The caring child: an evaluative case study of the Cornwall Young Carers project

This paper reports on an evaluation of the Cornwall Young Carers project (jointly funded by social services and the Cornwall and Isles of Scilly Health Action Zone), conducted during the period 2000–2002. A diverse range of methodological approaches were adopted (comparative national statistics, local pilot study, monthly and quarterly data capturing instruments, and a service user focus group) in monitoring and evaluating the project's high level statements/outcomes. Four evaluative themes are discussed, namely: identification of young carers; assessment of young carers' needs; direct service provision; and partnership working. Recommendations and action steps are proposed with a view of informing future planning and service delivery, as well as developing an ethos of integrating evaluation into everyday practice for the Cornwall Young Carers Project. Overall, the project has made significant progress in meeting and exceeding its original targets. The fact that the project has been able to identify 202 new young carers over this period is a key milestone in demonstrating the critical need for the project's services. It is suggested that existing referrals are only the ‘tip of the iceberg’ for work with young carers in Cornwall.     

Semi-parametric estimation of ROC curves based on binomial regression modelling

This paper presents a method of estimating a receiver operating characteristic (ROC) curve when the underlying diagnostic variable X is continuous and fully observed. The new method is based on modelling the probability of response given X , rather than the distribution of X given response. The method offers advantages in modelling flexibility and computational simplicity. The resulting ROC curve estimates are semi-parametric and can, in principle, take an infinite variety of shapes. Moreover, model selection can be based on standard methods within the binomial regression framework. Statistical accuracy of the curve estimate is provided by a simply implemented bootstrap approach.     

Residual analysis for spatial point processes (with discussion)

Summary.  We define residuals for point process models fitted to spatial point pattern data, and we propose diagnostic plots based on them. The residuals apply to any point process model that has a conditional intensity; the model may exhibit spatial heterogeneity, interpoint interaction and dependence on spatial covariates. Some existing ad hoc methods for model checking (quadrat counts, scan statistic, kernel smoothed intensity and Berman's diagnostic) are recovered as special cases. Diagnostic tools are developed systematically, by using an analogy between our spatial residuals and the usual residuals for (non-spatial) generalized linear models. The conditional intensity λ plays the role of the mean response. This makes it possible to adapt existing knowledge about model validation for generalized linear models to the spatial point process context, giving recommendations for diagnostic plots. A plot of smoothed residuals against spatial location, or against a spatial covariate, is effective in diagnosing spatial trend or co-variate effects. Q – Q -plots of the residuals are effective in diagnosing interpoint interaction.     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.     

Modelling data from single-photon emission computerized tomography

The completely random character of radioactive disintegration provides the basis of a strong justification for a Poisson linear model for single-photon emission computed tomography data, which can be used to produce reconstructions of isotope densities, whether by maximum likelihood or Bayesian methods. However, such a model requires the construction of a matrix of weights, which represent the mean rates of arrival at each detector of photons originating from each point within the body space. Two methods of constructing these weights are discussed, and reconstructions resulting from phantom and real data are presented.