Development of a Level 1 Geriatric Outpatient Social Work Screen in a Veterans Primary Care Clinic

Patient Aligned Care Teams (PACT) provide primary care to veterans. We describe our experience in a PACT (average age 66, 98% men, 8 medications, 16% yearly hospitalization rate) using a nurse-administered screen to identify patients in need of intervention by a Masters-level Social Worker. Our screening results—98% Positive predictive value (included social work concerns) and 73% negative predictive value (excluded social work concerns)—suggest that the nurse accurately identified patients. Another 15% of patients were identified by the social worker. Similar screens used in interprofessional clinics could help target patients in need of further social work care.     

Measuring Social Capital in Hamilton, Ontario

Social capital has been studied by academics for more than 20?years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and low socio-economic status (SES). A Social Capital Measurement Tool is proposed as a straightforward way to account for differences in social capital perceptions and actions among residents. Consistent with the literature, the paper found that there was a strong association between social capital perceptions and health, particularly mental health and life stress. Social capital was greater in the high and mixed SES neighbourhoods and much weaker in the low SES neighbourhoods. With respect to social capital actions, both volunteering and voting was associated with positive overall health and mental health. Finally, the paper identified the social capital ??elite????respondents with high or above average perceptions and who participated in the two social capital actions??voting and volunteering. Prominent among the social capital elite in Hamilton is the ??health wealthy?? senior, a positive development for the continued social well-being of the city.     

The Collaboration as Empowerment Claim: The Case of Visual Social Research

This article uses the case of visually based collaborative social science research to explore the problem of inequality between researchers and research subjects in social science research. This dilemma is ever present for social scientists researching topics where the research subject represents a group experiencing social exclusion. The paper uses the claim of those social scientists that argue that collaboration between researchers and research subjects can diminish the inequality problem by empowering research subjects. Through this interrogation of the “collaboration as empowerment claim,” as an ideal type construction the paper argues that (i) it pays insufficient attention to the knowledge frameworks and incentive structures around which research projects are carried out and disseminated, (ii) it does not interrogate the fact that the claim of empowerment as outcome is made by those in the researcher role, and (iii) it does not explicitly document the research subject's own assessment of a collaboration/empowerment link. The paper moves beyond the insights drawn from the visual case to point to their implications for other areas in which collaboration research is claimed as a means to empower research subjects and by implication to diminish researcher/research subject inequalities.     

CONSTRUCTION OF CROSSOVER DESIGNS WITH CORRELATED ERRORS

Crossover experiments are widely used, particularly where a sequence of treatments is given to subjects. Correlations between observations on the same subject are therefore likely and should be considered in both the design and analysis of crossover experiments. This paper presents an algorithm for the generation of efficient crossover designs with autoregressive and linear variance structures. The algorithm has been implemented as a module in the experimental design generation package CycDesigN (Release 3.0; CycSoftware, Hamilton, New Zealand). Output from the algorithm is compared with earlier work. Some results are given from the analysis of a crossover experiment assuming correlated errors.     

Persistent Private Information

This paper studies the design of optimal contracts in dynamic environments where agents have private information that is persistent. In particular, I focus on a continuous‐time version of a benchmark insurance problem where a risk‐averse agent would like to borrow from a risk‐neutral lender to stabilize his utility. The agent privately observes a persistent state variable, typically either income or a taste shock, and he makes reports to the principal. I give verifiable sufficient conditions showing that incentive‐compatible contracts can be written recursively, conditioning on the report and two additional state variables: the agent's promised utility and promised marginal utility of the private state. I then study two examples where the optimal contracts can be solved in closed form, showing how persistence alters the nature of the contract. Unlike the previous discrete‐time models with independent and identically distributed (i.i.d.) private information, the agent's consumption under the contract may grow over time. Furthermore, in my setting the efficiency losses due to private information increase with the persistence of the private information, and the distortions vanish as I approximate an i.i.d. environment.     

Analytic expressions for maximum likelihood estimators in a nonparametric model of tumor incidence and death

This research focuses on the estimation of tumor incidence rates from long-term animal studies which incorporate interim sacrifices. A nonparametric stochastic model is described with transition rates between states corresponding to the tumor incidence rate, the overall death rate, and the death rate for tumor-free animals. Exact analytic solutions for the maximum likelihood estimators of the hazard rates are presented, and their application to data from a long-term animal study is illustrated by an example. Unlike many common methods for estimation and comparison of tumor incidence rates among treatment groups, the estimators derived in this paper require no assumptions regarding tumor lethality or treatment lethality. The small sample operating characteristics of these estimators are evaluated using Monte Carlo simulation studies.     

Multivariate goodness-of-fit tests based on statistically equivalent blocks

Various nonparametric procedures are known for the goodness-of-fit test in the univariate case. The distribution-free nature of these procedures does not extend to the multivariate case. In this paper, we consider an application of the theory of statistically equivalent blocks(SEB)to obtain distribution-free procedures for the multivariate case. The sample values are transformed to random variables which are distributed as sample spacings from a uniform distribution on [0, 1], under the null hypothesis. Various test statistics are known, based on the spacings, which are used for testing uniformity in the univariate case. Any of these statistics can be used in the multivariate situation, based on the spacings generated from the SEB. This paper gives an expository development of the theory of SEB and a review of tests for goodness-of-fit, based on sample spacings. To show an application of the SEB, we consider a test of bivariate normality.