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.     

Trend smoothness achieved by penalized least squares with the smoothing parameter chosen by optimality criteria

This work presents a study about the smoothness attained by the methods more frequently used to choose the smoothing parameter in the context of splines: Cross Validation, Generalized Cross Validation, and corrected Akaike and Bayesian Information Criteria, implemented with Penalized Least Squares. It is concluded that the amount of smoothness strongly depends on the length of the series and on the type of underlying trend, while the presence of seasonality even though statistically significant is less relevant. The intrinsic variability of the series is not statistically significant and its effect is taken into account only through the smoothing parameter.     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

The effect of fast and slow decisions on risk taking

We experimentally compare fast and slow decisions in a series of experiments on financial risk taking in three countries involving over 1700 subjects. To manipulate fast and slow decisions, subjects were randomly allocated to responding within 7 seconds (time pressure) or waiting for at least 7 or 20 seconds (time delay) before responding. To control for different effects of time pressure and time delay on measurement noise, we estimate separate parameters for noise and risk preferences within a random utility framework. We find that time pressure increases risk aversion for gains and risk taking for losses compared to time delay, implying that time pressure increases the reflection effect of Prospect Theory. The results for gains are weaker and less robust than the results for losses. We find no significant difference between time pressure and time delay for loss aversion (tested in only one of the experiments). Time delay also leads to less measurement noise than time pressure and unconstrained decisions, and appears to be an effective way of decreasing noise in experiments.     

Latin hypercube sampling with multidimensional uniformity

Complex models can only be realized a limited number of times due to large computational requirements. Methods exist for generating input parameters for model realizations including Monte Carlo simulation (MCS) and Latin hypercube sampling (LHS). Recent algorithms such as maximinLHS seek to maximize the minimum distance between model inputs in the multivariate space. A novel extension of Latin hypercube sampling (LHSMDU) for multivariate models is developed here that increases the multidimensional uniformity of the input parameters through sequential realization elimination. Correlations are considered in the LHSMDU sampling matrix using a Cholesky decomposition of the correlation matrix. Computer code implementing the proposed algorithm supplements this article. A simulation study comparing MCS, LHS, maximinLHS and LHSMDU demonstrates that increased multidimensional uniformity can significantly improve realization efficiency and that LHSMDU is effective for large multivariate problems.     

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.     

Fear,Defensive Strategies and Caring for Cognitively Impaired Family Members

One topic rarely addressed in the literature on older adults and interpersonal violence is the violence that can be experienced by family carers in relationship with a person living with cognitive impairment. This violence tends to remain hidden and is rarely framed as intimate partner violence. We examine how situations of intimidation and violence invoked fear in family carers and how they interpreted and reacted to these circum- stances. Interview and diary data were collected from family members who had previously or were currently experiencing some form of aggression in caring for someone with cognitive impairment or dementia. Drawing on discussions of fear and applying the analytic lens of defensive strategies, we explore how these carers responded to situations of intimidation and violence.     

Using a “child's‐eye view” of social success to understand the importance of school readiness at the transition to formal schooling

Recent research into school readiness has highlighted the importance of not only children's cognitive and socio‐emotional skills, but also the degree to which they have family support in the home. The current study examines the association between social success upon school entry and teacher‐ratings of school readiness as assessed by the Brief Early Skills and Support Index (BESSI), controlling for language ability. Importantly, social success was assessed using a “child's‐eye view” with peer‐reported assessments of both social preference and reciprocated friendships. A total of 244 children (131 boys, M_age = 61 months, SD = 4.78 months) in their first year of formal schooling participated. Child school readiness was found to be important for social preference, with the association being more marked for boys versus girls. Family support was the only independent predictor of children's reciprocated friendships. The use of the BESSI, with its broad scope compared to other measures of school readiness, highlights the importance of focusing both on a child's cognitive and socio‐emotional skills at school entry and their family support when exploring the association of school readiness to children's social success at the transition to formal schooling.     

The exponential distribution analog of the Grubbs–Weaver method

Abstract

Grubbs and Weaver (1947 Grubbs, F. E., and C. L. Weaver. 1947. The best unbiased estimate of population standard deviation based on group ranges. Journal of the American Statistical Association 42 (238):224–41. doi: 10.2307/2280652.[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) suggest a minimum-variance unbiased estimator for the population standard deviation of a normal random variable, where a random sample is drawn and a weighted sum of the ranges of subsamples is calculated. The optimal choice involves using as many subsamples of size eight as possible. They verified their results numerically for samples of size up to 100, and conjectured that their “rule of eights” is valid for all sample sizes. Here we examine the analogous problem where the underlying distribution is exponential and find that a “rule of fours” yields optimality and prove the result rigorously.     

20 years of Bologna - a story of success,a story of failure

The Bologna Process is a unique harmonisation process taking place outside the policy-making framework of the European Union. It aims at enhancing the comparability and compatibility of higher education structures and degrees across Europe, as well as to institutionalise quality assurance mechanisms. The aim of this article is to provide a condensed, up-to-date overview of the Bologna Process with regard to structural characteristics, before embedding it into a discussion on processes on voluntary policy convergence and to which extent we should be able to find this kind of policy harmonisation in the realm of the Bologna Process. Related to this are questions why this, in principle, completely voluntary process of policy harmonisation, has appealed to so many countries and why they might or might not feel committed to the implementation of its policies and tools.