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31.
John D. Emerson David C. Hoaglin Frederick Mosteller 《Statistical Methods and Applications》1993,2(3):269-290
Summary Meta-analyses of sets of clinical trials often combine risk differences from several 2×2 tables according to a random-effects
model. The DerSimonian-Laird random-effects procedure, widely used for estimating the populaton mean risk difference, weights
the risk difference from each primary study inversely proportional to an estimate of its variance (the sum of the between-study
variance and the conditional within-study variance). Because those weights are not independent of the risk differences, however,
the procedure sometimes exhibits bias and unnatural behavior. The present paper proposes a modified weighting scheme that
uses the unconditional within-study variance to avoid this source of bias. The modified procedure has variance closer to that
available from weighting by ideal weights when such weights are known. We studied the modified procedure in extensive simulation
experiments using situations whose parameters resemble those of actual studies in medical research. For comparison we also
included two unbiased procedures, the unweighted mean and a sample-size-weighted mean; their relative variability depends
on the extent of heterogeneity among the primary studies. An example illustrates the application of the procedures to actual
data and the differences among the results.
This research was supported by Grant HS 05936 from the Agency for Health Care Policy and Research to Harvard University. 相似文献
32.
Dale R. Meers D.S.W. 《Child and Adolescent Social Work Journal》1992,9(2):99-116
The more things change, the worse they get.Presented April 18, 1991, Duke University, at the Department of Psychiatry's Grand Rounds, this paper condenses, integrates and updates the author's earlier publication. Acknowledgement and thanks for funding and professional sponsorship of the four research studies this paper draws from are selectively due to the Eugene and Agnes E. Meyer Foundation, the Edgar Stern Family Fund, The National Institute for Mental Health, the Baltimore-Washington Institute for Psychoanalysis and the Department of Psychiatry, Children's Hospital National Medical Center. 相似文献
33.
34.
Nick Cocco MA Louise Sharpe M. Psych. Alex P. Blaszczynski Ph.D. 《Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming》1995,11(2):221-229
Twelve problem poker machine players and thirteen horse race gamblers (20 males and 5 females; age range 28–69) completed a series of questionnaires which assessed levels of anxiety, their preferred state of arousal and their motivations to gamble. As predicted, problem poker machine gamblers were found to be more anxious and reported avoiding arousal more frequently than the horse race gamblers. Alternately, problem horse race gamblers were found to prefer heightened levels of arousal and appeared to gamble to achieve these optimal levels of arousal. However, there was no difference between the groups on proneness to boredom. The present results provide evidence which is consistent with the Reversal theory and its application to the field of problem gambling. 相似文献
35.
D R Lairson R Harrist D W Martin R Ramby T A Rustin J M Swint K Harlow J Cobb 《Journal of drug education》1992,22(4):337-352
Primary care physicians are well situated to identify patients with substance abuse problems and motivate them to seek appropriate assistance, but active programs are the exception. A study in a community setting was undertaken to assess the CAGE (the first letters of key words in a series of four questions about drinking: cut down; annoyed; guilty; and eye-opener), instrument in the routine screening for alcohol problems in both new and established patients. The screening process identified subjects for a pilot evaluation of a motivational interview designed to encourage problem-solving behavior. This article focuses on the screening results and the use of the CAGE instrument. During June and July of 1990, 687 patients of two primary care physicians belonging to a large group practice were asked to complete a health questionnaire that included the CAGE. Those who responded affirmatively to at least two of the four CAGE questions were requested to participate in follow-up assessment of problems associated with alcohol and health. The type and severity of alcohol problems experienced by patients who scored positive on the CAGE are described. Prevalence of a positive score on the CAGE was 8.6 percent with males, smokers, and blue collar and unemployed persons being more likely to score positive. The positive predictive value was .68. Primarily, persons with moderate alcohol problems were identified. Results show that the CAGE instrument is a useful screening device for identifying those with mild to moderate substance abuse problems, increasing the opportunity for intervention prior to serious medical complications. The instrument is easily administered, and has demonstrated relatively high levels of sensitivity and specificity. When combined with assessment and motivational interviews, the CAGE shows promise in the secondary prevention of substance abuse and related health problems. 相似文献
36.
In this article, we conduct a textual analysis of Edith Wharton's 1911 novel, Ethan Frome . We offer three readings. The first presents Wharton's account of illness through a framework developed foru decades later by Talcott Parsons. Wharton's sick role was less medico-centric than Parsons; it emphasized the importance of class, gender and community in defining and legitimizing the sick role. Our second reading explores the socially constructed nature of roles in illness. The sick role as portrayed by Wharton is not the social fact later conceived by Parsons, but a social construct with no determinate reference beyond that which the local community is willing to grant it. Our third reading examines the social context, particularly the power relations, within which this story of illness has been constructed. 相似文献
37.
Abstract Consumer concerns over pesticide residues and food additives have been growing in industrialized societies, including the United States and Japan. However, little comparative research has been carried out to determine which household characteristics may be significantly associated with these heightened concerns, and whether or not the same factors are useful for understanding variation in these worries in more than one society. This paper examines food safety attitudes in Seattle, Washington, and Kobe, Japan, and discovers that while the absolute level of expressed concern is higher in Kobe, the predictive power of household characteristics in explaining attitudinal differences within countries is similar. Implications for rural areas and future research on family structures in capitalist societies are discussed. 相似文献
38.
This paper examines the demand for money in Bolivia during the 1980s, a decade of extreme instability with annual inflation rates reaching over 20,000 percent, and a subsequent stabilization, with annual rates falling to less than 25 percent and remaining so for more than five years.
Our empirical analysis makes use of error-correction approaches, time-varying-parameter estimation with Kalman filtering, and GARCH models of expected inflation and inflation variance. We find that expected inflation and inflation uncertainty both matter for money demand. Time-varying estimates show that the reaction to monetary disequilibria was significantly faster during hyperinflation. 相似文献
Our empirical analysis makes use of error-correction approaches, time-varying-parameter estimation with Kalman filtering, and GARCH models of expected inflation and inflation variance. We find that expected inflation and inflation uncertainty both matter for money demand. Time-varying estimates show that the reaction to monetary disequilibria was significantly faster during hyperinflation. 相似文献
39.
40.
Research into the nature of aggressive behavior in youths has demonstrated that these youths are often the victims of abuse, exhibit aggressive behavior in early childhood, and remain aggressive into young adulthood. The treatment approach described in this article is a modification of Monahan's [1981] model of the prediction of violent behavior and the anger-management approach of Novaco [1985], and integrates the developmental models of Piaget [1963] and Erikson [1959]. The program is a combination of cognitive, behavioral, and expressive therapies and is targeted to the reduction of dysfunctional cognitive, affective, behavioral, and problem-solving patterns of aggressive youths. As referrals of such aggressive clients are often involuntary, interventions with unwilling and resistant clients are also presented. 相似文献