The analysis of incomplete data using stochastic covariates

In the development of many diseases there are often associated random variables which continuously reflect the progress of a subject towards the final expression of the disease (failure). At any given time these processes, which we call stochastic covariates, may provide information about the current hazard and the remaining time to failure. Likewise, in situations when the specific times of key prior events are not known, such as the time of onset of an occult tumour or the time of infection with HIV-1, it may be possible to identify a stochastic covariate which reveals, indirectly, when the event of interest occurred. The analysis of carcinogenicity trials which involve occult tumours is usually based on the time of death or sacrifice and an indicator of tumour presence for each animal in the experiment. However, the size of an occult tumour observed at the endpoint represents data concerning tumour development which may convey additional information concerning both the tumour incidence rate and the rate of death to which tumour-bearing animals are subject. We develop a stochastic model for tumour growth and suggest different ways in which the effect of this growth on the hazard of failure might be modelled. Using a combined model for tumour growth and additive competing risks of death, we show that if this tumour size information is used, assumptions concerning tumour lethality, the context of observation or multiple sacrifice times are no longer necessary in order to estimate the tumour incidence rate. Parametric estimation based on the method of maximum likelihood is outlined and is applied to simulated data from the combined model. The results of this limited study confirm that use of the stochastic covariate tumour size results in more precise estimation of the incidence rate for occult tumours.     

Benefits of preventive dentistry in children: Cost factors and public policy

Dental caries in children is now recognized as a preventable disease. The use of fluoride and sealants has produced a major reduction in caries prevalence among school aged children in the United States and other countries. A portion of the child population who are educationally and socioeconomically disadvantaged are not fully receiving these benefits. Public policy, insurance and medicaid groups must be made aware of these preventative measures and strategies developed to implement them.     

MOVING OUT OF THE HOUSE: AN ANALYSIS OF CONGRESSIONAL QUITS

Despite extensive study concerning involuntary departures by U.S. House members, little has been said about voluntary departures from the House–-quit behavior. This paper has three primary purposes: (1) to establish a theoretical framework that models the full range of choices a representative faces in any given term, (2) to measure the impact of different variables that affect representatives' quit behavior, and (3) to explain why Republicans have been more likely to pursue higher office than their Democratic colleagues.     

The gambling lifestyle: I. theory

This paper describes the lifestyle model of gambling behavior in which compulsive gambling behavior is conceptualized as a lifestyle characterized by pseudoresponsibility, self-ascension, hypercompetitiveness, and social rule breaking/bending/ twisting. The underlying premise of this theory is that gambling behavior takes on the appearance of a lifestyle when it is viewed by the individual as a viable means of enhancing self-worth, minimizing personal insecurity, and controlling fear. Three primary areas of theoretical and research interest are covered in this paper: (1) the theoretical underpinnings of lifestyle theory; (2) the individual components (conditions, choice, cognition) of a gambling lifestyle; and (3) the developmental progression of a gambling lifestyle.The author would like to thank Henry Lesieur and anonymous reviewers of earlier versions of this paper for their helpful comments. The assertions and opinions contained herein are the private views of the author and should not be construed as official or as reflecting the views of the Federal Bureau of Prisons or United States Department of Justice.     

Medicine on the line? Computer‐mediated social support and advice for people with diabetes

The advent of thousands of Usenet groups on the Internet, covering a vast range of medical and welfare issues and ostensibly devoted to the mutual social support of participating members, has raised the potential for the development of new forms of 'virtual' health care. This article critically analyses the use by people with diabetes of one such Usenet group. It seeks to establish, first, the extent to which such a site provides some demonstrable measure of social support to its participants. This is approached by undertaking a structural analysis of the site to identify the extent of usage, and the nature of supporting interventions using a fivefold classification (instrumental, informational, esteem and social companionship and other). Second, the article attempts to identify any disparity between the lay health-knowledge in evidence and biomedical opinions proffered by the use of a panel of consultant diabetiologists. The results of the analysis suggest that the diabetes newsgroup provides an example of an active forum for largely well-informed participants who routinely use the media as an aid to the reflexive management of their medical condition. It also raises the prospect of a renegotiated relationship between medical knowledge and lay experience based upon shared learning     

Women with Turner's Syndrome: helping them reach their full potential

The physical and psychological effects of Turner's Syndrome, a female sex chromosome abnormality, briefly are described. Principles for helping women master the special challenges posed by the disorder are discussed. The authors argue that women with TS must take control of defining their identities and potential in order to attain full status within society.     

Multilevel community health promotion: How can we make it work?

The need for multilevel, comprehensive health promotion programmeshas become widely accepted, as has the importance of communityapproaches. However, many health promotion programmes focuson change at the individual level, no doubt partly due to thedifficulty of implementing all-inclusive health promotion. Thispaper discusses two strategies for guiding multilevel projects:multiple methods for community assessment and charting projectactivities by level of change (a possibility framework). Thesestrategies help ensure a multilevel focus and provide valuableinformation that can assist with the implementation of multilevelhealth promotion research projects in specific community contexts.Our primary purpose, therefore, is not to focus on theory orresearch findings. Rather, our goal is to make visible two strategiesthat have been helpful in one health promotion research projectin Victoria, British Columbia, Canada.     

The Naked Self: Being a Body in Televideo Cybersex

Unlike text‐based cybersex, televideo is an embodied experience. Participants present their bodies as an object to be looked at. Through in‐depth interviews this study examines the relationships among selfhood and the body and the context in which both are located. The body, much like the self, exists as both a viewed object and an experienced subject. Televideo cybersex participants manipulate this relationship by presenting themselves as only a body, the experience of which acts back in an erotic “looking glass” affecting how the self conceives of the body. While in some cases the medium serves to create a “disembodied” context for interaction, as this study illustrates, it may also serve to fully embody. The obvious relationships among self, body, and social situation made evident in any form of sexual experience are largely unexplored in sociology, yet fully within the realm of interest and theoretical models of symbolic interaction.