A note on the empirical Bayes heterogeneity variance estimator in meta-analysis

This paper focuses on the empirical Bayes (EB) or Mandel-Paule estimator of the heterogeneity variance in meta-analysis, which was discussed by Morris and proposed in earlier publications by Mandel and Paule in an inter-laboratory context. The relationship of the EB estimator to other heterogeneity variance estimators typically used in meta-analysis is explored, and approximate variance estimators for the EB estimate of the heterogeneity variance are proposed based on the M-estimation method. Statistical inference for the overall treatment effect using the EB estimator and the proposed standard errors is discussed using two example data sets from meta-analysis applications.     

北京市医药分开综合改革对医生的影响调查与对策研究 ——以北京市10所三甲医院为例

目的了解北京市医药分开综合改革对医生的影响,在调查中发现问题,明确问题产生的原因,提出相应的对策和建议,为今后政策的制定提供依据。方法运用问卷调查、现场访谈和文献检索等数据收集法,开展北京市医药分开综合改革对医生影响的调查;利用对比分析法对现存医药卫生改革的两面性进行分析。结果医生整体上对北京市医药分开综合改革在一定程度上缓解了患者看病贵的问题持积极态度,但医生对医药分开综合改革的关注度和参与度不够。结论仍然需要调动医生的积极性,发挥主观能动性,依据供给侧改革政策和"两个允许"政策进一步完善医药分开综合改革。     

Assessing quality of a worksite health promotion programme from participants’ views: findings from a qualitative study in Malaysia

Background An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. Objective To explore the participants’ perceptions of the quality and effectiveness of the ‘Love Your Heart Programme’. Design A qualitative study using semi‐structured interviews with a purposive sample of participants of the ‘Love Your Heart’ programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio‐recorded, transcribed verbatim and analysed using the principles of grounded theory. Results A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the ‘Road to a Healthy Heart’ booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. Discussion and conclusions In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme.     

Patterns of Inpatient and Outpatient Care for Asthma in Erie and Niagara Counties,Western New York State

We surveyed cognitively normal teens with and without chronic illness regarding the perceived physical and social impact of various chronic diseases including asthma.

The overall physical impact of asthma was perceived equivalently to diabetes and arthritis, but less than epilepsy, Down's syndrome, leukemia, and human immunodeficiency virus infection. However, asthma was rated to more commonly cause physical disability (p < 0.001) and restrict activities (p < 0.0005). The social impact of asthma was perceived equivalently to diabetes, but more favorably than the other chronic diseases surveyed. Specifically, teens with asthma were perceived as having fewer behavior problems, being more honest, popular, and fun to be around, but less adept at sports. Only 6 of 149 (4%) teens surveyed expressed any degree of reluctance to befriend peers with asthma.     

Revelations of HIV-infected patients treated with highly active antiretroviral therapy (HAART) in rural Uganda

The purpose of this qualitative study was to explore the psychosocial changes revealed by persons living with HIV/AIDS (PLWHA) in western Uganda as a result of the introduction of highly active antiretroviral therapy (HAART). Fourteen participants were interviewed on two occasions. Two focus groups discussions were also conducted. Patients experienced important personal benefits as a result of HAART and the resulting clinical improvement. These benefits included a restoration of hope, self-esteem and personal agency. Patients were also relieved of the great fear which they had about the conditions of their death. The financial and social struggles introduced by AIDS illness continued after the introduction of HAART. The conclusion is that the HAART programs should provide more holistic care to patients to address the persistent family issues identified in this study.     

Synchronous extinction of North America's Pleistocene mammals

The late Pleistocene witnessed the extinction of 35 genera of North American mammals. The last appearance dates of 16 of these genera securely fall between 12,000 and 10,000 radiocarbon years ago (≈13,800–11,400 calendar years B.P.), although whether the absence of fossil occurrences for the remaining 19 genera from this time interval is the result of sampling error or temporally staggered extinctions is unclear. Analysis of the chronology of extinctions suggests that sampling error can explain the absence of terminal Pleistocene last appearance dates for the remaining 19 genera. The extinction chronology of North American Pleistocene mammals therefore can be characterized as a synchronous event that took place 12,000–10,000 radiocarbon years B.P. Results favor an extinction mechanism that is capable of wiping out up to 35 genera across a continent in a geologic instant.     

What is it like to be the wife of an addicted man in Iran? A qualitative study

Drug misuse is increasing and diversifying in Iran. This study is the first to explore in detail the impact on, and ways of coping used by, spouses of addicted men in Iran. Semi-structured interviews were conducted with 24 spouses. Four main themes were identified in the data: heart-breaking news of the husband’s addiction; coping alone; progressive deterioration and suffering; and disruption of family relationships and finances. Reactions upon learning of the husband’s addiction involved shock and collapse, and/or fear, disbelief and confusion. Spouses tried to hide the problem and to solve the problem alone, feeling for a long time as if they were “walking in the dark” without any social support and exposed to stigma. As time had gone on they had experienced distress and turmoil, and mixed feelings towards, and loss of trust and confidence in, their husbands, whose behaviour was increasingly unreliable. This had led to impairment in the relationship, and financial stress, and a general degradation and disruption of normal family life, leading to strain for spouses, akin to a state of burnout. Present findings confirm the conclusions of similar research conducted in other countries, that substance misuse in the family can have devastating effects for spouses, on children and all aspects of family life. The situation for Iranian wives may be compounded by the relatively closed nature of family life, and the existence of culturally based attitudes, including shame, towards “family defects” such as addiction. More information and support is needed for Iranian families of addicted individuals.