Type I error rates from likelihood‐based repeated measures analyses of incomplete longitudinal data

The last observation carried forward (LOCF) approach is commonly utilized to handle missing values in the primary analysis of clinical trials. However, recent evidence suggests that likelihood‐based analyses developed under the missing at random (MAR) framework are sensible alternatives. The objective of this study was to assess the Type I error rates from a likelihood‐based MAR approach – mixed‐model repeated measures (MMRM) – compared with LOCF when estimating treatment contrasts for mean change from baseline to endpoint (Δ). Data emulating neuropsychiatric clinical trials were simulated in a 4 × 4 factorial arrangement of scenarios, using four patterns of mean changes over time and four strategies for deleting data to generate subject dropout via an MAR mechanism. In data with no dropout, estimates of Δ and SE_Δ from MMRM and LOCF were identical. In data with dropout, the Type I error rates (averaged across all scenarios) for MMRM and LOCF were 5.49% and 16.76%, respectively. In 11 of the 16 scenarios, the Type I error rate from MMRM was at least 1.00% closer to the expected rate of 5.00% than the corresponding rate from LOCF. In no scenario did LOCF yield a Type I error rate that was at least 1.00% closer to the expected rate than the corresponding rate from MMRM. The average estimate of SE_Δ from MMRM was greater in data with dropout than in complete data, whereas the average estimate of SE_Δ from LOCF was smaller in data with dropout than in complete data, suggesting that standard errors from MMRM better reflected the uncertainty in the data. The results from this investigation support those from previous studies, which found that MMRM provided reasonable control of Type I error even in the presence of MNAR missingness. No universally best approach to analysis of longitudinal data exists. However, likelihood‐based MAR approaches have been shown to perform well in a variety of situations and are a sensible alternative to the LOCF approach. MNAR methods can be used within a sensitivity analysis framework to test the potential presence and impact of MNAR data, thereby assessing robustness of results from an MAR method. Copyright © 2004 John Wiley & Sons, Ltd.     

Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

What is good taste good for?

Bourdieu afflrme que le capital cultural est utile lorsque Ton veut obtenir une situation de classe supérieure, particuliérement dans certains secteurs, et n'est en fait qu'une seule chose: une culture de condition supérieure. Mais son argument, établit pour une France centralisée, est moins valable pour le Canada plus subdivisé. Cet article étudie les idées de Bourdieu sous tous leurs aspects pour un échantillon quota de Torontoniens. Les résultats suggèrent qu'un capital culturel de condition supérieure existe à Toronto, mais qu'il a peu d'effet sur les relations de classe au travail, ou le véritable capital culturel dirige la culture d'entreprise qui domine les entreprises privées. La culture d'entreprise est aussi repartie en classes et pourrait jouer un role dans la reproduction de classes qui est tres similaire a ce que Bourdieu revendique comme culture de condition supérieure.
Bourdieu argues that cultural capital is useful in gaining higher class location, especially in some sectors, and is essentially a single thing: high status culture. But his argument, developed for centralized France, is less suitable for more subdivided Canada. This paper explores Bourdieu's ideas through a quota sample of 40 Torontonians. Results suggest that high status cultural capital does exist in Toronto, but has little part in class relationships at work, where the true cultural capital is command of the business culture which dominates private enterprises. Business culture is also class stratified, and may play a role in class reproduction which is quite similar to that which Bourdieu asserts for high status culture.     

Books at JSTOR: An Interview with Bruce Heterick

In August 2012, Marilyn Geller interviewed Bruce Heterick, vice president at ITHAKA, which includes JSTOR and Portico. Heterick discusses the addition of e-books to the JSTOR platform (Books at JSTOR), the impact of e-books on academic library services, and the future of e-books in the realm of scholarly communications.     

Building Health Insurance Literacy: Evidence from the Smart Choice Health Insurance™ Program

With the passage of the Patient Protection and Affordable Care Act (ACA) of 2010, the health insurance literacy of Americans became a critical issue. In response, a consumer education program was created and tested by university researchers and educators associated with Cooperative Extension. This article draws extensively on the emerging literature on health insurance literacy and on data from participants in the Smart Choice Health Insurance? program. The intent of the study was to understand socio-demographic and environmental variables that predict initial health insurance literacy and gains in health insurance literacy. A standardized instrument measuring health insurance literacy was used to collect the data. Multivariate analysis showed higher income consumers demonstrated greater initial health insurance literacy scores compared to middle income consumers, whereas younger, male and lower educated consumers reported lower initial health insurance literacy. After participating in the Smart Choice Health Insurance? program, consumers who made greater gains in their health insurance literacy tended to be female, higher income, and consumers residing in states that showed supportiveness of the ACA. The findings highlight the importance of considering sociodemographic characteristics in program design and delivery, as well as how contextual issues, such as the political environment, might impact the delivery of educational efforts. Findings from the analyses help inform ways to adapt and tailor educational opportunities that focus on health insurance literacy for a range of consumers.     

Asset Decommissioning Risk Metrics for Floating Structures in the Gulf of Mexico

Public companies in the United States are required to report standardized values of their proved reserves and asset retirement obligations on an annual basis. When compared, these two measures provide an aggregate indicator of corporate decommissioning risk but, because of their consolidated nature, cannot readily be decomposed at a more granular level. The purpose of this article is to introduce a decommissioning risk metric defined in terms of the ratio of the expected value of an asset's reserves to its expected cost of decommissioning. Asset decommissioning risk (ADR) is more difficult to compute than a consolidated corporate risk measure, but can be used to quantify the decommissioning risk of structures and to perform regional comparisons, and also provides market signals of future decommissioning activity. We formalize two risk metrics for decommissioning and apply the ADR metric to the deepwater Gulf of Mexico (GOM) floater inventory. Deepwater oil and gas structures are expensive to construct, and at the end of their useful life, will be expensive to decommission. The value of proved reserves for the 42 floating structures in the GOM circa January 2013 is estimated to range between $37 and $80 billion for future oil prices between 60 and 120 $/bbl, which is about 10 to 20 times greater than the estimated $4.3 billion to decommission the inventory. Eni's Allegheny and MC Offshore's Jolliet tension leg platforms have ADR metrics less than one and are approaching the end of their useful life. Application of the proposed metrics in the regulatory review of supplemental bonding requirements in the U.S. Outer Continental Shelf is suggested to complement the current suite of financial metrics employed.     

A Quantitative Analysis of the Effects of Postsecondary Institution Conversions from Not-For-Profit to For-Profit

This study highlights the changes that have occurred at postsecondary institutions after conversion from not-for-profit to for-profit control. Using Delta Cost Project Data and a pre-post study design with a control group of not-for-profit institutions that did not convert, comparisons are drawn. The findings suggest that institutions that convert experience greater enrollment growth, a decline in fulltime employment levels per full time equivalent (FTE) student, no change in average expenses per FTE student, a decrease in total revenue, a decrease in Pell Grants received, a decrease in tuition and fees revenue, and a decline in average subsidy per student post conversion. These findings are critical to the creation of informed policy decisions regarding institutional conversions.     

Rhetoric and Reality of Economic Self-sufficiency Among Rural,Low-Income Mothers: A Longitudinal Study

This study examined the contributions of maternal labor force participation and marital status on economic self-sufficiency over time for rural mothers. Data were from 174 rural families participating in three waves of data collection in Rural Families Speak. χ ² and multiple logistic regression were utilized. Results revealed only one-third of mothers moved toward economic self-sufficiency over three years. Maternal education, employment status, and weekly work hours were associated with improved economic well-being. Compared to single-parent families, unmarried-couple and married-couple families had increased odds of improving economically. In an analysis of all mothers with partners, married or unmarried, martial status was not significant in economic improvement. Findings suggest the role of marriage in welfare reform for rural families should be reconsidered.