Improving the Quality of Outcome Evaluation Plans

Nonprofit agencies are struggling to meet new funder demands in outcome evaluation. This study is the first of its kind to examine factors that contribute to agency progress in this area. Path analysis is used to examine chains of influence among five predictors of success as well as three control variables. Study findings indicate that agency culture, technology, management support, and involvement are key predictors of quality. Nonprofit managers who want to succeed in the new era of accountability should consider the potential impact of these factors on the quality of outcome evaluation plans in their agencies.     

Nonparametric estimation of the mean function of a stochastic process with missing observations

In an attempt to identify similarities between methods for estimating a mean function with different types of response or observation processes, we explore a general theoretical framework for nonparametric estimation of the mean function of a response process subject to incomplete observations. Special cases of the response process include quantitative responses and discrete state processes such as survival processes, counting processes and alternating binary processes. The incomplete data are assumed to arise from a general response-independent observation process, which includes right- censoring, interval censoring, periodic observation, and mixtures of these as special cases. We explore two criteria for defining nonparametric estimators, one based on the sample mean of available data and the other inspired by the construction of Kaplan-Meier (or product-limit) estimator [J. Am. Statist. Assoc. 53 (1958) 457] for right-censored survival data. We show that under regularity conditions the estimated mean functions resulting from both criteria are consistent and converge weakly to Gaussian processes, and provide consistent estimators of their covariance functions. We then evaluate these general criteria for specific responses and observation processes, and show how they lead to familiar estimators for some response and observation processes and new estimators for others. We illustrate the latter with data from an recently completed AIDS clinical trial.     

Spatial distribution and the value of green spaces for urban red-tailed hawks

Raptors increasingly live and nest successfully in urban areas. In the urban landscape of Hartford, CT, red-tailed hawks established home ranges in large green spaces such as parks, golf courses, and cemeteries but also nested successfully in the commercial district of downtown and in densely built urban and suburban neighborhoods. Data collected from 11 radio-tagged breeding adult hawks indicated that year-round home ranges averaged 107.7 ha, much smaller than home ranges reported for hawks inhabiting rural areas. Most hawk home ranges had multiple core areas that were usually associated with favored perches or larger patches of ‘usable’ green space, defined as patches ≥0.25 ha in size, and home range size was positively associated with larger usable green space patches in core areas. Most nests were located in the largest core area and were within a larger patch of green space within the largest core area. Rather than just the amount or size of green space patches, the value of urban green spaces for these hawks likely also varies with the number and proximity of suitable perches such as buildings or tall trees, types and density of prey, and amount of human activity in and adjacent to these spaces. Territoriality and intraspecific competition may also influence home range size and dispersion of red-tailed hawks nesting in Hartford. In this urban area, mortality due to ingestion of rodenticides and collisions with vehicles affected hawk reproductive success.

     

A Case Study Evaluating the Risk of Infection from Middle Eastern Respiratory Syndrome Coronavirus (MERS‐CoV) in a Hospital Setting Through Bioaerosols

Middle Eastern respiratory syndrome, an emerging viral infection with a global case fatality rate of 35.5%, caused major outbreaks first in 2012 and 2015, though new cases are continuously reported around the world. Transmission is believed to mainly occur in healthcare settings through aerosolized particles. This study uses Quantitative Microbial Risk Assessment to develop a generalizable model that can assist with interpreting reported outbreak data or predict risk of infection with or without the recommended strategies. The exposure scenario includes a single index patient emitting virus‐containing aerosols into the air by coughing, leading to short‐ and long‐range airborne exposures for other patients in the same room, nurses, healthcare workers, and family visitors. Aerosol transport modeling was coupled with Monte Carlo simulation to evaluate the risk of MERS illness for the exposed population. Results from a typical scenario show the daily mean risk of infection to be the highest for the nurses and healthcare workers (8.49 × 10^?4 and 7.91 × 10^?4, respectively), and the lowest for family visitors and patients staying in the same room (3.12 × 10^?4 and 1.29 × 10^?4, respectively). Sensitivity analysis indicates that more than 90% of the uncertainty in the risk characterization is due to the viral concentration in saliva. Assessment of risk interventions showed that respiratory masks were found to have a greater effect in reducing the risks for all the groups evaluated (>90% risk reduction), while increasing the air exchange was effective for the other patients in the same room only (up to 58% risk reduction).     

Relationship Status and Activated Kin Support: The Role of Need and Norms

Using data from the Fragile Families and Child Wellbeing Study, we examined whether mothers' (N = 4,127) and fathers' (N = 3,405) relationship status influenced their activation of financial support from relatives over time. We found that relationship status influenced the activation of financial support from relatives but that the effects differed somewhat by gender. Mothers were significantly more likely to activate financial assistance if they did not reside with the focal father, whereas fathers had lower odds of activating support if they were no longer in a relationship with the mother. Thus, the need for assistance may encourage mothers to access support; fathers may be less likely to access support when they deviate from social norms.     

The end of the gender revolution? Gender role attitudes from 1977 to 2008

After becoming consistently more egalitarian for more than two decades, gender role attitudes in the General Social Survey have changed little since the mid-1990s. This plateau mirrors other gender trends, suggesting a fundamental alteration in the momentum toward gender equality. While cohort replacement can explain about half of the increasing egalitarianism between 1974 and 1994, the changes since the mid-1990s are not well accounted for by cohort differences. Nor is the post-1994 stagnation explained by structural or broad ideological changes in American society. The recent lack of change in gender attitudes is more likely the consequence of the rise of a new cultural frame, an "egalitarian essentialism" that blends aspects of feminist equality and traditional motherhood roles.     

The Transformative Nature of Grief and Bereavement

Both Freud and Loewald talked about the ways in which individuals may be changed by grief, for better and for worse. This paper extends that thinking by looking at the ways in which grief and mourning reconfigure the psychic structure of the bereaved. Mourning may be an occasion for mastery through acts of altruism. Mourning may offer new narratives of the self. Using clinical and non-clinical examples, the author argues that grief is always transformative. It may lead to self hate and to lowered self-esteem but it may also lead to new ideals, new capacities, and new kinds of relationships with the dead.     

Simulation to enhance care of patients with psychiatric and behavioral issues: use in clinical settings

Nurses with a medical-surgical clinical focus often care for patients with psychiatric and behavioral issues in acute care hospitals. This article describes how hospital staff and nursing and theater department faculty joined forces to develop realistic simulated psychiatric scenarios for use by practicing nurses.     

Use of actors as standardized psychiatric patients

Using actors in simulation provides opportunities for immersive, interactive, and reflective experiences to improve health care professionals' clinical expertise and practice. These experiences facilitate the development of enhanced critical thinking, problem-solving, and communication skills without risks to patients. This article discusses how to integrate actors and students into simulated experiences. Examples are provided using mental health simulations with actors as standardized psychiatric patients.