Time to Diagnosis: Accounting for Differential Endpoint Follow-up in Multi-Cohort Studies

Cox regression is widely used to analyze discrete survival time data. Differential endpoint follow-up across sub-cohorts where distribution of a covariate varies may cause typical estimators to be biased or inefficient. We demonstrate that with Cardiovascular Health Study data for incident type 2 diabetes. Two cohorts with extremely different race distribution have differential follow-up for fasting glucose levels. We study various scenarios of Cox regression. We suggest an alternative approach, Poisson generalized estimating equations with an offset to accommodate the differential follow-up. We use simulations to contrast the methods.     

Reliability of accelerometric measurement of physical activity in older adults-the benefit of using the trimmed sum

There is general consensus that physical activity is important for preserving functional capacities of older adults and positively influencing quality of life. While accelerometry is widely accepted and applied to assess physical activity in studies, several problems with this method remain (e.g., low retest reliability, measurement errors). The aim of this study was to test the intra-instrumental retest reliability of a wrist-worn accelerometer in a 3-day measurement of physical activity in older adults and to compare different estimators. A sample of 123 older adults (76.5?±?5.1?years, 59?% female) wore a uniaxial accelerometer continuously for 1?week. The data were split into two repeated measurement values (week set) of 3?days each. The sum, the 80?C99th quantiles and the 80?C99th trimmed sums were built for each week set. Retest reliability was assessed for each estimator and graphically demonstrated by Bland?CAltman plots. The intraclass correlation of the retest reliability ranged from 0.22 to 0.91. Retest reliability increases when a more robust estimator than the overall sum is used. Therefore, the trimmed sum can be recommended as a conservative estimate of the physical activity level of older adults.     

Gambling in Western and Eastern Europe: The Example of Hungary

The history of gambling in post-socialist countries is noticeably different from that of other countries in Europe. The goal of this study was therefore twofold: Firstly, to systematically review all European epidemiological studies related to excessive gambling in the general adult population, and secondly, to provide an overview of the state of gambling in Hungary based on the first ever nationwide representative survey, setting the results against the backdrop of the earlier European studies. A systematic review was carried out of European gambling studies which focus on a representative adult general population. Hungarian data was obtained from the National Survey on Addiction Problems in Hungary general adult population survey (N = 2,710). Pathological gambling was measured by the South Oaks Gambling Screen. Lifetime prevalence of excessive gambling (problem and pathological gambling) in the general adult population of European countries varies between 1.1% (Italy and Spain) and 6.5% (Estonia). In Hungary, the prevalence of problem gambling is 1.9%, with pathological gambling at 1.4%. The socio-demographic characteristics of the results are similar to those of other European countries. Using epidemiological data from the general adult populations of two post-socialist nations, it was possible to compare the results with data from 12 other European countries. Based on the data available, the extremely rapid liberation of the gambling market in the post-socialist countries has led to a similarly swift escalation in associated gambling problems.     

Correlates of sport participation among community-dwelling elderly people in Germany: a cross-sectional study

The aims of this study were (1) to analyze the sport participation in a cohort of community-dwelling elderly people in Germany and (2) to evaluate associations between sport participation, sociodemographic factors, cardiovascular risk factors, and health status. In a monitored prospective cohort study (getABI), 6,880 unselected patients ≥65 years have been followed up by 344 general practitioners beginning in 2001. As part of the 5-year follow-up telephone interview, a sample of 1,376 participants was interviewed on sport participation. The association between participation in at least one sporting activity (“sporty” yes/no) during the past week (cycling) or month (other sports) and the following parameters was analyzed by logistic regression: age, sex, immigration background, education, waist circumference, smoking, self-reported health, history of vascular events, diabetes mellitus, lipometabolic disorder, and arterial hypertension. Analysis of activities (n = 1,304; median age 76 (70–94) years; 55.1% women) showed that 27.6% of participants rode a bicycle during the previous week. During the previous month, 24.9% of participants did gymnastics or strength training, and 16.5% swam. Of all participants, 53.8% were sporty. Multivariate analysis revealed several independent factors to be associated with being sporty (p < 0.05): younger age, male sex, higher education, nonsmoking, better self-reported health, and not being diagnosed with diabetes. Immigration background, waist circumference, history of vascular events, lipometabolic disorder, and hypertension did not show a statistically significant association (p ≥ 0.05) with sport participation. Summing up, the most frequently performed sporting activities were cycling, gymnastics or strength training, and swimming. Sport participation was associated with, for example, age and sex.     

The Discreet Charm of Lenin

This article takes two postcards of Lenin as their point of departure to ask about articulations of Soviet history as image and kitsch. I am especially interested in the ways in which the dead body or mummy of Lenin comes to symbolize an imagined social coherence that accrues specific political significance after the demise of the Soviet Union. In looking at Lenin's mummy as a site of memory and key to understanding contemporary Russian political desires, the article offers one analytical interpretation of the continuing preservation of Russia's revolutionary and also Stalinist past. By arguing that the Lenin mummy simultaneously functions as camp and kitsch, and as an embodied time of eternity, I also seek to understand how “grandiose” understandings of Soviet history work in this present.     

Does Society Matter? Life Satisfaction in the Enlarged Europe

Life satisfaction is quite heterogeneously distributed across countries of the enlarged European Union. Previous research has shown how living conditions within individual countries, such as access to material and emotional resources, are important for personal well-being, but it has been less successful in explaining differences between countries. This article investigates whether it matters in which political and economic circumstances people live, as well as whether their particular perception of the quality of their societal environment plays a role. People are well aware that the institutional and cultural settings in which their lives are embedded create opportunities and limitations: within individual countries, perceptions of society influence life satisfaction outcomes irrespective of access to resources. However, their importance for well-being differs across Europe: perceptions of societies are highly decisive in countries that provide only a minimum of social security and in which the reliability of political institutions is poor. In rich and stable countries, the impact is weaker and private social support becomes more important. In addition to these country-specific weights of life satisfaction determinants, life satisfaction variations between countries can be explained to a large extent by taking into consideration the economic performance, the social security level, and the political culture in a country—all in all, general conditions that enable people to live a respectable life.     

Der Ebenenwechsel und seine Folgen Eine Gruppe experimentiert

Today, professionality is no longer safeguarded only by a specific professional membership. Particularly in the field of supervision, even organized supervisors have problems with quality safeguarding. For this reason the authors insist on a continuous reflection and development of concepts, and they report on their activities relating to this demand. The shift of level is a method of group dynamics based on the concept ”shift of perspectives“ in phenomenology.     

Semiparametric log-linear regression for longitudinal measurements subject to outcome-dependent follow-up

A common problem for longitudinal data analyses is that subjects follow-up is irregular, often related to the past outcome or other factors associated with the outcome measure that are not included in the regression model. Analyses unadjusted for outcome-dependent follow-up yield biased estimates. We propose a longitudinal data analysis that can provide consistent estimates in regression models that are subject to outcome-dependent follow-up. We focus on semiparametric marginal log-link regression with arbitrary unspecified baseline function. Based on estimating equations, the proposed class of estimators are root n consistent and asymptotically normal. We present simulation studies that assess the performance of the estimators under finite samples. We illustrate our approach using data from a health services research study.