Evaluating the effectiveness of the Massachusetts workforce development system using no-shows as a nonexperimental comparison group

This article examines the effect of the Massachusetts workforce development system on the earnings of disadvantaged adults using nonexperimental data from the late 1990s. The authors construct a comparison sample for program participants using individuals who apply for and are offered services yet do not participate in a training program. They present a series of difference-in-difference estimates that make several alternative efforts to correct for selectivity bias, including econometric models that regression adjust for observable characteristics and fixed-effect models that adjust for time-invariant person effects. They also employ probabilistic matching techniques to more finely align the treatment and comparison samples. On average, program participants experienced 20% increases in annual earnings 1 year postintervention and 25% increases after 2 years. The authors uncover considerable heterogeneity in these effects, suggesting that the most difficult to serve and the most job ready benefit the least.     

Are Adult Patients More Tolerant of Treatment Risks Than Parents of Juvenile Patients?

Understanding patient-specific differences in risk tolerance for new treatments that offer improved efficacy can assist in making difficult regulatory and clinical decisions for new treatments that offer both the potential for greater effectiveness in relieving disease symptoms, but also risks of disabling or fatal side effects. The aim of this study is to elicit benefit-risk trade-off preferences for hypothetical treatments with varying efficacy and risk levels using a stated-choice (SC) survey. We derive estimates of "maximum acceptable risk" (MAR) that can help decisionmakers identify welfare-enhancing alternatives. In the case of children, parent caregivers are responsible for treatment decisions and their risk tolerance may be quite different than adult patients' own tolerance for treatment-related risks. We estimated and compared the willingness of Crohn's disease (CD) patients and parents of juvenile CD patients to accept serious adverse event (SAE) risks in exchange for symptom relief. The analyzed data were from 345 patients over the age of 18 and 150 parents of children under the age of 18. The estimation results provide strong evidence that adult patients and parents of juvenile patients are willing to accept tradeoffs between treatment efficacy and risks of SAEs. Parents of juvenile CD patients are about as risk tolerant for their children as adult CD patients are for themselves for improved treatment efficacy. SC surveys provide a systematic method for eliciting preferences for benefit-risk tradeoffs. Understanding patients' own risk perceptions and their willingness to accept risks in return for treatment benefits can help inform risk management decision making.     

A hybrid solution to collaborative decision-making in a decentralized supply-chain

This paper considers a decentralized supply chain, where multiple independent manufacturing facilities manage some capital-intensive equipments or resources shared among them. In particular, these manufacturing facilities operate somewhat in isolation to serve their own customers, but coordinate closely with each other to ensure the shared resources are effectively utilized. Such cross-facility capacity management problems are common in high-tech industries, they are typical examples of collaborative decision-making in supply chain integration, and are critical to create a competitive edge in a more interconnected business environment. In this paper, a hybrid algorithm that integrates Lagrangian relaxation and immunity-inspired coordination scheme, known as LR-ICI, is proposed and investigated by extensive numerical experiments, and is shown to be competitive compared to similar algorithms.     

Using Virtual Simulations to Assess Situational Awareness and Communication in Medical and Nursing Education: A Technical Feasibility Study

ABSTRACT

Communication and situational awareness, among other “human factors,” are critical skills needed within high-reliability organizations (HROs). HROs are challenged to develop an effective methodology for the systematic assessment of these skills. Virtual reality (VR) simulation technology offers a promising approach to meet this challenge. By utilizing a verbal coding procedure in tandem with eye-tracking metrics, we conducted a technical feasibility study to assess the impact of an interprofessional training (TeamSTEPPS®) on communication accuracy and observing responses among medical and nursing students in a virtual simulation. The results suggest that communication accuracy significantly improved as a result of TeamSTEPPS® training. These findings and changes in situational awareness among individuals are discussed.     

Identifying Social Indicators for Sustainability Assessment of CCU Technologies: A Modified Multi-criteria Decision Making

Social Indicators Research - This paper analyses the trend and changes in Sri Lanka’s multidimensional poverty before the ethnic war in 2007, the transition through 2009 and after the war in...     

Optimal composite scores for longitudinal clinical trials under the linear mixed effects model

Clinical trials of chronic, progressive conditions use rate of change on continuous measures as the primary outcome measure, with slowing of progression on the measure as evidence of clinical efficacy. For clinical trials with a single prespecified primary endpoint, it is important to choose an endpoint with the best signal‐to‐noise properties to optimize statistical power to detect a treatment effect. Composite endpoints composed of a linear weighted average of candidate outcome measures have also been proposed. Composites constructed as simple sums or averages of component tests, as well as composites constructed using weights derived from more sophisticated approaches, can be suboptimal, in some cases performing worse than individual outcome measures. We extend recent research on the construction of efficient linearly weighted composites by establishing the often overlooked connection between trial design and composite performance under linear mixed effects model assumptions and derive a formula for calculating composites that are optimal for longitudinal clinical trials of known, arbitrary design. Using data from a completed trial, we provide example calculations showing that the optimally weighted linear combination of scales can improve the efficiency of trials by almost 20% compared with the most efficient of the individual component scales. Additional simulations and analytical results demonstrate the potential losses in efficiency that can result from alternative published approaches to composite construction and explore the impact of weight estimation on composite performance. Copyright © 2016. The Authors. Pharmaceutical Statistics Published by John Wiley & Sons Ltd.     

Discernment Counseling for “Mixed‐Agenda” Couples

This article describes discernment counseling, an approach to working with couples where one partner is leaning toward divorce and the other wants to preserve the relationship and work on it in couples therapy. These “mixed‐agenda” couples are common in clinical practice but have been neglected in the literature. The goal of discernment counseling is clarity and confidence regarding the next steps for the relationship, based on a deeper understanding of each partner's contributions. Sessions emphasize individual conversations with each partner. An analysis of 100 consecutive cases found that about half of the couples chose to start couples therapy in order to reconcile, with most of the rest choosing the divorce path. Longer term follow‐up information is also presented.     

The phylogenetic Kantorovich-Rubinstein metric for environmental sequence samples

It is now common to survey microbial communities by sequencing nucleic acid material extracted in bulk from a given environment. Comparative methods are needed that indicate the extent to which two communities differ given data sets of this type. UniFrac, which gives a somewhat ad hoc phylogenetics-based distance between two communities, is one of the most commonly used tools for these analyses. We provide a foundation for such methods by establishing that, if we equate a metagenomic sample with its empirical distribution on a reference phylogenetic tree, then the weighted UniFrac distance between two samples is just the classical Kantorovich-Rubinstein, or earth mover's, distance between the corresponding empirical distributions. We demonstrate that this Kantorovich-Rubinstein distance and extensions incorporating uncertainty in the sample locations can be written as a readily computable integral over the tree, we develop L(p) Zolotarev-type generalizations of the metric, and we show how the p-value of the resulting natural permutation test of the null hypothesis 'no difference between two communities' can be approximated by using a Gaussian process functional. We relate the L(2)-case to an analysis-of-variance type of decomposition, finding that the distribution of its associated Gaussian functional is that of a computable linear combination of independent [Formula: see text] random variables.