Addressing Bed Costs for the Elderly: A New Methodology for Modelling Patient Outcomes and Length of Stay

The proportion of elderly in the population has dramatically increased and will continue to do so for at least the next 50 years. Medical resources throughout the world are feeling the added strain of the increasing proportion of elderly in the population. The effective care of elderly patients in hospitals may be enhanced by accurately modelling the length of stay of the patients in hospital and the associated costs involved. This paper examines previously developed models for patient length of stay in hospital and describes the recently developed conditional phase-type distribution (C-Ph) to model patient duration of stay in relation to explanatory patient variables. The Clinics data set was used to demonstrate the C-Ph methodology. The resulting model highlighted a strong relationship between Barthel grade, patient outcome and length of stay showing various groups of patient behaviour. The patients who stay in hospital for a very long time are usually those that consume the largest amount of hospital resources. These have been identified as the patients whose resulting outcome is transfer. Overall, the majority of transfer patients spend a considerably longer period of time in hospital compared to patients who die or are discharged home. The C-Ph model has the potential for considering costs where different costs are attached to the various phases or subgroups of patients and the anticipated cost of care estimated in advance. It is hoped that such a method will lead to the successful identification of the most cost effective case-mix management of the hospital ward.

Extracting Policy Positions from Political Texts Using words as Data

We present a new way of extracting policy positions from political texts that treats texts not as discourses to be understood and interpreted but rather, as data in the form of words. We compare this approach to previous methods of text analysis and use it to replicate published estimates of the policy positions of political parties in Britain and Ireland, on both economic and social policy dimensions. We “export” the method to a non-English-language environment, analyzing the policy positions of German parties, including the PDS as it entered the former West German party system. Finally, we extend its application beyond the analysis of party manifestos, to the estimation of political positions from legislative speeches. Our “language-blind” word scoring technique successfully replicates published policy estimates without the substantial costs of time and labor that these require. Furthermore, unlike in any previous method for extracting policy positions from political texts, we provide uncertainty measures for our estimates, allowing analysts to make informed judgments of the extent to which differences between two estimated policy positions can be viewed as significant or merely as products of measurement error.

Selection Power and Selection Labor for Information Retrieval

This study examines the relation between selection power and selection labor for information retrieval (IR). It is the first part of the development of a labor theoretic approach to IR. Existing models for evaluation of IR systems are reviewed and the distinction of operational from experimental systems partly dissolved. The often covert, but powerful, influence from technology on practice and theory is rendered explicit. Selection power is understood as the human ability to make informed choices between objects or representations of objects and is adopted as the primary value for IR. Selection power is conceived as a property of human consciousness, which can be assisted or frustrated by system design. The concept of selection power is further elucidated, and its value supported, by an example of the discrimination enabled by index descriptions, the discovery of analogous concepts in partly independent scholarly and wider public discourses, and its embodiment in the design and use of systems. Selection power is regarded as produced by selection labor, with the nature of that labor changing with different historical conditions and concurrent information technologies. Selection labor can itself be decomposed into description and search labor. Selection labor and its decomposition into description and search labor will be treated in a subsequent article, in a further development of a labor theoretic approach to information retrieval.

The energy costs of sexual dimorphism in mole-rats are morphological not behavioural.

Different reproductive strategies of males and females may lead to the evolution of differences in their energetic costs of reproduction, overall energetic requirements and physiological performances. Sexual dimorphism is often associated with costly behaviours (e.g. large males might have a competitive advantage in fighting, which is energetically expensive). However, few studies of mammals have directly compared the energy costs of reproductive activities between sexes. We compared the daily energy expenditure (DEE) and resting metabolic rate (RMR) of males and females of two species of mole-rat, Bathyergus janetta and Georychus capensis (the former is sexually dimorphic in body size and the latter is not) during a period of intense digging when males seek females. We hypothesized that large body size might be indicative of greater digging or fighting capabilities, and hence greater mass-independent DEE values in males of the sexually dimorphic species. In contrast to this prediction, although absolute values of DEE were greater in B. janetta males, mass-independent values were not. No differences were apparent between sexes in G. capensis. By comparison, although RMR values were greater in B. janetta than G. capensis, no differences were apparent between the sexes for either species. The energy cost of dimorphism is most likely to be the cost of maintenance of a large body size, and not the cost of behaviours performed when an individual is large.