Risk patterns in drug safety study using relative times by accelerated failure time models when proportional hazards assumption is questionable: an illustrative case study of cancer risk of patients on glucose‐lowering therapies

Observational drug safety studies may be susceptible to confounding or protopathic bias. This bias may cause a spurious relationship between drug exposure and adverse side effect when none exists and may lead to unwarranted safety alerts. The spurious relationship may manifest itself through substantially different risk levels between exposure groups at the start of follow‐up when exposure is deemed too short to have any plausible biological effect of the drug. The restrictive proportional hazards assumption with its arbitrary choice of baseline hazard function renders the commonly used Cox proportional hazards model of limited use for revealing such potential bias. We demonstrate a fully parametric approach using accelerated failure time models with an illustrative safety study of glucose‐lowering therapies and show that its results are comparable against other methods that allow time‐varying exposure effects. Our approach includes a wide variety of models that are based on the flexible generalized gamma distribution and allows direct comparisons of estimated hazard functions following different exposure‐specific distributions of survival times. This approach lends itself to two alternative metrics, namely relative times and difference in times to event, allowing physicians more ways to communicate patient's prognosis without invoking the concept of risks, which some may find hard to grasp. In our illustrative case study, substantial differences in cancer risks at drug initiation followed by a gradual reduction towards null were found. This evidence is compatible with the presence of protopathic bias, in which undiagnosed symptoms of cancer lead to switches in diabetes medication. Copyright © 2015 John Wiley & Sons, Ltd.     

The male immigrant–native employment gap in Sweden: migrant admission categories and human capital

Journal of Population Research - Despite having a celebrated labor market integration policy, the immigrant–native employment gap in Sweden is one of the largest in the OECD. From a...     

Taking social policy personally: How does neuroticism affect welfare state attitudes?

The role of the “Big Five” personality traits in driving welfare state attitudes has received scant attention in social policy research. Yet neuroticism in particular—a disposition to stress, worry, and get nervous easily—is theoretically likely to be an important driver of welfare attitudes precisely because welfare states deliver social “security” and “safety” nets. Using cross-sectional data from the German Socio-Economic Panel, we study three distinct attitude types (dissatisfaction with the social security system, feelings of personal financial insecurity, and preferences for state provision) and multiple social need contexts (including unemployment, ill health, old age, and nursing care). Controlling for established explanations such as self-interest, partisanship, and socialization, neuroticism does not systematically affect support for state provision. But it robustly increases general dissatisfaction with social security, as well as financial insecurity across various need contexts. Neurotic people are thus less happy with welfare state programmes across the board, yet they also appear to need these programmes more. This trait may be an important deeper layer driving other social attitudes.     

Declining employment success of immigrant males in Sweden: Observed or unobserved characteristics?

Focusing on Nordic and Yugoslavian immigrant males, we study the determinants of employment success of natives and immigrants in Sweden. Furthermore, we investigate the reasons behind the arising gap in employment success between Swedes and immigrants from 1970 to 1990. In a decomposition analysis, we find that the main part of the decline in the employment probability of immigrants relative to Swedes over time is explained by a change in coefficients (unobserved characteristics) rather than a change in determinants (observed characteristics). Received: 22 June 1998/Accepted: 23 March 2000     

Actor and Partner Effects of Attachment on Relationship Satisfaction and Sexual Satisfaction Across the Genders: An APIM Approach

Previous studies found gender differences in relationship satisfaction and sexuality. We tested gender differences in associations between attachment, a lasting relationship determinant, and two outcomes, relationship and sexual satisfaction. This study improves on earlier research by examining these associations in one Actor‐Partner‐Interdependence‐Model, making direct statistical testing between outcomes possible. Furthermore, a community and a distressed sample (N = 113 heterosexual couples each) were included to attempt replication across samples and to examine clinical implications. In both genders, actor attachment avoidance negatively affected relationship satisfaction and (with one exception) sexual satisfaction. Also in both genders, partner attachment avoidance negatively affected sexual satisfaction. However, whereas partner attachment avoidance influenced female relationship satisfaction, it did not affect male relationship satisfaction. The findings replicated across samples. Clinical implications are discussed.     

Making sense of HIV/AIDS: Pascal de Duve and the sensitive historian of education1

ABSTRACT

Since the 1990s historians, in general, have increasingly engaged in critical analyses of the emergence and development of what has come to be known as ‘the HIV/AIDS pandemic’. Historians of education have also become interested in the role-played by education in the history of HIV/AIDS. Although the existing educational histories have successfully examined the multiple and far-reaching power structures that helped shape the educational responses to the disease, I will argue that their focus on ideological and geopolitical power structures runs the risk of losing sight of the crucial and often sensorial responses of individuals who have played a part in the educational history of HIV/AIDS. One such individual is the Flemish philosopher Pascal de Duve, who was diagnosed with HIV in 1989. De Duve’s particular approach to the disease clearly illustrate the importance of the senses in how people attributed particular meanings to HIV/AIDS. Knowing that this approach would prove surprising to both his readership and to his wider television audience, de Duve employed sensory experiences and modes of communication (for instance, gesture) to educative ends. I conclude that an intersensorial approach to the past will render historians of education more sensitive to unexpected personal responses towards HIV/AIDS to unexpected personal responses towards HIV/AIDS.     

Developing Entrepreneurship in Social Work Through International Education. Reflections on a European Intensive Programme

This paper addresses the issue of introducing training on entrepreneurial skills in social work education and illustrates the opportunities offered for doing so by international courses. It presents a critical reflection on the concept of entrepreneurship in social work based on the case of a European Intensive Programme within the Erasmus scheme. It explores the potential of using active experiential learning methods in an international environment and of creating a situation where participants are confronted with ‘real world’ problems so that they can develop entrepreneurial skills. The paper argues that experiences of this kind provide new stimuli and contribute substantially to developing an entrepreneurial mentality, by which is meant innovative and proactive attitudes as well as skills to develop the resources with which to face social problems in an adverse context.     

An Observational Analysis of the Impact of Board Dynamics and Directors' Participation on Perceived Board Effectiveness

This study addresses calls for closer examination of board dynamics by offering an inside view of director interactions. Video observations of three board meetings at each of two Australian corporations matched with director interviews and secondary data reveal distinct patterns of director interactions, their sources of variation and their impact on perceived board effectiveness. The data reveal that director interactions are multidimensional and dynamic: while group interactions across agenda items are similar, with a few directors leading the discussion, the contributing directors change across items. Moreover, directors' inclusiveness and evenness of participation are associated with higher perceptions of board effectiveness. Lastly, the study found that director interactions change with the nature of the items, board climate and board meeting arrangements. The study contributes to the literature by moving beyond the individual‐level analysis of directors' skills or independence, and offering a detailed view of how the joint group and individual dimensions of board dynamics affect board functioning.