Effectiveness of the Coral Tree Family Service family inpatient unit: a longitudinal study exploring change in family functioning

Child mental health disorders represent a major burden to public health in Australia due to high prevalence rates, the widespread impact across domains, and the potential for difficulties to persist into adolescence and adulthood. Extensive evidence exists for the use of parent management training and cognitive behavioural therapy to treat difficulties experienced by children; however, a proportion of children do not benefit as expected from these treatments. The use of complementary therapeutic approaches and variations to the mode and intensity of existing intervention is warranted; family inpatient units represent a unique example of this. The aim of this study is to evaluate the effectiveness of a well-established Australian inpatient unit that admits the whole family, for children aged 12 years and younger referred with mental health, behavioural, or emotional difficulties. This study's longitudinal within-subject study design utilised routinely collected outcome data from the systemic clinical outcome and routine evaluation, 15 item (SCORE-15)—a valid and reliable measure of family functioning—from a sample of 980 participants attending the Family Residential Program. This study reported significant improvement in family functioning across all outcome variables between baseline and post-intervention, with no variables returning to pre-intervention levels at follow-up. Clinically significant changes in overall family functioning showed that 37% of participant scores moved from the clinical range at baseline to the nonclinical range post-intervention. This study represents the first empirical evaluation of the Family Residential Program, and the reported results provide compelling evidence for the program to effect improvement in family functioning for families with long-standing and severe difficulties. Poor rates of questionnaire completion following intervention frequent the literature base of family inpatient units, with low post-intervention (56%) and follow-up (12%) rates evident in this study. This study uniquely contributes to the growing evidence base of family inpatient units using rigorous evaluation methods.     

Walk-in clinic counselling for emotional regulation with low-needs youth on the autism spectrum

A single-session consultation model for low-needs youth on the autism spectrum is presented with the mental health concern of emotional self-regulation, a common issue in family psychotherapy. This research is contextualised within the growing field of short-term therapy as it intersects the growing demand to therapeutically address clients on the autism spectrum. The treatment intervention is delineated through five sequential phases within the walk-in clinic setting for the practitioner clinician. A rationale, overview, and instruction for the practitioner clinician utilising this novel model is provided through a case study format. By using a more structured and integrated approach to treatment, organised through an externalised metaphor, it is suggested that the current model will be more effective for this specific clinical population. Additionally, a case illustration is provided that scaffolds the treatment model, which includes table formats and pictures. The case study illustrates the self-regulation map metaphor visually and interactively linking client challenges, strategies, and motivations simultaneously on multiple electronic devices in session. Relevant works were selected to explore the effectiveness of single-session consultation models for those presenting on the autism spectrum. Treatment interventions for specific clinical populations are recommended, especially within walk-in clinic therapy. This clinical research introduces a paradigm shift towards therapeutically addressing emotional self-regulation with low-needs youth on the spectrum through virtual, interactive technology.     

Stability analysis using mixed models: A critique of tolerance interval methods and a probabilistic solution

Recently, tolerance interval approaches to the calculation of a shelf life of a drug product have been proposed in the literature. These address the belief that shelf life should be related to control of a certain proportion of batches being out of specification. We question the appropriateness of the tolerance interval approach. Our concerns relate to the computational challenges and practical interpretations of the method. We provide an alternative Bayesian approach, which directly controls the desired proportion of batches falling out of specification assuming a controlled manufacturing process. The approach has an intuitive interpretation and posterior distributions are straightforward to compute. If prior information on the fixed and random parameters is available, a Bayesian approach can provide additional benefits both to the company and the consumer. It also avoids many of the computational challenges with the tolerance interval methodology.     

Revisiting the Prediction of Financial Vulnerability

Whether or not a nonprofit organization is vulnerable to financial problems is a concern of all stakeholders of the organization. Recently, Greenlee and Trussel (2000) and Trussel and Greenlee (2001) expanded Tuckman and Chang's work (1991) to predict which organizations are financially vulnerable. This article extends the work of these authors by developing a model of financial vulnerability that includes four financial indicators, controls for the sector to which an organization belongs, and is based on a sample of over ninety‐four thousand organizations. The model is useful as a screening, monitoring, and attention‐getting device.     

Borrowing Information across Populations in Estimating Positive and Negative Predictive Values

A marker's capacity to predict risk of a disease depends on disease prevalence in the target population and its classification accuracy, i.e. its ability to discriminate diseased subjects from non-diseased subjects. The latter is often considered an intrinsic property of the marker; it is independent of disease prevalence and hence more likely to be similar across populations than risk prediction measures. In this paper, we are interested in evaluating the population-specific performance of a risk prediction marker in terms of positive predictive value (PPV) and negative predictive value (NPV) at given thresholds, when samples are available from the target population as well as from another population. A default strategy is to estimate PPV and NPV using samples from the target population only. However, when the marker's classification accuracy as characterized by a specific point on the receiver operating characteristics (ROC) curve is similar across populations, borrowing information across populations allows increased efficiency in estimating PPV and NPV. We develop estimators that optimally combine information across populations. We apply this methodology to a cross-sectional study where we evaluate PCA3 as a risk prediction marker for prostate cancer among subjects with or without previous negative biopsy.     

Testing for qualitative interaction of multiple sources of informative dropout in longitudinal data

Longitudinal studies suffer from patient dropout. The dropout process may be informative if there exists an association between dropout patterns and the rate of change in the response over time. Multiple patterns are plausible in that different causes of dropout might contribute to different patterns. These multiple patterns can be dichotomized into two groups: quantitative and qualitative interaction. Quantitative interaction indicates that each of the multiple sources is biasing the estimate of the rate of change in the same direction, although with differing magnitudes. Alternatively, qualitative interaction results in the multiple sources biasing the estimate of the rate of change in opposing directions. Qualitative interaction is of special concern, since it is less likely to be detected by conventional methods and can lead to highly misleading slope estimates. We explore a test for qualitative interaction based on simultaneous confidence intervals. The test accommodates the realistic situation where reasons for dropout are not fully understood, or even entirely unknown. It allows for an additional level of clustering among participating subjects. We apply these methods to a study exploring tumor growth rates in mice as well as a longitudinal study exploring rates of change in cognitive functioning for Alzheimer's patients.     

Longitudinal dynamic analyses of cognition in the health and retirement study panel

The purpose of this paper is to highlight some classic issues in the measurement of change and to show how contemporary solutions can be used to deal with some of these issues. Five classic issues will be raised here: (1) Separating individual changes from group differences; (2) options for incomplete longitudinal data over time, (3) options for nonlinear changes over time; (4) measurement invariance in studies of changes over time; and (5) new opportunities for modeling dynamic changes. For each issue we will describe the problem, and then review some contemporary solutions to these problems base on Structural Equation Models (SEM). We will fit these SEM to using existing panel data from the Health & Retirement Study (HRS) cognitive variables. This is not intended as an overly technical treatment, so only a few basic equations are presented, examples will be displayed graphically, and more complete references to the contemporary solutions will be given throughout.     

Vendor Selection with Bundling: A Comment*

In a recent article by Rosenthal, Zydiak, and Chaudhry (1995), a mixed integer linear programming model was introduced to solve the vendor selection problem for the case in which the vendor can sell items individually or as part of a bundle. Each vendor offered only one type of bundle, and the buyer could purchase at most one bundle per vendor. The model employed n(m+ 1) binary variables, where n is the number of vendors and m is the number of products they sell. The existing model can lead to a purchasing paradox: it may force the buyer to pay more to receive less. We suggest a reformulation of the same problem that (i) eliminates this paradox and reveals a more cost-effective purchasing strategy; (ii) uses only n integer variables and significantly reduces the computational workload; and (iii) permits the buyer to purchase more than one bundle per vendor.     

Sociology's misfortune: disciplines, interdisciplinarity and the impact of audit culture

This paper is about tendencies to the subversion of sociology as a discipline. It connects external factors of the wider socio-political environment of higher education in the UK, especially those associated with the audit culture and new systems of governance, with the internal organization of the discipline. While the environment is similar for all social science subjects, the paper argues that there are specific consequences for sociology because of characteristics peculiar to the discipline. The paper discusses these consequences in terms of the changing relationship between sociology and the growing interdisciplinary area of applied social studies as a form of 'mode 2 knowledge'. It argues that while sociology 'exports' concepts, methodologies and personnel it lacks the internal disciplinary integrity of other 'exporter' disciplines, such as economics, political science and anthropology. The consequence is an increasingly blurred distinction between sociology as a discipline and the interdisciplinary area of applied social studies with a potential loss of disciplinary identity. The paper concludes with a discussion of how this loss of identity is associated with a reduced ability to reproduce a critical sensibility within sociology and absorption to the constraints of audit culture with its preferred form of mode 2 knowledge.