Handling missing data in a composite outcome with partially observed components: simulation study based on clustered paediatric routine data

Composite scores are useful in providing insights and trends about complex and multidimensional quality of care processes. However, missing data in subcomponents may hinder the overall reliability of a composite measure. In this study, strategies for handling missing data in Paediatric Admission Quality of Care (PAQC) score, an ordinal composite outcome, were explored through a simulation study. Specifically, the implications of the conventional method employed in addressing missing PAQC score subcomponents, consisting of scoring missing PAQC score components with a zero, and a multiple imputation (MI)-based strategy, were assessed. The latent normal joint modelling MI approach was used for the latter. Across simulation scenarios, MI of missing PAQC score elements at item level produced minimally biased estimates compared to the conventional method. Moreover, regression coefficients were more prone to bias compared to standards errors. Magnitude of bias was dependent on the proportion of missingness and the missing data generating mechanism. Therefore, incomplete composite outcome subcomponents should be handled carefully to alleviate potential for biased estimates and misleading inferences. Further research on other strategies of imputing at the component and composite outcome level and imputing compatibly with the substantive model in this setting, is needed.KEYWORDS: Composite outcome, multiple imputation, paediatrics, PAQC score, pneumonia     

Statistical Modeling of Fire Occurrence Using Data from the Tōhoku,Japan Earthquake and Tsunami

In this article, we develop statistical models to predict the number and geographic distribution of fires caused by earthquake ground motion and tsunami inundation in Japan. Using new, uniquely large, and consistent data sets from the 2011 Tōhoku earthquake and tsunami, we fitted three types of models—generalized linear models (GLMs), generalized additive models (GAMs), and boosted regression trees (BRTs). This is the first time the latter two have been used in this application. A simple conceptual framework guided identification of candidate covariates. Models were then compared based on their out‐of‐sample predictive power, goodness of fit to the data, ease of implementation, and relative importance of the framework concepts. For the ground motion data set, we recommend a Poisson GAM; for the tsunami data set, a negative binomial (NB) GLM or NB GAM. The best models generate out‐of‐sample predictions of the total number of ignitions in the region within one or two. Prefecture‐level prediction errors average approximately three. All models demonstrate predictive power far superior to four from the literature that were also tested. A nonlinear relationship is apparent between ignitions and ground motion, so for GLMs, which assume a linear response‐covariate relationship, instrumental intensity was the preferred ground motion covariate because it captures part of that nonlinearity. Measures of commercial exposure were preferred over measures of residential exposure for both ground motion and tsunami ignition models. This may vary in other regions, but nevertheless highlights the value of testing alternative measures for each concept. Models with the best predictive power included two or three covariates.     

The discursive structure of the social-technical divide: the example of information systems development1

The social and technical are commonly defined in opposition to each other. Yet technology practitioners are often quite comfortable with the idea that the technical is constitutively social. Drawing on an ethnographic study of a computerised information systems development project, this paper examines various usages of notions of ‘technical’. Attempts to situate the study at the ‘technical core’ of the project were met with a series of rebuffs. ‘Technical’ talk is to be understood as a categorising device which does boundary work. Technical talk invokes and performs a disjunction between networks of social relationships and stipulates a moral order with associated norms for acceptance and transition. The difficulty of penetrating the intelligibility of technical talk is understandable as a struggle in familiarising oneself with the routine social actions of a separate community. In addition, the private sphere of the technical is often distanced in time. The costs involved in journeying into the future are analogous to those of penetrating alien cultures. Ideas of progress and advance are often associated with the invocation of ‘the technical’. These connote a notion of timing which reinforces the distance and difference of—and hence depicts the costs involved in penetrating—removed sets of social relationships.     

Accurately depicting pathological gamblers: Policy and treatment implications

This paper describes results from a 3-year study of pathological gambling in the general population. Two distinct groups of pathological gamblers, based on income, were distinguished in the general population. These two groups varied considerably on several dimensions, including their demographic characteristics, gambling involvement and problematic gambling-related behaviors. These results contradict widely-accepted beliefs about the characteristics and behaviors of pathological gamblers and suggest that efforts in outreach, education and program development must be expanded to include types of pathological gamblers beyond those currently in treatment.This work was funded by Research Grant MH44295 from the Violence & Traumatic Stress Research Branch of the National Institute of Mental Health.     

Delivery, Management and Access Model for E_prints and Open Access Journals

A study conducted for the (United Kingdom) Joint Information Systems Committee reviewed possible models for implementing Open Access to research reports in institutional archives and Open Access journals. The conclusion was that a “harvesting model,” in which full texts reside on the original servers but metadata are harvested, held, and enhanced by a central service, was preferable to either a centralized national service or a completely decentralized service for the UK. The study included issues of populating institutional archives (IAs) and some form of mandatory archiving for publicly funded research results to obtain a critical mass of Open Access material in such a system.     

Homeless in the mind: A case-history of personal life in and out of a close orthodox community

A sociogenetic theoretical framework is applied to Berger, Berger, and Kellner's (1973) concept of cultural homelessness, extending its use beyond the sociological effects of modernity to the psychological development of persons who are closely tied to their collective-cultural contexts. The theory is grounded in the bidirectionality of cultural transmission, and the construction of culture in different cultural members. The construction of internal personal cultures is brought about by the individual with the support of social others. The processes by which cultural messages are internalized and externalize back into the culture explain how feeling at home or not at home are normal aspects of socialization. An illustrative example of a retrospective case-history of a woman's feeling of homelessness in an ultraorthodox community shows how the individual internalizes and transforms cultural norms. Examples of further applications of the theoretical principles are presented, and implications of feelings of homelessness for understanding the normal processes of socialization.     

Prevalence studies and the development of services for problem gamblers and their families

Where funded by government, prevalence studies have typically led to the development of services for problem gamblers and their families. Such assessments of the need for services have been seen as the appropriate political response to growing expressions of concern about problem gambling that often follow moves to legislate for an increasing range of gambling products. This theme is apparent for Australia, Canada, New Zealand and the United States. In this paper, initiatives in these different jurisdictions are briefly summarized and tabulated.     

The age pattern of first-birth rates among U.S. women: The bimodal 1990s

Between 1990 and 2002, the age pattern of Type I first-birth rates (i.e., the hazard of a first birth) among U.S. women was bimodal. This pattern, driven by changing differential fertility patterns among racial and ethnic groups, reached its apex at the mid-1990s and had almost vanished by the decade's end. Research on first-birth timing has tended to focus on Type II first-birth rates and therefore has failed to identify this larger, bimodal pattern. This article presents the benefits of using Type I rates, documents the emergence of the bimodal pattern via two new measures of bimodality, and uses a decomposition analysis to discuss the pattern's causes.     

Suitability of physical activity questionnaires for older adults in fall-prevention trials: a systematic review

The purpose of the study was to identify physical activity questionnaires for older adults that might be suitable outcome measures in clinical trials of fall-injury-prevention intervention and to undertake a systematic quality assessment of their measurement properties. PubMed, CINAHL, and PsycINFO were systematically searched to identify measurements and articles reporting the methodological quality of relevant measures. Quality extraction relating to content, population, reliability, validity, responsiveness, acceptability, practicality, and feasibility was undertaken. Twelve outcome measures met the inclusion criteria. There is limited evidence about the measures' properties. None of the measures is entirely satisfactory for use in a large-scale trial at present. There is a need to develop suitable measures. The Stanford 7-day Physical Activity Recall Questionnaire and the Community Health Activities Model Program for Seniors questionnaire might be appropriate for further development. The results have implications for the designs of large-scale trials investigating many different geriatric syndromes.