Disappearance of leprosy from Norway: an exploration of critical factors using an epidemiological modelling approach

BACKGROUND: By the middle of the 19th century, leprosy was a serious public health problem in Norway. By 1920, new cases only rarely occurred. This study aims to explain the disappearance of leprosy from Norway. METHODS: Data from the National Leprosy Registry of Norway and population censuses were used. The patient data include year of birth, onset of disease, registration, hospital admission, death, and emigration. The Norwegian data were analysed using epidemiological models of disease transmission and control. RESULTS: The time trend in leprosy new case detection in Norway can be reproduced adequately. The shift in new case detection towards older ages which occurred over time is accounted for by assuming that infected individuals may have a very long incubation period. The decline cannot be explained fully by the Norwegian policy of isolation of patients: an autonomous decrease in transmission, reflecting improvements in for instance living conditions, must also be assumed. The estimated contribution of the isolation policy to the decline in new case detection very much depends on assumptions made on build-up of contagiousness during the incubation period and waning of transmission opportunities due to rapid transmission to close contacts. CONCLUSION: The impact of isolation on interruption of transmission remains uncertain. This uncertainty also applies to contemporary leprosy control that mainly relies on chemotherapy treatment. Further research is needed to establish the impact of leprosy interventions on transmission

Teaching and Assessing Engineering Design Thinking with Virtual Internships and Epistemic Network Analysis

An engineering workforce of sufficient size and quality is essential for addressing significant global challenges such as climate change, world hunger, and energy demand. Future generations of engineers will need to identify challenging issues and design innovative solutions. To prepare young people to solve big and increasingly global problems, researchers and educators need to understand how we can best educate young people to use engineering design thinking. In this paper, we explore virtual internships, online simulations of 21st-century engineering design practice, as one method for teaching engineering design thinking. To assess the engineering design thinking, we use epistemic network analysis (ENA), a tool for measuring complex thinking as it develops over time based on discourse analysis. The combination of virtual internships and ENA provides opportunities for students to engage in authentic engineering design, potentially receive concurrent feedback on their engineering design thinking, and develop the identity, values, and ways of thinking of professional engineers

Design of a Professional Practice Simulator for Educating and Motivating First-Year Engineering Students

Increasingly, first-year engineering curricula incorporate design projects. However, the faculty and staff effort and physical resources required for the number of students enrolled can be daunting and affect the quality of instruction. To reduce these costs, ensure a high quality educational experience, and reduce variability in student outcomes that occur with individual design projects, we developed a simulation of engineering professional practice, NephroTex, in which teams of students are guided through multiple design-build-test cycles by a mentor in a virtual internship. Here we report on the design process for the virtual internship and results of testing with first-year engineering students at a large, public university. Our results demonstrate that the novel virtual internship successfully educated and motivated first-year-engineering students. Importantly, the virtual environment captures rich discourse that can be used to assess the process of student learning with tools from existing learning theory

The Psychological and HRQoL related Aftermaths of Extra Corporeal Membrane Oxygenation Treatment: A Cross‐Sectional Study

Objectives: To assess symptoms of post-traumatic stress disorder, anxiety, depression and health related quality of life in a sample of adult patients treated with veno-arterial extracorporeal membrane oxygenation. Design and setting: This is a cross-sectional study. The population were all patients discharged (2008–2018) from a thoracic surgical intensive ward at a tertiary university hospital in Norway. A sample of 20 patients was recruited. Main outcome measures: Symptoms of post-traumatic stress disorder were assessed using Impact of Events Scale-Revised, while symptoms of depression and anxiety were assessed using Hospital Anxiety and Depression Scale. RAND 36-Item Short Form Health Survey was applied to measure health-related quality of life. Results: Symptoms of post-traumatic stress disorder were reported by 40% of the participants. Twenty percent reported symptoms of depression and anxiety. Compared to the general population, participants reported poorer health-related quality of life on all domains, and significantly worse on the domains physical function, general health and social function. Conclusion: Patients in our study reported symptoms of post-traumatic stress disorder, anxiety, depression and impaired health-related quality of life following treatment with veno-arterial extra corporeal membrane oxygenation. Addressing possible emotional and psychological distress could represent a potential major improvement in health care provided to this group. Further research is needed to incorporate prophylactic methods, such as identifying vulnerable patients and implement corresponding interventions, into clinical practice.publishedVersio

Employment Trends During Preschool Years Among Mothers of Term Singletons Born with Low Birth Weight

Children born at term with low birth weight (LBW) are regarded growth restricted and are at particular risk of adverse health outcomes requiring a high degree of parental participation in the day-to-day care. This study examined whether their increased risk of special health care needs compared to other children may influence mothers’ opportunities for participation in the labor market at different times after delivery. Data from 32,938 participants in the population-based Norwegian Mother and Child Cohort Study with singleton children born at term in 2004–2006 were linked to national registers in order to investigate the mothers’ employment status when their children were 1–3 years in 2007 and 4–6 years in 2010. Children weighing less than two standard deviations below the gender-specific mean were defined as LBW children. Although not significantly different from mothers of children in the normal weight range, mothers of LBW children had the overall highest level of non-employment when the children were 1–3 years. At child age 4–6 years on the other hand, LBW was associated with an increased risk of non-employment (RR 1.39: 95 % CI 1.11–1.75) also after adjustment for factors associated with employment in general. In accordance with employment trends in the general population, our findings show that while mothers of normal birth weight children re-enter the labor market as their children grow older, mothers of LBW children born at term participate to a lesser extent in paid employment and remain at levels similar to those of mothers with younger children. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited

A Grounded Qualitative Analysis of the Effect of a Focus Group on Design Process in a Virtual Internship

A key component associated with the development of an entrepreneurial mindset is the ability to understand customerneeds and consider this when developing a product. This study sought to understand whether the inclusion of a customerfocus group as part of a virtual internship created any differences in the design processes of sophomore engineeringstudents (114 students). The Nephrotex virtual internship requires that students design a dialysis membrane by optimizinga selection of four components: membrane polymer, polymerization process, processing surfactant, and carbon nanotubepercentage. We found that sophomores who engaged in a focus group during the virtual internship Nephrotex showed(statistically) equal focus on cost versus technical measures of design performance during the focus group. Despite this,design cost was lower in the section that participated in a focus group, with no decrease in product quality. This indicatesthat customer voice may be an important factor in decreasing product cost. We also found that sophomore studentsprioritized their interviewing of customers within the focus group towards end users, such as the patient and nephrologist.Qualitative analysis of sophomore responses demonstrated that they found utility in the focus group (30% of participants)but did not necessarily believe that the customers had useful knowledge of the relevant design attributes (17% ofparticipants). Such realizations may have contributed to the equivalent quality and decreased costs associated with thedesigns of sophomores who participated in a focus group

Maternal Sick Leave Due to Psychiatric Disorders Following the Birth of a Child With Special Health Care Needs

Objective Child-related stress following the birth of a child with special health care needs (SHCN) can take a toll on parental health. This study examined how the risk of sick leave due to psychiatric disorders (PD) among mothers of children with SHCN compares with that of mothers of children without SHCN during early motherhood. Methods Responses from 58,532 mothers participating in the Norwegian Mother and Child Cohort Study were linked to national registries and monitored for physician-certified sick leave from the month of their child's first birthday until the month of their child's fourth birthday. Results As compared with mothers of children without SHCN, mothers of children with mild and moderate/severe care needs were at substantial risk of a long-term sick leave due to PD in general and due to depression more specifically. Conclusions Extensive childhood care needs are strongly associated with impaired mental health in maternal caregivers during early motherhoo

Massive galaxy clusters as gravitational telescopes for distant supernovae

We investigate the potential of using massive clusters as gravitational telescopes for searches and studies of supernovae of Type Ia and Type II in optical and near-infrared bands at central wavelengths in the interval 0.8-1.25 microns. Using high-redshift supernova rates derived from the measured star formation rate, we find the most interesting effects for the detection of core-collapse SNe in searches at limiting magnitudes m_lim~25-26.5 mag, where the total detection rate could be significantly enhanced and the number of detectable events is considerable even in a small field. For shallower searches, ~24, a net gain factor of up to 3 in the discovery rate could be obtained, and yet a much larger factor for very high source redshifts. For programs such as the GOODS/ACS transient survey, the discovery rate of supernovae beyond z~2 could be significantly increased if the observations were done in the direction of massive clusters. For extremely deep observations, m_lim > 27 mag, or for very bright SNe (e.g. Type Ia) the competing effect of field reduction by lensing dominates, and fewer supernovae are likely to be discovered behind foreground clusters.Comment: 9 pages, 17 figures, matches published versio

Separability problem for multipartite states of rank at most four

One of the most important problems in quantum information is the separability problem, which asks whether a given quantum state is separable. We investigate multipartite states of rank at most four which are PPT (i.e., all their partial transposes are positive semidefinite). We show that any PPT state of rank two or three is separable and has length at most four. For separable states of rank four, we show that they have length at most six. It is six only for some qubit-qutrit or multiqubit states. It turns out that any PPT entangled state of rank four is necessarily supported on a 3x3 or a 2x2x2 subsystem. We obtain a very simple criterion for the separability problem of the PPT states of rank at most four: such a state is entangled if and only if its range contains no product vectors. This criterion can be easily applied since a four-dimensional subspace in the 3x3 or 2x2x2 system contains a product vector if and only if its Pluecker coordinates satisfy a homogeneous polynomial equation (the Chow form of the corresponding Segre variety). We have computed an explicit determinantal expression for the Chow form in the former case, while such expression was already known in the latter case.Comment: 19 page