Bicol hospital reaches out to rural folk

The Ago General Hospital in Legaspi City of the Philippines was opened in 1965, antedating the national family planning movement by 5 years. The 180 bed hospital integrates family planning into the overall hospital service; sterilization is the main method used. Of the 3600 patients per year, 15% are family planning acceptors. The hospital employs 3 family planning strategies: inhospital, out patient and supportive. Inhospital strategies center on sterilization counseling and motivation. The counseling sessions include patient education. Primary targets include high risk pregnancies and young couples with a lot of children. Outpatient strategies include a referral system involving hospitals and agencies with family planning programs, lectures for community organizations and personal visits to other clinics and rural health units. The hospital's mobile clinic, staffed mainly by students, provides information, deworming, and pediatric services to the community. Supportive program strategies consist of mass communication, and an acceptor's club for previous acceptors of sterilization. These clubs meet regularly to share and discuss experiences.     

Outreach: helping achieve coordination in the field

The outreach officials of the National Population Program of the Philippines, with its 4 basic functions of research, training, information-education-communication, and clinic services, are trying to solve pressing problems which have been an outgrowth of developments of the early 1970s when population and family planning concepts were integrated into other government programs. Given the task of attacking these problems and coordinating the whole program was the newly organized Commission on Population (Popcom). The organizations which had their own programs cooperated with the government agencies. Initially thought of as workable, the early strategy was soon found to be inadequate, and in July 1975, Popcom implemented an integrated development approach in population work. The strategy is complex, and as it undergoes refinement, the program may well profit from the experiences or lessions gained by a number of agencies in carrying out population/development activities. The approach used by the Office of Nonformal Education of the Philippines Rural Reconstruction Movement is seen as potentially helpful to the outreach project in developing 3 types of leadership in order to properly integrate or link private and public agencies, and ensure a continuing development program: political, educational, and technical. It is stressed that outsiders can help, but it is the community which must basically do the job themselves. So different government technicians are trained so that they can effectively train other people from the community, and do it in such a way that the program will be continuing and self-releasing.     

A tale of two provinces

The population program in 2 provinces of the Philippines 1 which has achieved success already and 1 where success is expected ultimately - is described. The Laguna program, launched in 1960, has reduced the annual birthrate to 1.8%, the lowest rate in the country. Governor F.T. San Luis, elected that year, is credited with much of the success of the program. The relatively high standard of living of the people in the province, cooperation of various related agencies, and the consistency and continuity of the program have made for success, despite initial problems with financing, conservative opposition, and interagency confusion. Capiz province is the model family program of the Commission on Population - Total Integrated Development Approach program for the southern region of the country. This program originally worked to develop self-awareness concerning needs and ambitions for the future among the people. When the program got under way in 1975, it stressed training, orientation, and education campaigns. Family planning in Capiz is part of the larger socioeconomic development program.     

Trend smoothness achieved by penalized least squares with the smoothing parameter chosen by optimality criteria

This work presents a study about the smoothness attained by the methods more frequently used to choose the smoothing parameter in the context of splines: Cross Validation, Generalized Cross Validation, and corrected Akaike and Bayesian Information Criteria, implemented with Penalized Least Squares. It is concluded that the amount of smoothness strongly depends on the length of the series and on the type of underlying trend, while the presence of seasonality even though statistically significant is less relevant. The intrinsic variability of the series is not statistically significant and its effect is taken into account only through the smoothing parameter.     

Need-service matching in substance abuse treatment: Racial/ethnic differences

This study examines the impact of ancillary health and social services matched to client needs in substance abuse treatment for African Americans, Latinos and Whites. The study uses data collected from 1992 to 1997 for the National Treatment Improvement Evaluation Study, a prospective cohort study of substance abuse treatment programs and their clients. The analytic sample consists of 3142 clients (1812 African Americans, 486 Latinos, 844 Whites) from 59 treatment facilities. Results show that racial/ethnic minorities are underserved compared to Whites in the substance abuse service system. Different racial/ethnic groups come into treatment with distinct needs and receive distinct services. Although groups respond differentially to service types, substance abuse counseling and matching services to needs is an effective strategy both for retaining clients in treatment and for reducing post-treatment substance use for African Americans and Whites. Receipt of access services was related to reduced post-treatment substance use for Latinos. Study findings are relevant to planning special services for African Americans and Latinos.     

Trend estimation of multivariate time series with controlled smoothness

This paper extends the univariate time series smoothing approach provided by penalized least squares to a multivariate setting, thus allowing for joint estimation of several time series trends. The theoretical results are valid for the general multivariate case, but particular emphasis is placed on the bivariate situation from an applied point of view. The proposal is based on a vector signal-plus-noise representation of the observed data that requires the first two sample moments and specifying only one smoothing constant. A measure of the amount of smoothness of an estimated trend is introduced so that an analyst can set in advance a desired percentage of smoothness to be achieved by the trend estimate. The required smoothing constant is determined by the chosen percentage of smoothness. Closed form expressions for the smoothed estimated vector and its variance-covariance matrix are derived from a straightforward application of generalized least squares, thus providing best linear unbiased estimates for the trends. A detailed algorithm applicable for estimating bivariate time series trends is also presented and justified. The theoretical results are supported by a simulation study and two real applications. One corresponds to Mexican and US macroeconomic data within the context of business cycle analysis, and the other one to environmental data pertaining to a monitored site in Scotland.     

Organizational characteristics that foster early adoption of cultural and linguistic competence in outpatient substance abuse treatment in the United States

Recent years have seen an increased interest in developing culturally and linguistically responsive systems of care in substance abuse treatment in the United States. This study examines the extent to which external and internal organizational pressures contributed to the degree of adoption of culturally and linguistically responsive practices in the nation's outpatient substance abuse treatment system early in the period of development of this system of care. Findings show that a higher degree of adoption of culturally competent practices was most likely in treatment programs with high dependence on external funding and regulation. Internally, programs with a larger number of professionals were associated with the lowest degree of adoption, while managers’ cultural sensitivity contributed significantly to a high degree of adoption of these responsive practices. Considering the passage of recent legislation enforcing the use of cultural and linguistic competence in health care, implications of these baseline findings on early adoption patterns are discussed for future research and health care policy evaluation.     

Forecasting electricity consumption with extra-model information provided by consumers

SUMMARY Univariate time series models make efficient use of available historical records of electricity consumption for short-term forecasting. However, the information (expectations) provided by electricity consumers in an energy-saving survey, even though qualitative, was considered to be particularly important, because the consumers' perception of the future may take into account the changing economic conditions. Our approach to forecasting electricity consumption combines historical data with expectations of the consumers in an optimal manner, using the technique of restricted forecasts. The same technique can be applied in some other forecasting situations in which additional information-besides the historical record of a variable-is available in the form of expectations.     

Smoothing a Time Series by Segments of the Data Range

We consider the problem of estimating a trend with different amounts of smoothness for segments of a time series subjected to different variability regimes. We propose using an unobserved components model to consider the existence of at least two data segments. We first fix some desired percentages of smoothness for the trend segments and deduce the corresponding smoothing parameters involved. Once the size of each segment is chosen, the smoothing formulas here derived produce trend estimates for all segments with the desired smoothness as well as their corresponding estimated variances. Empirical examples from demography and economics illustrate our proposal.