Are we making progress? Not in haematology!

It will be shown, through the presentation of recent research findings, that haematology is a neglected area in terms of sensitive care of the dying. The Australian evidence indicates that scant progress has been made in relation to even the most basic palliative care practices such as sensitive, honest information giving or appropriate referral to the palliative system. Rather, the data show that during terminal trajectory, patients from these diagnostic groups and their families remain trapped in processes within the high-tech, curative system that are not responsive to the needs of the dying.     

The impact of non-bottleneck variation in a manufacturing cell

Protective capacity is the 'extra' capacity placed at non-bottleneck resources to absorb random disruptions in planned levels of performance so that the bottleneck resource continues to be effectively utilized. A full factorial experiment with a simulation model was conducted to explore issues associated with the quantity and location of processing variance in a five-station manufacturing cell. The cell's performance was measured using both mean flow time ( MFT ) and bottleneck shiftiness ( SHIFT ) for 3 patterns of variance for the non-bottlenecks at 5 different levels of variation. In order to investigate the importance of the quantity of added capacity on the variation both a low level of protective capacity (10%) and a high level (50%) were considered. The results indicate that having the higher variation work centres close to the bottleneck provides reduced MFT and SHIFT . The performance measures improved at both the low and high setting of protective capacity.     

CURRICULUM CHANGES TO MEET CHALLENGES: PREPARING MFT STUDENTS FOR MANAGED CARE SETTINGS

Fledgling therapists who graduate from family therapy traning programs will have to navigate the world of managed care. In this article, faculty of University of San Diego share changes in its accredited training program that prepare students for practice in an increasingly multidisciplinary world where health maintenence organizations and other versions of managed care predominate. The paper touches on contextual issues, provides a detailed outline of coursework presenting basic knowledge and skills involved in clinical pracice in a managed care environment, and comments on clinical placements and the challenge of helping the next generation of clinicans "fit" into the future of health care delivery while maintaining their unique identity as family therapists.     

Bias Reduction through First-order Mean Correction, Bootstrapping and Recursive Mean Adjustment

Standard methods of estimation for autoregressive models are known to be biased in finite samples, which has implications for estimation, hypothesis testing, confidence interval construction and forecasting. Three methods of bias reduction are considered here: first-order bias correction, FOBC, where the total bias is approximated by the O(T^-1) bias; bootstrapping; and recursive mean adjustment, RMA. In addition, we show how first-order bias correction is related to linear bias correction. The practically important case where the AR model includes an unknown linear trend is considered in detail. The fidelity of nominal to actual coverage of confidence intervals is also assessed. A simulation study covers the AR(1) model and a number of extensions based on the empirical AR(p) models fitted by Nelson & Plosser (1982). Overall, which method dominates depends on the criterion adopted: bootstrapping tends to be the best at reducing bias, recursive mean adjustment is best at reducing mean squared error, whilst FOBC does particularly well in maintaining the fidelity of confidence intervals.     

Toward a Culturally Informed Rehabilitation Treatment Model for American Indian/Alaska Native Veterans

American Indians and Alaska Natives (AI/AN) have a long tradition of military service, allying with Western forces in North America since the 1700s. It is hardly surprising, therefore, that AI/AN veterans experience higher rates of overall disability and service-related disability than veterans of other races and ethnicities. It is not clear, however, that AI/AN veterans with disabilities are receiving effective, culturally informed rehabilitation services. This article examines the incidence of disability among contemporary AI/AN veterans, considers barriers to effective treatment, and points out model programs tailored to the particular needs of this population, with attention to the historical and cultural context of AI/AN military service.     

The Patient Transit Assistance Scheme: A case for social work advocacy!

Abstract

The Patient Transit Assistance Scheme is one of Queensland Health's initiatives designed to facilitate equity of access for Queensland residents to essential health care services. The purpose of the scheme is to help all Queenslanders, irrespective of where they live, to have access to specialist medical services. It provides direct financial assistance to patients and in some cases their carers, to facilitate access to specialist medical services irrespective of geographic location.

The findings of recent research conducted on social worker involvement with PTAS for patients diagnosed with leukaemia and associated haematological disorders will be used to argue that the problems in relation to the administration of this scheme require serious attention at the level of patient care and health policy.     

The Cat and Mouse Game at the Mexico‐U.S. Border: Gendered Patterns and Recent Shifts1

This paper provides new insights into the process of undocumented border crossing by examining both men and women in the process. We investigate differences in the ways in which men and women make their way across the well‐guarded Mexico‐U.S. border, and the extent to which men and women by the end of the 1990s were similar to, or different from, their counterparts who crossed before 1986 and the implementation of immigration policy designed to reduce undocumented migration. We find substantial differences in how men and women crossed the border without legal documents and in their chances of being apprehended. Our analysis makes clear that shifts in U.S. immigration policy after 1986 have led to women's greater reliance on the assistance of paid smugglers to cross without documents but men were more likely to cross alone. Moreover, immediately after 1986, women on first U.S. trips faced higher risks of being apprehended compared to women who migrated in the early 1980s, but men faced lower risks. After accumulating some U.S. experience, however, both women and men faced lower risks of being detected after 1986 compared to earlier in that decade.