Case study in the Bayesian analysis of a cost‐effectiveness trial in the evaluation of health care technologies: Depression

We present a case study based on a depression study that will illustrate the use of Bayesian statistics in the economic evaluation of cost‐effectiveness data, demonstrate the benefits of the Bayesian approach (whilst honestly recognizing any deficiencies) with respect to frequentist methods, and provide details of using the methods, including computer code where appropriate. Copyright © 2003 John Wiley & Sons, Ltd.     

Individualism vs Collectivism in Different Cultures: A cross-cultural study

In this study, individualism vs collectivism, in line with the work of Triandis in 1985, was assessed in two groups of male and female students, in Egypt and Germany. The results confirm the effect that cultural background has on individualist vs collectivist orientations in both of these cultures for male and female students. Men and women scored higher on individualism in Germany than in Egypt, whereas collectivism scores were higher in Egypt than in Germany. These findings are discussed in terms of general recommendations for intercultural interventions that discourage viewing people solely in terms of group membership, and instead as distinct individuals.     

Data skeletons: simultaneous estimation of multiple quantiles for massive streaming datasets with applications to density estimation

We consider the problem of density estimation when the data is in the form of a continuous stream with no fixed length. In this setting, implementations of the usual methods of density estimation such as kernel density estimation are problematic. We propose a method of density estimation for massive datasets that is based upon taking the derivative of a smooth curve that has been fit through a set of quantile estimates. To achieve this, a low-storage, single-pass, sequential method is proposed for simultaneous estimation of multiple quantiles for massive datasets that form the basis of this method of density estimation. For comparison, we also consider a sequential kernel density estimator. The proposed methods are shown through simulation study to perform well and to have several distinct advantages over existing methods.     

Stochastic Modelling of Times to Temperature for Furnaces Supplying Titanium Blooms to a Rolling Mill at TIMET

In conjunction with TIMET at Waunarlwydd (Swansea, UK) a model has been developed that will optimise the scheduling of various blooms to their eight furnaces so as to minimise the time taken to roll these blooms into the finished mill products. This production scheduling model requires reliable data on times taken for the various furnaces that heat the slabs and blooms to reach the temperatures required for rolling. These times to temperature are stochastic in nature and this paper identifies the distributional form for these times using the generalised F distribution as a modelling framework. The times to temperature were found to be similarly distributed over all furnaces. The identified distributional forms were incorporated into the scheduling model to optimise a particular campaign that was run at TIMET Swansea. Amongst other conclusion it was found that, compared to the actual campaign, the model produced a schedule that reduced the makespan by some 35%.     

A simple estimator for a shared frailty regression model

Summary. We propose a simple estimation procedure for a proportional hazards frailty regression model for clustered survival data in which the dependence is generated by a positive stable distribution. Inferences for the frailty parameter can be obtained by using output from Cox regression analyses. The computational burden is substantially less than that of the other approaches to estimation. The large sample behaviour of the estimator is studied and simulations show that the approximations are appropriate for use with realistic sample sizes. The methods are motivated by studies of familial associations in the natural history of diseases. Their practical utility is illustrated with sib pair data from Beaver Dam, Wisconsin.     

Human immunodeficiency virus risk: is it possible to dissuade people from having unsafe sex?

Summary. The cumulative number of human immunodeficiency virus (HIV) infections worldwide has reached 60 million in little over 30 years. HIV continues to spread despite a detailed understanding of the manner in which it spreads and measures which can prevent spread. Some governments have been highly successful in containing the spread of HIV through blood products and from mother to child and among injecting drug users. Lack of political will, lack of resources or challenges to widely accepted scientific evidence have held back similar interventions in other countries. It has proved much more difficult to reduce the sexual transmission of HIV in both high and low income countries. A wide range of strategies has been identified but it remains unclear which strategies deserve priority and what methods of promoting them have the greatest effect. There is ample evidence that awareness of HIV and changes in sexual behaviour have occurred widely but the penetration of information remains poor in some vulnerable groups especially adolescents and women in poorer countries. Further obstacles face those who have information about the risk. The subordinate position of women and a desire for large families are important obstacles to condom negotiation and use. Urbanization, poverty, conflict and declining public services all exacerbate unsafe sexual behaviour. We argue that so-called 'structural' interventions directed at these wider contexts of unsafe behaviour merit greater attention. Such approaches have the added benefit of being less susceptible to 'risk compensation' which has the potential to undermine strategies directed at reducing the transmission efficiency of HIV.     

Research project on advocacy and autism

This article presents the findings of a qualitative research project about the difficulties in accessing advocacy faced by adults labelled as having autism and Asperger's Syndrome in the Northwest of England. It is also an example of partnership working between three organisations. The article examines both the process of team-led (emancipatory) research and the project findings. Seven main themes emerged throughout the research: late diagnosis and lack of service support; bad experiences with systems of care; feelings of 'not belonging' (identity issues); barriers around communication and sensitivity towards individuals; lack of awareness and access to advocacy and rights; difficulties of 'fitting into' what is already available; and interest in developing knowledge around advocacy. Examination of the main themes pointed to a disturbing link between poor service response, episodes of crisis and mental ill health. The Carlisle People First Research Team is made up of 6 researchers who are labelled as having 'learning difficulties' who work in partnership with one other researcher.     

Asthma Patients' Activities and Air Pollution: A Semiparametric Censored Regression Analysis

Asthma patients' health status may be especially sensitive to some types of air pollution, but the evidence on this is mixed. We explore the effects of ground-level ozone on asthma patient's activities, breaking apart the usual aggregated category of leisure into indoor and outdoor activities, and differentiating those by whether the activities were active or inactive. Applying the semiparametric censored estimation method we demonstrate that even though the period over which activities were observed was relatively low in ozone levels, there is a significant impact of ozone on a few activities. The (non-ozone) economic and demographic variables in the model play significant roles in explaining the allocation of time among seven activities, suggesting the suitability of the approach for other household decision-making contexts.