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There is the potential for high-dimensional information about patients collected in clinical trials (such as genomic, imaging, and data from wearable technologies) to be informative for the efficacy of a new treatment in situations where only a subset of patients benefits from the treatment. The adaptive signature design (ASD) method has been proposed for developing and testing the efficacy of a treatment in a high-efficacy patient group (the sensitive group) using genetic data. The method requires selection of three tuning parameters which may be highly computationally expensive. We propose a variation to the ASD method, the cross-validated risk scores (CVRS) design method, that does not require selection of any tuning parameters. The method is based on computing a risk score for each patient and dividing them into clusters using a nonparametric clustering procedure. We assess the properties of CVRS against the originally proposed cross-validated ASD using simulation data and a real psychiatry trial. CVRS, as assessed for various sample sizes and response rates, has a substantial reduction in the computational time required. In many simulation scenarios, there is a substantial improvement in the ability to correctly identify the sensitive group and the power of the design to detect a treatment effect in the sensitive group. We illustrate the application of the CVRS method on the psychiatry trial.

Fifty years ago, William J. Goode published World Revolution and Family Patterns, a highly influential study of international family change. Goode's main thesis, that, owing to industrialization, family patterns around the world would come to resemble the mid-twentieth-century Western conjugal family, was incorrect. For one thing, that model collapsed in the West soon afterward. But Goode's secondary hypotheses have proven to be correct in at least some regions of the world: that parents' control over their children's family lives would decline; and that the spread of the ideology of the conjugal family would occur even in countries where extensive industrialization had not taken place. Moreover, it is worth understanding why Goode was sometimes incorrect and what forces (such as globalization) he did not foresee. It is also worth examining more recent writings on world family change by leading scholars. This article provides a reconsideration of the book's impact a half-century after it appeared.

In this article, we examine variations in low-income mothers' patterns of intermittent cohabitation and the voluntary and involuntary nature of these unions. Intermittent cohabitation involves couples living together and separating in repeating cycles. Using Three-City Study ethnographic data, we identified 45 low-income mothers involved in these arrangements, 18 of whom resided with their children's fathers occasionally while saying that they were not in a cohabiting relationship. We term such relationships living together apart (LTA). Data analysis revealed that distinct patterns of voluntary and involuntary separations and reunifications characterized intermittent cohabitation and LTA and that these relationships were shaped by the bonds that shared parenting created and the economic needs of both parents. We argue that these dimensions may explain some disparate accounts of cohabitation status in low-income populations. They also demonstrate previously unexplored diversity in cohabiting relationships and suggest further questioning contemporary definitions of families.

We investigate the neighborhood contexts in which low-income families negotiate the new environment created by welfare reform. Using data from the Three-City Study and U.S. Census, we follow 1,059 low-income women from 1999 to 2005tracking their neighborhood quality, employment, and welfare use. Despite living in similar neighborhoods in 1999, women who left welfare experienced larger reductions in neighborhood disadvantage than women who remained on welfare. Likewise, women who left welfare with employment achieved larger increases in neighborhood quality than those who left welfare without work; the latter experiencing neighborhood change no different than those who stayed on welfare. Results indicate that neighborhood conditions are, at minimum, associated with welfare outcomes. We evaluate whether improvements in residential contexts facilitate transitions to economic self-sufficiency, but also test the reverse possibility. Findings suggest that neighborhood quality increases after women leave welfare, though we cannot reject the possibility that better neighborhoods lead to better outcomes.

Demographic trends in the 2000s showed the continuing separation of family and household due to factors such as childbearing among single parents, the dissolution of cohabiting unions, divorce, repartnering, and remarriage. The transnational families of many immigrants also displayed this separation, as families extended across borders. In addition, demographers demonstrated during the decade that trends such as marriage and divorce were diverging according to education. Moreover, demographic trends in the age structure of the population showed that a large increase in the elderly population will occur in the 2010s. Overall, demographic trends produced an increased complexity of family life and a more ambiguous and fluid set of categories than demographers are accustomed to measuring.

Recent scholarship concerning low rates of marriage among low-income mothers emphasizes generalized gender distrust as a major impediment in forming sustainable intimate unions. Guided by symbolic interaction theory and longitudinal ethnographic data on 256 low-income mothers from the Three-City Study, we argue that generalized gender distrust may not be as influential in shaping mothers' unions as some researchers suggest. Grounded theory analysis revealed that 96% of the mothers voiced a general distrust of men, yet that distrust did not deter them from involvement in intimate unions. Rather, the pivotal ways mothers enacted trust in their partners were demonstrated by 4 emergent forms of interpersonal trust that we labeled as suspended, compartmentalized, misplaced, and integrated. Implications for future research are discussed.

In her informative analysis of the content of magazine and journal articles, Usdansky (2009) finds that depictions of single-parent families resulting from divorce became less critical during the 20th century, but depictions of single-parent families resulting from a nonmarital birth remained just as critical as in the early 1900s. By the end of the century, she writes, Americans showed an "ambivalent acceptance" of divorce-based single parents while still finding fault with nonmarital births. What explains the different responses to divorce and nonmarital childbearing? Usdansky suggests that the relatively greater acceptance of divorce-based single parenthood may have resulted from its higher prevalence compared to nonmarital-birth-based single parenthood. Because divorce was the more common route to single parenthood, she hypothesizes, writers and social scientists - an increasing share of whom were themselves divorced - may have been reluctant to criticize divorced single parents, whereas they may have been less reluctant to criticize mothers who had children outside of marriage. Although the commonness-of-divorce explanation is plausible, it is at best incomplete. It is true that rates of divorce increased throughout most of the 20th century and that the rise occurred in all social classes (although divorce remained more common among the less educated; Cherlin, 1992). But the percentage of children born outside of marriage also increased greatly, rising from 4% in the 1950s to 33% in 2000 (U.S. National Center for Health Statistics, 2005). Both divorce and nonmarital childbearing became much more common, in other words, yet the increases in divorce were accepted less critically by Americans. Why is that? I would argue that the less critical view of divorce was able to draw upon a long tradition in American culture of ambivalence toward divorce, whereas there is no such tradition concerning nonmarital childbearing. The differing depictions of divorce and nonmarital childbearing have roots in American values and law that extend back to the colonial era - back to a time when divorce rates, although worrisome to observers at the time, were tiny compared to today. From that era forward to the mid-20th century, Americans have shown a moral and legal ambivalence toward divorce. In contrast, Americans at all times prior to the mid20th century showed a moral and legal rejection of nonmarital births. Examining the historical picture may help us place Usdansky' s late-20thcentury findings in context. Divorce in the American Past The New England colonists brought to the New World a Protestantism formed in dissension fromboth the Catholic Church and the Church of England. Part of that dissension concerned divorce. The Catholic Church did not allow divorce, although if a marriage had been formed in a way that violated church rules, it could be annulled, that is, treated as if it never happened. For instance, if either partner had been forced to consent to the marriage, it was invalid under Church rules and subject to annulment. There was, consequently, no tradition of divorce in Catholic Europe. Except for a brief period during the French revolution, for example, France did not legalize divorce until 1884 (Phillips, 1988). The Church of England also did not allow divorce. When Pope Clement denied Henry VTJJ the annulment he desired in order to marry Ann Boleyn, Henry withdrew his kingdom from the Catholic Church and established the Church of England, also known as the Anglican Church (and later, in the United States, as the Episcopalian Church). Yet Henry VJJJ never divorced anyone. He either annulled his marriages or simply beheaded his wives. Divorce remained illegal in England, except by Act of Parliament, until 1857 (Phillips). The New England colonists, however, followed the theology of John Calvin, who, in turn, based much of his thought on the writings of Martin Luther. As part of his break from Catholicism, Luther proposed that divorce, while always deplorable, ought to be allowed in two circumstances: adultery or desertion. …

Using survey data on low-income mothers in Boston, Chicago, and San Antonio (n = 1,722) supplemented with ethnographic data, we test 3 propositions regarding mothers’ attitudes toward childbearing, marriage, and divorce. These are drawn from Edin & Kefalas (2005) but have also arisen in other recent studies. We find strong support for the proposition that childbearing outside of marriage carries little stigma, limited support for the proposition that women prefer to have children well before marrying, and almost no support for the proposition that women hesitate to marry because they fear divorce. We suggest that mothers’ attitudes and preferences in these 3 domains do not support the long delay between childbearing and marriage that has been noted in the literature. Throughout, we are able to study attitudes among several Hispanic groups as well as among African Americans and non-Hispanic Whites.

Through health sector reform in developing countries, Ministries of Health have sought to enhance health care through greater community governance and improved management effectiveness in their public hospitals. In this paper, we present a partnership-mentoring model for enhancing management capacity that has been piloted in Ethiopia and may be useful in other developing countries. The model included needs assessment and baseline evaluation using a hospital management indicator checklist, deployment of 24 Fellows (US and international hospital administrators) for 1 year to work as mentors with hospital management teams in 14 Ethiopian hospitals, continuing didactic and practical training in quality improvement methods for hospital management teams, and 24 management improvement projects to be completed during the year with plans for replication more broadly as appropriate. Surveys of Fellows and Ethiopian managers within the first quarter of onsite activity found high levels of trust in one another's abilities and intent to implement changes. The partnership-mentoring model promotes sustainability and may provide other countries with approaches for improving the quality of hospital care through improved hospital management.

Alveolar Rhabdomyosarcoma (ARMS) patients carrying a chromosomal translocation of PAX3 and FOXO1 have the highest mortality rates, indicating the importance of understanding how this transcription ...

Ever since Carol Stack's influential study of low-income African American families in "The Flats" was published in 1974, the ethnographic literature on single mothers has focused on alliance and reciprocity: the ways in which single mothers build supportive linkages and maintain them (Stack, 1974). Stack conducted her study before West and Zimmerman (1987) made "doing" the favorite metaphor of sociologists of gender and family, but there is no doubt that she was describing how single mothers "do" family. Researchers have studied how common these networks are, the conditions under which they form, and the barriers to forming them. These questions all assume that single mothers seek to extend their networks by exchanging goods and services whenever possible. Margaret K. Nelson's thought-provoking and well-written article demonstrates, however, that creating ties also involves creating boundaries. In other words, the networks of single mothers are not seamless, free-flowing arrangements in which roles are interchangeable but rather partnerships with limits and tensions, at least among rural Whites. This may seem like an unremarkable statement once it is made, but it suggests a perspective that few sociologists have taken. Perhaps because the needs of many single mothers and their children are so great, sociologists have focused on how mothers solve the social problem of meeting those needs. Indeed, much of Nelson's (2005) book-length treatment of her Vermont ethnography addresses this problem. That the solutions may have their own problems has not been much remarked upon. The exception may be Stack herself, who described how participation in a sharing network made it difficult for mothers to amass enough resources-such as enough money for a security deposit or a second-hand car-to leave the network and set out on their own or with new partners. THE NORM OF NONINTERFERENCE But the idea of tension between mothers and grandmothers over issues of discipline and control-over who has the authority to say "no" to children-was absent in Stack's book and most of the ensuing literature. I wonder if that may be because much of that literature, including Stack's work, focused on African American families, whose ideas about who gets to say no may differ from European-American families. When Frank Furstenberg and I conducted a study of American grandparents in the 1980s, we found that Black grandparents were routinely assumed to have authority over their grandchildren in ways most White grandparents did not (Cherlin & Furstenberg, 1992). White grandparents and their adult children subscribed to what we called the "norm of noninterference." Over and over, White grandparents told us that they were loath to "interfere" with how their children were raising their grandchildren. One grandmother said: Quite often it is said that the mother and the father would still be together if the mother-in-law had not interfered. So I feel that situations between a mother and a father are very, very touchy situations. I feel that the mother-in-law has to be very careful, very tactful, how she gets in the picture, if she gets in the picture at all. I feel that unless it's ... a problem developing into a situation where the daughter or the granddaughter's life may be at stake, or something detrimental might be done to them, I think if possible the grandparent should stay out of it. (Cherlin & Furstenberg, 1992, p. 57) For these grandparents, a boundary around parental authority clearly existed, and the worst thing they could do was to cross it. Instead of playing the role of authority figures, White grandparents talked enthusiastically of being loving companions. They had raised their children, paid their dues, and now, they said, it was time to enjoy their grandchildren while leaving their upbringing to the parents. But this boundary was, if not absent, then at the least more permeable for Black grandparents, who rarely voiced fears of "interfering. …

This article argues that marriage has undergone a process of deinstitutionalization—a weakening of the social norms that define partners’ behavior—over the past few decades. Examples are presented involving the increasing number and complexity of cohabiting unions and the emergence of same-sex marriage. Two transitions in the meaning of marriage that occurred in the United States during the 20th century have created the social context for deinstitutionalization. The first transition, noted by Ernest Burgess, was from the institutional marriage to the companionate marriage. The second transition was to the individualized marriage in which the emphasis on personal choice and self-development expanded. Although the practical importance of marriage has declined, its symbolic significance has remained high and may even have increased. It has become a marker of prestige and personal achievement. Examples of its symbolic significance are presented. The implications for the current state of marriage and its future direction are discussed. A quarter century ago, in an article entitled ‘‘Remarriage as an Incomplete Institution’’ (Cherlin, 1978), I argued that American society lacked norms about the way that members of stepfamilies should act toward each other. Parents and children in first marriages, in contrast, could rely on well-established norms, such as when it is appropriate to discipline a child. I predicted that, over time, as remarriage after divorce became common, norms would begin to emerge concerning proper behavior in stepfamilies—for example, what kind of relationship a stepfather should have with his stepchildren. In other words, I expected that remarriage would become institutionalized, that it would become more like first marriage. But just the opposite has happened. Remarriage has not become more like first marriage; rather, first marriage has become more like remarriage. Instead of the institutionalization of remarriage

This study estimates the effect of welfare reform on adolescent behaviors using a difference-indifferences approach. After defining the pre-reform and reform cohorts and considering the life course development of adolescent behavior by following each cohort from age 14 to age 16 we compare the welfare-target and nontarget populations in the two cohorts. The difference-in-differences estimates are obtained using an event history model. Our analysis suggests that welfare reform has not reduced teenage fertility and school dropout. We find modest evidence that welfare reform is associated with higher risk of teenage births for girls in welfare families and higher risk of school dropout for girls in poor families. A combination of a difference-in-differences approach and a life course perspective can be a useful way to delineate the effect of societal-level change on family phenomena. (authors)

Variations in state welfare policies in the reform era may affect adolescents through two mechanisms: A competing labor market hypothesis posits that stringent state welfare policies may reduce adolescent employment; and a signaling hypothesis posits that stringent welfare policies may promote enrollment. To test these hypotheses, we use a dynamic joint model of adolescents' school enrollment and formal employment, separating state welfare policies from non-welfare state policies, state labor market conditions, and unobserved state characteristics. Longitudinal data from the NLSY97 on adolescents aged 14 to 18 and various state data sources over the period 1994–1999 support the competing labor market effect but not the signaling effect. In particular, lower-income dropouts suffer more severely from fewer labor market opportunities when state welfare policies are more stringent, which indicates that welfare reform may compromise work opportunities for lower-income dropouts. © 2004 by the Association for Public Policy Analysis and Management.

Purpose: To describe characteristics, attitudes, and communications of nurses regarding hospice and caring for terminally ill patients. Design: A cross-sectional study of randomly selected nurses (n=180) from six randomly selected Connecticut community hospitals was conducted in 1998 and 1999. Methods: Hospice-related training, knowledge and attitudes, demographic and practice characteristics, and personal experience with hospice were assessed with a self-administered questionnaire (response rate=82%). Logistic regression was used to model the effects of hospice-related training, knowledge, and attitudes on these outcomes, adjusting for personal experience and other characteristics of nurses. Findings: Characteristics associated with discussion of hospice with both patients and families included greater religiousness, having a close family member or friend who had used hospice, and reporting satisfaction with hospice caregivers. Greater self-rated knowledge was significantly associated with discussion of hospice with patients. Attitudinal scores indicating greater comfort with initiating discussion and greater perceived added benefit of hospice were significantly associated with discussion with patients' families. Conclusions: Nurses' discussion of hospice with terminally ill patients and their families are related to the potentially modifiable factors of self-rated knowledge and attitudes revealing comfort with discussion and perceived benefit of hospice care.

Alveolar Rhabdomyosarcoma (ARMS) patients carrying a chromosomal translocation of PAX3 and FOXO1 have the highest mortality rates, indicating the importance of understanding how this transcription factor influences gene expression. Many studies have been performed to identify PAX3-FOXO1 target genes and while some overlapping gene sets have been identified, there exists great variation in the genes identified. The search for these target genes is hampered by a lack of understanding of the full DNA-binding capabilities of this fusion protein. We have examined the truncated FOXO1 DNA-binding domain in PAX3-FOXO1 and found that it retains activity, but does not have the same sequence specifications for binding as full length FOXO1. A search of 1463 PAX3-FOXO1 putative binding sites revealed that 37% contained both a PAX3 paired domain and FOXO1 recognition sequence within close proximity. The sequences containing the dual motif mapped to 160 genes with the most interesting of these known to be regulated by P...

A theorem of Hall extends the sylow theory to π-subgroups of a finite solvable group for any set of primes π. This theorem has been generalized to solvable periodic linear groups [ 21 ] and to other similar settings [ 19 ]. We consider the same problem in a model-theoretic context. In model theory, the study of ω-stable groups generalizes the classical theory of algebraic groups in the case of a algebraically closed base field, and is closely connected with certain aspects of the general structure theory developed by Shelah, particularly in connection with the more geometric theory of Zilber, Buechler, Hrushovski, Pillay, and others. In this connection, the primary concern is with the structure of simple ω-stable groups of finite rank. One way to approach the study of ω-stable groups is by generalizing some of the methods of finite group theory to this setting. One anticipates that character theory and counting arguments will not be available, though one would hope to recover much of the ‘local analysis’. Unfortunately there is as yet no very satisfactory sylow theory for ω-stable groups, except for the prime 2 [ 4 ]. One of us (Nesin) noticed initially that there is a sylow theorem for connected solvable ω-stable groups of finite Morley rank; this prompted us to look for a generalization along the following lines.

We prove that for C a finite set of cycles, there is a universal C-free graph if and only if C consists precisely of all the odd cycles of order less than same specified bound. The sufficiency of this condition was proved by Komjath, Mekler, and Pach (Israel J. Math64 (1988), 158–168). © 1996 John Wiley & Sons, Inc.

No countable Cn-free graph contains every countable Cn-free graph as a subgraph, for n ≧ 4. For n = 4, this was proved earlier by J. Pach.