In several European countries, including Norway, polices to increase patient choice of hospital provider have remained high on the political agenda. The main reason behind the interest in hospital choice reforms in Norway has been the belief that increasing choice can remedy the persistent problem of long waiting times for elective hospital care. Prior to the 2013 General Election, the Conservative Party campaigned in favour of a new choice reform: "the treatment choice reform". This article describes the background and process leading up to introduction of the reform in the autumn of 2015. It also provides a description of the content and discusses possible implications of the reform for patients, providers and government bodies. In sum, the reform contains elements of both continuity and change. The main novelty of the reform lies in the increased role of private for-profit healthcare providers.
To gain a deeper understanding of women's thoughts and experiences regarding informed choices during childbirth.
A qualitative approach with individual in-depth interviews was chosen for data collection. Ten women were interviewed three to four weeks after the birth of their first child. The transcribed interviews were analysed using systematic text condensation.
Two main themes emerged based on the analysis: "women's resources and coping abilities" and "women's abilities to make informed choices during birth". Women's resources and coping abilities influenced how they retrieved information and made their own choices. Their abilities to make informed choices during birth were influenced by the course of the birth process and the fact that they were patients and submitted to the hospitals' routines.
Instead of using the term "informed choice", women in this study discussed involvement, participation and being heard and seen as individuals. How receptive women are to information during birth varies, and midwives play an important role during pregnancy in informing and encouraging them. The relationship between women and midwives influences women's abilities to make informed choices during birth. Women need individual care and should be encouraged to have realistic expectations and to gain knowledge and confidence in their ability to give birth. A model of care in which women experience greater continuity will have an impact on their expectations, decision-making and experience of birth.
There are at least two different criteria for assessing pedophilia in men: absolute ascertainment (their sexual interest in children is intense) and relative ascertainment (their sexual interest in children is greater than their interest in adults). The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) used relative ascertainment in its diagnostic criteria for pedophilia; this was abandoned and replaced by absolute ascertainment in the DSM-III-R and all subsequent editions. The present study was conducted to demonstrate the continuing need for relative ascertainment, particularly in the laboratory assessment of pedophilia. A total of 402 heterosexual men were selected from a database of patients referred to a specialty clinic. These had undergone phallometric testing, a psychophysiological procedure in which their penile blood volume was monitored while they were presented with a standardized set of laboratory stimuli depicting male and female children, pubescents, and adults.The 130 men selected for the Teleiophilic Profile group responded substantially to prepubescent girls but even more to adult women; the 272 men selected for the Pedophilic Profile group responded weakly to prepubescent girls but even less to adult women. In terms of absolute magnitude, every patient in the Pedophilic Profile group had a lesser penile response to prepubescent girls than every patient in the Teleiophilic Profile group. Nevertheless, the Pedophilic Profile group had a significantly greater number of known sexual offenses against prepubescent girls, indicating that they contained a higher proportion of true pedophiles. These results dramatically demonstrate the utility-or perhaps necessity-of relative ascertainment in the laboratory assessment of erotic age-preference.
In 1988, Becker and Murphy [Becker, G.S., Murphy, K.M., 1988. A theory of rational addiction. Journal of Political Economy, 96, 675-700.] launched a theory in which they proposed that the perspective of rational decision-making could be applied also to cases of addictive behaviour. This paper discusses the theory's assumptions of interpersonal variation and stability in time preferences on the basis of estimates derived from three groups of people with different consumption levels of illegal intoxicants. We find that active injectors of heroin and amphetamine have a higher discount rate than a group reporting that they have never used the substances. Of greater interest, though not in accordance with Becker and Murphy's assumption of stability, we also find that the discount rate among active and former users differs significantly. These findings raise the question of whether a high time-preference rate leads to addiction or whether the onset of an addiction itself alters people's inter-temporal equilibrium.
According to the 'good genes' hypothesis, females choose males based on traits that indicate the male's genetic quality in terms of disease resistance. The 'immunocompetence handicap hypothesis' proposed that secondary sexual traits serve as indicators of male genetic quality, because they indicate that males can contend with the immunosuppressive effects of testosterone. Masculinity is commonly assumed to serve as such a secondary sexual trait. Yet, women do not consistently prefer masculine looking men, nor is masculinity consistently related to health across studies. Here, we show that adiposity, but not masculinity, significantly mediates the relationship between a direct measure of immune response (hepatitis B antibody response) and attractiveness for both body and facial measurements. In addition, we show that circulating testosterone is more closely associated with adiposity than masculinity. These findings indicate that adiposity, compared with masculinity, serves as a more important cue to immunocompetence in female mate choice.
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Six hundred young adolescents (11 to 16 years old) from 4 countries (Guatemala, Iceland, Mexico, and the United States) ranked the importance of 10 qualities of the opposite-sex ideal person. Those from the United States responded in an individualistic fashion; they ranked being fun, being sexy, and having considerable money as important for the ideal. Those from Guatemala responded in a collectivistic fashion; they ranked liking children as important, but being fun and good looking as unimportant. Adolescents from Mexico and Iceland reported patterns of values not clearly associated with either collectivism or individualism.
Predatory species' usage of different prey types is affected by both prey availability and selectivity. The diet during the breeding season may affect the reproductive success of individual pairs. We studied the prey use of a small reversed size-dimorphic raptor, the Eurasian sparrowhawk Accipiter nisus, with respect to prey weight on two organizational levels. Using 13 years of data from southern Norway, we related reproductive output of individual breeding events to prey size taken. Further, we assessed the regional variation in prey usage between five Fennoscandian populations. This was done by fitting optimum-type functions to the prey species' numbers or relative predation risks. Pairs that successfully completed the season with more fledglings displayed less variation in prey size, suggesting a possible adaptive benefit of diet specialism, or possibly a correlative effect due to higher prey availability or lower female hunting effort. This finding contrasts with earlier raptor studies, which have suggested benefits of dietary (and hence nutritional) diversity. Indeed, our results might be limited to nutritionally substitutable prey items. We also found a tendency suggesting that older females raised more fledglings than 1-year-old females. In the population-level analysis, we found that optimum-type functions with constant width and spatially variable average best described the relationship between relative predation risk and log weight. This can reflect local conditions, such as prey availability. Our findings and new methodological tools could apply to a broader spectrum of predators. They also highlight the role of viewing usage or choice of prey at several spatial scales.
The role of lifestyle choices in explaining how socioeconomic inequalities in health vary with age has received little attention. This study explores how the income and education gradients in both important lifestyle choices and self-assessed health (SAH) vary with age. Repeated cross-sectional data from Norway (n=25,016) and logistic regression models are used to track the income and education gradients in physical activity, smoking, consumption of fruit and vegetables and SAH over the age range 25-79 years. The education gradient in smoking, the income gradient in consumption of fruit and vegetables and the education gradient in physical activity among males become smaller at older ages. Physical activity among females is the only lifestyle indicator in which the income and education gradients grow stronger at older ages. In conclusion, this study shows that income and education gradients in lifestyle choices may not remain constant, but vary with age, and such variation could be important in explaining corresponding age patterns of inequality in health.
Socioemotional selectivity theory postulates that, as people age, they prioritize emotionally meaningful goals. This study investigated whether these age differences in goals are reflected in how younger (aged 18-36, n = 111) and older adults (aged 62-86, n = 104) evaluated, remembered information from and were persuaded by health messages.
Participants were randomly assigned to read health pamphlets with identical factual information but emphasizing emotional or non-emotional goals.
Findings showed that health messages that emphasized emotional goals, but not those that emphasized future-oriented or neutral goals, were better remembered, were evaluated more positively and led to greater behavioral changes among older adults, but not younger adults.
These findings suggest that health messages targeting older adults may be more effective if they are framed in ways that emphasize love and caring.
In recent years, the notion of individual responsibility for one's health has been introduced into Swedish medico-political debate. Formerly expressed as a recommendation, it has now taken on the form of expectations. In a Swedish context, this shift from collective to individual responsibility is novel because it implies a break with well-established welfare state practice of comprehensive care for their citizens. Using a systems-theoretical approach, we interpret this shift of expectations as a political solution to the problem of legitimate allocation of scarce resources. A more inclusive medical conception of illness has facilitated the introduction of many new diagnoses that, in turn, have lead to a strong increase in claims for medical treatment and for compensation. This semantic change in medicine aggravates the budgetary situation of the welfare state. The political solution lies in a reorientation of the expectations the medical system can have on citizens as well as a shift of the expectations regarding the rights and obligations citizens can have on the medical system. Individuals are increasingly expected to live healthy lifestyles and to avoid hazardous habits. If they do not live up to these expectations, they have to face low prioritisation or denial of treatment.