Conclusion. The missing data is a common problem in clinical trial. The methodology development is urgently needed to detect the difference of two treatments drug in patient quality of life. The modified pattern mixture model incorporating generalized estimating equation method or multiple imputation method provides a solution to tackle the non-ignorable missing data problem. Different clinical trials with various treatment schedules, missing data patterns will be formed. Further studies are needed to study the optimal choice of patterns under the methods. / Introduction. Health-related Quality of Life (HRQoL) has now been included as a major endpoint in many cancer clinical trials in addition to the traditional endpoints such as tumor response and survival. It refers to how illness or its treatment affects patients' ability to function and whether it induces symptoms. Toxicity, progression and death are common outcome affecting patient's QOL in cancer trial. Since this type of missing data are not occurred at random and are called non-ignorable missing data, conventional methods of analyses are not appropriate. It is important to develop general methods to deal with this problem so that treatment effectiveness for improving patient's QOL or those with serious side effect that is detrimental to patient's QOL can be identified. / Methods. The generalized estimating equation based on modified pattern mixture model is constructed to deal with non-ignorable missing data problem. We conducted a simulation study to examine performance of the model for different types of data. Two scenarios were examined. The first case assumes that two groups have quadratic trend but with different rates of change. The second case assumes that one group has linear trend with time while the other group has quadratic trend with time. Moreover, the second methodology is the multiple imputation based on modified pattern mixture model. The main idea is to resample the data within each pattern to create the full data set and use the standard method to analyze the data. Comparison between two methods was carried out in this study. / Recently, joint models for the QOL outcomes and the indicators of drop-outs are used in longitudinal studies to correct for non-ignorable missing. Two broad classes of joint models, selection model and pattern mixture model, were used. Most of the methodology has been developed in the selection model while the pattern mixture model has attracted less attention due to the identifiability problem. Although pattern mixture model has its own limitation, a modified version of this model incorporating Generalized Estimating Equation can be used in practice. / Result. The power of generalized estimating equation alone is higher than pattern mixture model when the missing data is missing at random. Moreover, the bias of generalized estimating equation is less than that of pattern mixture model when the missing data is missing at random. However, the pattern mixture model performs well when the missing data is missing not at random. On the other hand, the modified pattern mixture model has higher power than the standard pattern mixture model if one group has quadratic trend and other group has linear trend. However, the power of modified pattern mixture model is similar or worst than the standard when the data is both quadratic trends with different rates of change. On the other hand, the results of multiple imputation based on modified pattern mixture model were similar but the power was less than the generalized estimating equation model. / Mo Kwok Fai. / "August 2006." / Adviser: Benny Zee. / Source: Dissertation Abstracts International, Volume: 68-09, Section: B, page: 6051. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 91-93). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (M.S.)--University of Michigan, 2000. / Running title: Measurement of quality-of-life in heart failure. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2000. / Running title: Measurement of quality-of-life in heart failure. Includes bibliographical references.

D.Litt. et Phil. / Please refer to full text to view abstract

Type 2 diabetes is a highly prevalent disease, projected to increase in prevalence, while expensive to treat. This study sought to identify significant predictors of each of the two study outcome variables—a higher quality of patient-provider communication, and a higher quality of life. The online sample (N=72) was 78% (n=56) female with a mean age of 55.3 years, while 71% Black/African American with a good overall health status. They rated the overall quality of care received from their provider between good and very good. Using the new Patient-Provider Communication Scale (PP-CS-07, patient-provider communication was closest to very good. Health literacy skills were closest to very good, and health literacy self-efficacy was closest to very good. Level of knowledge for caring for type 2 diabetes was closest to very good knowledge. Participants were in an action stage with 80% confidence (very good self-efficacy) to perform seven diabetes self-management behaviors. Some 43.1% experienced depression, 44.4% experienced anxiety, and 20.8% sought counseling in the past year. The mean quality of life rating was closest to good quality of life. While controlling for social desirability, backward stepwise regression showed better quality patient-provider communication was significantly predicted by: received diabetes education, higher rating of health care quality, higher level of health literacy skills, and, being in a lower stage of change for self-care behaviors—with 79.2% of variance explained by this model. Better quality of life was significantly predicted by: female gender, having received diabetes education, no past year anxiety, higher annual household income, lower weight status, higher health literacy self-efficacy, higher rating of knowledge of diabetes self-management—with 69.4% of the variance explained by this model. Findings make a compelling case for screening patients for depression and anxiety, using the brief tool used in this study; and future research evaluating the impact of health educators and providers being trained in motivational interviewing, while using the Patient-Provider Communication Scale (PP-CS-7) as a new tool to compare ratings by patients of providers trained in motivational interviewing. Healthcare policy should mandate such training in brief motivational interviewing, and evaluate the impact of training in containing costs.

Background of the Study The aims of this study was to specifically investigate the differences in culture, attitude towards life and social networks between Australian and Taiwanese men and women in addition to determining the factors that predict midlife men and women's quality of life in both countries. Because individualism and collectivism are the two most thoroughly researched constructs in inter-cultural and cross-cultural studies we should look at how these construct affects societies. The theme for individualist cultures (such as Western cultures) is autonomy, while the theme for collectivist cultures (such as Asian cultures) is connection. Most literature available on individualism and collectivism note all cultures have different values that influence their society and ultimately a person's individual health outcome. Very little work has been undertaken in this domain in Australia or Taiwan, particularly in the area of midlife transition and from a cultural perspective. Methodology Data was collected from a cross-sectional, supervised self-administered survey using census data and a probability proportional sampling (PPS) strategy on a general population of men and women aged 40-59 years old who live permanently in Brisbane, Australia and Taipei, Taiwan. The study population was divided into 163 Statistical Local Areas (SLAs) in Brisbane, and 449 Local Government Communities (LGCs) in Taipei. Sixty clusters were randomly selected using probability proportional sampling (PPS) to obtain 30 Australian clusters and 30 Taiwanese clusters. In this study, the 30 (areas) by 7(people) method was used with an additional strategy. The variables were measured including: culture (vertical and horizontal individualism and collectivism), attitude towards life (the total score of optimism), social networks (the total score of emotional, informational, affectionate, tangible, and positive social interaction) and quality of life (physical, psychological, social, and environmental health), social demographical factors and religion and spiritualty. The data analysis procedure included descriptive, bivarite and multivariate multiple regressions and classifications and regression trees (CART). A comparison of the linear regression and regression tree results were discussed. All data analysis was performed by SPSS and S-Plus softwares. Results The overall response rate for the study was 84.2% for midlife Australian men and women and 88.4% for midlife Taiwanese men and women this resulted in 278 Australians (45.3% men) and 398 Taiwanese (35.4% men) providing data to be analysed. Findings in this study indicated country of residence has an overwhelming impact on quality of life with significant differences seen between midlife Australian and Taiwanese men and women (F4, 666= 59.31, P< .001). Results suggest midlife Australian men and women have a better quality of life than midlife Taiwanese men and women. In addition, a comparison of the linear regression and regression tree results reveals that two models identified the same major affect variable for different countries of residence: which was attitude towards life in midlife Australians and social networks in midlife Taiwanese. However, regression trees were able to capture important nonlinear effects as well as interactions between cultural attribute variables. This study demonstrated culture significantly involves multiple functions and interacts with attitude towards life, social networks and individual factors to influence a person's quality of life. The interaction of cultural circumstances and the internal and external factors involved, show less comparative attributes and increased equality attributes, defining the need for people to have a good social networks and a healthy positive disposition. Conclusion Because of the ever increasing flexibility of world travel and a global population, people have much more opportunity to interact with many other cultures which would create improvement in learning opportunities and better health management effectiveness for people the world over. This study has addressed and contributed to the assessment of multi-cultural quality of life research and has important implications for all health professions in addition to government departments and organisational policy makers of both countries. And finally, this study has identified that there needs to be a concerted effort to implement major policy shifts in the near future because of the changing fabric of modern societies. At the same time technology and globalisation have advanced rapidly and point to new opportunities within and across countries for more diverse approaches in research and the implementation of policy initiatives to occur. This study has highlighted that opportunities exist to reflect on current policies for Australian and Taiwanese societies to provide enhanced opportunities to care for the growing midlife populations.

Indiana University-Purdue University Indianapolis (IUPUI) / Theoretically, inter-role conflict can occur between any life domains that place competing demands on an individual. However, inter-role conflict research has mainly focused on the conflict between only two domains: work and family. This limited focus is problematic because it has excluded many other potential life domains in which people participate. In order to focus more attention on other life domains, however, it is necessary to understand which life domains people are participating in. As such, the goal of the present qualitative research was to identify and define the full spectrum of life domains by asking two questions: What life domains are relevant to work-life conflict, and how do people value the various life domains in which they are involved? A total of 13 life domains emerged from the data. Participants engaged in an average of 9 of these domains, indicating that people engage in many activities in life outside just work and family.

South Africa's post-apartheid housing situation is permeated with the knowledge and criticisms of low-income housing. Of late, the latter has gained more exposure than the merits of the process of low-come housing provision, but the criticisms have been generalised comments that have rarely been based on a methodical format of collection and analysis. Furthermore, there have been no reported instruments that have garnered collective perceptions of residents of low-income housing settlements. In light of this gap, in both the academic and political aspects of low income housing, this dissertation describes the design of a multi-construct instrument, aimed at determining quality of life (QOL) in low-income settlements, and specifically describes the two aspects of development of that instrument. It describes the development of the model, as well as the development of the instrument that is derived from that model. Furthermore, results of qualitative tests of fitness for the model and internal reliability tests of the instrument are also described. The model design details the development of domains and variables, derived primarily from literature, while the instrument details the design of items that constitute each variable. Cronbach's alpha reliability tests used to determine the internal reliability of items of the instrument indicate good internal consistencies of twelve of the fifteen constructs constituting the instrument, while frequency tables and descriptive statistics indicate high prioritisation of existing domains used within the model. This high prioritisation and good internal consistencies suggests that the model and instrument are adequately appropriate, relevant and reliable in as far as they have been developed at this stage, and with suitable modifications as recommended on the basis of the research, will yield an appropriate tool for similar studies. / Thesis (M.Env.Dev.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.