A joint-modeling approach to assess the impact of biomarker variability on the risk of developing clinical outcome

In some clinical trials and epidemiologic studies, investigators are interested in knowing whether the variability of a biomarker is independently predictive of clinical outcomes. This question is often addressed via a naïve approach where a sample-based estimate (e.g., standard deviation) is calculated as a surrogate for the “true” variability and then used in regression models as a covariate assumed to be free of measurement error. However, it is well known that the measurement error in covariates causes underestimation of the true association. The issue of underestimation can be substantial when the precision is low because of limited number of measures per subject. The joint analysis of survival data and longitudinal data enables one to account for the measurement error in longitudinal data and has received substantial attention in recent years. In this paper we propose a joint model to assess the predictive effect of biomarker variability. The joint model consists of two linked sub-models, a linear mixed model with patient-specific variance for longitudinal data and a full parametric Weibull distribution for survival data, and the association between two models is induced by a latent Gaussian process. Parameters in the joint model are estimated under Bayesian framework and implemented using Markov chain Monte Carlo (MCMC) methods with WinBUGS software. The method is illustrated in the Ocular Hypertension Treatment Study to assess whether the variability of intraocular pressure is an independent risk of primary open-angle glaucoma. The performance of the method is also assessed by simulation studies.     

Teaching Note—Developing a Professional Writing Course Using a Holistic View of Competence

ABSTRACT

Writing is a skill that spans many competencies. The Council on Social Work’s Educational Policy and Accreditation Standards promotes a holistic view of competence informed by knowledge, values, skills, and cognitive and affective processes. This teaching note contributes to the scholarship of teaching and learning by describing a professional writing course that uses a holistic pedagogical approach. We provide pragmatic strategies and assignments that can be readily adapted by other faculty and programs.     

Political power beyond the State: problematics of government

This paper sets out an approach to the analysis of political power in terms of problematics of government. It argues against an overvaluation of the 'problem of the State' in political debate and social theory. A number of conceptual tools are suggested for the analysis of the many and varied alliances between political and other authorities that seek to govern economic activity, social life and individual conduct. Modern political rationalities and governmental technologies are shown to be intrinsically linked to developments in knowledge and to the powers of expertise. The characteristics of liberal problematics of government are investigated, and it is argued that they are dependent upon technologies for 'governing at a distance', seeking to create locales, entities and persons able to operate a regulated autonomy. The analysis is exemplified through an investigation of welfarism as a mode of 'social' government. The paper concludes with a brief consideration of neo-liberalism which demonstrates that the analytical language structured by the philosophical opposition of state and civil society is unable to comprehend contemporary transformations in modes of exercise of political power. ¹     

Children's Appraisals of their Experiences in Out-of-Home Care

Few studies have asked children directly about their experiences in out-of-home care. This study uses data collected from 180 nine- to-11-year-old children currently in out-of-home care who were asked about their perceptions and appraisals of out-of-home care. Analysis of variance and chi-square analyses were used to examine whether children's appraisals of their lives following removal from their families of origin differ as a function of age, gender, race/ethnicity, type and severity of maltreatment, length of time in out-of-home care, placement type, attachment to current caregivers, and rating of current caregiver/home. Youth who were sexually and emotionally abused, youth who were satisfied with their current caregivers and placements, and girls were more likely to state that their lives would have been worse had they remained with their families of origin. Youth who were physically abused were more likely to report that their lives would have remained the same. Children living in group care were more likely than those living in family foster care or with kin to report that their lives would have been better had they remained with their families of origin. Differences were not found between children living in family foster care and those living with kin nor did children's appraisals differ based on age, race, ethnicity, length of time in out-of-home care, neglect, or severity of maltreatment.     

Using Concept Mapping to Develop a Statewide Kinship Care Coalition: A Case Study

Increasingly, community coalitions are being developed to address a myriad of social challenges. However, documented research efforts related to planning processes associated with coalition formation are few. This case-study documents the use of concept mapping (CM) to d elineate a conceptual framework for developing a statewide kinship care coalition in one southeastern state. CM is a mixed-method research approach that analyzes qualitative data via nonmetric multidimensional scaling and hierarchical cluster analyses. After a review of relevant literature, this article discusses CM processes associated with this endeavor and examines implications for future use of CM for coalition formation and development.     

The Marriage and Family Therapy Practice Research Network (MFT‐PRN): Creating a More Perfect Union Between Practice and Research

This article describes the Marriage and Family Therapy Practice Research Network (MFT‐PRN). The MFT‐PRN is designed to build a professional community based on practice‐informed research and research‐informed practice, increase the diversity of participants in MFT research, and unify researchers and clinicians. Clinics choose measures from a list that best represent their clinic needs. Clients' outcomes are assessed regularly, and therapists receive immediate graphical feedback on how clients are progressing or digressing. Data are pooled to create a large and diverse database, while improving client outcomes. We will discuss advantages of the MFT‐PRN for researchers, therapists, clients, and agencies, and provide one model that we hope will inform other collaborative clinical‐research models in the field of marriage and family therapy. Video Abstract is found in the online version of the article .     

Polyvictimization in later life: Trauma-informed best practices

ABSTRACT

This article provides a summary of salient trauma findings and conveys the dearth of research pertaining specifically to the trauma of elder abuse. This material, in conjunction with information contained in other articles composing this special issue, lays the foundation for advancing a trauma-informed approach to assisting older adults who have experienced polyvictimization. Informed by the findings presented and their extensive clinical experience with victims of violence, the authors suggest steps for providing a trauma-informed and victim-centered response to older adults who have suffered polyvictimization. These steps are then illustrated with an in-depth late-life polyvictimization case analysis.     

The Present Retirement Crisis and How Social Workers Can Respond

ABSTRACT

Research on Americans’ retirement readiness indicates a wide range of preparedness for the golden years. Called a “crisis” by researchers, retirement for some may include significant choices: continued employment or utilization of social welfare services. This article describes factors contributing to the retirement crisis and roles social workers can play in assisting older retirees. Disparity in household retirement savings exists by ethnicity. On the front lines serving aging individuals and their families, social work professionals are well situated to collaborate with individuals, and other providers, to address financial, social and emotional pillars necessary in facilitating a safe and secure retirement.