Service coordination for frail elderly individuals: an analysis of case management practices in Québec

The objective of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, my goal is to describe practical coordination processes. I conducted a qualitative exploratory study using an embedded case study design. My research covers three Health and Social Services Centres in Québec. I observed that case management is more frequently justified by a situation in which home care is precarious than by the intensity and multidimensionality present in a situation. In such instances, case management intervenes through a standby mode.     

Structuring mental health within senior services: a case study of an outpatient mental health clinic serving latinos

The article presents a case study of an outpatient mental health clinic serving Latino older adults. The study explored staff perceptions on the clinic development and the context within an immigrant multicultural community. The study used in-depth, semistructured interviews with support staff, clinical social workers, and administrators. Interviews were analyzed using a thematic content analysis. The mental health clinic formation was perceived by staff as an ecological process stemming from the needs of the Latino immigrant senior clients. A close knit and interdependent culture allowed the clinic to adjust to diversity and changing cultural contexts.     

The relative performance of ensemble methods with deep convolutional neural networks for image classification

Artificial neural networks have been successfully applied to a variety of machine learning tasks, including image recognition, semantic segmentation, and machine translation. However, few studies fully investigated ensembles of artificial neural networks. In this work, we investigated multiple widely used ensemble methods, including unweighted averaging, majority voting, the Bayes Optimal Classifier, and the (discrete) Super Learner, for image recognition tasks, with deep neural networks as candidate algorithms. We designed several experiments, with the candidate algorithms being the same network structure with different model checkpoints within a single training process, networks with same structure but trained multiple times stochastically, and networks with different structure. In addition, we further studied the overconfidence phenomenon of the neural networks, as well as its impact on the ensemble methods. Across all of our experiments, the Super Learner achieved best performance among all the ensemble methods in this study.     

Modified slashed-Rayleigh distribution

A new family of slash distributions, the modified slashed-Rayleigh distribution, is proposed and studied. This family is an extension of the ordinary Rayleigh distribution, being more flexible in terms of distributional kurtosis. It arises as a quotient of two independent random variables, one being a Rayleigh distribution in the numerator and the other a power of the exponential distribution in denominator. We present properties of the proposed family. In addition, we carry out estimation of the model parameters by moment and maximum likelihood methods. Finally, we conduct a small-scale simulation study to evaluate the performance of the maximum likelihood estimators and apply the results to a real data set, revealing its good performance.     

Confidence biases and learning among intuitive Bayesians

We design a double-or-quits game to compare the speed of learning one’s specific ability with the speed of rising confidence as the task gets increasingly difficult. We find that people on average learn to be overconfident faster than they learn their true ability and we present an intuitive-Bayesian model of confidence which integrates confidence biases and learning. Uncertainty about one’s true ability to perform a task in isolation can be responsible for large and stable confidence biases, namely limited discrimination, the hard–easy effect, the Dunning–Kruger effect, conservative learning from experience and the overprecision phenomenon (without underprecision) if subjects act as Bayesian learners who rely only on sequentially perceived performance cues and contrarian illusory signals induced by doubt. Moreover, these biases are likely to persist since the Bayesian aggregation of past information consolidates the accumulation of errors and the perception of contrarian illusory signals generates conservatism and under-reaction to events. Taken together, these two features may explain why intuitive Bayesians make systematically wrong predictions of their own performance.     

A Support Group for Caregivers of Children with Craniofacial Differences

ABSTRACT

Caregivers of children with craniofacial differences (CFD) experience psychosocial stressors; however, few groups are described for this population. The authors outline an eight-session group and qualitative analysis of caregivers’ experiences. The majority of participants (n = 100) were mothers (76%) of children who were female (75%) and identified as Latino (79%). Children’s mean age was 10.6 (SD = 2.8) years, and they were born with cleft lip/palate (56%) along with other CFD diagnoses. Themes included: group appreciation (21%), mutual acceptance (18%), coping (18%), parenting skills (17%), learning (9%), resiliency (7%), empathy (4%), diagnosis information (3%), and self-care (3%). Caregivers’ reported experiences largely corresponded with group goals.     

The impact of social heterogeneity and commodity price shocks on civil conflicts

Do exogenous economic shocks promote civil conflicts directly? Do they affect all the societies alike? The current approach presents a large sample panel data evidence not only on the effect of commodity export price shocks on conflict incidence, rather than onsets, but also on the joint impact of both ethnic and religious polarization and fractionalization on political instability. In this regard, we find out that in ethnically polarized societies, the commodity export price shocks increase violence. Nonetheless, in ethnically and religiously fractionalized societies (as well as religiously polarized), the effect of commodity export price shocks on civil conflicts depends on the type of income shocks and category of commodity. These findings contribute to the existing literature by illuminating the compound effect of both income shocks and social diversity on intrastate conflicts.     

Key decisions in child protection services in cases of domestic violence: maintaining services and out‐of‐home placement

This paper looks at the response of the child protection services (CPS) system in cases where exposure to domestic violence occurs alone or together with abuse or neglect, focusing on the factors involved in decisions to maintain the case open for ongoing services or remove children from the home. The study is based on an analysis of clinical and administrative data from the files on children reported to a CPS agency in Montreal, Canada. A total of 1 071 substantiated reports were documented, including 337 cases of co‐occurrence (32%). Analysis of the data shows that domestic violence does not by itself constitute a factor liable to lead to more intrusive intervention. The CPS response appears to be influenced more by the existence of other forms of maltreatment and risk factors. Additionally, while domestic violence may be associated with more severe individual and family problems, it does not influence the decision to keep the case open because the child still need services. The lack of any connection between domestic violence and this decision is a cause for concern, as results indicate that such families need help. Knowing how to respond to their needs therefore remains a major challenge.     

Partisan Cleavages in the Importance of Citizenship Rights and Responsibilities*

Objective. Research indicates partisan polarization on a number of social and moral attitudes. However, it is unclear whether a similar polarization can be found regarding citizenship norms, a question we investigate. Methods. Using 2004 GSS data, we examine regression results analyzing citizens' beliefs about a wide range of citizenship duties and rights based on their partisan identity. Results. Democrats and Republicans differ little in regard to many key rights and duties, such as the importance of voting and the right to equal treatment by the government. However, compared to Republicans, Democrats attach more importance to social duties and rights for political participation and for minority groups. Independents are most distinctive, placing much less importance on political duties and social rights of equality and an adequate standard of living, particularly in comparison to Democrats. Conclusion. The majority of Americans share a common set of citizenship norms. Yet, some differences occur along partisan lines, and Independents hold weaker citizenship norms compared to Republicans and Democrats.     

A decision-theoretical view of default priors

In this article, we outline a simple and intuitively appealing procedure to derive default priors. The main idea is to regard the choice of such a prior as a formal Bayesian decision problem. We also discuss Jeffreys prior and more generally the reference prior of Bernardo (J R Stat Soc B 41:113–147, 1979) from this standpoint.