Measures of accountability and delegated discretion in activation work: lessons from the Norwegian Labour and Welfare Service

Activation work – the complex task of motivating, compelling and assisting marginalized citizens into labour market participation – pinpoints critical issues of discretion and accountability in the welfare state. Investigating accountability measures aimed at ensuring qualified discretionary judgements is therefore important. In this article, I discuss the reformed Norwegian Labour and Welfare Service and the accountability measures aimed at discretionary judgements of frontline workers. The conclusion is that, because activation tasks in the Norwegian frontline service imply professional discretion more than administrative discretion, structural measures aimed at restricting the discretionary space of frontline workers seem to have only limited impact. This is because the knowledge necessary to perform means – end judgements is insufficient. Rather, there seems to be a need for epistemic measures aimed at improving the knowledge base for professional discretionary reasoning.     

Studying children in armed conflict: data production,social indicators and analysis

The authors seek to give an overview of ways in which social indicators relevant to research on children affected by armed conflict can be developed, and how such research can be carried out. Technical and methodological challenges involved in this pursuit are discussed. It is argued that data production must consider issues of definition and delineation of the phenomenon of war-affected children more actively than it does currently. An analytical approach is proposed, in which children’s characteristics in different situations, or in different stages of conflict, may be used as intakes to understanding how the social processes pertaining to life histories of children in armed conflict are created and reproduced.

Medicalizing reproduction: the pill and home pregnancy tests

This article explores one chapter in the history of medicalization through a focused study of oral contraceptives and home pregnancy tests. Each commercially successful in developed nations and both decades old (the Food and Drug Administration approved oral contraceptives in 1960 and home pregnancy tests in 1977), these reproductive technologies created the first pharmaceutical mega-market comprised of young, healthy, sexually active, heterosexual women. Examining the discrete, but interconnected, histories of both products, this article explores how the Pill's popularity and profitability medicalized and feminized contraception, encouraging pharmaceutical companies to invest in the development of patented variants of hormonal contraception and creating a means by which the under-used Pap smear could be introduced to a population that had previously resisted it. Home pregnancy tests, too, had unintended consequences. Designed to shield the detection of a pregnancy from a "medical gaze," the test's widespread use encouraged women to become medical patients at an earlier stage of their pregnancy.     

Methods for exploring treatment effect heterogeneity in subgroup analysis: an application to global clinical trials

Multi‐country randomised clinical trials (MRCTs) are common in the medical literature, and their interpretation has been the subject of extensive recent discussion. In many MRCTs, an evaluation of treatment effect homogeneity across countries or regions is conducted. Subgroup analysis principles require a significant test of interaction in order to claim heterogeneity of treatment effect across subgroups, such as countries in an MRCT. As clinical trials are typically underpowered for tests of interaction, overly optimistic expectations of treatment effect homogeneity can lead researchers, regulators and other stakeholders to over‐interpret apparent differences between subgroups even when heterogeneity tests are insignificant. In this paper, we consider some exploratory analysis tools to address this issue. We present three measures derived using the theory of order statistics, which can be used to understand the magnitude and the nature of the variation in treatment effects that can arise merely as an artefact of chance. These measures are not intended to replace a formal test of interaction but instead provide non‐inferential visual aids, which allow comparison of the observed and expected differences between regions or other subgroups and are a useful supplement to a formal test of interaction. We discuss how our methodology differs from recently published methods addressing the same issue. A case study of our approach is presented using data from the Study of Platelet Inhibition and Patient Outcomes (PLATO), which was a large cardiovascular MRCT that has been the subject of controversy in the literature. An R package is available that implements the proposed methods. Copyright © 2014 John Wiley & Sons, Ltd.     

Self-Efficacy,Pulmonary Function,Perceived Health and Global Quality of Life of Cystic Fibrosis Patients

This study examined the extent that pulmonary function is related to perceived health status and global quality of life in adults suffering from cystic fibrosis, and the extent that self-efficacy modifies these relationships. Our sample comprised 86 adults (48% female; mean age, 29 years; age range, 18–54 years) with cystic fibrosis, recruited from the Norwegian Competence Centre for Cystic Fibrosis (83% response rate). Both subjective data on psychosocial aspects of living with cystic fibrosis, and objective data on pulmonary function (FEV1%) were assessed. Psychosocial aspects were assessed by a questionnaire that included St George’s Respiratory Questionnaire (perceived health status), the Generalized Self-Efficacy Scale (perceived self-efficacy), and the Quality of Life Scale (global quality of life). We found that self-efficacy is an additional factor explaining health status and global quality of life. Pulmonary function is important for health status, but not for global quality of life, for which perceived self-efficacy and health status are the most significant variables. These results show that self-efficacy is as important as pulmonary function for the perceived health status and global quality of life of patients. These valuable findings should be considered in the treatment and care of adult patients suffering from cystic fibrosis.     

Research approaches to networked employment services: A systematic review

Research on networked services aimed at the (re)employment of groups marginalised from the labour market has gained momentum in different scholarly traditions (e.g., public administration, healthcare and social policy), but the topic remains somewhat fragmented. In this paper, we systematise and synthesise this research with the aim of outlining distinct research approaches, facilitating increased cross-disciplinary understandings and promoting interdisciplinary research. Based on a systematic review of the literature (1990–2018, n = 273), we highlight four dominant research approaches: rehabilitation, disability, welfare and governance. We show that these research approaches involve distinct conceptualisations of labour market inclusion, networked services and the target groups. Nevertheless, the research approaches also apply similar terms and concepts (e.g., partnership, collaboration) but with different (more or less implicit) connotations, which lead to fragmentation. We do not suggest that there be a unified use of concepts across traditions; however, we argue for the necessity of increased awareness of the similarities and differences between these research traditions in order to increase understanding of the networked employment services available to marginalised groups.     

Dynamic DEA: A slacks-based measure approach

In data envelopment analysis, there are several methods for measuring efficiency changes over time, e.g. the window analysis and the Malmquist index. However, they usually neglect carry-over activities between two consecutive terms and only focus on the separate time period independently aiming local optimization in a single period, even if these models can take into account the time change effect. In the actual business world, a long time planning and investment is a subject of great concern. For these cases, single period optimization model is not suitable for performance evaluation. To cope with long time point of view, the dynamic DEA model incorporates carry-over activities into the model and enables us to measure period specific efficiency based on the long time optimization during the whole period. Dynamic DEA model proposed by Färe and Grosskopf is the first innovative contribution for such purpose. In this paper we develop their model in the slacks-based measure (SBM) framework, called dynamic SBM (DSBM). The SBM model is non-radial and can deal with inputs/outputs individually, contrary to the radial approaches that assume proportional changes in inputs/outputs. Furthermore, according to the characteristics of carry-overs, we classify them into four categories, i.e. desirable, undesirable, free and fixed. Desirable carry-overs correspond, for example, to profit carried forward and net earned surplus carried to the next term, while undesirable carry-overs include, for example, loss carried forward, bad debt and dead stock. Free and fixed carry-overs indicate, respectively, discretionary and non-discretionary ones. We develop dynamic SBM models that can evaluate the overall efficiency of decision making units for the whole terms as well as the term efficiencies.     

Queering the spinsters: single middle-class women in Norway, 1880-1920

Constituting what may be called "a community of spinsters," Norwegian middle-class unmarried woman played an important role in undermining and destabilizing the heterosexual cultural matrix during the period 1880-1920. In their anti-sexuality, self-sufficiency and hatred of men the spinsters challenged the heteronormativity of the period, and their queerness still presents a challenge to the harmony-oriented, heteromormative Norwegian women's history.     

Immigration, integration and fiscal sustainability

Economic theory points out that immigration of even low-skilled immigrants may improve public finances in Western welfare states, and it is sometimes suggested that fiscal sustainability problems in Western countries caused by ageing populations could be solved by increasing immigration. We examine consequences of various immigration scenarios using the large-scale computable general equilibrium model Danish rational economic agents model describing the Danish economy. It turns out that increased immigration will generally worsen the Danish fiscal sustainability problem. Improved economic integration of immigrants and their descendants, however, may alleviate the problems of the public sector considerably. Responsible editor: Klaus F. Zimmermann     

Egoist's dilemma: a DEA game

This paper deals with problems of consensus-making among individuals or organizations with multiple criteria for evaluating their performance when the players are supposed to be egoistic; in the sense that each player sticks to his superiority regarding the criteria. We analyze this situation within the framework or concept developed in data envelopment analysis (DEA). This leads to a dilemma called the `egoist's dilemma'. We examine this dilemma using cooperative game theory and propose a solution. The scheme developed in this paper can also be applied to attaining fair cost allocations as well as benefit–cost distributions.