A general systems approach to the patient, hospital staff, family, and community: implications for health care services

This article concerns the application of a general systems concept to the health care system. A system consists of a set of interacting components which are interrelated and interdependent, and function as a unit. In order to identify some of the significant influences on the patient who has been hospitalized, this general systems concept has been applied to health care systems at a number of open systems levels in which he or she participates. These are the body-mind system of the patient (an organism); the patient-hospital staff system (an organization); the system relating the patient to his or her family (a group); and the patient-community system. Analyses of the strategic parts of these systems, their mutual dependencies and the processes which link them, together with their functions, have implications for both hospital-based health-care professionals and hospital administrators. These analyses are generalizable across these four levels of systems. Their implications have importance for health care services.     

Estimation of larval feeding rates using normal linear models involving censored and truncated observations

Experiments to estimate the feeding rates of aquatic insect larvae involved destructive sampling of larvae to determine the position of an introduced food marker as it passed through their guts. A normal linear model involving censoring (equal to complete passage) and truncation is fitted to the measurement of the passage of food. A method for maximum likelihood estimation is derived together with the second order variance-covariance equations. Methods for estimating the effect of larval size on feeding rate are examined.     

Age at Entry into Prostitution: Relationship to Drug Use,Race, Suicide,Education Level,Childhood Abuse,and Family Experiences

This study seeks to explore factors related to age at entry into prostitution. Participants were 389 women arrested for prostitution who had attended a diversion program. Women who entered prostitution as minors were found to be more likely to be African-American; report having a family member with a substance use problem; have a history of attempted suicide; and not have completed middle or high school. The age at first drug use was found to significantly impact the reported age at entry. Key areas for intervention should include improving school connectedness and preventing adolescent substance abuse, specifically for African-Americans.     

Introduction to Special Issue: Restoring the Florida Everglades—Balancing Population and the Environment

Population and Environment -     

Heart disease and gender in mass print media

Heart disease is a major cause of death, disease and disability in the developed world for both men and women. Nevertheless, the evidence suggests that women are under-diagnosed both because they fail to visit the doctor with relevant symptoms and because doctors tend to dismiss the seriousness of women's symptoms of heart disease. This study examines the way that popular mass print media present the possible links between gender and heart disease. The findings suggest that the 'usual candidates' for heart disease are considered to be high achieving and active men for whom the 'heart attack' is sometimes seen as a 'badge of honour' and a symbol of their success. In contrast, women are less often seen as likely to succumb, but they are portrayed as if they are and ought to be worried about their husbands. Women's own bodies are described as so problematic as to be perhaps useless to diagnose, because they are so difficult to understand and treat.     

Older Adults’ Gambling Motivation and Problem Gambling: A Comparative Study

Gambling participation rates among older adults (65+ years) have been increasing in recent years. Very few studies have compared older and younger gamblers on gambling motivation and problem gambling. This study compared 41 male and 63 female older gamblers (66-87 years; median 73) to 20 male and 85 female younger gamblers (17-34 years; median 20) in New Zealand on gambling involvement, gambling motives and number of gambling related problems in the previous 12 months. The questionnaire included the Gambling Motivation Scale (GMS) and the Revised South Oaks Gambling Screen (SOGS-R) of current problem gambling. There were between-group age differences but no significant gender or gender by age interaction effects. While older adults had significantly lower scores on all the measures, except they gambled more frequently, for both groups frequency of gambling, number of activities, largest amount spent in a single session and all motives were correlated with SOGS-R scores. Preferences for electronic gaming machines and bingo were related to SOGS-R scores for both age groups. Hierarchical regression analysis showed that after statistically controlling for age, gambling involvement and other motives, tension release uniquely predicted SOGS-R scores. For both age groups, increasing severity of problem gambling is more likely to be associated with releasing tension than with winning money or seeking sensation.     

Asymptotics for an Adaptive Trimmed Likelihood Location Estimator

An asymptotic normality result is given for an adaptive trimmed likelihood estimator of location, which parallels the asymptotic normality result for the adaptive trimmed mean. The new result comes out of studying the adaptive trimmed likelihood estimator modelled parametrically by a normal family but then examining the behavior when the underlying distribution is in fact some F different from normal. The asymptotic variance of the adaptive estimator is equal to the asymptotic variance of the trimmed likelihood estimator at the optimal trimming proportion for the distribution F, subject to that trimming proportion being positive and F being suitably smooth.