An investigation into the two‐stage meta‐analytic copula modelling approach for evaluating time‐to‐event surrogate endpoints which comprise of one or more events of interest

Clinical trials of experimental treatments must be designed with primary endpoints that directly measure clinical benefit for patients. In many disease areas, the recognised gold standard primary endpoint can take many years to mature, leading to challenges in the conduct and quality of clinical studies. There is increasing interest in using shorter‐term surrogate endpoints as substitutes for costly long‐term clinical trial endpoints; such surrogates need to be selected according to biological plausibility, as well as the ability to reliably predict the unobserved treatment effect on the long‐term endpoint. A number of statistical methods to evaluate this prediction have been proposed; this paper uses a simulation study to explore one such method in the context of time‐to‐event surrogates for a time‐to‐event true endpoint. This two‐stage meta‐analytic copula method has been extensively studied for time‐to‐event surrogate endpoints with one event of interest, but thus far has not been explored for the assessment of surrogates which have multiple events of interest, such as those incorporating information directly from the true clinical endpoint. We assess the sensitivity of the method to various factors including strength of association between endpoints, the quantity of data available, and the effect of censoring. In particular, we consider scenarios where there exist very little data on which to assess surrogacy. Results show that the two‐stage meta‐analytic copula method performs well under certain circumstances and could be considered useful in practice, but demonstrates limitations that may prevent universal use.     

Adolescent Substance Use Prevention Interventions Outside of Classroom Settings

Substance use prevention programs empowering individual adolescents to resist substance use through education and skills training are crucial to reducing substance use within this population. However, existing programs of this type are designed primarily for classroom use, and may not meet the needs of social workers intervening with adolescents outside classroom settings. A literature review identified six programs that have demonstrated statistically significant reductions in substance use when implemented outside the classroom. The current study describes these programs, identifies their common characteristics, and draws on additional prevention research to outline recommendations for practitioners seeking to apply the field’s most current knowledge base in community settings.     

Continued childbearing among women who were pregnant as adolescents

Conclusions The data presented in this paper and the earlier one in this series suggest that the effects of special comprehensive programs for school age mothers are seen most clearly in delay of the first pregnancy subsequent to the programs, as originally indicated by Klerman and Jekel (1973). Rather than terminating childbearing after the second pregnancy, those young mothers who had one subsequent pregnancy usually went on to become pregnant again rather quickly.A question can be raised about the generalizability of the finding from this study which is based on a rather small, black, poverty-lever sample. Although Furstenberg's (1976) results support those of this report in a population with similar characteristics, additional studies of white and non-poverty populations receiving a variety of services are critically needed if the country is to understand the phenomenon of adolescent pregnancy and find effective ways of minimizing its consequences.This study was supported by Grant #MC-R-090357 from the Maternal and Child Health Service, Public Health Service, Dept. of Health, Education and Welfare.     

A Meta-Analysis of Children's Hand-to-Mouth Frequency Data for Estimating Nondietary Ingestion Exposure

Because of their mouthing behaviors, children have a higher potential for exposure to available chemicals through the nondietary ingestion route; thus, frequency of hand-to-mouth activity is an important variable for exposure assessments. Such data are limited and difficult to collect. Few published studies report such information, and the studies that have been conducted used different data collection approaches (e.g., videography versus real-time observation), data analysis and reporting methods, ages of children, locations, and even definitions of "mouthing." For this article, hand-to-mouth frequency data were gathered from 9 available studies representing 429 subjects and more than 2,000 hours of behavior observation. A meta-analysis was conducted to study differences in hand-to-mouth frequency based on study, age group, gender, and location (indoor vs. outdoor), to fit variability and uncertainty distributions that can be used in probabilistic exposure assessments, and to identify any data gaps. Results of this analysis indicate that age and location are important for hand-to-mouth frequency, but study and gender are not. As age increases, both indoor and outdoor hand-to-mouth frequencies decrease. Hand-to-mouth behavior is significantly greater indoors than outdoors. For both indoor and outdoor hand-to-mouth frequencies, interpersonal, and intra-personal variability are approximately 60% and approximately 30%, respectively. The variance difference among different studies is much bigger than its mean, indicating that different studies with different methodologies have similar central values. Weibull distributions best fit the observed data for the different variables considered and are presented in this article by study, age group, and location. Average indoor hand-to-mouth behavior ranged from 6.7 to 28.0 contacts/hour, with the lowest value corresponding to the 6 to <11 year olds and the highest value corresponding to the 3 to <6 month olds. Average outdoor hand-to-mouth frequency ranged from 2.9 to 14.5 contacts/hour, with the lowest value corresponding to the 6 to <11 year olds and the highest value corresponding to the 6 to <12 month olds. The analysis highlights the need for additional hand-to-mouth data for the <3 months, 3 to <6 months, and 3 to <6 year age groups using standardized collection and analysis because of lack of data or high uncertainty in available data. This is the first publication to report Weibull distributions as the best fitting distribution for hand-to-mouth frequency; using the best fitting exposure factor distribution will help improve estimates of exposure. The analyses also represent a first comprehensive effort to fit hand-to-mouth frequency variability and uncertainty distributions by indoor/outdoor location and by age groups, using the new standard set of age groups recommended by the U.S. Environmental Protection Agency for assessing childhood exposures. Thus, the data presented in this article can be used to update the U.S. EPA's Child-Specific Exposure Factors Handbook and to improve estimates of nondietary ingestion in probabilistic exposure modeling.     

Formerly Incarcerated Parents and Their Children

The negative effects of incarceration on child well-being are often linked to the economic insecurity of formerly incarcerated parents. Researchers caution, however, that the effects of parental incarceration may be small in the presence of multiple-partner fertility and other family complexity. Despite these claims, few studies have directly observed either economic insecurity or the full extent of family complexity. We study parent-child relationships with a unique data set that includes detailed information about economic insecurity and family complexity among parents just released from prison. We find that stable private housing, more than income, is associated with close and regular contact between parents and children. Formerly incarcerated parents see their children less regularly in contexts of multiple-partner fertility and in the absence of supportive family relationships. Significant housing and family effects are estimated even after we control for drug use and crime, which are themselves negatively related to parental contact. The findings point to the constraints of material insecurity and the complexity of family relationships on the contact between formerly incarcerated parents and their children.     

Evidence-based practice knowledge and utilization among social workers

In this study the researchers examined the knowledge, skills, and use of Evidence-Based Practice in a sample of social workers from different practice settings. Using an electronic survey, data were collected from a group of social work practitioners (N = 200). Participants in their 30s and 40s demonstrated the most knowledge and use of Evidence-Based Practice. In addition, a high percentage of social workers reported to be knowledgeable about social work research databases; a smaller percentage actually used online resources in their practice. Through this study the researchers add to what is currently known about social workers' perceptions, knowledge, and use of Evidence-Based Practice.     

Dropping the ball on media inquiries: The role of deadlines in media catching

Deadlines have always played a significant role in the practice of public relations, especially the media relations specialization. Public relations textbooks and practitioner handbooks encourage budding practitioners to learn how and when journalists, broadcasters, and Internet authors work so that they may pitch story ideas to them appropriately. Even though media catching, an emerging trend in media relations, reverses the traditional direction of story pitching, deadlines are still critical for this new media relations approach. Through a content analysis of 2802 Help-A-Reporter-Out media requests, this study examines how deadlines vary among media outlets engaging in this new media relations story. Statistically significant differences provide insights for public relations practitioners as to how they can best utilize the service to compete for media placements.