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141.
Interest in utilizing technology to help older adults remain living at home is growing; however, uptake remains low. We present a conceptual framework for understanding independent living technology innovation within health and social services. Public policy and innovation in the United States, the United Kingdom, and Scandinavia are profiled as case studies. In all profiled countries, independent living technology is more rapidly advancing than associated state policy, regulation, and payment systems. The findings from this comparative analysis reveal areas for further exploration, including policy subsystem environments in which technologies and services are regulated, as well as trends and desires of older adults and their caregivers within particular cultural contexts.  相似文献   
142.
Researchers have suggested that child sex offenders hold distorted views on social interactions with children. Misinterpreting children’s behavior and intentions could lead to sexually abusive behavior toward children. It is further suggested that the interpretation process is influenced by offenders’ offense-supportive cognitions and levels of empathy. To examine the relationships between these three concepts, 47 contact offenders completed self-reports on offense-supportive cognitions and empathy. Vignettes were developed to assess the extent to which offenders attributed responsibility, benefit, and complicity to children in hypothetical child molestation incidents. This study showed that cognitions that justify sexual offending against children seem to diminish the threshold for sexual assault by assigning more cooperation and willingness of the victim in a child molestation incident.  相似文献   
143.
客户回报率是衡量公司通过客户创造价值能力的惟一现有指标由于越来越多的企业争夺有限的客户群,精明的企业逐渐将关注点转向客户——如何维系及培养高价值的客户。近来,客户管理专家唐·佩勃斯与玛莎·罗杰斯提出了一个新指标:客  相似文献   
144.
This paper discusses work with a parent in a foster care situation. A case example is used to demonstrate the value of a model of a parentchild relationship for therapeutic work with seemingly unmotivated clients such as parents whose child is in foster care.  相似文献   
145.
146.
The Additive Genetic Gamma Frailty Model   总被引:1,自引:0,他引:1  
In this paper the additive genetic gamma frailty model is defined. Individual frailties are correlated as a result of an additive genetic model. An algorithm to construct additive genetic gamma frailties for any pedigree is given so that the variance–covariance structure among individual frailties equals the numerator relationship matrix times a variance. The EM algorithm can be used to estimate the parameters in the model. Calculations are similar using the EM algorithm in the shared frailty model, however the E step is not correspondingly simple. This is illustrated re-analysing data, analysed by the shared frailty model in Nielsen et al . (1992), from the Danish adoptive register. Goodness of fit of the additive genetic gamma frailty model can be tested after analysing data with the correlated frailty model. Doing so, a "defect" in the often used and otherwise well behaving likelihood was found  相似文献   
147.
Formal proof of efficacy of a drug requires that in a prospective experiment, superiority over placebo, or either superiority or at least non-inferiority to an established standard, is demonstrated. Traditionally one primary endpoint is specified, but various diseases exist where treatment success needs to be based on the assessment of two primary endpoints. With co-primary endpoints, both need to be “significant” as a prerequisite to claim study success. Here, no adjustment of the study-wise type-1-error is needed, but sample size is often increased to maintain the pre-defined power. Studies that use an at-least-one concept have been proposed where study success is claimed if superiority for at least one of the endpoints is demonstrated. This is sometimes also called the dual primary endpoint concept, and an appropriate adjustment of the study-wise type-1-error is required. This concept is not covered in the European Guideline on multiplicity because study success can be claimed if one endpoint shows significant superiority, despite a possible deterioration in the other. In line with Röhmel's strategy, we discuss an alternative approach including non-inferiority hypotheses testing that avoids obvious contradictions to proper decision-making. This approach leads back to the co-primary endpoint assessment, and has the advantage that minimum requirements for endpoints can be modeled flexibly for several practical needs. Our simulations show that, if planning assumptions are correct, the proposed additional requirements improve interpretation with only a limited impact on power, that is, on sample size.  相似文献   
148.
VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - The COVID-19 pandemic presents Northern-based development organisations with unprecedented difficulties. They are...  相似文献   
149.
There has been a paradigm shift in diagnostic conceptualization of Alzheimer's disease (AD) based on the current evidence suggesting that structure and biology changes start to occur before clinical symptoms emerge. Consequently, therapeutic drug development is also shifting to treat early AD patients using biomarkers for enrichment in clinical trials. A similar paradigm shift is occurring for Parkinson disease. In the absence of acceptable biomarkers that could be combined with a clinical endpoint to demonstrate a disease modification (DM) effect in neurodegenerative disorders, a delayed‐start design can be applied to demonstrate a lasting effect on the disease course. The delayed‐start design includes two treatment periods, where in period 1, patients are randomized to receive an active treatment or placebo, and in period 2, placebo patients are switched to the active treatment while patients in the active treatment arm will continue the same treatment. The hypothesis is that patients who start the active treatment later will fail to catch up to the treatment benefit achieved by patients who receive the active treatment in both periods. A usual analytical approach has sought to demonstrate the divergence of slope during period 1 and the parallelism of slopes during period 2 as the DM effect. However, due to heterogeneity in timing and the magnitude of maximal effect among patients, nonlinear response over time could be observed within the two treatment arms in both periods. We propose an approach to evaluate the DM effect with the linearity assumption for treatment differences, but not for each arm separately.  相似文献   
150.
Poor hygiene when handling food is a major cause of foodborne illness. To investigate whether hygiene practices visible in television cooking shows influence viewers’ kitchen hygiene, a study on the adoption of demonstrated hygiene behavior was conducted under controlled, experimental conditions. In a study ostensibly on cooking by following recipes participants (n = 65) were randomly assigned to one of three conditions, in which they watched a cooking video that differed only with regard to the hygiene behavior of the chef. In condition 1, the chef engaged in poor hygiene practices while preparing the dish, in condition 2 the chef's hygiene behavior was exemplary and in condition 3, the chef's hygiene behavior was not visible (control condition). After watching the video, participants were instructed to cook the recipe individually in the fully equipped laboratory kitchen. Cooking sessions were videotaped and experimenters blind to condition coded hygiene lapses committed by participants. The level of kitchen hygiene displayed in the cooking video significantly affected hygiene practices of participants cooking the recipe. Participants who had watched the cooking video with correct hygiene practices committed significantly fewer hygiene lapses than those who had watched the video with poor hygiene practices. From a risk communication perspective, TV cooking shows are well placed to convey knowledge of essential hygiene practices during food preparation to a broad audience. To facilitate behavioral change toward safer food‐handling practices among viewers, visibly performing correct hygiene practices in cooking shows is a promising strategy.  相似文献   
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