Statistical modeling for Bayesian extrapolation of adult clinical trial information in pediatric drug evaluation

Children represent a large underserved population of “therapeutic orphans,” as an estimated 80% of children are treated off‐label. However, pediatric drug development often faces substantial challenges, including economic, logistical, technical, and ethical barriers, among others. Among many efforts trying to remove these barriers, increased recent attention has been paid to extrapolation; that is, the leveraging of available data from adults or older age groups to draw conclusions for the pediatric population. The Bayesian statistical paradigm is natural in this setting, as it permits the combining (or “borrowing”) of information across disparate sources, such as the adult and pediatric data. In this paper, authored by the pediatric subteam of the Drug Information Association Bayesian Scientific Working Group and Adaptive Design Working Group, we develop, illustrate, and provide suggestions on Bayesian statistical methods that could be used to design improved pediatric development programs that use all available information in the most efficient manner. A variety of relevant Bayesian approaches are described, several of which are illustrated through 2 case studies: extrapolating adult efficacy data to expand the labeling for Remicade to include pediatric ulcerative colitis and extrapolating adult exposure‐response information for antiepileptic drugs to pediatrics.     

Home Modifications among Community-Dwelling Older Adults: A Closer Look at Race and Ethnicity

ABSTRACT

This study investigated racial and ethnic differences in home modification use. Data from the 2011 National Health and Aging Trends Study were used (n=6,764). Compared with non-Hispanic Whites, Hispanics were less likely to have a grab bar (odds ratio (OR) = 0.6), bath seat (OR = 0.8), or raised toilet (OR = 0.6). Non-Hispanic Blacks were less likely to have a grab bar (OR = 0.7) or bath seat (OR = 0.7) than non-Hispanic Whites, but more likely to have a raised toilet (OR = 1.3). English proficiency largely explained ethnic differences, while health status partially accounted for racial disparities.     

Suicide ideation,anxiety, and depression: Are children a protective factor for male Veterans?

ABSTRACT

Numerous mental health disorders plague our veterans when they return from deployment including anxiety and depressive disorders, which have been linked to elevated suicide risk when left untreated. Family factors, such as parenthood status, may serve as a protective factor against these mental health issues. This study examined the role of parenthood status of male veterans (N = 234) based on age of the child in order to determine whether a child’s age (minor children v. adult children) affects the likelihood of meeting diagnosis criteria for anxiety, depression, and suicide ideation after controlling for marital status. Three hierarchical binary logistic regression models were constructed to assess the predictive influence of children 18 years old and younger, children older than 18, and no children with the results indicating that parenthood status did meaningfully enhance the prediction of suicide ideation. Complete findings, clinical implications, and future considerations are discussed.     

Assessing the Relationship Between Gender,Household Structure,and Net Worth in the United States

This paper examines wealth disparities by gender and household structure in the United States using data from the 1998–2013 Survey of Consumer Finances. Following studies of economic insecurity, we placed households at the center of our analysis to highlight the interconnected nature of wealth with multiple aspects of family structure. We investigated net worth by both gender and household structure, which includes variation by partnership status and the presence of other adult relatives and their roles within the household. We found that wealth disparities were largest among single adult households, but these varied by gender. Female single adult households held some of the lowest levels of net worth, but after accounting for key explanations of wealth inequality, single male households actually held greater wealth than two-adult partnered households. This relationship further depended on the presence of extended family members, where gender disparities were smaller among households with other relatives present.     

‘More like a daughter than an employee’: the kinning process between migrant care workers,elderly care receivers and their extended families

ABSTRACT

This paper explores the intersections of formal and informal care in the relationships that develop between elderly care receivers and their families and migrant domestic care workers and their families. The domestic migrant care literature has tended to focus on two main ‘hidden costs’ of this ‘care-chain’: the ‘care exploitation’ of paid carers by their employers and the ‘care drain’ impact on the family members left behind by the migrant. In this paper, we employ a care circulation framework to examine the process of becoming kin-like – or ‘kinning’, which remains relatively under-explored and warrants further research. An analysis of this process of kinning helps to highlight how the domestic space of care receiver homes are transformed – through the negotiation of relationships with migrant care workers – into transnational social fields that bring the diaspora worlds of the migrants into the everyday worlds of the locals.     

Totally tall sounds totally younger: Intensification at the socio‐semantics interface

In two social perception experiments, we explore the relationship between the social meaning and the semantic/pragmatic properties of the intensifier totally in American English. In Experiment 1, we show that totally is perceived as a more salient index of social identity categories – measured in terms of Age, Solidarity and Status attributes – when it targets a scalar dimension grounded in the speaker's attitude, as opposed to when it occurs in contexts where the scale is provided by the subsequent predicate. In Experiment 2, we show that the social indexicality of totally is even more salient in contexts in which the intensifier, by virtue of its pragmatic contribution, invites a stance of heightened proximity and convergence between the interlocutors. These results point to a principled connection between the semantic, pragmatic and personality‐based social meanings of totally, providing new insights into the dynamics whereby different layers of meaning conspire to determine what an expression ‘says’ when deployed in interaction.     

Southern knowledge online? Climate change research discoverability and communication practices

The networked age promises global digital cultures with flattened power relations, given the affordances of information and communication technologies to collapse distance, enable easier cross-country collaborations and create new opportunities for knowledge production and sharing. In the academic domains, indications are that knowledge patterns continue to reflect physically based geopolitical realities – where knowledge from the South is still peripheral while knowledge from the North still dominates in terms of all the conventional metrics. This study explores the potential role of digital affordances to challenge structural Northern bias and generates questions about knowledge production and dissemination in the climate change knowledge domain. It is framed by the field of scholarly communication within an African setting and by the emergent field of climate change which is fraught with debates and contestations, particularly regarding mitigation and adaptation. It draws on Southern theory which interrogates the global dynamics of knowledge production and dissemination. It explores the intersection of the discoverability and visibility of local climate change research methodologically from the outside in, through an experiment of searches for ‘climate change/South Africa’ and from the inside out by reviewing the online presence of one climate change group in a top-ranked African university.     

Pierre Bourdieu: theorizing the digital

ABSTRACT

Pierre Bourdieu is known for his research in the areas of education and cultural stratification that led to a number of theoretical contributions informing the social sciences. Bourdieu’s interrelated concepts of field, capital, and habitus have become central in many approaches to inequality and stratification across the social sciences. In addition, we argue that Bourdieu’s ideas also feature in what is increasingly known as ‘digital sociology.’ To underscore this claim, we explore the ways in which Bourdieu’s ideas continue to have a major impact on social science research both on and with digital and Internet-based technologies. To do so, we offer a review of both Bourdieusian theorizing of the digital vis-à-vis both research on the social impacts of digital communication technologies and the application of digital technologies to social science research methods. We contend that three interconnected features of Bourdieu’s sociology have allowed his approach to flourish in the digital age: (1) his theories’ inseparability from the practice of empirical research; (2) his ontological stance combining realism and social constructionism; and (3) his familiarity with concepts developed in other disciplines and participation in interdisciplinary collaborative projects. We not only reason that these three factors go some way in accounting for Bourdieu’s influence in many sociological subfields, but we also suggest that they have been especially successful in positioning Bourdieusian sociology to take advantage of opportunities associated with digital communication technologies.