Creating a reference to a complex emergency situation using time series methods: war in Guinea-Bissau 1998-1999

Impacts of complex emergencies or relief interventions have often been evaluated by absolute mortality compared to international standardized mortality rates. A better evaluation would be to compare with local baseline mortality of the affected populations. A projection of population-based survival data into time of emergency or intervention based on information from before the emergency may create a local baseline reference. We find a log-transformed Gaussian time series model where standard errors of the estimated rates are included in the variance to have the best forecasting capacity. However, if time-at-risk during the forecasted period is known then forecasting might be done using a Poisson time series model with overdispersion. Whatever, the standard error of the estimated rates must be included in the variance of the model either in an additive form in a Gaussian model or in a multiplicative form by overdispersion in a Poisson model. Data on which the forecasting is based must be modelled carefully concerning not only calendar-time trends but also periods with excessive frequency of events (epidemics) and seasonal variations to eliminate residual autocorrelation and to make a proper reference for comparison, reflecting changes over time during the emergency. Hence, when modelled properly it is possible to predict a reference to an emergency-affected population based on local conditions. We predicted childhood mortality during the war in Guinea-Bissau 1998-1999. We found an increased mortality in the first half-year of the war and a mortality corresponding to the expected one in the last half-year of the war.     

Uncertain Numbers and Uncertainty in the Selection of Input Distributions—Consequences for a Probabilistic Risk Assessment of Contaminated Land

Risks from exposure to contaminated land are often assessed with the aid of mathematical models. The current probabilistic approach is a considerable improvement on previous deterministic risk assessment practices, in that it attempts to characterize uncertainty and variability. However, some inputs continue to be assigned as precise numbers, while others are characterized as precise probability distributions. Such precision is hard to justify, and we show in this article how rounding errors and distribution assumptions can affect an exposure assessment. The outcome of traditional deterministic point estimates and Monte Carlo simulations were compared to probability bounds analyses. Assigning all scalars as imprecise numbers (intervals prescribed by significant digits) added uncertainty to the deterministic point estimate of about one order of magnitude. Similarly, representing probability distributions as probability boxes added several orders of magnitude to the uncertainty of the probabilistic estimate. This indicates that the size of the uncertainty in such assessments is actually much greater than currently reported. The article suggests that full disclosure of the uncertainty may facilitate decision making in opening up a negotiation window. In the risk analysis process, it is also an ethical obligation to clarify the boundary between the scientific and social domains.     

Trust and health in Eastern Europe: Conceptions of a new society

Little attention has been paid to why trends and levels of mortality and morbidity differ in Eastern Europe and few studies have addressed people's own perceptions of their new political system – perceptions which per se may be important for social development. The aim of the present study was to analyse the extent to which trust and economic circumstances affect self‐rated health in Poland, Estonia and Russia and how much health differences between the countries can be explained by these factors. A better economy and higher trust were related to better individual health, while economic factors seemed most important for inter‐country differences. It is probable that both institutional factors and individual perceptions contribute to people's well‐being, but in terms of social policy, an improved welfare system may be the most effective way forward.     

Forms of gambling,gambling involvement and problem gambling: evidence from a Swedish population survey

The purpose of this study was to explore the association between problem gambling (PG) and participation in different forms of gambling in order to elucidate relationships between PG, gambling involvement and gambling intensity. Using data from the first wave of the Swedish Longitudinal Gambling Study (Swelogs) (n = 4,991), the study tested four hypotheses, namely that (1) some forms of gambling are more closely associated with PG than other forms; (2) high gambling involvement is associated with PG; (3) gambling involvement is positively associated with the intensity of gambling; and (4) the relationship between gambling involvement and PG is influenced by the specific forms of gambling in which individuals participate. All four hypotheses were supported. More specifically, the study found that while many PGs regularly participate in multiple forms of gambling, half of PGs participate regularly in only one or two forms of gambling. The study concluded that some forms of gambling are more closely associated with problem gambling than other forms, and that gambling policy and regulation, as well as the development of responsible gambling initiatives, should focus on these forms.     

Play and Imitation: Multimodal Interaction and Second-Language Development in Preschool

This article targets the multimodal character of children’s play and its potential for scaffolding second-language development. We follow children who are newcomers to a Swedish preschool and analyze their interactions. Play is, we argue, based on rules or tacit agreements between children, originating in the human capacity of imitation, and creates an opportunity to test out cultural patterns. Despite their limited language abilities, the children naturally engage in bodily play interactions where different objects are deployed. This can potentially underpin second-language development, not least when a child or teacher with better Swedish language proficiency participates.     

The impact of learning opportunities and decision authority on occupational health

In an investigation of 418 employees in the Norwegian Postal Service, employees with high learning opportunities and high decision authority were found to be better off on psychological functioning, health and organizational outcome variables than employees with low scores on these variables. Decision authority and learning opportunities had specific and independent impact on subjective health, psychological functioning, coping style and organizational outcome variables. There were, however, also interaction effects between demands, learning opportunities, and decision authority on subjective health. Learning opportunities and decision authority were operationalized with a questionnaire, supplemented with questions on the opportunities to learn skills beyond the present job situation. It is suggested that this is a particularly important dimension for coping with the present day rapid changes in working life, where the objective for many workers will be to broaden their repertoire and competence to increase their flexibility in the labour market.     

Regression Analysis of Restricted Mean Survival Time Based on Pseudo-Observations

Regression models for survival data are often specified from the hazard function while classical regression analysis of quantitative outcomes focuses on the mean value (possibly after suitable transformations). Methods for regression analysis of mean survival time and the related quantity, the restricted mean survival time, are reviewed and compared to a method based on pseudo-observations. Both Monte Carlo simulations and two real data sets are studied. It is concluded that while existing methods may be superior for analysis of the mean, pseudo-observations seem well suited when the restricted mean is studied.