Integrating self-care into clinical practice with trauma clients

ABSTRACT

Self-care is recognized as an important aspect of social work practice. Beginning in educational settings, developing social workers are encouraged to learn about and practice self-care. However, self-care is typically promoted through strategies and approaches outside of the practice context. Social workers are oftentimes encouraged to use individualized self-care plans, which often feature a variety of relaxation and secondary techniques; focus on self-awareness and self-reflection; and have proper use of supervision. Although these strategies are invaluable, they do little to directly benefit the social worker during direct practice or while in session with a client which is a time period when clinicians are particularly vulnerable to distress or burnout. The importance of real-time self-care strategies is particularly critical for clinicians, especially those who engage in trauma work, given the sensitivity of topics that clients may have endured or benefit from assistance in processing. Further, little information has been published on the use of self-care techniques during a session with a client or in a clinical context. The purpose of the present paper is to discuss self-care strategies that can be useful both outside of and within a clinical setting and present a model of such strategies that focus on integrating self-care in clinical practice particularly for those engaging in trauma work. The paper will conclude by discussing the relevancy of the developed model in practice.     

Simultaneous edit-imputation and disclosure limitation for business establishment data

Business establishment microdata typically are required to satisfy agency-specified edit rules, such as balance equations and linear inequalities. Inevitably some establishments' reported data violate the edit rules. Statistical agencies correct faulty values using a process known as edit-imputation. Business establishment data also must be heavily redacted before being shared with the public; indeed, confidentiality concerns lead many agencies not to share establishment microdata as unrestricted access files. When microdata must be heavily redacted, one approach is to create synthetic data, as done in the U.S. Longitudinal Business Database and the German IAB Establishment Panel. This article presents the first implementation of a fully integrated approach to edit-imputation and data synthesis. We illustrate the approach on data from the U.S. Census of Manufactures and present a variety of evaluations of the utility of the synthetic data. The paper also presents assessments of disclosure risks for several intruder attacks. We find that the synthetic data preserve important distributional features from the post-editing confidential microdata, and have low risks for the various attacks.     

民汉双语诉讼规则之探索

我国宪法赋予了公民用自己的民族语言文字参加诉讼的权利，目的在于实现民族平等、促进民族团结、禁止民族分裂、保护中华民族语言文化的多样性，进而提高我国的文化软实力。通过调查民族语言文字诉讼司法实务，发现当前存在着少数民族语言文字诉讼程序混乱、不符合诉讼原理等问题，不利于民族语言文字诉讼权利的实现。究其原因，在于该诉讼制度缺乏程序保障。为了确保民族语言文字诉讼权利的有效实现，应设立“民汉双语诉讼规则”，以为司法机关提供统一的操作规范。民汉双语诉讼规则应该明确民汉双语诉讼的概念、类型以及民族语言文字诉讼权利的内容，并且根据不同诉讼类型有针对性地设置审判语言与诉讼语言的适用规则。     

Resource Distribution in Multiple Attacks with Imperfect Detection of the Attack Outcome

This article extends the previous research of consecutive attacks strategy by assuming that an attacker observes the outcome of each attack imperfectly. With given probabilities it may wrongly identify a destroyed target as undestroyed, and wrongly identify an undestroyed target as destroyed. The outcome of each attack is determined by a contest success function that depends on the amount of resources allocated by the defender and the attacker to each attack. The article suggests a probabilistic model of the multiple attacks and analyzes how the target destruction probability and the attacker's relative resource expenditure are impacted by the two probabilities of incorrect observation, the attacker's and defender's resource ratio, the contest intensity, the number of attacks, and the resource distribution across attacks. We analyze how the attacker chooses the number of attacks, the attack stopping rule, and the optimal resource distribution across attacks to maximize its utility.     

Improved communality estimation in factor analysis

The symmetric treatment of an asymmetric approach to factor analysis is shown to provide accurate communality estimates. In comparison with existing estimates including upper and lower bounds, the present approach is shown to be superior. In one example with known communalities, the present approach perfectly captures those communalities. In two empirical examples, it is shown to produce better communality estimates than any existing method.     

Adaptive designs for single‐arm phase II trials in oncology

Clinical phase II trials in oncology are conducted to determine whether the activity of a new anticancer treatment is promising enough to merit further investigation. Two‐stage designs are commonly used for this situation to allow for early termination. Designs proposed in the literature so far have the common drawback that the sample sizes for the two stages have to be specified in the protocol and have to be adhered to strictly during the course of the trial. As a consequence, designs that allow a higher extent of flexibility are desirable. In this article, we propose a new adaptive method that allows an arbitrary modification of the sample size of the second stage using the results of the interim analysis or external information while controlling the type I error rate. If the sample size is not changed during the trial, the proposed design shows very similar characteristics to the optimal two‐stage design proposed by Chang et al. (Biometrics 1987; 43:865–874). However, the new design allows the use of mid‐course information for the planning of the second stage, thus meeting practical requirements when performing clinical phase II trials in oncology. Copyright © 2012 John Wiley & Sons, Ltd.     

多重身份的复合--论唐顺之对曾巩散文的评价

唐顺之作为一名笃诚的心学家、理学家，势必会从思想价值的角度对文学作品进行评价。同时他又是一个优秀的八股文名家、古文评点家，有时又会摆脱心学和理学的思维模式，从文学自身的角度考量创作。受此多重身份的复合影响，唐顺之对道学气息浓厚而艺术性较差的曾巩散文进行评价时，就显得颇为矛盾：既认为“三代以下之文未有如南丰”，又以为曾巩散文法度平实，缺少变化，只能居于唐宋八家之末。     

Generating synthetic data to produce public-use microdata for small geographic areas based on complex sample survey data with application to the National Health Interview Survey

Small area statistics obtained from sample survey data provide a critical source of information used to study health, economic, and sociological trends. However, most large-scale sample surveys are not designed for the purpose of producing small area statistics. Moreover, data disseminators are prevented from releasing public-use microdata for small geographic areas for disclosure reasons; thus, limiting the utility of the data they collect. This research evaluates a synthetic data method, intended for data disseminators, for releasing public-use microdata for small geographic areas based on complex sample survey data. The method replaces all observed survey values with synthetic (or imputed) values generated from a hierarchical Bayesian model that explicitly accounts for complex sample design features, including stratification, clustering, and sampling weights. The method is applied to restricted microdata from the National Health Interview Survey and synthetic data are generated for both sampled and non-sampled small areas. The analytic validity of the resulting small area inferences is assessed by direct comparison with the actual data, a simulation study, and a cross-validation study.     

Model averaging for treatment effect estimation in subgroups

In many clinical trials, biological, pharmacological, or clinical information is used to define candidate subgroups of patients that might have a differential treatment effect. Once the trial results are available, interest will focus on subgroups with an increased treatment effect. Estimating a treatment effect for these groups, together with an adequate uncertainty statement is challenging, owing to the resulting “random high” / selection bias. In this paper, we will investigate Bayesian model averaging to address this problem. The general motivation for the use of model averaging is to realize that subgroup selection can be viewed as model selection, so that methods to deal with model selection uncertainty, such as model averaging, can be used also in this setting. Simulations are used to evaluate the performance of the proposed approach. We illustrate it on an example early‐phase clinical trial.     

All pairwise comparisons of exponential location parameters under type i censoring — equal scale parameter case

In this paper, procedures for all pairwise comparisons of location parameters of negative exponential populations are developed when the common scale parameter is known or unknown using large sample distributional approximations of the relevant random variables. The small sample performance of these procedures are then examined using Monte Carlo simulation.