Governance,Accountability, and Organizational Development: Eldercare Unit Managers’ and Local Politicians’ Experiences of and Responses to State Supervision of Swedish Eldercare

This article explores how local politicians and care unit managers in Swedish eldercare experience and respond to state supervision (SSV). Twelve politicians and twelve managers in 15 previously inspected municipalities were interviewed about their experiences of and reactions to SSV in relation to their views of care quality and routines in eldercare practice. The findings indicate that local managers and political chairs perceived SSV in eldercare positively at a superficial level but were critical of and disappointed with specific aspects of it. In terms of (a) governance, chairs and managers said SSV strengthened implementation of national policies via local actors, but they were critical of SSV’s narrow focus on control and flaws in eldercare practice. With regard to (b) accountability, SSV was seen as limited to accountability for finances and systemic performance, and regarding (c) organizational development, SSV was seen as limited to improving routines and compliance with legislation, while local definitions of quality are broader than that. In general, local actors regarded SSV as improving administrative aspects and routines in practice but ignoring the relational content of eldercare quality.     

A Coalition Perspective on Nonprofit Governance Quality: Analyzing Dimensions of Influence in an Exploratory Comparative Case Analysis

We answer the call that governance research should focus more on processes outside the boundaries of boards, especially for nonprofit organizations. In particular, we suggest and elaborate concrete steps with respect to the advantages of a leadership coalition perspective to focus more on the behavioral and informal aspects of governance. Through a comparative case analysis of five nonprofit organizations, we explore contingencies between characteristics of nonprofit leadership coalitions and governance quality. We identify two dimensions to classify leadership coalitions: centralized versus diffused influence and specific versus holistic influence. These dimensions are subsequently related with observed governance quality. We frame our finding in the existing literature on group faultlines, which are socially constructed dividing lines within groups, and we discuss the importance of establishing a balanced coalition between a weak or nonexisting and a strong dominant coalition to ensure high governance quality. We also present propositions on how governance quality and its various sub-dimensions can be studied as a complex, nonlinear intermediate concept between coalitional aspects of leadership groups and nonprofit organizational performance. Finally, we discuss concrete avenues for further testing and verification of our theoretical interpretation.     

Barriers to substance use disorder treatment in a sub-acute setting

ABSTRACT

With the changing times, it is essential integrate behavioral health within the primary care of patients. The need is based on the research that links a number of health issues being directly to substance use and mental health diagnosis. With the current opioid epidemic there is a need to address substance use disorders when treating patients in different health care settings. Despite the necessity of integrated care, there are barriers to addressing addiction in sub-acute care settings. With the lack of buy-in from the patients and health care providers and the stigma surrounding addiction it is time to address the barriers that prevents integration of care where it is most needed.     

Finding ways to the hard to reach—considerations on the content and concept of outreach work

In this article central elements and characteristics of outreach work are discussed. The empirical basis is documentation from five research circles conducted in Sweden, where outreach workers participated and put their work experiences into words. The findings from the circles are weighed against accounts from detached youth workers and it is argued that there are common methodological key components in outreach work that can be identified throughout the different contexts where the method is applied. The three main tasks of outreach work are contact making, initiating social change processes and providing social support to keep the process going. The efforts are performed in quite different surroundings, typically, however, in settings that the outreach worker does not organize or control. This has effects on how relations are built with target groups. Since outreach workers often meet people in vulnerable positions, engagement and respect are stressed as important professional qualities. Linking people to other resources is common and outreach workers need an extensive network of contacts to other organizations. The processes and situations that outreach workers engage in often have an open and unpredictable character. Managing contingency is therefore a central aspect of the work. Finally, a definition of outreach work is suggested.     

GRIND OR GAMBLE? AN EXPERIMENT ON EFFORT AND SPREAD SEEKING IN CONTESTS

We conduct a contest experiment to study if spread seeking and effort can be managed when participants can invest in increasing both the mean and the spread of an uncertain performance variable. Subjects are treated with different prize schemes and in accordance with theory, we observe higher investments in spread for the winner-take-all scheme. Both types of investments can be controlled with a three-level prize scheme. However, the control management is imperfect and behavior is characterized by inertia. We also explore the correlation between effort and spread across subjects and find that is robustly positive.     

Use and Usability of Assisted Living Facilities for the Elderly: An Observation Study in Gothenburg Sweden

To meet the demographic development, measures were initiated by the Swedish government entailing changed conditions for municipal eldercare, such as assisted living. Participant observation is used to study the daily use of common spaces in 14 assisted living units in Gothenburg. The results show examples where the current use diverges from the intended use and suggest diverging objectives and conflicts of use. The observations indicate that the degree of usability is determined by the physical environment itself in some cases, by the users and by changes in use in other cases, and by a combination of both in some cases.     

Perceived tax evasion and the importance of trust

Using Swedish individual survey data, we analyze the perception of tax evasion in terms of ten different taxes. We find large variation across taxes, highlighting the importance of studying different taxes separately rather than treating tax evasion as one common phenomenon. We focus on the importance of trust in taxpayers and in politicians. Those who do not trust their fellow citizens are more likely to believe that they are evading taxes, but distrust in politicians has an even greater effect, especially for redistributive and fiscally motivated taxes. Hence, it is important for politicians to be perceived as trustworthy in order to be able to collect taxes for maintaining the welfare state.     

Lifestyle enterprising: the ‘ambiguity work’ of Swedish horse-farmers

This article introduces the concept of ambiguity work as a specific form of work–life balancing performed when making a livelihood based on leisure interests and a personal lifestyle. The study focuses on female self-employed horse-farmers in Sweden involved in service work with and through horses. Through an analysis of narratives and practices of this service work, based on ethnographic interviews and observations, boundary negotiations of various social spheres are discernible: work and life, and the commercial and the personal. The analysis shows that the horse-farmers perform a delicate and ongoing balancing act between family interests, individual leisure and paid work. Drawing on the notion of sociological ambivalence, it is suggested that this balancing act does not strive for demarcations, but rather to stay betwixt and between social spheres. It is argued that lifestyle enterprising is enacted and confirmed through ongoing boundary negotiations, or ambiguity work, that sustain a tension between keeping and blurring social boundaries. It is further argued that ambiguity work in this type of lifestyle enterprising both reinforces and questions ideals and norms concerning small business management and professional versus nonprofessional relationships.