Spousal agreement on preferred waiting time to next birth in sub-Saharan Africa

This study investigates how various social, demographic and economic factors affect spousal agreement on preferred waiting time to next birth. Data for matched cohabiting couples from ten Demographic and Health Surveys in sub-Saharan Africa (Benin, Burkina Faso, Ghana, Guinea, Mali, Ethiopia, Kenya, Mozambique, Zambia and Zimbabwe), conducted between 2003 and 2006, were analysed to compare reported waiting time to next birth by the husband and the wife. Couples where the reported waiting time to next birth was the same for both partners (difference is 0 months) were defined as having agreement on waiting time to next birth. In sub-Saharan Africa, spousal agreement on waiting time to next birth was found to be associated with wanting the next child sooner. When the spouses disagree on waiting time to next birth, the wives want to wait longer than their husbands in most cases. Additionally, the study found that demographic factors are the primary determinants of spousal agreement on waiting time to next birth, not socioeconomic factors. The strongest predictors of spousal agreement on waiting time to next birth were number of living children, difference between the number of ideal and living children and wife's age. Couples with fewer children, a younger wife and those with a difference of five or more children between ideal and living number of children were more likely to agree on waiting time to next birth. Effects of socioeconomic factors, such as education and wealth status, on spousal agreement on waiting time to next birth were generally weak and inconsistent. The findings highlight some of the challenges in developing programmes to promote spousal communication and birth spacing and underscore the need for programmes to be gender-sensitive.     

Expected waiting time for the visual response

Let the light-quanta be absorbed in the retina according to a Poisson process. The present paper derives bounds for the expected waiting time for an occurence of a visual response. These bounds can serve as control limits for a proposed coincidence threshold. An upper bound for the probability that a visual response has not occured in (O,t) is derived and is used to obtain an upper bound for the mean visual threshold.     

Genetic progression and the waiting time to cancer

Cancer results from genetic alterations that disturb the normal cooperative behavior of cells. Recent high-throughput genomic studies of cancer cells have shown that the mutational landscape of cancer is complex and that individual cancers may evolve through mutations in as many as 20 different cancer-associated genes. We use data published by Sjöblom et al. (2006) to develop a new mathematical model for the somatic evolution of colorectal cancers. We employ the Wright-Fisher process for exploring the basic parameters of this evolutionary process and derive an analytical approximation for the expected waiting time to the cancer phenotype. Our results highlight the relative importance of selection over both the size of the cell population at risk and the mutation rate. The model predicts that the observed genetic diversity of cancer genomes can arise under a normal mutation rate if the average selective advantage per mutation is on the order of 1%. Increased mutation rates due to genetic instability would allow even smaller selective advantages during tumorigenesis. The complexity of cancer progression can be understood as the result of multiple sequential mutations, each of which has a relatively small but positive effect on net cell growth.     

Assortative marriage for physical characteristics in newlyweds

The objective of this study was to estimate the degree of spouse resemblance in the first 6 months of marriage and to compare these estimates with those of previous studies on long-standing marriages. The participants, 215 couples, were selected from the marriage licenses issued in two counties within the San Francisco Bay Area. They attended one of several group sessions in which questionnaires were filled out and forearm length measurements were taken. Only the results for the couples of European ancestry (N = 164) are presented here since the other subsamples were too small to analyze separately. The husband-wife correlations for body size were found to be essentially equal to those in long-standing marriages. Thus, it appears that physical resemblance in couples is the result of initial assortment rather than convergence arising from long cohabitation. A significant residual husband-wife correlation for weight was found after statistically partialing out height. It may be that assortative marriage for food habits and attractiveness produces spouse resemblance in weight, independently of height. Alternatively, convergence in eating habits may occur during courtship and the early months of marriage which may increase the resemblance in weight. There was very little homogamy for eye color independently of race, and no evidence of assortative marriage for handedness.     

Determinants and effects of waiting time to coitus.

Nonuse of contraception at first intercourse among adolescents is well documented in the adolescent sexuality research literature. This study provides a formal test of the hypothesis that an increase in the courtship period (i.e., waiting time to intercourse) increases the likelihood that a couple will discuss contraception and use it at first intercourse. The data analyzed are from personal interviews with 1,314 women aged 20-29 in the 1983 National Survey of Unmarried Women. The results are mixed about the effect of waiting time on contraceptive behavior, providing weak support for the hypothesis, but also elucidating individual and relative characteristics of the couples, such as age and education of the respective partners, that affected contraceptive behavior at first intercourse. Support for the hypothesis may prove more robust in data with different characteristics from the survey used here.     

Willingness of patients to change surgeons for a shorter waiting time for joint arthroplasty

Background

To improve access to care, many jurisdictions have proposed waiting-time benchmarks and guarantees. We assessed the willingness of patients to consider changing their surgeon to one with a shorter waiting time for arthroplasty.

Methods

We mailed a questionnaire to 2 random samples of patients who either were awaiting hip or knee replacement arthroplasty or had had one of these procedures within the preceding 3–12 months. We used logistic regression to assess the determinants of patients'' likelihood to consider changing surgeons.

Results

Of 1200 responses from a sample of 2000, 557 (46%) were from patients awaiting surgery and 643 (54%) were from people who had undergone surgery. The mean age of respondents was 69.9 years (standard deviation 10.8), and 682 (57%) were women. The median waiting time for surgery was 8 months. Overall, 753 (63%) of the patients were unlikely to consider changing surgeons. Increased likelihood of changing surgeons was associated with male sex (adjusted odds ratio [OR] 1.49, 95% confidence interval [CI] 1.10–2.02), a high school education or higher (OR 1.73, 95% CI 1.15– 2.62) and having already undergone surgery (OR 1.71, 95% CI 1.19– 2.46). Decreased likelihood was associated with preference for a particular surgeon before referral (OR 0.57, 95% CI 0.42– 0.79), a better score on the EuroQol (EQ-5D) index (a measure of health-related quality of life) (OR 0.39, 95% CI 0.24– 0.66), perception that the waiting time to see the surgeon was acceptable (OR 0.50, 95% CI 0.36–0.70), perception that the waiting time to surgery was acceptable (OR 0.62, 95% CI 0.43–0.91) and perceived fairness of treatment (OR 0.53, 95% CI 0.36– 0.78).

Interpretation

Despite long waits for surgery, most patients, if given the choice, would be unlikely to change their surgeon to one with a shorter waiting time.Long waiting times for elective surgery are a concern in countries with publicly funded health care systems.¹ To try to improve access, governments in Canada and some other countries in the Organisation for Economic Co-operation and Development have proposed or implemented waiting-time benchmarks and care guarantees.² These benchmarks, typically between 3 and 12 months, usually refer to the time between assessment by a specialist and in-patient treatment.³Waiting times for hip and knee arthroplasty are perceived as excessive in many countries, including Canada.^4–6 In 2005, Canada''s federal, provincial and territorial health ministers set a target waiting time of 26 weeks for hip and knee arthroplasty, and in 2007 they agreed to establish waiting-time guarantees by 2010 in selected priority areas, including joint arthroplasty.⁷ A waiting-time guarantee implies that, if necessary medical treatment for a publicly insured service is not available within a medically acceptable timeframe, patients may receive treatment at another facility, even outside their home province, at public expense. This change in the location of treatment implies that another surgeon would perform the surgery. However, patients are not always willing to accept re-referral to a provider with a shorter waiting time.^8–12Most other studies investigating patient choice in the context of long waiting times have referred to the choice of an alternative hospital rather than the choice of an alternative surgeon. Even though many patients may indicate that they are willing to travel to another hospital, fewer actually choose such a change.¹¹ In addition to waiting time,^8,13 other factors influencing provider choice are the hospital''s reputation, follow-up care and travel time.^8,13,14 Little is known about what factors patients consider and what information they want and can use when choosing a provider.^11,15We sought to assess patients'' willingness to consider changing to a surgeon with a shorter waiting time for hip and knee arthroplasty. We formulated the following research questions: Would patients consider changing to a surgeon with shorter waiting times? What factors influence patients'' willingness to consider changing surgeons? Do patients waiting for surgery have a different perspective than patients who have already undergone their surgery?     

Determinants of waiting time to third pregnancy using censored linear regression

The intervals between pregnancies have important effects on fertility and maternal and infant health outcomes. This study uses linear regression with censored observation to assess the determinants of the waiting time to third pregnancy. The analysis is applied to data from the Second Malaysian Family Life Survey consisting of 1172 women who had their second delivery ending in a live birth. Contraceptive use, age of the woman, duration of breast-feeding, length of previous pregnancy interval and education of the woman all affect the waiting time to third pregnancy significantly.     

A study of waiting time in an emergency department

A study was undertaken to determine the time spent by 3459 patients in the Emergency Department of the hospital and also to assess whether full-time physician supervision of interns appreciably influenced this time.The study was divided into three phases, each lasting two weeks. Cases were classified into five graded categories of severity. The data so accumulated were subjected to computer analysis, and time intervals relevant to the study obtained.Mean waiting times compared favourably with those recorded in other studies. Full-time physician supervision of interns was found to produce a small, but none the less appreciable, decrease in this time.     

Applying a data duplication technique in linear regression analysis of waiting time to pregnancy

This analysis demonstrates the application of a data duplication technique in linear regression with censored observations of the waiting time to third pregnancy ending in two outcome types, using data from Malaysia. The linear model not only confirmed the results obtained by the Cox proportional hazards model, but also identified two additional significant factors. The method provides a useful alternative when Cox proportionality assumption of the hazards is violated.     

Concordance between vocal and genetic diversity in crested gibbons

Background  

Gibbons or small apes are, next to great apes, our closest living relatives, and form the most diverse group of contemporary hominoids. A characteristic trait of gibbons is their species-specific song structure, which, however, exhibits a certain amount of inter- and intra-individual variation. Although differences in gibbon song structure are routinely applied as taxonomic tool to identify subspecies and species, it remains unclear to which degree acoustic and phylogenetic differences are correlated. To trace this issue, we comparatively analyse song recordings and mitochondrial cytochrome b gene sequence data from 22 gibbon populations representing six of the seven crested gibbon species (genus Nomascus). In addition, we address whether song similarity and geographic distribution can support a recent hypothesis about the biogeographic history of crested gibbons.     

Weak Concordance between Fish and Macroinvertebrates in Mediterranean Streams

Although anthropogenic degradation of riverine systems stimulated a multi-taxon bioassessment of their ecological integrity in EU countries, specific responses of different taxonomic groups to human pressure are poorly investigated in Mediterranean rivers. Here, we assess if richness and composition of macroinvertebrate and fish assemblages show concordant variation along a gradient of anthropogenic pressure in 31 reaches across 13 wadeable streams in central Italy. Fish and invertebrate taxonomic richness was not correlated across sites. However, Mantel test showed that the two groups were significantly, albeit weakly, correlated even after statistically controlling for the effect of environmental variables and site proximity. Variance partitioning with partial Canonical Correspondence Analysis showed that the assemblages of the two groups were influenced by different set of environmental drivers: invertebrates were influenced by water organic content, channel and substratum features, while fish were related to stream temperature (mirroring elevation) and local land-use. Variance partitioning revealed the importance of biotic interactions between the two groups as a possible mechanisms determining concordance. Although significant, the congruence between the groups was weak, indicating that they should not be used as surrogate of each other for environmental assessments in these Mediterranean catchments. Indeed, both richness and patterns in nestedness (i.e. where depauperate locations host only a subset of taxa found in richer locations) appeared influenced by different environmental drivers suggesting that the observed concordance did not result from a co-loss of taxa along similar environmental gradients. As fish and macroinvertebrates appeared sensitive to different environmental factors, we argue that monitoring programmes should consider a multi-assemblage assessment, as also required by the Water Framework Directive.     

Concordance between ecotypes and macroinvertebrate assemblages in Mediterranean streams

1. According to the guidelines of the European Water Framework Directive, assessment of the ecological quality of streams and rivers should be based on ecotype-specific reference conditions. Here, we assess two approaches for establishing a typology for Mediterranean streams: a top-down approach using environmental variables and bottom-up approach using macroinvertebrate assemblages.
2. Classification of 162 sites using environmental variables resulted in five ecotypes: (i) temporary streams; (ii) evaporite calcareous streams at medium altitude; (iii) siliceous headwater streams at high altitude; (iv) calcareous headwater streams at medium to high altitude and (v) large watercourses.
3. Macroinvertebrate communities of minimally disturbed sites ( n  = 105), grouped using UPGMA (unweighted pair-group method using arithmetic averages) on Bray–Curtis similarities, were used to validate four of the five ecotypes obtained using environmental variables; ecotype 5, large watercourses, was not included as this group had no reference sites.
4. Analysis of similarities ( anosim ) showed that macroinvertebrate assemblage composition differed among three of the four ecotypes, resulting in differences between the bottom-up and top-down classification approaches. Siliceous streams were clearly different from the other three ecotypes, evaporite and calcareous ecotypes did not show large differences in macroinvertebrate assemblages and temporary streams formed a very heterogeneous group because of large variability in salinity and hydrology.
5. This study showed that stream classification schemes based on environmental variables need to be validated using biological variables. Furthermore, our findings indicate that special attention should be given to the classification of temporary streams.     

Decreasing waiting time for treatment before and during implementation of cancer patient pathways in Norway

Background: In 2015, Norway implemented cancer patient pathways to reduce waiting times for treatment. The aims of this paper were to describe patterns in waiting time and their association with patient characteristics for colorectal, lung, breast and prostate cancers.Methods: National, population-based data from 2007 to 2016 were used. A multivariable quantile regression examined the association between treatment period, age, stage, sex, place of residence, and median waiting times.Results: Reduction in median waiting times for radiotherapy among colorectal, lung and prostate cancer patients ranged from 14 to 50 days. Median waiting time for surgery remained approximately 21 days for both colorectal and breast cancers, while it decreased by 7 and 36 days for lung and prostate cancers, respectively. The proportion of lung and prostate cancer patients with metastatic disease at the time of diagnosis decreased, while the proportion of colorectal patients with localised disease and patients with stage I breast cancer increased (p < 0.001). After adjusting for case-mix, a patient’s place of residence was significantly associated with waiting time for treatment (p < 0.001), however, differences in waiting time to treatment decreased over the study period.Conclusions: Between 2007 and 2016, Norway experienced improved stage distributions and consistently decreasing waiting times for treatment. While these improvements occurred gradually, no significant change was observed from the time of cancer patient pathway implementation.     

Concordance between phenotypical features and PCR-REA for the identification of Malassezia spp

The genus Malassezia has been recently revised and nowadays includes 11 species that cannot always be differentiated from each other by physiological and morphological tests. This study was aimed to evaluate the correlation between a molecular method and conventional phenotypic features in the identification of Malassezia spp. To achieve this aim, 92 Argentinean clinical strains isolated between 2001 and 2005 were analyzed along with three reference strains (Malassezia furfur CBS 7019, Malassezia sympodialis CBS 7222 and Malassezia slooffiae CBS 7956). By using PCR and restriction enzyme analysis with three different DNA endonucleases (PCR-REA), the molecular method consistently identified all three reference strains and all 92 clinical isolates as follows: 63 M. sympodialis, 18 M. furfur, 10 Malassezia globosa and one Malassezia obtusa. Phenotypic studies undentified 85 clinical isolates and two of the reference strains (total agreement > 91%). In particular for M. sympodialis, M. furfur and M. globosa, the species more frequently involved in human pathology, the agreement ranged between 84 and 96%. This result suggests that phenotypic studies are suitable for the presumptive identification of important Malassezia species in the clinical medical mycology laboratories where molecular methodologies are not available.     

Concordance between locomotor morphology and foraging mode in lacertid lizards

Foraging behaviors exist along a continuum from highly sedentary, ambush foraging, to more continuous searching, or active foraging. Foraging strategies, or modes, are defined based upon locomotor behaviors (e.g. percent time moving, moves per minute). In lizards, traits correlated with ambush and active foraging have been of interest for some time; however, general patterns of correlated evolution between locomotor morphology and locomotor behavior have only recently begun to be quantified. In this study, variation in hindlimb morphology is investigated in a model group of lizard species that vary between active foraging and more sedentary (or mixed) foraging mode. Canonical variates analysis reveals that the two active foraging species occupy similar regions of the morphospace, while the two more sedentary species occupy different regions. The active foraging species have a narrow pelvis with shorter tibia and femora. The more sedentary species have a wide pelvis, long tibia and femora, and slightly longer metatarsals. Phylogenetic patterns of trait variation were examined through ancestral character state reconstruction and show morphological shifts in concert with foraging mode in these species. The observed shifts in locomotor morphology are discussed in light of published data on sprint speed and endurance in these species. Together, the data show that linking morphological variation to variation in stride length and stride frequency is critical to understanding the evolution of locomotor performance. Much more stride length and frequency data are needed among ambush, mixed, and active foraging species because these parameters, and their morphological components, are likely correlated with variation in food acquisition mode.