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821.
Journal of Population Research - The extant literature shows that fertility desires are an important indicator for understanding and predicting the future course of fertility; however, little work...  相似文献   
822.
Noninferiority trials intend to show that a new treatment is ‘not worse'' than a standard-of-care active control and can be used as an alternative when it is likely to cause fewer side effects compared to the active control. In the case of time-to-event endpoints, existing methods of sample size calculation are done either assuming proportional hazards between the two study arms, or assuming exponentially distributed lifetimes. In scenarios where these assumptions are not true, there are few reliable methods for calculating the sample sizes for a time-to-event noninferiority trial. Additionally, the choice of the non-inferiority margin is obtained either from a meta-analysis of prior studies, or strongly justifiable ‘expert opinion'', or from a ‘well conducted'' definitive large-sample study. Thus, when historical data do not support the traditional assumptions, it would not be appropriate to use these methods to design a noninferiority trial. For such scenarios, an alternate method of sample size calculation based on the assumption of Proportional Time is proposed. This method utilizes the generalized gamma ratio distribution to perform the sample size calculations. A practical example is discussed, followed by insights on choice of the non-inferiority margin, and the indirect testing of superiority of treatment compared to placebo.KEYWORDS: Generalized gamma, noninferiority, non-proportional hazards, proportional time, relative time, sample size  相似文献   
823.
Over the twentieth and twenty-first centuries, veterans have been more likely to enter into race/ethnic intermarriages than non-veterans. Theories of race/ethnic intermarriage variously point to how minority race/ethnicity, race/ethnically diverse social settings, progressive racial attitudes, and high socioeconomic status increase individuals’ likelihood of intermarrying. Veterans’ unique racial and socioeconomic characteristics may contribute to their greater likelihood of intermarrying relative to non-veterans: larger percentages of veterans than non-veterans are members of racial and ethnic minority groups, while military service increases individual service members’ long-term economic and educational prospects. At the same time, veterans share in common their exposure to the unique military environment, which may increase their likelihood of intermarriage by diversifying their social circles, and subjecting their attitudes and behavior to group norms that are more explicitly egalitarian than those of society at large. The present study considers these two possible explanations for veterans’ greater likelihood of intermarriage. We use data on seven cohorts of men over six decades in the Current Population Survey, representing a total of 1,456,742 observations, to decompose the difference in likelihood of racial intermarriage between veterans and non-veterans among married men aged 18–65. We find that across cohorts and decades, veterans’ greater likelihood of intermarrying is not fully explained by their race/ethnic and socioeconomic composition. We argue that veterans’ greater likelihood of intermarrying may therefore be driven by their exposure to the military environment.  相似文献   
824.
Sea-Level Rise (SLR) Projections from the National Oceanic and Atmospheric Administration (NOAA) and the U.S. Army Corp of Engineers (USACE) indicate increasing, and imminent, risk to coastal communities from tidal flooding and hurricane storm surge. Building on recent research related to the potential demographic impacts of such changes (Hauer et al. 2016, in Nat Clim Chang 3:802–806, 2017; Neumann et al. 2015; Curtis and Schneider in Popul Environ 33:28–54, 2011), localized flooding projections in the Miami Beach area (Wdowinski et al. in Ocean Coast Manag 126:1–8, 2016) and projected economic losses associated with this rise in projected SLR (Fu et al. Ocean Coast Manag 133:11–17, 2016); this research investigates the accrued current cost, in terms of real-estate dollars lost, due to recurrent tidal flooding and projected increases of flooding in Miami-Dade County. Most directly related to this line of research, Keenan et al. (2018) have recently produced results indicating that Climate Gentrification is taking place in Miami, FL with higher elevations in flood prone areas appreciating at a higher rate. In that vein of thinking, we seek to answer a question posed by such research: What is the actual accrued loss to sea-level rise over the recent past? To answer this question, we replicate well-documented estimation methods by combining publicly available sea-level rise projections, tide gauge trends, and property lot elevation data to identify areas regularly at risk of flooding. Combining recent patterns of flooding inundation with future forecasts, we find that properties projected to be inundated with tidal flooding in 2032 have lost $3.08 each year on each square foot of living area, and properties near roads that will be inundated with tidal flooding in 2032 have lost $3.71 each year on each square foot of living area. These effects total over $465 million in lost real-estate market value between 2005 and 2016 in the Miami-Dade area.  相似文献   
825.
826.

Problem

Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.

Purpose

The purpose of this study was twofold: (1) to explore maternal health care providers’ perceptions and experiences of barriers in providing care to Marshallese women, and (2) providers perceived barriers of access to care among Marshallese women. This is the first paper to explore perceived barriers to maternal health care among a Marshallese community from maternal health care providers’ perspectives in the United States.

Methods

A phenomenological, qualitative design, using a focus group and in-depth interviews with 20 maternal health care providers residing in northwest Arkansas was chosen.

Findings

Several perceived barriers were noted, including transportation, lack of health insurance, communication and language, and socio-cultural barriers that described an incongruence between traditional and Western medical models of care. There was an overall discord between the collectivist cultural identity of Marshallese families and the individualistic maternal health care system that merits further research.

Discussion

Solutions to these barriers, such as increased cultural competency training for maternal health care providers and the incorporation of community health workers are discussed.  相似文献   
827.
828.
This study illuminates the association between cigarette smoking and adult mortality in the contemporary United States. Recent studies have estimated smoking-attributable mortality using indirect approaches or with sample data that are not nationally representative and that lack key confounders. We use the 1990–2011 National Health Interview Survey Linked Mortality Files to estimate relative risks of all-cause and cause-specific mortality for current and former smokers compared with never smokers. We examine causes of death established as attributable to smoking as well as additional causes that appear to be linked to smoking but have not yet been declared by the U.S. Surgeon General to be caused by smoking. Mortality risk is substantially elevated among smokers for established causes and moderately elevated for additional causes. We also decompose the mortality disadvantage among smokers by cause of death and estimate the number of smoking-attributable deaths for the U.S. adult population ages 35+, net of sociodemographic and behavioral confounders. The elevated risks translate to 481,887 excess deaths per year among current and former smokers compared with never smokers, 14 % to 15 % of which are due to the additional causes. The additional causes of death contribute to the health burden of smoking and should be considered in future studies of smoking-attributable mortality. This study demonstrates that smoking-attributable mortality must remain a top population health priority in the United States and makes several contributions to further underscore the human costs of this tragedy that has ravaged American society for more than a century.  相似文献   
829.

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.

Aim

Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided.

Methods

Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity.

Findings

Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities.

Conclusion

Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive prenatal online resources.  相似文献   
830.
The authors investigated whether trends in attitudes about gender were consistent with the gender stall primarily occurring in the family domain and examined potential mechanisms associated with changing gender norms. Using data from Monitoring the Future surveys (1976–2015), the authors assessed three components of trends in youth's beliefs about gender: the marketplace, the family, and mothers' employment. Findings showed continued increases in egalitarianism from 1976 through the mid‐1990s across all three dimensions. Thereafter, support for egalitarianism in the public sphere plateaued at high levels, rising support for mothers' employment persisted at a slower pace, and conventional ideology about gender in families returned. The changing demographic composition of American high school students did not account for the gender attitude trends. Youth's mothers' employment and increased education were related to increased egalitarianism. Changes in population averages of mothers' employment and educational attainment were only weakly associated with increases in egalitarian attitudes.  相似文献   
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