Progression-free survival in oncological clinical studies: Assessment time bias and methods for its correction

Progression-free survival (PFS) is a frequently used endpoint in oncological clinical studies. In case of PFS, potential events are progression and death. Progressions are usually observed delayed as they can be diagnosed not before the next study visit. For this reason potential bias of treatment effect estimates for progression-free survival is a concern. In randomized trials and for relative treatment effects measures like hazard ratios, bias-correcting methods are not necessarily required or have been proposed before. However, less is known on cross-trial comparisons of absolute outcome measures like median survival times. This paper proposes a new method for correcting the assessment time bias of progression-free survival estimates to allow a fair cross-trial comparison of median PFS. Using median PFS for example, the presented method approximates the unknown posterior distribution by a Bayesian approach based on simulations. It is shown that the proposed method leads to a substantial reduction of bias as compared to estimates derived from maximum likelihood or Kaplan–Meier estimates. Bias could be reduced by more than 90% over a broad range of considered situations differing in assessment times and underlying distributions. By coverage probabilities of at least 94% based on the credibility interval of the posterior distribution the resulting parameters hold common confidence levels. In summary, the proposed approach is shown to be useful for a cross-trial comparison of median PFS.     

Drinking Motives,Alcohol Use,and Sexual Attraction in Youth

Sexual minority youth were found to be more likely to drink alcohol during weekdays compared to heterosexual youth. Drinking during weekdays was associated with consuming alcohol as a coping strategy. Sexual minority youth also more frequently consumed alcohol to eliminate personal worries (coping) and to not be excluded by their peers (conformity). Sexual orientation–related alcohol problems should be addressed at an early stage. Such efforts are likely to be effective if insecurities and stress related to sexual orientation are addressed as well.     

Coparenting in Stepfamilies: A Cluster Analysis

The aim of this study was to identify types of coparenting in stepfamilies based on observational data and to examine whether these types differed regarding marital satisfaction and child adjustment. Forty-five couples attended two videotaped discussion tasks on topics of agreement and disagreement regarding coparenting issues. An exploratory cluster analysis identified three main types of coparenting in stepfamilies: (1) Cooperative coparenting (n = 19), (2) Complementing coparenting (n = 16), and (3) Conflictual coparenting (n = 10). The Complementing coparenting type appeared as a new type of coparenting that had not been described in earlier studies and that might be specific to coparenting between non-biological parents. Comparison between the three clusters showed no differences for marital satisfaction and child adjustment. Each cluster is illustrated by a family case to provide a better understanding of coparenting dynamics in stepfamilies.     

The Compensating Income Variation of Social Capital

There is a small but growing literature on the determinants of social capital. Most of these studies use a measure of trust to define social capital empirically. In this paper we use three different measures of social capital: the size of the individual’s social network, the extent of their social safety net and membership of unions or associations. A second contribution to the literature is that we analyze what social capital contributes to our well-being. Based on this, we calculate the compensating income variation of social capital. We find differences in social capital when we differentiate according to individual characteristics such as education, age, place of residence, household composition and health. Household income generally has a statistically significant effect. We find a significant effect of social capital on␣life␣satisfaction. Consequently, the compensating income variation of social capital is substantial. Thanks to Tijl Woortman for his research assistance.     

Body Mass Index, Perceived Health, and Happiness: Their Determinants and Structural Relationships

The structural relationships between body mass index, perceived health and happiness have been studied in a survey of 700 native Dutch citizens. We found an indirect effect of body mass index on happiness, via perceived health. Age had an inverted U-shaped relationship with body mass index, and both education and smoking had a negative effect on body mass index. Being married, doing paid work, owning a house, and doing sports had positive effects on perceived health, suggesting that living a regular life may lead to a better perceived health. Being married positively affected happiness. The other socio-demographic variables either had no effects on happiness or indirect effects via body mass index and perceived health.     

'Tomorrow Inch Allah, Chance!' People Smuggler Networks in Sangatte

The people-smuggling network prospers. Organized crime of this type runs from Western Europe through Central Europe into even the smallest village in the Middle East. Much of this clandestine migration ends up in northern France. The Sangatte reception centre near Calais is the final stop before the migration journey to England, the Eldorado that has attracted them throughout the months or even years that they have been travelling. Once in Sangatte, migrants must again contact the smugglers in order to reach their final destination.     

The Multidimensional Gender Inequalities Index (MGII): A Descriptive Analysis of Gender Inequalities Using MCA

This paper constructs a weighted measure of the multidimensional concept of gender inequality: the Multidimensional Gender Inequality Index (MGII). Multiple Correspondence Analysis is used to rank the separate forms in which gender inequality appears in developed and developing countries respectively. Eight dimensions were identified as relevant for economic purposes: identity, physical integrity, intra-family laws, political activity, education, health, access to economic resources, and economic activity. In the 109 developing countries considered, gender inequality in the identity and family dimensions are particularly severe for women: these dimensions hence have greater weight in the MGII. However, in OECD countries gender inequality occurs mainly in the political and family dimensions. Nevertheless, the family sphere remains particularly important for gender inequality, whatever the level of development. The MGII is a non-linear weighted composite indicator of gender inequality which yields a country ranking. The South-Asian region is calculated to be the most unequal.     

Sexual Functioning Following Elective Hysterectomy: The Role of Surgical and Psychosocial Variables

In this article, two studies were conducted to investigate the surgical and psychosocial correlates of women's post-hysterectomy sexual functioning. In Study 1, sexual functioning was measured in an online convenience sample of 65 women who had undergone elective hysterectomy. Results suggested that most women experienced improved sexual functioning after their hysterectomy. Women who underwent hysterectomy to treat endometriosis reported less improvement in sexual functioning as compared to women who had hysterectomies for other indications, and women who had abdominal hysterectomies reported less improvement in sexual functioning as compared to women who had vaginal hysterectomies. Sexual functioning post-hysterectomy was associated with psychosocial variables, particularly body esteem and relationship quality. In Study 2, sexual functioning was investigated at two time points three to five months apart in a sample of 14 women who reported developing sexual problems following their elective hysterectomies. Results suggested that, among women suffering from post-hysterectomy sexual dysfunction, sexual pain and difficulty with orgasm increased over time.     

Repartnering Following Divorce: Implications for Older Fathers' Relations With Their Adult Children

This study examined the implications of postdivorce fathers' new unions and additional (step)children for two aspects of older fathers' relations with adult children born from a prior relationship: frequency of social contact and fathers' financial transfers. Data from multiple waves of the Health and Retirement Study (N = 13,017 observations on 4,997 adult children belonging to 1,917 ever‐divorced fathers) were used to estimate multilevel models. The results indicated that divorced fathers who go on to form a new union have weaker relations with adult children from a prior union than their postdivorce counterparts who remain single. This finding partly reflects the detrimental effects of repartnered older fathers' new biological children and stepchildren. There is no difference between older remarried and cohabiting fathers' intergenerational ties. Moreover, fathers' additional biological children and stepchildren have similarly negative effects on fathers' relations with adult children from a previous union.