antisocial PD. The remaining nine categorical DSM-IV PD diagnoses were not significantly related to recidivism. In dimensional analyses, each additional antisocial and schizoid PD symptom endorsed by participants at baseline increased the risk for violent reoffending. Our results suggest a relationship between self-reported behavioral instability and interpersonal dysfunction captured primarily by DSM-IV antisocial and schizoid PD constructs, and criminal re-offending also in a multi-problem sample of identified offenders.

Psychopathy and violent recidivism among young criminal offenders

To investigate the predictive validity of psychopathic personality traits (assessed with the revised psychopathy checklist, PCL-R; Hare, 1991) for violent criminal recidivism among young offenders. The relationship between PCL-R psychopathy and violent re-offending was studied in 98 young (M=18.40, range 15-20 years) violent and sex offenders subjected to forensic psychiatric evaluation in Sweden during 1988-95. Subjects were followed during detainment and for 24 months in the community to first reconviction for a violent offence. We found a modest but significant association between PCL-R scores and violent recidivism, almost exclusively accounted for by behavioural criteria. Among 13 possible confounders tested, conduct disorder before age 15 and a young age at first conviction eliminated the relationship between psychopathy and violent recidivism in pair-wise logistic regression models. PCL-R psychopathy may be a less valid predictor for violent criminal recidivism among severe youthful offenders than among adult offenders.

Psychopathy (PCL-R) predicts violent recidivism among criminal offenders with personality disorders in Sweden.

Psychopathy as conceptualized with Hare's Psychopathy Checklist Revised, PCL-R, has attracted much research during the 1990s. In the Scandinavian countries, few studies that empirically support the validity of North American risk assessment techniques in our regional context have been published. The purpose of this paper is to explore the predictive power of the PCL-R in a population of personality-disordered violent offenders subjected to forensic psychiatric evaluation in Sweden. Following release from prison (n = 172), discharge from forensic psychiatric treatment (n = 129), or probation (n = 51), a total of 352 individuals were followed for up to 8 years (mean = 3.7 years) with reconviction for violent crime as endpoint variable (base rate 34%). As the estimate of predictive power, the area under the curve of a receiver operating characteristic (AUC of ROC) analysis was calculated. For PCL-R scores to predict 2-year violent recidivism, AUC of ROC was .72 (95% CI: .66-.78). In addition, the personality dimension of psychopathy (Factor 1) and the behavioral component (Factor 2) both predicted 2-year recidivism significantly better than random: AUC of ROC .64 (95% CI: .57-.70) and .71 (95% CI: .65-.77), respectively. We conclude that psychopathy is probably as valid a predictor of violent recidivism in Swedish forensic settings as seen in previous North American studies.

Evaluation as Policymaking: Introducing Evaluation Into a National Decentralized Educational System

Part 1 The education system in Norway - the need for evaluation, Marit Granheim. Part 2 The governing of education systems and decentralization: education policy making, decentralization and evaluation, Ulf P.Lundgren decentralization in educational governance - an exercise in contradiction, Hans Weiler factors behind decentralization in educational systems, Jon Lauglo. Part 3 Decentralization, evaluation and knowledge production: some problems and problematics in the production of evaluation, Thomas S.Popkewitz evaluation and decentralization of knowledge, Steinar Kvale the trade off between evaluation and autonomy - who cheats who?, Kjell Eide national assessment of competencies and skills, Ingmar Wedman. Part 4 The state of the art and specific policy questions: the American debate on educational evaluation and the national evaluation in Sweden, Sigbrit Franke-Wikeberg evaluation in the context of national policy and local organization - the U.S. case, Gary Sykes some notes on a Norwegian evaluation programme, Erik Wallin evaluation and political governing in a decentralized educational system - giving integration of the handicapped in education a national policy concern, Lise Vislie. Part 5 The case of Norway - decentralization evaluation for Norway, Ernest R.House evaluation in a decentralized school system - where to we stand, Tim Tiller fitting evaluation with the governance of education, Maurice Kogan.