Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change

Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices.     

The Attributes of Effective NGOs and the Leadership Values Associated with a Reputation for Organizational Effectiveness

Building on prior research characterizing organizational effectiveness as a social construction, this article identifies the perceived attributes of effective transnational nongovernmental organizations (NGOs) and the leadership values associated with higher reputations for organizational effectiveness. Results are based on an in‐depth, mixed‐method interview study of 152 NGO leaders located in the United States and representing all major sectors of organizational activity. Among the twenty‐nine attributes that leaders identified in peer organizations that they regarded as particularly effective, leaders stressed instantiation of sound principles or strategy, a grassroots approach, large organizational size and resources, being collaborative, singleness of focus, campaigning abilities, funding and fundraising prowess, global scope, and quality people. Furthermore, statistical analysis reveals that NGOs with leaders who value similarities with peer organizations, grassroots approaches, diversity of strategies, dedication, professionalism, and distributed organizational structures have significantly higher reputations for effectiveness.     

‘Keeping the story alive’: is ethnic and racial dilution inevitable for multiracial people and their children?

This paper explores how multiracial parents with White partners articulate narratives of ethnic and racial ‘dilution’ and cultural loss in relation to the socialization of their children. In our broader study of how multiracial parents raise their children, we found that parents commonly spoke of concerns around dilution and generational change in relation to four key themes: the loss of cultural knowledge and diminishing practices that connected parents and their children to a minority ancestry; the embodiment of White‐appearing children and the implications of this for family relationships; the use of biological or genetic discourses in relation to reduced blood quantum; and concerns amongst Black/White participants about whitening and the loss of racial consciousness. Parental understandings of dilution varied greatly; some expressed sadness at ‘inevitable’ loss; others were more philosophical about generational change; and others still proactively countered loss through strategies to connect their children to their minority heritages. We show that despite growing awareness of the social constructedness of race and an emergent cosmopolitanism among these parents, discourses of genetics, cultural lineage, and the ‘naturalness’ of race continue to hold sway amongst many multiracial parents.     

A Bayesian estimate of the concordance correlation coefficient with skewed data

Concordance correlation coefficient (CCC) is one of the most popular scaled indices used to evaluate agreement. Most commonly, it is used under the assumption that data is normally distributed. This assumption, however, does not apply to skewed data sets. While methods for the estimation of the CCC of skewed data sets have been introduced and studied, the Bayesian approach and its comparison with the previous methods has been lacking. In this study, we propose a Bayesian method for the estimation of the CCC of skewed data sets and compare it with the best method previously investigated. The proposed method has certain advantages. It tends to outperform the best method studied before when the variation of the data is mainly from the random subject effect instead of error. Furthermore, it allows for greater flexibility in application by enabling incorporation of missing data, confounding covariates, and replications, which was not considered previously. The superiority of this new approach is demonstrated using simulation as well as real‐life biomarker data sets used in an electroencephalography clinical study. The implementation of the Bayesian method is accessible through the Comprehensive R Archive Network. Copyright © 2015 John Wiley & Sons, Ltd.     

Joint modelling of longitudinal biomarker and gap time between recurrent events: copula-based dependence

In this paper, we will extend the joint model of longitudinal biomarker and recurrent event via copula function for accounting the dependence between the two processes. The general idea of joining separate processes by allowing model-specific random effect may come from different families distribution. It is a main advantage of the proposed method that a copula construction does not constrain the choice of marginal distributions of random effects. A maximum likelihood estimation with importance sampling technique as a simple and easy understanding method is employed to model inference. To evaluate and verify the validation of the proposed joint model, a bootstrapping method as a model-based resampling is developed. Our proposed joint model is also applied to pemphigus disease data for assessing the effect of biomarker trajectory on risk of recurrence.     

Small Area Estimation Using Estimated Population Level Auxiliary Data

Unit level linear mixed models are often used in small area estimation (SAE), and the empirical best linear unbiased prediction (EBLUP) is widely used for the estimation of small area means under such models. However, EBLUP requires population level auxiliary data, atleast area specific aggregated values. Sometimes population level auxiliary data is either not available or not consistent with the survey data. We describe a SAE method that uses estimated population auxiliary information. Empirical results show that proposed method for SAE produces an efficient set of small area estimates.     

混业经营:21世纪中国金融业发展的必由之路

混业经营是世界金融业发展的大趋势,它必将对中国金融业的发展产生重要影响。文章在阐述21世纪中国金融业混业经营的客观必然性的基础上,分析21世纪中国金融业混业经营的可行条件和现实障碍,并提出21世纪中国金融业混业经营的对策。     

新型树脂切割砂轮的研制

本文介绍一种新型的混合磨料树脂结合剂切割砂轮的制造技术,对其切割机理进行了探讨,系统阐述了影响树脂切割砂轮的切割效率、耐用度等方面的因素.     

The likelihood ratio test for homogeneity in finite mixture models

The authors study the asymptotic behaviour of the likelihood ratio statistic for testing homogeneity in the finite mixture models of a general parametric distribution family. They prove that the limiting distribution of this statistic is the squared supremum of a truncated standard Gaussian process. The autocorrelation function of the Gaussian process is explicitly presented. A re‐sampling procedure is recommended to obtain the asymptotic p‐value. Three kernel functions, normal, binomial and Poisson, are used in a simulation study which illustrates the procedure.