Enhancing hospital performance through perioperative services

Perioperative services are the lifeblood of a hospital, but with increasing competition, the services are under attack. Discover ways to protect and improve a hospital's perioperative services.     

Sudanese refugee youth in foster care: the "lost boys" in America

This study examined the resettlement experiences of unaccompanied Sudanese refugee youth placed in foster care from the perspectives of the youth, foster parents, and agency caseworkers. Youth experienced considerable success. The challenges of adjusting to school and family life, however, suggest a need for funding to support more intensive educational services, more cultural training and support for foster parents and school personnel, and flexibility to provide services in more culturally appropriate modalities.     

Vitamin A and Infant Mortality: Beyond Intention-to-Treat in a Randomized Trial

This paper investigates the effect of one dose of vitamin A on subsequent 4 month mortality in children under 6 months of age in a randomized, double-blind placebo-controlled community trial in Nepal. An earlier published intention-to-treat analysis showed no benefit, but ignored the information on actual receipt of treatment. Structural failure time models (Robins and Tsiatis, '91) use randomization based inference and incorporate compliance information which is possibly selective. The data presented here offer some new challenges for this approach: ward-based randomization induces correlation between survival outcomes; and the actual receipt of vitamin A dose is not always recorded. To tackle the problem of the clustered survival data we consider a robust version of the structural parameter vector estimator. A sensitivity analysis captures boundaries for the estimated structural parameters reflecting a range of potential values of children whose true receipt of treatment is unknown. The analysis suggests that the effect of vitamin A was beneficial in the beginning of the trial but towards the end of the trial there was a reversal of this effect.     

The NUDIST qualitative data analysis system

Most computer approaches to qualitative data analysis have concentrated on coding and retrieval of text. This paper describes a research project which set out to support a range of methods for the analysis of unstructured data, with emphasis on the building and testing of grounded theory. It resulted in software whose innovations include: a) No limit to the number of coding categories and sub-categories, and no limit to the number of times a given text passage can be coded; b) The use of separate document and indexing databases, interrelated and of unlimited flexibility; c) Comprehensive hypermedia-like browsing tools for both document and indexing databases; d) Ability to search for words and lexical patterns occurring in text and to combine this with indexing of the text; e) Ability to handle off-line textual and non-textual data as well as on-line data; f) Ability to record textual comments in indexing categories — a memoing facility for emerging ideas and categories; g) Support and exploitation of hierarchical indexing systems; h) Mechanisms for creating new indexing categories out of existing ones, relating them to the data documents, and using them for further analyses. New goals of the project are to provide a number of artificial intelligence based information structuring and reasoning facilities which can be used to aid the organization and retrieval of qualitative data, and to extend the present capabilities of the software to express and test new ideas, concepts, generalizations and hypotheses about the data.     

Dynamics of some special populations with NRR = 1

We discuss two special cases of population dynamics with changing vital rates subject to the constraint NRR = I and consider the specifics of ergodicity and stationarity. By restricting the number of age groups to two, we can make explicit the way weak ergodicity works. When mortality is constant and the period NRR = I, a life-table stationary population eventually results; everything of demographic interest (except age-specific fertility and the cohort NRR) is asymptotically constant. With changing mortality, but both period and cohort NRR = 1, only weak ergodicity holds, and everything changes over time.     

Developing and transferring behavioral technologies for children and youth

Behavioral researchers have developed a variety of technologies for improving the capacities of children and their caregivers. Despite the availability of behavioral technologies for children and youth, their widespread adoption and sustained use has been limited. Characteristics for appropriate (e.g., sustainable, effective) technologies for children and youth are suggested here, and strategies for research and development of these methods are described. This paper outlines the process of transferring behaviorial technologies including the phases of awareness, interest, assessment, trial, implementation, maintenance, and reinvention. Finally, issues implicit in the process of transferring behavioral technologies for children and youth are discussed.     

Culture and Causality: An Anthropological Comment

Anthropology's unique contribution to a discussion of causality is rooted in its specialization in culture rather than in methodological protocols for bolstering our confidence in correlations. This is so because causal arguments are inherently interpretive and, moreover, because human actors themselves operate in terms of meaning. The best interpretive models direct analytic attention to contexts of meaning and motivation. Because these meanings lie inside of people's heads, the interpretation of causality in these terms demands that the validity of analyses be argued for in terms of logical coherence based on highly localized criteria. As with all explanations of human behavior, demographic explanations are as a consequence open to constant reformulation based on new information and the never‐ending search for coherence.