Methods for estimating relative risk in studies of common binary outcomes

Studying the effect of exposure or intervention on a dichotomous outcome is very common in medical research. Logistic regression (LR) is often used to determine such association which provides odds ratio (OR). OR often overestimates the effect size for prevalent outcome data. In such situations, use of relative risk (RR) has been suggested. We propose modifications in Zhang and Yu and Diaz-Quijano methods. These methods were compared with stratified Mantel Haenszel method, LR, log binomial regression (LBR), Zhang and Yu method, Poisson/Cox regression, modified Poisson/Cox regression, marginal probability method, COPY method, inverse probability of treatment weighted LBR, and Diaz-Quijano method. Our proposed modified Diaz-Quijano (MDQ) method provides RR and its confidence interval similar to those estimated by modified Poisson/Cox and LBRs. The proposed modifications in Zhang and Yu method provides better estimate of RR and its standard error as compared to Zhang and Yu method in a variety of situations with prevalent outcome. The MDQ method can be used easily to estimate the RR and its confidence interval in the studies which require reporting of RRs. Regression models which directly provide the estimate of RR without convergence problems such as the MDQ method and modified Poisson/Cox regression should be preferred.     

Modeling U‐Shaped Exposure‐Response Relationships for Agents that Demonstrate Toxicity Due to Both Excess and Deficiency

Essential elements such as copper and manganese may demonstrate U‐shaped exposure‐response relationships due to toxic responses occurring as a result of both excess and deficiency. Previous work on a copper toxicity database employed CatReg, a software program for categorical regression developed by the U.S. Environmental Protection Agency, to model copper excess and deficiency exposure‐response relationships separately. This analysis involved the use of a severity scoring system to place diverse toxic responses on a common severity scale, thereby allowing their inclusion in the same CatReg model. In this article, we present methods for simultaneously fitting excess and deficiency data in the form of a single U‐shaped exposure‐response curve, the minimum of which occurs at the exposure level that minimizes the probability of an adverse outcome due to either excess or deficiency (or both). We also present a closed‐form expression for the point at which the exposure‐response curves for excess and deficiency cross, corresponding to the exposure level at which the risk of an adverse outcome due to excess is equal to that for deficiency. The application of these methods is illustrated using the same copper toxicity database noted above. The use of these methods permits the analysis of all available exposure‐response data from multiple studies expressing multiple endpoints due to both excess and deficiency. The exposure level corresponding to the minimum of this U‐shaped curve, and the confidence limits around this exposure level, may be useful in establishing an acceptable range of exposures that minimize the overall risk associated with the agent of interest.     

Recalibrating Management: Feminist Activism to Achieve Equality in an Evolving University

In this paper we examine the process of incorporating gender equality into a higher education institution as it evolves into a managerial university. The case illustrates the ongoing processes between structure, activism and features of gender equality, and provides insights into how activists adapt to changes in governance and influence managerial responses to equality. Tracing the interaction of employee activism with new managerialism over nearly two decades, four phases of change are identified. These provide a basis for generating two concepts – managerial recalibration and individual activism – while challenging the social abeyance hypothesis of social movements.     

Tuning in to Teens: Improving Parent Emotion Socialization to Reduce Youth Internalizing Difficulties

Research in child development suggests that parents' emotional competence and emotion socialization practices are related to children's emotional functioning, including child internalizing difficulties. This research has not yet been translated into intervention or prevention programs targeting parents of older children and adolescents. The current study examined the efficacy of the Tuning in to Teens parenting program in improving emotion socialization practices in parents of preadolescents and reducing youth internalizing difficulties. Schools were randomized into intervention and control conditions. Data were collected from 225 parents and 224 youth during the young person's final year of elementary school (sixth grade) and again 10 months later in their first year of secondary school (seventh grade). Multilevel analyses showed significant improvements in parental emotion socialization and reductions in youth internalizing difficulties for the intervention condition. This study provides support for the efficacy of the TINT parenting program with a community sample.     

Democracy,Participation, and Life Satisfaction*

Objectives. We examine whether democracy, political participation, and differing systems of democracy influence individual levels of subjective well‐being. Methods. We use individual data on life satisfaction and characteristics related to satisfaction for approximately 46 countries. We estimate ordered probit models with country and time dummy variables and cluster‐adjusted robust standard errors. Results. Democracy is positively correlated with individual levels of well‐being. The opportunity to participate in the political process and whether the democracy is parliamentary or presidential are related to individual well‐being. Conclusions. Democratic institutions influence subjective well‐being. The well‐being of individuals with minority political views decreases in parliamentary systems.     

Marital Conflict in the Context of Parental Depressive Symptoms: Implications for the Development of Children's Adjustment Problems

Relations among parental depressive symptoms, overt and covert marital conflict, and child internalizing and externalizing symptoms were examined in a community sample of 235 couples and their children. Families were assessed once yearly for three years, starting when children were in kindergarten. Parents completed measures of depressive symptoms and children's internalizing and externalizing symptoms. Behavioral observations of marital conflict behaviors (insult, threat, pursuit, and defensiveness) and self report of covert negativity (feeling worry, sorry, worthless, and helpless) were assessed based on problem-solving interactions. Results indicated that fathers' greater covert negativity and mothers' overt destructive conflict behaviors served as intervening variables in the link between fathers' depressive symptoms and child internalizing symptoms, with modest support for the pathway through fathers' covert negativity found even after controlling for earlier levels of constructs. These findings support the role of marital conflict in the impact of fathers' depressive symptoms on child internalizing symptoms.     

College Age Lesbianism as a Developmental Phenomenon

Abstract

Based on clinical work with lesbian college students, this paper discusses a relationship between their lesbianism and the development of autonomy and intimacy. Three subgroups among the students are described, oriented respectively to: ideology, personal development, and interpersonal feelings. It is suggested that for these students lesbian orientation be understood in terms of ongoing ego development more than arrested psychosexual development. The students oriented to ideology and personal development seem to be experiencing a shift from authority and sense of identity located externally, in others' expectations, to a more autonomous, self-governing self. The interpersonally-oriented students seem more focally involved with issues of intimacy than of autonomy. The cultural context is seen as crucial to the lesbianism of these students, particularly traditional cultural assumptions of male dominance and more recent changes in womens' attitudes toward themselves. It is assumed that homosexuality may have many styles, origins and meanings, and that this paper does not elucidate the experience of all lesbians or even all lesbian college students.