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111.
In organ transplantation, placebo-controlled clinical trials are not possible for ethical reasons, and hence non-inferiority trials are used to evaluate new drugs. Patients with a transplanted kidney typically receive three to four immunosuppressant drugs to prevent organ rejection. In the described case of a non-inferiority trial for one of these immunosuppressants, the dose is changed, and another is replaced by an investigational drug. This test regimen is compared with the active control regimen. Justification for the non-inferiority margin is challenging as the putative placebo has never been studied in a clinical trial. We propose the use of a random-effect meta-regression, where each immunosuppressant component of the regimen enters as a covariate. This allows us to make inference on the difference between the putative placebo and the active control. From this, various methods can then be used to derive the non-inferiority margin. A hybrid of the 95/95 and synthesis approach is suggested. Data from 51 trials with a total of 17,002 patients were used in the meta-regression. Our approach was motivated by a recent large confirmatory trial in kidney transplantation. The results and the methodological documents of this evaluation were submitted to the Food and Drug Administration. The Food and Drug Administration accepted our proposed non-inferiority margin and our rationale. 相似文献
112.
Kirstin R. Painter Maria Scannapieco Gary Blau Amy Andre Kris Kohn 《Journal of social service research》2018,44(2):223-235
ABSTRACTThe purpose of this groundbreaking study was to evaluate outcomes of 482 LGBTQ (lesbian, gay, bisexual, transgender, or questioning) youth and young adults who received services and supports through the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances Program (CMHI). This study was a secondary data analysis using data from a larger study of 3208 LGBTQ and non-LGBTQ youth ages 11 through 21 who had a serious emotional disturbance (SED). This study is significant in that it evaluates functional outcomes for young people identified as LGBTQ based on a specialized service framework (i.e., system of care approach). In essence, do LGBTQ youth with SED benefit from a specific approach to intervention? In addition, a comparison at intake on suicidality, bullying and victimization was conducted between the LGBTQ and non-LGBTQ identifying youth from the larger sample. The youth and a caregiver were interviewed face-to-face separately at intake, 6-months, and 12-months. Significant improvements were found across all of the dependent variables, supporting the viability of SOC for improving outcomes for LGBTQ youth. Future research should continue to build on this study by adding to the design a control group to improve internal validity of the findings. 相似文献
113.
Amy Vaughan Mikyoung Jun Cheolwoo Park 《Journal of the Korean Statistical Society》2012,41(1):115-135
SiZer (SIgnificant ZERo crossing of the derivatives) is a graphical scale-space visualization tool that allows for statistical inferences. In this paper we develop a spatial SiZer for finding significant features and conducting goodness-of-fit tests for spatially dependent images. The spatial SiZer utilizes a family of kernel estimates of the image and provides not only exploratory data analysis but also statistical inference with spatial correlation taken into account. It is also capable of comparing the observed image with a specific null model being tested by adjusting the statistical inference using an assumed covariance structure. Pixel locations having statistically significant differences between the image and a given null model are highlighted by arrows. The spatial SiZer is compared with the existing independent SiZer via the analysis of simulated data with and without signal on both planar and spherical domains. We apply the spatial SiZer method to the decadal temperature change over some regions of the Earth. 相似文献
114.
James H. Price Amy Thompson Jagdish Khubchandani Joseph Dake Erica Payton Karen Teeple 《Journal of American college health : J of ACH》2013,61(7):461-469
AbstractObjective: To assess the perceptions and practices of a national sample of college and university presidents regarding their support for concealed handguns being carried on college campuses. Participants: The sample for this study consisted of a national random sample of 900 college or university presidents. Methods: In the spring of 2013, a 3-wave mailing procedure was used to ensure an adequate response rate to a valid and reliable questionnaire. Results: The response rate was 46%, more than what was needed based on the power analysis. The vast majority (95%) of respondents were not supportive of carrying concealed handguns on campuses. They perceived there to be more disadvantages than advantages to handguns on campus. However, college administrators were not focused enough on the primary prevention of campus firearm trauma. Conclusions: The findings of this study suggest a number of activities that could be implemented to enhance safety on college and university campuses. 相似文献
115.
Amy J. Jeffers Katherine E. Vatalaro Hill Eric G. Benotsch 《Journal of American college health : J of ACH》2013,61(5):336-342
Abstract Objective: The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. Participants/Methods: This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association–National College Health Assessment II confidentially online during February 2012. Results: This study revealed that the majority reported lifetime consumption of energy drinks (68.4%) and a substantial minority (30.2%) reported past-30-day consumption. Chi-square and t test results suggest that consumption is associated with concerns about personal appearance, weight loss attempts, and disordered eating behaviors (eg, vomiting). Hierarchical logistic regressions revealed that after controlling for demographics, the relations between energy drink consumption and the act of trying to lose weight, the use of diet pills, and the use of vomiting/laxatives remained significant. Conclusions: The current findings suggest that energy drink consumption is associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors. Future research should examine the prevalence of energy drink consumption for the purpose of weight loss. 相似文献
116.
James J. Annesi Amy Howton Ping H. Johnson Kandice J. Porter 《Journal of American college health : J of ACH》2013,61(4):268-278
AbstractObjective: Small-scale pilot testing of supplementing a required college health-related fitness course with a cognitive-behavioral exercise-support protocol (The Coach Approach). Participants: Three classes were randomly assigned to Usual processes (n = 32), Coach Approach–supplemented: Mid-size Groups (n = 32), and Coach Approach–supplemented: Small Groups (n = 34) conditions. Methods: Repeated-measures analyses of variance (ANOVAs) assessed overall and between-class changes in the behavioral/physiological factors of exercise, fruit/vegetable intake, and body mass index (BMI); and the psychosocial factors of self-regulation, exercise self-efficacy, mood, and body satisfaction. Dependent t tests evaluated within-class changes. Multiple regression analyses tested prediction of exercise by changes in self-regulation, self-efficacy, and mood. Results: Significant improvements in self-regulation and fruit/vegetable intake were found in all classes. The Coach Approach–supplemented classes demonstrated significant increases in exercise. Significant improvements in BMI, self-efficacy, and body satisfaction were found in only The Coach Approach–supplemented: Small Groups class. Psychosocial changes predicted increased exercise. Self-regulation was the strongest contributor. Conclusions: Overall, results were positive and warrant more comprehensive testing. 相似文献
117.
Amy L. Copeland PhD Magdalena Kulesza MA Scott M. Patterson PhD Meredith A. Terlecki MA 《Journal of American college health : J of ACH》2013,61(3):203-212
Abstract Objective: Students who smoke are more likely to engage in risky behaviors such as binge drinking and unprotected sex (Schnieder and Morris, Environ Behav. 1999; 23:575–591). The goals of the present study were to determine whether smokers assess these behaviors as lower risk than nonsmokers, and if smoking rate influences risk perceptions. Methods: Participants were 303 college students. Cognitive Appraisal of Risky Activities (Fromme et al., Cognit Ther Res. 1997; 21:421–442) and smoking were assessed August–November, 2006. Results: Smokers reported significantly less risk, more benefit, and more involvement in risky behaviors than nonsmokers (p < .01). In hierarchical linear regression, risk perceptions moderated the association between smoking and (a) expected benefit from risky sexual behaviors (β = ?1.121, p < .05); and (b) expected involvement with illicit drugs (β = ?.313, p < .01). Conclusions: College smokers’ assessment of high-risk behaviors influenced their intended involvement. Risk perception change may therefore alter their involvement in high-risk behaviors. 相似文献
118.
Approximately 5% of older adults have a dementia diagnosis, and language deterioration is commonly associated with this disorder (Kempler, 2005). Several instruments have been developed to diagnose dementia and assess language capabilities of elderly adults. However, none of these instruments take a functional approach to language assessment as described by Skinner (1957). The purpose of this study was to develop and evaluate a function-based assessment for language deficits of older adults. Thirty-one participants were categorized into a control group (n = 15) and a dementia group (n = 16) based on their score on the Dementia Rating Scale-2. Individuals with dementia performed significantly worse on the tact assessment than those without dementia. Participants from both groups performed better on measures of tacts than intraverbals or mands, even though topographically identical responses were required in these assessments. The data provide support for Skinner''s conceptualization of functionally independent verbal operants. 相似文献
119.
This article integrates critical gerontology and masculinities theories to examine how midlife gay and heterosexual men experience their bodies in relation to cultural discourses of aging. Analyses of in-depth interviews with 15 gay and 15 heterosexual men ages 40–60 reveal that while both groups of men describe their bodies as deteriorating or declining in terms of functionality and are often distressed by these changes, midlife gay men also articulate a concern with a perceived decline in bodily appearance. Both gay and heterosexual midlife men frame their bodies as fundamentally different from women's, possibly in an attempt to protect a masculine identity in response to the threat that aging bodies pose to that identity. We argue that midlife men's embodied experiences are shaped by a discourse of midlife decline as well as inequalities between gay and heterosexual men. We also discuss the implications of embodiment for midlife men's well-being. 相似文献
120.
Emma Russell Amy Lloyd-Houldey Ally Memon Joanna Yarker 《Journal of Technology in Human Services》2013,31(4):222-240
AbstractWhen young people need health information they are increasingly likely to use online sources and health apps (applications). Yet, these are not necessarily well-designed, reliable or appropriate, and research has primarily focused on adult use. Our study is the first to use qualitative mixed methods (focus groups and interviews) to apply the Technology Acceptance Model (TAM) to understand 26 young people’s uptake and use of a new, clinically-approved health app (application) for 16–25?year olds. We found that perceived usefulness, perceived ease-of-use, social influences and trust, all differently impacted children and young people health-app acceptance and effectiveness. Implications for future research and young-person health-app development are discussed. 相似文献