Measures of Association

2019 ◽  
pp. 27-40
Author(s):  
Daniel Westreich
Keyword(s):  
Epidemiologic Methods ◽  
Large Population ◽  
Measures Of Association ◽  
Policy Makers ◽  
Study Population

This chapter discusses the measures of contrast between two groups within the study population. Whereas in Chapter 1 the researcher might describe the total number of cases of a disease in a large population as a whole, in this chapter the researcher is interested in (for example) contrasting risk among those exposed to a drug and those unexposed to that drug within a larger population. In this chapter, the author primarily focuses on difference and ratio measures. This chapter introduces the 2 × 2 table, a widely used tool for learning epidemiologic methods. The author also discusses how to communicate these findings for researchers, policy makers, clinicians, and patients, all of whom may need to make decisions based on these data.

scholarly journals POS0675 THE COMPARATIVE 3-YEAR RETENTION RATE OF TARGETED-SYNTHETIC AND BIOLOGIC DRUGS FOR RHEUMATOID ARTHRITIS: REAL-LIFE DATA FROM THE ITALIAN GISEA REGISTRY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 582.1-582
Author(s):  
E. G. Favalli ◽  
F. Iannone ◽  
E. Gremese ◽  
R. Gorla ◽  
R. Foti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Retention Rate ◽  
Large Population ◽  
Real Life ◽  
Mechanisms Of Action ◽  
Biologic Drugs ◽  
Real Life Setting ◽  
Study Population ◽  
Targeted Drug

Background:Long-term observational data on the real-life use of JAK inhibitors (JAKis) for rheumatoid arthritis (RA) and their comparison with biological drugs are still very limited. Large population-based registries have been increasingly used to investigate the performance of targeted drugs in a real-life setting.Objectives:The aim of this study is to evaluate and compare the 3-year retention rate of JAKis, TNF inhibitors (TNFis) and biologic drugs with other mechanisms of action (OMAs) in the large cohort of RA patients included in the Italian national GISEA registry.Methods:Data of all RA patients treated with targeted synthetic or biologic drugs were prospectively collected in the Italian multicentric GISEA registry. The analysis was limited to patients who started a first- or second-line targeted drug in the period after the first JAKi was marketed in Italy (1st December 2017). The 3-year retention rate was calculated by the Kaplan-Meier method and compared between different drug classes by a log-rank test. A descriptive analysis of reasons for discontinuation was performed.Results:The study population included 1027 RA patients (79.8% females, mean age [±SD] 56.9 [±13.5] years, mean disease duration 9.8 [±9] years, mean baseline SDAI 17.5 [±11.9], ACPA positive 67.4%, RF positive 62.7%) who received JAKis (baricitinib or tofacitinib, n=297), TNFis (n=365), or OMAs (n=365) as first or second targeted drug. Main baseline characteristics of study population were overall well balanced between treatment groups. Retention rate was numerically but not statistically higher (p=0.18) in patients treated with JAKis compared with TNFis or OMAs (80.6, 78.9 and 76.4% at 1 year and 73, 56.8 and 63.8% at 3 years, respectively) (Figure 1). Drug survival was significantly higher in patients receiving concomitant methotrexate (MTX) compared with monotherapy only in TNFis (66.8 vs 47.1%, p=0.04) but not in JAKis (76.1 vs 70.1%, p=0.54) and OMAs (66.1 vs 61.9%, p=0.41) group. Therapy was discontinued in a total of 211 patients because of ineffectiveness (n=107), adverse events (n=88), or compliance/other reasons (n=16). The most frequent reason for treatment withdrawal was ineffectiveness in both JAKis (n=30 out of 56) and TNFis (n=45 out of 74) groups, whereas OMAs were discontinued more frequently because of adverse events (n=41 out of 81).Conclusion:Our data confirmed in a real-life setting a favorable 3-year retention rate of all available targeted mechanisms of action for RA therapy. As expected, concomitant MTX significantly impacted persistence on therapy of TNFis only. Discontinuations of JAKis for adverse events were infrequent overall, confirming the safety profile observed in randomized clinical trials.Figure 1.Three-year retention rate by treatment groupDisclosure of Interests:None declared

scholarly journals Perceptions of ‘Precision’ and ‘Personalised’ Medicine in Singapore and Associated Ethical Issues

2021 ◽  
Vol 13 (2) ◽  
pp. 179-194
Author(s):  
Serene Ong ◽  
Jeffrey Ling ◽  
Angela Ballantyne ◽  
Tamra Lysaght ◽  
Vicki Xafis
Keyword(s):  
Precision Medicine ◽  
Ethical Issues ◽  
Personalised Medicine ◽  
Large Population ◽  
Data Sets ◽  
Visual Aids ◽  
Policy Makers ◽  
The Social ◽  
Genomic Analyses ◽  
Common Understanding

AbstractGovernments are investing in precision medicine (PM) with the aim of improving healthcare through the use of genomic analyses and data analytics to develop tailored treatment approaches for individual patients. The success of PM is contingent upon clear public communications that engender trust and secure the social licence to collect and share large population-wide data sets because specific consent for each data re-use is impractical. Variation in the terminology used by different programmes used to describe PM may hinder clear communication and threaten trust. Language is used to create common understanding and expectations regarding precision medicine between researchers, clinicians and the volunteers. There is a need to better understand public interpretations of PM-related terminology. This paper reports on a qualitative study involving 24 focus group participants in the multi-lingual context of Singapore. The study explored how Singaporeans interpret and understand the terms ‘precision medicine’ and ‘personalised medicine’, and which term they felt more aptly communicates the concept and goals of PM. Results suggest that participants were unable to readily link the terms with this area of medicine and initially displayed preferences for the more familiar term of ‘personalised’. The use of visual aids to convey key concepts resonated with participants, some of whom then indicated preferences for the term ‘precision’ as being a more accurate description of PM research. These aids helped to facilitate dialogue around the ethical and social value, as well as the risks, of PM. Implications for programme developers and policy makers are discussed.

scholarly journals Barriers to Puberty Talk between Mothers and Daughters: A Qualitative Study

2021 ◽  
Vol 43 (05) ◽  
pp. 362-367
Author(s):  
Firoozeh Mirzaee ◽  
Malihe Pouredalati ◽  
Atefeh Ahmadi ◽  
Masumeh Ghazaznfarpour
Keyword(s):  
Adolescent Girls ◽  
Sociocultural Factors ◽  
Mothers And Daughters ◽  
Policy Makers ◽  
Purposeful Sampling ◽  
Content Analysis Method ◽  
Semistructured Interviews ◽  
Data Saturation ◽  
Study Population ◽  
School Role

Abstract Objective The aim of the present study is to explain the barriers to puberty talk between mothers and daughters. Methods In the present study, the conventional content analysis method was used. The present study was conducted from September 2018 to August 2019 in Iran. The study population consisted of mothers and adolescent girls. The data was collected using purposeful sampling method. The sample consisted of 4 mothers and 6 girls that were interviewed using semistructured interviews. Data collection continued until data saturation was achieved. Data analysis was conducted as described by Graneheim et al. using NVivo 11 software. Results In the present study, after exploring the views of the participants about barriers to puberty talk between mothers and daughters, one dominant theme emerged. Puberty talk is seen as an “inappropriate talk with a girl.” There were several subthemes, including “lack of mother's awareness regarding the school role, the busy schedule of the mother, and the adoption of alternatives to mother's talk with girls”. Conclusions Different sociocultural factors affect puberty talk between mothers and adolescent girls. It is important that mothers and policy makers take these barriers into account.

scholarly journals Financial Factors Affecting Earnings Management and Earnings Quality: New Evidence from an Emerging Market

2020 ◽  
Vol 9 (1) ◽  
pp. 198-216
Author(s):  
Isam Saleh ◽  
Malik Abu Afifa ◽  
Fadi Haniah
Keyword(s):  
Earnings Management ◽  
Emerging Market ◽  
Earnings Quality ◽  
Panel Data Analysis ◽  
Insurance Companies ◽  
Policy Makers ◽  
Factors Affecting ◽  
Financial Factors ◽  
Study Population ◽  
New Evidence

The purpose of this study is to examine the effect of financial factors on earnings management and earnings quality. Moreover, the study examines the role of earnings management as a mediator in the effect of the financial factors on earnings quality. It provides some empirical evidences from an emerging market, especially from the Jordanian market. The study uses a panel data analysis method over a ten-year period (2009-2018). The study population includes all Jordanian insurance companies listed in Jordanian market at the end of the year 2019, and the study sample consists of 20 Jordanian insurance companies (a complete population), giving a total of 200 observations for each variable. The results indicate that all financial factors in the model combined affect the earnings management and earnings quality. In addition, earnings management negatively affects earnings quality, and earnings management fully mediates the effect of financial factors on earnings quality. The study advises that policy makers ought to follow good legislation to curb the company's earnings management activities. Hence, the policy makers need to apply regulations which enrich the company’s effectiveness and efficiency whilst protecting the investors and other interested parties from risk.

scholarly journals Introduction

2021 ◽  
pp. 1-26
Author(s):  
Matthew T. Lee ◽  
Laura D. Kubzansky ◽  
Tyler J. VanderWeele
Keyword(s):  
Well Being ◽  
Policy Makers ◽  
Broad Audience

Policy-makers, researchers, employers, and governments are expressing growing interest in well-being (Diener et al., 2017; see also Chapter 1 by Helliwell, and Chapter 2 by Allin, both in this volume). Scholarly and popular works on the topic are also finding a broad audience (e.g., ...

British Thinking about Tactical Nuclear Weapons

2019 ◽  
pp. 22-53
Author(s):  
Simon J. Moody
Keyword(s):  
Nuclear Weapons ◽  
Deterrent Effect ◽  
British Government ◽  
Policy Makers ◽  
British Policy ◽  
Civilian Leaders ◽  
Strategic Theories ◽  
Nuclear Exchange ◽  
Massive Retaliation

Chapter 1 examines how British policy-makers viewed the arrival of tactical nuclear weapons, employing as a vehicle in the 1950s debate on the relative merits of the opposing strategic theories of ‘graduated deterrence’ and ‘massive retaliation’. It shows how the British government rejected any suggestion to draw distinctions in peacetime between strategic and tactical nuclear weapons because of a strong belief that such an announcement would undermine the overall deterrent effect of nuclear weapons. Gripped by a ‘deterrence habit of mind’, civilian leaders viewed tactical nuclear weapons not as meaningful military tools, but as weapons of escalation whose use would trigger a strategic nuclear exchange between the superpowers. The rejection of any kind of graduated deterrence through the use of tactical nuclear weapons set a precedent in how British policy-makers conceived the utility of tactical nuclear weapons, which would have important consequences in the following debates about NATO strategy.

scholarly journals 2533

2017 ◽  
Vol 1 (S1) ◽  
pp. 54-54
Author(s):  
Sharon A. Croisant ◽  
Christine Arcari ◽  
John Prochaska ◽  
Amber Anthony ◽  
Brittany Wallace ◽  
...  
Keyword(s):  
Community Health ◽  
Public Health Practice ◽  
Policy Makers ◽  
Family Service ◽  
Research Education ◽  
Local Schools ◽  
Community Health Needs Assessment ◽  
Study Population ◽  
Successful Replication ◽  
Community Science

OBJECTIVES/SPECIFIC AIMS: The Institute for Transnational Sciences (ITS) has developed novel methods to ethically engage stakeholders across the transnational research spectrum, up to and including public health practice and policy. METHODS/STUDY POPULATION: In 2014, the ITS co-founded The Research, Education, And Community Health (REACH), the mission of which was to facilitate communication, collaborative research, and service activities between faculty and scientists and area community leaders. The intent was to identify and meet the needs of our communities without gaps and/or redundancies, thus better leveraging time, funding, and efforts. RESULTS/ANTICIPATED RESULTS: REACH now boasts 23 Centers, Departments, and Institutes, as well as 39 community organizations, including public and mental health agencies, clinicians, policy makers, family service centers, cultural and faith-based organizations, business, and local schools/colleges. We offer 3 methods for consideration as best practices: (1) a comprehensive community health needs assessment, (2) an “Offer and Ask” community/campus partnership mechanism, and (3) Community Science Workshops, based on the European Union’s Science Shops. DISCUSSION/SIGNIFICANCE OF IMPACT: Results of REACH’s work have been used to provide guidance for enhanced, data-driven programs and allocation of resources for local and statewide initiatives. The organization has evolved into an independent coalition seeking 501(c)3 status and is planning to expand its scope to 5 counties. REACH thus serves as model for successful replication across applicable CTSA hubs.

scholarly journals Adolescent Reproductive Health: The Role of Agency and Autonomy

2003 ◽  
Vol 42 (4II) ◽  
pp. 569-583 ◽  
Author(s):  
Azeema Faizunnisa ◽  
Minhaj Ul Haque
Keyword(s):  
Large Population ◽  
Fertility Transition ◽  
Significant Decline ◽  
Age Group ◽  
Policy Makers ◽  
Population Pyramid ◽  
The Past ◽  
Adolescent Reproductive Health ◽  
Age Range

The world is experiencing the largest cohort of adolescents in its history, and there are about 1 billion youngsters in this age group, most of whom belong to the developing countries. Worldwide, the adolescent age group is gaining prominence for researchers, policy-makers and donors. This issue is more important for Pakistan where about one-third of 150 million Pakistanis are in the age range of 10-24 years [Pakistan Census Organisation (2001)]. In Pakistan, the fertility transition has just begun [Sathar and Casterline (1998)], and we will have the largest cohort of young people in next five years. With a TFR of 4.1 which represents a significant decline in fertility in the past two decades for about two children [Pakistan (2003)], still we have a large population base. Nearly 33 percent of the population is aged 10-24, and ready to enter marriage and childbearing. Adolescents represents as a “bulge” in the population pyramid of Pakistan that will have serious implications at a variety of levels.

The Origin of Hmong Entanglement in the Vietnam War

2019 ◽  
pp. 12-25
Author(s):  
Chia Youyee Vang
Keyword(s):  
United States ◽  
Vietnam War ◽  
Ethnic Minorities ◽  
The United States ◽  
Military Leadership ◽  
Divide And Conquer ◽  
Military Leaders ◽  
Policy Makers ◽  
Us Military

Chapter 1 explores how the United States moved in to Indochina to replace the French following the latter’s defeat in 1954, which resulted in those who collaborated with Americans becoming dependent on US military and humanitarian aid from the early 1960s through the mid-1970s. The chapter illustrates calculated decisions by American policy makers to continue colonial policies to divide and conquer their subjects, which enabled decisions made at the highest level to promote the use of ethnic minorities in counterinsurgency operations. Such decisions were precisely what facilitated Hmong men’s participation in the covert Project Water Pump that trained Lao fighter pilots. The chapter further explains how CIA officers circumvented resistance from ethnic Lao military leaders and American officials to establish an air operation in the region under Hmong military leadership.

The disparity in geographical accessibility to healthcare resources in Iran: the comparison of two cross-section

2016 ◽  
Vol 9 (2) ◽  
pp. 86-94
Author(s):  
Sara Emamgholipour Sefiddashti ◽  
Ali Kazemi Karyani ◽  
Sadegh Ghazanfari
Keyword(s):  
Health Sector ◽  
Health Resources ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Access To Healthcare ◽  
Cross Sectional ◽  
Healthcare Resources ◽  
Policy Makers ◽  
Content Type ◽  
Study Population

Purpose – Accessing adequate healthcare to all people is one of the main goals of the health sector. The purpose of this paper is to investigate healthcare services access development of the provinces in Iran during 2007 and 2013. Design/methodology/approach – This is a descriptive cross-sectional study. The study population included all the provinces in Iran. The data for 13 variables, including physical and human health resources, was collected from the Ministry of Health and Medical Education and the Statistics Center of Iran. Taxonomy technique was used to determine the degree of healthcare services access development in the provinces. Findings – The findings show that Semnan was the province with the most developed healthcare services access with development score of 0.342 while Sistan Balocehstan province was the least developed with development score of one in 2007. In the year 2013, Chahar-Mahal Bakhtiari and Sistan Baluchestan were the least and most developed provinces with scores of 0.551 and 0.989, respectively. The mean and standard deviation of the development scores in access to healthcare services in 2007 and 2013 were 0.7463±0.1268 and 0.7766±0.1058, respectively. Originality/value – Most previous studies that examined disparities in access to healthcare resources in Iran only considered one resource. This study applied a taxonomy technique to investigate the disparity and changes in access using 13 main healthcare resources. This approach helped the authors to investigate whether the decisions of the policy makers were intended to eliminate the disparities.

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