Quality Differences of Public,For-Profit and Nonprofit Providers in Scandinavian Welfare? User Satisfaction in Kindergartens

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - Research on differences between public, for-profit, and nonprofit providers of welfare services has provided mixed...     

How Do the Professional Lives of Family Therapists Affect their Private Relationships: A Qualitative Study

This article is based on a qualitative research project about how the professional lives of family therapists affect their private relationships. The overarching research question was: How does your professional work as a family therapist affect your private relationships? To answer this question, semi‐structured qualitative interviews were conducted with four therapists from two different Family Counseling Services. Through the use of interpretative phenomenological analysis, three main findings were identified: (1) family therapists’ knowledge and values are a basis for interpersonal encounters; (2) participants describe resonance in relation to clients’ stories; and (3) therapists can be challenged in managing confidential knowledge particularly where they belong to the same communities as clients. The study also explores societal expectations and discourses that accompany the role of therapist, which can affect therapists’ freedom of movement in their private lives. These issues are discussed in relation to family therapy theory and relevant research.     

Does educational inequality predict exercise of users' choice? Survey evidence from domiciliary care services among elderly in Oslo,Norway

The traditional goal of equality in services remains at the heart of the Scandinavian welfare model; however, in recent decades, policymakers have also placed increased emphasis on user influence over services. Voice and choice are two channels to achieve this goal. The possibility to give feedback and voicing dissatisfaction to service providers (voice) is a well-established channel of service users' influence, however it is increasingly supplemented by user choice schemes (choice), where one can choose between different public and private service providers. We use the case of domiciliary care for the elderly to examine how the traditional goal of user equality is associated with the growing emphasis on user influence through voice and choice. The analyses are based on user surveys carried out by the municipality in the city of Oslo, which is arguably the only municipality in Norway where user choice plays a significant role in elderly care. Since the municipality subsidizes the private providers, individual economic resources should have less relevance. However, voicing dissatisfaction and choosing between different providers may anticipate cognitive resources that are not equally distributed among the users. The survey data indicate that there is an association between level of education and propensity to exploit all channels of user influence. Expanding user influence by introducing user choice thus confirms the differences between highly educated and less educated.     

What works for whom? An analysis of active labour market programmes in Norway

This article examines whether some active labour market programmes (ALMP) targeted at social assistance recipients are more effective for some groups than for others in increasing self-sufficiency , i.e. gross earnings . The study focuses on the interaction between two types of programmes – employment programmes and training programmes – and the social charac-teristics of the participants. The data are derived from the pool of the entire population of social assistance recipients registered in Norway in 1995. The study adopts a quasi-experimental design. To handle selection bias, a matching procedure based on a propensity score approach is applied. Training programmes yield positive outcomes overall and for subgroups, whereas employment programmes produce no significant effects overall. However, for employment programmes there is an interaction effect between the likelihood of participation and outcome: beneficiaries with social characteristics (e.g. age, education, work experience) that are associated with a medium chance of participating experience a positive and significant increase in earnings. For those with lower and higher chances, the effect is negative. This points to the importance of conducting stratified analyses in effect evaluations. Thus, the results are also likely to be more relevant to policy makers.     

Quality of the intimate and sexual relationship in first‐time parents six months after delivery

This study aimed to describe the quality of the intimate relationship among parents six months after the birth of their first child. The Dyadic Adjustment Scale (DAS) has been modified and used on 820 responding first‐time parents, of which 768 were couples. The results reveal that most parents were happy in their relationship, but both mothers and fathers were discontented with the dyadic sexuality. “Being too tired for sexual activity “ was a problem, especially for the mothers, and the most common frequency of intercourse was once or twice per month. The result does not support the assumption that the couples compensate the lacking sexuality with sensuality. Good communication within the couple was associated with higher levels of several dimensions of the intimate relationship, especially dyadic consensus and satisfaction. Thus, one way to stabilize and strengthen a relationship when dyadic sexual activity is low would be to emphasize dyadic communication and sensual activity.     

Defining the Research Category in Pediatric Phase I Oncology Trials

Clinical research studies in children are classified by risk into three major categories. These are as follows: a) minimal risk studies, b) more than minimal risk studies but with benefit, and c) studies with minor increase over minimal risk but with no benefit.

Pediatric Phase I oncology trials, which are conducted in a highly vulnerable population of severely ill children with cancer, are designed to establish safety and to determine the maximum tolerated dose (MTD), as well as establish dose limiting toxicity (DLT). These types of studies can be associated with significant risk. The research design of such high- risk studies, which comprise short-term treatments with varying doses, is generally not associated with any clinical benefit. Classification of the research category in these pediatric studies poses a special problem for the Institutional Review Board (IRB) with major implications for the consenting process. The challenges associated with the classification of such studies are discussed in this article.     

Organizational synergy in medical groups

True synergy, as an organizational design, is uncommon in medical groups. This article addresses the experiences of a medical group that practiced an extreme form of synergy--the total equality of its physicians--since its inception almost 30 years ago. Synergy is the close coordination of the efforts and resources of individuals working together so that the performance of the whole is greater than the sum of the parts. Why use synergy in organizational design? By flattening the hierarchical levels, synergy addresses key issues of power (control, resource allocation, planning) and money (salary, bonuses, benefits), treating all physicians as equal partners. It also ensures access to the highest-quality candidates because the lure of equality, ownership, and permanence is so powerful. Synergy in medical groups works best where there is: A clearly stated mission and vision statement, as well as specific goals and objectives; careful selection of associates; a small group of between seven and nine members; a short-term duration of ten years or less; and a certain simplicity, whereby the group avoids risk-prone ventures or projects that distract it from its original mission and vision.