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391.
In an attempt to provide a statistical tool for disease screening and prediction, we propose a semiparametric approach to analysis of the Cox proportional hazards cure model in situations where the observations on the event time are subject to right censoring and some covariates are missing not at random. To facilitate the methodological development, we begin with semiparametric maximum likelihood estimation (SPMLE) assuming that the (conditional) distribution of the missing covariates is known. A variant of the EM algorithm is used to compute the estimator. We then adapt the SPMLE to a more practical situation where the distribution is unknown and there is a consistent estimator based on available information. We establish the consistency and weak convergence of the resulting pseudo-SPMLE, and identify a suitable variance estimator. The application of our inference procedure to disease screening and prediction is illustrated via empirical studies. The proposed approach is used to analyze the tuberculosis screening study data that motivated this research. Its finite-sample performance is examined by simulation. 相似文献
392.
Health promotion activities are enjoying renewed attention fromgovernments under the rubric of chronic disease prevention,yet often with similar and inadequate resources. Seed-fundingopportunities are popular means for governments to distributemonies and groom communities to embed the funded activitiesinto local ecology. The success of seed funding in nurturingcommunity capacity and engendering program sustainability iscontroversial. This article discusses a recent seed-fundingexperience in the Canadian province of British Columbia. 相似文献
393.
While the existence of racial disproportionality has been well documented, the causes of disproportionality are less clear. Studies identifying contributing factors have relied largely on analyses of state and national data sets, which may lack the robust data necessary to fully explain the factors related to this issue. Further, a limitation of existing research is the lack of data from the voice of those in communities affected by disproportionality. This study was designed to develop a deeper understanding of disproportionality from the views of multiple community stakeholders. Using a qualitative approach, data were collected to provide a greater depth of information that can be used alongside existing studies toward developing an enhanced understanding of disproportionality in child welfare. 相似文献
394.
In 2001, DePuy, a wholly-owned subsidiary of Johnson & Johnson (J&J/DePuy), initiated a seeding study called the “Multi-center, Prospective, Clinical Evaluation of Pinnacle Acetabular Implants in Total Hip Arthroplasty” (PIN Study). J&J/DePuy designed this study to develop new business opportunities during the launch of their Pinnacle Hip System (PHS) and generate survivorship data for marketing. This article, the first review of a seeding trial for a medical device, examines internal company documents relating to the PIN Study; the analysis herein focuses on the integrity of J&J/DePuy’s research practices in conception, implementation, and analysis. J&J/DePuy violated the study protocol and manipulated data; consented participants in violation of standards protecting human subjects; and did not secure Institutional Review Board approval for all study sites. J&J/DePuy used PIN Study results as the “fundamental selling point” for the PHS. Medical device seeding trials are distinct from previously-documented pharmaceutical seeding trials because companies can profit directly from device sales and because these studies may be the first clinical evaluation of the device (as was the case for the PIN Study). Seeding trials are malleable marketing projects, not rigorous scientific studies. Regulatory bodies, physicians, and others should be vigilant for persuasive marketing accounts disguised as science. 相似文献
395.
Biased health care decision making has been regarded as responsible for inefficient behaviours (for example, the limited insurance
purchase). This paper empirically examines two sets of biases in the perception of old age disability and longevity. Particularly,
we test for the existence of a so called cumulative bias and, secondly’ a so called optimism’ bias. Findings are suggestive
of a significant overestimation of disability risks but no overestimation of longevity expectations is found. Both disability
and longevity perceptions appear to exhibit a ‘cumulative’ pattern when mapped over time. Healthier individuals are less likely
to perceive high disability and longevity risks whilst female and younger respondents perceive a higher risk of disability
in old age at a population level but not at an individual level. 相似文献
396.
Women earn less than men. The reason may be due to either industrial segmentation or occupational segregation or both according to the current research. Researches focusing on one structure tend to neglect the other or to use an inadequate representation. This article examines the simultaneous impact of industrial sector and gender on imputed wages with labor force incumbents in four detailed occupations. These occupations are from a set identified as relatively internally homogeneous on measures of task performed from the Dictionary of Occupational Titles. Thus, within-occupational differences in work performed between males and females are minimized. The findings reinforce the importance of industrial sector for economic outcomes and demonstrate the value of an improved representation of occupation. The decomposition shows wage discrimination exists against females in each of these occupations, and in two sector-by-sector occupation comparisons, females should earn more than males. 相似文献
397.
What's So Special? Teachers' Models and Their Realisation in Practice in Segregated Schools 总被引:1,自引:1,他引:0
The concept of 'special' has played a crucial role in the development of educational policy and practice, and the meaning of the term has been the subject of far-reaching debates and controversy. This paper is based on research which explored the meaning of 'specialness' in theory and practice from the point of view of practitioners working in segregated schools, providing education for young people designated as having moderate and severe learning difficulties. The research demonstrates the articulation of the individual model of special in teachers' thinking about pupils, themselves and their relationships with pupils, and also in the learning environment provided for different categories of young people. We argue that the dominant discursive practices of practitioners construct and maintain 'otherness' in special education, and pre-empt alternative discourses. 相似文献
398.
Christina Nilsson Joan Lalor Cecily Begley Margaret Carroll Mechthild M. Gross Susanne Grylka-Baeschlin Ingela Lundgren Andrea Matterne Sandra Morano Jane Nicoletti Patricia Healy 《Women and birth : journal of the Australian College of Midwives》2017,30(6):481-490
Problem and background
Vaginal birth after caesarean section is a safe option for the majority of women. Seeking women’s views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low.Aim
To investigate women’s views on important factors to improve the rate of vaginal birth after caesareanin countries where vaginal birth rates after previous caesarean are low.Methods
A qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country.Findings
Important factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean, that they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficiently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean.Discussion and conclusion
Women’s decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychosocial, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after a previous caesarean as a mode of birth. 相似文献399.
Tucker JS Edelen MO Go MH Pollard MS Green HD Kennedy DP 《Journal of research on adolescence》2012,22(1):113-122
This longitudinal study examines individual differences in the tendency to initiate (N = 4,612) and escalate (N = 2,837) smoking when adolescents gain a best friend who smokes. Potential moderating factors include self-esteem, depression, problem behavior, school and family bonds, and household access to cigarettes. In addition to acquiring a smoking best friend, initiation was predicted by trouble at school, household access, poorer grades and delinquency, whereas escalation was predicted by depressive symptoms. There was little evidence that the examined individual difference factors moderate the association between gaining a smoking best friend and increased adolescent smoking. Results point to the challenges of identifying factors that may lead adolescents to be more or less susceptible to the influence of pro-smoking friends. 相似文献
400.
Toto PE Raina KD Holm MB Schlenk EA Rubinstein EN Rogers JC 《Journal of aging and physical activity》2012,20(3):363-378
This single-group repeated-measures pilot study evaluated the effects of a 10-wk, multicomponent, best-practice exercise program on physical activity, performance of activities of daily living (ADLs), physical performance, and depression in community-dwelling older adults from low-income households (N = 15). Comparison of pretest and posttest scores using a one-tailed paired-samples t test showed improvement (p < .05) for 2 of 3 ADL domains on the Activity Measure-Post Acute Care and for 6 physical-performance measures of the Senior Fitness Test. Repeated-measures ANOVA revealed significant main effects for 3 of 8 physical activity measures using the Yale Physical Activity Scale. Retention rate was 78.9%, and the adherence rate for group sessions was 89.7%. Results suggest that participation in a multicomponent, best-practice physical activity program may positively affect sedentary, community-dwelling older adults' physical activity, ADL performance, and physical performance. 相似文献