107159 research outputs found
Sort by
Conditional likelihood ratio test with many weak instruments
No full textThis article extends the validity of the conditional likelihood ratio (CLR) test developed by Moreira (2003, Econometrica 71(4), 1027-–1048) to instrumental variable regression models with unknown homoskedastic error variance and many weak instruments. We argue that the conventional CLR test with estimated error variance loses exact similarity and is asymptotically invalid in this setting. We propose a modified critical value function for the likelihood ratio (LR) statistic with estimated error variance, and prove that our modified test achieves asymptotic validity under many weak instruments asymptotics. Our critical value function is constructed by representing the LR using four statistics, instead of two as in Moreira (2003, Econometrica 71(4), 1027-–1048). A simulation study illustrates the desirable finite sample properties of our test
Brothers, sisters, and support to older parents: separate spheres across and within support types?
No full textAdult children, especially sons, are often considered a linchpin of support to older parents in many patriarchal societies. We develop a model of transfers from adult children to older parents as existing in separate spheres depending on the child’s gender and type of transfer. Using data from the China Health and Retirement Longitudinal Study, we find strong evidence of such differentiation. Coresidential support comes almost exclusively from sons as do large transfers, while daughters are more likely to make smaller transfers. Interestingly, crowding-out of financial transfers by siblings occurs primarily within gender: sons give less when they have more brothers but not when they have more sisters, and daughters give less when they have more sisters but not when they have more brothers. This pattern is present for both in-kind and cash transfers, suggesting that support from adult children may not be substitutable between genders, even for relatively fungible currencies
Enhanced recovery pathway for older people with hip fracture and cognitive impairment in acute hospitals: the PERFECTED research programme including an RCT
No full textBackground Hip fracture has a substantial impact on the health, well-being and independence of patients and their families. In the 12 months after fracture, patients are at increased risk of cognitive and functional decline, admission to long-term care institutions and higher mortality. People with cognitive impairment are among the most vulnerable in acute hospital settings. They have lower short-term survival, with 24% mortality during admission. They are susceptible to suboptimal and inconsistent care standards that contribute to cognitive deterioration, increase risk of postoperative complications, prolong their length of stay and cause loss of independence. Objectives Establish best-practice from a systematic review of literature, observations of practice, perspectives of service users, carers, healthcare professionals, health service managers and experts in the field. Design the care pathway. Determine cultural/organisational changes necessary to implement and maximise adherence to the enhanced recovery pathway in hospital settings. Develop staff training and a training manual. Undertake a feasibility randomised controlled trial and collect outcomes to identify potential clinical and cost-effectiveness of the enhanced recovery pathway. Disseminate the findings and develop a definitive trial bid. Design A programme to develop an enhanced recovery pathway for people with hip fracture and cognitive impairment, tested for implementation and refined in the clinical environment. This refined enhanced recovery pathway was then tested in a feasibility study in 10 hospitals across the UK. Setting Acute care. Participants Hospital staff, people with cognitive impairment and hip fracture, carers and national and international experts in hip fracture or dementia. Interventions An enhanced recovery care pathway with checklist and an implementation process. Main outcome measures Mortality, patient and carer quality of life, cognition, activities of daily living. Data sources Clinical trial. Results A total of 284 participants were recruited, 132 to the PEFECT-ER intervention arm and 150 to the control arm, had good retention in the study and provided data for analysis. There was no evidence of any systematic between group difference at either the point of discharge from hospital or at 1-month follow-up. However, at 3 months, a relatively small effect of around one quarter of a standard deviation (0.071 units), was evidenced with respect to the health-related quality of life of the patient based on the EuroQol-5 Dimensions, five-level version by proxy in the intervention group (95% confidence interval 0.018 to 0.124; p = 0.009). A difference of 0.099 units in favour of the intervention group was also seen at the 6-month follow-up (95% confidence interval 0.001 to 0.198; p = 0.047). ‘Timed Up and Go’ and the Suitable Informant EuroQol-5 Dimensions, five-level version showed a no statistically significant difference except the model for length of stay. Those individuals in the intervention group had significantly longer lengths of stay, on average 1.22 times longer (95% confidence interval 1.02 to 1.45; p = 0.028). Mortality was similar in both groups, with a 6.1% mortality rate by 30 days post surgery. The process evaluation found that patients and carers were unable to comment on receiving the intervention. Limitations This was a feasibility study and was not designed as a definitive evaluation of the intervention. Lack of direct access to patient notes meant that researchers were unable to verify the Perioperative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia-Enhanced Recovery check listing results. The relationship between changes in documentation of practices and changes in care practices is also unclear. Patient and suitable informants did not assist understandings of implementation, mechanisms of action or experiences of interacting with the intervention. Client Services Receipt Inventory data collection burden was an issue. Conclusions The Perioperative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia-Enhanced Recovery feasibility trial demonstrated mean recruitment of 1.87 participant per centre per month. Retention at 1 month was over 80% and at 6 months approximately 50%. This information is useful for those wishing to design a definitive clinical trial. Although 30-day mortality was the same in both groups, the potential for reduction, by Perioperative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia-Enhanced Recovery being implemented, exists from cumulatively increased good practices across a range of care domains. To compare longer-term survival of patients who received the intervention, we would recommend measuring 3-month (110-day) mortality in addition to 30-day mortality. These data are readily available from National Hip Fracture Database and are thus ideal for efficient trial design. Client Services Receipt Inventory can be reduced for a definitive trial, removing equipment questions and some community health use questions. Qualitative interviews with Perioperative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia-Enhanced Recovery trial patient and carer should not take place. Future work Work to date shows that the intervention pathway for Perioperative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia-Enhanced Recovery required considerable input from champions for delivery. We are exploring further funding options to facilitate work to understand these mechanisms and further test, pilot and produce the Perioperative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia-Enhanced Recovery manual. Trial registration This trial is registered as Current Controlled Trials ISRCTN99336264. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research Programme (NIHR award ref: DTC-RP-PG-0311-12004) and is published in full in Programme Grants for Applied Research; Vol. 13, No. 1. See the NIHR Funding and Awards website for further award information
Co-occurrences of forms of child undernutrition in India: insights from the National Family Health Survey
No full textBackground: The composite index of anthropometric failure (CIAF) studies co-occurrences of three forms of child undernutrition: stunting (S), wasting (W), and underweight (U). This study attempts to modify it through the inclusion of a fourth form of undernutrition, that is, anaemia (A), serving as a proxy for micronutrient deficiencies among under-five children in India. Methods: Spatial and multivariate analyses were employed to analyse the co-occurrences of child undernutrition with reference to the child’s and mother’s characteristics using National Family Health Survey (NFHS) data. Results: The modified index of “CIAF + Anaemia” identified thirteen manifestations of child undernutrition in India, the most prevalent co-occurrence being “only anaemia” (30%), followed by a triple burden or co-occurrence of stunting, underweight, and anaemia (SUA) (12%). The prevalence of the quadruple burden of child undernutrition (SWUA) was found to be highest in the states of Jharkhand and Gujarat (7%). A higher likelihood of the co-occurrence of “SUA” was observed among underweight mothers (16%), whereas that of “only anaemia” was observed more among overweight mothers (35%) compared to their counterparts. The co-occurrences “SUA” and “SWUA” were found to be moderately clustered among the districts of India. Conclusions: Overall, the study reinforces the need for early identification and specialised treatment approaches for children burdened with multiple forms of undernutrition to prevent its scarring effect
Technology in UK Conservative Party rhetoric, 1979–2019: an integrative dual-method conceptual and ideological analysis
No full textThis article presents an integrative dual-method conceptual and ideological analysis of British Conservative Party rhetoric from 1979 to 2019, focusing on the concept of “technology”. It demonstrates the Conservatives have embraced “technology” rhetoric, and increasingly done so more than Labour and the Liberal Democrats. The article contends that “technology” rhetoric provides a window into the fluid process of ideological adaptation in Conservative Party politics. It contributes to the subdiscipline of British rhetorical studies in three ways: (1) methodologically, through development of a novel, theoretically informed integrative approach to mixed quantitative-qualitative rhetorical analysis; (2) empirically, through original analysis of a new composite corpus of British political rhetoric; and (3) theoretically, by interrogating use of the versatile political concept “technology” in Conservative Party rhetoric and ideology
What drives immigrant inequalities in career growth in the age of mass migration?
No full textThis article examines the association between modernization and career growth of American men and European immigrants, focusing on heterogeneity along ancestry, ethnicity, and early-career class position. Analyses rely on datasets built with individual-level linked historical Censuses (1901–1940), which longitudinally map socio-economic indices of full occupational careers of late-nineteenth-century population birth cohorts (1884–1891). Modernization is measured by time-variant and metropolitan area-specific indicators of key industries, employment chances, domestic migration, and urbanicity. Contradicting modernization theory and the logic of industrialism, results demonstrate that macroeconomic opportunity structures do not explain differences in career growth curves of first- and second-generation immigrants in comparison to White men with US-born parents. Instead, we argue that structural ethnic cleavages, in combination with early-career class allocation, account for most of the observed immigrant variation in intragenerational mobility. We also find that the career growth curves of second-generation immigrants from Ireland, the Nordic countries, and Russia, in particular, far exceed those of multi-generational American men, but only if they started their careers in the working-class rather than the agricultural sector
The civic participation in China survey: key trends in philanthropic and voluntary activities
No full textThe Civic Participation in China Survey (CPCS) is a nationwide, randomized online study of urban residents, conducted in four waves between 2018 and 2024. It examines philanthropic and volunteering activities, as well as perceptions of citizenship and civic engagement. This article outlines the survey’s methodology and analyzes trends in civic participation in mainland China, exploring connections to democratization and good governance. The study highlights complex dynamics in volunteerism under authoritarian rule. Volunteers acquire ‘citizen skills’ to navigate social problem solving, but generally reinforce state authority rather than challenge it. By 2024, respondents increasingly believed the state could handle crises independently, reflecting rising political centralization and performance legitimacy under Xi Jinping. Distinctions between state-led and citizen-led volunteerism emerge, with skepticism toward the authenticity of state-driven efforts. While civic participation fosters social trust and governance improvements, resistant ‘bad citizens’ reveal challenges in promoting philanthropy. These findings emphasize China’s delicate balance in managing civil society
Lessons-learnt from growth pole strategies in the developing world
No full textGrowth pole policies, despite claims otherwise, remain highly relevant and widely applied across the globe. Over recent years, they have emerged as a key instrument in development strategies, often under different names. However, the concept of growth pole policies has remained somewhat elusive, and few studies have systematically evaluated their effectiveness. This has resulted in a lack of comprehensive analysis, particularly regarding their viability and impact in developing countries. The main aim of this paper is to examine the key advantages and challenges involved in the design and implementation of growth pole policies. It outlines the theoretical foundations of these policies and reviews their recent application in various developing regions. Ten case studies were analysed to identify six key lessons, differentiating between successful initiatives —those that met their objectives— and less successful ones
Barriers to women in accessing healthcare in the UK – a review
No full textThis paper examines the persistent gender health gap in the United Kingdom, highlighting disparities in healthcare access and outcomes between men and women. While women report higher morbidity rates across a range of conditions compared to men, healthcare research have historically been structured around male-centric models, leading to diagnostic delays, inadequate treatment, and unmet healthcare needs. The study explores the socioeconomic, systemic, and behavioural roots of these disparities, and consequences, which include reduced productivity and labour market inefficiencies. Key factors contributing to the gender health gap – such as caregiving responsibilities, financial constraints, workplace policies, and structural biases in medical research – are analysed. The effectiveness of the UK Women’s Health Strategy (2021) is critically evaluated, focusing on policy interventions such as the expansion of women’s health hubs, mental health support, and workplace reforms. Despite these measures, challenges persist, particularly in addressing intersectional inequalities affecting women from disadvantaged and minority backgrounds. The paper concludes by emphasising the need for a more comprehensive policy approach that integrates healthcare access with broader economic and social reforms to achieve gender equity in health outcomes
Geographies of place-affective trans-becoming: an ethnography of drag in Istanbul
No full textThis paper presents an ethnographic study of Dudakların Cengi, a drag and queer performing event series in Istanbul, where a community of predominantly trans and non-binary performers create a place of collectivity for self-expression and gender exploration. Drawing on trans and feminist geographical perspectives, we examine how the participants use drag as a way of creating shared imagery, exploring themselves in relation to gender, and producing places in the city through their performances beyond the stage. We conceptualise Dudakların Cengi as a place-as-becoming that emerges from the intensities of social ties, flows, narratives, and sensations. We also propose a geographical understanding of gendered embodiment to account for transness in new spatial ways that enable the interrogation of phenomena that do not immediately yield their relevancy to the category of gender. The data was collected in over three years of presence within the field through situated and reflexive participant observation, informal conversations, in-depth interviews, and the participants’ written narratives. We analyse the data with iterative cycles of grounded theory completed with continuous collaborative theorisation with participants. Through this collaborative theorisation, a series of concepts emerge that explain the experiences of the participants: opening drag, collectivising the stage, socialising in drag, urban navigation of gender, and an unfolding sense of drag. Together, these concepts help explain a novel understanding of place-affective trans-becoming