The Impact of Estimation: A New Method for Clustering and Trajectory Estimation in Patient Flow Modeling

The ability to accurately forecast and control inpatient census, and thereby workloads, is a critical and long‐standing problem in hospital management. The majority of current literature focuses on optimal scheduling of inpatients, but largely ignores the process of accurate estimation of the trajectory of patients throughout the treatment and recovery process. The result is that current scheduling models are optimizing based on inaccurate input data. We developed a Clustering and Scheduling Integrated (CSI) approach to capture patient flows through a network of hospital services. CSI functions by clustering patients into groups based on similarity of trajectory using a novel semi‐Markov model (SMM)‐based clustering scheme, as opposed to clustering by patient attributes as in previous literature. Our methodology is validated by simulation and then applied to real patient data from a partner hospital where we demonstrate that it outperforms a suite of well‐established clustering methods. Furthermore, we demonstrate that extant optimization methods achieve significantly better results on key hospital performance measures under CSI, compared with traditional estimation approaches, increasing elective admissions by 97% and utilization by 22% compared to 30% and 8% using traditional estimation techniques. From a theoretical standpoint, the SMM‐clustering is a novel approach applicable to any temporal‐spatial stochastic data that is prevalent in many industries and application areas.     

Marijuana: modern medical chimaera

Marijuana has been used medically since antiquity. In recent years there has been a resurgence of interest in medical applications of various cannabis preparations. These drugs have been cited in the medical literature as potential secondary treatment agents for severe pain, muscle spasticity, anorexia, nausea, sleep disturbances, and numerous other uses. This article reviews the research literature related to medical applications of various forms of cannabis. Benefits related to medical use of cannabinoids are examined and a number of potential risks associated with cannabis use, both medical and recreational, are considered. There is a clearly identified need for further research to isolate significant benefits from the medical application of cannabinoids and to establish dosage levels, appropriate delivery mechanisms and formulations, and to determine what role, if any, cannabinoids might play in legitimate medical applications. It is also imperative to determine if reported dangers pose a significant health risks to users.     

The Use of Incarceration in Canada: A Test of Political and Social Threat Explanations on the Variation in Prison Admissions across Canadian Provinces, 2001–2010

Recent scholarship has indicated that political and ethnic threat theories—which maintain that the use of prison is not only determined by the extent of crime in society but also by various features related to power, ideology, and access to resources—provide powerful accounts as to why the use of punishment varies within and between societies. However, no study to date has tested these theories within Canada, a country in which such theories are quite plausible. This study begins to fill this void by assessing these theoretical claims using a pooled time series analysis of the variation in imprisonment rates across Canadian provinces from the years 2001 to 2010. After accounting for several measures including charge rates, the results show that Canadian incarceration rates are largely driven by ethnic threat. The size of the Aboriginal and visible minority populations across each province are the most significant determinants of the variation in punishment. Furthermore, we find a nonlinear relationship consistent with a political version of the threat hypothesis. Results, however, do not support political accounts which stress the power of right‐wing parties or a conservative public.     

Adult-Adult and Adult-Child/Adolescent Online Sexual Interactions: An Exploratory Self-Report Study on the Role of Situational Factors

Alcohol intoxication, sexual arousal, and negative emotional states have been found to precede certain sexual behaviors. Using data from an online self-report survey distributed to adults (N = 717; 423 men and 304 women), we compared adults with adult online sexual interactions (n = 640; 89.3%) to adults with interactions with a child or an adolescent (n = 77; 10.7%) on how much they reported being affected by the following factors surrounding the time of the interactions: alcohol intoxication, sexual arousal, sadness, boredom, stress, and shame. We found that those with a child or adolescent contact reported higher sexual arousal and more shame before the interaction, compared with those with an adult contact. In addition, the levels of negative emotional states varied when levels before the interactions were compared with levels after the interactions, suggesting that engaging in online sexual interactions alleviated negative emotional states, at least temporarily. The alleviatory effects, however, were accompanied by higher levels of shame after the interactions. Overall, adults that engage in online sexual interactions have remarkably similar perceptions of the situation surrounding these activities, independent of the age of their online contacts. Limitations of the study are discussed.     

Adaptive exponentielle glättung erster ordnung

In the paper we introduce an adaptive procedure of the first order exponential smoothing. In this procedure we get a sequence of estimation converging in mean square to the unknown smoothing parameter and an asymptotically optimum prediction in the sense of the least square error. In case of breaks in the structure of time series we recommend a modification of the procedure.     

Veränderung öffentlicher Beschäftigung im Prozess der Liberalisierung und Privatisierung

The paper summarises the empirical results of a study on the impact of liberalisation and privatisation of public services on employment, working conditions and labour relations and links these results to a broader sociological debate on the current restructuring of work and employment in the emergence of a market-oriented accumulation regime. The consequences of liberalisation and privatisation include a massive cut in public sector jobs, an extension of atypical forms of employment, a reduction in wage costs and a substantial deterioration of working conditions. Another result is the decentralisation and fragmentation of bargaining structures in public services. Privatisation and liberalisation, hence, do not only alter public ownership and governance structures of public sector firms, but also change the character and function of the public employment regime that played a decisive role in the post-war model of development. With privatisation and liberalisation the political character of employment standards in the public sector is increasingly questioned and subjected to supposedly non-political market mechanisms. The result is not only a marketisation of work and employment as indicated by the concept of the market-oriented accumulation regime, but also a far-reaching flexibilisation, precarisation and henceforth recommodification of labour.