The Millhill

This study reports on discharged patients' experiences of care at a therapeutic community - The Millhill. Data were collected by means of a questionnaire and interviews. The focus of the study is on the former patients' own experiences of The Millhill and their present state. The majority report positive changes when they compare how they feel today with how they felt just prior to admission and just after discharge. Eighty-five percent claim that the major problem which led them to seek treatment is less serious today than it was when they were admitted to The Millhill. Compared with other inpatient care, the interviews showed that treatment at The Millhill was based on long-term individual treatment plans and that those undergoing treatment were treated as "individuals", whereas treatment in the psychiatric wards was more like "storage" and medication and those undergoing treatment were treated as "patients".     

Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses

In a national study of the work environment, physical, and mental well-being of more than 2600 Swedish nurses, 30% reported having experienced violence at work. Possible association between violence and a range of occupational, demographic, and lifestyle characteristics were studied. Stepwise multiple linear and logistic regressions were used to further examine risk factors for violence. Occupational factors with significant correlations to workplace violence were nursing discipline (type of ward or facility), years of work experience, supervisory responsibilities, night work, work dissatisfaction, work-related musculoskeletal injury, and frequency of patient handling. Demographic/lifestyle factors related to violence were age, gender, smoking, coffee consumption at work, and use of alcohol to relax after work. The best fit linear regression model explained 17% of the variance in violence, 13%, of the variance in threat of violence. The logistic regression model confirmed an increased risk of violence and threats in psychiatric and geriatric settings. However, much remains unexplained about the aetiology of violencc in health carc settings. This report provides the basis for a pilot intervention study currently in progress.     

DO LABOR MARKETS PROVIDE ENOUGH SHORT-HOUR JOBS? AN ANALYSIS OF WORK HOURS AND WORK INCENTIVES

This paper examines the role that work incentives play in the determination of work hours. We use a conventional efficiency wage model to analyze how firms respond to worker preferences regarding wage-hours packages. In contrast to previous work, we study markets in which workers have heterogeneous preferences. In this context we demonstrate that job offers will specify both wages and work hours and many individuals will not be able to work their preferred number of hours. We show that the labor market equilibrium may be characterized by a less than optimal number of short-hour jobs.     

Bias in transition-specific survival and movement probabilities estimated using capture-recapture data

Transition probabilities can be estimated when capture-recapture data are available from each stratum on every capture occasion using a conditional likelihood approach with the Arnason-Schwarz model. To decompose the fundamental transition probabilities into derived parameters, all movement probabilities must sum to 1 and all individuals in stratum r at time i must have the same probability of survival regardless of which stratum the individual is in at time i + 1. If movement occurs among strata at the end of a sampling interval, survival rates of individuals from the same stratum are likely to be equal. However, if movement occurs between sampling periods and survival rates of individuals from the same stratum are not the same, estimates of stratum survival can be confounded with estimates of movement causing both estimates to be biased. Monte Carlo simulations were made of a three-sample model for a population with two strata using SURVIV. When differences were created in transition-specific survival rates for survival rates from the same stratum, relative bias was <2% in estimates of stratum survival and capture rates but relative bias in movement rates was much higher and varied. The magnitude of the relative bias in the movement estimate depended on the relative difference between the transition-specific survival rates and the corresponding stratum survival rate. The direction of the bias in movement rate estimates was opposite to the direction of this difference. Increases in relative bias due to increasing heterogeneity in probabilities of survival, movement and capture were small except when survival and capture probabilities were positively correlated within individuals.     

Cross-cultural issues in illness and wellness: Implications for depression

This paper addresses cultural factors in illness and wellness, using depression as a specific context. The issue of cultural relativism and commensurability of diagnosis and evaluation of outcomes across cultures is discussed. The concepts underlying traditional systems of healing are compared to those of Western orthodox medicine.     

Statistical approaches for the reliability of structural designs

The Construction Industry Research and Information Association (CIRIA) has produced some guidelines for the assessment of the reliability of components and/or structures. The methods of analysis suggested by these guidelines are far from adequate and, in certain cases, contain some imperfections. In this paper, some of the weaknesses of the guidelines are identified. The shortcomings are mainly in the ease of calculations and the feasibility of the assumptions which are imposed. Three alternative methods aimed at tackling some of the weaknesses are introduced. A simulation study is used to compare these methods.     

Modelling age variation in survival and reporting rates for recovery models

In this paper, we focus on models for recovery data from birds ringed as young. In some cases, it is important to be able to include in these models a degree of age variation in the reporting probability. For certain models this has been found, empirically, to result in completely flat likelihood surfaces, due to parameter redundancy. These models cannot then be fitted to the data, to produce unique parameter estimates. However, empirical evidence also exists that other models with such age variation can be fitted to data by maximum likelihood. Using the approach of Catchpole and Morgan (1996b), we can now identify which models in this area are parameter-redundant, and which are not. Models which are not parameter-redundant may still perform poorly in practice, and this is investigated through examples, involving both real and simulated data. The Akaike Information Criterion is found to select inappropriate models in a number of instances. The paper ends with guidelines for fitting models to data from birds ringed as young, when age dependence is expected in the reporting probability.