Development of predictive signatures for treatment selection in precision medicine with survival outcomes

For survival endpoints in subgroup selection, a score conversion model is often used to convert the set of biomarkers for each patient into a univariate score and using the median of the univariate scores to divide the patients into biomarker‐positive and biomarker‐negative subgroups. However, this may lead to bias in patient subgroup identification regarding the 2 issues: (1) treatment is equally effective for all patients and/or there is no subgroup difference; (2) the median value of the univariate scores as a cutoff may be inappropriate if the sizes of the 2 subgroups are differ substantially. We utilize a univariate composite score method to convert the set of patient's candidate biomarkers to a univariate response score. We propose applying the likelihood ratio test (LRT) to assess homogeneity of the sampled patients to address the first issue. In the context of identification of the subgroup of responders in adaptive design to demonstrate improvement of treatment efficacy (adaptive power), we suggest that subgroup selection is carried out if the LRT is significant. For the second issue, we utilize a likelihood‐based change‐point algorithm to find an optimal cutoff. Our simulation study shows that type I error generally is controlled, while the overall adaptive power to detect treatment effects sacrifices approximately 4.5% for the simulation designs considered by performing the LRT; furthermore, the change‐point algorithm outperforms the median cutoff considerably when the subgroup sizes differ substantially.     

Portrayals of the internal God among Ashkenazi Jewish Orthodox lesbians in Israel

Abstract

Most of the existing literature on Ashkenazi Orthodox Jewish lesbians focuses on sociological aspects, mainly the negative attitudes held by religious communities towards their sexual identity and the various problems that arise from these. Less attention has been paid to lesbians’ psychological coping mechanisms with the tensions between their two central identities: the religious and the sexual. Ashkenazi Orthodox lesbians find themselves in a complicated situation where they remain on the margins of both their “natural” communities: the religious one and the homosexual one. As a result, they feel rejected, isolated, and even punished by society. As believers, God is their ultimate refuge. But there are different conceptions of God, ranging from benevolent to persecutory, accepting or highly judgmental and punishing. This variance has not been considered in regard to the dual identity of Ashkenazi Orthodox lesbians. This article focuses on this neglected issue, examining Ashkenazi Orthodox lesbians’ conception of God and its relation to their managing the conflict between their apparently conflicting identities.     

Perceptions of transition-related health and mental health services among transgender adults

The opportunity to live authentically is critical for the well-being of transgender individuals. For many this requires accessing transition-related services. Current knowledge of transition-related care is limited. This study aims to elucidate experiences and needs of transgender individuals (N = 65) related to (a) therapeutic support, (b) medical care, and (c) aspects of living authentically in order to inform the development and delivery of trans-affirmative services. Findings reveal challenges accessing health care providers with trans-specific competency; gaps between critical aspects of transition-related care and receipt of services; and heterogeneity of experiences and needs. Recommendations for improving transgender-affirmative services are provided.     

Beyond the heartlands: deindustrialization,naturalization and the meaning of an ‘industrial’ tradition

Deindustrialization is a complex and multifaceted series of processes and transitions, reflecting the equally complicated web of social relationships and interdependencies that constitute(d) an industrial society. Contemporary scholars have looked beyond just the economic impact of industrial loss, to the cultural, temporal and spatial legacies and impacts wrought by the mass closures of the 1980s, as well as the continuing presence of an industrial identity in struggles over representation and regeneration. However, deindustrialization has a history that precedes the volatility and culmination of that period, and has impacted upon a more geographically diverse range of former industrial locations than are commonly represented. The narratives that surround some sites are complicated by their displacement in time, place and discourse; they lack the political capital of an ‘industrial’ identity through this disassociation. In this article I aim to go beyond what we might consider the industrial ‘heartlands’ of the UK to a place that has felt the impact of deindustrialization, but which falls outside of the usual representations of the UK's industrial past. I explore how the industrial identity and memory of a place can be naturalized and selectively reworked for the needs of the hour, the very meaning of ‘industrial’ altered in the process. I argue that for sites unable to access or utilize the imagery of modern, heavy industry for community or promotional aims, deindustrialization becomes a process of rewriting an historic identity – one that sheds new light on industrial loss in diverse situations, and at an ever‐increasing distance from closure.     

Chinese youth performing identities and navigating belonging online

This paper examines the experiences of belonging of young Chinese internet users through an analysis of their online identity practices. Drawing on a qualitative research project about online citizenship practices of 31 young Chinese citizens from mainland China, I explore their experiences of belonging on two online platforms (Weibo and WeChat) and the identities formed and sustained through these experiences. The results show that young people experience different senses of belonging in different social media spaces. Their strategies in navigating these experiences are informed by (a) their perceptions of online spaces as private or public, and (b) using online identity performance as a supplement to or escape from identities in physical life. I argue that young Chinese internet users experience different senses of belonging by flexibly appropriating the affordances of social media platforms for communication and networking; these senses of belonging play a key role in forming and sustaining their identities, and are crucial for their wellbeing.     

“Still Looking for My Jonathan”: Gay Black Men's Management of Religious and Sexual Identity Conflicts

This article looks at homosexual Black men who are heavily involved in fundamentalist African-American churches. These men describe themselves as “out as same-sex loving individuals” even though the messages preached by their church leaders and the doctrines of their churches are, at the very least, heterosexist, but more likely to be stridently anti-homosexuality. Not only do these men attend the churches they are parts of, but they are viewed as leaders in these churches in positions ranging from associate pastor to director of facilities management. The study uses structured interviews to understand how these men manage the conflict between a committed gay identity and a strong religious identity that says the two cannot coexist.     

Homosexual Experience,Desire and Identity Among Young Adults

ABSTRACT

Is young people's sexuality becoming more fluid and less tied to steady, stable identity patterns? Are we developing into a society where sexual relationships between individuals of the same sex are no longer reserved for the small minority of gay men and lesbian women? Adherents of so-called queer theory have promulgated such views. Using a population-based sample of young adults (aged 19 to 26, N 2753), we investigated homosexual experiences, desire and identity. We found that levels of prevalence of homosexuality were primarily a function of the criteria we used. Using the most restricted (“narrow”) definitions, we found that about one percent of both genders reported “exclusive” homosexual interest and identity. Using the most inclusive criteria, we found that one of ten young men and one of four young women reported having some homosexual experience, interest or identity. Still, the most striking finding involved the substantial gender-specific differences: homoerotic activity and interest are far more interwoven with heterosexual activity for women. There are strong indications that homosexuality is a lot more threatening and potentially in conflict with traditional male gender roles than we find to be the case for women. In other words, while there may be signs of more fluid sexual identity categories, this phenomenon primarily applies to women.     

Survival and lifetime data analysis with a flexible class of distributions

We introduce a general class of continuous univariate distributions with positive support obtained by transforming the class of two-piece distributions. We show that this class of distributions is very flexible, easy to implement, and contains members that can capture different tail behaviours and shapes, producing also a variety of hazard functions. The proposed distributions represent a flexible alternative to the classical choices such as the log-normal, Gamma, and Weibull distributions. We investigate empirically the inferential properties of the proposed models through an extensive simulation study. We present some applications using real data in the contexts of time-to-event and accelerated failure time models. In the second kind of applications, we explore the use of these models in the estimation of the distribution of the individual remaining life.     

The international field placement: a reconciliation of identity

The international field placement is a site of both identity confusion and identity development for the social work student. Aiming to develop their professional identity they are faced with a challenge: the presence of two dominant identities, the tourist identity and the student identity. Whilst the embodiment of the tourist identity has often facilitated the student’s motivation to undertake the placement experience, the student identity is what both university staff and agency field educators perceive as integral to student engagement in this remote educational setting. Social work educators perceive this identity challenge as an impediment to learning. In contrast, students report feeling that their tourist traits strengthened their personal and professional capacity, natural curiosity and ability to engage with the local community. By analysing the roles of university staff as liaison support, and field educators as agency supervisors, it is possible to explore a teaching and learning relationship that is student-centred, grounded in the immersive international experience. Through privileging the student’s voice social work educators involved with organising, supporting and supervising international field placements are able to understand the placement as a continuum of learning. On this continuum identity reconciliation is viewed as a crucial element in the development of a professional identity.