Analysis of a longitudinal ordinal response clinical trial using dynamic models

Summary.  In many areas of pharmaceutical research, there has been increasing use of categorical data and more specifically ordinal responses. In many cases, complex models are required to account for different types of dependences among the responses. The clinical trial that is considered here involved patients who were required to remain in a particular state to enable the doctors to examine their heart. The aim of this trial was to study the relationship between the dose of the drug administered and the time that was spent by the patient in the state permitting examination. The patient's state was measured every second by a continuous Doppler signal which was categorized by the doctors into one of four ordered categories. Hence, the response consisted of repeated ordinal series. These series were of different lengths because the drug effect wore off faster (or slower) on certain patients depending on the drug dose administered and the infusion rate, and therefore the length of drug administration. A general method for generating new ordinal distributions is presented which is sufficiently flexible to handle unbalanced ordinal repeated measurements. It consists of obtaining a cumulative mixture distribution from a Laplace transform and introducing into it the integrated intensity of a binary logistic, continuation ratio or proportional odds model. Then, a multivariate distribution is constructed by a procedure that is similar to the updating process of the Kalman filter. Several types of history dependences are proposed.     

The Impact of Autism Spectrum Disorders on the Family: A Qualitative Study of Mothers’ Perspectives

An estimated 730,000 Americans younger than age 21 in the United States have an autism spectrum disorder (ASD), and current trends predict 36,500 new diagnoses each year. Due to this rapid increase in ASD diagnoses, it is critical to understand the impact having a child with ASD has on a family's daily functioning to better coordinate services and design effective interventions. Qualitative semistructured interviews with eight mothers were conducted, and four primary themes emerged identifying primarily negative impacts of having a child with ASD. Implications for practice and future research are addressed to inform the development of best practices for families.     

How frames present BMW as embracing an aging workforce

As the population begins to age, organizations are starting to plan for an influx of older employees. Since the workforce is “graying,” the question now becomes how to best utilize this growing segment of the population within an organizational context. This case study applied framing analysis to the BMW Today for Tomorrow program in order to understand how BMW built support for its efforts to create a more age diverse workforce. This initiative was intended to redesign the production lines at BMW in order to become more age-appropriate for BMW's increasingly older employees. The Today for Tomorrow program included the implementation of over 70 small changes that improved the efficiency of an experimental production line (e.g., magnifying glasses, stretching station, wooden floors, and ergonomic standing chairs). Several texts were analyzed including media stories, the organizational website, and the BMW Sustainability Report. Based on this case study, BMW's Today for Tomorrow program contained two overarching frames that aided in the attempt to highlight its age appropriate workplace initiatives. These frames are age as a valuable resource and BMW as a responsible organization. In addition, BMW incorporated both episodic (specific examples) and thematic (general context) framing techniques in order to localize and globalize the issue of an aging workforce simultaneously.     

Cigarette Use Among Young Adults: Comparisons Between 2-Year College Students, 4-Year College Students,and Those Not in College

Abstract

Objective: To examine cigarette smoking among young adults based on education status. Participants: Community-based sample of 2,694 young adults in the United States Methods: The authors compared 3 groups—those not in college with no college degree, 2-year college students/graduates, 4-year college students/graduates—on various smoking measures: ever smoked, smoked in past month, smoked in past week, consider self a smoker, began smoking before age 15, smoked over 100 cigarettes in lifetime, ever tried to quit, and plan to quit in next year. Results: The authors found that for nearly all the smoking measures, the 4-year college group was at lowest risk, the noncollege group was at highest risk, and the 2-year college group represented a midpoint. Differences between groups remain after adjusting for parents’ education and other potential confounding factors. Conclusions: Smoking behaviors clearly differ between the 2-year, 4-year, and no college groups. Interventions should be tailored for each group.     

Social Security in Italy

The United States is confronting two simultaneous demographic shifts with profound implications for public policy: population aging and increasing diversity. These changes are accelerating during a dramatic economic downturn, placing entitlement reform prominently on the national policy agenda. Using decennial census data from 2000, this paper examines the nexus of these trends by examining characteristics of Latino baby boomers. In the census data, Latinos constituted 10% of the 80 million boomers; roughly one-third of Latino boomers (37%) were born in the United States or abroad to a U.S. parent; 6% were born in a U.S. territory; 21% were naturalized citizens; and 36% were noncitizens. Compared to non-Latinos, Latino baby boomers had lower levels of education, home ownership, and investment income and higher rates of material hardship and poverty; however, there was considerable variation based on citizenship status. A better understanding of Latino baby boomers will help policy makers anticipate the retirement needs of baby boomers as the United States prepares for the aging of a racially and ethnically diverse population.     

Abortion,Partial-Birth Abortion,and Adolescent Access to Abortion: An Overview for Social Workers

Although the U.S Supreme Court Roe v. Wade decision legalized abortion in 1973, intense controversy over access, legality, and morality has persisted ever since that landmark decision. National opinion data collected from 1975 to 2007 show that a majority of Americans support a woman's right to an abortion, but this right is increasingly under attack, and recent proposed changes to abortion access are not in line with how most Americans feel. This paper considers public opinion trends in the sharply divided arenas of abortion, partial-birth abortion, and adolescents' rights to access abortion with a critical eye to social work practice. We explore several opportunities for social workers to advocate for clients, including legislative advocacy, reform through litigation, social action, and social policy analysis.     

Using Photovoice to Identify Service Needs of Older African American Methadone Clients

ABSTRACT

This article presents findings from a photovoice project designed to identify service needs of older-adult African American methadone clients, as well as their current barriers to and supports for abstinence. The project involved 10 participants (aged 53 to 63 years old) recruited from a methadone maintenance program in a large Northeastern U.S. city. Thematic analysis techniques were used to analyze participants’ narratives of their pictures. Transportation emerged as a significant challenge to accessing services, and caregiving was a motivation for remaining abstinent. Future research should use similar participatory methods and engage a broader group of aging people struggling with substance abuse.