Empowered and self-managing users in methadone treatment?

Empowerment is a keyword in treatment. Users should have the means and possibilities to influence their treatment and become self-managing. Drawing on ethnographic fieldwork in a Danish methadone treatment project, we find that the practices of users and staff are often not carried out in accordance with governmental intentions. We identify a gap between the official notions of treatment and practices. We analyse the notions and practices of empowerment by applying two analytical perspectives. First, we apply a constructionist perspective in which empowerment is analysed as wanting to set users ‘free’ but also as ways to govern. We elaborate the analysis by applying a more practice-oriented focus. Drawing on this perspective, we analyse the ways in which staff and users constantly produce, construct and negotiate institutional practices that differ from the governmental intentions for treatment.     

How to Be a Good Alcoholic

Alcoholism is not one singular thing. It takes many forms, some more dignified and less destructive than others. This article explores how people drinking in the early hours of the day in bars present themselves and their relationship with alcohol and alcoholism. By means of ethnographic data, I analyze their strategies in dealing with the deviant use of alcohol. I find that the early morning drinkers use distinctions along three dimensions: managing drunkenness, taking breaks from drinking, and claiming certain motives for drinking. These distinctions are used in order to position oneself on a normative scale of different types of alcoholics.     

A Scoping Review of Challenges in Adult Intimate Relationships After Childhood Sexual Abuse

Childhood sexual abuse is a severe problem worldwide. Childhood sexual abuse can be detrimental to children and their abilities to cope with and communicate in their subsequent adult intimate relationships. The aim of this review was to generate and summarize knowledge about how childhood sexual abuse manifests in adult intimate relationships so healthcare professionals can incorporate this knowledge into treatment and care. A scoping review methodology was selected because it supports examination of the extent, range, and nature of research activity. A content analysis of the studies included in this review led to three thematic categories of challenges in adult intimate relationships after childhood sexual abuse: (a) relationship satisfaction, (b) sexual satisfaction, and (c) communication and trust.     

Validation of the 12 Item Short form Health Survey in a Sample from Region Central Jutland

In 2010 the Danish regions started a new program of public health surveillance in collaboration with the national and local health authorities using the short form health survey (SF-12) for measuring and reporting on health related quality of life among the Danish adult population. The instrument has not, however, been validated in a Danish setting. The aim of this study was to assess the reliability and validity of the physical component summary (PCS) and the mental component summary (MCS) score of the 12-item short form health survey (SF-12) in a sample from Central Denmark Region. A total of 26,397 persons above the age of 25 were included in the analyses. Reliability was assessed by Cronbach’s α. The validity was assessed using known-groups comparisons and convergent validity. The factor structure was investigated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Cronbach’s α showed high reliability with a score of 0.90 and 0.85 for PCS and MCS respectively. The SF-12 discriminated well with respect to gender, age, educational status and long term illness. Individual items correlated higher with own hypothesized scales than with other scales and summary measures corroborating the convergent validity. The EFA gave a two-factor structure. Irrespective of the chosen rotation method (varimax and oblimin) the items related to PCS loaded on one factor and the items related to MCS loaded on another factor. The factor structure was validated with acceptable model-fit values in CFA. The SF-12 instrument is a reliable and valid measure of health related quality of life among the population of Central Denmark Region.     

Have the relative employment prospects for the low-skilled deteriorated after all?

Has the relative unemployment propensity for the low-skilled increased during the 1990s? We address this question empirically, based on two notions of low skills; i) low education, and ii) low ability, conditioned on education and work experience. Ability is identified by previous earnings. Evaluated by the education-based measure, we find that unemployment propensity has not developed unfavourably for the low-skilled. Evaluated by the ability-based measure, it has. We uncover a steady deterioration of employment prospects for persons with low ability relative to others with similar formal qualifications. The adverse employment effects of being low-skilled are stronger the higher is formal education.All correspondence to Knut Røed. The paper is part of the project Sorting, exposed groups and labour market programs financed by the Research Council of Norway. We wish to thank Rolf Aaberge, Paul Gertler, Harald Goldstein, Karl Ove Moene, Jon Strand, Steinar Strøm, Asbjrn Rødseth and an anonymous referee for helpful comments. Responsible editor: John F. Ermisch.     

Knowledge Management Systems in Multinational Corporations: Typology and Transitional Dynamics

Knowledge Management Systems (KMSs) are becoming part of the agenda in many of today's leading firms. Through in-depth case studies of seven multinational companies (MNCs), examined over a period of four years, we identify four distinctive types of KMS - Fragmented, Content-based, Process-based and Capability-based - and their characteristics. These characteristics include both the structure, dimension and flow of the knowledge itself, and the staffing, training and reward systems in place to support the KMS. Relevant organisational factors influencing KMS design and implementation include the level of resource commitment by the headquarters, the structure of the firm, and the distribution of roles between headquarters and subsidiaries. Key external influences include the degree of environmental change and pressures to follow industry norms in technology investment. Our empirical evidence suggests that while some MNCs adopt the same type of KMS for relatively long periods of time, others transit between different KMS types. Moreover, transitions between types may follow either an increased resource commitment and augmented KMS sophistication, or a decreased resource commitment and reduced KMS complexity. Insights from the strategy-structure-process and change management literatures are utilised to examine these transitions between KMS types. Key lessons for MNC managers are provided in relation to both the initial adoption of a KMS and the handling of transitions between different systems.