Differences in Caregiver Self-Efficacy and Satisfaction Related to Sexual Abuse of Offspring

Research suggests parents of sexually abused children may experience negative perceptions of themselves and their parenting abilities following the victimization of their children, which may influence the recovery process in treatment for these families. This study assessed perceived self-efficacy and parenting satisfaction among female caregivers of sexually abused children and female caregivers whose children were not victimized. Results indicated that caregivers of child victims had significantly lower levels of perceived parenting efficacy than their counterparts. There were no significant differences found between groups with regard to parenting satisfaction. The results highlight the importance of evaluating perceived parenting competence in the treatment of nonoffending caregivers in order to facilitate optimal treatment of the child victim and all members of the family system.     

Proposed best practice for statisticians in the reporting and publication of pharmaceutical industry‐sponsored clinical trials

In this paper we set out what we consider to be a set of best practices for statisticians in the reporting of pharmaceutical industry‐sponsored clinical trials. We make eight recommendations covering: author responsibilities and recognition; publication timing; conflicts of interest; freedom to act; full author access to data; trial registration and independent review. These recommendations are made in the context of the prominent role played by statisticians in the design, conduct, analysis and reporting of pharmaceutical sponsored trials and the perception of the reporting of these trials in the wider community. Copyright © 2010 John Wiley & Sons, Ltd.     

Formative research methods to understand patient and provider responses to heart attack symptoms

Formative research is often required for program planning, and for reducing uncertainty about generalizability of program effects. This article describes and justifies methods of formative research conducted for the REACT study (Rapid Early Action for Coronary Treatment), a multi-center collaborative randomized community trial aimed at reducing patient delay in seeking care for acute myocardial infarction (AMI). Formative research cast light on patient and community members’ decision-making process in seeking help for AMI, as well as barriers and facilitators of this process. Investigators at all five REACT Field Centers participated in the formative research. The process consisted of: (1) developing a common theoretical framework for the study intervention; (2) conducting a literature review and qualitative research to identify and address gaps in knowledge; and (3) developing a common protocol for the REACT study that accommodated the diversity of the target communities in terms of services, resources, history, and ethnicity. Analysis employed triangulation, defined as an explicit search for heterogeneous data sources to reduce uncertainty about forces at work and opportunities for intervention across settings and populations. Because the collection and interpretation of data went in stages, staff of several REACT Field Centers had independent input to the overall synthesis, then shared and revised the results. Advantages and limitations of this approach are discussed.     

Accommodating stochastic departures from percentile invariance in causal models

Summary.  Consider a clinical trial in which participants are randomized to a single-dose treatment or a placebo control and assume that the adherence level is accurately recorded. If the treatment is effective, then good adherers in the treatment group should do better than poor ad- herers because they received more drug; the treatment group data follow a dose–response curve. But, good adherers to the placebo often do better than poor adherers, so the observed adherence–response in the treatment group cannot be completely attributed to the treatment. Efron and Feldman proposed an adjustment to the observed adherence–response in the treatment group by using the adherence–response in the control group. It relies on a percentile invariance assumption under which each participant's adherence percentile within their assigned treatment group does not depend on the assigned group (active drug or placebo). The Efron and Feldman approach is valid under percentile invariance, but not necessarily under departures from it. We propose an analysis based on a generalization of percentile invariance that allows adherence percentiles to be stochastically permuted across treatment groups, using a broad class of stochastic permutation models. We show that approximate maximum likelihood estimates of the underlying dose–response curve perform well when the stochastic permutation process is correctly specified and are quite robust to model misspecification.     

加强临床实验室建设 促进和谐医院的构建

构建和谐医院既是建设社会主义和谐社会的本质要求,也是新时期医院生存和发展的重要条件。构建和谐医院就是要构建和谐的医患关系、和谐的医疗手段和和谐的医院文化。以人为本、人性化管理和实施医院管理年活动是加强医院管理,建设和谐医院的两个主要手段。临床实验室在和谐医院构建中发挥重要作用,这主要通过全面的实验室质量管理和优质的人性化服务来实现。     

Using statistical techniques to detect fraud: a test case

In an experiment to test the effectiveness of statistical measures in detecting fraud, three physicians fabricated scores on the Montgomery–Åsberg Depression Rating Scale (MADRS) for a number of subjects in three sites. The fabricated data were then planted among MADRS data from 18 genuine sites. A statistician blinded as to the identity and quantity of the fabricated data attempted to detect the ‘fraudulent’ data by searching for unusual means and correlations. One of the three fabricated sites was correctly identified, and one genuine site was incorrectly identified as a potential fabrication. In addition, inlying and/or outlying means and correlations found in the genuine data suggested the possibility of using statistical checks for unusual data early in a study so that sites with unusual patterns could be prioritized for monitoring, training and, if necessary, auditing. Copyright © 2004 John Wiley & Sons Ltd.     

美国诊所式法律教育模式研究及对我们的启示

诊所式法律教育,是20世纪60年代以后在美国开始通行的一种实践性法律教育模式,这种法律教育模式在教育理念、教育原则及教学方法上对传统法律教育模式均有所突破,文章试图通过对这一课题的研究,为我国一般高校法学院系的法律教育模式改革,提供一些值得借鉴的先进经验。     

非隶属附属医院内涵建设刍议

结合非隶属附属医院的建设实践,从教育观念、教学意识、师资培训、教学管理和教学条件的改善等方面阐述了做好非隶属附属医院内涵建设的重要性和意义。     

Testing for ordered failure rates under general progressive censoring

For exponentially distributed failure times under general progressive censoring schemes, testing procedures for ordered failure rates are proposed using the likelihood ratio principle. Constrained maximum likelihood estimators of the failure rates are found. The asymptotic distributions of the test statistics are shown to be mixtures of chi-square distributions. When testing the equality of the failure rates, a simulation study shows that the proposed test with restricted alternative has improved power over the usual chi-square statistic with an unrestricted alternative. The proposed methods are illustrated using data of survival times of patients with squamous carcinoma of the oropharynx.     

Dynamic allocation as a balancing act

The CPMP Points to Consider on Adjustment for Baseline Covariates recently came into operation. As well as providing sound guidance, this document states a strong position against dynamic allocation. This paper reviews the most important issues involved and aims to stimulate interest in further investigating alternative allocation methods in clinical trials. Copyright © 2004 John Wiley & Sons, Ltd.