Summing up. Recommendations and experiences for evaluation of community-level prevention programs

This article provides recommendations and observations about evaluation of a locally based prevention project to reduce problems at a total community or aggregate level. The shift from targeting specific individuals or subpopulations to the overall structure and environment of a community is most demanding. Evaluation tools and analysis techniques have lagged behind program development because community-level interventions are not linked to a specific target group who can be separately studied. Thus assumptions about using random assignment and/or comparison communities as means to control for confounding variables are weakened when the unit of analysis is the community itself and dependent measures are subject to trending and the effects of history.     

On the shrinkage of local linear curve estimators

Local linear curve estimators are typically constructed using a compactly supported kernel, which minimizes edge effects and (in the case of the Epanechnikov kernel) optimizes asymptotic performance in a mean square sense. The use of compactly supported kernels can produce numerical problems, however. A common remedy is ridging, which may be viewed as shrinkage of the local linear estimator towards the origin. In this paper we propose a general form of shrinkage, and suggest that, in practice, shrinkage be towards a proper curve estimator. For the latter we propose a local linear estimator based on an infinitely supported kernel. This approach is resistant against selection of too large a shrinkage parameter, which can impair performance when shrinkage is towards the origin. It also removes problems of numerical instability resulting from using a compactly supported kernel, and enjoys very good mean squared error properties.     

The birds and the bees: interactive graphics and problem solving in the teaching of statistics

Software which allows interactive exploration of graphical displays is widely available. In addition there now exist sophisticated authoring tools which allow more general textual and graphical material to be presented in computer-based form. The role of an authoring tool in providing a graphical interface to a strategy for solving simple statistical problems in the context of teaching is discussed. This interface allows a variety of resources to be integrated. Specific examples, including the use of dynamic graphical displays in exploring data and in communicating the meaning of a model, are proposed. These ideas are illustrated by a problem involving the identification of the sex of a herring gull.     

Net worth and the economic diversity of the elderly

Using data from the 1984 panel of the Survey of Income and Program Participation (SIPP), this article examines characteristics of the older population disaggregated by net-worth quintiles. The authors argue that income is not a sufficient measure of economic status for current policy discussions on issues such as changing Medicare co-payments, increasing the taxation of social security benefits, or means-testing under Medicaid. Net worth is a better measure of economic status, particularly for the elderly, because it represents the net value of assets accumulated over the life course. Their results indicate that there is considerable diversity in the economic status of the older population, which is masked by aggregate statistics (such as means and medians) typically used to summarize the economic status of population groups. Stereotypical views of the elderly based on such aggregates result in misdirected policy formulation. In the future, policymakers will need to formulate policies and programs using information on the distributions of income and assets among the older populations rather than relying on statistical aggregates.     

How well is debt managed by nonprofits?

Little is known about why nonprofits accrue debt, how much they owe, and whether the funds they borrow are used productively. This article distinguishes between productive, problematic, and deferred debt. Employing a data base representative of 114,726 tax-filing charitable nonprofits in the United States in 1986, it examines the pervasiveness of nonprofit debt and the relation between this debt and nonprofit financial health. The analysis finds that over 70 percent of the nonprofits hold debt, the distribution of this debt is highly concentrated, and the level of debt and leverage varies with asset size and type of activity. Nonprofits with higher leverage and absolute debt levels are financially healthier than those with lower levels. While the analysis does not determine whether financially stronger nonprofits are better able to borrow, the results support the view that borrowing in the nonprofit sector is economically efficient.     

The minds of a medical director

This article is offered in a nod to all those readers who have been exposed to "whole brain" theory, either through the American College of Physician Executives or elsewhere. As managers struggle with balancing the "left brain" and "right brain" aspects of their work, the author says, they might consider exploiting a third area of activity, or inactivity--the "no brain." This center position can be especially effective in dealing with the high-technology aspects of delivering health care.     

Human genetic technology: who shall control?

The biotechnical "revolution" has fast come upon us. It promises to produce both substantial benefits and difficult dilemmas for individuals and society. Despite the growing attention being paid to biotechnology, a major unanswered question is who shall control the development and use of the powerful array of human genetic and reproductive innovations. Should the decisions be left to individual consumers and private industry or should they be made by the government or other social institutions? After briefly reviewing development in human genetics and reproduction and describing trends toward commercialization of them, this article discusses the dilemmas these trends raise for a democratic society. It argues for the urgent need to delineate societal goals and priorities for the future and for technology assessment as early as possible in the developmental process. The article concludes by presenting some examples of the social policy problems now emerging.