Deductive Care Methodology: Describing and testing modes of care research

OBJECTIVE

Define the modes of procedure of the Deductive Care Methodology (DCM) in the generation of knowledge about person's health care.

METHODOLOGY

Design and test of the DCM modes based on three phases: mapping of the DCM, generation of models from this methodology and testing of the models through studies in a clinical context.

RESULTS

The DCM presents five levels of abstraction with three modes broken down to 16 types. The modes are: Philosophical Mode to conceptualize and obtain generalities about reality, Mathematical Mode to operate with generalities, and Physical Mode to operationally verify, validating the results and the predictive capacity of the model. This MDC allows the creation of three models: Knowledge Model about Person Care, an ontology of care, Vulnerability Model about the person and Taxonomic Triangulation Model for knowledge management. All models generate products for computational knowledge management. In addition, the models are applied in teaching and generate research with more than a hundred participations in conferences and journals, of which five impact publications (from 2008 to 2022) classified in the categories of Nursing and Informatics are analysed.

CONCLUSIONS

The DCM collects prior knowledge to work with certainties, evidence and applying inferences that do not depend on the number of cases or inductive designs. This research presents a formal structure of the DCM with an interdisciplinary orientation between Health Sciences and Computer Sciences.

Assessment of the learning curve of peribulbar blocks using the Learning-Curve Cumulative Sum Method (LC-CUSUM): an observational study

INTRODUCTION

This study aimed to assess the learning curves of peribulbar anesthesia and estimate the number of blocks needed to attain proficiency.

METHODS

Anonymized records of sequential peribulbar blocks performed by first-year anesthesia residents were analyzed. The block sequential number and the outcomes were extracted from each record. Success was defined as a complete sensory and motor block of the eye, and failure was defined as an incomplete block requiring supplemental local anesthetic injections or general anesthesia. Learning curves using the LC-CUSUM method were constructed, aiming for acceptable and unacceptable failure rates of 10% and 20%, and 10% probability of type I and II errors. Simulations were used to determine the proficiency limit h0. Residents whose curves reached h0 were considered proficient. The Sequential Probability Ratio Test Cumulative Sum Method (SPRT-CUSUM) was used for follow-up.

RESULTS

Thirty-nine residents performed 2076 blocks (median = 52 blocks per resident; Interquartile Range (IQR) [range] = 27-78 [4-132]). Thirty residents (77%) achieved proficiency after a median of 13 blocks (13-24 [13-24]).

CONCLUSIONS

The LC-CUSUM is a robust method for detecting resident proficiency at peribulbar anesthesia, defined as success rates exceeding 90%. Accordingly, 13 to 24 supervised double-injection peribulbar blocks are needed to attain competence at peribulbar anesthesia.

Modelling the impact of vaccination and sexual behaviour adaptations on mpox cases in the USA during the 2022 outbreak

BACKGROUND

The 2022 mpox outbreak has infected over 30 000 people in the USA, with cases declining since mid-August. Infections were commonly associated with sexual contact between men. Interventions to mitigate the outbreak included vaccination and a reduction in sexual partnerships. Understanding the contributions of these interventions to decreasing cases can inform future public health efforts.

METHODS

We fit a dynamic network transmission model to mpox cases reported by Washington DC through 10 January 2023. This model incorporated both vaccine administration data and reported reductions in sexual partner acquisition by gay, bisexual or other men who have sex with men (MSM). The model output consisted of daily cases over time with or without vaccination and/or behavioural adaptation.

RESULTS

We found that initial declines in cases were likely caused by behavioural adaptations. One year into the outbreak, vaccination and behavioural adaptation together prevented an estimated 84% (IQR 67% to 91%) of cases. Vaccination alone averted 79% (IQR 64% to 88%) of cases and behavioural adaptation alone averted 25% (IQR 10% to 42%) of cases. We further found that in the absence of vaccination, behavioural adaptation would have reduced the number of cases, but would have prolonged the outbreak.

CONCLUSIONS

We found that initial declines in cases were likely caused by behavioural adaptation, but vaccination averted more cases overall and was key to hastening outbreak conclusion. Overall, this indicates that outreach to encourage individuals to protect themselves from infection was vital in the early stages of the mpox outbreak, but that combination with a robust vaccination programme hastened outbreak conclusion.

Confirmation of the utility of the CA-125 elimination rate (KELIM) as an indicator of the chemosensitivity in advanced-stage ovarian cancer in a "real-life setting"

OBJECTIVE

The modeled CA-125 ELIMination rate constant K (KELIM) has been validated as a marker of response to chemotherapy in >12,000 patients with advanced epithelial ovarian carcinoma (EOC) treated in first-line setting enrolled in >12 clinical trials. Patient KELIM is calculable online https://www.biomarker-kinetics.org/presentation. The objective was to investigate the prognostic value of KELIM in a large real-life national cancer registry with non-selected patients.

METHODS

We investigated 4,025 EOC patients from the Netherlands Cancer Registry treated with neoadjuvant chemotherapy (NACT) ± followed by interval debulking surgery (IDS). Patient KELIM values were calculated in patients with ≥ 3 CA-125 measurements during NACT. KELIM was standardized with a pre-specified cut-off and scored as unfavorable/favorable (<1.0/≥1.0). KELIM's prognostic value regarding radiological response, completeness of IDS, progression-free survival (PFS), and overall survival (OS) was assessed using univariate/multivariate analyses.

RESULTS

The data from 1,582 patients treated with heterogeneous chemotherapy regimens and sequences were assessable. KELIM was prognostic for radiological response and the likelihood of complete IDS after NACT (odds ratio=2.59; 95% confidence interval [CI]=2.04-3.29). Moreover, KELIM was independently associated with PFS (hazard ratio [HR]=0.76; 95% CI=0.66-0.87), and OS (HR=0.79; 95% CI=0.69-0.91). Combining KELIM with the completeness of the IDS resulted in 3 prognostic groups (satisfactory, intermediate, and poor) with significant OS differences, namely a good, intermediate, and poor survival respectively.

CONCLUSION

The value of KELIM, as a pragmatic indicator of response to chemotherapy, was maintained in a large real-life population-based cohort, highlighting its applicability in routine conditions.

Sick leave due to COVID-19 during the first pandemic wave in France, 2020

OBJECTIVES

To quantify the burden of COVID-19-related sick leave during the first pandemic wave in France, accounting for sick leaves due to symptomatic COVID-19 ('symptomatic sick leaves') and those due to close contact with COVID-19 cases ('contact sick leaves').

METHODS

We combined data from a national demographic database, an occupational health survey, a social behaviour survey and a dynamic SARS-CoV-2 transmission model. Sick leave incidence from 1 March 2020 to 31 May 2020 was estimated by summing daily probabilities of symptomatic and contact sick leaves, stratified by age and administrative region.

RESULTS

There were an estimated 1.70M COVID-19-related sick leaves among France's 40M working-age adults during the first pandemic wave, including 0.42M due to COVID-19 symptoms and 1.28M due to COVID-19 contacts. There was great geographical variation, with peak daily sick leave incidence ranging from 230 in Corse (Corsica) to 33 000 in Île-de-France (the greater Paris region), and greatest overall burden in regions of north-eastern France. Regional sick leave burden was generally proportional to local COVID-19 prevalence, but age-adjusted employment rates and contact behaviours also contributed. For instance, 37% of symptomatic infections occurred in Île-de-France, but 45% of sick leaves. Middle-aged workers bore disproportionately high sick leave burden, owing predominantly to greater incidence of contact sick leaves.

CONCLUSIONS

France was heavily impacted by sick leave during the first pandemic wave, with COVID-19 contacts accounting for approximately three-quarters of COVID-19-related sick leaves. In the absence of representative sick leave registry data, local demography, employment patterns, epidemiological trends and contact behaviours can be synthesised to quantify sick leave burden and, in turn, predict economic consequences of infectious disease epidemics.

Osteopathic Models Integration Radar Plot: A Proposed Framework for Osteopathic Diagnostic Clinical Reasoning

OBJECTIVE

The purpose of this article is to propose a tool to assist with clinical reasoning to select and integrate different osteopathic models and evidence-based actions into clinical practice.

DISCUSSION

The authors adopted the guidelines for writing a commentary as a reporting framework for the present article. The proposed Osteopathic Models Integration Radar Plot has potential for integration into clinical practice and the educational environment. This framework may enable clinicians to manage complex clinical phenomena, such as musculoskeletal disorders related to allostatic load.

CONCLUSION

This proposed framework may be helpful to communicate the outcome of osteopathic evaluations to other healthcare professionals. This proposed model will need to be tested to determine feasibility.

The Person-Centered Rehabilitation Model: Framing the concept and practice of person-centered adult physical rehabilitation based on a scoping review and thematic analysis of the literature

OBJECTIVE

To develop a cross-professional model framing the concept and practice of Person-Centered Rehabilitation (PCR) in adult populations, based on a scoping review and thematic analysis of the literature.

DATA SOURCES

Key databases (PubMed, Scopus, CINAHL), snowballing searches, and experts' consultation were the data sources for English-language empirical or conceptual papers, published from January 2007 to February 2020.

STUDY SELECTION

Two independent reviewers selected adult-based papers addressing at least one of the six categories of PCR-related content, a priori specified in the published review protocol. From 6527 unique references, 147 were finally included in the analysis. Of those, 26 were exclusively conceptual papers.

DATA EXTRACTION

Two independent reviewers extracted textual data on what PCR entails conceptually or as a practice. No quality appraisals were performed as is typical in scoping reviews.

DATA SYNTHESIS

A thematic analysis produced thematic categories that were combined into an emergent model (the PCR Model), which was reviewed by five external experts. PCR was framed as a way of thinking about and providing rehabilitation services "with" the person. PCR is embedded in rehabilitation structures and practice across three levels: 1) the person-professional dyad, 2) the micro-system level (typically an interprofessional team, involving significant others) and 3) a macro-system level (organization within which rehabilitation is delivered). Thematic categories are articulated within each level, detailing both the conceptual and practice attributes of PCR.

CONCLUSION

The PCR model can inform both clinical and service organization practices. The PCR Model may benefit from further developments including obtaining wider stakeholders' input, determining relevance in different cultural and linguistic groups, and further operationalization and testing in implementation projects.

A way forward in pulmonary aspiration incidence reduction: ultrasound, mathematics, and worldwide data collection

Aspiration of gastric contents during induction of general anesthesia remains a significant cause of mortality and morbidity in anesthesia. Recent data show that pulmonary aspiration still accounts for many cases with implications on mortality despite technical and technological evolution. Practical, ethical, and methodological issues prevent high-quality research in the setting of aspiration and rapid sequence induction/intubation, and significant controversy is ongoing. Patients' position, drugs choice, dosing and timing, use of cricoid force, and a reliable risk assessment are widely debated with significant questions still unanswered. We focus our discussion on three approaches to promote a better understanding of rapid sequence induction/intubation and airway management decision-making. Firstly, we review how we can use qualitative and quantitative assessment of fasting status and gastric content with the point-of-care ultrasound as an integral part of preoperative evaluation and planning. Secondly, we propose using imaging-based mathematical models to study different patient positions and aspiration mechanisms, including identifying aspiration triggers. Thirdly, we promote the development of a global data collection system aiming to obtain precise epidemiological data. Therefore, we fill the gap between evidence-based medicine and experts' opinion through easily accessible and diffused computer-based databases. A better understanding of aspiration epidemiology obtained through focused global data gathering systems, the widespread use of ultrasound-based prandial status evaluation, and development of advanced mathematical models might potentially guide safer airway management decision making in the 21^st century.

Perspectives on the pharmacist's "product": a narrative review

Clarity about the pharmacist’s “product” is fundamental to developing and communicating the value of pharmacy offerings. It is clear within the profession that pharmacists use their scope of knowledge and technical skills to address medication-related needs of individuals and populations. However, confusion still remains in the professional and public literature about what a pharmacist precisely produces for society. Is it a drug, service, program, solution, or something else? As the profession evolves from one that focuses on dispensing drugs to a profession that seeks to achieve positive patient health outcomes, pharmacists need to better conceptualize and articulate what they produce. This narrative review explores ideas from the marketing, business strategy, and entrepreneurship literature to discuss diverse perspectives on the pharmacist’s product. The four perspectives are the product as (1) a tangible product, (2) an intangible service, (3) a “smart, connected” good or service, and (4) a solution to a customer problem in whatever form provided. Based upon these perspectives, the pharmacist’s product can be any combination of tangible or intangible, face-to-face or virtual offering produced by pharmacists that seeks to satisfy medication-related needs and wants of pharmacy patients and customers. Ideas discussed in this review include the total product concept, classification schemes from the services marketing literature, the theory of service-dominant logic, the concepts of “smart, connected” products and industrialized intimacy, and the jobs-to-be-done framework. These various perspectives offer lessons for pharmacists on how to innovate when serving patients and customers and to communicate the pharmacist’s value proposition to the people they serve.

Improving outpatient medication counselling in hospital pharmacy settings: a behavioral analysis using the theoretical domains framework and behavior change wheel

Background:

Despite the importance of medication counselling for patients, it is common knowledge that it is often sub-optimally carried out by pharmacy staff. While some interventions have been designed to help improve counselling, no study till date has used the Capability Opportunity and Motivation behavior model (COM-B) or Theoretical Domains Framework (TDF) as a basis for identifying evidence-based intervention strategies to improve medication counselling.

Objective:

To understand barriers/facilitators to optimal medication counselling by conducting a behavioral analysis using the COM-B model and TDF, and use the Behavior Change Wheel (BCW) as a basis for identifying evidence-based intervention strategies and policy categories that could be used to improve outpatient medication counselling by pharmacy staff in hospital settings located within Northwest Nigeria.

Methods:

Semi-structured interviews were used to collect data from 25 purposively sampled pharmacy staff working at eight major public hospitals, from January till March 2020. Data from the interviews were then transcribed and deductively coded using the COM-B model and TDF. These findings were then used to identify areas requiring change, as well as the intervention type and policy functions required to support these changes.

Results:

Findings from the behavioral analysis revealed shortfalls in pharmacy staff capability, opportunity and motivation with respect to outpatient medication counselling. To improve their counselling behaviors, change was identified as necessary in eight TDF domains namely ‘knowledge’, ‘interpersonal skills’, ‘memory’ ‘environmental context’, ‘social influences’, ‘intentions’, ‘reinforcement’ and ‘beliefs about capabilities’. Seven intervention functions including ‘education’, ‘training’, ‘modelling’, ‘enablement’ and ‘environmental restructuring’, in addition to three policy categories (‘guidelines’, ‘regulations’ and ‘environmental/social planning’) were also identified as relevant to future intervention design.

Conclusions:

Various factors were identified as affecting medication counselling by the pharmacy staff, with several of them requiring changes if counselling was to be improved upon. Multi-component interventions combining several of these intervention functions are recommended for hospital authorities and other relevant stakeholders to improve outpatient medication counselling.

[Forecasting the Pandemic: The Role of Mathematical Models]

N/a.

A Technical Perspective for Understanding Quantitative Arterial Spin-Labeling MR Imaging Using Continuous ASL

The current paper describes visually the system of CBF measurement by continuous ASL using schematic illustration. I also discussed the effects of the parameters used in continuous ASL to CBF values as measured with ASL-MRI.

Risk-Taking Attitudes of Patients who Seek Health Care: An Exploratory Approach through Lottery Games

BACKGROUND

The characterization of the risk-taking attitude of individuals may be useful for planning health care interventions. It has been attempted to study expressions of risk-taking attitude and evaluate characteristics of a standard lottery game in a population that seeks health care to elicit these attitudes.

METHODS

Multicentric cross-sectional study. Demographic and socioeconomic characteristics, quality of life (EuroQol-5D), and health risk behaviors were collected from 662 users of 23 health centers selected by random sampling. Risk-taking attitude was evaluated by means of a self-evaluation scale and two lottery games, (L1 and L2; L2 included the possibility of economic losses). Generalized estimating equations (GEE) explicative models were used to evaluate the variability of risk-taking attitude.

RESULTS

Nineteen percent out of interviewed people (CI95%: 15.6-22.6%) expressed a high risk appetite, but only 10.0% (CI95% 7.0 to 13.0) were classified as risk-seeking by L2. It was found association between increased risk appetite and having a better perception of health status (0.110, CI95%: 0,007-0,212) or a higher income (0.010, CI95%: 0.017- 0.123) or smoking status (0.059, CI95%: 0.004- 0.114). Being Spanish was associated with lower risk appetite (-0.105, CI95%: -0.005 --0.205), as being over 65 (-0.031, CI95%:- 0.061- -0.001) or a woman (-0.038, CI95%:-0.064- -0.012). The intraclass correlation coefficient for self-evaluation scale was 0.511 (95% CI: 0.372 to 0.629), 0.571 (95% CI: 0.441 to 0.678) for L1 and 0.349 (95% CI: 0.186-0.493) to L2.

CONCLUSIONS

People who seek health care express certain inclination to risk, but this feature is attenuated when methodologies involving losses are used. Risk appetite seems greater in young people, males, people with better health, or more income, and in immigrants. Lottery games such as the proposed ones are a simple and useful tool to estimate individuals' inclination to risk.

In-Silico Trials for Glucose Control in Hospitalized Patients with Type 2 Diabetes

Although various basal-bolus insulin therapy (BBIT) protocols have been used in the clinical environment, safer and more effective BBIT protocols are required for glucose control in hospitalized patients with type 2 diabetes (T2D). Modeling approaches could provide an evaluation environment for developing the optimal BBIT protocol prior to clinical trials at low cost and without risk of danger. In this study, an in-silico model was proposed to evaluate subcutaneous BBIT protocols in hospitalized patients with T2D. The proposed model was validated by comparing the BBIT protocol and sliding-scale insulin therapy (SSIT) protocol. The model was utilized for in-silico trials to compare the protocols of adjusting basal-insulin dose (BBIT1) versus adjusting total-daily-insulin dose (BBIT2). The model was also used to evaluate two different initial total-daily-insulin doses for various levels of renal function. The BBIT outcomes were superior to those of SSIT, which is consistent with earlier studies. BBIT2 also outperformed BBIT1, producing a decreased daily mean glucose level and longer time-in-target-range. Moreover, with a standard dose, the overall daily mean glucose levels reached the target range faster than with a reduced-dose for all degrees of renal function. The in-silico studies demonstrated several significant findings, including that the adjustment of total-daily-insulin dose is more effective than changes to basal-insulin dose alone. This research represents a first step toward the eventual development of an advanced model for evaluating various BBIT protocols.

Lifestyle of the employees working in hamadan public sectors: application of the trans-theoretical model

BACKGROUND

A healthy lifestyle is a valuable source to reduce the prevalence of health problems, and promoteehealth.

OBJECTIVES

The current study aimed to evaluate the lifestyle and obesity status of Hamadan public employees and their status based on the trans-theoretical model (TTM).

PATIENTS AND METHODS

This analytical cross-sectional study was performed in 2014 on 1200 public employees in Hamadan city, Iran selected through proportional stratified random sampling. Data collection was performed using a three-section questionnaire including demographic characteristics, The FANTASTIC lifestyle questionnaire, and the five-part algorithm. Data were analyzed by SPSS-20 using linear regression, Chi-square, Fisher exact test, and ANOVA.

RESULTS

The mean age of the employees was 38.12 ± 8.04 years. Most of the employees (61.7%) had favorable lifestyle. About half of the employees were at the preparation stage of TTM. Most of the employees were in a poor condition regarding the physical activity and healthy eating habits. In most of the evaluated items, females got higher scores than males. The associations between lifestyle and age, gender, work experience, income satisfaction, and marital status were significant. Moreover, the associations between obesity and work experience, marital status, number of offspring, and gender were significant (P < 0. 05). Significant predicting variables of obesity were age and work experience; they explained 31.2% variance of obesity (adjusted R(2) = 0.312, R(2) change = 0.01).

CONCLUSIONS

Planning health education interventions for employees through effective approaches seems necessary.

Backcalculation of flexible linear models of the human immunodeficiency virus infection curve

The authors present a regression approach to the backcalculation of flexible linear models of the HIV infection curve. They note that "because expected AIDS incidence can be expressed as a linear function of unknown parameters, regression methods may be used to obtain parameter and covariance estimates for a variety of interesting quantities, such as the expected number of people infected in previous time intervals and the projected AIDS incidence in future time intervals. We exploit these ideas to show that estimates based on maximum likelihood are, for practical purposes, equivalent to approximate estimates based on quasi-likelihood and on Poisson regression. These algorithms are readily implemented on a personal computer." These concepts are illustrated by projecting AIDS incidence in the United States up to 1993.

A general theory of life table construction and a precise abridged life table method

"In this paper we lay the foundation of life table construction by unifying the existing life table methods. We also present a new method of constructing current (period) abridged life tables.... The development includes (1) a careful formulation and computation of age-specific death rates, (2) derivation of a new set of formulas for computing the survivorship function from the observed age-specific death rates and populations, (3) estimation of the main life table functions by spline interpolation, integration and differentiation, and (4) use of a quadratic and a Gompertz function to close the life table.... The method is illustrated with construction of abridged life tables using Canadian data."

Child survivorship estimation: methods and data analysis

"The past 20 years have seen extensive elaboration, refinement, and application of the original Brass method for estimating infant and child mortality from child survivorship data. This experience has confirmed the overall usefulness of the methods beyond question, but it has also shown that...estimates must be analyzed in relation to other relevant information before useful conclusions about the level and trend of mortality can be drawn.... This article aims to illustrate the importance of data analysis through a series of examples, including data for the Eastern Malaysian state of Sarawak, Mexico, Thailand, and Indonesia. Specific maneuvers include plotting completed parity distributions and 'time-plotting' mean numbers of children ever born from successive censuses. A substantive conclusion of general interest is that data for older women are not so widely defective as generally supposed."

Aging, intergenerational distribution and public pension systems

"This paper develops an intertemporal simulation model capable of addressing the macroeconomic and distributional effects of demographic shocks in a small open economy. Two sources of population aging are examined, viz. lower birth rates and prolonged expected lifetimes at retirement age. Due to strong expectational effects, both shocks are found to change average consumption in a downward direction, in the short run as well as in the long run. This effect is matched by a strong net acquisition of foreign assets. Furthermore, it turns out that the intergenerational distribution of the burden of adjusting to an aging population is strongly dependent on whether the benefit rate, the contribution rate, or the relative non-capital income of pensioners and workers is held fixed."

Generalized Lotka distribution incorporating migration

"This paper proposes to introduce the migration component into the stable population model and examine the stability of the age distribution. The analysis [is restricted] to one sex as [has been] done by others." The model is applied to Canadian data.

Non-white migration patterns in northern metropolitan areas, 1960-1970: the interaction between economic and affinitive factors

"The principal objective of this article is to investigate the determinants of variation in the growth of non-white populations attributable to migration across northern [U.S.] metropolitan areas during the 1960s." The investigation is done by means of a single equation framework model, which is applied to U.S. Bureau of the Census data. The results indicate that "the migration-related growth of non-white populations in northern metropolitan areas during the 1960s was...importantly and directly associated both with the level of employment opportunities as measured by the proportion of the non-white population of labor force age officially employed in the mainstream economy of an SMSA and with the SMSA rate of net migration occurring over the preceding 10-year period, which indicates the role of chain migration."

Estimation of mean age at first marriage: use of a simple mathematical model

"The present paper is an attempt to introduce a simple mathematical model to describe the age pattern of proportion never married women. The underlying model was found to give fairly close fit to an observed set of data of some 17 WFS [World Fertility Survey] countries. A mathematical formulation was then suggested in terms of the parameters in the model to estimate the mean age at first marriage. The mean ages obtained under the approach agreed quite closely with those obtained by Hajnal's method. The agreement between the estimates of ever married proportions obtained by the suggested model and...Coale's nuptiality model appeared also to be satisfactory."

Parental benefits, employment, and fertility dynamics

"This paper investigates the effect of parental benefits on the timing and spacing of births and on employment dynamics of Swedish women. Using microdata on wages and incomes, I estimate a reduced-form multistate duration model of the bivariate life-cycle fertility and employment process. The paper provides an example of the application of empirical procedures to develop and evaluate multistate hazard models. Estimation results are mixed, with estimated wage effects generally consistent with theoretical predications while estimated effects of the benefits are not. The evaluation procedures offer valuable diagnostic information and suggest several avenues for future research."

Modelling population movement into the Scottish highlands and islands from the remainder of Britain, 1990-1991

"In this analysis, data are used from the 1991 Census Special Migration Statistics to model the migration flows into the Scottish highlands and islands, from the remainder of Britain, between 1990 and 1991. A Poisson regression approach is used to identify the origins of unusually large flows into this broad destination area, and to introduce origin-based explanatory variables which help to explain the factors influencing these flows. The flows into this area which originate in Scotland are contrasted with those which originate in England and Wales and the findings suggest that middle class in-migration from southern England continues to be a significant element of population change in this remote rural destination."

A regression analysis of migration to urban areas of a less-developed country: the case of Iran

The factors affecting internal migration in Iran are analyzed using a regression-based model. "The model used is of the 'push-pull' variety stated in the form of a single equation explaining out-migration from a given region of origin (i) to all other regions (j) in the country." The focus is on the period prior to 1976.

[Contributions to regional mortality differentials]

"In this article there have been applied some analytical methods of multidimensional analysis based on calculated abridged mortality tables for the districts of Czechoslovakia (1981-1985)." The techniques were used to assess average life span and probability of death. (SUMMARY IN ENG AND RUS)

Asian urbanization and development: a comparative view

A comparative perspective on urbanization trends in Asia is provided. "The trends for the different Asian regions are first presented in the context of the world's more developed and less developed regions. Comparative data on the constituent countries in each of the regions are next shown. Then a modified urbanization-development model is proposed and subsequently tested empirically. The concluding section summarizes the findings and implications." The data are taken primarily from published U.N. sources.

A model of pre-sterilization ambivalence and post-sterilization regret in married couples

"We have presented a general theoretical perspective on couple decision-making and subsequent adaptation which serves as a framework for understanding the complex phenomenon commonly referred to as post-sterilization regret. We have anchored this framework by means of a series of specific hypotheses about ambivalence and post-sterilization regret among both tubal ligation and vasectomy married couples. Using our hypotheses, we constructed three models. These were tested on data gathered from 400 married couples.... The results, including unanticipated pathways and differences in specific areas of each model between sexes and method groups, not only provide a confirmation of our general theoretical perspective but also allow us to have insights and to speculate about the psychological and marital dynamics of sterilization decision-making and adaptation." Data are from a longitudinal study conducted in Santa Clara, California, in 1985.

Deprivation in London wards: mortality and unemployment trends in the 1980's

"This paper describes the use of current estimates of population and economic activity for London's wards in developing small area social indicators. The particular focus is on changes in the spatial pattern of mortality and unemployment differences in the 1980s in relation to the wider incidence of deprivation in wards. A conditional model of change is developed for mortality and unemployment indices to assess whether spatial differences are widening over time and how far changes in these indices are linked to social class and deprivation. The evidence is of widening unemployment differences, and a slight widening in premature mortality."

[Theories on migration and migration policy]

"In its first part the article gives a short historical overview of theories on migration.... The author tries to clarify the term[s]...'migration policy' and...'migration' itself and assesses the usefulness of various migration typologies. The final chapter analyses determinants and trends of migration policies in Europe in the 1990s: the continuing pressures for migration in developing countries, the end of numerous barriers to emigration, the revival of nationalistic concepts of immigration and exclusionary tendencies founded on culturalistic arguments, the process of harmonizing control mechanisms in the European Union, and the influence of international human rights declarations on the formulation of migration policies." (SUMMARY IN ENG AND FRE)