5 results
Search Results
2. A test for the correct specification of marginal structural models.
- Author
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Sall, Alioune, Aubé, Karine, Trudel, Xavier, Brisson, Chantal, and Talbot, Denis
- Subjects
STATISTICAL models ,TECHNICAL specifications ,WHITE collar workers ,BLOOD pressure ,CAUSAL models ,COMPUTER simulation ,RESEARCH ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,COMPARATIVE studies ,AMBULATORY blood pressure monitoring ,RESEARCH funding ,INDUSTRIAL hygiene - Abstract
Marginal structural models (MSMs) allow estimating the causal effect of a time-varying exposure on an outcome in the presence of time-dependent confounding. The parameters of MSMs can be estimated utilizing an inverse probability of treatment weight estimator under certain assumptions. One of these assumptions is that the proposed causal model relating the outcome to exposure history is correctly specified. However, in practice, the true model is unknown. We propose a test that employs the observed data to attempt validating the assumption that the model is correctly specified. The performance of the proposed test is investigated with a simulation study. We illustrate our approach by estimating the effect of repeated exposure to psychosocial stressors at work on ambulatory blood pressure in a large cohort of white-collar workers in Québec City, Canada. Code examples in SAS and R are provided to facilitate the implementation of the test. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
3. Comparing the attitudes of four groups of stakeholders from Quebec, Canada, toward extending medical aid in dying to incompetent patients with dementia.
- Author
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Bravo, Gina, Trottier, Lise, Rodrigue, Claudie, Arcand, Marcel, Downie, Jocelyn, Dubois, Marie‐France, Kaasalainen, Sharon, Hertogh, Cees M., Pautex, Sophie, Van den Block, Lieve, and Dubois, Marie-France
- Subjects
DEMENTIA patients ,TERMINALLY ill ,ALZHEIMER'S patients ,CAREGIVERS ,GENERALIZED estimating equations ,ASSISTED suicide ,ATTITUDE (Psychology) ,CAPACITY (Law) ,PSYCHOLOGY of caregivers ,COMPARATIVE studies ,DEMENTIA ,RESEARCH methodology ,MEDICAL cooperation ,MEDICAL personnel ,RESEARCH ,RESEARCH funding ,TERMINAL care ,EVALUATION research - Abstract
Objective: The Canadian province of Quebec has recently legalized medical aid in dying (MAID) for competent patients who satisfy strictly defined criteria. The province is considering extending the practice to incompetent patients. We compared the attitudes of four groups of stakeholders toward extending MAID to incompetent patients with dementia.Methods: We conducted a province-wide postal survey in random samples of older adults, informal caregivers of persons with dementia, nurses, and physicians caring for patients with dementia. Clinical vignettes featuring a patient with Alzheimer's disease were used to measure the acceptability of extending MAID to incompetent patients with dementia. Vignettes varied according to the stage of the disease (advanced or terminal) and type of request (written or oral only). We used the generalized estimating equation (GEE) approach to compare attitudes across groups and vignettes.Results: Response rates ranged from 25% for physicians to 69% for informal caregivers. In all four groups, the proportion of respondents who felt it was acceptable to extend MAID to an incompetent patient with dementia was highest when the patient was at the terminal stage, showed signs of distress, and had written a MAID request prior to losing capacity. In those circumstances, this proportion ranged from 71% among physicians to 91% among informal caregivers.Conclusion: We found high support in Quebec for extending the current MAID legislation to incompetent patients with dementia who have reached the terminal stage, appear to be suffering, and had requested MAID in writing while still competent. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
4. Requesting Cesareans without Medical Indications: An Option Being Considered by Young Canadian Women.
- Author
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Gallagher, Frances, Bell, Linda, Waddell, Guy, Benoît, Annie, and Côté, Nathalie
- Subjects
ANALYSIS of variance ,CESAREAN section ,CHI-squared test ,COLLEGE students ,STATISTICAL correlation ,DECISION making ,DELIVERY (Obstetrics) ,FISHER exact test ,RESEARCH methodology ,PATIENTS ,QUESTIONNAIRES ,RESEARCH ,RESEARCH funding ,STATISTICAL sampling ,STATISTICS ,STUDENT attitudes ,VAGINA ,SAMPLE size (Statistics) ,DATA analysis ,MULTIPLE regression analysis ,NULLIPARAS ,DESCRIPTIVE statistics - Abstract
Background: Cesarean delivery on maternal request is a worldwide growing phenomenon. The goal of this study was to describe young nulliparous women's attitudes about cesarean delivery on maternal request. Methods: A total of 140 nulliparous women in Canada aged between 18 and 24 years and attending school from the vocational ( n = 53), college ( n = 61), and university ( n = 18) levels ( n = 8 other) participated in the survey. The self-administered questionnaire consisted of 23 open-ended questions. The outcome measure was the participant's attitude toward cesarean delivery on maternal request. Descriptive, bivariate, and multiple regression analyses were performed. Results: Many of the respondents (63%) had previously heard about cesarean delivery on maternal request, and of these women 28.6 percent had a favorable attitude toward the procedure. Sociodemographic variables were not associated with participants' attitudes toward cesarean delivery on maternal request except for place of residence and type of professional preferred for pregnancy care. Thinking that vaginal birth was more painful than cesarean delivery ( p = 0.012) and had more consequences for the mother ( p < 0.001) were related to a positive attitude toward cesarean delivery on maternal request. A positive attitude by peers was also associated with participants' favorable attitude toward cesarean delivery on maternal request ( p < 0.001). The overall predictive success of the model was 66.5 percent. Conclusions: Young women are spreading the word about cesarean delivery on maternal request and may influence one another about their preferred delivery method. During prenatal visits practitioners need to address women's fear of vaginal birth and its consequences for the mother, counseling, and women's understanding of the consequences of cesarean delivery. This study supports the urgent need to systematically document cesarean delivery on maternal request as a medical procedure and to study its prevalence and related factors. (BIRTH 39:1 March 2012) [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
5. Checklists: An Under-Used Tool for the Inventory and Monitoring of Plants and Animals.
- Author
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Droege, Sam, Cyr, André, and Larivée, Jacques
- Subjects
RESEARCH ,INVENTORY control - Abstract
Checklists are widely used to catalog field observations of plants and animals. We used 25 years of bird checklist data from the Études des Populations d'Oiseaux du Quebec program to examine the ability of checklists to produce reliable conservation, management, and ecological information. We found that checklists can provide reliable information on changes in bird populations, phenology, and geographic and climate abundance patterns at local, regional, and continental scales. Professional and amateur conservation groups that need to develop extensive monitoring programs should take advantage of the fact that checklists, unlike other time‐consuming and expensive techniques, can be used to detect large‐scale changes in an entire community of species. Lastas de Chequeo: Una Herramienta Subutilizada en el Inventario y Monitoreo de Plantas y Animales Las listas de comprobación son ampliamente usadas para catalogar observaciones de plantas y animales en el campo. Utilizamos datos de listas de chequeo de aves de 25 años del programa de Estudios de Poblaciones de Aves de Quebec para examinar la habilidad de las listas para generar información confiable de conservación, manejo y ecología. Encontramos que las listas proveen información confiable sobre cambios en las poblaciones de aves, fenología y patrones de abundancia geográfica y climática a escala local, regional y continental. Grupos de conservacionistas profesionales y aficionados que necesitan desarrollar programas de monitoreo extensivos deberían tomar ventaja del hecho de que las listas, a diferencia de otras técnicas caras y de uso extensivo de tiempo, pueden ser usadas para detectar cambios de gran escala en una comunidad entera de especies. [ABSTRACT FROM AUTHOR]
- Published
- 1998
- Full Text
- View/download PDF
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