REVIEWS

Bailey, C. E. (Ed.) (2000). Children in therapy: Using the family as a resource. Doherty, W. J. (2001). Take back your marriage: Sticking together in a world that pulls us apart. New York: Guilford. Larson, J. H. (2000). Should we stay together? A scientically proven method for evaluating your relationship and improving its chances for long‐term success. Weiner‐Davis, M. (2001). The divorce remedy: The proven 7‐step program for saving your marriage.     

Non-ignorable missing covariate data in survival analysis: a case-study of an International Breast Cancer Study Group trial

Summary.  Non-ignorable missing data, a serious problem in both clinical trials and observational studies, can lead to biased inferences. Quality-of-life measures have become increasingly popular in clinical trials. However, these measures are often incompletely observed, and investigators may suspect that missing quality-of-life data are likely to be non-ignorable. Although several recent references have addressed missing covariates in survival analysis, they all required the assumption that missingness is at random or that all covariates are discrete. We present a method for estimating the parameters in the Cox proportional hazards model when missing covariates may be non-ignorable and continuous or discrete. Our method is useful in reducing the bias and improving efficiency in the presence of missing data. The methodology clearly specifies assumptions about the missing data mechanism and, through sensitivity analysis, helps investigators to understand the potential effect of missing data on study results.     

Statistics for weighing benefits and harms in a proposed genetic substudy of a randomized cancer prevention trial

Summary.  When evaluating potential interventions for cancer prevention, it is necessary to compare benefits and harms. With new study designs, new statistical approaches may be needed to facilitate this comparison. A case in point arose in a proposed genetic substudy of a randomized trial of tamoxifen versus placebo in asymptomatic women who were at high risk for breast cancer. Although the randomized trial showed that tamoxifen substantially reduced the risk of breast cancer, the harms from tamoxifen were serious and some were life threaten-ing. In hopes of finding a subset of women with inherited risk genes who derive greater bene-fits from tamoxifen, we proposed a nested case–control study to test some trial subjects for various genes and new statistical methods to extrapolate benefits and harms to the general population. An important design question is whether or not the study should target common low penetrance genes. Our calculations show that useful results are only likely with rare high penetrance genes.     

Use of Technology in Delivering Career Services Worldwide

The authors review the trends in the use of computers in the delivery and support of career guidance and counseling identified at the symposium International Perspectives on Career Development. The papers presented emphasized that 20th‐century computer‐based systems continue to be used, mainly delivered via the World Wide Web. These systems are enhanced through audio, video, graphics, strategies to provide needs assessment, and support by cybercounselors or expert system design. The papers also revealed a new trend: the use of elegant Web sites to store and search immense libraries of resources needed by professionals and clients and to facilitate communication and collaboration among professionals in cyberspace. Concerns, issues, and resources related to many areas, including the readiness of clients to use computer‐based systems, were also raised; existing sources of guidelines are noted.     

Real nonparametric regression using complex wavelets

Summary.  Wavelet shrinkage is an effective nonparametric regression technique, especially when the underlying curve has irregular features such as spikes or discontinuities. The basic idea is simple: take the discrete wavelet transform of data consisting of a signal corrupted by noise; shrink or remove the wavelet coefficients to remove the noise; then invert the discrete wavelet transform to form an estimate of the true underlying curve. Various researchers have proposed increasingly sophisticated methods of doing this by using real-valued wavelets. Complex-valued wavelets exist but are rarely used. We propose two new complex-valued wavelet shrinkage techniques: one based on multiwavelet style shrinkage and the other using Bayesian methods. Extensive simulations show that our methods almost always give significantly more accurate estimates than methods based on real-valued wavelets. Further, our multiwavelet style shrinkage method is both simpler and dramatically faster than its competitors. To understand the excellent performance of this method we present a new risk bound on its hard thresholded coefficients.     

Who am I? Concepts of disability and their implications for people with learning difficulties

The relationship between concepts of disability, group membership and self-concept was examined. It was argued that people with learning difficulties have been categorised, by non-disabled people, as 'belonging' to a devalued social group with a rigid boundary based on IQ level. Findings from studies of self-concept have shown little evidence of a sense of belonging. It was suggested that people with learning difficulties may prefer not to identify with this social group because of the negative effect it may have on their self-esteem. The analysis based on intergroup and social identity theories proposed that people with learning difficulties may be encouraged in creating a positive self-concept by abandoning the IQ criterion for social categorisation; softening the boundaries between disabled and non-disabled people; and adopting collective rather than individual strategies for social change.     

Improving performance? The adoption and implementation of quality systems in U.K. nonprofits

There are increasing and multiple pressures on nonprofit organizations to demonstrate excellence in performance. Although there is a growing literature on the various approaches to performance improvement taken by nonprofits, little is known about the processes involved in the adoption and implementation of specific approaches. This article is about the adoption and use of one approach to performance improvement, “quality systems,” in the U.K. nonprofit sector. We report findings about factors that encourage nonprofits to adopt quality systems. We also analyze the distinctive challenges of implementing quality approaches in a nonprofit sector context and suggest critical success factors. The article concludes with a discussion of the organizational and policy implications of applying the management concepts of quality and performance to the nonprofit sector.     

Dealing with Toxicity in the Risk Society: The Case of the Hamilton,Ontario Plastics Recycling Fire*

Une perspective de la construction sociale sert de cadre a l'analyse des controverses sur la gestion des risques qui ont été provoquées à la suite d'un incendie majeur dans une usine de recyclage de matières plastiques à Hamilton, en Ontario. En mettant l'accent sur les processus de réclamation au c?ur de l'interaction entre les représen‐tants du gouvernement, les acteurs environnementaux, les experts techniques et les résidants, il a été révélé qu'un accent trop limité aux questions d'ordre technique avait mené a l'exclusion des préoccupations fondées sur la rationalité culturelle ayant ainsi entraine un cadre d'interaction très litigieux divisant profondément. Les conséquences des conclusions empiriques de la thése de la société des risques ainsi que de la théorie sur la communication des risques sont explorées. A social construction perspective is applied in the analysis of the risk management controversies that arose in response to a large toxic fire that occurred at a Hamilton, Ontario plastics recycling facility. By focussing on the claimsmaking processes involved in the interaction of government officials, environmental movement actors, technical experts, and residents, it was found that an overly narrow focus on technical matters led to the exclusion of lay concerns based on cultural rationality, thereby resulting in a very contentious and divisive setting for interaction. Implications of the empirical findings for the risk society thesis and risk communication theory are explored.     

Struggles with Time: the careers of parents with adult sons and daughters with learning disabilities

The experiences of parents with adult offspring with learning disability and the meanings their parental careers have for them, has been the subject of very little empirical research. In this paper we describe and examine some of the features that gave shape and meaning to the day to day lives of parents of 33 co-resident adults with learning disabilities. Their accounts of their situations revealed that 'time' was a factor of some importance. Participants suggested that socialisation into the parental role was one that continued over the life course. In addition, they also felt that the services they received were based upon an inadequate and too narrow an understanding of how they experienced 'time'. The data reveal that both 'over time' and 'in time', parents struggled to maintain a set of aspirations for a typical life. The data show that for many parents there was a slow accommodation to the constraints of service provision and, as a result, their needs for service support became less extensive.