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The determinants of IUD discontinuation in China: a discrete-time competing risk model analysis.

This research examines the social, demographic, and family-planning-program factors that influence the occurrence of IUD discontinuation among Chinese women, using a sample of 14,639 IUD use segments from the 1988 Chinese National Survey of Fertility and Contraceptive Prevalence. A discrete-time competing-risk event history method is employed to identify the determinants of IUD discontinuation by five kinds of reasons: contraceptive failure, expulsion, switching method, side-effects and other nonmethod-related reasons. The predictors of IUD discontinuation suggest that a number of mechanisms are in operation. Some of the determinants may reflect the effects of the family planning program; some may illustrate women's physiological and biological reactions to IUD's; some may be related to women's previous history of contraceptive use; and still others may indicate social characteristics of women that lead them to have their IUD's removed.

Adult↗

Contraceptive and condom use adoption and maintenance: a stage paradigm approach.

The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.

Adolescent↗

Relative incidence estimation from case series for vaccine safety evaluation.

A method is described for estimating the relative incidence of clinical events in defined time intervals after vaccination compared to a control period using only data on cases. The method is derived from a Poisson cohort model by conditioning on the occurrence of an event and on vaccination histories. Methods of analysis for event-dependent vaccination histories and survival data are discussed. Asymptotic arguments suggest that the method retains high efficiency relative to the full cohort analysis under conditions which commonly apply to studies of vaccine safety.

Biometry↗

A death in the family: household structure and mortality in rural Liaoning: life-event and time-series analysis, 1792-1867.

"Through a discrete-time life-event analysis of triennial household register data from a northeast Chinese village, Daoyi, between 1774 and 1873, we find that an individual's probability of dying, which we treat as an indicator of access to resources and the nature of household roles, was affected by the composition of their coresident kin.... Widows and widowers had higher mortality than the currently married. Orphans had higher mortality than children with at least one parent present. Reflecting the dependence of a wife's status on whether she had produced an heir for her husband, married women in young adulthood and middle age who had at least one son had substantially lower mortality than those without. Reflecting the strength of the claim that elderly males could make on household resources, children with coresident grandfathers had higher mortality than those without. Even though sons were supposed to be a form of old-age security, however, the death rate of the elderly was not reduced by the presence of sons and grandsons."

Age Factors↗

Effects of lactation and contraceptive use on birth-spacing in Bolivia.

Based on the 1989 Demographic and Health Survey of Bolivia, analysis of the joint effects of breastfeeding and contraceptive use on birth-spacing showed the IUD to be the most effective contraceptive method used to delay conception. Breastfeeding significantly lengthened the birth interval, but only following second and higher parity births. In addition, conditions of poverty appeared to further inhibit the return of fecundity and delay conception.

Adolescent↗

A discrete-time multilevel mixture model for event history data with long-term survivors, with an application to an analysis of contraceptive sterilization in Bangladesh.

Event history models typically assume that the entire population is at risk of experiencing the event of interest throughout the observation period. However, there will often be individuals, referred to as long-term survivors, who may be considered a priori to have a zero hazard throughout the study period. In this paper, a discrete-time mixture model is proposed in which the probability of long-term survivorship and the timing of event occurrence are modelled jointly. Another feature of event history data that often needs to be considered is that they may come from a population with a hierarchical structure. For example, individuals may be nested within geographical regions and individuals in the same region may have similar risks of experiencing the event of interest due to unobserved regional characteristics. Thus, the discrete-time mixture model is extended to allow for clustering in the likelihood and timing of an event within regions. The model is further extended to allow for unobserved individual heterogeneity in the hazard of event occurrence. The proposed model is applied in an analysis of contraceptive sterilization in Bangladesh. The results show that a woman's religion and education level affect her probability of choosing sterilization, but not when she gets sterilized. There is also evidence of community-level variation in sterilization timing, but not in the probability of sterilization.

Adolescent↗

Welfare reform and interstate migration of poor families.

The thesis of this study is that as a result of increased inequalities in welfare rules, the 1996 welfare reform act not only enhanced incentives for poor families to move but also (and perhaps more important) created disincentives for them to stay in "race to the bottom" states. In testing this thesis, we evaluated the mediating and moderating roles of state economic development and family structure. We merged data from three main sources: the 1996-1999 panel of the Survey of Income and Program Participation, the Urban Institute's Welfare Rules Database, and state economic data from the Bureau of Labor Statistics. Modeling both destination (pull) and departure (push) effects of welfare policy measures and selected covariates in a nested discrete-time event-history migration analysis, we found robust support for the thesis that stringency in state welfare-eligibility and behavior-related rules stimulated interstate out-migration of poor families in the United States. However poor families were not drawn to states with relatively more-lenient welfare rules, although stringency in state welfare dollar benefits inhibited in-migration and state unemployment patterns may have conditioned the migration effects of welfare-reform rules on the choice of destination. Single mothers were not more directly affected by welfare-eligibility and behavior-related rules than were poor married couples.

Data Collection↗

[Was Spanish influenza in Kristiania a socially neutral disease?].

BACKGROUND: A debate has been going on since 1918 over whether there were social differences in mortality from Spanish influenza. Mot commentators have concluded that mortality was socially neutral. In this paper it is discussed why the influenza pandemic of 1918-19 was different from recent influenza epidemics, which have displayed greater social differences in mortality than most other causes of death. MATERIALS AND METHODS: Multivariate analysis and event history data are used for the first time to analyse the variation in mortality from Spanish influenza. The study is confined to a west end and an east end parish in Norway's capital city. Historical demographic data for Norway has a good reputation internationally. The data are also unique because--Norway being a neutral country--they can be used to estimate the effect of the Spanish influenza on mortality net of the effect of the First World War. RESULTS: Middle class and bourgeois mortality was 19-25% lower than working class mortality (not significant). Those living in apartments with four to six rooms had on average 50 % lower mortality than those living in one-room apartments (significant). Moreover, the east end parish had 50 % higher mortality than the west end parish (significant). INTERPRETATION: These findings challenge the myth that Spanish influenza picked its victims at random. The study may have international relevance because data difficult to obtain for other countries have been used.

Adult↗

Evolution of aminoacyl-tRNA synthetases--analysis of unique domain architectures and phylogenetic trees reveals a complex history of horizontal gene transfer events.

Phylogenetic analysis of aminoacyl-tRNA synthetases (aaRSs) of all 20 specificities from completely sequenced bacterial, archaeal, and eukaryotic genomes reveals a complex evolutionary picture. Detailed examination of the domain architecture of aaRSs using sequence profile searches delineated a network of partially conserved domains that is even more elaborate than previously suspected. Several unexpected evolutionary connections were identified, including the apparent origin of the beta-subunit of bacterial GlyRS from the HD superfamily of hydrolases, a domain shared by bacterial AspRS and the B subunit of archaeal glutamyl-tRNA amidotransferases, and another previously undetected domain that is conserved in a subset of ThrRS, guanosine polyphosphate hydrolases and synthetases, and a family of GTPases. Comparison of domain architectures and multiple alignments resulted in the delineation of synapomorphies-shared derived characters, such as extra domains or inserts-for most of the aaRSs specificities. These synapomorphies partition sets of aaRSs with the same specificity into two or more distinct and apparently monophyletic groups. In conjunction with cluster analysis and a modification of the midpoint-rooting procedure, this partitioning was used to infer the likely root position in phylogenetic trees. The topologies of the resulting rooted trees for most of the aaRSs specificities are compatible with the evolutionary "standard model" whereby the earliest radiation event separated bacteria from the common ancestor of archaea and eukaryotes as opposed to the two other possible evolutionary scenarios for the three major divisions of life. For almost all aaRSs specificities, however, this simple scheme is confounded by displacement of some of the bacterial aaRSs by their eukaryotic or, less frequently, archaeal counterparts. Displacement of ancestral eukaryotic aaRS genes by bacterial ones, presumably of mitochondrial origin, was observed for three aaRSs. In contrast, there was no convincing evidence of displacement of archaeal aaRSs by bacterial ones. Displacement of aaRS genes by eukaryotic counterparts is most common among parasitic and symbiotic bacteria, particularly the spirochaetes, in which 10 of the 19 aaRSs seem to have been displaced by the respective eukaryotic genes and two by the archaeal counterpart. Unlike the primary radiation events between the three main divisions of life, that were readily traceable through the phylogenetic analysis of aaRSs, no consistent large-scale bacterial phylogeny could be established. In part, this may be due to additional gene displacement events among bacterial lineages. Argument is presented that, although lineage-specific gene loss might have contributed to the evolution of some of the aaRSs, this is not a viable alternative to horizontal gene transfer as the principal evolutionary phenomenon in this gene class.

Amino Acid Sequence↗

The event history approach in demography.

"In the present paper, we shall examine...changes in the field of demography, by following the progression from period analysis to cohort analysis. We shall discuss the hypotheses underlying each of these approaches and show how their distance from actual human behaviour could lead to mistaken or incomplete conclusions. We shall then show how event history analysis can solve these problems and we shall define the hypotheses implied by this new approach. Finally, we shall come back to the complimentarity of the different social sciences."

Behavior↗

The relationship between childbearing and transitions from marriage and cohabitation in Britain.

In this article, we describe a general framework for the analysis of correlated event histories, with an application to a study of partnership transitions and fertility among a cohort of British women. Using a multilevel, multistate competing-risks model, we examine the relationship between prior fertility outcomes (the presence and characteristics of children and current pregnancy) and the dissolution of marital and cohabiting unions and movements from cohabitation to marriage. Using a simultaneous-equations model, we model these partnership transitions jointly with fertility, allowing for correlation between the unobserved woman-level characteristics that affect each process. The analysis is based on the partnership and birth histories that were collected for the 1958 birth cohort (National Child Development Study) aged 16-42. The findings indicate that preschool children have a stabilizing effect on their parents 'partnership, whether married or cohabiting, but the effect is weaker for older children. There is also evidence that although pregnancy precipitates marriage among cohabitors, the odds of marriage decline to prepregnancy levels following a birth.

Adolescent↗

Migration theories and behavioural models.

"This review presents a probabilistic formulation of the decision making process, leading to a rigorous treatment of migration behaviour for projection purposes....Aggregate-level models may be applied to migration flows for which the objectively measured characteristics of areas of department and destination act as subjectively measured characteristics and stimuli....Individual-level models use event history methods of analysis to introduce a great variety of characteristics of the subject on the decision to move. They lead to projections using microsimulation models. A further step is taken in integrating macro- and microbehavioural models. The use of aggregate and individual characteristics simultaneously leads to more efficient and sophisticated projection models: the factors affecting behaviour at the micro-level cannot be inferred from aggregate studies and conversely."

Behavior↗

Sterilisation of married couples: husband versus wife sterilisation.

Sterilisation has been increasing in the United States in recent decades. Using the National Survey of Families and Households, this paper examines sterilisation among married couples using event history techniques, viewing husband and wife sterilisation as competing risks. Wives are more likely to experience sterilisation and at shorter durations of marriage. Number of children has a curvilinear effect on sterilisation, increasing and then decreasing its likelihood. Wives who are older than their husbands are more likely to get sterilised themselves. Black and Hispanic husbands are more likely to undergo sterilisation.

Adult↗

From awareness to adoption: the effect of AIDS education and condom social marketing on condom use in Tanzania (1993-1996).

This paper uses retrospective event-history data covering a four-year period to examine the timing of exposure to HIV/AIDS education and social marketing condom promotion campaigns, relative to the timing of changes in sexual risk behaviour in Tanzania. Analysis of the event-history data shows that the process of exposure to AIDS education messages and exposure to brand advertising for Salama brand condoms was very different. While exposure to AIDS education was early and gradual, exposure to Salama brand condoms started later, but was much more rapid. After one year of advertising, over half of the target population had been reached by the Salama advertising campaign, mostly through newspapers, radio and television. During the study period, condom use increased from 15% at the beginning of 1993 to 42% at the end of 1996. Increases in condom use were driven both by men who became sexually active, and by men who were not yet protected, or not fully protected. The results further show that it is uncommon for men who adopted condom use to return to more risky behaviour, which suggests that behaviour change in the study population is permanent.

Adolescent↗

Risk factors for late stroke after coronary artery bypass grafting.

BACKGROUND: Postoperative stroke is a severe complication immediately after coronary artery bypass grafting, and it significantly deteriorates the postoperative quality of life if it occurs in the long term. It was the aim of our study to determine factors associated with the occurrence of new strokes during long-term follow-up after coronary artery bypass grafting. METHODS: From 387 of 500 patients undergoing coronary artery bypass grafting (age, 67 years [33-84 years]; 76% male) who had intraoperative epiaortic ultrasonography for assessment of ascending aortic wall thickness, a complete follow-up regarding postoperative stroke was achieved. The median follow-up time was 52 months (9-74 months). RESULTS: A stroke occurred in 26 (7%) of 387 patients, and the cumulative freedom from stroke was 99%, 95%, and 89% after 1, 3, and 5 years, respectively. A significantly lower freedom from stroke was present in patients with an age of 70 years or more (P = .007), preoperative unstable angina (P = .031), chronic obstructive pulmonary disease (P = .009), carotid artery disease (P < .001), preoperative history of neurologic events (P < .001), and a maximum ascending aortic wall thickness of 4 mm or more (P = .010). Multivariate analysis revealed preoperative history of neurologic events (P = .021) to be an independent risk factor. CONCLUSION: Patients with ascending aortic atherosclerosis, older age (> or =70 years), preoperative unstable angina, chronic obstructive pulmonary disease, and carotid artery disease are at risk for late postoperative stroke after coronary artery bypass grafting. A history of neurologic events is of special predictive importance.

Adult↗

The influence of historical events on psychoanalysis: a case history.

Parts of the analysis of a patient are described, whose childhood had been overshadowed by serious traumatic experiences (death of father, flight). The interaction between these events which was dictated by recent history and the inner psychic world of the patient is investigated and consequences for the transference, countertransference and psychoanalytic technique are discussed. Special problems can arise when patient and analyst as members of the German post-war generation are equally confronted by the Nazi past during the analytical process.

Adult↗