Bayesian Analysis of DNA Profiling Data in Forensic Identification Applications

The utilization of DNA evidence in cases of forensic identification has become widespread over the last few years. The strength of this evidence against an individual standing trial is typically presented in court in the form of a likelihood ratio (LR) or its reciprocal (the profile match probability). The value of this LR will vary according to the nature of the genetic relationship between the accused and other possible perpetrators of the crime in the population. This paper develops ideas and methods for analysing data and evaluating LRs when the evidence is based on short tandem repeat profiles, with special emphasis placed on a Bayesian approach. These are then applied in the context of a particular quadruplex profiling system used for routine case-work by the UK Forensic Science Service.     

Learning from the Experiences of Ethnic Minorities Accessing HIV Services in Ireland

Since the mid-1990s, Ireland has become a more culturally diversesociety. To ensure equitable, culturally sensitive services,social workers need to consult with and listen to views of serviceusers. This paper reports on findings of two recent studiesby social workers in Ireland with migrants living with HIV.It highlights how many of those newly diagnosed with HIV arefrom sub-Saharan African countries and still in the asylum processand discusses barriers to accessing support and integratinginto Irish society. The paper points out that unless properlysupported, those living with HIV may find it difficult to disclosetheir HIV status and highlights the importance of tackling HIVstigma. It concludes with the need to provide training for healthcare workers to provide culturally appropriate services, andargues against immigration policies which inhibit integration.     

MONOPOLY, MONOPSONY AND CONTESTABILITY IN HEALTH INSURANCE: A STUDY OF BLUE CROSS PLANS

As dominant sellers of health insurance and buyers of health services, Blue Cross and Blue Shield have potential monopoly and monopsony power. The credible threat of entry resulting from the increased competitiveness of these markets in the 1980s may have produced competitive outcomes—reduced prices, improved quality and efficient cost structures—even in a concentrated market. We find the plans used economies of scale and monopsony power to reduce administrative costs, provide payments and consumer premiums. Our findings suggest that steps to enhance the contestability of health markets may be a better response than regulation.     

Social and Health Factors Affecting Community Service Use by Vulnerable Older People

Abstract

This article reports on Outcomes for older people with complex or chronic care needs, a study undertaken by the Brotherhood of St Laurence and La Trobe University, examining older Victorians’ use of community services following Aged Care Assessment Service (ACAS) recommendations that they remain living at home. The paper reports on interviews with older people and carers undertaken at three-monthly intervals, over 12 months. This paper contributes to understanding the factors that impede or facilitate uptake of community aged care services that are critical to meeting the needs of older people and their carers. The study found that among other factors social isolation, high carer burden, and the older person reporting low mood were important barriers to service uptake. Cost, waiting lists, and service satisfaction were also identified in qualitative data as influencing factors. The study concludes there is a need for better means of identifying and supporting older people and carers at risk to improve community service uptake.     

A comparison of procedures to correct for base-line differences in the analysis of continuous longitudinal data: a case-study

Summary.  The main advantage of longitudinal studies is that they can distinguish changes over time within individuals (longitudinal effects) from differences between subjects at the start of the study (base-line characteristics; cross-sectional effects). Often, especially in observational studies, subjects are very heterogeneous at base-line, and one may want to correct for this, when doing inferences for the longitudinal trends. Three procedures for base-line correction are compared in the context of linear mixed models for continuous longitudinal data. All procedures are illustrated extensively by using data from an experiment which aimed at studying the relationship between the post-operative evolution of the functional status of elderly hip fracture patients and their preoperative neurocognitive status.     

SURVEY DESIGN

Survey design involves planning and documenting questionnaires, sample selection and survey operations. It constitutes a simultaneous solution to numerous interrelated conceptual and practical design issues, more than may usually be settled effectively, or even recognised, in any reasonable time by contemplation alone. The alternative is an iterative approach, making a trial plan, testing and then improving it, and, if necessary, repeating it until a satisfactory plan is evolved. Pilot testing can then become the focus of design decisions by providing relevant data and operating experience, and by using experimental methods, as a basis for adroit revision of trial survey plans. This paper concerns the planning of efficient survey design processes along these lines.