Finding the best treatment under heavy censoring and hidden bias

Summary.  We analyse male survival duration after hospitalization following an acute myocardial infarction with a large ( N =11024) Finnish data set to find the best performing hospital district (and to disseminate its treatment protocol). This is a multiple-treatment problem with 21 treatments (i.e. 21 hospital districts). The task of choosing the best treatment is difficult owing to heavy right censoring (73%), which makes the usual location measures (the mean and median) unidentified; instead, only lower quantiles are identified. There is also a sample selection issue that only those who made it to a hospital alive are observed (54%); this becomes a problem if we wish to know their potential survival duration after hospitalization, if they had survived to a hospital contrary to the fact. The data set is limited in its covariates—only age is available—but includes the distance to the hospital, which plays an interesting role. Given that only age and distance are observed, it is likely that there are unobserved confounders. To account for them, a sensitivity analysis is conducted following pair matching. All estimators employed point to a clear winner and the sensitivity analysis indicates that the finding is fairly robust.     

Searching for Innovative Design: Architectural Competitions in the Silvering Swedish Welfare State

The new millennium has seen an increased interest in appropriate housing for the senior part of the Swedish population, defined as those aged 65 years and older. In 2010, the Swedish government launched a 2-year program called “Growing Old, Living Well” that targeted the living conditions of not only older people with few or some needs for homecare services, but also the smaller group of dependent and frail older persons whose everyday living depends upon regular caregiving. The program promoted architectural competitions as a tool for innovation. This article assesses the outcome of 3 architectural competitions that were carried out by 3 municipalities in accordance with the program. It concludes that existing notions about appropriate space for aging populations prevailed, since the competition briefs evolved from existing data and consequently allowed for only a low degree of innovative thinking. Hence, the relationship between architectural design and older people's age-related needs was only addressed indirectly. Further work needs to be done in the area of housing for the Swedish silvering welfare state in order for this factor to become an essential criterion for creating innovative architecture and urban design.     

跨国人口流动与族群认同——以东南亚的尼泊尔移民为例

通过对缅甸、泰国的尼泊尔移民的田野调查,探讨了跨国人口流动中的族群认同问题。在理论上,运用巴特的族群理论,批判了英美两国人类学传统上视社会和文化为孤立整体的思想,强调社会是一个无序的系统,并且不具备封闭性。而在方法论上,在国内首次阐述了好奇心在人类学田野调查中的重要作用,要求人类学工作者要以具体的人类行为和环境因素为基本研究对象;空间上外延、时间上后延来追溯研究对象的影响因素,同时以现存理论和模型为指导进行研究。     

Teenagers as Victims in the Press

Research into press reporting on young people has tended to concentrate on young people as offenders. In contrast, this article focuses on press coverage of teenagers as victims. Reports in two Swedish newspapers (a morning broadsheet and an evening tabloid) were studied over a period of four months and subjected to a qualitative analysis of discourse on teenagers as victims of various forms of violence and ill‐treatment. It was found that danger and threats to the teenagers were seen as gendered, and as emanating from their own age group and from outside the home and family. The class background of the victims was not salient and child welfare issues were seldom mentioned. Copyright © 2006 The Author(s). Journal compilation © National Children's Bureau.     

Muscle pain and coping with working life in Norway: A review

This paper reviews ongoing research initiated by the Norwegian Research Council for Science and Humanities aimed at improving Health and Living Conditions (HEMIL). Attempts to classify muscle pain states are reviewed, and the pathophysiology and psychophysiology of the condition are evaluated. The psychological aspects are emphasized, in particular relationships to coping resources, coping strateges and to what extent the individual feels able to cope with the environment. Also reviewed are multidisciplinary approaches to treatment, aimed at both psychological and physical aspects. Interventions involving physical as well as psychological training seem to have the best effects. The contribution from physical load is moderate, except for static muscle work. There is a growing concern that the response from the welfare society may produce attitudes that are counterproductive for prevention and treatment. Do we over-react and impose disease concepts on regular complaints that may be a part of normal life?.     

Divorce-risk trends in Sweden 1971–1993

The purpose of this paper is to introduce an updated system of annual indexes of divorce risks and to use the system to display trends in divorce risks for Swedish women over the years since 1971. Divorce-risk trends turn out to have been quite different for women at different parities. Trends for women in their first marriage (the majority) are also somewhat different from trends in later marriages. After a spurt in divorces at parity 0 connected with a divorce reform in 1974, divorce risks have been quite stable for women at this parity, but they have increased steadily among married mothers, mostly as an effect of an increasing prevalence of premarital childbearing. Our indexes are produced by an indirect standardization of register data with respect to women's age at marriage, duration of marriage, and order of marriage. We also recommend standardization with respect to an indicator of premarital childbearing, which is particularly important in a population with extensive nonmarital cohabitation.     

When Will the Russians Come? On Post‐Soviet Immigration and Integration in Sweden

The focus of this paper is one of the paradoxes of international migration: the unexpectedly low level of migration between neighbouring countries with large macro‐economic differentials; in this case migration from the former Soviet republics to Sweden. In line with Faist (2000) , one assumption in the study is that the dynamics of international migration are strongly influenced by the emergence of a transnational social space. Based on a database (ASTRID) containing individual information about all residents in Sweden for the period 1986–2003, the study includes an analysis of migration in relation to the transnational social space ‐‐ its bridging and adaptive functions ‐‐ including labour market integration, family situation, intermarriage, population circulation and the spatial clustering of immigrants. The study reveals an over‐representation of female immigrants and a high frequency of intermarriage among women migrants. Moreover, a changing migrant composition over the past decades was found, including a growing number of students, whereas the empirical analyses indicate a rather weak labour market position among immigrants from former Soviet republics. However, the position of recently arrived migrants has been enhanced over time, and migrants who stay for longer periods attain a stronger position on the labour market. The analyses also show an increasing number of highly educated persons among immigrants from the former Soviet republics. Furthermore, migrants from the former Soviet republics who move to Sweden tend to remain rather than return. In addition, the empirical analysis shows only minor tendencies of spatial clustering among the migrants. In sum, the study indicates that the lack of a more developed transnational social space may explain the rather low level of migration but also that the changing mobility patterns could represent an initial phase of a denser transnational social space that may trigger higher migration rates between the former Soviet republics and Sweden in the near future.     

Children with disabilities in Swedish child welfare – a differentiating and disabling practice

ABSTRACT

Research shows that children with disabilities are victims of violence and abuse to a higher extent than other children and thus need support from social services. In Sweden, cooperation between two different social services units is required to support children with disabilities in socially vulnerable families. In this study, we have examined the intersection between children and disability in a Swedish social services context from the perspective of childhood studies and disability studies. The reasoning of the two units including the child perspective emerged during focus group interviews based on two vignettes. The results show two different rationalities, which has consequences for the disabled child. In spite of a social policy where the ‘best interests of the child’ are meant to prevail and disabilities are meant to be interpreted as barriers in society, children with disabilities seem to be reduced to individuals who are lacking in ability and competency and who are profoundly victimised by power structures that favour the adult perspective in social services.     

High incidence of disability pension with a psychiatric diagnosis in western Sweden. A population-based study from 1980 to 1998

Regional differences in Sweden in the prevalence of disability pension with a psychiatric diagnosis are unexplained, in spite of the significant impact on the population's health, rehabilitation systems, and the health care system. The purpose of this study was to describe the pattern of disability pensions with a psychiatric diagnosis and to analyze the impact of age and gender. We examined the incidence rates in one urban and one semi-rural region and compared these to national rates. The study sample was drawn from employed persons between 16-64 years of age who, because of their sickness insurance coverage, would be eligible to access disability pensions should it be necessary. Analysis of annual incidences and standardized morbidity ratios were made for 1980, 1985, 1990, 1995, and 1998. Data on disability pension cases were collected from the National Social Insurance registers. In the urban region we found that the proportion of men and women clearly outnumbered the national average: approximately twice the number of persons between 16-64 years of age with a psychiatric diagnosis were receiving a disability pension. In the semi-rural region there were fewer men overall on disability pensions with psychiatric disorders, but in 1980, 1985, and 1995 women clearly outnumbered men. Access to psychiatric care, unemployment, alcohol dependence, and previous sickness absence are suggested as possible factors that might affect the rates of disability pension in different geographical settings.     

Lifestyle, harassment at work and self-assessed health of female flight attendants, nurses and teachers

Health-related lifestyle, harassment at work, and self-assessed health of female flight attendants in comparison to that of female nurses and female primary school teachers were surveyed. A higher proportion of flight attendants than nurses or teachers were smokers, 26% vs. 15% and 17% respectively; and consumed alcohol at least once a week, 40% vs. 21% and 16%. Repeated sexual harassment at work was more common among the flight attendants, 31% vs. 8% and 4%; whereas bullying, physical violence and threats were less prevalent among the flight attendants (12%) than among nurses (19%). Flight attendants were on average somewhat taller, but weighed on average less, 63.8 kg vs. 72.4 kg and 72.7 kg respectively. Repeated exposure to sexual harassment, bullying, violence and threats was related to less physical and psychological well-being in all the groups. Teachers scored on average significantly lower than did the flight attendants on general health and physical well-being, while nurses did not.