Does poor weight gain identify children in need?

To determine the socioeconomic variables in children with slow growth (failure to thrive), a case–control study was carried out in two economically deprived areas of Newcastle upon Tyne. Three hundred and six children, aged 12–24 months, registered at two health authority clinics, were studied by reviewing their growth charts. Sixty-three had poor growth (weight deviating downwards across two major centiles from the maximum centile attained at 4–8 weeks of age). Five children were excluded because of known organic disease. A matched control group of normally growing children was selected from the same clinics. Study children and controls were examined and their parents interviewed on a range of socioeconomic, health and interactional factors. A health visitor assessment and a record of social work contact was obtained. The slowly growing children differed significantly from controls in being lighter and shorter, while their mothers spent less on food, needed more help with the child, had a poorer home environment and expressed greater concern over their child's health. Four different patterns of poor growth were identified by inspection of the charts: early onset (before 6 months but sustained), late onset (after 6 months), temporary and recurrent. The ‘recurrent’ group was associated with parenting difficulties and the ‘late onset’ group with adverse socioeconomic factors. Slow growth patterns in children under 2 years may be used as a screening tool to identify ‘children in need’ and should be sought on a population basis. Those identified can then be assessed further to ascertain the area where underlying difficulties lie, for intervention to follow as appropriate.     

15 minutes of statistical fame

Tony Lawrance surveyed his email one morning to find an urgent request from the West Mercia Police Authority to give a statistical opinion on a government report recommending the merger of the current 43 police forces into as few as 12. The Authority asked for an independent objective assessment, "even if we don't like the answer." Persuaded by this freedom, he submitted his report within the 2-day deadline and returned, as he thought, to the day job. Well, not quite—a media storm followed.     

Validation of a longitudinally measured surrogate marker for a time-to-event endpoint

The objective of this paper is to extend the surrogate endpoint validation methodology proposed by Buyse et al. (2000) to the case of a longitudinally measured surrogate marker when the endpoint of interest is time to some key clinical event. A joint model for longitudinal and event time data is required. To this end, the model formulation of Henderson et al. (2000) is adopted. The methodology is applied to a set of two randomized clinical trials in advanced prostate cancer to evaluate the usefulness of prostate-specific antigen (PSA) level as a surrogate for survival.     

Dicing with the unknown

There are many things that I am uncertain about, says Tony O'Hagan. Some are merely unknown to me, while others are unknowable. This article is about different kinds of uncertainty, and how the distinction between them impinges on the foundations of Probability and Statistics.     

Structural and Cognitive Aspects of Social Capital and All-Cause Mortality: A Meta-Analysis of Cohort Studies

Social capital covers different characteristics such as social networks, social participation, social support and trust. The aim of this study was to explore which aspects of social capital were predictive of mortality. Criteria for inclusion in the meta-analysis were: population based observational cohort studies (follow-up ≥5 years); study sample included the adult population; parts of social capital as the primary exposure variable of interest; reported a mortality outcome; and sample size >1,000 individuals. Twenty studies provided eligible data for the meta-analyses. A random effect model was used to estimate the combined overall hazard rate ratio effects of structural social capital such as social participation and social networks, and cognitive social capital including social support and trust in relation to mortality. The results showed that social participation and social networks were negatively associated with mortality. The impact of social networks attenuated somewhat when controlling for gender and age. While trust also appeared to be negatively associated with mortality, we remain cautious with this conclusion, since only two studies provided eligible data. Perceived social support failed to show a significant impact upon mortality. The findings suggest that people who engage socially and report frequent contacts with friends and family live longer.     

Development of a Short-Form Scale of Public Attitudes Toward Homelessness

Nationwide, demographic changes have led to an increased awareness of the impact of cultural diversity on the delivery of medical and psychological care. Due to the over-representation of minority and socially stigmatized groups among those affected by HIV, understanding the effects of psychosocial, linguistic and cultural membership or treatment relationships is crucial. In the psychological treatment of HIV-infected patients, psychotherapists can enhance the lives of their patients and support their involvement and compliance with medical treatment planning Case studies are presented in which psychotherapy helped resolve difficulties in the medical care of three HIV-positive women that were due to cultural misunderstanding between doctors and patients.     

Gaining control: trends in the processes of change for video lottery terminal gamblers

This study examined the processes of change used by problem gamblers in the action and maintenance stages of the Transtheoretical Model of Change (TTM) as proposed in the research by Prochaska and DiClemente. A sample of 25 problem gamblers in the action stage and 38 in the maintenance stage were compared in terms of usage of three of these processes (counterconditioning, stimulus control and reinforcement management). Two mediating variables, self-efficacy and situational temptation, were also assessed. As hypothesised, the usage of counterconditioning and stimulus control declined significantly between the action and maintenance stages. No change was found in reinforcement management between the stages. Self-efficacy increased and situational temptation declined between the action and maintenance stages. Problem gamblers made significant use of these processes suggesting the TTM model is applicable to problem gambling. The discussion focuses on possible regulatory and venue operator actions that might help the problem gambler utilise these processes in the natural recovery process.