Evaluation of Measurement Comparisons Using Generalized Least Squares: the Role of Participants’ Estimates of Systematic Error

We consider the evaluation of laboratory practice through the comparison of measurements made by participating metrology laboratories when the measurement procedures are considered to have both fixed effects (the residual error due to unrecognised sources of error) and random effects (drawn from a distribution of known variance after correction for all known systematic errors). We show that, when estimating the participant fixed effects, the random effects described can be ignored. We also derive the adjustment to the variance estimates of the participant fixed effects due to these random effects.     

Supplemental Security Income recipients affected by Hurricanes Katrina and Rita: an analysis of two years of administrative data

Approximately 350,000 Supplemental Security Income (SSI) recipients—elderly and disabled individuals with low incomes and assets—lived in the areas directly affected by Hurricanes Katrina and Rita in August 2005. We show that recipients from affected areas were more likely to leave the program, have more volatile participation patterns, and leave the area in the 2 years following the hurricanes than were recipients from unaffected areas. Among recipients from more severely affected areas relative to those from unaffected states, the odds of dying were 40% greater and the odds of leaving SSI for other reasons were 23% greater. Additionally, 31% of recipients from more severely affected areas had experienced a non-payment month, with 46% subsequently returning to the rolls (compared with 23% and 41% of recipients from unaffected states). Nearly 60% of SSI recipients from more severely affected areas lived in a different county or parish 2 years after the hurricanes, compared with about 12% from unaffected areas. In all, our findings demonstrate that natural disasters such as Hurricanes Katrina and Rita can have large and persistent impacts on SSI recipients, including effects on program status, mortality, and geographic location.     

Constructive and Destructive Marital Conflict,Parenting, and Children's School and Social Adjustment

This study addresses the links between destructive and constructive marital conflict and mothers' and fathers' parenting to understand associations with children's social and school adjustment. Multi‐method, longitudinal assessments of 235 mothers, fathers, and children (129 girls) were collected across kindergarten, first, and second grades (ages 5–7 at time 1; ages 7–9 at time 3). Whereas constructive marital conflict was related to both mothers' and fathers' warm parenting, destructive marital conflict was only linked to fathers' use of inconsistent discipline. In turn, both mothers' and fathers' use of psychological control was related to children's school adjustment, and mothers' warmth was related to children's social adjustment. Reciprocal links between constructs were also explored, supporting associations between destructive marital conflict and mothers' and fathers' inconsistent discipline. The merit of examining marital conflict and parenting as multidimensional constructs is discussed in relation to understanding the processes and pathways within families that affect children's functioning.     

Devolution and Patient Choice: Policy Rhetoric versus Experience in Practice

Background: market reforms in England have been identified as making a clear distinction between English health policy and health policy in the devolved systems in Northern Ireland, Scotland and Wales. Patient choice is a high profile policy in the English National Health Service that constitutes significant changes to the demand side of health care. It is not clear what national differences this has led to regarding implementation of policy. This article presents the findings from a large UK‐wide study on the development and implementation of policies related to patient choice of provider. The findings reported here relate specifically to the policy development and organizational implementation of choice in order to examine the impact of devolution on health care policy. Aim: this study examines patient choice of provider across all four countries of the UK to understand the effect of differences in national policies on the organization and service how choice of provider presented to patients. Methods: at the macro‐level, we interviewed policymakers and examined policy and guidance documents to analyze the provenance and determinants of national policy in each UK nation. At the Primary Care Trust or Health Board level, we interviewed a range of public and private health service providers to identify the range of referral pathways and where and when choices might be made. Finally, we interviewed ear, nose and throat, and orthopaedics patients to understand how such choices were experienced. Findings: while we found that distinct rhetorical differences were identifiable at a national policy level, these were less visible at the level of service organization and the way choices were provided to patients. Conclusion: historical similarities in both the structure and operation of health care, coupled with common operational objectives around efficient resource use and waiting times, mediate how strategic policy is implemented and experienced in the devolved nations of the UK.     

Weight-preserving simulated tempering

Statistics and Computing - Simulated tempering is a popular method of allowing MCMC algorithms to move between modes of a multimodal target density $$pi $$. One problem with simulated tempering...     

Toward a dimensional model of risk and protective factors influencing children's early cognitive,social, and emotional development during the COVID-19 pandemic

Variation in infants’ home environment is implicated in their cognitive and psycho-social development. The pandemic has intensified variations in home environments through exacerbating socioeconomic inequalities, and increasing psychological stressors for some families. This study investigates the effects of parental (predominantly maternal) mental health, enriching activities and screen use on 280 24- to 52-month-olds’ executive functions, internalising and externalising problems, and pro-social behaviour; with socioeconomic status and social support as contextual factors. Our results indicate that aspects of the home environment are differentially associated with children’s cognitive and psycho-social development. Parents who experienced sustained mental distress during the pandemic tended to report higher child externalising and internalising problems, and executive function difficulties at follow-up. Children who spent more time engaged in enriching activities with their parents showed stronger executive functions and social competence six months later. Screen use levels during the first year of the pandemic were not associated with outcomes. To mitigate the risk of persistent negative effects for this ‘pandemic generation’ of infants, our study highlights the importance of supporting parents’ mental health. As our results demonstrate the impact of social support on mental health, investing in support services and interventions promoting building support networks are likely to be beneficial.     

Psychotherapy of a preschool cancer survivor: Promoting mastery and understanding

The prolonged and invasive treatment common to cancer therapy protocols may lead to precocious defenses which impede the future development of preschool-aged cancer survivors. Focal play therapy offers the young cancer survivor a chance to understand and master the cancer experience. At present there are no accounts in the literature of the psychotherapy of young cancer survivors. This paper presents a detailed account of the therapy of a preschooler who survived a brain tumor, emphasizing the child's perspective on the cancer experience and an intervention approach which stresses mastery of developmental impasses, rather than psychopathology.     

'Til death do us part: intimacy and sexuality in the marriages of Alzheimer's patients.

1. Alzheimer's disease (AD) is likely to have a significant effect on sexual behavior, but both patient and partner will still have sexual feelings and needs. 2. Research has shown that a high proportion of men with AD develop erection problems, but causes of their erection difficulties are not understood. 3. Research has shown that inappropriate sexual behavior in AD patients is uncommon, although it can be very troubling to the family and health-care provider if it occurs. 4. More professionals need to be trained to discuss sexual issues openly and sensitively with AD patients and partners and to offer useful clinical suggestions.     

Local Voices in an Internal Market: The Case of Community Health Services*

This paper presents findings from a study of contract specification and implementation in community health services (CHS). In this paper, we focus on one aspect of that study: the role of local people in informing the assessment of health needs and in determining the provision of community health services in the context of the NHS “internal market”. The paper is based on fieldwork undertaken in three districts within one region. Analysis of data obtained from these localities suggests that while there appears to be a genuine commitment to the principle of local involvement, ideas about how that involvement can be built into the activities of either purchasers or providers are less transparent.