Problem solving: not good medicine for health care

Explore the challenging paradoxes that run throughout health care and consider ways to accept them into an organization.     

Applying statistical tests to empirically compare tabu search parameters for MAX 3-SATISFIABILITY: A case study

The application of stochastic heuristic, like tabu search or simulated annealing, to address hard discrete optimization problems has been an important advance for efficiently obtaining good solutions in a reasonable amount of computing time. A challenge when applying such heuristics is assessing when a particular set of parameter values yields better performance compared to other such sets of parameter values. For example, it can be difficult to determine the optimal mix of memory types to incorporate into tabu search. This in turn prompts users to undertake a trial and error phase to determine the best combination of parameter settings for the problem under study. Moreover, for a given problem instance, one set of heuristic parameter settings may yield a better solution than another set of parameters, for a given initial solution. However, the performance of this heuristic on this instance for a single heuristic execution is not sufficient to assert that the first set of parameter settings will always produce superior results than the second set of parameters, for all initial solutions.     

Addressing the Dependency Problem in Access Security System Architecture Design

The objective of this research is to present a method for evaluating the performance of access control security systems, such as airport security operations. This requires the examination of security system architectures, which involve security technology devices and the algorithms that coordinate their operations. Dependence between device responses in multiple-device systems is a critical practical issue in assessing the performance of such architectures, though no results on this problem have appeared in the literature. This paper presents a method for evaluating when multipledevice security systems with overlapping capabilities are cost-effective. This is achieved using a dependency structure for security system devices to quantify how various technologies interact and to measure the impact of device dependence on system error probabilities. A measure of device response dependence for a two-device system is defined and its properties are explored, including bounds on the dependency measure. The effect of dependence on the system Type I and Type II error probabilities is examined for the two-device system. System performance is compared for independent vs. dependent device responses and desirable dependence relationships are identified. Results are also presented for a cascading sequence of devices. An example is presented to illustrate the results for the two-device system. Implications of these results are discussed, such as how they can be used to identify the optimal use of security devices and to determine whether new technologies warrant investment.     

A REVIEW AND EVALUATION OF MARITAL AND FAMILY THERAPIES FOR AFFECTIVE DISORDERS

Although the efficacy of individual treatments of affective disorders has been well-documented, there are also significant limitations to existing treatments. In the last decade attention has focused increasingley on the interpersonal context of affective illness, and on marital and family relationships in particular. As a result, a number of approaches have been developed which directly involve family members in treatment. In this article we evaluate the current status of marital and family therapies for affective illness. We begin with a discussion of several lines of research bearing on the relationships between family processes and affective illness. The available treatment outcome data evaluating the efficacy of marital and family interventions are then reviewed, with particular attention paid to predictors of treatment success and cost efficacy issues. Finally, we suggest several priorities for future research.     

Life politics,nature and the state: Giddens' sociological theory and The Politics of Climate Change

Anthony Giddens' The Politics of Climate Change represents a significant shift in the way in which he addresses ecological politics. In this book, he rejects the relevance of environmentalism and demarcates climate‐change policy from life politics. Giddens addresses climate change in the technocratic mode of simple rather than reflexive modernization. However, Giddens' earlier sociological theory provides the basis for a more reflexive understanding of climate change. Climate change instantiates how, in high modernity, the existential contradiction of the human relationship with nature returns in new form, expressed in life politics and entangled with the structural contradictions of the capitalist state. The interlinking of existential and structural contradiction is manifested in the tension between life politics and the capitalist nation‐state. This tension is key for understanding the failures so far of policy responses to climate change.     

The Faculty Meeting: Practicing Social Justice-Oriented Group Work

Social group work scholars and practitioners have begun to locate and recognize important sites for thinking about and practicing social group work as increasing evidence demonstrates its diminishing importance. This article identifies faculty meetings as a significant site for integrating social group work more fully into departments and schools of social work and helping to achieve the profession's social justice mission. Challenging the meaning of the faculty meeting and thinking of it as a faculty group is a necessary prerequisite to realize this goal. A set of principles is presented and next steps explored to reclaim and reinsert the value of social group work for the profession today.     

A Cost-Benefit Analysis of Alternative Device Configurations for Aviation-Checked Baggage Security Screening

The terrorist attacks of September 11, 2001 have resulted in dramatic changes in aviation security. As of early 2003, an estimated 1,100 explosive detection systems (EDS) and 6,000 explosive trace detection machines (ETD) have been deployed to ensure 100% checked baggage screening at all commercial airports throughout the United States. The prohibitive costs associated with deploying and operating such devices is a serious issue for the Transportation Security Administration. This article evaluates the cost effectiveness of the explosive detection technologies currently deployed to screen checked baggage as well as new technologies that could be used in the future. Both single-device and two-device systems are considered. In particular, the expected annual direct cost of using these devices for 100% checked baggage screening under various scenarios is obtained and the tradeoffs between using single- and two-device strategies are studied. The expected number of successful threats under the different checked baggage screening scenarios with 100% checked baggage screening is also obtained. Lastly, a risk-based screening strategy proposed in the literature is analyzed. The results reported suggest that for the existing security setup, with current device costs and probability parameters, single-device systems are less costly and have fewer expected number of successful threats than two-device systems due to the way the second device affects the alarm or clear decision. The risk-based approach is found to have the potential to significantly improve security. The cost model introduced provides an effective tool for the execution of cost-benefit analyses of alternative device configurations for aviation-checked baggage security screening.