Robust Bayesian nonlinear mixed‐effects modeling of time to positivity in tuberculosis trials

Early phase 2 tuberculosis (TB) trials are conducted to characterize the early bactericidal activity (EBA) of anti‐TB drugs. The EBA of anti‐TB drugs has conventionally been calculated as the rate of decline in colony forming unit (CFU) count during the first 14 days of treatment. The measurement of CFU count, however, is expensive and prone to contamination. Alternatively to CFU count, time to positivity (TTP), which is a potential biomarker for long‐term efficacy of anti‐TB drugs, can be used to characterize EBA. The current Bayesian nonlinear mixed‐effects (NLME) regression model for TTP data, however, lacks robustness to gross outliers that often are present in the data. The conventional way of handling such outliers involves their identification by visual inspection and subsequent exclusion from the analysis. However, this process can be questioned because of its subjective nature. For this reason, we fitted robust versions of the Bayesian nonlinear mixed‐effects regression model to a wide range of TTP datasets. The performance of the explored models was assessed through model comparison statistics and a simulation study. We conclude that fitting a robust model to TTP data obviates the need for explicit identification and subsequent “deletion” of outliers but ensures that gross outliers exert no undue influence on model fits. We recommend that the current practice of fitting conventional normal theory models be abandoned in favor of fitting robust models to TTP data.     

Evidence-based practice in Chinese social work: overcoming language and developmental barriers

This scoping review followed Cochrane guidelines to comprehensively assess the use and understanding of Evidence-Based Practice (EBP) in Chinese social science literature. We conducted a research across three electronic databases and three major social science journals for the studies published between 2004 and 2016. Chinese social work literature demonstrates a precise understanding of EBP defined as a process, but it lacks comprehensive discussions about EBP that extend beyond basic principles and process definitions. We identified language barriers and developmental issues for social work in China that contribute to these incomplete discussions. We examined the importance of broadening and enriching the discussions around EBP, especially for Chinese educators, researchers, and clinicians involved with empirically supported treatments. We also consider the implications of our findings for the development of social work in China.     

上海长期护理供需匹配机制探索

长期护理供需不匹配,包括因评估结论失准、服务机构匹配偏差、服务质量不高导致申请人合理需求无法满足,以及因难以纠正申请人过度需求引发的供给短缺.建立和完善长期护理保险制度,必须从现实与可能的角度,建立需求识别、流程管理、服务质量管理的长期护理供需匹配机制.     

Modernity and Globalization: The Local and Global Sources of Individualistic and Materialistic Values in Shanghai

Sociological research has arrived at an intellectual crossroad where it faces the challenge of understanding how the dynamics of globalization have joined the forces of modernization in inducing social change. In this paper, using a survey conducted in Pudong, Shanghai, in 2001, which had captured conditions of the area's rapid transformations in a globalizing city, first, we have uncovered two distinctive dimensions of individualistic vs. materialistic values via factor analysis. Second, we have shown strong bivariate relationships between these two dimensions of values and several demographic and socioeconomic variables, as well as personal global connections (PGCs). Third, we have found that PGCs have uneven significant effects on the emergence of individualistic and materialistic values net of the demographic and socioeconomic variables. Finally, we discuss how modernizing and globalizing conditions are conducive to the formation of individualistic and materialistic values in Shanghai, heralding this process in other rapidly modernizing and globalizing cities in China and elsewhere.     

Cities evolution tree and applications to predicting urban growth

China’s unprecedented urbanization and economic modernization have brought about significant growth and land use changes in cities and their surroundings. Traditional analyses of the relationship between urbanization and land use change have not fully incorporated important factors like city function or developmental stage. We define and apply a new visualization and analysis tool—an evolution tree—showing how an understanding of evolutionary pathways taken by growing cities contributes to visualization and forecasting of urban development and spatial expansion. We clustered 253 Chinese cities by type and developmental stage, arranging them in a “tree” structure, with types grouped as branches and leaf position along branches reflecting developmental stage. Urban growth rates are higher for business-oriented, manufacturing-oriented, and functionally comprehensive cities than for those oriented toward tourism. Extent of spatial growth is dominated by city type and developmental stage. Cities evolve along typical pathways, punctuated by occasional leap developments across functional types.     

Perception of Earthquake Risk in Taiwan: Effects of Gender and Past Earthquake Experience

This study explored how individuals in Taiwan perceive the risk of earthquake and the relationship of past earthquake experience and gender to risk perception. Participants (n= 1,405), including earthquake survivors and those in the general population without prior direct earthquake exposure, were selected and interviewed through a computer‐assisted telephone interviewing procedure using a random sampling and stratification method covering all 24 regions of Taiwan. A factor analysis of the interview data yielded a two‐factor structure of risk perception in regard to earthquake. The first factor, “personal impact,” encompassed perception of threat and fear related to earthquakes. The second factor, “controllability,” encompassed a sense of efficacy of self‐protection in regard to earthquakes. The findings indicated prior earthquake survivors and females reported higher scores on the personal impact factor than males and those with no prior direct earthquake experience, although there were no group differences on the controllability factor. The findings support that risk perception has multiple components, and suggest that past experience (survivor status) and gender (female) affect the perception of risk. Exploration of potential contributions of other demographic factors such as age, education, and marital status to personal impact, especially for females and survivors, is discussed. Future research on and intervention program with regard to risk perception are suggested accordingly.     

公共卫生支出、健康结果与卫生投入政策——基于189个国家和地区的面板门槛分析（1995—2011年）

利用189个国家和地区1995—2011年的数据实证检验公共卫生支出规模对一个国家的健康结果（婴儿死亡率和出生时的平均期望寿命）的影响，结果表明，公共卫生支出占GDP的比重对婴儿死亡率和出生时的平均期望寿命的影响具有门槛效应，门槛值分别位于1.9%和6.62%。分段回归结果显示，公共卫生支出占GDP的比重低于1.9%时，公共卫生投入对出生时的平均期望寿命没有显著影响，对婴儿死亡率的影响较弱；超过1.9%后，公共卫生投入的规模效应开始体现，对健康结果指标的影响均显著增强；超过6.62%后，公共卫生投入对婴儿死亡率的影响不再显著，对出生时平均期望寿命的弹性系数不再变化，单位边际贡献不再增加。中国当前政府卫生投入规模仍然较低，需要继续增大公共资金投入、降低个人卫生支出比重。     

Cross-Sectional and Longitudinal Associations of Categories of Physical Activities with Dimensions of Subjective Well-Being in Taiwanese Older Adults

Physical activity takes place in different social contexts such as leisure, home, and work. However, the differential associations of these distinct categories of activity with aspects of well-being have rarely been investigated. This study was designed to estimate independent associations of (a) leisure-time, (b) domestic and (c) work-related physical activities with subjective well-being in older adults. A cross-sectional survey was conducted in 2009 with 2,295 community-dwelling older adults aged 65 or older in Kaohsiung, Taiwan. Among them, 307 participants were selected for a 3-year follow-up study in 2012. The results based on cross-sectional and longitudinal analyses demonstrated that leisure-time physical activity, after multivariate adjustment, was positively associated with five dimensions of well-being, including ‘physical’, ‘psychological’, ‘independence’, ‘learning and growth’, and ‘social’ well-being. Household physical activity was positively associated only with ‘social’ well-being. Occupational physical activity was not related to any dimension of well-being. The study suggests that associations between physical activity and dimensions of subjective well-being during later life are dependent on the social context in which the activity takes place. This study indicates that physical activity taken as leisure has greatest potential to enhance the quality of life of older adults.