A fast Monte Carlo expectation–maximization algorithm for estimation in latent class model analysis with an application to assess diagnostic accuracy for cervical neoplasia in women with atypical glandular cells

In this article, we use a latent class model (LCM) with prevalence modeled as a function of covariates to assess diagnostic test accuracy in situations where the true disease status is not observed, but observations on three or more conditionally independent diagnostic tests are available. A fast Monte Carlo expectation–maximization (MCEM) algorithm with binary (disease) diagnostic data is implemented to estimate parameters of interest; namely, sensitivity, specificity, and prevalence of the disease as a function of covariates. To obtain standard errors for confidence interval construction of estimated parameters, the missing information principle is applied to adjust information matrix estimates. We compare the adjusted information matrix-based standard error estimates with the bootstrap standard error estimates both obtained using the fast MCEM algorithm through an extensive Monte Carlo study. Simulation demonstrates that the adjusted information matrix approach estimates the standard error similarly with the bootstrap methods under certain scenarios. The bootstrap percentile intervals have satisfactory coverage probabilities. We then apply the LCM analysis to a real data set of 122 subjects from a Gynecologic Oncology Group study of significant cervical lesion diagnosis in women with atypical glandular cells of undetermined significance to compare the diagnostic accuracy of a histology-based evaluation, a carbonic anhydrase-IX biomarker-based test and a human papillomavirus DNA test.     

Disabled Women Sexually Abused in Childhood: Treatment Considerations

There is a dearth of literature addressing the issues presented in the treatment of adult disabled women who were victims of childhood sexual abuse. This article focuses on the pertinent issues involved in clinically treating this population, such as the meaning of the traumatic event of sexual abuse for the individual, the disability and how it may have impacted her in terms of dependence, body integrity, and sexuality. Coping strategies and case examples are presented and possible countertransferential reactions are examined.     

The resolution of faulty identification process in a borderline adolescent girl

This paper discusses problems of identification which interfere with a borderline adolescent girl's completion of her adolescent developmental tasks. Therapeutic work entails the provision of a protective environment to assist processes of identification, separation and completion of structural restoration.     

The importance of selected housing features at various stages of the life cycle

The spatial environment of the home is an important factor in the consideration of satisfactory housing for families. With the increasing demand for housing, it has become common to simply provide the basic structure without addressing the various wants and needs of individuals and families. It is the purpose of the study reported here to evaluate the importance of specific housing features based on stage in the family lifecycle. Results show that those features with the highest importance involve low maintenance, aesthetics, and environmental quality. Implications for home designers, educators, and consumers are discussed.Kathleen Ann Lodl is an Instructor in the Department of Consumer Science and Education, 128 Home Economics, University of Nebraska-Lincoln, Lincoln, NE 68583-0801. Her research interests include housing design, residential alterations, and female-headed households. She is currently working on a Ph.D. from the University of Nebraska.Betsy S. Gabb is an Assistant Professor in the Department of Textiles, Clothing and Design, 226 Home Economics, University of Nebraska-Lincoln, NE 68583-0802. Her research interests include housing design and residential space use. She received her Ed.D. from the University of Nebraska.E. Raedene Combs is a Professor in the Department of Consumer Science and Education, 134 Home Economics, University of Nebraska-Lincoln, Lincoln, NE 68583-0801. Her research interests include housing designs for special populations and families at risk. She received her Ph.D. from Purdue University.     

Contextual Accounts of Student Absences

Analysis of college student accounts given for classroom absences shows that some students provide justifications, but most rely on excuses. Females produced more accounts and were more likely to cite illness as an excuse, while males were more likely to refer to other pressing classwork requirements. A correlation existed between absences explained and grade, while preparation for another class was the only explanation found to be significantly related to course grade.     

Limitsetting,coping and adaptation: A theoretical context for clinicians and caregivers

Limitsetting in child therapeutic work presents the practitioner with a complex and often conflictual challenge of deciding what limitsetting techniques are appropriate with which children under what specific circumstances. This paper places the clinical limitsetting challenge within a frame of reference derived from the literature on coping and adaptation in an attempt to offer practitioners a more comprehensive, systemic framework within which to evaluate a child's limitsetting needs.     

JUST ANOTHER CRIME? Examining Disparity in Homicide Sentencing

Analyses of disparity in sentencing most frequently use general felony court samples. Because of this, little is known about the specific patterns of sentencing disparity among defendants convicted of criminal homicide. Using a sample of defendants adjudicated guilty of homicide in Philadelphia, Pennsylvania, over the period 1995–2000, this research seeks to describe and explain patterns of sentencing with reference to legal and extralegal defendant and case characteristics. The findings indicate that it is primarily legally relevant variables that influence sentencing outcomes in homicide cases; however, some evidence is found for case processing effects as well as for the operation of criminal stereotypes in the generation of sentence disparities. Implications of these findings for research designs and theory development are discussed.     

Risk and Resiliency Factors Among Adolescents Who Experience Marital Transitions

Using a resiliency framework, we examined familial and extrafamilial factors associated with adolescent well‐being in intact, blended, and divorced single‐parent families. Hierarchical regression analyses were conducted using a large sample of 7th‐, 9th‐, and 11th‐grade adolescents (N= 2,011) to test the moderating effect of peer support, school attachment, and neighbor support when parental support and monitoring were low. Significant two‐ and three‐way interactions were probed. Findings indicate that divorced and blended families have some of the same forms of resiliency as intact families. For adolescents in a divorced single‐parent family, peer support moderated the effect of low parental support on internalizing symptoms. We discuss the merits of examining divorce from a resiliency perspective.     

Solidary labour: its nature and marginalisation

This paper represents an attempt to analyse the labour involved in producing and reproducing caring relationships as a form of work. The term ‘solidary’or ‘love labour’is coined to differentiate this kind of work from other forms of human service work, domestic work and/or economic labour. We suggest that solidary labour cannot be understood as a structural necessity emanating from the political and economic requirements of the wider system. Yet, the latter approach has been the modal one in both structural functionalist and Marxist analyses of caring. Caring and being cared for involve the construction of symbolic bonds regardless of the economic context in which they are embedded. The sociological understanding of these, demands that we take account of the situated meaning of solidary relations and not merely reduce them to by products of structural forces. In the latter part of the paper we use time-budget studies and other surveys to show how solidary labour is being marginalised in our society. In particular, we argue that both domestic labour and productive material labour are in open competition with solidary labour for the use of time. Research to date would suggest that solidary labour is the loser in this competition.