Coherence principles in interval‐based dose finding

This paper studies the notion of coherence in interval‐based dose‐finding methods. An incoherent decision is either (a) a recommendation to escalate the dose following an observed dose‐limiting toxicity or (b) a recommendation to deescalate the dose following a non–dose‐limiting toxicity. In a simulated example, we illustrate that the Bayesian optimal interval method and the Keyboard method are not coherent. We generated dose‐limiting toxicity outcomes under an assumed set of true probabilities for a trial of n=36 patients in cohorts of size 1, and we counted the number of incoherent dosing decisions that were made throughout this simulated trial. Each of the methods studied resulted in 13/36 (36%) incoherent decisions in the simulated trial. Additionally, for two different target dose‐limiting toxicity rates, 20% and 30%, and a sample size of n=30 patients, we randomly generated 100 dose‐toxicity curves and tabulated the number of incoherent decisions made by each method in 1000 simulated trials under each curve. For each method studied, the probability of incurring at least one incoherent decision during the conduct of a single trial is greater than 75%. Coherency is an important principle in the conduct of dose‐finding trials. Interval‐based methods violate this principle for cohorts of size 1 and require additional modifications to overcome this shortcoming. Researchers need to take a closer look at the dose assignment behavior of interval‐based methods when using them to plan dose‐finding studies.     

Passing Encounters East and West: Comparing Japanese and American Pedestrian Interactions

This study examined the microinteractions of pedestrians in Japan and in the United States as they walked past a confederate. Specifically, the effects of culture, condition (avoid, look-only, and look plus smile) and sex of confederate on glances, smiles, nods, and greetings by passing pedestrians were examined in a field study on over 1000 participants. The hypotheses of (1) lower responsiveness in Japanese pedestrians than in American pedestrians and (2) increased responsiveness as a function of condition were supported in a series of log-linear analyses of pedestrian glances, smiles, nods, and greetings. Both of these main effects were, however, qualified by Culture X Condition interactions on smiles, nods, and greetings, with the large condition effects present in the American pedestrians, but absent in the Japanese pedestrians. The results are discussed in terms of the functions of glances, smiles, nods, and greetings in these brief encounters and how differing cultural norms affect Japanese and American responsiveness. Finally, the limitations of this study and the broader utility of this research paradigm are discussed.

Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Applications and Implementation A SEPARABLE PROGRAMMING APPROACH TO EXPECTED COVERAGE: AN APPLICATION TO AMBULANCE LOCATION

The maximum expected covering location problem (MEXCLP) is reformulated using a separable programming approach. The resulting formulation—nonlinear maximum expected covering location problem (NMEXCLP)—guarantees optimality and also solves more quickly than previous heuristic approaches. NMEXCLP allows two important extensions. First, minor formulation changes allow the specification of the minimum number of times each node is to be covered in order to satisfy expected coverage criteria. Second, coverage matrices can be constructed that consider two different types of coverage simultaneously. Both extensions are useful for ambulance location problems and are demonstrated in that setting.     

AN APPROXIMATION TO THE HYPERCUBE MODEL WITH PATROL-INITIATED ACTIVITIES: AN APPLICATION TO POLICE

This paper applies the patrol-initiated-activity hypercube queuing model to historical data from a police agency. The model allows servers to handle both calls assigned by a central dispatcher and activities initiated by the servers. By duplicating a fairly complex dispatch strategy, the model was found to predict both assigned and server-initiated work loads accurately for the overall system and individual servers. The model is apparently ineffective in predicting small unit-travel-time differences for this police agency.     

Guest editorial: Image analysis

Statistics and Computing -     

Learning from a lot: Empirical Bayes for high‐dimensional model‐based prediction

Empirical Bayes is a versatile approach to “learn from a lot” in two ways: first, from a large number of variables and, second, from a potentially large amount of prior information, for example, stored in public repositories. We review applications of a variety of empirical Bayes methods to several well‐known model‐based prediction methods, including penalized regression, linear discriminant analysis, and Bayesian models with sparse or dense priors. We discuss “formal” empirical Bayes methods that maximize the marginal likelihood but also more informal approaches based on other data summaries. We contrast empirical Bayes to cross‐validation and full Bayes and discuss hybrid approaches. To study the relation between the quality of an empirical Bayes estimator and p, the number of variables, we consider a simple empirical Bayes estimator in a linear model setting. We argue that empirical Bayes is particularly useful when the prior contains multiple parameters, which model a priori information on variables termed “co‐data”. In particular, we present two novel examples that allow for co‐data: first, a Bayesian spike‐and‐slab setting that facilitates inclusion of multiple co‐data sources and types and, second, a hybrid empirical Bayes–full Bayes ridge regression approach for estimation of the posterior predictive interval.     

A systematic literature review of the etiology of borderline personality disorder from an ecological systems PERSPECTIVE

Borderline Personality Disorder (BPD) is one of the most common, complex, costly, and severely impairing personality disorders, affecting an estimated 2% to 9% of the general population and 40% to 44% of the inpatient psychiatric population. A review of the literature was conducted using a systematic methodology. By incorporating an ecological systems perspective, a holistic and comprehensive critique of the literature surrounding the etiology of BPD is presented. The findings reveal that the etiology of BPD is a complex integration of psychological, biological, and social factors. More specifically, however, this review found that: (1) the etiology of BPD is complex and has many factors, (2) the dominant discourse about the etiology of BPD is based primarily in the psychological and biological literature, and (3) the examination of BPD etiology has focused solely on the individual and microsystems levels, neglecting to consider systemic factors such as the impact of discriminatory health and mental healthcare practices. Findings and future directions are explored through the ecological systems theory lens.     

Self-Stigma of seeking help and job burnout in mental health care providers: the comparative study of Lithuanian and the USA samples

This study aimed to explore the correlation between job burnout and self-stigma of seeking help among nonmedical mental health care providers (psychologists, social workers, and counselors) in two countries – Lithuania and the US. The study included 234 professionals (111 social workers and 123 psychologists) from Lithuania and 93 professionals (33 counselors, 23 social workers, and 37 psychologists) from the US on a voluntary basis (93% females, mean age – 39.81?years). They completed a self-reported questionnaire with the Self-Stigma of Seeking Help Scale (SSOSH) and the Maslach Burnout Inventory-General Survey (MBI-GS). The results revealed a statistically significant positive correlation between self-stigmatization and burnout in the Lithuanian sample, but only weak positive correlation between depersonalization and self-stigma of seeking help in the US sample. The relationship between the self-stigma of seeking help and burnout was stronger in the Lithuanian sample of professionals when compared to their colleagues in the US.     

Trajectories of Interracial Heterosexual Couples: A Longitudinal Analysis of Relationship Quality and Separation

Minimal research has examined interracial couples’ relationship satisfaction and dissolution patterns over time. Using dyadic data across 8 years, we examined potential differences in relationship quality trajectories through latent growth curve modeling with 1,336 couples as well as differential risks for relationship dissolution through logistic regression between same‐race and interracial relationships using a different subset of 2,370 couples. Results indicated that women in interracial relationships were significantly lower in initial relationship quality than women in same‐race relationships. Further, interracial couples of Black‐Hispanic partnerings were twice as likely to separate across 8 years than same‐race couples. These results suggest that despite interracial relationships not substantively differing from same‐race couples in trajectories of relationship quality, specific Black‐Hispanic interracial couples are at a higher risk of eventual separation.