Dependence Estimation Over a Finite Bivariate Failure Time Region

This articleconcerns nonparametric estimation of association between bivariatefailure times. In the presence of independent right censoring,the support for failure time variates may be restricted and measuresof dependence over a finite failure time region may be of particularinterest. To this end, the reciprocal cross ratio function, weightedby the bivariate failure time density, is proposed as a summarymeasure of dependence over a failure time region. This `relativerisk' estimator is shown to be consistent and asymptoticallynormally distributed, with consistent bootstrap variance estimator.A finite-region version of Kendall's tau, which is suitable forcensored failure time data, is also proposed, and correspondingasymptotic distribution theory is noted. The accuracy of theseasymptotic approximations is studied in simulations and an illustrationis provided.     

Setting up a CLIA-certified laboratory in a student health services clinic

Performing some laboratory tests on site at a student health service clinic may increase efficiency and cut costs for patients. However, with the passage of the Clinical Laboratory Improvement Amendments (CLIA) of 1988, many laboratories in physician offices and clinics have shut down because of increased regulatory requirements. The personnel in one SHS laboratory found that the guidelines proposed by CLIA help assure quality care and are not prohibitive. In this article, the process of applying for and receiving a CLIA certificate in the student health clinic setting is explored.     

The use of temporary restraining orders (TROs) as a strategy to address intimate partner violence

One of the most prominent interventions developed to protect victims in domestic abuse cases is the temporary restraining order or "TRO," the purpose of which is to restrain an alleged defendant from further harassment or abuse against a plaintiff. This report analyzes 397 restraining order petitions, and subsequent arrest and conviction data for TRO defendants from 1996 to 1998. Findings confirm that TRO petitioners report many types of abuse and while half of TRO defendants do not re-offend, a small percent of defendants are responsible for multiple police reports, arrests, and criminal violations. Outcome data are discussed for program and policy implications.     

Effective targeted and community HIV/STD prevention programs

Community interventions and interventions targeting specific groups at risk of STDs/HIV have demonstrated significant impacts on sexual behavior, particularly condom use and safer sex. The scientific evidence suggests the factors that make these interventions particularly effective include the establishment of community, including business and CBO partnerships; maintainance of the intervention post-research funding; and buy-in by the community or target group. The modification of risky normative beliefs through the use of opinion leaders and role models, and through intervention delivery by peer educators, is an important facet of such interventions. Interventions delivered by health professionals, absent a community base, appear to be unsuccessful. Where cultures or subcultures are targeted, the close involvement of such groups in the design and delivery of messages is critical to their success. Diffusion of interventions through existing social networks further extends the intervention into the community and acts to reinforce and maintain changes in peer norms toward safer sexual behavior. The available data confirm that community or medical infrastructure-based interventions are effective in changing sexual behavior and can reach a wider range of the population than face-to-face programs if they incorporate peer educators as role models in modifying norms, and if diffusion of the intervention is integral to the design.     

Bridging child welfare and juvenile justice: preventing unnecessary detention of foster children

Gaps in service coordination between child welfare and other child-serving agencies are well documented. This article examines the gap between the child welfare and juvenile justice systems and discusses a program, Project Confirm, designed to reduce the problems associated with this gap. Project Confirm aims to improve cooperation between juvenile justice and child welfare agencies to prevent the unnecessary detention of arrested foster children in secure facilities. The program's design is outlined, and implementation statistics and government partner perceptions of the program in its first year of operations are provided. The article also identifies future challenges to implementation and discusses the broader implications of the program. In making this appeal for coordination and collaboration among public agencies, I'm not talking about pro forma integration efforts-I'm not talking about memoranda of understanding or top-level reorganizations that have autonomous agencies vaguely reporting to a single box labeled "human services." Rather, I'm talking about the much more challenging objective of achieving real working partnerships at the front line. (Nelson, 1998, p. 6)     

Health professional students' occupational exposures to blood-borne pathogens: primary and secondary prevention strategies

Health science students, along with the health professionals they hope to become, are at increased risk for certain occupational injuries and illnesses. One of these risks is occupational exposure to blood-borne pathogens, such as human immunodeficiency virus (HIV) and hepatitis, which may result in severe illnesses or even death. Two case studies demonstrate postexposure care of exposed individuals at the University of Texas Medical Branch Student Health Services before and after policy changes and prevention strategies were strengthened in response to exposure incidents.     

Evaluating basic research strategies

A model has been developed to describe the pharmaceutical research and drug innovation process. The model originally served to show the range of results that could arise from research in the field of infectious disease chemotherapy over a sustained period of time. The main goal of the model was to illuminate the risk/reward/time tradeoff faced by management in selecting a particular research strategy. The results obtained with this model were one of several considerations influencing the research strategy decision of CIBA-GEIGY in 1976 to adapt and strengthen its research effort in infectious disease chemotherapy.This model has so far been applied only for the comparative evaluation of infectious disease chemotherapy research strategies. However, there is no conceptual reason why it should be limited to this field of drug research or indeed to pharmaceutical research at all. This type of analysis should be applicable wherever clear, product-oriented research goals can be identified and defined, where some reasonable financial reward can be attached to achieving these goals, and where an assessment—albeit subjective—can be made of the likelihood of achieving these goals.     

A Taxometric Analysis of Problem Gambling Data from a South African National Urban Sample

We investigate the question whether problem gambling (PG) in a recent South African sample, as measured by the Problem Gambling Severity Index (PGSI), is dimensional or categorical. We use two taxometric procedures, Mean Above Minus Below A Cut (MAMBAC) and Maxim Covariance (MAXCOV), to investigate the taxonic structure of PG as constructed by the PGSI. Data are from the 2010 South African National Urban Prevalence Study of Gambling Behavior. A representative sample of the urban adult population in South Africa (N = 3,000). Responses are to the 9 item PGSI. MAMBAC provided positive but modest evidence that PG as measured by the PGSI was taxonic. MAXCOV pointed more strongly to the same conclusion. These analyses also provide evidence that a PGSI cutoff score of 10 rather than the standard 8 may be called for. PG as constructed by the PGSI may best be thought of as categorical, but further studies with more theory based measurements are needed to determine whether this holds in a wider range of samples and for other screens. A higher cutoff score may be called for on the PGSI when it is used for research purposes to avoid false positives.