Nonparametric maximum likelihood estimation for artificially truncated absence data

In manpower planning it is cornmoniy tue case tnat employees withuraw from active service for a period of time before returning to take up post at a later date. Such periods of absence are frequently of major concern to employers who are anxious to ensure that employees return as soon as possible. The distribution of duration of such periods of absence are therefore of considerable interest as is the probability that such employees will ever return to active service. In this paper we derive a nonparametric estimator for such a lifetime distribution based on renewal data which are subject to various forms of incompleteness, namely right censoring, left and right truncation, and forward recurrence. Artificial truncation is used to ensure that the data are time homogeneous. A nonparametric maximum likelihood estimator for the lifetime.     

‘Pick me up and not a down down,up up’: how are the identities of people with aphasia represented in aphasia,stroke and disability websites?

Suddenly acquiring a permanent impairment means a person must learn to think differently (Frank, 1995), and he or she does so partly by telling stories. The most commonly told illness narratives are 'restitution' narratives. People with aphasia (a communication impairment commonly following stroke) surfed aphasia, stroke and disability websites, read the personal stories attached to them, and created their own narratives in response. Charitable and disability-related websites excluded people with aphasia through their tone, content and narrative 'voice.' Engagement with some websites was contingent on subscribing to a specific perspective on aphasia. Personal narratives attached to charitable websites were seen to reflect the organisational stance. In particular, idiosyncracies of aphasic language were often eliminated. When participants constructed their own web pages they replicated the stylistic traits that had previously been criticised. Identities are mercurial and difficult to pinpoint. Further work with people with aphasia using videoclips, soundclips and other non-text-based techniques to create illness narratives is planned.     

Challenges of Dealing with Financial Concerns during Life-Threatening Illness: Perspectives of Health Care Practitioners

ABSTRACT

The costs of serious medical illness and end of life care are often a heavy burden for patients and families (Collins, Stepanczuk, Williams, & Rich, 2016 Collins, A., Stepanczuk, C., Williams, N., & Rich, E. (2016). Supporting better patient decisions at the point of care: What payers and delivery systems can do (Mathematica Policy Research Issue Brief). Retrieved from http://econpapers.repec.org/paper/mprmprres/6c6a86e28d7149c993713352eeceaa18.htm [Google Scholar]; Kim, 2007 Kim, P. (2007). Cost of cancer care: The patient perspective. Journal of Clinical Oncology, 25(2), 228–232. doi:10.1200/JCO.2006.07.9111[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; May et al., 2014 May, C. R., Eton, D. T., Boehmer, K., Gallacher, K., Hunt, K., MacDonald, S.,?… &?Rogers, A. E. (2014). Rethinking the patient: Using burden of treatment theory to understand the changing dynamics of illness. BMC health services research, 14(1), 1–11. doi:10.1186/1472-6963-14-281[Crossref], [PubMed] , [Google Scholar]; Zarit, 2004 Zarit, S. H. (2004). Family care and burden at the end of life. Canadian Medical Association Journal, 170(12), 1811–1812. doi:10.1503/cmaj.1040196[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Twenty-six practitioners, including social workers, managers/administrators, supervisors, and case managers from five health care settings, participated in qualitative semistructured interviews about financial challenges patients encountered. Seven practitioners took part in a focus group. Practitioners were recruited from hospice (n?=?5), long-term care (n?=?5), intensive care (n?=?5), dialysis (n?=?6), and oncology (n?=?5). Interview and focus group questions focused on financial challenges patients encountered when facing life-threatening illness. Interview data were transcribed and thematically coded and trustworthiness of data was established with peer debriefing, member checking, and agreement on themes among the authors. Practitioners described interacting micro, meso, and macroinfluences on the financial well-being and challenges patients encountered. Microlevel influences involved patient characteristics, such as their demographic profile and/or health status that set them up for financial aptitude or challenges. Macrolevel influences involved the larger health care/safety net system, which provided valuable resources for some patients but not others. Practitioners also discussed the mesolevel of influence, the local setting where they worked to match available resources with patients’ individual needs given the constraints emerging from the micro and macrolevels. Practitioners described how they navigated the interplay of these three areas to meet patients’ needs and cope with financial challenges. Implications for practice point to directly addressing the kind of financial concerns that patients and families facing financial burden from serious medical illness have, and identifying ways to bridge knowledge and resource access gaps at the individual, organizational, and societal levels.     

Developing management capability within a horizontal supply chain in performance measurement deployment and evolution: a Dynamic Capabilities and Goal Theory perspective

Abstract

Complex collaboration in rapidly changing business environments create challenges for management capability in Utility Horizontal Supply Chains (UHSCs) involving the deploying and evolving of performance measures. The aim of the study is twofold. First, there is a need to explore how management capability can be developed and used to deploy and evolve Performance Measurement (PM), both across a UHSC and within its constituent organisations, drawing upon a theoretical nexus of Dynamic Capability (DC) theory and complementary Goal Theory. Second, to make a contribution to knowledge by empirically building theory using these constructs to show the management motivations and behaviours within PM-based DCs. The methodology uses an interpretive theory building, multiple case-based approach (n = 3) as part of a USHC. The data collection methods include, interviews (n = 54), focus groups (n = 10), document analysis and participant observation (reflective learning logs) over a five-year period giving longitudinal data. The empirical findings lead to the development of a conceptual framework showing that management capabilities in driving PM deployment and evolution can be represented as multilevel renewal and incremental Dynamic Capabilities, which can be further understood in terms of motivation and behaviour by Goal-Theoretic constructs. In addition, three interrelated cross-cutting themes of management capabilities in consensus building, goal setting and resource change were identified. These management capabilities require carefully planned development and nurturing within the UHSC.     

Contemporary Political Communications: Audiences, Politicians and the Media in International Research

Research into political communication has grown rapidly in the past three decades, shifting from specific, quantitative and utilitarian studies to include a broad variety of research questions, methods and theoretical frameworks. Interdisciplinary work in political communication takes audiences, political actors (such as governments and politicians), and media content and media institutions as central foci. Research has traditionally focused on election campaign-specific studies within national contexts. Emerging research, however, is now addressing broader questions about media texts and organisations and also about representations and power. This research is working to trace technological changes and developments in an era of globalised media and political communication and developing new, complex conceptions of audience agency and reception.     

A framework for providing telecommuting as a reasonable accommodation: some considerations on a comparative case study

Telecommuting, whether full time, part time, or over short periods when the need arises, can be an important accommodation for employees with disabilities. Indeed, telecommuting may be the only form of accommodation that offers employees whose disabilities fluctuate a means to stay consistently and gainfully employed. This article describes one employer's experience in considering a request for telecommuting as a reasonable accommodation for a particular employee. Drawing on real-life examples, both positive and negative, this article provides a win/win framework for decision-making that can help employers evaluate the use of telecommuting as a possible accommodation and facilitates open and ongoing communication between employer and employee.     

Inflammatory effects and immune system correlates of rape

The purpose of this study was to evaluate the feasibility of measuring stress hormones and immunity following rape. The long-term goal is to evaluate the predictive value of stress-immune-inflammatory responses to later health outcomes. Fifteen women reporting rape were compared with 16 control participants. Serum stress hormones, proinflammatory cytokines, acute phase proteins, functional assays, and lymphocyte subsets were measured in blood samples. Women reporting rape had higher cytotoxic cells, lower B lymphocyte counts, higher proinflammatory biomarkers, and decreased lymphocyte proliferation compared to the control group. This finding suggests that rape produces activation of the innate immunity and suppression of some aspects of adaptive immunity. If these immune changes persist, they may contribute to the pathophysiology of long-term health sequelae by provoking chronic inflammation and decreased cellular immunocompetence.     

Integrating the older/special needs adoptive child into the family

This qualitative, grounded theory study investigated 11 families who reported having successfully integrated into their family unit at least one older/special needs adoptee. The theory that emerged through the constant comparative methodology consisted of two categories (Decision to Adopt and Adjustment) and a core category (Developing a Sense of Family). The two categories and core category comprised a process that was informed by the Family Narrative Paradigm and culminated in the successful integration of the child or children into the existing family unit. Parental perceptions that appeared to facilitate this process included: (a) finding strengths in the children overlooked by previous caregivers, (b) viewing behavior in context, (c) reframing negative behavior, and (d) attributing improvement in behavior to parenting efforts.     

Voices from Segregated Schooling: towards an inclusive education system

Romantown LEA, like other authorities in England and Wales, is adopting a policy of 'inclusion' in providing education for young disabled people. The reorganisation has involved the closure of Adamston, an all-age school for pupils with physical disabilities. This article addresses the meaning of 'inclusion' from the viewpoint of disabled people who have experienced segregated education. We draw first on the literature to offer an analysis of the documented views of survivors of special schools. Secondly, we explore the views and experiences of Adamston pupils prior to the closure of the school. In presenting what clearly represents a wide range of experiences we seek to take the debate beyond the sterile analysis of 'pros and cons' of special schools. We argue that voices from experiences of segregation are central in constructing 'inclusion' and essential in any process of change towards an education system which is truly inclusive.