Ambulance allocation for maximal survival with heterogeneous outcome measures

This paper proposes new models for locating emergency medical services (EMS) by incorporating survival functions for capturing multiple-classes of heterogeneous patients. The Maximal Expected Survival Location Model for Heterogeneous Patients (MESLMHP) aims to maximize the overall expected survival probability of multiple-classes of patients, whereby different classes could be defined according to agreed patient categories based on response time targets, or by capturing differing medical conditions each with a corresponding survival function. Furthermore, we propose and demonstrate an approximation approach to solving the extended stochastic version of MESLMHP, which utilizes queuing theory to permit the modeling of congestion and utilization at each ambulance station, and does not require assumptions to be made on the utilization of ambulances. Both models are demonstrated using data from the ambulance service in Wales. We show that our multiple outcome measures and survival-maximizing approach, rather than one based on average response time targets alone or a single patient class provides more effective EMS ambulance allocations.     

Bittersweet and Paradoxical

The American Red Cross is the most active nonprofit organization involved in disaster planning and response in the United States. The organization deployed nearly 50,000 volunteers to provide essential support to victims of some 125,000 domestic disasters, including home fires, hurricanes, wildfires, and floods, in a recent two‐year period. This study asks how American Red Cross disaster response volunteer experiences function to cultivate satisfaction and, at the other end of the spectrum, the kind of dissatisfaction that leads people to quit; it pays particular attention to ways in which volunteer management shapes dissatisfaction and fatigue because of implications for volunteer retention. Paradoxically, the Red Cross facilitates the highly satisfying act of helping victims, but volunteers feel dissatisfied when management practices get in the way of helping. The study suggests voluntary organizations that rely on skilled, long‐term volunteers to deliver services should evaluate and strengthen their communication strategies, recognition practices, and support systems for volunteers in distress.     

Incomes after Job‐loss in the United States: From Programme Rules to Panel Data

Welfare state studies are usually motivated by one or both of two concerns: programme effects on the incidence of poverty, and the possibility of perverse incentive effects. Most research has been comparative, using cross‐national indicators from the Organisation for Economic Co‐operation and Development and other international organizations. That research often contrasts the generosity of programmes in a number of European countries and the lack of it in the USA. Focusing on income transfers after job‐loss, in this article we critically examine the comparative evidence on US welfare state generosity and then use the Panel Study of Income Dynamics (PSID) to estimate what happens to job‐losers' incomes. The comparative analysis suggests conclusions more nuanced than found in much of the literature. The PSID analysis shows how the income effects of job‐loss vary across job‐losers and suggests that the role of unemployment compensation programmes in supporting incomes may be overstated.     

Coming Full Circle: Reoccurring Career Development Trends in Schools

Current state and national mandates focusing on academic achievement have drawn critical counseling resources away from career development. As the world of work radically changes and economic situations remain uncertain, the call for a return to school counseling roots based in career guidance has never been louder. The authors explore reoccurring career guidance trends throughout the history of school counseling to expand awareness of the basis of today's career and technical education discussions and increase understanding of the interconnectedness of career guidance and counseling and educational reform.     

Individual Differences in Infant Oculomotor Behavior During the Viewing of Complex Naturalistic Scenes

Little research hitherto has examined how individual differences in attention, as assessed using standard experimental paradigms, relate to individual differences in how attention is spontaneously allocated in more naturalistic contexts. Here, we analyzed the time intervals between refoveating eye movements (fixation durations) while typically developing 11‐month‐old infants viewed a 90‐min battery ranging from complex dynamic to noncomplex static materials. The same infants also completed experimental assessments of cognitive control, psychomotor reaction times (RT), processing speed (indexed via peak look during habituation), and arousal (indexed via tonic pupil size). High test–retest reliability was found for fixation duration, across testing sessions and across types of viewing material. Increased cognitive control and increased arousal were associated with reduced variability in fixation duration. For fixations to dynamic stimuli, in which a large proportion of saccades may be exogenously cued, we found that psychomotor RT measures were most predictive of mean fixation duration; for fixations to static stimuli, in contrast, in which there is less exogenous attentional capture, we found that psychomotor RT did not predict performance, but that measures of cognitive control and arousal did. The implications of these findings for understanding the development of attentional control in naturalistic settings are discussed.     

The Resilient Survivor—A Student Social Worker's Journey on Placement

This paper represents the continuation of my ‘personal and professional journey’ from social work student to social work practitioner focusing on my first Practice Learning Opportunity (PLO). Recognising the potential impact of childhood sexual abuse (CSA) in a classroom environment is as important as the potential impact on actual practice learning and practice. This is salient in the real world of social work practice as the potential misuse of a painful childhood experience has greater ramifications. Utilising the ideas and assumptions of social constructionism (including context and multivocality) the significance of silence from social work educators shall be examined in relation to self-disclosure as a means of aiding PLO learning and practice. This paper will also focus on the concept of critical reflection and its significance in exploring the transferability of a childhood experience such as CSA and personal and professional dilemmas regarding self-disclosure. This paper concludes by highlighting areas for consideration for both students and social work educators and conveys an important message regarding the importance of communication between students and social work educators.     

Cross‐Milieu Terrorist Collaboration: Using Game Theory to Assess the Risk of a Novel Threat

This article uses a game‐theoretic approach to analyze the risk of cross‐milieu terrorist collaboration—the possibility that, despite marked ideological differences, extremist groups from very different milieus might align to a degree where operational collaboration against Western societies becomes possible. Based upon theoretical insights drawn from a variety of literatures, a bargaining model is constructed that reflects the various benefits and costs for terrorists’ collaboration across ideological milieus. Analyzed in both sequential and simultaneous decision‐making contexts and through numerical simulations, the model confirms several theoretical arguments. The most important of these is that although likely to be quite rare, successful collaboration across terrorist milieus is indeed feasible in certain circumstances. The model also highlights several structural elements that might play a larger role than previously recognized in the collaboration decision, including that the prospect of nonmaterial gains (amplification of terror and reputational boost) plays at least as important a role in the decision to collaborate as potential increased capabilities does. Numerical simulation further suggests that prospects for successful collaboration over most scenarios (including operational) increase when a large, effective Islamist terrorist organization initiates collaboration with a smaller right‐wing group, as compared with the other scenarios considered. Although the small number of historical cases precludes robust statistical validation, the simulation results are supported by existing empirical evidence of collaboration between Islamists and right‐ or left‐wing extremists. The game‐theoretic approach, therefore, provides guidance regarding the circumstances under which such an unholy alliance of violent actors is likely to succeed.     

Predictors of Intrusive Sexual Behaviors in Preschool-Aged Children

Intrusive sexual behaviors (ISBs) are a specific type of problematic sexual behavior characterized by the invasive nature of the acts (e.g., touching others’ private parts, attempting intercourse; Friedrich, 1997). The limited amount of research on ISBs has focused on sexual abuse history as the primary predictor. However, Friedrich, Davies, Feher, and Wright (2003) found that ISBs in children up to age 12 were related to four broad conceptual factors: (a) exposure to sexual content, (b) exposure to violent behavior, (c) family adversity, and (d) child vulnerabilities. The current study sought to replicate Friedrich’s study using a clinical sample of 217 preschool-aged children (ages two to six). Results supported variables from within the child vulnerabilities construct (externalizing behaviors, β_EXT = 0.032, p = 0.001), post-traumatic stress disorder (PTSD) criteria met (β_PTSD = 0.177, p = 0.02), and an inverse relationship with age (β_AGE = ?0.206, p = 0.024). These results highlight the importance of considering childhood behavioral patterns and reactivity to traumatic events as correlates of ISBs in young children.     

Telling and Re‐telling Stories: The Use of Narrative and Drawing in a Group Intervention with Parents and Children in a Remote Aboriginal Community

The Let's Start Parent‐Child Program is a manualised parent‐child program which aims to improve educational, social and emotional outcomes for Aboriginal parents and their four‐ to seven‐year‐old children. It has been implemented in the Northern Territory, Australia on the Tiwi Islands and in Darwin since 2005. This paper outlines the adaptation of the program to include narrative approaches, the sharing of stories and the use of expressive arts as a way to build understanding between program leaders and participating families. An example from a recent program is used to illustrate how the sharing of stories and expressive use of art engages and binds group participants together. It supports parents to tell their own stories, to speak about their lived experience, to reconsider aspects of their own and their children's experiences and to achieve an increased awareness of their personal resources and a sense of self‐empowerment. The program is designed and delivered with sensitivity to individual parents, children and families, where cultural and interpersonal differences and different developmental and family situations can be taken into account.