Finances and Well-Being: A Dynamic Equilibrium Model of Resources.

This study of 513 Dutch farmers tested a dynamic equilibrium model of resources (an extension of the conservation of resources theory; S. E. Hobfoll, 1989, 1998, 2001). With structural equation modeling, the advantages of a 3-wave longitudinal design were comprehensively used, such as addressing bidirectional causal effects and within-individual vs. between-individual change. This allowed for a careful analysis of the management function of resources in the stress process. Results showed that well-being had stronger within-person stability than finances. Increased levels of financial problems temporarily increased psychological distress but not self-reported illness. Conversely, farmers with higher stable baselines of psychological distress also had higher baselines of self-reported illness and experienced more negative changes in their financial situation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

电源效率冲上电力市场浪尖？

政府机构正在与公用事业公司合作,减少由于低效率电源所导致的功耗增长。在今天的电力供应市场上,效率是一个热门话题。增加效率曾是一个被忽视的角色,但现在却是一个全球性的重要动向。这种转变有两个主要原因。     

Endoscopic study of the small intestine with push enteroscopy. A prospective study

OBJECTIVE: To evaluate whether push enteroscopy of the small bowel (PES), undertaken after extensive previous investigations in suspected intestinal bleeding from an uncertain site, chronic diarrhoea or lymphoma of the small intestine, contributes to the diagnosis, and to ascertain the results of PES and its clinical significance. PATIENTS AND METHODS: 56 consecutive patients (29 men, 27 women; mean age 63 years) were investigated prospectively. The main indications for PES were the search for the source of intestinal bleeding in 79% of patients (group A), chronic diarrhoea or tropical sprue in 16% (group B) and search for tumour of lymphoma in 5% (group C). PES was always performed in fasting patients under sedation/analgesia using a video PES, which contrary to catheter enteroscopy provides a channel for intervention. RESULTS: In group A 27% of patients were found to have lesions, in particular angiodysplasias, or (in once case) leiomyoma. Half of these patients were successfully treated endoscopically without later surgical intervention being required (mean follow-up of six months). In the other half operation became necessary, either because the disease itself indicated it or the bleeding persisted, the source being in the more distant small intestine and thus not accessible to endoscopic intervention: only 50% of the length of the small intestine proved to be within reach of the instrument. No abnormalities were discovered in patients of groups B and C. CONCLUSION: In cases of gastrointestinal bleeding from an uncertain source PES should be performed first, because in many cases it may obviate surgical intervention. But PES seems to contribute little of diagnostic value in other indications.     

Contributions of empirical research to medical ethics

Empirical research pertaining to cardiopulmonary resuscitation (CPR), clinician behaviors related to do-not-resuscitate (DNR) orders and substituted judgment suggests potential contributions to medical ethics. Research quantifying the likelihood of surviving CPR points to the need for further philosophical analysis of the limitations of the patient autonomy in decision making, the nature and definition of medical futility, and the relationship between futility and professional standards. Research on DNR orders has identified barriers to the goal of patient involvement in these life and death discussions. The initial data on surrogate decision making also points to the need for a reexamination of the moral basis for substituted judgment, the moral authority of proxy decision making and the second-order status of the best interests standard. These examples of empirical research suggest that an interplay between empirical research, ethical analysis and policy development may represent a new form of interdisciplinary scholarship to improve clinical medicine.     

An efficient sampling scheme: Updated Latin Hypercube Sampling

An efficient sampling scheme called Updated Latin Hypercube Sampling is presented. The proposed method is an improved variant of Latin Hypercube Sampling. It uses specially modified tables of independent random permutations of rank numbers which form the strategy of generating input samples for a simulation procedure. The method is presented in order to obtain these specially modified tables. The aim of this paper is to compare estimates of certain widely used statistical parameters obtained by Updated Latin Hypercube Sampling, Latin Hypercube Sampling and Simple Random Sampling. It is shown that Updated Latin Hypercube Sampling usually results in a substantial decrease of the variance in the estimates of commonly used statistical parameters and that the bias is quite small for a moderate number of simulations. This sampling technique seems to be generally very useful, efficient and superior to other methods especially in the case of statistical, sensitivity and probability analyses of complex analytical models with random input variables.     

Uncertainty Matters: Computer Models at the Science–Policy Interface

The use of computer models offers a general and flexible framework that can help to deal with some of the complexities and difficulties associated with the development of water management plans as prescribed by the Water Framework Directive. However, despite the advantages modelling presents, the integration of information derived from models into policy is far away from being trivial or the norm. Part of the difficulties of this integration is rooted in the lack of confidence policy makers have on the incorporation of modelling information into policy formulation. In this paper we examine the reasons for this apparent lack of confidence and explore how some tools, presently in use, address this problem. We conclude that public confidence in models is highly dependent on the way uncertainties are addressed and suggest possible directions of action to improve the current situation. Four real case studies illustrate how computer models have been used in The Netherlands for carrying out management plans at regional and national scale. We suggest that the solution to integrate modelling information into policy formulation lies on both the modelling and the policy-making communities.