Latent class models for longitudinal studies of the elderly with data missing at random

The elderly population in the USA is expected to double in size by the year 2025, making longitudinal health studies of this population of increasing importance. The degree of loss to follow-up in studies of the elderly, which is often because elderly people cannot remain in the study, enter a nursing home or die, make longitudinal studies of this population problematic. We propose a latent class model for analysing multiple longitudinal binary health outcomes with multiple-cause non-response when the data are missing at random and a non-likelihood-based analysis is performed. We extend the estimating equations approach of Robins and co-workers to latent class models by reweighting the multiple binary longitudinal outcomes by the inverse probability of being observed. This results in consistent parameter estimates when the probability of non-response depends on observed outcomes and covariates (missing at random) assuming that the model for non-response is correctly specified. We extend the non-response model so that institutionalization, death and missingness due to failure to locate, refusal or incomplete data each have their own set of non-response probabilities. Robust variance estimates are derived which account for the use of a possibly misspecified covariance matrix, estimation of missing data weights and estimation of latent class measurement parameters. This approach is then applied to a study of lower body function among a subsample of the elderly participating in the 6-year Longitudinal Study of Aging.     

Does Marital History Matter? Marital Status and Wealth Outcomes Among Preretirement Adults

Data from the 1992 Health and Retirement Survey are used to specify ordinary least squares (OLS) regression models predicting wealth. Separate models are estimated for men and women. The results indicate that individuals who are not continuously married have significantly lower wealth than those who remain married throughout the life course. Remarriage offsets the negative effect of a marital dissolution. There are significant gender differences in these effects. The results demonstrate that accounting for the sequence of marital events provides a detailed picture of the life paths that lead to wealth heterogeneity among the older population.     

Working with managers to improve services: changes in the role of research in social care

The setting of specific objectives for children's services and the identification of key outcome indicators, together with the development of a core information specification for children's services with its practical application in the implementation of the Integrated Children's System, all mean that substantially more data are now available to child welfare agencies. Not so long ago in the UK it was the role of research teams to collect and analyse such data. Now that so much of it is already available to agencies, are researchers who work in this area of applied social policy research becoming redundant? Using data from the cohorts of looked after children being studied at the Centre for Child and Family Research, Loughborough University, the paper demonstrates how researchers can work in consultation with the managers of child welfare agencies to make better sense of the data at their disposal. It considers three issues: what additional variables need to be explored to help agencies better understand their performance; how groups of children could be identified who follow predictable pathways through social care; and how qualitative information is necessary to gain a true picture of what is happening. All of these examples demonstrate a fundamental role for researchers in working with social services personnel to identify how services can be improved.     

Adoption Research: An Assessment of Empirical Contributions to the Advancement of Adoption Practice

This article examines the current state of adoption research as it applies to each member of the adoption triad. It includes a review of the research that has focused on birth mothers and fathers in both domestic and international adoptions; adopted children, adolescents, and adults; and adoptive parents. The paper also examines the areas of research in which a paucity of studies currently exist, and suggests that although major contributions to clinical practice and policy have been made, the dialogue should continue to seek to study issues such as international adoption and the adoption of children in foster care.     

How children experience fostering outcomes: participatory research with children

This paper presents findings from longitudinal research that uses quantitative and qualitative methods to explore children’s perceptions of outcomes of the care experience. Children’s self‐assessments on two occasions reflect a high level of psychosocial need. Important relationships emerged regarding the children’s judgements of their interpersonal skills and attachments. Children who displayed stronger maternal attachment were likely to sustain highly cohesive relationships with the rest of the foster family. Themes emerging from the data are discussed, including the role of foster mothers and fathers in enhancing developmental outcomes for children.     

Union Dissolution and Mobility: Who Moves From the Family Home After Separation?

We investigate which partner of a 2‐gender couple moves out after separation. We test hypotheses on the impact of differences between the partners in the costs of moving out and resources, using data from the Divorce in the Netherlands survey (N = 1,537 ex‐couples who separated between 1972 and 1998). Ex‐partners initiating the separation were more likely to leave, as were those for whom a new partnership was a reason for the separation. An ex‐partner with custody of children was less likely to leave, as was an ex‐partner with more resources. A woman was less likely to leave when the joint children no longer lived at home or when the partnership had been longer lasting.     

Gynecologic age is an important risk factor for obstetric and perinatal outcomes in adolescent pregnancies

BackgroundAdolescent pregnancy is an important public health problem. Physiological maturity affects obstetric and perinatal outcomes. Almost all assessments of adolescent pregnancies are based on chronological age. Gynecologic age (GA) is defined as age in years at conception minus age at menarche and it is an indicator of physiological maturity.AimTo compare obstetric and perinatal outcomes between adult and adolescent pregnancies as categorized according to GA.MethodsIn this retrospective study, 233 adolescent pregnant women were divided into two groups based on GA ≤ 3 years (101 women) and GA > 3 years (132 women). Their obstetric and perinatal results were compared with 202 adult pregnancies who gave birth in the same period.FindingsGestational age at delivery, APGAR scores, birth weight, and incidence of preterm birth, admission to neonatal intensive care unit (NICU), intrauterine growth restriction, low birth weight, and premature rupture of membranes were significantly different between the study groups. Compared to adolescent pregnancies with GA > 3 years, adolescent pregnancies with GA ≤ 3 years had significantly lower birth weight, gestational age, APGAR scores, and significantly higher incidence of intrauterine growth restriction, low birth weight and admission to NICU.ConclusionLow GA is associated with an increased rate of obstetric and perinatal complications in adolescent pregnancies. Although the main aim is the prevention of adolescent pregnancies, a detailed evaluation of such pregnancies including determination of the gynecological age together with a multidisciplinary approach may decrease potential complications.     

Becoming Dialogical: Psychotherapy or a Way of Life?

After birth the first thing we learn is becoming a participant in dialogue. We are born in relations and those relations become our structure. Intersubjectivity is the basis of human experience and dialogue the way we live it. In this paper the dilemma of looking at dialogue as either a way of life or a therapeutic method is described. The background is the open dialogue psychiatric system that was initiated in Finnish Western Lapland. The author was part of the team re‐organizing psychiatry and afterwards became involved in many different types of projects in dialogical practices. Lately the focus has shifted from looking at speech to seeing the entire embodied human being in the present moment, especially in multifarious settings. Referring to studies on good outcomes in acute psychosis, the contribution of dialogical practice as a psychological resource will be clarified.     

Recent Two-Stage Sample Selection Procedures With an Application to the Gender Wage Gap

Recently developed two-stage estimation methods of sample selection models are used, in the context of data from the 1989 Labor Market Activity Survey, to examine labor supply decisions and wage outcomes for employed men and women. Recent hypothesis test procedures are used to test for no sample selection and to test for a parametric against a semiparametric selection-correction procedure. We conclude that selection is indeed an issue for the sample at hand and that the semiparametric specification is appropriate. We also present the standard decomposition of the gender wage gap into its explained and unexplained portions.