Characterizations,length-biasing,and infinite divisibility

SupposeL(X) is the law of a positive random variableX, andZ is positive and independent ofX. Admissible solution pairs (L(X),L(Z)) are sought for the in-law equation $\hat X \cong X o Z$ °Z, where $L\left( {\hat X} \right)$ is a weighted law constructed fromL(X), and ° is a binary operation which in some sense is increasing. The class of weights includes length biasing of arbitrary order. When ° is addition and the weighting is ordinary length biasing, the class of admissibleL(X) comprises the positive infinitely divisible laws. Examples are given subsuming all known specific cases. Some extensions for general order of length-biasing are discussed.     

When You Can't Afford to Leave Home: Clinical Implications of Economic Realities

Young adults entering the job market are finding that, despite strong corporate profits, economic growth is not trickling down to worker earnings, and federal policies are moving from the notion of entitlement to one of blame (Uchitelle, 1996, Sec. 4, p. 1). Adolescence is becoming increasingly confusing, since for many Americans economic opportunity is more fantasy than reality. This article highlights the declining opportunity for young adults and points out the limitations of existing adult developmental theory, both of which call for altered treatment conceptualizations that include the clinician operating as an anthropologist and utilizing the concepts of relationship-differentiation and response/ability from Stone Center writings.     

Physician perceptions of medical malpractice and defensive medicine

Using judgments obtained in interviews with 33 Massachusetts physicians, the annual statewide volume of expenditures incurred for defensive medical reasons in 1982 was estimated to be $1.0 billion, 12% of all medical care expenditures. Estimates for the nation were $37 billion, 14% of expenditures. Nationally, 180,000 cesarean deliveries were thought to be performed for defensive motives. In their own institutions, respondents judged 43% of all skull x-rays following injury to be medically justified, 30% to be defensive medicine, 16% to be placebos, and 11% to be physician misjudgments. In considering the economic and noneconomic costs of medical malpractice procedures, the dollar costs of insurance were considered most serious, followed closely by defensive medicine, unfairness, and poorer relations with patients. Thirty-two percent of the responsibility for the negative aspects of malpractice processes was assigned to lawyers, 21% to physicians, 18% to legislatures and courts, 16% to patients, and 13% to insurance companies.     

Evaluating alternative approaches to strategic planning

The question which, unfortunately, often goes unanswered, is whether a company's process of corporate planning is optimal. Furthermore, even if they wished to answer such a question there is little in the literature which can provide them with a direct, and explicit evaluative model. This paper examines the development of planning and the many different contributors towards its theoretical underpinning. Whilst recognizing that planning is a field which is a ‘semantic's jungle’ the authors carefully pick their way through the mine-field of misunderstanding and misquotation and clearly establish a base-line for evaluation and indeed propose a detailed methodology. It is hoped that this paper will be a fore-runner of many which will assist the executive in his important evaluative role concerning alternative planning approaches.     

How Autonomous are Public Corporations in Hong Kong? The Case of the Airport Authority

This article examines the degree of autonomy of Hong Kong’s Airport Authority (AA). Traditionally, airport management in Hong Kong was the responsibility of the government’s Civil Aviation Department. The AA was established in 1995 to manage the new international airport at Chek Lap Kok which opened in 1998. It was expected to run as a commercial enterprise but, because of its strategic importance, there was concern that it should not become an independent empire detached from government control. As a hybrid type of organization, the AA has moved steadily towards full commercialization. The government has also put its privatization on the agenda. Its transformation may have some implications for the redefinition of the future autonomy boundaries of public corporations in Hong Kong.

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Improving Risk Management: From Lame Excuses to Principled Practice

The three classic pillars of risk analysis are risk assessment (how big is the risk and how sure can we be?), risk management (what shall we do about it?), and risk communication (what shall we say about it, to whom, when, and how?). We propose two complements as important parts of these three bases: risk attribution (who or what addressable conditions actually caused an accident or loss?) and learning from experience about risk reduction (what works, and how well?). Failures in complex systems usually evoke blame, often with insufficient attention to root causes of failure, including some aspects of the situation, design decisions, or social norms and culture. Focusing on blame, however, can inhibit effective learning, instead eliciting excuses to deflect attention and perceived culpability. Productive understanding of what went wrong, and how to do better, thus requires moving past recrimination and excuses. This article identifies common blame‐shifting “lame excuses” for poor risk management. These generally contribute little to effective improvements and may leave real risks and preventable causes unaddressed. We propose principles from risk and decision sciences and organizational design to improve results. These start with organizational leadership. More specifically, they include: deliberate testing and learning—especially from near‐misses and accident precursors; careful causal analysis of accidents; risk quantification; candid expression of uncertainties about costs and benefits of risk‐reduction options; optimization of tradeoffs between gathering additional information and immediate action; promotion of safety culture; and mindful allocation of people, responsibilities, and resources to reduce risks. We propose that these principles provide sound foundations for improving successful risk management.     

Practical procedures to deal with common support problems in matching estimation

This paper assesses the performance of common estimators adjusting for differences in covariates, such as matching and regression, when faced with the so-called common support problems. It also shows how different procedures suggested in the literature affect the properties of such estimators. Based on an empirical Monte Carlo simulation design, a lack of common support is found to increase the root-mean-squared error of all investigated parametric and semiparametric estimators. Dropping observations that are off support usually improves their performance, although the magnitude of the improvement depends on the particular method used.     

Why Frequency is Not Well Defined for Engineering Systems with Nonexponential Failure Times

Dr. Yellman proposes to define frequency as “a time‐rate of events of a specified type over a particular time interval.” We review why no definition of frequency, including this one, can satisfy both of two conditions: (1) the definition should agree with the ordinary meaning of frequency, such as that less frequent events are less likely to occur than more frequent events, over any particular time interval for which the frequencies of both are defined; and (2) the definition should be applicable not only to exponentially distributed times between (or until) events, but also to some nonexponential (e.g., uniformly distributed) times. We make the simple point that no definition can satisfy (1) and (2) by showing that any definition that determines which of any two uniformly distributed times has the higher “frequency” (or that determines that they have the same “frequency,” if neither is higher) must assign a higher frequency number to the distribution with the lower probability of occurrence over some time intervals. Dr. Yellman's proposed phrase, “time‐rate of events … over a particular time interval” is profoundly ambiguous in such cases, as the instantaneous failure rates vary over an infinitely wide range (e.g., from one to infinity), making it unclear which value is denoted by the phrase “time‐rate of events.”     

A Comparative Pharmacokinetic Estimate of Mercury in U.S. Infants Following Yearly Exposures to Inactivated Influenza Vaccines Containing Thimerosal

The use of thimerosal preservative in childhood vaccines has been largely eliminated over the past decade in the United States because vaccines have been reformulated in single‐dose vials that do not require preservative. An exception is the inactivated influenza vaccines, which are formulated in both multidose vials requiring preservative and preservative‐free single‐dose vials. As part of an ongoing evaluation by USFDA of the safety of biologics throughout their lifecycle, the infant body burden of mercury following scheduled exposures to thimerosal preservative in inactivated influenza vaccines in the United States was estimated and compared to the infant body burden of mercury following daily exposures to dietary methylmercury at the reference dose established by the USEPA. Body burdens were estimated using kinetic parameters derived from experiments conducted in infant monkeys that were exposed episodically to thimerosal or MeHg at identical doses. We found that the body burden of mercury (AUC) in infants (including low birth weight) over the first 4.5 years of life following yearly exposures to thimerosal was two orders of magnitude lower than that estimated for exposures to the lowest regulatory threshold for MeHg over the same time period. In addition, peak body burdens of mercury following episodic exposures to thimerosal in this worst‐case analysis did not exceed the corresponding safe body burden of mercury from methylmercury at any time, even for low‐birth‐weight infants. Our pharmacokinetic analysis supports the acknowledged safety of thimerosal when used as a preservative at current levels in certain multidose infant vaccines in the United States.