Risk Assessment for Hospital-Acquired Diseases: A Risk-Theory Approach

We introduce a new approach to hospital-acquired disease risk assessment from public health databases. In a spirit similar to actuarial risk theory, we define an adjustment coefficient that can quantify the risk associated with a hospital department, allowing comparisons of similar departments. The adjustment coefficient characterizes the tail of the distribution of the total patient length of stay in a department before the first disease event occurs. We show that this coefficient is the solution of a Lundberg-like equation, and we provide a nonparametric estimation procedure for this measure, based on a Cramér-Lundberg approximation for the tail of the distribution. Using simulations, we provide evidence of the robustness of the approximation to various individual risk models. In addition, we illustrate the relevance of this approach by evaluating the risk associated with a standard patient safety indicator in 20 hospitals of southeastern France.     

Efficacy of Risk-Based, Culturally Sensitive Ogaa (Walleye) Consumption Advice for Anishinaabe Tribal Members in the Great Lakes Region

The Great Lakes Indian Fish and Wildlife Commission (GLIFWC) has produced Ogaa (walleye— Sander vitreus ) consumption advisories since 1996 for Anishinaabe from GLIFWC member tribes in the 1837 and 1842 ceded territories of Wisconsin. GLIFWC's advisory maps were revised in 2005 to address cultural sensitivities (to protect tribal lifeways), to utilize recent mercury exposure information, and to incorporate changes in advisory levels for methyl mercury. Lake-specific, risk-based, culturally sensitive consumption advice was provided on color-coded maps for two groups: children under age 15 years and females of childbearing age, and males 15 years and older and females beyond childbearing age. The maps were distributed to, and a behavioral intervention program developed for, the six GLIFWC member tribes in Wisconsin as well as member tribes in Minnesota and the 1842 ceded territory of Michigan. Tribal fish harvesters, tribal health care providers, women of childbearing age or with young children, tribal leaders, elders, and children were targeted specifically for the behavioral intervention. The efficacy of the behavioral intervention was assessed using surveys of 275 tribal fish harvesters from Wisconsin, 139 tribal harvesters from Michigan and Minnesota, and 156 Wisconsin women of childbearing age. Significant increases in the percentage of survey participants who indicated awareness of advisory maps occurred among Wisconsin harvesters (increase from 60% to 77%), Michigan and Minnesota harvesters (29% to 51%), and women of childbearing age in Wisconsin (40% to 87%). A significant increase in preference for smaller Ogaa occurred among tribal harvesters in Wisconsin (41% to 72%) and tribal harvesters in Michigan and Minnesota (49% to 71%), although not among women of childbearing age. The GLIFWC map-based advisory program did not adversely affect tribal harvest of Ogaa, which increased from 63,000 to 88,000 fish in the three states after the intervention.     

Low wages and high unemployment rates: The role of social interactions in hiring discrimination

The purpose of this paper is to explain why low-wage workers with identical qualifications to higher-wage workers are more exposed to unemployment. Each worker is considered to belong to a social group (defined according to his/her gender, age, and nationality). We assume that workers experience both productive interdependencies and social interactions within the firm. Also inter- and intra-group interactions determine worker productivity, and frictions on the labor market limit the hiring of the most productive workers. Consequently, externalities acting both within the firm and in the labor market can lead to a higher rate of unemployment for low-wage workers.     

Managing Corporate Knowledge Experiences with SODA and V·I·S·A

It is often said that success in today's competitive environment depends on the acquisition and application of sound, relevant knowledge. This paper introduces two management science approaches that have been used for the effective management of knowledge, towards the development of strategy, planning and decision making, in a wide range of organizational settings. Both approaches make use of computer technology to provide a flexible and interactive environment incorporating a visual representation of the problem. The paper briefly describes each approach, together with a case study illustrating its use in practice. A number of common themes relevant to the management of knowledge are identified and discussed. The themes highlight the benefits which arise through the use of computer technology alongside a number of issues relevant to the management of the group process.     

A bayesian estimator for the dependence function of a bivariate extreme‐value distribution

Any continuous bivariate distribution can be expressed in terms of its margins and a unique copula. In the case of extreme‐value distributions, the copula is characterized by a dependence function while each margin depends on three parameters. The authors propose a Bayesian approach for the simultaneous estimation of the dependence function and the parameters defining the margins. They describe a nonparametric model for the dependence function and a reversible jump Markov chain Monte Carlo algorithm for the computation of the Bayesian estimator. They show through simulations that their estimator has a smaller mean integrated squared error than classical nonparametric estimators, especially in small samples. They illustrate their approach on a hydrological data set.