Different levels of policy change: A comparison between the public discussion on social security in Sweden and in Finland

The deep economic recession that hit Sweden and Finland at the beginning of the 90s, and the fall in public revenues and rapidly growing public debts that followed on it, triggered a development of cutbacks and restructuring measures which has resulted in a scientific debate over what this has meant for these countries’ systems of social policy, traditionally resting on the Nordic welfare state paradigm. In this connection, questions of to what extent changes made can be ascribed mainly to the economic constraints posed by the recession at all, or rather, to other more long-term societal trends or phenomena, including globalisation, European integration and/or ideational or ideological shifts among influential (elite) groups, have often been touched upon. Applying an ideas-centred approach, this paper attempts to contribute to the knowledge on the reasoning of influential elite societal groups in social policy issues before, during and after the 90’s recession, by empirically analysing their statements on social security made in the press. A distinction is made between three different levels of proposed policy changes, reaching from minor alterations of single programs to changes of the policy paradigm. Results show that the 1990s did not only mean the emergence of suggestions for minor cutbacks in and alterations of prevailing programmes. The share of suggestions implying de facto a (further) departure from the basic features of the social security system also showed that the model was under continuous pressure throughout the 90s. However, many of the changes suggested were not justified by any clear references to a policy paradigm in either country (or not justified at all). Instead, references to “purely” structural justifications did become more common over time. In this respect, as regards social security, our results cannot confirm the fairly popular notion among many researchers of a clearly ideological attack on the welfare state. However, it remains uncertain whether and to what extent the increased proportion of references to “structural realities” in the 90s should be interpreted as an indication of a change in the idea of what the welfare state is and what the goals behind it are. Results further show that the patterns of the discussion in the two countries studied bore a remarkable resemblance at a general level, whereas there are indications of differences in the driving forces behind suggestions for similar reforms in these two countries.

Running Head: Social Work Developments in Lithuania

Following the end of a half-century of Soviet occupation, Lithuania, like other former Soviet republics, has been in socio-economic disorder. Now that Lithuania is free, the system of social welfare is characterized by under-funded health services and pensions, and a large number of institutions. Semi-structured interviews were conducted with students and practitioners focusing on community development, using Lofland’s model of social setting analysis.Results indicate that the collaborative efforts successfully produced a revolutionary and successful social service program, a multi-generational living facility offering full-time social services to unwed mothers, infants, and elderly residents.This article is based upon the qualitative study of social work practitioners and social work students and chronicles the successes and difficulties encountered within the process of community development.

Market, Management and Profession. Social Business in the Polder

In a recent policy document of the organized employers in the care and welfare sector in The Netherlands (the MO Group), directors and board members of care and welfare institutions present themselves as "social entrepreneurs", managing their institutions as look-a like commercial companies. They are hardly criticized and there is not any countervailing power of significance. The workers are focusing on their own specialized professional fields and divided as a whole. Many government officials are in favour or do not bother. The relatively small number of intellectual workers in Dutch care and welfare are fragmented and pragmatic. From a democratic point of view this is a worrying situation. From a professional point of view the purpose and functions of professional care and welfare work are at stake. The penetration of market mechanisms and the take-over by commercially orientated managers result from unquestioned adaptation of Anglo-Saxon policy in The Netherlands in the 1990's, following the crisis of the Welfare State in the late 1980's. The polder country is now confronted fully with the pressure and negative effects of unbalanced powers in the institutions, i.e. Managerialism. After years of silence, the two principal authentic critics of Dutch care and welfare, Harry Kunneman and Andries Baart, are no longer voices crying in the wilderness, but are getting a response from a growing number of worried workers and intellectuals. Kunneman and Baart warn against the restriction of professional space and the loss of normative values and standards in the profession. They are right. It is high time to make room for criticism and to start a debate about the future of the social professions in The Netherlands, better: in Europe. Research, discussion and action have to prove how worrying the everyday situation of professional workers is, what goals have to be set and what strategy to be chosen.

The Development of Social Work as a Speciality and the Profession in Estonia

For Estonia and its people social work is one of the vitally important fields that had to be built up from almost nothing since independence was regained in 1991. During Soviet times social work and social workers did not receive the necessary attention. Severe social problems were denied and kept hidden since according to official communist ideology, life in the Soviet Union was the best in the world and getting better all the time. Social workers did not receive specialised education and their functions were to be carried out by the workers of trade unions and the party, by teachers and by the workers of the personnel departments. In the 1990s big changes, having also an effect on social life, took place in the development of Estonian society. Concepts such as social work and social worker were rediscovered in Estonia. There are certain prerequisites for the success of any activity (including social work). One of the most important ones is being a professional, a worker with thorough preparation. Social work as an occupation requires specialised academic education, which is based on theoretical knowledge and practical skills that have been acquired through theoretical knowledge. Specialised knowledge is a foundation for attaining a specialised qualification. However, at the same time one has to keep in mind that social work as an occupation is constantly changing, there is no absolute knowledge - everything is relative, dynamic and changing (Tamm, 1998). The changing nature of the activity requires reflection by a social worker, who also has to be able to evaluate his/her work and its basis and learn from experiences. Academic specialised education implies also the development of a new professional identity and higher levels of competence. This underlines the necessity of specialised education.

New Initiative on postgraduate developments in social work in Europe

In September 2004 five European Schools for social work started to develop an international doctoral studies program in social work. The initiative came from the Faculty of Social Work Ljubljana and the meeting was held in Ljubljana, Slovenia. The partners designed a mission statement which is now published for the first time.

De-Territorialization and Re-Territorialization of “the social”. A debate

Deterritorialization has been used as an anthropological concept to designate the weakened ties between culture and place: Certain cultural/social processes and relations seem to increasingly transcend their previously given territorial boundaries in flexible capitalist societies. At the same time, policy studies, especially Studies on Governmentality, have emphasized the re-territorialization of the social, in which the former national welfare arrangements (welfare and nation state) as the scale of bio-political integration patterns are more and more substituted by small scaled inclusion areas (e.g. neighbourhoods, districts and communities). Drawing on Deleuze and Guattari, de-territorialization processes have therefore always to be understood as combined with processes of a re-territorialization, producing new spatial formations. In this view, spatial arrangements and connections are not given and static structures, but controversial and unstable – nevertheless they are influential.

Comments on Kevin Stenson’s ‘Governing the Local: Sovereignty, Social Governance and Community Safety’

It is a challenging time to be a social scientist. Many of the concepts and categories we took for granted have been revealed as temporally and geographically specific. It is now widely accepted that the nation-state is no longer the sole container for economic, political and social processes, if indeed it ever was. This is where Kevin Stenson begins his paper. He traces the re-ordering of both state and nation, highlighting recent discussions about the unbundling and rescaling of the state and outlining how increasing ethnic and cultural diversity challenge homogeneous conceptions of the nation. In Stenson’s account these are largely empirical processes that are the basis for the important questions he raises about changing understandings of publics and social order, and their implications for the local governance of community safety. He contrasts two alternative positions; the ‘universal human rights position’ which refuses to privilege the interests of majority populations, and a more ‘communitarian and nationalistic position’ which he argues is most likely to be deployed by right wing politicians and interests groups. Drawing from extensive research in the Thames Valley region of the United Kingdom, he shows how these two understandings have both shaped the local policy response to crime and disorder.

Social Structural Effects on the Level and Development of the Individual Experience of Anomie in the German Population

Can one observe an increasing level of individual lack of orientation because of rapid social change in modern societies? This question is examined using data from a representative longitudinal survey in Germany conducted in 2002–04. The study examines the role of education, age, sex, region (east/west), and political orientation for the explanation of anomia and its development. First we present the different sources of anomie in modern societies, based on the theoretical foundations of Durkheim and Merton, and introduce the different definitions of anomia, including our own cognitive version. Then we deduce several hypotheses from the theory, which we test by means of longitudinal data for the period 2002–04 in Germany using the latent growth curve model as our statistical method. The empirical findings show that all the sociodemographic variables, including political orientation, are strong predictors of the initial level of anomia. Regarding the development of anomia over time (2002–04), only the region (west) has a significant impact. In particular, the results of a multi-group analysis show that western German people with a right-wing political orientation become more anomic over this period. The article concludes with some theoretical implications.

The Implementation of Full-time Schools: The Situation in the Federal State of Sao Paulo (Brazil)

During the past years, Brazil has been mentioned internationally as a one of the so-called BRICs (Brazil, Russia, India and China). These countries have been taking increasing space in the economical and political global scenarios in the XXI century. The facts that they possess a vast territory and stand among the highest populated countries increase their relevance within the United Nations. Besides, three of them constitute nuclear powers and two of them belong to the United Nations Security Council. Brazil has significantly participated in forums such as WTO and UNO, representing central political articulation and stability to Latin America and in the structuring and growth of MERCOSUL (Brazil, Argentina, Uruguay, Paraguay and Venezuela). Once again among the ten greatest economies of the world, the country has launched ambitious poverty-fighting programs helping more than 20 million people in the last years, such as the “Bolsa Família” (Familienstipendium) Program or and its complements). Nevertheless, Latin American countries are far from generating structural funds as the “European Social Fund” to assist specific demands of big cities as Sao Paulo and Buenos Aires. The commitments are restricted to commercial areas and bring nothing but slow and scarce advances to education or infra-structure and to the integration of systems related to these areas.

Semiotic Analysis in the Study of Social Work

Research and professional practices have the joint aim of re-structuring the preconceived notions of reality. They both want to gain the understanding about social reality. Social workers use their professional competence in order to grasp the reality of their clients, while researchers’ pursuit is to open the secrecies of the research material. Development and research are now so intertwined and inherent in almost all professional practices that making distinctions between practising, developing and researching has become difficult and in many aspects irrelevant. Moving towards research-based practices is possible and it is easily applied within the framework of the qualitative research approach (Dominelli 2005, 235; Humphries 2005, 280). Social work can be understood as acts and speech acts crisscrossing between social workers and clients. When trying to catch the verbal and non-verbal hints of each others’ behaviour, the actors have to do a lot of interpretations in a more or less uncertain mental landscape. Our point of departure is the idea that the study of social work practices requires tools which effectively reveal the internal complexity of social work (see, for example, Adams & Dominelli & Payne 2005, 294 – 295). The boom of qualitative research methodologies in recent decades is associated with much profound the rupture in humanities, which is called the linguistic turn (Rorty 1967). The idea that language is not transparently mediating our perceptions and thoughts about reality, but on the contrary it constitutes it was new and even confusing to many social scientists. Nowadays we have got used to read research reports which have applied different branches of discursive analyses or narratologic or semiotic approaches. Although differences are sophisticated between those orientations they share the idea of the predominance of language. Despite the lively research work of today’s social work and the research-minded atmosphere of social work practice, semiotics has rarely applied in social work research. However, social work as a communicative practice concerns symbols, metaphors and all kinds of the representative structures of language. Those items are at the core of semiotics, the science of signs, and the science which examines people using signs in their mutual interaction and their endeavours to make the sense of the world they live in, their semiosis. When thinking of the practice of social work and doing the research of it, a number of interpretational levels ought to be passed before reaching the research phase in social work. First of all, social workers have to interpret their clients’ situations, which will be recorded in the files. In some very rare cases those past situations will be reflected in discussions or perhaps interviews or put under the scrutiny of some researcher in the future. Each and every new observation adds its own flavour to the mixture of meanings. Social workers have combined their observations with previous experience and professional knowledge, furthermore, the situation on hand also influences the reactions. In addition, the interpretations made by social workers over the course of their daily working routines are never limited to being part of the personal process of the social worker, but are also always inherently cultural. The work aiming at social change is defined by the presence of an initial situation, a specific goal, and the means and ways of achieving it, which are – or which should be – agreed upon by the social worker and the client in situation which is unique and at the same time socially-driven. Because of the inherent plot-based nature of social work, the practices related to it can be analysed as stories (see Dominelli 2005, 234), given, of course, that they are signifying and told by someone. The research of the practices is concentrating on impressions, perceptions, judgements, accounts, documents etc. All these multifarious elements can be scrutinized as textual corpora, but not whatever textual material. In semiotic analysis, the material studied is characterised as verbal or textual and loaded with meanings. We present a contribution of research methodology, semiotic analysis, which has to our mind at least implicitly references to the social work practices. Our examples of semiotic interpretation have been picked up from our dissertations (Laine 2005; Saurama 2002). The data are official documents from the archives of a child welfare agency and transcriptions of the interviews of shelter employees. These data can be defined as stories told by the social workers of what they have seen and felt. The official documents present only fragmentations and they are often written in passive form. (Saurama 2002, 70.) The interviews carried out in the shelters can be described as stories where the narrators are more familiar and known. The material is characterised by the interaction between the interviewer and interviewee. The levels of the story and the telling of the story become apparent when interviews or documents are examined with the use of semiotic tools. The roots of semiotic interpretation can be found in three different branches; the American pragmatism, Saussurean linguistics in Paris and the so called formalism in Moscow and Tartu; however in this paper we are engaged with the so called Parisian School of semiology which prominent figure was A. J. Greimas. The Finnish sociologists Pekka Sulkunen and Jukka Törrönen (1997a; 1997b) have further developed the ideas of Greimas in their studies on socio-semiotics, and we lean on their ideas. In semiotics social reality is conceived as a relationship between subjects, observations, and interpretations and it is seen mediated by natural language which is the most common sign system among human beings (Mounin 1985; de Saussure 2006; Sebeok 1986). Signification is an act of associating an abstract context (signified) to some physical instrument (signifier). These two elements together form the basic concept, the “sign”, which never constitutes any kind of meaning alone. The meaning will be comprised in a distinction process where signs are being related to other signs. In this chain of signs, the meaning becomes diverged from reality. (Greimas 1980, 28; Potter 1996, 70; de Saussure 2006, 46-48.) One interpretative tool is to think of speech as a surface under which deep structures – i.e. values and norms – exist (Greimas & Courtes 1982; Greimas 1987). To our mind semiotics is very much about playing with two different levels of text: the syntagmatic surface which is more or less faithful to the grammar, and the paradigmatic, semantic structure of values and norms hidden in the deeper meanings of interpretations. Semiotic analysis deals precisely with the level of meaning which exists under the surface, but the only way to reach those meanings is through the textual level, the written or spoken text. That is why the tools are needed. In our studies, we have used the semiotic square and the actant analysis. The former is based on the distinctions and the categorisations of meanings, and the latter on opening the plotting of narratives in order to reach the value structures.

Social-Software-Portfolios im Einsatz

Die Dissertationsschrift widmet sich der Erforschung des Online-Lernens mittels Weblogs unter Anwendung der E-Portfolio Methode als einer seit mehreren Jahren verstärkt aufkommenden Lern- und Präsentationsform im Bildungskontext. Über mehrere Lehrveranstaltungen des Studiengangs "Angewandte Medien- und Kommunikationswissenschaft" an der Technischen Universität Ilmenau hinweg wurden drei Fallstudien gebildet. Innerhalb dieser wurde das Führen von eigenen E-Portfolio Blogs durch Studierende über einen Zeitraum von etwa drei Jahren evaluiert. Als Evaluationsziel wurde anhand spezifischer Fragestellungen ermittelt, wie das damit einhergehende selbstgesteuert-konnektive Lernen zu entsprechendem Erfolg führen kann. Hierbei wurde insbesondere die Teildimension Medienkompetenz im Spannungsfeld von Lernaktivität, Wissenserwerb und Informations-/Wissensmanagement betrachtet sowie weitere intervenierende Variablen, wie zum Beispiel Aufwand oder Akzeptanz, berücksichtigt. Inhaltlich wurden zunächst begriffliche Grundlagen dargestellt, die Nutzung von E-Portfolios in Theorie und Praxis beschrieben, Medienkompetenz-Ansätze detailliert aufgezeigt sowie in den Kontext von E-Portfolios gebracht und schließlich eine umfangreiche Analyse des Forschungsstandes aufbereitet. Diese gingen mit Erkenntnissen aus einer qualitativen Vorstudie in Form von fünf leitfadengestützten Experteninterviews einher. Die darauf aufbauende Hauptstudie widmete sich anschließend der Erhebung und Auswertung quantitativer Daten anhand von Online-Befragungen mit den Studierenden zu fünf Zeitpunkten aus intra- und interindividueller Perspektive. Als markanteste empirische Erkenntnis der Arbeit kann festgehalten werden, dass es durch das selbstgesteuert-konnektive Lernen mit E-Portfolio Blogs zu einer nachhaltigen Förderung der Medienkompetenz kommt, die sich auch in signifikanten Zusammenhängen mit den anderen Teildimensionen und intervenierenden Variablen widerspiegelt. Darüber hinaus bieten sich aber auch Potenziale für eine steigende Lernaktivität, einen ansteigenden Wissenserwerb und ein verbessertes Informations-/Wissensmanagement, die es aber noch weiterführend zu erforschen gilt. Demgegenüber können allerdings der entstehende und kontinuierlich hohe Aufwand sowie die erforderliche (Eigen-) Motivation als entscheidende Herausforderungen dieser Lernmethode identifiziert werden.

Design and Impact of Awareness Functions – A Study about Social Media in Virtual Teams

The usage of social media in leisure time settings has become a prominent research topic. However, less research has been done on the design of social media in collaboration settings. In this study, we investigate how social media can support asynchronous collaboration in virtual teams and specifically how they can increase activity awareness. On the basis of an open source social networking platform, we present two prototype designs: a standard platform with basic support for information processing, communication and process – as suggested by Zigurs and Buckland (1998) – and an advanced platform with additional support for activity awareness via specialfeed functions. We argue that the standard platform already conveys activity awareness to a certain extent, however, that this awareness can be increased even more by the feeds in the advanced platform. Both prototypes are tested in a field experiment and evaluated with respect to their impact on perceived activity awareness, coordination and satisfaction. We show that the advanced design increases coordination and satisfaction through increased perceived activity awareness.

A shift from oral to intravenous iron supplementation therapy is observed over time in a large swiss cohort of patients with inflammatory bowel disease

BACKGROUND In 2007, leading international experts in the field of inflammatory bowel disease (IBD) recommended intravenous (IV) iron supplements over oral (PO) ones because of superior effectiveness and better tolerance. We aimed to determine the percentage of patients with IBD undergoing iron therapy and to assess the dynamics of iron prescription habits (IV versus PO). METHODS We analyzed anonymized data on patients with Crohn's disease and ulcerative colitis extracted from the Helsana database. Helsana is a Swiss health insurance company providing coverage for 18% of the Swiss population (1.2 million individuals). RESULTS In total, 629 patients with Crohn's disease (61% female) and 398 patients with ulcerative colitis (57% female) were identified; mean observation time was 31.8 months for Crohn's disease and 31.0 months for ulcerative colitis patients. Of all patients with IBD, 27.1% were prescribed iron (21.1% in males; 31.1% in females). Patients treated with steroids, immunomodulators, and/or anti-tumor necrosis factor drugs were more frequently treated with iron supplements when compared with those not treated with any medications (35.0% versus 20.9%, odds ratio, 1.94; P < 0.001). The frequency of IV iron prescriptions increased significantly from 2006 to 2009 for both genders (males: from 2.6% to 10.1%, odds ratio = 3.84, P < 0.001; females: from 5.3% to 12.1%, odds ratio = 2.26, P = 0.002), whereas the percentage of PO iron prescriptions did not change. CONCLUSIONS Twenty-seven percent of patients with IBD were treated with iron supplements. Iron supplements administered IV were prescribed more frequently over time. These prescription habits are consistent with the implementation of guidelines on the management of iron deficiency in IBD.

Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner

BACKGROUND & AIMS Development of strictures is a major concern for patients with eosinophilic esophagitis (EoE). At diagnosis, EoE can present with an inflammatory phenotype (characterized by whitish exudates, furrows, and edema), a stricturing phenotype (characterized by rings and stenosis), or a combination of these. Little is known about progression of stricture formation; we evaluated stricture development over time in the absence of treatment and investigated risk factors for stricture formation. METHODS We performed a retrospective study using the Swiss EoE Database, collecting data on 200 patients with symptomatic EoE (153 men; mean age at diagnosis, 39 ± 15 years old). Stricture severity was graded based on the degree of difficulty associated with passing of the standard adult endoscope. RESULTS The median delay in diagnosis of EoE was 6 years (interquartile range, 2-12 years). With increasing duration of delay in diagnosis, the prevalence of fibrotic features of EoE, based on endoscopy, increased from 46.5% (diagnostic delay, 0-2 years) to 87.5% (diagnostic delay, >20 years; P = .020). Similarly, the prevalence of esophageal strictures increased with duration of diagnostic delay, from 17.2% (diagnostic delay, 0-2 years) to 70.8% (diagnostic delay, >20 years; P < .001). Diagnostic delay was the only risk factor for strictures at the time of EoE diagnosis (odds ratio = 1.08; 95% confidence interval: 1.040-1.122; P < .001). CONCLUSIONS The prevalence of esophageal strictures correlates with the duration of untreated disease. These findings indicate the need to minimize delay in diagnosis of EoE.

Accounting for baseline differences and measurement error in the analysis of change over time

If change over time is compared in several groups, it is important to take into account baseline values so that the comparison is carried out under the same preconditions. As the observed baseline measurements are distorted by measurement error, it may not be sufficient to include them as covariate. By fitting a longitudinal mixed-effects model to all data including the baseline observations and subsequently calculating the expected change conditional on the underlying baseline value, a solution to this problem has been provided recently so that groups with the same baseline characteristics can be compared. In this article, we present an extended approach where a broader set of models can be used. Specifically, it is possible to include any desired set of interactions between the time variable and the other covariates, and also, time-dependent covariates can be included. Additionally, we extend the method to adjust for baseline measurement error of other time-varying covariates. We apply the methodology to data from the Swiss HIV Cohort Study to address the question if a joint infection with HIV-1 and hepatitis C virus leads to a slower increase of CD4 lymphocyte counts over time after the start of antiretroviral therapy.