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991.
This study examined how men's masculine gender-role conflict and the importance men placed on interpersonal relationships in defining their self-identities predicted their relational health experiences in same-sex, dyadic friendships and community relationships. Using an Internet sample of 283 self-identified bisexual, gay, and straight men, results of hierarchical linear regression analyses indicated that for men across sexual orientations, the more importance men placed on interpersonal relationships with other men, the greater the degree of relational health they experienced in dyadic friendships. Additionally, for bisexual and gay men in dyadic friendships with other men, gender-role conflict was inversely related to the relational health of their friendships. In the domain of community relationships, the importance that bisexual and straight men placed on interpersonal relationships in defining their self-identities and levels of gender-role conflict predicted relational health experiences. For gay men, however, feelings of masculine gender-role conflict, alone, predicted poorer relational health in community relationships. Study limitations, clinical implications for practice, and future research directions are discussed.  相似文献   
992.
The basic reproduction number of an infection, R 0, is the average number of secondary infections generated by a single typical infective individual in a totally susceptible population. It is directly related to the effort required to eliminate infection. We consider statistical methods for estimating R 0 from age-stratified serological survey data. The main difficulty is indeterminacy, since the contacts between individuals of different ages are not observed. We show that, given an estimate of the average age-specific hazard of infection, a particular leading left eigenfunction is required to specify R 0. We review existing methods of estimation in the light of this indeterminacy. We suggest using data from several infections transmitted via the same route, and we propose that the choice of model be guided by a criterion based on similarity of their contact functions. This approach also allows model uncertainty to be taken into account. If one infection induces no lasting immunity, we show that the only additional assumption required to estimate R 0 is that the contact function is symmetric. When matched data on two or more infections transmitted by the same route are available, the methods may be extended to incorporate the effect of individual heterogeneity. The approach can also be applied in partially vaccinated populations and to populations comprising loosely linked communities. The methods are illustrated with data on hepatitis A, mumps, rubella, parvovirus, Haemophilus influenzae type b and measles infection.  相似文献   
993.
994.
Slob  W.  Pieters  M. N. 《Risk analysis》1998,18(6):787-798
The use of uncertainty factors in the standard method for deriving acceptable intake or exposure limits for humans, such as the Reference Dose (RfD), may be viewed as a conservative method of taking various uncertainties into account. As an obvious alternative, the use of uncertainty distributions instead of uncertainty factors is gaining attention. This paper presents a comprehensive discussion of a general framework that quantifies both the uncertainties in the no-adverse-effect level in the animal (using a benchmark-like approach) and the uncertainties in the various extrapolation steps involved (using uncertainty distributions). This approach results in an uncertainty distribution for the no-adverse-effect level in the sensitive human subpopulation, reflecting the overall scientific uncertainty associated with that level. A lower percentile of this distribution may be regarded as an acceptable exposure limit (e.g., RfD) that takes account of the various uncertainties in a nonconservative fashion. The same methodology may also be used as a tool to derive a distribution for possible human health effects at a given exposure level. We argue that in a probabilistic approach the uncertainty in the estimated no-adverse-effect-level in the animal should be explicitly taken into account. Not only is this source of uncertainty too large to be ignored, it also has repercussions for the quantification of the other uncertainty distributions.  相似文献   
995.
Legionnaires' disease (LD), first reported in 1976, is an atypical pneumonia caused by bacteria of the genus Legionella, and most frequently by L. pneumophila (Lp). Subsequent research on exposure to the organism employed various animal models, and with quantitative microbial risk assessment (QMRA) techniques, the animal model data may provide insights on human dose-response for LD. This article focuses on the rationale for selection of the guinea pig model, comparison of the dose-response model results, comparison of projected low-dose responses for guinea pigs, and risk estimates for humans. Based on both in vivo and in vitro comparisons, the guinea pig (Cavia porcellus) dose-response data were selected for modeling human risk. We completed dose-response modeling for the beta-Poisson (approximate and exact), exponential, probit, logistic, and Weibull models for Lp inhalation, mortality, and infection (end point elevated body temperature) in guinea pigs. For mechanistic reasons, including low-dose exposure probability, further work on human risk estimates for LD employed the exponential and beta-Poisson models. With an exposure of 10 colony-forming units (CFU) (retained dose), the QMRA model predicted a mild infection risk of 0.4 (as evaluated by seroprevalence) and a clinical severity LD case (e.g., hospitalization and supportive care) risk of 0.0009. The calculated rates based on estimated human exposures for outbreaks used for the QMRA model validation are within an order of magnitude of the reported LD rates. These validation results suggest the LD QMRA animal model selection, dose-response modeling, and extension to human risk projections were appropriate.  相似文献   
996.
Summary.  The main statistical problem in many epidemiological studies which involve repeated measurements of surrogate markers is the frequent occurrence of missing data. Standard likelihood-based approaches like the linear random-effects model fail to give unbiased estimates when data are non-ignorably missing. In human immunodeficiency virus (HIV) type 1 infection, two markers which have been widely used to track progression of the disease are CD4 cell counts and HIV–ribonucleic acid (RNA) viral load levels. Repeated measurements of these markers tend to be informatively censored, which is a special case of non-ignorable missingness. In such cases, we need to apply methods that jointly model the observed data and the missingness process. Despite their high correlation, longitudinal data of these markers have been analysed independently by using mainly random-effects models. Touloumi and co-workers have proposed a model termed the joint multivariate random-effects model which combines a linear random-effects model for the underlying pattern of the marker with a log-normal survival model for the drop-out process. We extend the joint multivariate random-effects model to model simultaneously the CD4 cell and viral load data while adjusting for informative drop-outs due to disease progression or death. Estimates of all the model's parameters are obtained by using the restricted iterative generalized least squares method or a modified version of it using the EM algorithm as a nested algorithm in the case of censored survival data taking also into account non-linearity in the HIV–RNA trend. The method proposed is evaluated and compared with simpler approaches in a simulation study. Finally the method is applied to a subset of the data from the 'Concerted action on seroconversion to AIDS and death in Europe' study.  相似文献   
997.
998.
999.
About half of injured workers choose not to file workers' compensation claims. This is thought to result from their use of health insurance instead of workers' compensation. However, the data suggest that insured workers are actually less likely to file than their more vulnerable uninsured counterparts. We found that this relationship emerges as the result of employer characteristics and, in particular, that employers who offer health insurance to employees are more likely to have workers who file claims; this is much more important than the insurance status of workers themselves or fixed worker characteristics. ( JEL I1, J3)  相似文献   
1000.
In this paper, we consider chain ratio and regression type estimators for estimating median in survey sampling. We find expressions for the variance of the chain-ratio and chain-regression type estimators considered in the present investigation. The optimum values of the first phase and second phase sample sizes are also obtained for the fixed cost of survey. The relative efficiency of chain-ratio and chain-regression type estimators have been studied in comparison to ratio and regression type estimators of median proposed by Singh, Joarder and Tracy (2001).  相似文献   
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