A Bootstrap Approach for Testing Marginal Independence Between Two Categorical Variables When Subjects Have Repeated Responses

To assess independence in two-way contingency tables, the Pearson chi-square test or Fisher’s exact test are typically used. These tests assume that each subject contributes at most one count to only one table cell (e.g., sex versus blood type). In other situations, each subject may have more than one count contributing to the table and these counts may occur in different cells of the table. One may wish to test independence, adjusting for the within-subject correlation. We provide a simple nonparametric bootstrap approach and assess its performance through simulation studies. The method is illustrated on subjects with multiple mental health presentations to Emergency Departments.     

Till Debt do us Part: A Model of Divorce and Personal Bankruptcy

The number of personal bankruptcies has increased dramatically since 1990, and a growing number of filers are divorced. While previous research shows that divorce significantly increases the probability of bankruptcy, these studies assume divorce is exogenous. This study uses the Panel Study of Income Dynamics to investigate the relationship between divorce and bankruptcy. Single-equation probit results show that divorce significantly increases the probability of bankruptcy and bankruptcy significantly increases the probability of divorce. However, after controlling for endogeneity, the effect of divorce on bankruptcy and the effect of bankruptcy on divorce both fall by a significant amount and are statistically insignificant. The findings suggest that future research needs to more carefully model the role that financial distress plays within a marriage.

The Negotiation of Child Care and Employment Demands Among Low-Income Parents

Low-income working mothers face significant child care challenges. These challenges are particularly salient in an era of welfare reform, when welfare recipients are under increased pressure to find a job. The current study examines how child care demands are negotiated for an urban sample of low-income mothers. The sample includes a racially and ethnically diverse group of 57 respondents with and without welfare experience who are mothering children under 13 years of age and working in entry-level jobs. Findings suggest that respondents seek arrangements that are affordable, convenient, and safe, and informal arrangements may be most compatible with convenience and cost considerations. Informal care is not universally available, however, andmay be less reliable. Implications for child care policy are discussed.     

Corporate Environmentalism and Organic Agriculture in Australia: The Case of Uncle Tobys1

Abstract Recent expansion in the organic food industry represents an increasing awareness amongst an array of actors of the implications of conventional agriculture. In particular, the organic agriculture movement has been driven by both organic producers and consumers concerned about the environmental implications of food production and the health effects associated with food consumption. The recent institutionalization of the organic movement in organic regulatory bodies and through the involvement of food companies has encapsulated other actors within this network. This paper looks specifically at Uncle Tobys, a producer of breakfast cereals, which joined this network when it decided to produce an organic breakfast cereal called “Organic Vita Brits.” The integration of this company has expanded the range of actors participating within the organic network and altered the relationships between them. The temporary involvement of Uncle Tobys in the organic food industry has also resulted in a shift in the construction of meaning of “organic.” The limited success, despite many efforts to appeal to green consumers, of Uncle Tobys within this network suggests that organic food remains a niche product, consumed by a minority of consumers.     

Spatio‐temporal modelling of disease mapping of rates

This paper studies generalized linear mixed models (GLMMs) for the analysis of geographic and temporal variability of disease rates. This class of models adopts spatially correlated random effects and random temporal components. Spatio‐temporal models that use conditional autoregressive smoothing across the spatial dimension and autoregressive smoothing over the temporal dimension are developed. The model also accommodates the interaction between space and time. However, the effect of seasonal factors has not been previously addressed and in some applications (e.g., health conditions), these effects may not be negligible. The authors incorporate the seasonal effects of month and possibly year as part of the proposed model and estimate model parameters through generalized estimating equations. The model provides smoothed maps of disease risk and eliminates the instability of estimates in low‐population areas while maintaining geographic resolution. They illustrate the approach using a monthly data set of the number of asthma presentations made by children to Emergency Departments (EDs) in the province of Alberta, Canada, during the period 2001–2004. The Canadian Journal of Statistics 38: 698–715; 2010 © 2010 Statistical Society of Canada     

Rights To Health—Or Medicine: The Health Promotion Perspective

The right to perfect health—something that in its fullest sense is unattainable—and the right to pursue it can distract us from achievable goals that take into account the inevitability of disability and death and the necessity of providing people with the capacities and rights that will enable each person to cope with their own imperfections.     

Bouncing back

If you have taken a career sidetrack, realize that you are still marketable. You have skills, traits, and knowledge that are transferable to many new opportunities. Fortunately, many leaders today in health care and executive search are familiar with your plight, given that they all have their own version of initiatives that did not fly. They will not judge you unfairly because they understand all too well the complex pressures of today's health care environment, filled with risk, cost constraints, and unrealistic profit targets. If you're bouncing back from an unfortunate career move, these steps may keep you focused on your search for new opportunities: (1) recognize that you are not alone, (2) realize that the entity failed, not you, (3) discuss the former position in a positive light, (4) don't give in to cynicism or self-pity, (5) don't let it happen to you again, and (6) play an active role in structuring your next position.     

Delegation can make (or break) your career

Delegation is not a soft skill. Physician executives who do not delegate well and strategically cannot expect to achieve the top jobs now or in the future. It's not enough to have great communications skills to convey your vision. You won't achieve that vision alone; you must have a great team to bring that vision to fruition. However, you can't delegate your first and most important step--self-assessment. To maximize your strengths and minimize your weaknesses, you'll need a clear view of what makes you tick. Then start thinking about your executive role in these terms: Conceptualize work mandates as projects; choose people who are better than you for your team; and try to work yourself out of a job. By learning to delegate, physician executives can make their own careers (as well as those on their team) richer and more fulfilled.