Change point-cure models with application to estimating the change-point effect of age of diagnosis among prostate cancer patients

Previous research on prostate cancer survival trends in the United States National Cancer Institute's Surveillance Epidemiology and End Results database has indicated a potential change-point in the age of diagnosis of prostate cancer around age 50. Identifying a change-point value in prostate cancer survival and cure could have important policy and health care management implications. Statistical analysis of this data has to address two complicating features: (1) change-point models are not smooth functions and so present computational and theoretical difficulties; and (2) models for prostate cancer survival need to account for the fact that many men diagnosed with prostate cancer can be effectively cured of their disease with early treatment. We develop a cure survival model that allows for change-point effects in covariates to investigate a potential change-point in the age of diagnosis of prostate cancer. Our results do not indicate that age under 50 is associated with increased hazard of death from prostate cancer.     

Impacts of media on sexual behaviour and relationships among youth in foster care

Youth in foster care (YFC) are at high risk of negative reproductive and other health outcomes and may be especially vulnerable to negative impacts of media due to early adversity and a lack of stable caregiver relationships. The aim of this project was to explore how access and exposure to media impacts YFC in order to inform future research in this realm and promote resilience in this understudied population. We conducted semistructured interviews with YFC ages 15–21 (n = 22) and focus groups with foster caregivers (n = 86). We used thematic analysis to analyse data for themes related to media. Youth and caregivers described four main themes: (a) impacts of media on youth norms and attitudes, (b) impacts of media on youth behaviour, (c) impacts of youth exposure to pornography, and (d) caregiver monitoring and mediation of media. Data from this study indicate that media has unique, important effects on YFC norms and behaviours, including sexual behaviours. Foster caregivers encounter multiple barriers to monitoring and mediating media use for YFC. Further research is needed to explore differential effects of media on YFC versus non‐YFC in order to develop effective interventions and mitigate potential negative effects of media.     

Power, desire, and pleasure in sexual fantasies

One hundred and sixty-two participants (ages 21-45) wrote open-ended sexual fantasies and completed self-report measures of rape myth acceptance, adversarial sexual beliefs, and attitudes toward women. We coded fantasies using a newly developed scoring system that includes themes of dominance, submission, sexual pleasure, and sexual desire. Men fantasized about dominance more than women did; they also tended to focus more on the desire and pleasure of their partner. Desire and pleasure were more closely linked in the fantasies of men than in the fantasies of women, for whom the two were distinct constructs. Although fantasies of submission were not associated with problematic attitudes for either gender, men's fantasies of dominance were associated with greater acceptance of rape myths. For women, greater rape myth acceptance was associated with emotional and romantic fantasy themes.     

Impact of smoke-free residence hall policies: the views of administrators at 3 state universities

Nationwide efforts to protect the public against the health effects of secondhand smoke have prompted college and university administrators to adopt more restrictive smoking policies. Some campus officials are concerned that new policies will lead to student backlash, increased staff workloads, and an increased economic burden. To understand the impact of smoke-free residence hall policies, we conducted key informant interviews and gathered archival data at 3 large state universities. The implementation of smoke-free residence hall policies imposed little economic burden. We noted positive impacts in several key areas, including decreased damage to residence hall buildings, increased student retention, and improved enforcement of marijuana policies. Increased costs, such as the purchase of outdoor cigarette receptacles, were outweighed by the benefits. Findings from this study should encourage college and university administrators to enact smoke-free residence hall policies.     

How schools can do better: fostering stronger connections between teachers and students

Teachers are a centrally important yet often overlooked resource in the lives of youth. Teacher-student relationships, when properly harnessed, may emulate mentoring at its best. This chapter explores the teacher-student relationship and examines ways in which it can be enhanced to the benefit of youth and adults.     

Child abuse and neglect in Cambodian refugee families: characteristics and implications for practice

This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services (LAC-DCFS). Some of the major findings include (1) Cambodian child maltreatment cases were most frequently reported to the LAC-DCFS among various Asian Pacific ethnic groups; (2) Cambodian refugee families were more likely to be charged with neglect, while their Asian Pacific counterparts were more likely charged with physical abuse; (3) the circumstances under which maltreatment occurred most frequently were parental substance abuse and mental illness; and (4) while fathers who maltreated their child were likely to use alcohol, mothers were also more likely to have a mental health problem such as depression. This study suggests the importance of collaboration between Child Protective Service agencies, substance abuse programs, traditional healers, mental health services, and other social service agencies for effective child abuse prevention and intervention efforts.     

Towards New Indicators of Disadvantage: Deprivation and Social Exclusion in Australia

Concern over the reliability of conventional poverty studies has focused attention on the need to demonstrate that those identified as poor are actually experiencing hardship. This paper takes a step in this direction by examining poverty using a living standards approach derived from the literature on deprivation and social exclusion. Deprivation – defined as an enforced lack of socially perceived necessities – has emerged as a way of identifying who is missing out on what the community regards as the necessities (or essentials) of life. Social exclusion – which exists when individuals do not participate in key activities in society – has opened up new areas of inquiry relating to a lack of connectedness between individuals, the communities in which they live, and key economic and social processes. The findings indicate that many Australians face deprivation and exclusion in numerous aspects of their lives, and that those defined as poor in income terms are different from those who are deprived or excluded. The low overlap between the three indicators implies that they all have a role to play in documenting the extent of social disadvantage and helping to identify the factors that contribute to its various manifestations.     

A Qualitative Assessment of South African Adolescents' Motivations For and Against Substance Use and Sexual Behavior

Focus groups (N=15 groups; 8 with girls, 7 with boys) with adolescents in high schools near Cape Town, South Africa, were used to conduct a qualitative investigation of reported reasons for using and not using substances and for having and not having sex. Adolescents reported Enhancement, Negative States, Social, and Aversive Social motivations for both substance use and sexual behavior. In addition, being addicted as a reason for using drugs and rape as a context for sexual behavior were frequently reported. Motivations against behaviors included Physical/Behavioral Consequences, Ethical Objections, Social Disapproval, and Incompatible Activities and Goals reasons. Preventive interventions should address existing motivations for and against substance use and sexual behavior to acknowledge adolescents' experiences in context.     

The Reproductive Context of Cohabitation in the United States: Recent Change and Variation in Contraceptive Use

Drawing on data from 2 waves of the National Survey of Family Growth (N = 11,065), the current research addressed 2 overarching questions about the reproductive context of cohabitation in the United States. First, did patterns of contraceptive use among cohabitors change during the last 2 decades of the 20th century? Second, did patterns of contraceptive use among cohabiting women tend to vary by education or race/ethnicity? Results point to a growing resemblance between never‐married cohabiting women and those in first marriages in the likelihood of using a “very effective” contraceptive method and suggest that cohabitation is most “marriage like” with respect to reproductive behavior among the least educated.