Hospital Community Benefit in Rural Appalachia: One More Gap*

Non‐profit hospitals are important anchors in Appalachian communities, in part because of the concentration of health care dollars within these institutions. Community benefit efforts of these hospitals, therefore, have the potential to fill gaps in public health and social service provision in underserved areas with documented health disparities and access barriers. To date, however, we do not fully understand how community benefit practices vary by hospital setting. Employing hierarchical linear modeling using a multilevel mixed‐effects approach, this study analyzes data from the years 2010 to 2016 to assess community benefit practices and spending between hospitals in Appalachia and non‐Appalachian counties. Findings indicate that hospitals within Appalachian counties, and rural hospitals in this region, in particular, spent less on community benefit than hospitals, not in this region. Given the potential for community benefit to impact health outcomes and access to care, this disparity is important to state and local public health efforts and suggests the need for additional support for hospitals to engage their communities around critical health needs.     

Landmark estimation of transition probabilities in non-Markov multi-state models with covariates

Lifetime Data Analysis - In non-Markov multi-state models, the traditional Aalen–Johansen (AJ) estimator for state transition probabilities is generally not valid. An alternative, suggested...     

Shaping ethics: youth workers matter

The authors propose that youth workers and educators committed to informing and shaping the ethical understandings of young people first need to explore and become aware of their own ethics. This requires front-line staff and caregivers to critically reflect on the impact their day-to-day choices and decisions have on youth. Once they become clearer about their own ethics and the consequences of their decisions, youth workers are then in a position to promote opportunities for youth to make ethical choices. The authors use observations and ideas from their experiences with the Minnesota Youth Work Institute. Their overarching aim is to promote ethical congruence between what is taught, how it is taught, and how it is practiced in daily work with youth.     

Public or Private Management? A Comparative Analysis of Social Policies in Europe

Across the world, political leaders and policy experts frequently use the labels ‘public’ and ‘private’ to organize social policies. A line seemingly separates public from private efforts, with social policies publicly organized in some countries and privately organized in others. According to this perspective, a public social policy is undertaken by government or deals with a public matter. When a social policy is private, non‐public actors and institutions, like employers, undertake it or it deals with a private matter, like body control. This article examines whether public or private approaches to managing social policies are currently emphasized in European countries. I begin by defining social policy and then provide an overview of the public–private dichotomy in managing social policy. I review predominant typological frameworks of public–private organization of social policies and examine three welfare social policies and three social policies dealing with body control by comparing public–private organization of these six policy areas across 21 European countries. I conclude by discussing the limited diversity of public–private organizations of social policies in Europe.     

Karhunen–Loève Basis in Goodness-of-Fit Tests Decomposition: An Evaluation

In a previous article (Grané and Fortiana, 2006 Grané , A. , Fortiana , J. ( 2006 ). An adaptive goodness-of-fit test . Commun. Statist. A. Theor. Meth 35 ( 6 ): 1141 – 1155 .[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]), we studied a flexible class of goodness-of-fit tests associated with an orthogonal sequence, the Karhunen–Loève decomposition of a stochastic process derived from the null hypothesis. Generally speaking, these tests outperform Kolmogorov–Smirnov and Cramér–von Mises, but we registered several exceptions. In this work we investigate the cause of these anomalies and, more precisely, whether and when such poor behavior may be attributed to the orthogonal sequence itself, by replacing it with the Legendre polynomials, a commonly used basis for smooth tests. We find an easily computable formula for the Bahadur asymptotic relative efficiency, a helpful quantity in choosing an adequate basis.     

Asymptotic properties of a goodness-of-fit test based on maximum correlations

We study the efficiency properties of the goodness-of-fit test based on the Q _n statistic introduced in Fortiana and Grané [Goodness-of-fit tests based on maximum correlations and their orthogonal decompositions, J. R. Stat. Soc. B 65 (2003), pp. 115–126] using the concepts of Bahadur asymptotic relative efficiency and Bahadur asymptotic optimality. We compare the test based on this statistic with those based on the Kolmogorov–Smirnov, the Cramér-von Mises criterion and the Anderson–Darling statistics. We also describe the distribution families for which the test based on Q _n is locally asymptotically optimal in the Bahadur sense and, as an application, we use this test to detect the presence of hidden periodicities in a stationary time series.     

How and when does speech-acting generate social innovations

Speaking is a normal, a special and ubiquitous human activity. Speaking or writing as a subjective and willful activity directed at others takes place within a dense set of behavioral norms. Speaking also activates selectively resources, concepts, logics and rules in language. We investigate the power of the language institution, speech-acting, constructed narratives and deliberations in creating social innovations. We look at new organizations, especially the constitution of new groups with operative collective intentions as social innovations. We ask how speech-acting theory can add or deepen insight into the constitution, the creation, the sustainability and the breakdown of organizations. Speech-acting theory has a focus on rationality as reasoning. Both Amartya Sen and John Searle have delved into reasoning – as creative subjectivity in multi-institutional settings. We try to exploit critically some of their philosophical findings into the field of empirical organization and social innovation studies.     

Rights and the role of family engagement in child welfare: an international treaties perspective on families' rights, parents' rights, and children's rights

According to international human rights treaties, what rights do family members, parents, and children have in family engagement in child welfare decision-making? A socio-legal analytical approach produces a typology of rights, then applies the typology to eight countries' approaches to family engagement to show that strong bundles of rights are available in some countries, but not in others. This study reveals international treaties have articulated many rights necessary to family engagement, but some rights are missing.