The attributable estimand: A new approach to account for intercurrent events

The term “intercurrent events” has recently been used to describe events in clinical trials that may complicate the definition and calculation of the treatment effect estimand. This paper focuses on the use of an attributable estimand to address intercurrent events. Those events that are considered to be adversely related to randomized treatment (eg, discontinuation due to adverse events or lack of efficacy) are considered attributable and handled with a composite estimand strategy, while a hypothetical estimand strategy is used for intercurrent events not considered to be related to randomized treatment (eg, unrelated adverse events). We explore several options for how to implement this approach and compare them to hypothetical “efficacy” and treatment policy estimand strategies through a series of simulation studies whose design is inspired by recent trials in chronic obstructive pulmonary disease (COPD), and we illustrate through an analysis of a recently completed COPD trial.     

Nondrinker Mortality Risk in the United States

The literature has shown that people who do not drink alcohol are at greater risk for death than light to moderate drinkers, yet the reasons for this remain largely unexplained. We examine whether variation in people’s reasons for nondrinking explains the increased mortality. Our data come from the 1988–2006 National Health Interview Survey Linked Mortality File (N = 41,076 individuals age 21 and above, of whom 10,421 died over the follow-up period). The results indicate that nondrinkers include several different groups that have unique mortality risks. Among abstainers and light drinkers the risk of mortality is the same as light drinkers for a subgroup who report that they do not drink because of their family upbringing, and moral/religious reasons. In contrast, the risk of mortality is higher than light drinkers for former drinkers who cite health problems or who report problematic drinking behaviors. Our findings address a notable gap in the literature and may inform social policies to reduce or prevent alcohol abuse, increase health, and lengthen life.     

RESPONDING TO FEMALE GENITAL MUTILATION: THE AUSTRALIAN EXPERIENCE IN CONTEXT

The increasing number of migrant women and girls in Australia affected by female genital mutilation (PGM) presents a significant challenge for public policy. Addressing FGM requires an understanding of the practice, its incidence and consequences; as of the cultural patterns and belief systems that underwrite it in those countries where it is commonly practised. Australian policy and programmatic responses to FGM are placed in the context of both international initiatives and those in other countries of settlement, and the underlying principles that guide effective FGM policy development identified.     

Developing a researcher-practitioner partnership for the effective evaluation of professional social work training

This paper reports on the development and operationalisation of a partnership between researchers at the Centre for Child Care Research at Queens University, Belfast and the Southern Health and Social Services Board Training Unit to undertake an evaluation of the Children (NI) Order Training Programme. The concept of partnership and its application to researcher-practitioner relationships is discussed. The stages of development of the partnership between the Training Unit and the researchers, and the outcomes achieved from this partnership, are described. The similarities and differences between the partnership approach developed by the CCCR and the SHSSB are highlighted. The potential benefit of this approach for other researchers and practitioners seeking to develop such links is presented.     

The Potential Impact of ‘Public Access’ Legislation on Access to Forestry Literature

There have been increasing calls for the United States (U.S.) government’s implementation of broad public access policies mandating free online access to federally funded research. This study examines the potential impact of such a policy on peer-reviewed forestry literature. The authors analyze information about federal government authorship, federal government funding, and U.S. authorship indicated in articles published in five core forestry journals in 2006. The results of the analysis provide evidence that federal public access legislation would have a significant impact on the accessibility of forestry literature published in leading journals in the field.     

Young people’s participation in Fiji: understanding conceptualizations and experiences

Young people’s participation has become a cliché in western democracies. In the case of Fiji, it is a novel concept, not because young people have not participated before but because they are exposed to new and different ways of involvement. This paper is one of the earliest attempts to explore young people’s understanding and experiences of participation in Fiji. It is based on data drawn from an exploratory study conducted with a select group of young people in Suva, Fiji. Forms of young people’s engagement although diverse are dominated by the traditional discourse of participation represented in ‘performance and responsibility’ and tend to be represented in the media and policy circles. This paper shows that young people are not bound by these conceptions but talk of participation as experienced in the hybridized settings of their everyday reality. The study offers a window into understanding young people’s participation in Fiji and suggests that a deeper appreciation of this facet of their lives can be achieved with an emphasis on participatory talk with and an exploration of spaces where young people are constantly negotiating the traditional expectations of being young, being dutiful citizens and self-directed individuals.     

Nuclear Waste Management under Approaching Disaster: A Comparison of Decommissioning Strategies for the German Repository Asse II

This article compares different strategies for handling low‐ and medium‐level nuclear waste buried in a retired potassium mine in Germany (Asse II) that faces significant risk of uncontrollable brine intrusion and, hence, long‐term groundwater contamination. We survey the policy process that has resulted in the identification of three possible so‐called decommissioning options: complete backfilling, relocation of the waste to deeper levels in the mine, and retrieval. The selection of a decommissioning strategy must compare expected investment costs with expected social damage costs (economic, environmental, and health damage costs) caused by flooding and subsequent groundwater contamination. We apply a cost minimization approach that accounts for the uncertainty regarding the stability of the rock formation and the risk of an uncontrollable brine intrusion. Since economic and health impacts stretch out into the far future, we examine the impact of different discounting methods and rates. Due to parameter uncertainty, we conduct a sensitivity analysis concerning key assumptions. We find that retrieval, the currently preferred option by policymakers, has the lowest expected social damage costs for low discount rates. However, this advantage is overcompensated by higher expected investment costs. Considering all costs, backfilling is the best option for all discounting scenarios considered.     

Semiparametric methods in nonlinear time series analysis: a selective review

Time series analysis is a tremendous research area in statistics and econometrics. In a previous review, the author was able to break down up 15 key areas of research interest in time series analysis. Nonetheless, the aim of the review in this current paper is not to cover a wide range of somewhat unrelated topics on the subject, but the key strategy of the review in this paper is to begin with a core the ‘curse of dimensionality’ in nonparametric time series analysis, and explore further in a metaphorical domino-effect fashion into other closely related areas in semiparametric methods in nonlinear time series analysis.     

Seasonal analysis of emergency department presentations in Western Australia, 2009/10–2014/15

Understanding the dynamic effects of seasonal variations of emergency department (ED) presentations is necessary to enhance health service planning and delivery, avoid overcrowding and meet the demand of the population. Time series analysis of seasonal trend decomposition using Loess (STL) was used to decompose and isolate the seasonal component of the ED presentations in Western Australia (WA) hospitals. Between 2009/10 and 2014/15, there were 5,652,556 ED presentations that show distinctive seasonal pattern. The overall seasonal variation was 7.0% (95% CI: 6.0–8.4%) and peaked in winter, with the highest in August. However, stratification analysis revealed that patients aged 15–64 years and those with triage 4 and 5 peaked in summer. The stratification for the most frequent conditions presented to metropolitan EDs and triaged as categories 1, 2 or 3 (most urgent conditions) shown that acute upper respiratory infection, pneumonia, viral infection, status asthmaticus and breathing abnormalities peaked in winter, whereas cellulitis, urinary tract infection, threatened abortion, intestinal infection, gastroenteritis and colitis, nausea and vomiting, and open wound of finger peaked in summer. The findings may be important in developing strategies and policies to manage ED demand in peak periods to avoid overcrowding and improve service delivery.