A latent variable model for analyzing mixed longitudinal (k,l)-inflated count and ordinal responses

A random effects model for analyzing mixed longitudinal count and ordinal data is presented where the count response is inflated in two points (k and l) and an (k,l)-Inflated Power series distribution is used as its distribution. A full likelihood-based approach is used to obtain maximum likelihood estimates of parameters of the model. For data with non-ignorable missing values models with probit model for missing mechanism are used.The dependence between longitudinal sequences of responses and inflation parameters are investigated using a random effects approach. Also, to investigate the correlation between mixed ordinal and count responses of each individuals at each time, a shared random effect is used. In order to assess the performance of the model, a simulation study is performed for a case that the count response has (k,l)-Inflated Binomial distribution. Performance comparisons of count-ordinal random effect model, Zero-Inflated ordinal random effects model and (k,l)-Inflated ordinal random effects model are also given. The model is applied to a real social data set from the first two waves of the national longitudinal study of adolescent to adult health (Add Health study). In this data set, the joint responses are the number of days in a month that each individual smoked as the count response and the general health condition of each individual as the ordinal response. For the count response there is incidence of excess values of 0 and 30.     

Do resources of network members help in help seeking? Social capital and health information search

Does social capital as resources of network members affect health information search? Analyzing data from the 2004 General Social Survey in the United States, this study measures two social capital indicators (average education of network members and proportion of network members with a high school degree or higher) using the name generator. Most results are consistent using those two indicators. Both indicators are positively associated with frequency of health information seeking and seekers’ frequency of use of two sources (friends or relatives and the Internet). Also average education of network members is positively associated with seekers’ diversity of used sources and frequency of consultation with medical professionals. But neither indicator is associated with seekers’ frequency of use of other four sources (health-related magazines or newsletters, general magazines, daily newspapers, and radio or television programs). The findings demonstrate the theoretical utility of social capital in the social dynamics of medical help-seeking.     

On the Post-90s＇ Modern Health Concept from the Perspective of Public Hygienic Events

伴随社会经济的迅猛发展和城市化步伐的加快，生态破坏、环境污染等问题日益加剧。生物界自然平衡状态的打破导致近年来我国各类公共卫生危机频发，处于公共卫生事件的高发期，“90后”作为一个特殊的青少年群体，由于其身心机能发育尚未成熟，不但是此类事件中最主要的易感人群，更容易产生各类心理障碍与行为问题。现代健康观念的树立和综合健康素养的提升在这一阶段尤为关键。研究发现，“90后”青少年的健康观念趋于科学理性，健康自我管理能力和习惯养成有待提升：对健康危机的忧患意识较强，危机状态下的心理承受能力较弱；具备一定的公民责任意识和行为自律意识，但面对一些较为复杂的社会现象，现代法制观念和人文关怀意识仍有所欠缺     

Public broadcast of health communication: Extending public relations through social capital in Taiwan

This paper shows how a public media can effectively utilize its social capital, and integrate with different resources from the related non-profit organizations and corporations in public relations perspective. A case study of a high-popularity Taiwanese public traffic radio: Police Broadcasting Service (PBS) is conducted. The finding shows that the public radio can cost-effectively deliver health communication with the principle of social marketing.     

Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

Optimal financing and dividend policy with Markovian switching regimes

This work investigates an optimal financing and dividend problem for an insurer whose surplus process is modulated by an observable continuous-time and finite-state Markov chain. We assume that the insurer should never go bankrupt by issuing new equity. The goal of the insurer is to maximize the expected present value of the dividends payout minus the discounted cost of equity issuance. We obtain the optimal policies and explicit expressions for the value functions when the risk reserve process is modeled by both upward jump model and its diffusion approximation. Numerical illustrations of the sensitivities of the model parameters are provided.     

Managing diversity: academic’s perspective on culture and teaching

As UK Higher Education institutions continue to accept students from ethnically diverse backgrounds, there is now an onus and an expectation for academics to provide learning environments and experiences that are inclusive, validating and affirming. The aim of this paper is to explore, through the lens of the academic tutor, the pedagogical methods employed towards the implementation of ‘cultural branching’, which we define as helping ethnically diverse students to build bridges between their pre-existing knowledge and what they are expected to learn. To investigate this in more detail, the researchers interviewed 22 academic tutors across three UK Higher Education Institutions in the North of England. The findings suggest that current curriculum structures and pedagogical approaches favour the dominant non-ethnically diverse learner. Our research proposes that additional emphasis needs to be placed on developing a practical and functional approach which embeds cultural branching via technological platforms.     

Educational gradient of health in rural China

The aim of this paper is to examine whether and how rural residents’ educational attainment is associated with their self-rated health in China. Taking advantage of the National Exercise Facility Survey that was collected between December 2015 and March 2016, we find that educational attainment has a significant and positive correlation with self-rated health, net of the effects of age, gender, and geographical region. This correlation is mediated by factors such as perceived importance of exercise and healthy lifestyle. Relatively, people’s cognitive knowledge about health-related information and material resource access fail to play a significant mediating role. The findings highlight the non-material and non-cognitive attributes of educational attainment in shaping the gradient of health in the rural setting of China. Interventions that expand formal education to the mass and optimize teaching contents may offer an effective means to balance the health gradient.     

Smoking during pregnancy,stigma and secrets: Visual methods exploration in the UK

BackgroundMoral judgements are commonly directed towards mothers through reference to health behaviour in pregnancy, and working-class mothers are particularly subject to this moral gaze.AimTo gain an in-depth understanding of the health issues affecting 10 low income pregnant women from deprived areas of south Wales, UK.MethodsParticipants completed visual activities (timelines, collaging or thought bubbles and dyad sandboxing) prior to each interview. Participants’ visual representations were used in place of a topic guide, to direct the interview. Guided by feminist principles, 28 interviews were completed with 10 women. Data were analysed thematically.FindingsSmoking was discussed at length during interviews, and this paper focuses on this issue alone. Five of the participants had smoked during pregnancy. Negative reactions were directed towards pregnant women who smoked in public, resulting in maternal smoking being undertaken in private. Participants also reported awkward relationships with midwives and other health professionals, including receipt of public health advice in a judgemental tone.DiscussionSmoking during pregnancy is a particularly demonised and stigmatised activity. This stigma is not always related to the level of risk to the foetus, and instead can be seen as a moral judgement about women. We urgently need to move from individualised neo-liberal discourses about the failure of individual smokers, to a more socio-ecological view which avoids victim blaming.ConclusionStigma from friends, family, strangers and health professionals may lead to hidden smoking. This is a barrier to women obtaining evidence based stop smoking support.     

Multi-objective optimization in partitioning the healthcare system of Parana State in Brazil

Motivated by a proposal of the local authority for improving the existing healthcare system in the Parana State in Brazil, this article presents an optimization-based model for developing a better system for patients by aggregating various health services offered in the municipalities of Parana into some microregions. The problem is formulated as a multi-objective partitioning of the nodes of an undirected graph (or network) with the municipalities as the nodes and the roads connecting them as the edges of the graph. Maximizing the population homogeneity in the microregions, maximizing the variety of medical procedures offered in the microregions, and minimizing the inter-microregion distances to be traveled by patients are considered as three objective functions of the problem. An integer-coded multi-objective genetic algorithm is adopted as the optimization tool, which yields a significant improvement to the existing healthcare system map of the Parana State. The results obtained may have a strong impact on the healthcare system management in Parana. The model proposed here could be a useful tool to aid the decision-making in health management, as well as for better organization of any healthcare system, including those of other Brazilian States.