Joint Regression and Association Models for Repeated Categorical Responses

The focus of this study is on statistical analysis of categorical responses, where the response values are dependent of each other. The most typical example of this kind of dependence is when repeated responses have been obtained from the same study unit. For example, in Paper I, the response of interest is the pneumococcal nasopharengyal carriage (yes/no) on 329 children. For each child, the carriage is measured nine times during the first 18 months of life, and thus repeated respones on each child cannot be assumed independent of each other. In the case of the above example, the interest typically lies in the carriage prevalence, and whether different risk factors affect the prevalence. Regression analysis is the established method for studying the effects of risk factors. In order to make correct inferences from the regression model, the associations between repeated responses need to be taken into account. The analysis of repeated categorical responses typically focus on regression modelling. However, further insights can also be gained by investigating the structure of the association. The central theme in this study is on the development of joint regression and association models. The analysis of repeated, or otherwise clustered, categorical responses is computationally difficult. Likelihood-based inference is often feasible only when the number of repeated responses for each study unit is small. In Paper IV, an algorithm is presented, which substantially facilitates maximum likelihood fitting, especially when the number of repeated responses increase. In addition, a notable result arising from this work is the freely available software for likelihood-based estimation of clustered categorical responses.

Good Lives, Hidden Miseries : An Ethnography of Uncertainty in a Finnish Village

This is an ethnographic study, in the field of medical anthropology, of village life among farmers in southwest Finland. It is based on 12 months of field work conducted 2002-2003 in a coastal village. The study discusses how social and cultural change affects the life of farmers, how they experience it and how they act in order to deal with the it. Using social suffering as a methodological approach the study seeks to investigate how change is related to lived experiences, idioms of distress, and narratives. Its aim has been to draw a locally specific picture of what matters are at stake in the local moral world that these farmers inhabit, and how they emerge as creative actors within it. A central assumption made about change is that it is two-fold; both a constructive force which gives birth to something new, and also a process that brings about uncertainty regarding the future. Uncertainty is understood as an existential condition of human life that demands a response, both causing suffering and transforming it. The possibility for positive outcomes in the future enables one to understand this small suffering of everyday life both as a consequence of social change, which fragments and destroys, and as an answer to it - as something that is positively meaningful. Suffering is seen to engage individuals to ensure continuity, in spite of the odds, and to sustain hope regarding the future. When the fieldwork was initiated Finland had been a member of the European Union for seven years and farmers felt it had substantially impacted on their working conditions. They complained about the restrictions placed on their autonomy and that their knowledge was neither recognised, nor respected by the bureaucrats of the EU system. New regulations require them to work in a manner that is morally unacceptable to them and financial insecurity has become more prominent. All these changes indicate the potential loss of the home and of the ability to ensure continuity of the family farm. Although the study initially focused on getting a general picture of working conditions and the nature of farming life, during the course of the fieldwork there was repeated mention of a perceived high prevalence of cancer in the area. This cancer talk is replete with metaphors that reveal cultural meanings tied to the farming life and the core values of autonomy, endurance and permanence. It also forms the basis of a shared identity and a means of delivering a moral message about the fragmentation of the good life; the loss of control; and the invasion of the foreign. This thesis formed part of the research project Expressions of Suffering. Ethnographies of Illness Experiences in Contemporary Finnish Contexts funded by the Academy of Finland. It opens up a vital perspective on the multiplicity and variety of the experience of suffering and that it is particularly through the use of the ethnographic method that these experiences can be brought to light. Keywords: suffering, uncertainty, phenomenology, habitus, agency, cancer, farming

Fuzzy Coherence: Making Sense of Continuity in Hypertext Narratives

Hypertexts are digital texts characterized by interactive hyperlinking and a fragmented textual organization. Increasingly prominent since the early 1990s, hypertexts have become a common text type both on the Internet and in a variety of other digital contexts. Although studied widely in disciplines like hypertext theory and media studies, formal linguistic approaches to hypertext continue to be relatively rare. This study examines coherence negotiation in hypertext with particularly reference to hypertext fiction. Coherence, or the quality of making sense, is a fundamental property of textness. Proceeding from the premise that coherence is a subjectively evaluated property rather than an objective quality arising directly from textual cues, the study focuses on the processes through which readers interact with hyperlinks and negotiate continuity between hypertextual fragments. The study begins with a typological discussion of textuality and an overview of the historical and technological precedents of modern hypertexts. Then, making use of text linguistic, discourse analytical, pragmatic, and narratological approaches to textual coherence, the study takes established models developed for analyzing and describing conventional texts, and examines their applicability to hypertext. Primary data derived from a collection of hyperfictions is used throughout to illustrate the mechanisms in practice. Hypertextual coherence negotiation is shown to require the ability to cognitively operate between local and global coherence by means of processing lexical cohesion, discourse topical continuities, inferences and implications, and shifting cognitive frames. The main conclusion of the study is that the style of reading required by hypertextuality fosters a new paradigm of coherence. Defined as fuzzy coherence, this new approach to textual sensemaking is predicated on an acceptance of the coherence challenges readers experience when the act of reading comes to involve repeated encounters with referentially imprecise hyperlinks and discourse topical shifts. A practical application of fuzzy coherence is shown to be in effect in the way coherence is actively manipulated in hypertext narratives.