Optimal Paths and Costs of Adjustment in Dynamic DEA Models: With Application to Chilean Department Stores

In this paper we propose a range of dynamic data envelopment analysis (DEA) models which allow information on costs of adjustment to be incorporated into the DEA framework. We first specify a basic dynamic DEA model predicated on a number or simplifying assumptions. We then outline a number of extensions to this model to accommodate asymmetric adjustment costs, non-static output quantities, non-static input prices, and non-static costs of adjustment, technological change, quasi-fixed inputs and investment budget constraints. The new dynamic DEA models provide valuable extra information relative to the standard static DEA models-they identify an optimal path of adjustment for the input quantities, and provide a measure of the potential cost savings that result from recognising the costs of adjusting input quantities towards the optimal point. The new models are illustrated using data relating to a chain of 35 retail department stores in Chile. The empirical results illustrate the wealth of information that can be derived from these models, and clearly show that static models overstate potential cost savings when adjustment costs are non-zero.

Adjustment in mothers of children with Asperger syndrome: An application of the double ABCX model of family adjustment

The present study examined the applicability of the double ABCX model of family adjustment in explaining maternal adjustment to caring for a child diagnosed with Asperger syndrome. Forty-seven mothers completed questionnaires at a university clinic while their children were participating in an anxiety intervention. The children were aged between 10 and 12 years. Results of correlations showed that each of the model components was related to one or more domains of maternal adjustment in the direction predicted, with the exception of problem-focused coping. Hierarchical regression analyses demonstrated that, after controlling for the effects of relevant demographics, stressor severity, pile-up of demands and coping were related to adjustment. Findings indicate the utility of the double ABCX model in guiding research into parental adjustment when caring for a child with Asperger syndrome. Limitations of the study and clinical implications are discussed.

The positive impact of multiple sclerosis (MS) on carers: Associations between carer benefit finding and positive and negative adjustment domains

Purpose. This study examined benefit finding in MS carers including the dimensionality of benefit finding, relations between carer and care recipient benefit finding, and the effects of carer benefit finding on carer positive and negative adjustment domains. Method. A total of 267 carers and their care recipients completed questionnaires at Time 1 and 3 months later, Time 2 (n=155). Illness data were collected at Time 1, and number of problems, stress appraisal, benefit finding, negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) adjustment domains were measured at Time 2. Results. Qualitative data revealed seven benefit finding themes, two of which were adequately represented by the Benefit Finding Scale (BFS) [1] (Mohr et al. Health Psychology 1999; 18: 376). Factor analyses indicated two factors (Personal Growth, Family Relations Growth) which were psychometrically sound and showed differential relations with illness and adjustment domains. Although care recipients reported higher levels of benefit finding than carers, their benefit finding reports regarding personal growth were correlated. The carer BFS factors were positively related to carer and care recipient dyadic adjustment. Care recipient benefit finding was unrelated to carer adjustment domains. After controlling for the effects of demographics, care recipient characteristics, problems and appraisal, carer benefit finding was related to carer positive adjustment domains and unrelated to carer negative adjustment domains. Conclusion. Findings support the role of benefit finding in sustaining positive psychological states and the communal search for meaning within carer-care recipient dyads.

Adjustment of chldren who have a sibling with Down syndrome: perspectives of mothers, fathers and children

Background A number of methodological weaknesses have contributed to our relatively poor understanding of the impact on children of having a brother or sister with a disability. These include a focus on poor adjustment, using multidiagnostic groups, inadequate matching, and a failure to consider the perspectives of children and parents together. Method This study compared the adjustment of 53 siblings of a child with Down syndrome with a comparison group of siblings of children who were developing typically. Children were matched on a case-by-case basis for gender, age and position in family. Families were matched for family size and father's occupation. The age range of the target siblings was 7-14 years. Data were gathered from mothers, fathers and siblings. Results There were no significant differences between the groups on adjustment measures. These included parent perceptions of externalizing and internalizing behaviours, parent perceptions of sibling competence, and sibling perceptions of their own competence and self-worth. Associations between measures of adjustment and child reports of their contribution to household functioning depended on sex rather than group membership. There was an association between parental reports of externalizing behaviour and sibling relationships with the brother/sister closest in age. Conclusions Having a brother or sister with Down syndrome does not inevitably lead to poor adjustment. Examination of within-family processes would appear to be more useful in identifying children at risk than merely group membership.

Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care

Background: Acute hospital general medicine services care for ageing complex patients, using the skills of a range of health-care providers. Evidence suggests that comprehensive early assessment and discharge planning may improve efficiency and outcomes of care in older medical patients. Aim: To enhance assessment, communication, care and discharge planning by restructuring consistent, patient-centred multidisciplinary teams in a general medicine service. Methods: Prospective controlled trial enrolling 1538 consecutive medical inpatients. Intervention units with additional allied health staff formed consistent multidisciplinary teams aligned with inpatient admitting units rather than wards; implemented improved communication processes for early information collection and sharing between disciplines; and specified shared explicit discharge goals. Control units continued traditional, referral-based multidisciplinary models with existing staffing levels. Results: Access to allied health services was significantly enhanced. There was a trend to reduced index length of stay in the intervention units (7.3 days vs 7.8 days in control units, P = 0.18), with no change in 6-month readmissions. in-hospital mortality was reduced from 6.4 to 3.9% (P = 0.03); less patients experienced functional decline in hospital (P = 0.04) and patients' ratings of health status improved (P = 0.02). Additional staffing costs were balanced by potential bed-day savings. Conclusion: This model of enhanced multidisciplinary inpatient care has provided sustainable efficiency gains for the hospital and improved patient outcomes.

A genetically informed study of the processes underlying the association between parental marital instability and offspring adjustment

Parental divorce is associated with problematic offspring adjustment, but the relation may be due to shared genetic or environmental factors. One way to test for these confounds is to study offspring of twins discordant for divorce. The current analyses used this design to separate the mechanisms responsible for the association between parental divorce, experienced either before or after the age of 16, and offspring well-being. The results were consistent with a causal role of divorce in earlier initiation of sexual intercourse and emotional difficulties, in addition to a greater probability of educational problems, depressed mood, and suicidal ideation. In contrast, the increased risk for cohabitation and earlier initiation of drug use was explained by selection factors, including genetic confounds.

Development of a measure to assess coping for auditory hallucinations

This paper describes the development of an instrument to assess coping strategies for auditory hallucinations. An inventory of coping strategies was obtained by conducting semi-structured interviews with 17 male participants. This inventory was then used to develop a 27-item questionnaire, the Responses to Auditory Hallucinations Questionnaire (RAHQ). The RAHQ was administered to 125 respondents. Measures of symptom severity, appraisal, anxiety, depression and coping dissatisfaction were also administered. Factor Analysis of the RAHQ yielded three coping subscales, Active coping, Passive coping and Suppression coping. The subscales were shown to be empirically distinct and to possess satisfactory internal reliability. For a small subgroup of participants, two of the three subscales demonstrated satisfactory test-retest reliability. Construct validity was assessed within a stress and coping framework. The RAHQ will facilitate the investigation of the efficacy of coping strategies for the management of auditory hallucinations.

Investigation of the coping antecedents to positive outcomes and distress in multiple sclerosis (MS)

This study examined relations between stress and coping predictors and distress and positive outcomes in multiple sclerosis (MS). A total of 502 people with MS completed a questionnaire at Time 1 and, 3 months later, Time 2 (n= 404). Predictors included Time 1 illness (duration, number of symptoms, course), number of problems, appraisal and coping (acceptance, problem solving, emotional release, avoidance, personal health control, energy conservation). Dependent variables were Time 2 distress (anxiety, depression) and positive outcomes (life satisfaction, positive affect, benefits). Results indicated that as hypothesised, personal health control, emotional release and physical assistance were related to the positive outcomes, whereas avoidance was related to distress, and acceptance was associated with the positive outcomes and distress. Findings highlight the differential relations between coping strategies and positive and negative outcomes and the role of appraisal and coping in regulating distress and promoting positive psychological states while managing a chronic illness.

Passion and psychological adjustment: A test of the person-environment fit hypothesis

Passion represents a strong inclination toward an activity that is important, liked, and in which significant time is invested. Although a harmonious passion is well integrated in one’s identity and is emitted willingly, obsessive passion is not well integrated and is emitted out of internal pressure. This study tested for the presence of a Passion × Environment fit interaction with respect to psychological adjustment. Elite hockey players (N = 233) who tried out for a team in a highly competitive league participated in this short-term longitudinal study. As hypothesized, being selected by the highly competitive leagues led to higher psychological adjustment than not being selected by such leagues. Two months later, an interaction revealed that among athletes who were playing in highly competitive leagues, obsessively passionate athletes reported higher psychological adjustment than did harmonious athletes. Conversely, among athletes playing in less competitive leagues, harmonious athletes reported higher psychological adjustment than did obsessive athletes.

Predictors of cultural adjustment: Intergroup status relations and boundary permeability

We examined intergroup predictors of cultural adjustment among Asian international students in Australia. Sociostructural beliefs (status, legitimacy, and permeability) and initial adjustment were assessed (N = 113) at Time 1, and measures of adjustment were obtained (N = 80) at Time 2 eight weeks later. International students who perceived their cultural group to be relatively low in status experienced lower levels of psychological adjustment. Also, as expected, the effects of status were moderated by perceptions of both the permeability of intergroup boundaries and the legitimacy of the status differential. At high levels of legitimacy, perceptions of permeable group boundaries were associated with better psychological, sociocultural, and academic adjustment among international students perceiving their group to be low in status, but lower levels of adjustment among students who perceived their group to be high in status. At low levels of legitimacy, irrespective of group status position, perceived permeability was not related to adjustment.

The MMPI-2 Gender-Masculine and Gender-Feminine scales: Gender roles as predictors of psychological health in clinical patients

Previous research measuring various biosocial factors such as age, sex, and marital status has found them to be essentially unrelated to measures of psychological health. Recent empirical studies have revealed that personality constructs may be more significant than demographic variables in the prediction of psychological well-being. The present study assessed the personality constructs of masculinity and femininity and hypothesized that the Gender-Masculine ( GM) scale of the MMPI-2 would be more effective than the Gender-Feminine (GF) scale in predicting psychological well-being. This hypothesis stems from previous research that has indicated the dominance of the masculinity model. It is suggested that previous research supporting androgyny as a primary indicator of well-being was influenced by the masculinity component of this gender orientation. One hundred and seventy-seven psychiatric patients from Australia (N = 107) and Singapore ( N 5 70) completed the MMPI-2. Hierarchical multiple regression revealed significantly stronger masculinity effects, with significance achieved on measures of ego strength and low self-esteem. No significant relationship between psychological well-being and the GF variable was found. Similarly, androgyny did not add any further variance to the model when masculinity was controlled for. Overall, the results are consistent with an interpretation that GM is a better correlate of psychological well-being as compared to the GF scale.