title: Analysis of interval-censored data from circular migrant and non-migrant sexual partnerships using the EM algorithm

authors: Zuma, K.

subjects: statistics

abstract: In epidemiological studies where subjects are seen periodically on follow-up visits, interval-censored data occur naturally. The exact time the change of state (such as HIV seroconversion) occurs is not known exactly, only that it occurred sometime within a specific time interval. Methods of estimation for interval-censored data are readily available when data are independent. However, methods for correlated interval-censored data are not well developed. This paper considers an approach for estimating the parameters when data are interval-censored and correlated within sexual partnerships. We consider the exact event times for interval-censored observations as unobserved data, only known to be between two time points. Dependency induced by sexual partnerships is modelled as frailties assuming a gamma distribution for frailties and an exponential distribution on the time to infection. This formulation facilitates application of the expectation-maximization (EM) algorithm. Maximization process maximizes the standard survival frailty model. Results show high degree of heterogeneity between sexual partnerships. Intervention strategies aimed at combating the spread of HIV and other sexually transmitted infections (STI)s should treat sexual partnerships as social units and fully incorporate the effects of migration in their strategies. Copyright © 2006 John Wiley & Sons, Ltd.

text: Analysis of interval-censored data from circular migrant and non-migrant sexual partnerships using the EM algorithm In epidemiological studies where subjects are seen periodically on follow-up visits, interval-censored data occur naturally. The exact time the change of state (such as HIV seroconversion) occurs is not known exactly, only that it occurred sometime within a specific time interval. Methods of estimation for interval-censored data are readily available when data are independent. However, methods for correlated interval-censored data are not well developed. This paper considers an approach for estimating the parameters when data are interval-censored and correlated within sexual partnerships. We consider the exact event times for interval-censored observations as unobserved data, only known to be between two time points. Dependency induced by sexual partnerships is modelled as frailties assuming a gamma distribution for frailties and an exponential distribution on the time to infection. This formulation facilitates application of the expectation-maximization (EM) algorithm. Maximization process maximizes the standard survival frailty model. Results show high degree of heterogeneity between sexual partnerships. Intervention strategies aimed at combating the spread of HIV and other sexually transmitted infections (STI)s should treat sexual partnerships as social units and fully incorporate the effects of migration in their strategies. Copyright © 2006 John Wiley & Sons, Ltd.

year: 2006

title: Development of a mental health recovery module for the WHOQOL

authors: Rowthorn, Melissa J.

subjects: Quality of life

abstract: Purpose
The WHOQOL tools are widely used, multi-faceted, patient-rated, quality of life (QoL) measures, developed by the World Health Organization. The WHOQOL questionnaires are used to assess generic quality of life issues affected by all health problems. This study developed a module to use with the WHOQOL tools to improve their sensitivity to Health Related QoL issues relevant to mental health recovery.

Methods
Using a sequential mixed-methods approach, two research stages occurred. A qualitative stage invited 88 participants with experience of mental health recovery, into focus groups and importance rating activities, to identify candidate items for the new module. Following this, a quantitative stage involved 667 participants with, and without, mental health/addiction issues completing online or paper-based questionnaires to analyze which candidate items differentiated between those with and without mental health/addiction issues. Classical test theory and iterative Partial Credit Rasch Analysis were used to identify the most suitable candidate items for a reliable and valid mental health recovery module to be used with the WHOQOL tools.

Results
Seventeen candidate items captured important HRQoL facets relevant to mental health recovery. Rasch analysis removed 10 misfitting items. The final 7-item module, which demonstrated the best Rasch model fit, enquires about recovery beliefs, identifying strengths, self-awareness, acceptance, capacity to relate, feeling understood, and recovery progress. Ordinal-to-interval conversion tables have been developed to optimize measurement precision when using the module.

Conclusions
Important HRQoL issues central to mental health recovery can be reliably evaluated by using the recovery module with the WHOQOL tools.

text: Development of a mental health recovery module for the WHOQOL Purpose
The WHOQOL tools are widely used, multi-faceted, patient-rated, quality of life (QoL) measures, developed by the World Health Organization. The WHOQOL questionnaires are used to assess generic quality of life issues affected by all health problems. This study developed a module to use with the WHOQOL tools to improve their sensitivity to Health Related QoL issues relevant to mental health recovery.

Methods
Using a sequential mixed-methods approach, two research stages occurred. A qualitative stage invited 88 participants with experience of mental health recovery, into focus groups and importance rating activities, to identify candidate items for the new module. Following this, a quantitative stage involved 667 participants with, and without, mental health/addiction issues completing online or paper-based questionnaires to analyze which candidate items differentiated between those with and without mental health/addiction issues. Classical test theory and iterative Partial Credit Rasch Analysis were used to identify the most suitable candidate items for a reliable and valid mental health recovery module to be used with the WHOQOL tools.

Results
Seventeen candidate items captured important HRQoL facets relevant to mental health recovery. Rasch analysis removed 10 misfitting items. The final 7-item module, which demonstrated the best Rasch model fit, enquires about recovery beliefs, identifying strengths, self-awareness, acceptance, capacity to relate, feeling understood, and recovery progress. Ordinal-to-interval conversion tables have been developed to optimize measurement precision when using the module.

Conclusions
Important HRQoL issues central to mental health recovery can be reliably evaluated by using the recovery module with the WHOQOL tools.

year: 2019

title: “She didn’t ask me about my grandma”. Using process drama to explore issues of cultural exclusion and educational leadership.

authors: Kana, Pare

subjects: dramatization

abstract: Purpose – This purpose of this paper is to describe a collaborative project from the University of Waikato, Hamilton New Zealand, in which the authors used process drama to engage final year teaching students with complex issues of cultural diversity, enabling them to “grow into” different kinds of leadership positions in an imagined educational setting. The paper describes the project and makes a case for process drama as a means of providing opportunities for leadership and as a potent tool for learning about issues of social justice. Design/methodology/approach – The drama was based on a fictional scenario described by Hall and Bishop, where a beginner teacher (of European descent) unwittingly diminishes the experiences of Maori and other non-European children in her class. Using a three-phase process planning model and with facilitators in role alongside the students, the drama explored the scenario from all points of view. Students were encouraged to build empathy for the beginner teacher and for the children and also to explore the dilemma faced by the teacher's tutor in deciding whether, and how, to confront the teacher on the issue. Findings – Through the drama, students built a sense of empathy for all sides of the issue and engaged in deep thinking about the experience of cultural exclusion. The safety and distance provided by the drama “frame” spurred students to take leadership roles and “stand up” for issues of social justice. The authors suggest that through such dramas students gain skills and perspectives that they may carry into their professional lives. Research limitations/implications – The paper describes a small project, over one lesson with a specific group of students. More research is needed into the effectiveness of process drama as a sustained strategy for teacher education. Originality/value – This scenario explored in the drama has currency in Aotearoa New Zealand, where the population is increasingly culturally diverse, where underachievement of Maori students continues to be of concern, and where research has shown the centrality of teacher-student relations in raising educational achievement for Maori. The authors believe this paper makes a compelling case for the value of drama as a tool for student teachers to encounter social justice issues in a meaningful way, and suggest that the paper is a valuable contribution to more than one discipline, as it straddles the fields of professional practice and drama as pedagogy.

text: “She didn’t ask me about my grandma”. Using process drama to explore issues of cultural exclusion and educational leadership. Purpose – This purpose of this paper is to describe a collaborative project from the University of Waikato, Hamilton New Zealand, in which the authors used process drama to engage final year teaching students with complex issues of cultural diversity, enabling them to “grow into” different kinds of leadership positions in an imagined educational setting. The paper describes the project and makes a case for process drama as a means of providing opportunities for leadership and as a potent tool for learning about issues of social justice. Design/methodology/approach – The drama was based on a fictional scenario described by Hall and Bishop, where a beginner teacher (of European descent) unwittingly diminishes the experiences of Maori and other non-European children in her class. Using a three-phase process planning model and with facilitators in role alongside the students, the drama explored the scenario from all points of view. Students were encouraged to build empathy for the beginner teacher and for the children and also to explore the dilemma faced by the teacher's tutor in deciding whether, and how, to confront the teacher on the issue. Findings – Through the drama, students built a sense of empathy for all sides of the issue and engaged in deep thinking about the experience of cultural exclusion. The safety and distance provided by the drama “frame” spurred students to take leadership roles and “stand up” for issues of social justice. The authors suggest that through such dramas students gain skills and perspectives that they may carry into their professional lives. Research limitations/implications – The paper describes a small project, over one lesson with a specific group of students. More research is needed into the effectiveness of process drama as a sustained strategy for teacher education. Originality/value – This scenario explored in the drama has currency in Aotearoa New Zealand, where the population is increasingly culturally diverse, where underachievement of Maori students continues to be of concern, and where research has shown the centrality of teacher-student relations in raising educational achievement for Maori. The authors believe this paper makes a compelling case for the value of drama as a tool for student teachers to encounter social justice issues in a meaningful way, and suggest that the paper is a valuable contribution to more than one discipline, as it straddles the fields of professional practice and drama as pedagogy.

year: 2007