“Super-covariates”: Using predicted control group outcome as a covariate in randomized clinical trials

The power of randomized controlled clinical trials to demonstrate the efficacy of a drug compared with a control group depends not just on how efficacious the drug is, but also on the variation in patients' outcomes. Adjusting for prognostic covariates during trial analysis can reduce this variation. For this reason, the primary statistical analysis of a clinical trial is often based on regression models that besides terms for treatment and some further terms (e.g., stratification factors used in the randomization scheme of the trial) also includes a baseline (pre-treatment) assessment of the primary outcome. We suggest to include a “super-covariate”—that is, a patient-specific prediction of the control group outcome—as a further covariate (but not as an offset). We train a prognostic model or ensembles of such models on the individual patient (or aggregate) data of other studies in similar patients, but not the new trial under analysis. This has the potential to use historical data to increase the power of clinical trials and avoids the concern of type I error inflation with Bayesian approaches, but in contrast to them has a greater benefit for larger sample sizes. It is important for prognostic models behind “super-covariates” to generalize well across different patient populations in order to similarly reduce unexplained variability whether the trial(s) to develop the model are identical to the new trial or not. In an example in neovascular age-related macular degeneration we saw efficiency gains from the use of a “super-covariate”.     

Associations between attitudes towards scientific misconduct and self-reported behavior

We investigate the relationship between doctoral students’ attitudes towards scientific misconduct and their self-reported behavior. 203 questionnaires were distributed to doctoral candidates at the Faculty of Medicine, University of Oslo 2016/2017. The response rate was 74%. The results show a correlation between attitudes towards misconduct and self-reported problematic behaviors among doctoral students in biomedicine. The four most common reported misbehaviors are adding author(s) who did not qualify for authorship (17.9%), collecting more data after seeing that the results were almost statistically significant (11.8%), turning a blind eye to colleagues’ use of flawed data or questionable interpretation of data (11.2%), and reporting an unexpected finding as having been hypothesized from the start (10.5%). We find correlations between scientific misbehavior and the location of undergraduate studies and whether the respondents have had science ethics lectures previously. The study provides evidence for the concurrent validity of the two instruments used to measure attitudes and behavior, i.e. the Kalichman scale and the Research Misbehavior Severity Score (RMSS). Although the direction of causality between attitudes and misbehavior cannot be determined in this study the correlation between the two indicates that it can be important to engender the right attitudes in early career researchers.     

Growing into Relative Income Poverty: Urban China, 1988–2013

Social Indicators Research - This paper presents several arguments for applying a relative poverty line to urban China. For example between 2002 and 2013 urban residents in China changed their...     

Time Use on Trains: Media Use/Non-use and Complex Shifts in Activities

This study explores how travel time is used and how passengers conceptualise travel time in Danish intercity trains and intercity fast trains. The new contribution to the literature this study can offer is in the inclusion of all kinds of passengers in the different compartments to understand train travel as a dynamic act of moving with shifts in activities. A mixed-method approach is used with self-completed questionnaires, frequency observations, shadowing observations and interviews. The findings reveal that the train passengers’ acts on the move are framed by both macro- and microstructures. The passengers create a travel space in which they make dynamic shifts in different kinds of activities: media use, media non-use, social interactions and non-social interactions. Passengers expect the train operator to provide the travel space for different activities (including the possibility of mobile communication), and passengers can be frustrated and have anxiety if these needs are not fulfilled. The mobile phone is heavily used during train travel, and it appears that passengers are not typically annoyed by phone conversations during travel but may refer to previous experiences with annoyances.     

Making the most of the frame: developing the analytical potential of frame analysis

Frame analysis has been developed and applied across contexts in several disciplines such as policy analysis, where the perspective has proven fruitful to carve out essential differences in the construction of meaning and to understand the responsiveness of the strategic use of ideas. However, this article argues in line with other scholars that the analytical potential of frame analysis is not fully utilized in most empirical studies. The article addresses two points of critique raised against frame analytical perspectives: the limited view of the framing process and the limited understanding of frame effects. We suggest two analytical dimensions that help to develop the analytical potential of frame analysis in policy analysis and beyond: firstly, the institutionalization process of frames which can capture the struggle of meaning within policy processes and also distinguish between the varying influences of different frames over space and time. Secondly, the extension of frame effects that through a reconceptualization of frame effects can capture how a frame has an effect on actors other than the audience and beyond its immediate purpose.     

Autonomy,Choice and Control for Older Users of Home Care Services: Current Developments in Swedish Eldercare

In Sweden, a policy shift towards more individualized eldercare, with an emphasis on consumer choice, has taken place. The aim of this study was to analyze the processes and practices of individualized eldercare, focusing on preconditions for older peoples’ choice and control. Data consist of qualitative interviews with users of home care services (n – 12) and staff (n – 12) and participant observations (n – 7) of meetings between staff and older people. The choice and control available to older users emerged as decisions about ‘what’ care and services, ‘who’ should provide the care and services, and ‘how’ the care and services should be performed. Three approaches to enable older people choice and control over their home care services were revealed: test and revise, services elaborated in close collaboration between users, care managers and home care staff; choices in the moment, users could choose services at each occasion; and quality improvement through competition, competing providers develop attractive services. The findings could guide policy makers in combining the strengths of these approaches to enable older people in need of support to become co-producers in designing, managing, as well as consuming, care and services. Future quantitative research is needed to achieve generalizable knowledge about the strengths and weaknesses of different ways to organize eldercare services.     

Masculine domination and gender subtexts: The role of female professionals in the renewal of the Swedish video game industry

The video game industry is a showcase industry in the entrepreneurial, knowledge-intensive, and technology-based economy. Despite recent technological shifts rendering digital media portable in the form of smartphones, tablets, and laptops, attracting new categories of gamers, most notably women above the age of 35, the video game industry is struggling to handle its masculine domination, prescribing specific and gendered divisions of labor in terms of lowering thresholds for female video game developers. This article reports on empirical material based on interviews from the burgeoning Swedish video game industry and suggests that female professionals entering the industry encounter inherited gendered beliefs and ways of organizing work which locate women in specific, and not always desirable, roles within the industry. In this regime of masculine domination, the study concludes, female video game developers are understood as a particular group primarily knowledgeable about female gamers’ preferences and not as the possessors of general skills attractive to the video game companies. Ultimately, the masculine domination and the historical gendered divisions of labor are preventing the industry from creating more gender-equal workplaces and, as a consequence, fully exploiting market potentials.     

Equality of opportunity and the distribution of long-run income in Sweden

Equality of opportunity is an ethical goal with almost universal appeal. The interpretation taken here is that a society has achieved equality of opportunity if it is the case that what individuals accomplish, with respect to some desirable objective, is determined wholly by their choices and personal effort, rather than by circumstances beyond their control. We use data for Swedish men born between 1955 and 1967 for whom we measure the distribution of long-run income, as well as several important background circumstances, such as parental education and income, family structure and own IQ before adulthood. We address the question: in Sweden, given its present constellation of social policies and institutions, to what extent is existing income inequality due to circumstances, as opposed to ‘effort’? Our results suggest that several circumstances, importantly both parental income and own IQ, are important for long-run income inequality, but that variations in individual effort account for the most part of that inequality.     

Discrepancies in pain presentation caused by adverse psychosocial conditions as compared to pain due to high physical workload?

Disorders in the musculoskeletal system have been associated with a high physical workload as well as psychosocial and individual factors. It is however not obvious which of these factors that is most important to prevent. Musculoskeletal disorders in neck and upper extremity was assessed by interview and clinical examination in 79 teachers and 93 assisting nurses, all females. Psychosocial work environment was assessed by questionnaire. The physical workload was recorded by technical measurements of postures, movements and muscular load, in 9 teachers and 12 nurses. The physical workload was lower among the teachers, but they had a more demanding psychosocial work environment. Among the nurses, but not in the teachers, the neck-shoulder disorders were associated with a high body mass index (BMI). The teachers reported neck-shoulder complaints to a higher extent than the nurses, but had much lower prevalence of diagnoses in the clinical examination (12% vs. 25%; POR 0.3 CI 0.1 - 1.2; adjusted for age and BMI). The results suggest that adverse psychosocial conditions among the teachers give rise to a different kind of pain in the neck-shoulder region than from physical overload, troublesome but not as severe as the one afflicting the nurses.