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71.
Over the last three decades, Palestinian society in Israel has undergone numerous changes, reflected in the rising numbers of families headed by single mothers. This article is based on a study conducted between 2007 and 2011 among 24 divorced, separated, and widowed Palestinian single mothers in Israel. I analyze this emerging family configuration, focusing on these women’s experiences as mothers and on how they accord new meaning to motherhood. My analysis will deal with the diverse ways these women ‘do motherhood’ and negotiate with different familial players. It will extend beyond the discourse on motherhood to shed light on the current changes in power and gender relations taking place in Palestinian-Israeli society.  相似文献   
72.
Fathers' absence is a pattern that shows intergenerational continuity, most notably within disadvantaged populations. The process whereby this pattern is repeated across generations is not well understood. Using data from the Concordia Longitudinal Risk Project, the authors investigated pathways between fathers' absence in 1 generation and the experience of fathers' absence by their children. The current sample included 386 socioeconomically at‐risk individuals across 2 waves of data collection: (a) when they were children and (b) when they were adults with their own children. Analyses based on structural equation modeling revealed that men whose fathers were absent when they were children were more likely to become absent fathers, and women whose fathers were absent when they were children were more likely to have children with absent partners. Indirect pathways between fathers' absence in 2 generations through aggression, education, and substance abuse were illustrated for women. These findings add to the literature suggesting that fathers' absence during childhood has intergenerational effects.  相似文献   
73.

Background

Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment.

Methods

Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20–25 (baseline), week 36 and two months after birth.

Results

Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience.

Conclusion

Women’s birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research.  相似文献   
74.
In a randomized controlled trial (RCT), it is possible to improve precision and power and reduce sample size by appropriately adjusting for baseline covariates. There are multiple statistical methods to adjust for prognostic baseline covariates, such as an ANCOVA method. In this paper, we propose a clustering-based stratification method for adjusting for the prognostic baseline covariates. Clusters (strata) are formed only based on prognostic baseline covariates, not outcome data nor treatment assignment. Therefore, the clustering procedure can be completed prior to the availability of outcome data. The treatment effect is estimated in each cluster, and the overall treatment effect is derived by combining all cluster-specific treatment effect estimates. The proposed implementation of the procedure is described. Simulations studies and an example are presented.  相似文献   
75.
Multi-regional clinical trial (MRCT) is an efficient design to accelerate drug approval globally. Once the global efficacy of test drug is demonstrated, each local regulatory agency is required to prove effectiveness of test drug in their own population. Meanwhile, the ICH E5/E17 guideline recommends using data from other regions to help evaluate regional drug efficacy. However, one of the most challenges is how to manage to bridge data among multiple regions in an MRCT since various intrinsic and extrinsic factors exist among the participating regions. Furthermore, it is critical for a local agency to determine the proportion of information borrowing from other regions given the ethnic differences between target region and non-target regions. To address these issues, we propose a discounting factor weighted Z statistic to adaptively borrow information from non-target regions. In this weighted Z statistic, the weight is derived from a discounting factor in which the discounting factor denotes the proportion of information borrowing from non-target regions. We consider three ways to construct discounting factors based on the degree of congruency between target and non-target regions either using control group data, or treatment group data, or all data. We use the calibrated power prior to construct discounting factor based on scaled Kolmogorov–Smirnov statistic. Comprehensive simulation studies show that our method has desirable operating characteristics. Two examples are used to illustrate the applications of our proposed approach.  相似文献   
76.
Designs for early phase dose finding clinical trials typically are either phase I based on toxicity, or phase I-II based on toxicity and efficacy. These designs rely on the implicit assumption that the dose of an experimental agent chosen using these short-term outcomes will maximize the agent's long-term therapeutic success rate. In many clinical settings, this assumption is not true. A dose selected in an early phase oncology trial may give suboptimal progression-free survival or overall survival time, often due to a high rate of relapse following response. To address this problem, a new family of Bayesian generalized phase I-II designs is proposed. First, a conventional phase I-II design based on short-term outcomes is used to identify a set of candidate doses, rather than selecting one dose. Additional patients then are randomized among the candidates, patients are followed for a predefined longer time period, and a final dose is selected to maximize the long-term therapeutic success rate, defined in terms of duration of response. Dose-specific sample sizes in the randomization are determined adaptively to obtain a desired level of selection reliability. The design was motivated by a phase I-II trial to find an optimal dose of natural killer cells as targeted immunotherapy for recurrent or treatment-resistant B-cell hematologic malignancies. A simulation study shows that, under a range of scenarios in the context of this trial, the proposed design has much better performance than two conventional phase I-II designs.  相似文献   
77.
应用资本资产定价模型中的单因子模型表达贷款收益和风险函数,以不同行业贷款组合后的总体风险最小化为目标,运用非线性规划方法建立了基于组合贷款总体风险优化的行业贷款分配模型。通过负相关行业的风险对冲,避免了选择单个或少数行业进行贷款所导致的、当该行业不景气时的系统性风险对贷款质量的影响,降低了贷款组合的系统性风险。从组合贷款总风险中分离出系统风险和非系统风险,并通过实例验证行业组合可以降低系统性风险,显示通过行业组合可以部分地抵消由于行业自身所产生的系统性风险。  相似文献   
78.
本文给出了解决等式约束问题的一种信赖域算法。算法用Byrd和Omojokun方法计算试探步,但在计算试探步时采取了降维的方法。在不要求约束条件的梯度是列满秩的条件下证明了算法的全局收敛性。  相似文献   
79.
Lynn Hempel 《Risk analysis》2011,31(7):1107-1119
We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44–31.14%), and by 71.88% (95% CI, 39.48–211.82%) for single females with children. Monthly time‐series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02–1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03–1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two‐dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata.  相似文献   
80.
Using a Yamaguchi‐type generalized gamma failure‐time mixture model, we analyse the data from a study of autologous and allogeneic bone marrow transplantation in the treatment of high‐risk refractory acute lymphoblastic leukaemia, focusing on the time to recurrence of disease. We develop maximum likelihood techniques for the joint estimation of the surviving fractions and the survivor functions. This includes an approximation to the derivative of the survivor function with respect to the shape parameter. We obtain the maximum likelihood estimates of the model parameters. We also compute the variance‐covariance matrix of the parameter estimators. The extended family of generalized gamma failure‐time mixture models is flexible enough to include many commonly used failure‐time distributions as special cases. Yet these models are not used in practice because of computational difficulties. We claim that we have overcome this problem. The proposed approximation to the derivative of the survivor function with respect to the shape parameter can be used in any statistical package. We also address the issue of lack of identifiability. We point out that there can be a substantial advantage to using the gamma failure‐time mixture models over nonparametric methods. Copyright © 2003 John Wiley & Sons, Ltd.  相似文献   
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