Motivated by a breast cancer research program, this paper is concerned with the joint survivor function of multiple event times when their observations are subject to informative censoring caused by a terminating event. We formulate the correlation of the multiple event times together with the time to the terminating event by an Archimedean copula to account for the informative censoring. Adapting the widely used two-stage procedure under a copula model, we propose an easy-to-implement pseudo-likelihood based procedure for estimating the model parameters. The approach yields a new estimator for the marginal distribution of a single event time with semicompeting-risks data. We conduct both asymptotics and simulation studies to examine the proposed approach in consistency, efficiency, and robustness. Data from the breast cancer program are employed to illustrate this research.
There is no current validated clinical assessment tool to measure the attainment of midwifery student competence in the midwifery practice setting. The lack of a valid assessment tool has led to a proliferation of tools and inconsistency in assessment of, and feedback on student learning.
Objective
This research aimed to develop and validate a tool to assess competence of midwifery students in practice-based settings.
Design
A mixed-methods approach was used and the study implemented in two phases. Phase one involved the development of the AMSAT tool with qualitative feedback from midwifery academics, midwife assessors of students, and midwifery students. In phase two the newly developed AMSAT tool was piloted across a range of midwifery practice settings and ANOVA was used to compare scores across year levels, with feedback being obtained from assessors.
Findings
Analysis of 150 AMSAT forms indicate the AMSAT as: reliable (Cronbach alpha greater than 0.9); valid—data extraction loaded predominantly onto one factor; and sensitivity scores indicating level of proficiency increased across the three years. Feedback evaluation forms (n = 83) suggest acceptance of this tool for the purpose of both assessing and providing feedback on midwifery student’s practice performance and competence.
Conclusion
The AMSAT is a valid, reliable and acceptable midwifery assessment tool enables consistent assessment of midwifery student competence. This assists benchmarking across midwifery education programs. 相似文献
This study investigated the risk factors associated with the occurrence of child physical and psychological abuse in South Korea based on the ecological theory of child maltreatment. A subsample of 3‐ to 18‐year‐old children from “A Study on the Current State of Child Abuse and Neglect,” a nationally representative study on child abuse and neglect, was utilized for secondary data analysis. The sample was divided into two age groups (third graders in elementary school and below and fourth graders and above). We utilized hierarchical logistic regression for each age group separately to analyze the data. The variables at each level of the system (i.e., ontogenic development, microsystem, and exosystem) were entered into the model in sequential order. The results showed the common risk factors for both age groups are the caregiver's experience of abuse in childhood, the child's problem behavior, exposure to domestic violence, community size, and informal social control. The child's age was also significant in both groups but in the opposite direction. Social support was a significant predictor for the younger age group only, while the caregiver's level of education was significant for the older age group only. Implications for future research and practice are discussed based on the study results. 相似文献
Summary. Relative survival techniques are used to compare survival experience in a study cohort with that expected if background population rates apply. The techniques are especially useful when cause-specific death information is not accurate or not available as they provide a measure of excess mortality in a group of patients with a certain disease. Whereas these methods are based on group comparisons, we present here a transformation approach which instead gives for each individual an outcome measure relative to the appropriate background population. The new outcome measure is easily interpreted and can be analysed by using standard survival analysis techniques. It provides additional information on relative survival and gives new options in regression analysis. For example, one can estimate the proportion of patients who survived longer than a given percentile of the respective general population or compare survival experience of individuals while accounting for the population differences. The regression models for the new outcome measure are different from existing models, thus providing new possibilities in analysing relative survival data. One distinctive feature of our approach is that we adjust for expected survival before modelling. The paper is motivated by a study into the survival of patients after acute myocardial infarction. 相似文献
AIDS education started very early in Zimbabwe and is now compulsory in all schools. This evaluation documents the development of the primary and secondary school AIDS Action Programme from 1991 to 1998. Six programme aspects were evaluated: programme start-up, planning and management, development of syllabi and materials, teacher training, research, monitoring and evaluation, and co-ordination. The Programme drew on resources from within the existing educational system. Due to broad-based consultation and participation, it was supported by Government and partners. Flexible management ensured implementation of mid-course corrections. It was concluded that school AIDS programmes should stress participatory teaching and learning methods and life-skills training. Curriculum writers and teachers needed training and supervision in participatory techniques. Cluster workshops between district and school levels were needed to strengthen the cascade model of teacher training that had been adopted. Systematic research, monitoring and evaluation were essential, including follow-ups to baseline surveys. The Zimbabwean programme was well-designed, relatively inexpensive and replicable. 相似文献
To examine flexible work scheduling of married workers a conceptual framework was developed and tested using the 1997 Current Population Survey Work Schedules Supplement. Odds of flextime use were higher for married males, non-Hispanic whites, those with relatively higher levels of education and income, those with a preschool aged child, residents of the Midwest or West (as compared with the South), managers or professionals, and employees of the federal government. 相似文献
This study examines the relationship between occupational status and fertility timing during a period of rapid development in Puerto Rico. Our fundamental hypothesis is that women with higher status occupations face greater opportunity costs than those with less valued jobs and therefore will be more likely to postpone parenthood until later ages than women without such high costs. We test this hypothesis using event history techniques with data from the 1982 Puerto Rico Fertility and Family Planning Assessment, an island-wide survey of women between the ages of 15 and 49. The analysis examines the effects of occupational status on the timing of first births, and finds strong support for the basic hypothesis, especially regarding the post-ponement of teen births. After the teen years, the effects are less pronounced. Overall, it appears that employment opportunities have played an important role in childbearing decisions in Puerto Rico.An earlier version of this paper was presented at the annual meeting of the Population Association of America, Denver, Colorado, 30 April–2 May 1992. 相似文献
Sex differences in expressiveness are well documented, but the reasons for and correlates of these important differences are not well studied. A comprehensive set of emotion-relevant personality measures was administered to 40 female and 39 male undergraduate participants, who were also videotaped in three situations: engaging in natural social interaction, describing a past emotional experience, and posing various emotions. Videotapes were judged by sets of naive observers as to emotion communicated and overall impression. Expressive females, who appeared friendly and dominant in social interaction, were found to have a hostile/aggressive personality (but this was not true of males). Expressive females also tended to look angry/disgusted when describing happy and sad experiences. The findings suggest that nonverbally skilled, charismatic women (but not men) may often possess a dominant/aggressive but self-controlled personality, in a new twist on the theory that sex differences in expressiveness result in part from the oppression of women in society.This research was supported in part by an intramural research grant from University of California, Riverside. 相似文献