Still-births among the offspring of male radiation workers at the Sellafield nuclear reprocessing plant: detailed results and statistical aspects

Summary. This study investigates whether there was evidence of increasing risk of still-birth with increasing paternal exposure to ionizing radiation received during employment at the Sellafield nuclear installation before the child was conceived. A significant positive association is found between the total paternal preconceptional exposure to external ionizing radiation and the risk of still-birth (after adjustment for year of birth, social class, birth order and paternal age, odds ratio at 100 mSv 1.24 (95% confidence interval 1.04–1.45)). A summary of the principal scientific findings of this study has been published in the Lancet . This paper describes in detail the statistical methods that were used in the investigation and presents the results in full.     

A modified random-effect procedure for combining risk difference in sets of 2×2 tables from clinical trials

Summary Meta-analyses of sets of clinical trials often combine risk differences from several 2×2 tables according to a random-effects model. The DerSimonian-Laird random-effects procedure, widely used for estimating the populaton mean risk difference, weights the risk difference from each primary study inversely proportional to an estimate of its variance (the sum of the between-study variance and the conditional within-study variance). Because those weights are not independent of the risk differences, however, the procedure sometimes exhibits bias and unnatural behavior. The present paper proposes a modified weighting scheme that uses the unconditional within-study variance to avoid this source of bias. The modified procedure has variance closer to that available from weighting by ideal weights when such weights are known. We studied the modified procedure in extensive simulation experiments using situations whose parameters resemble those of actual studies in medical research. For comparison we also included two unbiased procedures, the unweighted mean and a sample-size-weighted mean; their relative variability depends on the extent of heterogeneity among the primary studies. An example illustrates the application of the procedures to actual data and the differences among the results. This research was supported by Grant HS 05936 from the Agency for Health Care Policy and Research to Harvard University.     

The current state of the labor queue: National and regional Evidence

We employ vector autoregressive techniques to determine the current state of the labor queue. Unemployment rate differentials have narrowed in recent years, potentially due to a change in the queue ordering, though a tight labor market and a stable queue would yield similar results. We find no evidence that the queue ordering has changed, which brings into question the resiliency of gains made by minority groups. We employ the same techniques to reveal the state of the queue across geographic regions and find that substantial differences exist across regions, implying variation in the relative labor force status of demographic groups.     

Improving the contributions of technology assessment to the health care system of the U.S.A.

Summary Based on 14 case studies of highly effective therapies and the reasons they succeeded less frequently than they could, we propose a variety of steps to improve the health care system of the U.S.A. Whatever proposal emerges from current national debates until innovations are shown to be safe and effective, they should not be supported; when slightly better technologies are much more expensive than other good ones we need to consider appropriate choices carefully; simplified billing and bookkeping would reduce our costs; when a technology is rapidly introduced cautionnary measures may be needed; tracking immunization and repairing their omissions requires a new system; educational programs such as seen effective in hypertension should be applied in other areas such as vaccination; in organ transplantation the nation should consider “presumed consent”; our payment system sometimes creates perverse incentives and therefore needs review; and the preferences of the public in allocation of health resources need to be discovered once the public is informed about the issues. Research supported by Andrew W. Mellon Foundation.     

The changing character of industrial relations: Comment

Readers wishing to correspond with Mr. O’Connell may do so through the editorial office of the Journal.     

Economic Reform in the Czech Republic: Economic Strain,Depression, Hostility,and the Difference Gender Makes*

The Czech Republic is changing rapidly and its current economic transformation is a strain on Czech families. In this study, the connection between economic strain and individual well-being is investigated via mailed questionnaires from 234 households in the Czech Republic. For Czech women, depression rises more with economic strain than does hostility, while Czech men become more hostile than depressed in the face of economic strain. For women, social support is a buffer between economic strain and hostility, whereas self-esteem is a buffer for depression. For men, both self-esteem and social support exacerbate hostility in the context of economic strain.     

Age Cohort, Ancestry, and Immigrant Generation Influences in Family Relations and Psychological Well-Being among Black Caribbean Family Members

Immigration is contributing to the U.S. population becoming increasingly ethnically diverse. This article examines the role of family relations and well-being among different generations of Black Caribbean immigrants. Family disruptions, such as migration, can have complex effects on the support networks and emotional well-being of family members. Data from a recently completed national study of American Blacks in the United States, however, reveal significant similarities across ancestry and immigrant status in family contact, solidarity and well-being. It is concluded that intrafamilial relations may serve to overcome barriers of geographical distance in providing comparable levels of contact, solidarity, and well-being for both U.S.-born and immigrant Black Caribbean family members of different generations. Because of the increasing numbers of immigrant elders, these sources of family support will become increasingly more important in bridging the gaps between government resources and needed assistance in an aging society.     

Effects of Category Order on Answers in Mail and Telephone Surveys1

Abstract Past research suggests that mail surveys encourage a primacy effect, which is a tendency to choose the first answers from a list, whereas telephone surveys encourage a recency effect, a tendency to choose the last answers from a list. This paper summarizes results from 82 new experiments conducted in 12 separate surveys in seven states. Only four of 33 mail survey comparisons exhibited significant primacy effects, while five of 26 experiments in telephone surveys exhibited recency effects. In addition, only three of 23 cross-method comparisons produced a significant primacy/recency effect in the expected manner. The conclusion is that the prevalence of primacy and recency effects has been over-estimated by past research and a new theoretical approach that takes into account multiple causation is needed for examining these effects.