Incorporating quality into data envelopment analysis of nursing home performance: A case study

When using data envelopment analysis (DEA) as a benchmarking technique for nursing homes, it is essential to include measures of the quality of care. We survey applications where quality has been incorporated into DEA models and consider the concerns that arise when the results show that quality measures have been effectively ignored. Three modeling techniques are identified that address these concerns. Each of these techniques requires some input from management as to the proper emphasis to be placed on the quality aspect of performance. We report the results of a case study in which we apply these techniques to a DEA model of nursing home performance. We examine in depth not only the resulting efficiency scores, but also the benchmark sets and the weights given to the input and output measures. We find that two of the techniques are effective in insuring that DEA results discriminate between high and low quality performance.     

Computation of finite population parameters and approximate probability values for multi-response randomized block permutation procedures (mrbp)

An algorithm is presented for computing the finite population parameters and the approximate probability values associated with a recently-developed class of statistical inference techniques termed multi-response randomized block permutation procedures (MRBP).     

Information matrix for a mixture of two inverse gaussian distributions

In this paper, Fisher information matrix about the five parameters ρ, μ_:1, μ², λ¹and λ²of a mixture of two Inverse Gaussian density functions is obtained. The Leguerre-Gauss quadrature formula is used to evaluate the essential integral on which the twenty five elements of the information matrix are based. Results involving the computation of the information about p are compared with those involving both the power series expansion and Simpson's method of integration. Laguerre-Gauss quadra-ture was found to lead to good approximations as compared with other methods. It was therefore chosen for the computations of the elements of the information matrix.     

Activating adult allies from a rural community on lesbian,gay, bisexual,transgender, and queer student issues in school using photovoice

Purpose: Many students who are lesbian, gay, bisexual, transgender, or queer (LGBTQ) face hostile school environments that can negatively impact their mental health and education. This study involved a photovoice project where high school students from a gay-straight alliance in the rural southeastern United States took photographs that depicted the issues LGBTQ students were facing and then exhibited their photographs and stories to individuals from the school system and local community to promote awareness, dialogue, and action. Methods: Twenty adults who attended the photovoice exhibit responded to an online survey about their experiences with the intervention. Results: Eighty-five percent of adults reported that the intervention made them think about issues they had not previously considered, including the struggles LGBTQ youths face, gender issues, and living in a rural community. Common emotions experienced at the intervention included feeling excited, concern for the youths, and proud of the youths. Furthermore, 81% of the adults indicated that they would take action or behave differently as a result of the intervention, including supporting and affirming LGBTQ students, using gender-neutral and -inclusive language, and confronting bias in themselves and others. Conclusions: Photovoice is a promising strategy for LGBTQ students to activate adult allies in their community.     

Micro‐level dynamics of social assistance receipt: Evidence from four European countries

This study investigated the monthly dynamics of social assistance benefit receipt – in particular the incidence of long‐term benefit receipt – in four European countries: Luxembourg, The Netherlands, Norway and Sweden. The analysis is based on four separate administrative panel data sets, each covering the 96‐month period from January 2001 to December 2008. Benefit dynamics were found to vary considerably across countries. In the two Nordic countries, long‐term benefit receipt was found to be a rare exception. Most recipients, however, had multiple spells and the majority of benefit leavers returned to benefits within a few months of leaving. In Luxembourg and The Netherlands, long‐term benefit receipt was frequent, but benefit leavers were much less likely to return to benefit receipt after exit. The total duration of benefit receipt per individual across spells was two to three times as high in The Netherlands and Luxembourg as in Norway and Sweden.     

Title IX: Consequences for Gender Relations in Sport

Legal interventions have succeeded in creating new opportunities for female athletes, but some argue that this is at the expense of opportunities for male athletes. In this review, we examine the consequences of a particular legal intervention in sport, the US education law Title IX, for female athletes, male athletes, and the construction of gender. Research indicates that sport participation is linked to important attainment outcomes, such as completing education and receiving higher salaries, for both male and female athletes. In addition, playing sports has several protective effects for women’s and girls’ mental and physical health. While positive effects for male athletes are important, courts’ interpretations of Title IX do not require the elimination of men’s opportunities but also do not protect those opportunities in current enforcement. Legal interventions that assure female sports participation also challenge the ways sport is used to create and reproduce definitions of masculinity, exposing dangerous emphases on toughness, aggressiveness, and heterosexual conquest that are damaging to both female and male athletes.     

Erectile dysfunction is strongly linked with decreased libido in diabetic men

Erectile dysfunction frequently occurs with diabetes mellitus. A survey of diabetic men was conducted by anonymous questionnaire to investigate the associations of erectile dysfunction with various predictive factors. A total of 112 diabetic males without an obvious history of erectile dysfunction were available for analyses. The mean age and duration of diabetes were 53.7?±?12.2 years and 10.2?±?8.6 years (mean?±?standard deviation), respectively. The questionnaire included questions on the presence or absence of smoking, hypertension, libido and subjective symptoms of diabetic neuropathy that may be associated with erectile dysfunction. Analysis of the answers to the questionnaire revealed that 40% of the patients complained of erectile dysfunction (erection ‘always insufficient’). Erectile dysfunction was significantly correlated with age (p?=?0.005), but not with duration of diabetes (p?=?0.25), adjusted for age. Erectile dysfunction was also associated with sensory neuropathy and reduced libido, independently of age. The logistic regression analysis revealed that erectile dysfunction was positively associated with reduced libido and age. The odds ratio of erectile dysfunction for reduced compared to unreduced libido was 18.21, suggesting that psychogenic factors have a marked influence on erectile dysfunction. It is concluded that the presence of erectile dysfunction should be considered when symptoms related to diabetic neuropathy are observed; psychological approaches, such as sexual counseling, could be applied for the treatment of erectile dysfunction.     

Locally optimal designs for the simple death process

We demonstrate the existence and uniqueness of optimal observation schedules for discrete observation of the simple death process. Optimality is framed in the sense of observing the process at times that maximise the Fisher information for the death rate. We examine the relationship of our designs with those obtained by other authors for the simple birth process. A number of interesting properties are uncovered. Practical considerations in the application of these designs in an experimental setting are investigated, and we examine the performance of some approximately optimal designs that are usually simpler to implement. We will show that our optimal designs are highly robust to mis-specification of the death rate.     

Statistical techniques in stereology

Stereology typically concerns estimation of properties of a geometric structure from plane section information. This paperprovides a brief review of some statistical aspects of this rapidly developing field, with some reference to applications in the earth sciences. After an introductory discussion of the scope of stereology, section 2 briefly mentions results applicable when no assumptions can be made about the stochastic nature of the sampled matrix, statistical considerations then arising solelyfrom the ‘randomness’ of the plane section. The next two sections postulate embedded particles of specific shapes, the particular case of spheres being discussed in some detail.

References are made to results for ‘thin slices’ and other prob-ing mechanisms. Randomly located convex particles, of otherwise arbitrary shape, are discussed in section 5 and the review concludes with a specific application of stereological ideas to some data on neolithic mining.