Substance Use Decision-Making – Are Clinicians Using the Evidence?

Clinical assessment and treatment decision-making is a complex, everyday task for the substance use workforce. This Canadian study conducted with community substance use providers in the Interior region of British Columbia examines the factors clinicians pay attention to in their decision-making. A randomized factorial survey approach, using three unique vignettes embedded with factors of interest, was used to test the effect of case and respondent factors on assessment and treatment decisions. Responses were received from 106 participants, representing approximately a 35% response rate, yielding a sample size (n) of 308 vignettes. Multiple regression tested the independent effects of the vignette and clinician factors on assessment and treatment decisions. Factors within the vignette associated with withdrawal, physical illness and mental health issues emerged as the most predictive elements. The social complexity of people’s lives, client’s stated treatment preferences and readiness for change, and respondent characteristics were obscured in decision-making. This study indicates a lack of fidelity in the use of core assessment and treatment-matching tools, suggesting that clinician decision-making may, in everyday practice, be more heuristic and evidence-informed than evidence-based. Further research on normative decision-making practices in the substance-field is warranted.     

On Extending Russell and Krajewski's Algorithm for Economic Purchase Order Quantities*

Russell and Krajewski presented an optimal purchase order quantity algorithm that considered the effect of the transportation rate structure for less-than-truckload (LTL) shipments. The authors applied the Russell and Krajewski algorithm to a variety of freight classes and lengths-of-haul. Anomalous cases were found in which the freight rate schedule, when used with the suggested algorithm, resulted in incorrect order size decisions. In this comment, the authors consider the impact of these anomalies on the optimal order quantity and associated total costs. A procedure is presented to adjust the Russell and Krajewski algorithm to arrive at the optimal purchase order quantity and the lowest total annual cost.     

Bayesian covariance matrix estimation using a mixture of decomposable graphical models

We present a Bayesian approach to estimating a covariance matrix by using a prior that is a mixture over all decomposable graphs, with the probability of each graph size specified by the user and graphs of equal size assigned equal probability. Most previous approaches assume that all graphs are equally probable. We show empirically that the prior that assigns equal probability over graph sizes outperforms the prior that assigns equal probability over all graphs in more efficiently estimating the covariance matrix. The prior requires knowing the number of decomposable graphs for each graph size and we give a simulation method for estimating these counts. We also present a Markov chain Monte Carlo method for estimating the posterior distribution of the covariance matrix that is much more efficient than current methods. Both the prior and the simulation method to evaluate the prior apply generally to any decomposable graphical model.     

The Impact of Alternative Vendor/ Buyer Communication Structures on the Quality of Purchased Materials

This paper examines the critical interface between manufacturing, purchasing, and quality assurance by exploring the impact of two alternative structures of buyer and vendor communication on attempts to improve the quality of purchased items. Those two structures of communication are the parallel structure and the serial structure. The research analyzes and compares the advantages and disadvantages of these two specific communication structures; the results have implications for both researchers and managers. The analysis of data suggests that the parallel structure is associated with significantly higher levels of quality than the serial structure. From a managerial perspective, the results of the research suggest that manufacturers must consider the parallel communication structure as a viable alternative for improving the quality of purchased components. While this study has helped frame some key managerial issues, the need and opportunity for further research in related areas is delineated.     

A cost of living longer: Projections of the effects of prospective mortality improvement on economic support ratios for 14 advanced economies

The economic implications of increasing life expectancy are important concerns for governments in developed countries. The aims of this study were as follows: (i) to forecast mortality for 14 developed countries from 2010 to 2050, using the Poisson Common Factor Model; (ii) to project the effects of the forecast mortality patterns on support ratios; and (iii) to calculate labour force participation increases which could offset these effects. The forecast gains in life expectancy correlate negatively with current fertility. Pre-2050 support ratios are projected to fall most in Japan and east-central and southern Europe, and least in Sweden and Australia. A post-2050 recovery is projected for most east-central and southern European countries. The increases in labour force participation needed to counterbalance the effects of mortality improvement are greatest for Japan, Poland, and the Czech Republic, and least for the USA, Canada, Netherlands, and Sweden. The policy implications are discussed.     

Respite and family support services: Responding to the need

Increased focus on the needs of parents and guardians for structured opportunities for temporary relief from care of disabled persons has stimulated policy and implementation initiatives at the state government level on behalf of these families. This article presents qualitative and quantitative data on the need for respite services not only in terms of relief, but as a positive, supportive force in the prevention of permanent placement outside the home. Current services are outlined and issues important to clinicians and managers working with such families are discussed.Planning and Development     

“Did You See What I Saw?” Gender Differences in Perceptions of Avenues to Prestige among Adolescents

We use data from 1,796 college students to explore gender differences in perceptions of avenues to prestige during adolescence. Students attending seven large universities during the 1997–98 academic year provided information on the ways in which adolescents in their high schools had gained prestige with peers. The analysis reveals substantial gender differences in perceptions regarding the most common avenues to prestige. Most important, men were less likely than women to report that female students in their high schools accrued prestige through sports and grades, and more likely than women to report that male students accrued prestige through engaging in deviant behaviors, such as sexual activity, drug and alcohol use, and fighting. We discuss the findings in the context of gender differences in social perception and gender-role attitudes.     

Status Roles and Recall of Nonverbal Cues

In two experiments, interpersonal status was experimentally manipulated by assigning one dyad member to be the owner of a mock art gallery and the other to be the owner's assistant. Without forewarning, participants were asked immediately following the interaction to recall their partner's hand gestures, self-touch, gazing, smiling, and nodding. Accuracy of recall was determined by comparing these ratings to their partners' behavior as coded from the videotape. In both experiments, assistants were more accurate at recalling the amount of owners' self-touch than vice versa, but there was little evidence of an accuracy difference in recall of the other nonverbal cues. When accuracy was defined as the correlation between a participant's ratings of the partner's behaviors and the partner's actual behaviors, there was evidence that assistants were more accurate than owners when a combined p-value was calculated across both studies.