State transition modeling of complex monitored health data

This article considers the analysis of complex monitored health data, where often one or several signals are reflecting the current health status that can be represented by a finite number of states, in addition to a set of covariates. In particular, we consider a novel application of a non-parametric state intensity regression method in order to study time-dependent effects of covariates on the state transition intensities. The method can handle baseline, time varying as well as dynamic covariates. Because of the non-parametric nature, the method can handle different data types and challenges under minimal assumptions. If the signal that is reflecting the current health status is of continuous nature, we propose the application of a weighted median and a hysteresis filter as data pre-processing steps in order to facilitate robust analysis. In intensity regression, covariates can be aggregated by a suitable functional form over a time history window. We propose to study the estimated cumulative regression parameters for different choices of the time history window in order to investigate short- and long-term effects of the given covariates. The proposed framework is discussed and applied to resuscitation data of newborns collected in Tanzania.     

Public transport and people with impairments – exploring non-use of public transport through the case of Oslo,Norway

abstract

Despite the attention given to universal design in recent years, many people with impairments still refrain from travelling on public transport. This explorative case study, conducted in the greater Oslo region in Norway, aims to add knowledge on why this is so. Findings indicate that insecurity while travelling and expectations of problems along the way are significant barriers. For many it is the sum of all challenges combined, from experience or anticipation that leads to non-use of public transport. The study shows that universal design policy, as of today, does not lead to accessible public transport systems that rendered impairments irrelevant. If society could safeguard the individuals’ travel needs, this might have profound societal repercussions through increased workforce participation and value added in society. Only then can society make the best use of all its inhabitants while championing inclusiveness and equality.     

Quality of Life in Intentional Communities

The present study was initiated to investigate levels and predictors of wellbeing among inhabitants of intentional communities (ICs). An anonymous, Internet-based questionnaire was distributed to US and Canadian ICs. Responses were obtained from 913 members. Wellbeing was measured by the widely used satisfaction with life scale (SWLS). Hierarchical linear regression analyses were run to test the predictive validity of Social support, Identity fusion, Meaning in life, Community satisfaction and Life change, and Religious activity above and beyond demographic variables and personality traits. Mean scores on the SWLS were estimated to 5.27 and 5.47 (1–7 scale) for men and women, respectively. The full model explained 41.4% of the variance for men and 38.2% for women. Personality explained 13.4 (men) and 14.4% (women) of the variation, while demographic variables only had a minor impact. Overall, presence of Meaning in life and Social support were the most important predictors. The IC inhabitants reported wellbeing on par with the highest scores previously published. The findings support the contention that sustainability, in the form of a communal lifestyle of low ecological footprint, may be promoted without forfeiting wellbeing.     

Young Norwegians and their views on climate change and the future: findings from a climate concerned and oil-rich nation

Young people represent the future, but little is known about their attitudes towards climate change, one of the most serious issues facing the world today. The purpose of the present study is to contribute with improved and new knowledge of young Norwegians’ understanding of and attitudes towards this issue, with a special focus on perspectives of the future. Of particular interest is the influence of divergent framings of the climate question in Norway, due to conflicting interests between the petroleum industry and climate concern. The young people's voices are elicited through two different surveys undertaken during the fall of 2013, one national (Norwegian Citizen Panel) and one local (School survey conducted among high-school students). The study generated both quantitative and qualitative findings, stemming from closed-ended as well as open-ended questions. The data were handled through a mixed methods approach, combining quantitative and qualitative analyses. The results show that the voices tend to be oriented towards the opinion that Norway has a responsibility to help poor countries as well as a duty to prevent climate change and that the country should reduce its oil production. We further observe that young Norwegians have an optimistic view of the future, based on a pronounced belief in technology and science.     

Radical alternative conceptualizations of the classical welfare state? Contrasting the United Kingdom and the Netherlands with Norway

In many countries, new, broad, and normative “conceptions of society” gained prominence that represent fundamentally different discursive alternatives to the classical welfare state. We present two political projects that contain radical alternative conceptualizations of the classical welfare state, the “Big Society” in Britain and the “Participation Society” in the Netherlands, and contrast these with Norwegian developments, where no such a radical alternative conceptualization of the welfare state can be found. We show that the British and Dutch political projects were attempts to replace the welfare state, whereas there is no comparable big idea about a radical overhaul of the welfare state in Norway. Our analysis contributes to a better understanding of a fundamental shift in welfare state reform, namely a radical reconsidering of the ideational and normative foundation that defines and underpins what the welfare state is or should be.     

Parent–child joint media engagement in infancy

Early conversations are an important source in shaping children's cognitive and emotional development, and it is vital to understand how parents use media as a platform to engage in conversations with their young children and what might predict the quality of these interactions. Thus, in the current study we explored the nature of parent–child discourse while engaging in media (i.e., joint media engagement) with infants, and how parent (empathic concern and responsiveness) and child (negative emotionality and regulatory capacity) variables might be associated with the quality of engagement. The current study consisted of 269 infants (50% female, M_age = 17.09 months, SD = 3.93; 59% White) and their primary caregiver (98% mothers) who engaged in a variety of in‐home tasks and parental questionnaires. Results established three meaningful codes for both parent and child that assessed positive and negative joint media engagement. Further, results suggested that parental empathic concern was associated with positive parent and child media engagement, while child negative emotionality was associated with lower levels of distraction. Discussion focuses on the importance of studying parent–child discourse in the context of joint media engagement and recommends limiting media exposure before 18 months of age.     

Health-Related Quality of Life Among Abused Women One Year After Leaving a Violent Partner

This is the first follow up study measuring quality of life among abused women who have left their abusive partner. The women (n = 22) answered a questionnaire while staying at women’s shelter and one year later. The aim was to examine long-term effects of intimate partner violence against women on health-related quality of life. Health-related quality of life was measured using the SF-36 Health Survey and the WHOQOL-BREF. The meantime for living in a violent partnership was 11 years, most of the women had children under 10 years living with them, low income and were on sickness absence or disability pension. About half of the women had experienced threats of violence and 6 had experienced violent acts after leaving their partner. SF-36 scores after one year were significantly better in vitality (t-test, P < 0.001), mental health (t-test P < 0.001) and social domains (t-test, P < 0.04). WHOQOL-BREF scores did not change significantly from baseline, showing that the SF-36 showed more responsiveness in this population. Regression analysis showed that serious physical violence reported at baseline predicted significantly less improvement in physical and mental health and role-emotional in the SF-36 and in social relationships and environmental health in the WHOQOL-BREF. High psychological violence at baseline predicted significantly less improvement in mental health in the SF-36 and in social relationships and environmental health in the WHOQOL-BREF.     

Maternal Work Absence: A Longitudinal Study of Language Impairment and Behavior Problems in Preschool Children

Combining work and family responsibilities is challenging when children have special needs, and mothers commonly make employment‐related adjustments. In this study, the authors examined associations between maternal work absence and child language impairment and behavior problems in preschool children. Questionnaire data at child age 3 years from 33,778 mothers participating in the prospective population‐based Norwegian Mother and Child Cohort Study were linked to national register data on employment and long‐term physician‐certified sick leave at child age 3–5 years. Mothers who reported having a child with language impairment had a consistently higher risk of not being employed and were at increased risk of taking long‐term sick leave at child age 5 years. Co‐occurring problems were associated with excess risk. Language impairments in preschool children, in particular when they are co‐occurring with behavior problems, are likely to have a range of negative short‐ and long‐term consequences for the financial and overall health and well‐being of mothers and their families.     

Parents Forever: Evaluation of an Online Divorce Education Program

Divorce education programs are conducting increasingly rigorous impact evaluations to assess if their curriculum improves parenting practices, reduces conflict in the coparenting relationship, and improves outcomes for children. This article presents a 6-month follow-up evaluation of the online version of Parents Forever, an 8-hour divorce education course developed by the University of Minnesota Extension. At follow-up, parents (N = 232) reported significant improvements on several questions about postdivorce parenting and well-being, indicating that the online version of Parents Forever is effective in promoting positive behavioral change for parents.     

The Impact of Child Behaviour Problems on Maternal Employment: A Longitudinal Cohort Study

This prospective population-based study examined associations between children’s behaviour problems and maternal employment. Information on children’s behaviour problems at 3 years from 22,115 mothers employed before pregnancy and participating in the Norwegian Mother and Child Cohort Study were linked to national register data on employment and relevant social background factors, mothers’ self-reported susceptibility to anxiety/depression and mother-reports of day-care attendance and fathers’ income. Mothers reporting their child to have severe (>2 SD) internalizing or severe combined behaviour problems (5 %) had excess risk of leaving paid employment irrespective of other important characteristics generally associated with maternal employment (RR 1.24–1.31). The attributable risk percent ranged from 30.3 % (internalizing problems) to 32.4 % (combined problems). Externalizing behaviour problems were not uniquely associated with mothers leaving employment.