Quality Assessment of the Oncology Health Service in a Public Hospital

Quality assessment is a crucial issue in the strategic management of the public health sector. The objective of this study is to investigate the patients’ perception of the health system quality and explore the relationships between doctors and long-term cancer patients. The data under study have been collected during a survey conducted with long-term cancer patients who follow an oncological therapy in a Public Hospital. In the study, exploratory factorial analysis is developed and two structural equation models are proposed. The first model describes the service quality as perceived by the patients, which is influenced by four important factors, namely tangible aspects, reliability, empathy (doctor–patient human relations) and hospital organization. The second model describes the relationship between doctors and long-term cancer patients, which is influenced by three factors, that is reliability, empathy and hospital organization. The discussion highlights the contribution that the results of the study may make to the investigation of the possible strategies for improving health care service quality.

     

So Close,So Far. The Cultural Distance of Foreigners in Italy

Social Indicators Research - The presence of foreigners in a host country is a contentious issue: opponents claim, among other things, that the cultural distance between them and natives is too...     

Projecting Long-Term Care Expenditure in Four European Union Member States: The Influence of Demographic Scenarios

This study examines the sensitivity of future long-term care demand and expenditure estimates to official demographic projections in four selected European countries: Germany, Spain, Italy and the United Kingdom. It uses standardised methodology in the form of a macro-simulation exercise and finds evidence for significant differences in assumptions about demographic change and its effect on the demand for long-term care, and on relative and absolute long-term care expenditure. It concludes that mortality-rate assumptions can have a considerable influence on welfare policy planning. Relative dispersion between country-specific and Eurostat official estimates was found to be higher for the United Kingdom and Germany than for Italy and Spain, suggesting that demographic projections had a greater influence in those countries.

Quality of Life in Europe: Objective and Subjective Indicators A Spatial Analysis Using Classification Techniques

Social Indicators Research -     

A computer algebra package for approximate conditional inference

This paper presents a set of REDUCE procedures that make a number of existing higher-order asymptotic results available for both theoretical and practical research. Attention has been restricted to the context of exact and approximate inference for a parameter of interest conditionally either on an ancillary statistic or on a statistic partially sufficient for the nuisance parameter. In particular, the procedures apply to regression-scale models and multiparameter exponential families. Most of them support algebraic computation as well as numerical calculation for a given data set. Examples illustrate the code.     

Restricted likelihood inference for generalized linear mixed models

We aim to promote the use of the modified profile likelihood function for estimating the variance parameters of a GLMM in analogy to the REML criterion for linear mixed models. Our approach is based on both quasi-Monte Carlo integration and numerical quadrature, obtaining in either case simulation-free inferential results. We will illustrate our idea by applying it to regression models with binary responses or count data and independent clusters, covering also the case of two-part models. Two real data examples and three simulation studies support the use of the proposed solution as a natural extension of REML for GLMMs. An R package implementing the methodology is available online.     

Global and local statistical properties of fixed-length nonparametric smoothers

The main purpose of this study is to analyze the global and local statistical properties of nonparametric smoothers subject to a priori fixed length restriction. In order to do so, we introduce a set of local statistical measures based on their weighting system shapes and weight values. In this way, the local statistical measures of bias, variance and mean square error are intrinsic to the smoothers and independent of the data to which they will be applied on. One major advantage of the statistical measures relative to the classical spectral ones is their easiness of calculation. However, in this paper we use both in a complementary manner. The smoothers studied are based on two broad classes of weighting generating functions, local polynomials and probability distributions. We consider within the first class, the locally weighted regression smoother (loess) of degree 1 and 2 (L1 and L2), the cubic smoothing spline (CSS), and the Henderson smoothing linear filter (H); and in the second class, the Gaussian kernel (GK). The weighting systems of these estimators depend on a smoothing parameter that traditionally, is estimated by means of data dependent optimization criteria. However, by imposing to all of them the condition of an equal number of weights, it will be shown that some of their optimal statistical properties are no longer valid. Without any loss of generality, the analysis is carried out for 13- and 9-term lengths because these are the most often selected for the Henderson filters in the context of monthly time series decomposition. We would like to thank an Associate Editor and an anonymous referee for their valuable comments on an earlier version of this paper. Financing from MURST is also gratefully acknowledged.     

A non-linear time series approach to modelling asymmetry in stock market indexes

In this paper we analyse the performances of a novel approach to modelling non-linear conditionally heteroscedastic time series characterised by asymmetries in both the conditional mean and variance. This is based on the combination of a TAR model for the conditional mean with a Constrained Changing Parameters Volatility (CPV-C) model for the conditional variance. Empirical results are given for the daily returns of the S&P 500, NASDAQ composite and FTSE 100 stock market indexes.     

Childhood Maltreatment and Difficulties in Emotion Regulation: Associations with Sexual and Relationship Satisfaction among Young Adult Women

This study examined relations among childhood maltreatment, difficulties in emotion regulation, and sexual and relationship satisfaction among young adult women reporting current involvement in committed, romantic relationships. A sample of 192 women (ages 18–25) completed self-report questionnaires as part of an Internet-based survey. It was hypothesized that severity of childhood maltreatment and difficulties in emotion regulation would each independently and negatively predict (a) sexual satisfaction, (b) relationship intimacy, and (c) expression of affection within the context of the relationship. Furthermore, it was hypothesized that greater emotion regulation difficulties would moderate the effects of childhood maltreatment on these sexual and relationship variables (i.e., sexual satisfaction, relationship intimacy, and expression of affection). Findings suggest that difficulties in emotion regulation demonstrated an incremental effect with regard to sexual satisfaction, but not with intimacy and affection expression. In contrast to predictions, no significant interactive effects were documented. Clinical implications and future directions related to this line of inquiry are discussed.