Effects of a single-lesson tobacco prevention curriculum on knowledge, skill identification and smoking intention

One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not to smoke. Data were collected, via electronic keypads, from students visiting a non-school, health education center in Michigan (n = 704 intervention and 85 comparison). Contingency table Chi-squared tests and t-tests demonstrated that a single lesson can improve general knowledge and ability to identify appropriate refusal techniques. Improvement in intent not to smoke was not significant because both groups had very high intent prior to implementation. Similar to results from other programs, multivariate logistic regression of gender, general knowledge, and skill identification revealed that only the skill variable was associated with intent not to smoke at pretest. Recommendations are given for further research and for designing more effective curricula or programs.     

Doing gender,modestly: Conceptualizing workplace experiences of Pakistani women doctors

Using the theoretical framework of inequality regimes, this article offers a reconceptualization of purdah as it is practised, lived and experienced by women doctors of Pakistan. Based on an ethnographic study of Pakistani women doctors, this research indicates that practising purdah in the workplace is perceived as doing femininity within the hegemonic masculine workplace culture of Pakistan. In Pakistani organizations, individual and institutionalized practices of purdah create a gendered substructure which marginalizes women doctors by dictating the norms of conduct, international ethics, organization of physical space and work allocation. Patriarchal interpretations of religious doctrines of modesty provide legitimacy to the existence of these inequality regimes. Based on this, the article argues for a system‐level theorization of purdah that accounts for both individual and institutional norms of veil. Such conceptualization contributes to our understanding of how religion intersects with gender, class and race to create complex systemic inequities in organizational structure.     

Minority Stress in the Lives of Men Who Have Sex With Men in Cape Town,South Africa

The mental health outcomes of men who have sex with men (MSM) living in sub-Saharan Africa are understudied, despite evidence that discrimination and stigma are widespread. This article examines the occurrence and mental health effects of minority stress in a sample of diverse South African MSM. Twenty-two MSM living in Cape Town took part in exploratory qualitative in-depth interviews and completed mental health questionnaires. Results indicate that the majority of participants experienced minority stress, which affected their sexual relationships and coping strategies. Concealment behaviors and perceived discrimination levels were high and were associated with race, religion, SES, and geographical location.     

Doubly sparse regression incorporating graphical structure among predictors

Recent research has demonstrated that information learned from building a graphical model on the predictor set of a regularized linear regression model can be leveraged to improve prediction of a continuous outcome. In this article, we present a new model that encourages sparsity at both the level of the regression coefficients and the level of individual contributions in a decomposed representation. This model provides parameter estimates with a finite sample error bound and exhibits robustness to errors in the input graph structure. Through a simulation study and the analysis of two real data sets, we demonstrate that our model provides a predictive benefit when compared to previously proposed models. Furthermore, it is a highly flexible model that provides a unified framework for the fitting of many commonly used regularized regression models. The Canadian Journal of Statistics 47: 729–747; 2019 © 2019 Statistical Society of Canada     

A simple approach to analyzing clustered longitudinal data

When modeling correlated binary data in the presence of informative cluster sizes, generalized estimating equations with either resampling or inverse-weighting, are often used to correct for estimation bias. However, existing methods for the clustered longitudinal setting assume constant cluster sizes over time. We present a subject-weighted generalized estimating equations scheme that provides valid parameter estimation for the clustered longitudinal setting while allowing cluster sizes to change over time. We compare, via simulation, the performance of existing methods to our subject-weighted approach. The subject-weighted approach was the only method that showed negligible bias, with excellent coverage, for all model parameters.     

Migration,Diaspora and Citizenship: A Qualitative Study of the Perceptions of Pakistani Nationals towards the Political Rights of Pakistani Dual Citizens

The dual citizenship has been the subject of intense political debate in Pakistan barring the elected representatives, in parliament, the provincial assemblies and the presidency, from holding dual nationality. The perceptions that holding a foreign citizenship challenges the undiluted loyalty to country further engender question mark over their political participation in country’s affairs. A qualitative study has been carried out in the city of Rawalpindi to explore the stance of Pakistani nationals on such exclusion of Pakistani dual citizens from mainstream politics of Pakistan asking should the individual’s association to the state be an exclusive one? In this paper, in‐depth interviews were conducted with a sample of 40 male and female respondents (22 Pakistani citizens, 18 Pakistani dual citizens) and 6 constitutional experts. The results indicate distrust among Pakistani citizens when considering dual citizens’ right of representation in general elections of Pakistan, stemming from a mistrust of their “split loyalties”.     

Considering the best interests of infants in foster care placed separately from their siblings

This article offers a perspective on the child welfare practice of placing infants and their siblings in foster care using the theoretical frameworks of attachment and infant mental health. The authors highlight issues for child welfare workers to consider when determining if moving an infant or young child from one home to another for the purpose of placing him with his siblings would cause trauma or disruption; and also issues to consider when determining the infant or young child's best interest when separated from siblings. First, the authors summarize the literature regarding attachment relationships and attachment disruptions. Then, they review outcome studies of children residing in foster care who are placed with their siblings and of those who are placed separately. Finally, the authors conclude with specific recommendations for child welfare workers to aid in making such difficult decisions about placing infants in foster care.     

Developing a clinical trial governance framework for pharmaceutical industry-funded clinical trials

ABSTRACT

Rising concerns relating to pharmaceutical sponsor bias in the conduct of clinical trials have compelled the need to develop a clinical trial governance framework. This article describes the development of the Conflict of Interest in Research (COIR), a clinical trial governance framework. The COIR, consisting of three process phases (initiation, concurrent, and ongoing), developed following a needs assessment, using a four-stage methodology, and evaluated against the International Conference on Harmonization--Good Clinical Practice (ICH-GCP) guidelines. The Conflict of Interest Resolution algorithm, the backbone of COIR, enables constant surveillance to detect/resolve conflicts at all stages of the clinical trial life-cycle. COIR promotes interaction between the regulatory system and the sponsors, independent of individuals. COIR enables rapid detection of scientific and financial conflicts, to prevent subject harm and, to assure optimal funds utilization, the latter feature helped to reduce a significant burden for the ethics committee, as it lacks financial expertise. COIR is a semi-automated Oracle system, requires manpower, and is affected by human expertise and subjectivity. Complete automation to overcome this limitation will still need human expertise to scale changing trial regulations. Nevertheless, the COIR has won the distinction of the “most favored site” from pharmaceutical sponsors and is anticipated to be adopted by other clinical trial sites.     

Understanding of elder abuse and neglect among health care professionals in Malaysia: An exploratory survey

ABSTRACT

Elder abuse and neglect (EAN) is a hidden public health challenge for Malaysia. This cross-sectional survey studied the awareness of EAN among 148 doctors and nurses from two neighboring states in Malaysia using a self-administered questionnaire exploring their knowledge, perceptions, practices, and experience concerning EAN. Both doctors and nurses demonstrated poor understanding of signs of EAN and exhibited misperceptions on reporting requirements. Both groups perceived EAN as a national burden and reporting it as their responsibility; but most felt they had not been trained to diagnose it. Many were unsure of procedures and whether their own intervention could be effective. Only four (nurses) of 41 participants who suspected abuse during the past year reported the cases. Targeted education and uniform protocols are mandatory to ensure best practice with regards to EAN. Further research is crucial to extend this inquiry into the broader health care workforce.     

Expert Testimony Influences Juror Decisions in Criminal Trials Involving Recovered Memories of Childhood Sexual Abuse

We examined the impact of expert witness orientation (researcher or clinical practitioner) and type of testimony (testimony for the prosecution, defense, both prosecution and defense, or no testimony) on mock jurors’ decisions in a sexual abuse trial. Participants acted as mock jurors on a sexual abuse criminal trial based on recovered memory that included expert witness testimony. Results showed that expert witness testimony provided by a researcher did not impact mock jurors’ guilt ratings any differently than the expert witness testimony provided by a clinical practitioner. However, type of testimony had a significant effect on jurors’ guilt ratings such that jurors who read only defense or only prosecution testimony made decisions favoring the relevant side.