Recent Mortality Trend Reversal in Russia: Are Regions Following the Same Tempo?

After several decades of negative trends and short-term fluctuations, life expectancy has been increasing in Russia since 2004. Between 2003 and 2014, the length of life rose by 6.6 years among males and by 4.6 years among females. While positive trends in life expectancy are observed in all regions of Russia, these trends are unfolding differently in different regions. First, regions entered the phase of life expectancy growth at different points in time. Second, the age- and cause-specific components of the gains in life expectancy and the number of years added vary noticeably. In this paper, we apply decomposition techniques—specifically, the stepwise replacement algorithm—to examine the age- and cause-specific components of the changes in inter-regional disparities during the current period of health improvement. The absolute inter-regional disparities in length of life, measured by the population-weighted standard deviation, decreased slightly between 2003 and 2014, from 3.3 to 3.2 years for males, and from 2.0 to 1.8 years for females. The decomposition of these small changes by ages and causes of death shows that these shifts were the result of diverse effects of mortality convergence at young and middle ages, and of mortality divergence at older ages. With respect to causes of death, the convergence is mainly attributable to external causes, while the inter-regional divergence of trends is largely determined by cardiovascular diseases. The two major cities, Moscow and Saint Petersburg, are currently pioneering mortality improvements in Russia and are making the largest contributions to the inter-regional divergence.     

Assessing the Need for Higher Levels of Care Among Problem Gambling Outpatients

Most treatment for gambling disorder is provided on an outpatient basis. Only a small number of jurisdictions in North America provide higher levels of gambling treatment, such as residential or intensive outpatient (IOP) care, despite the potential need for these services. Further, there appear to be few guidelines for determining appropriate level of gambling treatment. The aim of the present study was to assess the appropriateness of higher levels of problem gambling care among clients receiving outpatient treatment. Problem gamblers and their therapists independently completed questionnaires that assessed the need and desire for residential and IOP treatment. About 42% of problem gambling outpatients noted that they would be “probably” or “definitely” willing to attend residential treatment, and about half indicated they would be equally likely to attend IOP. Therapists recommended about a third of their clients as appropriate for higher levels of care. For both client and therapist assessments, there was a significant association between desire or recommendation for level of treatment and severity of gambling and co-occurring problems. Further, therapist recommendations for level of care were significantly associated with client willingness to attend higher levels of treatment. Our data reveal the potential need for higher levels of care for problem gambling, as evaluated by clients and their therapists. Policy implications for the funding of residential and IOP treatment are discussed.     

The Case Study Method in Psychodynamic Psychology: Focus on Addiction

The case study method has been essential in psychoanalysis and psychodynamic therapy, since it is the only way to describe and explore the deepest levels of the human psyche. Addiction is no more and no less than a particular psychological mechanism, identical at its core to other psychological compulsions, and is therefore best understood and reported by this method that explores the mind in depth. We will discuss the value of the case report method in general and in specific with regard to psychoanalysis and addiction, criticisms raised about this method, and comparisons of it with nomothetic research.     

The Nigerian Civil Registration and Vital Statistics System: Contexts,Institutions, Operation

Civil Registration and Vital Statistics (CRVS) Systems are playing increasing roles in national and global data infrastructure, facilitating the achievement of key developmental goals. The performance of CRVS systems in many developing countries including Nigeria is sub optimal and information on their structure and operations scanty. This paper characterizes the statutory, institutional, and operational elements and social contexts of the Nigerian CRVS System. It includes a context analysis of the system and a review of improvement strategies and interventions. The paper shows that the Nigerian CRVS System is built on viable statutory and institutional platforms—the constitutional enshrinement of: universal, compulsory and continuous civil registration and, a central registration institution—the National Population Commission (NPC). NPC has registration hierarchy and infrastructure deployed at every level of political administration and mechanisms for efficient coordination of registration and production of vital statistics on live-births, deaths and stillbirths amongst other vital events. The major weaknesses of the system include inadequate financing and deployment of registration facilities, conflicting statutes and institutional arrangements for the registration of key events like death and stillbirths. Other weaknesses include intra-organizational conflicts in resource allocation and weak ICT infrastructure within the NPC. These are compounded by overarching contextual issues namely registration unfriendly sociocultural norms, weak national data infrastructure, systemic corruption, poverty and undeveloped civic culture. Domestic initiatives and interventions to improve the system have focused on birth registration, while multilateral interventions have only made a modest impact on the system. Thus, holistic in-country improvement initiatives supported with robust interventions are imperative to overcome weaknesses in the Nigerian CRVS system. However fundamental improvements in CRVS systems in developing countries like Nigeria may likely only follow sustainable solutions to overarching contextual issues especially poor infrastructure, weak institutions, poverty and systemic corruption.     

Heterogeneous climate effects on human migration in Indonesia

We examine the effect of anomalous temperatures, rainfall levels, and monsoon timing on migration outcomes in Indonesia. Using panel data from the Indonesian Family Life Survey and high-resolution climate data, we assess whether intra- and inter-province moves are used as a response to climatic shocks. We evaluate the relative importance of temperature, rainfall, and monsoon timing for migration. Only temperature and monsoon timing have significant effects, and these do not operate in the direction commonly assumed. Estimated effects vary according to individuals’ gender, membership in a farm household, and location. We also analyze climate effects on sources of household income, which highlights the multi-phasic nature of household responses. Results undermine narratives of a uniform global migratory response to climate change and highlight the heterogeneous use of migration as a response to such changes. By extending previous research on environmentally induced migration in Indonesia, we also highlight the sensitivity of estimates to alternative climate and migration measures.     

A robust automatic clustering algorithm for probability density functions with application to categorizing color images

This study develops a robust automatic algorithm for clustering probability density functions based on the previous research. Unlike other existing methods that often pre-determine the number of clusters, this method can self-organize data groups based on the original data structure. The proposed clustering method is also robust in regards to noise. Three examples of synthetic data and a real-world COREL dataset are utilized to illustrate the accurateness and effectiveness of the proposed approach.     

Estimation of the cumulative incidence function under multiple dependent and independent censoring mechanisms

Competing risks occur in a time-to-event analysis in which a patient can experience one of several types of events. Traditional methods for handling competing risks data presuppose one censoring process, which is assumed to be independent. In a controlled clinical trial, censoring can occur for several reasons: some independent, others dependent. We propose an estimator of the cumulative incidence function in the presence of both independent and dependent censoring mechanisms. We rely on semi-parametric theory to derive an augmented inverse probability of censoring weighted (AIPCW) estimator. We demonstrate the efficiency gained when using the AIPCW estimator compared to a non-augmented estimator via simulations. We then apply our method to evaluate the safety and efficacy of three anti-HIV regimens in a randomized trial conducted by the AIDS Clinical Trial Group, ACTG A5095.     

A penalized likelihood method for nonseparable space–time generalized additive models

In this paper, we study space–time generalized additive models. We apply the penalyzed likelihood method to fit generalized additive models (GAMs) for nonseparable spatio-temporal correlated data in order to improve the estimation of the response and smooth terms of GAMs. The results show that our space–time generalized additive models estimated response and smooth terms reasonable well, and in addition, the mean squared error, mean absolute deviation and coverage intervals improved considerably compared to the classic GAM. An application on particulate matter concentration in the North-Italian region of Piemonte is also presented.