Creating a reference to a complex emergency situation using time series methods: war in Guinea-Bissau 1998-1999

Impacts of complex emergencies or relief interventions have often been evaluated by absolute mortality compared to international standardized mortality rates. A better evaluation would be to compare with local baseline mortality of the affected populations. A projection of population-based survival data into time of emergency or intervention based on information from before the emergency may create a local baseline reference. We find a log-transformed Gaussian time series model where standard errors of the estimated rates are included in the variance to have the best forecasting capacity. However, if time-at-risk during the forecasted period is known then forecasting might be done using a Poisson time series model with overdispersion. Whatever, the standard error of the estimated rates must be included in the variance of the model either in an additive form in a Gaussian model or in a multiplicative form by overdispersion in a Poisson model. Data on which the forecasting is based must be modelled carefully concerning not only calendar-time trends but also periods with excessive frequency of events (epidemics) and seasonal variations to eliminate residual autocorrelation and to make a proper reference for comparison, reflecting changes over time during the emergency. Hence, when modelled properly it is possible to predict a reference to an emergency-affected population based on local conditions. We predicted childhood mortality during the war in Guinea-Bissau 1998-1999. We found an increased mortality in the first half-year of the war and a mortality corresponding to the expected one in the last half-year of the war.     

Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

Social identities and political cleavages: the role of political context

Summary. Using a novel method, the paper investigates the influence of social group identities on attitudes and on voting in a variety of political contexts. Examining the major regions of Britain, Canada and the USA, we find considerable national and regional diversity in the nature of social cleavages. For example, social class and race had widely different effects across societies, but within societies their effects on attitudes and on voting were very similar. However, despite that, age and religion had a similar effect on attitudes across societies; the effects on voting varied considerably. The significant within-country differences underline the importance of using region, rather than country, as the unit of analysis. More importantly, these results highlight the role of political context, especially competing cleavages and the structure of party competition, in the establishment of politically relevant social cleavages.     

Sexuality in Older Adults (65+)—An Overview of the Literature,Part 1: Sexual Function and its Difficulties

Objectives: The aim of the current article was to provide an overview of literature on sexual function and sexual difficulties in older adults. Method: The authors conducted a narrative review of papers published in English between January 2005 and July 2015 based on an extensive search in PsycINFO. Results: The review showed that although common biological changes may adversely affect sexual function in old age, sexual experience seems to also be affected by psychological and interpersonal factors. Conclusions: Greater life expectancy and better medical care will result in older individuals with chronic diseases living longer. The need for help to cope with changes in sexual health is likely to increase in older adults, as sexuality may be negatively affected through several pathways.     

Computer use and ulnar neuropathy: results from a case-referent study

We aimed to evaluate associations between vocational computer use and 1) ulnar neuropathy, and 2) ulnar neuropathy- like symptoms as distinguished by electroneurography. We identified all patients aged 18-65 years, examined at the Department of Neurophysiology on suspicion of ulnar neuropathy, 2001-2007. We mailed a questionnaire to 546 patients with ulnar neuropathy, 633 patients with ulnar neuropathy-like symptoms, and three community referents per case, matched on sex, age, and primary care centre. From a Job Exposure Matrix we extracted estimates of daily hours of computer use. The analysis was performed by conditional logistic regression.There were a negative association between daily hours of computer use and the two outcomes of interest. Participants who reported their elbow to be in contact with their working table for 2 hours or more during the workday had an elevated risk for ulnar neuropathy (OR=2.16, 95 % CI; 1.06-4.44).The two outcomes were not associated with daily hours of computer use. Findings suggested specific effects of pressure on the elbow, and might be an explanation for the overweight of left-sided outcomes in this primarily right-handed group. Preventive efforts would then be straightforward by providing appropriate arm support for the left arm and elbow.     

DOES THE PUBLIC SECTOR IMPLODE FROM BAUMOL'S COST DISEASE?

The root of the Baumol cost disease is higher productivity increases for manufactured goods than for services. The implied increase in relative costs of service production is widely claimed to have devastating implications for the public sector as a provider of tax‐financed services such as health, education, and care. To match the increasing costs it appears inevitable that tax rates would be ever increasing. It is shown that this inference does not follow under standard assumptions when accounting explicitly for service provision from both the private and public sectors. Strikingly under assumptions often made in the literature, the welfare maximizing tax rate for a utilitarian policy maker would remain constant despite the Baumol cost disease, and by implication the share of public employment in total employment will remain constant. (JEL H5, H11, O41)     

Guest Editorial Production Planning and Control in other Industries

This paper provides an excursion into various scheduling problems arising in the manufacturing environment and possible approaches that can be taken to solve them. It reviews the research in production scheduling from the perspective of designing and operating a production system and examines the research strategies adopted to find the solution of the practical problems. This review is in the form of the paradigms that evolved during the twentieth century and shows the transition in theory and practice of each paradigm. It covers the fundamental frameworks of scheduling theory, outlining various approaches that can be taken to solve (optimally or approximately) such problems, and the difficulties arising in their practical use. Subsequently, an iterative scheduling process is suggested as an extension of existing paradigms to solve practical production scheduling problems and to bridge the gap between theory and practice in production scheduling and control.     

Introspection as intra-professionalism in social and health care

This article analyses two cases from health and social care, adopting a psycho-societal approach. The analysis highlights how professionalism evolves and develops through an introspection of the relational and scenic processes between professionals, as well as between the professional and the client or patient. As a phenomenon at the core of professional practice, it will be argued that introspection needs to recognize and encompass the intra- and inter-psychic responses and understandings of professionals and their clients and patients. The first case places supervision as a learning space, where framing and complex exchanges of loss and confirmation, and of denial and displacement take place between a group of social workers and their supervisor. In the second case, it becomes apparent how the research interview opens up an opportunity for processing the emotions and socially critical experiences involved in hospital work.