<p>The aim of this thesis emanated from a discussion whether voluntary associations have a choice or not regarding their democratic development. Robert Michels (1911/1983), one of the classic sociological thinkers, says no. The path towards oligarchy is inevitable. Nevertheless, maybe there are certain points, where the organizations face a certain democratic “dilemma” (Merton, 1966), forcing them more or less easily towards the oligarchic path? Seven counterarguments deriving from modern perspectives on participatory democracy (Pateman 1985; 1989) where used to find a way to avoid the oligarchic path and by that develop democracy in organizations. Since democracy also requires equality, the dissertation explored the question of power and influence in democratic organisations by studying the use of (spoken) language. Inspired by sociolinguistic theory (Milles, 2004) the aim was to identify dominance of the conversation: Who are taking part of the conversation? Are there differences between women and men in democratic organisations?</p><p>The main part of the study consists of group interviews. Members of the boards of six relatively small voluntary associations where chosen as units of analysis. Information around founding an association gathered from 75 homepages on Internet served as background data. The language as each one of the 27 board members where studied both separately and as conversation.</p><p>The conclusion is that formal structures build in hierarchal levels already when voluntary organisations take form. The dilemmas seem to revolve around the two fundamental criteria of democratic government, namely effectiveness and responsiveness are more or less explicitly stated. Awareness of dilemmas seems to be a possible way to avoid the determinism of oligarchy. The need for reinterpretation of the goals now and then could make it easier to find alternative actions. The associations have to strike a balance between effectiveness in relation to their goals and effectiveness in a democratic sense, a balance not always held. By clarifying the work and development processes of the voluntary organisations it is possible to identify (the lack of) democratic work within the organisations – a useful instrument in practice. The elite that runs the organisations is almost exclusively male and is preventing the members, especially women, from voicing their opinion. Democracy obstructs by structures demanded by society, socialised gender structures and the need of efficiency. The representatives are not always carrying out their task as elected representatives; self-interest puts before the common good.</p>

<p>Human skeletal muscles possess thixotropic, i.e. history-dependent mechanical properties. This means that the degree of passive muscle stiffness and resting tension is dependent on the immediately preceding history of contractions and length changes. Athletes, for instance, reduce passive muscle stiffness by various types of ‘limbering-up’ procedures, whereas muscle stiffness gradually increases during inactivity.</p><p>Passive resistance of antagonistic muscles may significantly add to the total load during voluntary muscle contractions. This resistance may vary from one moment to another, depending on immediately preceding events. This research was conducted to determine whether history-dependent variations in passive muscular forces influence motor control of voluntary joint movements and steady maintenance of joint positions in healthy subjects. </p><p>In study I, the EMG signal revealed motor compensations for history-dependent variations in passive stiffness of the antagonists during slow voluntary wrist joint movements. Studies II and III demonstrated that the voluntary muscle activity required to maintain a certain wrist joint position was highly influenced by previous changes in forearm muscle length and contractions. Study IV showed that rapid voluntary movements varied in speed and onset time depending on the prevailing degree of muscle resistance, and in addition that the central nervous reaction time required to execute rapid movements was highly influenced by immediately preceding muscle-conditioning procedures.</p><p>History-dependent variations in passive muscular forces seem to be effectively compensated by the motor control system. Presumably, voluntary motor commands to the muscles are automatically adjusted in strength to history-dependent changes in passive muscular forces. Such adjustments occur within the central nervous system, which receives information about the mechanical state of the muscles. Several issues in connection with muscle thixotropy remain unaddressed. For instance, do alterations in the normal thixotropic mechanical behaviour of the muscles impose a particular problem in patients with certain neuromuscular diseases? </p>

<p>This thesis aims at investigating the relationship between citizens' attempts to influence decision-making in a democracy and the representativeness of policy outcome. The question is to what extent the degree of citizen political activity, in terms of expressing policy preferences, affects: 1. The <i>policy agreement</i> between citizens and their elected representatives. 2. The <i>perceptual accuracy</i> of citizen opinions among representatives. It is argued that both policy agreement and perceptual accuracy are potentially important prerequisites to attain responsiveness in a democratic political system. The important normative question of the thesis is based on the fact that citizen's attempts to influence public decision-making often seems to be biased in favour of social groups already rich in resources. If political participation is socially biased the question is if this participation also will cause a bias in the opinions articulated towards decisionmakers and in the end also in a biased political influence.</p><p>Earlier research on the topic of this thesis has basically been limited to the classical study published by Sidney Verba and Norman H. Nie in 1972: <i>Participation in America. Political democracy and social equality.</i> In order to examine this issue further, a survey was conducted in 40 Swedish municipalities. Included was a random sample of citizen from each municipality as well as a sample including all elected councilors in the municipalities. The effects of four different channels of citizen preference articulation is examined 1) participation in local elections, 2) non-electoral political participation, 3) activities and membership in voluntary associations and 4) everyday contacts between citizens and their elected representatives.</p><p>The results of the empirical analyses show that electoral participation does not have a positive effect on either policy agreement or perceptual accuracy in Swedish municipalities. The main tendency as regards the non-electoral channels of citizen preference articulation indicates a linear and positive effect on the policy agreement between citizens and representatives but no similar positive effect on the perceptual accuracy. </p>

This paper examines the theoretical and empirical differences between the behavior of nonprofit and for-profit hospitals. Considerations are extended to include the possibility of collusion when hospitals make strategic choices. The operating objectives of the firms take into account price, quantity, and quality. Defining the quality of hospital care is discussed and applied to the empirical work. The model predicts nonprofit hospitals will provide a higher level of quality and a lower price than for-profit hospitals. Theoretically, under a collusive outcome for nonprofits, price will increase but the change in quality is indeterminate relative to a competitive, non-collusive outcome. The empirical section offers evidence of differences between nonprofit and for-profit hospital behavior. Nonprofit hospitals do provide higher quality and a lower price when compared to their for-profit rivals. It seems the competitive forces extend to the area of quality. There is evidence that increased competition between nonprofits fosters quality competition. From the for-profit perspective, quality competition appears to be provoked in markets where the for-profit competes more directly against nonprofits. This paper provides theoretical and empirical analyses of hospital interactions and how these interactions change depending upon the type of control. / Graduation date: 2001

Since Sweden has one of the most comprehensive welfare states, the role of voluntary organizations active in the field of welfare is often neglected. The unique Swedish nonprofit sector is characterized by 1) the tradition of popular mass movements in which members are central and the real owners of the organization, 2) large membership and volunteering, but low employment levels, 3) dominance in the fields of culture and recreation, but the relative marginalization in welfare. This Ph.D. dissertation empirically studies work and the perception of work in voluntary welfare organizations (VWOs) in Sweden. I completed a series of 38 interviews of employees and volunteers in four VWOs: 1) a children’s rights organization; 2) a women’s center; 3) a volunteer bureau; and 4) a humanitarian organization. A quantitative survey of some 200 VWOs supplements the qualitative data. Looking at the internal work setting and interactions between workers one realizes that work in VWOs is influenced not only by the popular mass movements (folkrörelser), which are the foundation model of all Swedish voluntary organizations, but also by paradigms emerging out of the public and for-profit sectors: 1) the public paradigm permanently shapes voluntary welfare organizations through the action of paid workers who often have public sector work experience; and 2) work in voluntary organizations is partly integrated into the regular labor market, and interfaces emerge between volunteering and professional life (for-profit paradigm). The private sphere also interferes with volunteering. Finally, this sheds a new light on the claims of VWOs that they are autonomous, “free” entities, and their contribution to social integration and strengthening of social ties.

The origin of voluntary organizations has not been studied much in sociology. This study develops a three-phase model of a voluntary organization origin and three case studies are conducted to try out the model. The aim of the study is to describe and analyze the birth of a voluntary organization and its development. The empiric material has been gathered in three voluntary organizations from the mid-80'ies. The organizations are Noaks Ark (working with HIV), 5i12-rörelsen (working with refugees) and Farsor och Morsor på Stan (working with teenagers in Stockholm city). All three organizations still exist. The empiric material has been collected though interviews and other written materials. The theoretical model is divided into three phases, the preorigin phase, the phase of origin and the maturity phase. Each phase has its special character and there is no automatic transference to the next phase. In the first phase - the preorigin phase - the key notion is the entrepreneur or the agitator. The entrepreneur or the agitator sees a problem in society. Often this is coupled with a personal experience of the problem and a desire to do something about it. They gather more knowledge in the area, meet other people and develop an idea of how to solve the problem. In the phase of origin the key notion is the organizer. The leader has to have knowledge of organizing; how to organize people and how to mobilize resources. The organizers are often charismatic and use their charisma to gather people around their idea. In the maturity phase all the distinctive marks of a voluntary organizations can be seen. The key notion is the members' need for security and continuity. The members can also develop a personal need for the organization. The dependence on the founder or the leader decreases in significance, and bureaucracy is developed. Forces outside and inside the organization influence the voluntary organization and it is shaped by its history and surrounding. It is argued that the emergence of a voluntary organization is dependent on three things that has to coincide, discontent and an idea how to relieve it, resources and an organizer. The empiric findings support the three-phase model. In theory the phases are distinctive but in the case studies the phases could overlap.

The two most controversial ends of life decisions are those in which physicians help patients take their lives and when the physician deliberately and directly intervenes to end the patients’ life upon his request. These are often referred to as voluntary euthanasia and physician assisted suicide. Voluntary euthanasia and physician assisted suicide have continued to be controversial public issues. This controversy has agitated the minds of great thinkers including ethicians, physicians, psychologists, moralists, philosophers even the patient himself. Hence the physician, patient, the public and policy makers have recently had to face several difficult questions. Is it morally right to end the life of the patients? Is there any moral difference at all between Voluntary euthanasia and physician assisted suicide? Should a terminally ill patient be allowed to take his life and should the medical profession have the option of helping the patient die. Should voluntary euthanasia and physician assisted suicide be legalised at all? And what actually will be the legal and moral implications if they are allowed. In a bid to find a lasting solution to these moral problems and questions has led to two different strong positions viz opponents and proponents of voluntary euthanasia and physician assisted suicide. The centre of my argument in this work is not to develop new general arguments for or against voluntary euthanasia and physician assisted suicide but to make a critical ethical comparative analysis of voluntary euthanasia and physician assisted suicide. This is the focus of my work. The sole aim of this work is neither to solely condemn nor to support voluntary euthanasia and physician assisted suicide but to critically analyze the two since we live in a world of pluralism.

Human skeletal muscles possess thixotropic, i.e. history-dependent mechanical properties. This means that the degree of passive muscle stiffness and resting tension is dependent on the immediately preceding history of contractions and length changes. Athletes, for instance, reduce passive muscle stiffness by various types of ‘limbering-up’ procedures, whereas muscle stiffness gradually increases during inactivity. Passive resistance of antagonistic muscles may significantly add to the total load during voluntary muscle contractions. This resistance may vary from one moment to another, depending on immediately preceding events. This research was conducted to determine whether history-dependent variations in passive muscular forces influence motor control of voluntary joint movements and steady maintenance of joint positions in healthy subjects. In study I, the EMG signal revealed motor compensations for history-dependent variations in passive stiffness of the antagonists during slow voluntary wrist joint movements. Studies II and III demonstrated that the voluntary muscle activity required to maintain a certain wrist joint position was highly influenced by previous changes in forearm muscle length and contractions. Study IV showed that rapid voluntary movements varied in speed and onset time depending on the prevailing degree of muscle resistance, and in addition that the central nervous reaction time required to execute rapid movements was highly influenced by immediately preceding muscle-conditioning procedures. History-dependent variations in passive muscular forces seem to be effectively compensated by the motor control system. Presumably, voluntary motor commands to the muscles are automatically adjusted in strength to history-dependent changes in passive muscular forces. Such adjustments occur within the central nervous system, which receives information about the mechanical state of the muscles. Several issues in connection with muscle thixotropy remain unaddressed. For instance, do alterations in the normal thixotropic mechanical behaviour of the muscles impose a particular problem in patients with certain neuromuscular diseases?

The aim of this thesis emanated from a discussion whether voluntary associations have a choice or not regarding their democratic development. Robert Michels (1911/1983), one of the classic sociological thinkers, says no. The path towards oligarchy is inevitable. Nevertheless, maybe there are certain points, where the organizations face a certain democratic “dilemma” (Merton, 1966), forcing them more or less easily towards the oligarchic path? Seven counterarguments deriving from modern perspectives on participatory democracy (Pateman 1985; 1989) where used to find a way to avoid the oligarchic path and by that develop democracy in organizations. Since democracy also requires equality, the dissertation explored the question of power and influence in democratic organisations by studying the use of (spoken) language. Inspired by sociolinguistic theory (Milles, 2004) the aim was to identify dominance of the conversation: Who are taking part of the conversation? Are there differences between women and men in democratic organisations? The main part of the study consists of group interviews. Members of the boards of six relatively small voluntary associations where chosen as units of analysis. Information around founding an association gathered from 75 homepages on Internet served as background data. The language as each one of the 27 board members where studied both separately and as conversation. The conclusion is that formal structures build in hierarchal levels already when voluntary organisations take form. The dilemmas seem to revolve around the two fundamental criteria of democratic government, namely effectiveness and responsiveness are more or less explicitly stated. Awareness of dilemmas seems to be a possible way to avoid the determinism of oligarchy. The need for reinterpretation of the goals now and then could make it easier to find alternative actions. The associations have to strike a balance between effectiveness in relation to their goals and effectiveness in a democratic sense, a balance not always held. By clarifying the work and development processes of the voluntary organisations it is possible to identify (the lack of) democratic work within the organisations – a useful instrument in practice. The elite that runs the organisations is almost exclusively male and is preventing the members, especially women, from voicing their opinion. Democracy obstructs by structures demanded by society, socialised gender structures and the need of efficiency. The representatives are not always carrying out their task as elected representatives; self-interest puts before the common good.

This thesis aims at investigating the relationship between citizens' attempts to influence decision-making in a democracy and the representativeness of policy outcome. The question is to what extent the degree of citizen political activity, in terms of expressing policy preferences, affects: 1. The policy agreement between citizens and their elected representatives. 2. The perceptual accuracy of citizen opinions among representatives. It is argued that both policy agreement and perceptual accuracy are potentially important prerequisites to attain responsiveness in a democratic political system. The important normative question of the thesis is based on the fact that citizen's attempts to influence public decision-making often seems to be biased in favour of social groups already rich in resources. If political participation is socially biased the question is if this participation also will cause a bias in the opinions articulated towards decisionmakers and in the end also in a biased political influence. Earlier research on the topic of this thesis has basically been limited to the classical study published by Sidney Verba and Norman H. Nie in 1972: Participation in America. Political democracy and social equality. In order to examine this issue further, a survey was conducted in 40 Swedish municipalities. Included was a random sample of citizen from each municipality as well as a sample including all elected councilors in the municipalities. The effects of four different channels of citizen preference articulation is examined 1) participation in local elections, 2) non-electoral political participation, 3) activities and membership in voluntary associations and 4) everyday contacts between citizens and their elected representatives. The results of the empirical analyses show that electoral participation does not have a positive effect on either policy agreement or perceptual accuracy in Swedish municipalities. The main tendency as regards the non-electoral channels of citizen preference articulation indicates a linear and positive effect on the policy agreement between citizens and representatives but no similar positive effect on the perceptual accuracy.