Social Work with the Osteoporotic Woman

A chronic, progressive, and potentially debilitating condition, osteoporosis has a multitude of currently untapped implications for effective social work practice. A working knowledge of the medical framework of the disease process itself is a prerequisite to informed practice. This article presents such information, along with the psychological and social components, in order to provide the social worker with the comprehensive biopsyehosaial knowledge base necessary for effective practice with the osteoporotic woman and her family.     

信息不对称下医药营销服务外包契约设计

为了缩减销售成本,一些制药企业将营销服务外包给合约销售公司(contract sales organization,CSO).由于CSO的营销努力不可合同化,制药企业需要基于市场销量来激励CSO的营销努力.然而,市场销量受制药企业定价决策的影响,因此CSO将面临制药企业提高定价的道德风险.此外,药品营销难度信息可能是CSO的私人信息,这使得制药企业面临逆向选择问题.当制药企业将营销服务外包给多个CSO时,由于制药企业针对同一药品在不同市场的售价相同,其定价决策对多个CSO所服务市场的销量具有共同的影响.相对绩效的激励契约能够消除共同不确定因素对代理人产出的影响,从而更有利于激励代理人付出高水平的努力.因此依据信息甄别的博弈模型,分析基于个体绩效与基于相对绩效的激励契约的有效性.研究发现:1)药品营销难度信息对称时,基于相对绩效的激励契约占优于基于个体绩效的激励契约,且可以获得全局最优的营销努力和期望利润;2)药品营销难度信息不对称时,两种激励契约均不能获得全局最优的营销努力和期望利润.数值分析表明,药品营销难度的先验概率,市场价格敏感性和高低类型药品营销难度差异的变化会影响制药企业的契约选择,较高的市场价格敏感性和较低的高低类型药品营销难度差异使得基于相对绩效的激励契约更有效.     

Factor screening in nonregular two-level designs based on projection-based variable selection

In this paper, we focus on the problem of factor screening in nonregular two-level designs through gradually reducing the number of possible sets of active factors. We are particularly concerned with situations when three or four factors are active. Our proposed method works through examining fits of projection models, where variable selection techniques are used to reduce the number of terms. To examine the reliability of the methods in combination with such techniques, a panel of models consisting of three or four active factors with data generated from the 12-run and the 20-run Plackett–Burman (PB) design is used. The dependence of the procedure on the amount of noise, the number of active factors and the number of experimental factors is also investigated. For designs with few runs such as the 12-run PB design, variable selection should be done with care and default procedures in computer software may not be reliable to which we suggest improvements. A real example is included to show how we propose factor screening can be done in practice.     

Family violence in gambling help-seeking populations

Elevated rates of family violence among treatment-seeking problem gamblers compared to general population estimates have been reported in Spain, Canada and Australia. This study examined the occurrence of family violence among 454 problem gambling help-seeking clients (370 gamblers, 84 affected others) recruited through 3 national gambling treatment services in New Zealand. Measures used were the Problem Gambling Severity Index, and a modified version of the HITS Scale which assessed physical, emotional, verbal and sexual abuse. Past-year family violence among gamblers in this sample was 46.8% for victimization, 41.2% for perpetration and 55.0% for any form of family violence. Among affected others the occurrence was 65.5% for victimization, 57.1% for perpetration and 71.4% for any form of violence. The most common type of violence was verbal intimate partner violence. Affected others and women gamblers reported higher rates of violence victimization and perpetration. These findings underscore the importance of screening gambling help-seeking clients for family violence, and the development of prevention and treatment programmes to address violence in this population, with particular attention to affected others and women gamblers. Future research should assess coercive control and the gendered nature of family violence among problem gambling help-seekers.     

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool

Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71–100%) and 90% (95% CI 85–93%), respectively. These results inform a proposed screening tool for multisite validation testing.     

The roller-coaster of experiences: becoming the parent of a deaf child

When early testing indicates a hearing loss, parents find themselves on a roller-coaster of experiences leaving little time or space for reflection. This study is based on interviews with families in the Flemish region of Belgium, one of the earliest in the world to introduce universal neonatal screening for hearing loss. Starting from a phenomenological approach, we explore parents’ accounts of their experiences in order to uncover the meanings of early parenting of a child identified with a label. Soon after birth, these parents encounter a different world in which intertwined discourses construct parenthood with a deaf child. During the process of becoming a parent, representations of deafness as impairment were omnipresent. In contrast to a medical and technological perspective that insists on the need to intervene as fast as possible, it is argued that the private and social implications of rapid intervention require explicit consideration.     

Application of FISK,an Invasiveness Screening Tool for Non‐Native Freshwater Fishes,in the Murray‐Darling Basin (Southeastern Australia)

The Fish Invasiveness Scoring Kit (FISK) is currently one of the most popular pre‐screening tools for freshwater fishes. A recent upgrade has ensured its wider climatic relevance to countries with subtropical regions. This enhancement is of particular importance to Australia, which encompasses tropical, arid, and temperate zones, and where the introduction of non‐native fish species poses a significant risk to biodiversity. In this study, 55 fish species previously evaluated in a U.K.‐based calibration of FISK are reassessed for their potential invasiveness in the Murray‐Darling Basin (MDB; southeastern Australia), the continent's largest catchment encompassing arid and temperate climates. Approximately half of the species were classed as “medium risk” and the other half as “high risk,” and the ≥19 threshold previously identified from the calibration study was confirmed. The three highest scoring species (common carp Cyprinus carpio carpio, goldfish Carassius auratus, and eastern mosquitofish Gambusia holbrooki) were those already present and invasive in the area, whereas nearly half of the tropical and subtropical species had lower scores compared to U.K. assessments, possibly because of climate change predictions of drier conditions across the MDB. There were some discordances between FISK and two Australian‐based assessment protocols, one of which is qualitative and the other represents a simplified version of FISK. Notably, the Australian origins of FISK should provide for an additional reason for further applications of the tool in other RA areas (i.e., drainage basins) of the continent, ultimately encouraging adoption as the country's reference screening tool for management and conservation purposes.     

Revisions of the Fish Invasiveness Screening Kit (FISK) for its Application in Warmer Climatic Zones,with Particular Reference to Peninsular Florida

The initial version (v1) of the Fish Invasiveness Scoring Kit (FISK) was adapted from the Weed Risk Assessment of Pheloung, Williams, and Halloy to assess the potential invasiveness of nonnative freshwater fishes in the United Kingdom. Published applications of FISK v1 have been primarily in temperate‐zone countries (Belgium, Belarus, and Japan), so the specificity of this screening tool to that climatic zone was not noted until attempts were made to apply it in peninsular Florida. To remedy this shortcoming, the questions and guidance notes of FISK v1 were reviewed and revised to improve clarity and extend its applicability to broader climatic regions, resulting in changes to 36 of the 49 questions. In addition, upgrades were made to the software architecture of FISK to improve overall computational speed as well as graphical user interface flexibility and friendliness. We demonstrate the process of screening a fish species using FISK v2 in a realistic management scenario by assessing the Barcoo grunter Scortum barcoo (Terapontidae), a species whose management concerns are related to its potential use for aquaponics in Florida. The FISK v2 screening of Barcoo grunter placed the species into the lower range of medium risk (score = 5), suggesting it is a permissible species for use in Florida under current nonnative species regulations. Screening of the Barcoo grunter illustrates the usefulness of FISK v2 as a proactive tool serving to inform risk management decisions, but the low level of confidence associated with the assessment highlighted a dearth of critical information on this species.     

Understanding Normative Growth and Development in Aging

No abstract available for this article.