Risk Assessment for Hospital-Acquired Diseases: A Risk-Theory Approach

We introduce a new approach to hospital-acquired disease risk assessment from public health databases. In a spirit similar to actuarial risk theory, we define an adjustment coefficient that can quantify the risk associated with a hospital department, allowing comparisons of similar departments. The adjustment coefficient characterizes the tail of the distribution of the total patient length of stay in a department before the first disease event occurs. We show that this coefficient is the solution of a Lundberg-like equation, and we provide a nonparametric estimation procedure for this measure, based on a Cramér-Lundberg approximation for the tail of the distribution. Using simulations, we provide evidence of the robustness of the approximation to various individual risk models. In addition, we illustrate the relevance of this approach by evaluating the risk associated with a standard patient safety indicator in 20 hospitals of southeastern France.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.     

农民工子女健康危险行为思考

农民工子女健康危险行为日益增多,影响到社会安定。进行青少年健康危险行为的有关理论、概念、影响因素、预防和干预策略的阐述和总结,并为今后农民工子女健康危险行为研究提出建议。     

Sequential estimation problems for negative exponential populations

The literature on sequential estimation problems for negative exponential populations has been reviewed here, We attempt to bring in all the published and unpublished materials known to us in a fairly coherent fashion. Both the concepts and theoretical findings are discussed.     

Perception and Communication of Flood Risks: A Systematic Review of Empirical Research

Flood hazards are the most common and destructive of all natural disasters. For decades, experts have been examining how flood losses can be mitigated. Just as in other risk domains, the study of risk perception and risk communication has gained increasing interest in flood risk management. Because of this research growth, a review of the state of the art in this domain is believed necessary. The review comprises 57 empirically based peer‐reviewed articles on flood risk perception and communication from the Web of Science and Scopus databases. The characteristics of these articles are listed in a comprehensive table, presenting research design, research variables, and key findings. From this review, it follows that the majority of studies are of exploratory nature and have not applied any of the theoretical frameworks that are available in social science research. Consequently, a methodological standardization in measuring and analyzing people's flood risk perceptions and their adaptive behaviors is hardly present. This heterogeneity leads to difficulties in comparing results among studies. It is also shown that theoretical and empirical studies on flood risk communication are nearly nonexistent. The article concludes with a summary on methodological issues in the fields of flood‐risk perception and flood‐risk communication and proposes an agenda for future research.     

The Continuum of Care System

Abstract

The Continuum of Care System is a Decision Support System designed to assist social workers responsible for identifying and selecting alternative living arrangements for children unable to remain in their own families. The Continuum of Care System consists of two software packages called MATCH and PROFILE. MATCH produces a rank-ordered list of prospective placement alternatives by statistically comparing an individual child to groups of children previously admitted into different residential facilities. PROFILE summarizes the characteristics and problems of children at each facility in the system.     

On selecting the best population

This paper deals with the problem of selecting the “best” population from a given number of populations in a decision theoretic framework. The class of selection rules considered is based on a suitable partition of the sample space. A selection rule is given which is shown to have certain optimum properties among the selection rules in the given class for a mal rules are known.     

Human Health Risk Assessment of Penicillin/Aminopenicillin Resistance in Enterococci Due to Penicillin Use in Food Animals

Penicillin and ampicillin drugs are approved for use in food animals in the United States to treat, control, and prevent diseases, and penicillin is approved for use to improve growth rates in pigs and poultry. This article considers the possibility that such uses might increase the incidence of ampicillin-resistant Enterococcus faecium (AREF) of animal origin in human infections, leading to increased hospitalization and mortality due to reduced response to ampicillin or penicillin. We assess the risks from continued use of penicillin-based drugs in food animals in the United States, using several assumptions to overcome current scientific uncertainties and data gaps. Multiplying the total at-risk population of intensive care unit (ICU) patients by a series of estimated factors suggests that not more than 0.04 excess mortalities per year (under conservative assumptions) to 0.14 excess mortalities per year (under very conservative assumptions) might be prevented in the whole U.S. population if current use of penicillin drugs in food animals were discontinued and if this successfully reduced the prevalence of AREF infections among ICU patients. These calculations suggest that current penicillin usage in food animals in the United States presents very low (possibly zero) human health risks.     

累积的异质性：生命历程视角下的老年人分化

本文以生命历程理论为研究视角，以深度访谈的方法收集老年人“主诉”的关于过去的生活资料，试图通过对个人能动性与生命历程时间性的强调，来分析个体生命历程与社会变迁的相互嵌入过程，以及这一过程中不断分化的内部机制。研究发现，老化的过程是一个随时间推移不断累积与分化的过程，累积因素的先后顺序对个体之间的分化具有重要意义，累积是生命历程资本遭遇生命历程风险的结果，是社会结构与个人能动性相互作用的动态过程，其中社会政策的变迁对累积过程具有决定性的影响。     

Predicting infectious disease outbreak risk via migratory waterfowl vectors

The spread of an emerging infectious disease is a major public health threat. Given the uncertainties associated with vector-borne diseases, in terms of vector dynamics and disease transmission, it is critical to develop statistical models that address how and when such an infectious disease could spread throughout a region such as the USA. This paper considers a spatio-temporal statistical model for how an infectious disease could be carried into the USA by migratory waterfowl vectors during their seasonal migration and, ultimately, the risk of transmission of such a disease to domestic fowl. Modeling spatio-temporal data of this type is inherently difficult given the uncertainty associated with observations, complexity of the dynamics, high dimensionality of the underlying process, and the presence of excessive zeros. In particular, the spatio-temporal dynamics of the waterfowl migration are developed by way of a two-tiered functional temporal and spatial dimension reduction procedure that captures spatial and seasonal trends, as well as regional dynamics. Furthermore, the model relates the migration to a population of poultry farms that are known to be susceptible to such diseases, and is one of the possible avenues toward transmission to domestic poultry and humans. The result is a predictive distribution of those counties containing poultry farms that are at the greatest risk of having the infectious disease infiltrate their flocks assuming that the migratory population was infected. The model naturally fits into the hierarchical Bayesian framework.