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261.
This study examined system barriers that precluded injured workers from accessing services and supports in the return-to-work (RTW) process. A grounded theory approach was used to investigate injured worker experiences. Methods included in-depth telephone interviews and the constant comparative method to analyze the data. Findings revealed that consumers experienced tensions or a tug-of-war between the RTW system, the health care system, and in accessing and using knowledge. Over time consumers reflected upon these tensions and initiated strategies to enhance return to function and RTW. Insights from consumer-driven strategies that might inform future policy change and promote positive service delivery for injured workers are examined.  相似文献   
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The stratified Cox model is commonly used for stratified clinical trials with time‐to‐event endpoints. The estimated log hazard ratio is approximately a weighted average of corresponding stratum‐specific Cox model estimates using inverse‐variance weights; the latter are optimal only under the (often implausible) assumption of a constant hazard ratio across strata. Focusing on trials with limited sample sizes (50‐200 subjects per treatment), we propose an alternative approach in which stratum‐specific estimates are obtained using a refined generalized logrank (RGLR) approach and then combined using either sample size or minimum risk weights for overall inference. Our proposal extends the work of Mehrotra et al, to incorporate the RGLR statistic, which outperforms the Cox model in the setting of proportional hazards and small samples. This work also entails development of a remarkably accurate plug‐in formula for the variance of RGLR‐based estimated log hazard ratios. We demonstrate using simulations that our proposed two‐step RGLR analysis delivers notably better results through smaller estimation bias and mean squared error and larger power than the stratified Cox model analysis when there is a treatment‐by‐stratum interaction, with similar performance when there is no interaction. Additionally, our method controls the type I error rate while the stratified Cox model does not in small samples. We illustrate our method using data from a clinical trial comparing two treatments for colon cancer.  相似文献   
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The aim of this study is to describe the self‐reported experiences of adolescents in population‐based samples when completing health‐related surveys on topics with varying potential for evoking distress. Survey data were collected in three school‐based studies of bullying behaviors (N = 1,771, 12–14 years), alcohol use (N = 823, 12, 15, and 17 years), and electronic image sharing (N = 274, 13 years). Between 5% and 15% of respondents reported being upset at survey completion, but at most 1.4% were entirely negative in their evaluation. Age was not associated with being upset, but younger adolescents were more likely to see benefit in participation. Although concurrent mental health symptoms increased the risk of being upset, this was mostly mitigated by perceived benefits from participation.  相似文献   
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The experiments reported here investigated the development of a fundamental component of cognition: to recognize and generalize abstract relations. Infants were presented with simple rule‐governed patterned sequences of visual shapes (ABB, AAB, and ABA) that could be discriminated from differences in the position of the repeated element (late, early, or nonadjacent, respectively). Eight‐month‐olds were found to distinguish patterns on the basis of the repetition, but appeared insensitive to its position in the sequence; 11‐month‐olds distinguished patterns over the position of the repetition, but appeared insensitive to the nonadjacent repetition. These results suggest that abstract pattern detection may develop incrementally in a process of constructing complex relations from more primitive components.  相似文献   
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Although a homophobic and sexist archetype of heterosexual masculinity has been thought to permeate competitive teamsport, matters have been rapidly changing. This is evident in research on openly gay athletes, attitudes among heterosexual athletes, and recent studies on decreasing homophobia among sport media content. In this research, however, we examine how some men still adhere to a homophobic and sexist masculine deposition when discussing sport on the Internet. A textual analysis was used to analyze hegemonic masculinity from a popular American football message board. Although posts related to hegemonic masculinity did not permeate the data, we found that this traditional form of masculinity was upheld through misogyny, homophobia, and the objectification of women. Thus, whereas mainstream sport media is increasingly policed for homophobia and sexism, this research shows that the anonymity of the Internet permits hegemonic masculinity to flourish in specific locations, without contestation.  相似文献   
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