Bayesian Weibull tree models for survival analysis of clinico-genomic data

An important goal of research involving gene expression data for outcome prediction is to establish the ability of genomic data to define clinically relevant risk factors. Recent studies have demonstrated that microarray data can successfully cluster patients into low- and high-risk categories. However, the need exists for models which examine how genomic predictors interact with existing clinical factors and provide personalized outcome predictions. We have developed clinico-genomic tree models for survival outcomes which use recursive partitioning to subdivide the current data set into homogeneous subgroups of patients, each with a specific Weibull survival distribution. These trees can provide personalized predictive distributions of the probability of survival for individuals of interest. Our strategy is to fit multiple models; within each model we adopt a prior on the Weibull scale parameter and update this prior via Empirical Bayes whenever the sample is split at a given node. The decision to split is based on a Bayes factor criterion. The resulting trees are weighted according to their relative likelihood values and predictions are made by averaging over models. In a pilot study of survival in advanced stage ovarian cancer we demonstrate that clinical and genomic data are complementary sources of information relevant to survival, and we use the exploratory nature of the trees to identify potential genomic biomarkers worthy of further study.     

Residential care for children and young people: priority areas for change

Abuse in residential childcare has been of concern to the public and the profession for a number of years. This article highlights a Scottish Institute for Residential Child Care's (SIRCC) response to the Scottish Government which was requested following allegations of abuse in Glasgow City Council's Kerelaw residential school and secure unit. It offers priority actions to address the challenges of residential childcare and ensure the safety of children and young people as far as is practicably possible. It contextualises the residential childcare task, and explores four interrelated areas in which change is strongly recommended: (1) organisations' cultures; (2) workforce challenges including the status of the sector, staff selection standards, the role of residential childcare workers in relation to their level of autonomy and their education levels; (3) abuse allegations, in particular the sector's growing fearfulness of false allegations, support for practitioners' anonymity when accused of abuse and a reconsideration of criminal record certificate information; and (4) service delivery related to behaviour management and advocacy support. The intersection between the SIRCC and the subsequent Kerelaw Inquiry reports is outlined. Finally, it concludes with a scan of the immediate strategic policy horizon which indicates an unprecedented momentum for change. While based in the Scottish context, it reflects lessons which are applicable internationally. Copyright © 2010 John Wiley & Sons, Ltd.     

Response

Edmund King, England 1175–1425 (1979), xiii+208 (Routledge &; Kegan Paul, £6.50).

G. R. Quaife, Wanton Wenches and Wayward Wives. Peasants and Illicit Sex in Early Seventeenth Century England (1979), 282 (Croom Helm, £11.50).

Louis Bergeron, Banquiers, négociants et manufacturiers parisiens du Directoire à l'Empire (1978), 436 (Ecole des Hautes Etudes en Sciences Sociales, collection ‘Civilisations et Sociétés’ no. 51, Mouton, Paris, 130 fr.). (Bankers, Merchants and Manufacturers in Paris from the Directory to the Empire)

Clive Emsley, British Society and the French Wars, 1793–1815 (1979), viii+216 (Macmillan, £8.95, paperback £3.95).

Dennis Hardy, Alternative Communities in Nineteenth Century England (1979) xii+268 (Longman, £9.95; paperback £5.95).

Richard Lawton (ed.) The Census and Social Structure (1978), xii+330 (Frank Cass, £12.50).

M. Jeanne Peterson, The Medical Profession in Mid‐Victorian London (1978) x+406 (University of California Press, £12.25).

Michael D. Biddiss (ed.) Images of Race (1979), 259 (Leicester University Press, £9.50, paperback £5.00).

Hans Pohl (ed.), Forschungen zur Lage der Arbeiter im Industrialisierungtprozeß (1978), 132 (Ernst Klett Verlag, Stuttgart, DM 32). (Studies of Working‐class Conditions in the Process of Industrialization)

Jack Common (ed.), Seven Shifts (1978), xi+271 (E.P. Pubulishing, £5.95).

Robert Currie, Industrial Politics (1979), xiii+294 (Clarendon Press, Oxford University Press, £10.00).

Pogge von Strandmann, Unternehmens‐Politik und Unternehmens‐Fuehrung: Der Dialog zwischen Aufsichtsrat und Vorstand bei Mannetmann, 1900 bis 1919 (1978), 204 (ECON Verlag, Diisseldorf, DM 28). (The Politics and Leadership of Enterprise: The Dialogue between Directors and Management of Mannesmann)     

The use,role and application of advanced technology in the lives of disabled people in the UK

Disabled people are excited by the potential benefits of using advanced technologies at home. However, many devices are abandoned early and lie unused. This research project aimed to explore why this happens, what the users of such technologies require, how advanced technologies can rise to the challenges of flexibility and user choice, which applications enhance independence and improve quality of life and what the barriers are to take‐up and future utilization. It was found that disabled people wish to use advanced technology to increase independence in and beyond home but the cost of both mainstream and ‘specialist’ devices are prohibitive. The role of advanced technology should be to enhance independence and provide mainstream solutions that disabled people request, rather than designing and engineering ‘specialist’ expensive products. Furthermore, the application of advanced technology for use in the home should be directed by disabled people, collectively and individually.     

Key issues for elderly patients contemplating clinical trial participation

ABSTRACT

This pilot study explored issues important to enrollment in clinical trials by elderly patients. We surveyed and interviewed elderly patients who had been asked to participate in trials. The information covered general attitudes toward research and specific aspects of trial recruitment. Elderly patients had favorable attitudes toward research. This favorable attitude was significantly stronger in men than in women and stronger in Whites than non-Whites but not significantly so. Altruistic motives, physician recommendations, and individual assessment of inconveniences, benefits, and risks of trial participation drove decisions. Elderly patients have positive views of research; however, this will only facilitate trial participation if patients perceive the commitment of enrolling, the potential risks, and possible side effects as reasonable.     

Perceived Challenges to the Sustainability of Community-Based Aging Initiatives: Findings from a National Study of Villages

Concerns have been raised regarding the sustainability of Villages, a rapidly-expanding set of organizations that typically use a participant-directed approach to improve older adults’ quality of life and ability to age in place. Using online survey and telephone-interview data from a 2013 follow-up study of Villages across the United States, this study examined organizational leaders’ perceptions of the major challenges to sustainability. Major challenges identified included: (a) funding, (b) membership recruitment, (c) leadership development, (d) meeting members’ service needs, and (e) limitations of the Village model itself. Findings point to a number of important considerations for the development, implementation, and sustainability of the Village model, including the role of social workers in addressing these challenges.     

Developmental Foundations and Clinical Applications of Social Information Processing: A Review

Social information processing has emerged as an important construct in understanding children's interpersonal functioning. This article reviews (1) the theoretical models guiding research, (2) the development of normative and atypical social problem solving, and (3) the connection between social information processing and individual differences in functioning. Finally, this review ends with a summary of efficacy of programs aimed at preventing social information processing biases or intervening with youth who display dysfunctional social information processing skills.