Trunk stabilization with sling training in osteoporosis patients—a randomized clinical trial

Fractures due to osteoporosis are one of the principal causes of functional limitations, chronic pain, and greater morbidity in advanced age. In addition to bone risk factors for osteoporotic fractures include extraosseous causes such as falls or reduced neuromuscular capacity. Muscle and coordination exercises enhance the patients’ abilities in daily life and prevent falls. In view of recent conclusions drawn from competitive sports, which stress the significance of the muscles of the trunk in respect of reducing back pain and optimizing posture, we used sling exercises to determine whether osteoporosis patients benefit from it and whether it is more advantageous than traditional physiotherapy. Fifty patients were randomized into two groups. Group A received traditional physiotherapy, while group B was given sling exercises, in each case twice a week for a period of 3 months. The results of treatment (pre-post) were analyzed in terms of pain levels, mobility, trunk strength, and the shape of the back. After a further 3 months with no specific exercise treatment, we retested all patients in order to draw conclusions about the long-term effects of the two types of exercise. Forty-four patients (88 %) completed the study. Patients were assigned to small groups (a maximum of five patients in each group) and, thus, received individual attention and motivation. Positive training effects were achieved in both groups. Significantly better results as regards improvement of mobility and reduction of falls were registered in the sling exercise group.     

Direction,not destination: Institutional work practices in the face of field-level uncertainty

Though field-level uncertainty represents a common challenge, research seldom addresses how institutional work that aims to influence institutional change occurs in the face of uncertainty. We study institutional work practices in a field beset with high uncertainty. Focusing on a field-configuring event in the semiconductor industry, we show how institutional work is possible through practices of dealing with uncertainty that do not eliminate the basic uncertainty but nevertheless configure the field and institutionalize a common direction without specifying a final destination. We find evidence of the open-endedness and collectiveness of institutional work and we contribute to the microfoundations of institutional theory conceptualizing a set of four practices of dealing with field-level uncertainty purposively but not purposefully, i.e., bootstrapping, roadmapping, leader-picking, and issue-bracketing. We highlight the reciprocal relationship between practices and uncertainty, focus on the coordination of institutionalization, and distinguish between events in fields marked by high versus low uncertainty.     

Build–operate–transfer (BOT): an emerging entry mode for service offshoring

Build–operate–transfer (BOT) is a well-established solution used in the engineering and construction industries for building different types of infrastructure (e.g. railways, highways, power plants). In recent years, BOT has increasingly been adopted by companies in the service industry as a mode for entering foreign markets. BOT in service offshoring (SO) is characterised by a number of significant peculiarities (e.g. different numbers of involved parties, fee methods, lengths of the concession period), which may call into question the possibility of extending existing findings that relate to infrastructure projects. The aims of this work are as follows: to collect and systematise existing knowledge on engineering and construction BOT projects; to highlight – through an exploratory case study – how these results could be applied to BOT in SO; and to shed light on the factors affecting the choice between different entry modes (including BOT).     

An Indicator for the Measurement of Political Participation: The Case of Italy

In the modern globalized world, political participation is of paramount importance for balanced socio-economic growth and for human development. The Indagine Multiscopo sulle famiglie, a survey by Italian public institutions (ISTAT and CNEL), provides a wide range of data to evaluate specific aspects of Italian life. This work uses a set of data from the Indagine to analyse political participation in Italy at a regional level, by means of a composite indicator using parametric (Pena’s distance) and non-parametric (Mazziotta–Pareto Index) techniques. We have obtained a ranking that shows the level of political participation in different territorial contexts. The aim is to analyse the relation between Italian regions and the political behaviour of their communities: political discussions, participation in political meetings and marches, voluntary activity or donations to political parties and so on. The ranking is not correlated to voter turnout. We can assume that the politically engaged minority are unable to convince and involve the rest. At the same time, these small groups do not alter the general mistrust in parties and, generally speaking, in politics, which is spreading across Italy and also Europe.     

Planning a Bayesian early-phase phase I/II study for human vaccines in HER2 carcinomas

Recent innovative statistical approaches for phase I/II clinical trials allow one to jointly model the toxicity and efficacy of a new treatment, taking into account the information gathered during the trial. Prior probabilities are then updated with interim data and thus predictive probabilities become more accurate as the trial progresses. In this study, prior distribution elicited from a physician's opinion on the available dose levels planned for a vaccination dose-finding trial, with human DNA in patients with HER2-positive tumours in terms of toxicity and therapeutic response is presented and discussed. A simulation study was conducted in order to quantify the impact of the choice of prior on study results, i.e. the recommended dose level at the end of the trial.     

Employment Spells and Previous Labour Market History

ABSTRACT: In this paper the author analyses the influence of the past labour market history of an individual on the length of employment spells he will experience. Most empirical works emphasize the so called Markov model, which implies that the probability of an individual changing state depends only on the state currently occupied. Using data on the labour market histories of a sample of unemployed persons, we specify and estimate a reduced form model where job separation rates arc a function of the entire labour market history and of variables related to personal characteristics and labour market conditions. The empirical analysis supports the claim that transition probabilities are related to past labour market history.     

On estimands and the analysis of adverse events in the presence of varying follow‐up times within the benefit assessment of therapies

The analysis of adverse events (AEs) is a key component in the assessment of a drug's safety profile. Inappropriate analysis methods may result in misleading conclusions about a therapy's safety and consequently its benefit‐risk ratio. The statistical analysis of AEs is complicated by the fact that the follow‐up times can vary between the patients included in a clinical trial. This paper takes as its focus the analysis of AE data in the presence of varying follow‐up times within the benefit assessment of therapeutic interventions. Instead of approaching this issue directly and solely from an analysis point of view, we first discuss what should be estimated in the context of safety data, leading to the concept of estimands. Although the current discussion on estimands is mainly related to efficacy evaluation, the concept is applicable to safety endpoints as well. Within the framework of estimands, we present statistical methods for analysing AEs with the focus being on the time to the occurrence of the first AE of a specific type. We give recommendations which estimators should be used for the estimands described. Furthermore, we state practical implications of the analysis of AEs in clinical trials and give an overview of examples across different indications. We also provide a review of current practices of health technology assessment (HTA) agencies with respect to the evaluation of safety data. Finally, we describe problems with meta‐analyses of AE data and sketch possible solutions.     

Reciprocal Relations across Time between Basic Values and Value‐expressive Behaviors: A Longitudinal Study among Children

The current study examines the reciprocal relations between children's values and value‐expressive behavior over a sixth‐month period. Three hundred and ten sixth‐grade students in Italy completed value and value‐expressive behavior questionnaires three times in three‐month intervals during the scholastic year. We assessed Schwartz's (1992) higher‐order values of conservation, openness to change, self‐enhancement, and self‐transcendence, as well as their respective expressive behaviors. Reciprocal relations over time between values and behaviors were examined using a cross‐lagged longitudinal design. Results showed that values and behaviors had reciprocal longitudinal effects on one another, after the stability of the variables was taken into account (i.e., values predicted change in behaviors, but also behaviors predicted change in values). Our findings also revealed that: (1) values were more stable over time than behaviors and (2) the longitudinal effect of values on behaviors tended to be stronger than the longitudinal effect of behaviors on values. Findings are discussed in light of the recent developmental literature on value change.