Modelling Patient Duration of Stay to Facilitate Resource Management of Geriatric Hospitals

A fundamental aspect of health care management is the effective allocation of resources. This is of particular importance in geriatric hospitals where elderly patients tend to have more complex needs. Hospital managers would benefit immensely if they had advance knowledge of patient duration of stay in hospital. Managers could assess the costs of patient care and make allowances for these in their budget. In this paper, we tackle this important problem via a model which predicts the duration of stay distribution of patients in hospital. The approach uses phase-type distributions conditioned on a Bayesian belief network.

Hicks meets Hotelling: the direction of technical change in capital-resource economies

We analyze a two-sector growth model with directed technical change where man-made capital and exhaustible resources are essential for production. The relative profitability of factor-specific innovations endogenously determines whether technical progress will be capital- or resource-augmenting. We show that any balanced growth equilibrium features purely resource-augmenting technical change. This result is compatible with alternative specifications of preferences and innovation technologies, as it hinges on the interplay between productive efficiency in the final sector, and the Hotelling rule characterizing the efficient depletion path for the exhaustible resource. Our result provides sound micro-foundations for the broad class of models of exogenous/endogenous growth where resource-augmenting progress is required to sustain consumption in the long run, contradicting the view that these models are conceptually biased in favor of sustainability.

Language and Power: A Resource Book for Students

Language and Power offers a comprehensive survey of the ways in which language intersects and connects with the social, cultural and political aspects of power; provides a comprehensive introduction to the history of the field, and covers all the major approaches, theoretical concepts and methods of analysis in this important and developing area of academic study; covers all the 'traditional' topics, such as race, gender and institutional power, but also incorporates newer material from forensic discourse analysis, the discourse of new capitalism and the study of humour as power; includes readings from works by seminal figures in the field, such as Roger Fowler, Deborah Cameron and Teun van Dijk; uses real texts and examples throughout, including advertisements from cosmetics companies; newspaper articles and headlines; websites and internet media; and spoken dialogues such as a transcription from the Obama and McCain presidential debate; and is accompanied by a supporting website that aims to challenge students at a more advanced level and features a complete four-unit chapter which includes activities, a reading and suggestions for further work.

Information gathering and decision making about resource value in animal contests

Contestants are predicted to adjust the cost of a fight in line with the perceived value of the resource and this provides a way of determining whether the resource has been assessed. An assessment of resource value is predicted to alter an animal's motivational state and we note different methods of measuring that state. We provide a categorical framework in which the degree of resource assessment may be evaluated and also note limitations of various approaches. We place studies in six categories: (1) cases of no assessment, (2) cases of internal state such as hunger influencing apparent value, (3) cases of the contestants differing in assessment ability, (4) cases of mutual and equal assessment of value, (5) cases where opponents differ in resource value and (6) cases of particularly complex assessment abilities that involve a comparison of the value of two resources. We examine the extent to which these studies support game theory predictions and suggest future areas of research. (C) 2008 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.

Motivation matters: cheliped extension displays in the hermit crab, Pagurus bernhardus, are honest signals of hunger

Whether animal signals convey honest information is a central evolutionary question, since selection pressures could, in some circumstances, favour dishonesty. A prior study of signalling in hermit crabs proposed that the cheliped extension display of Pagurus bernhardus might represent such an instance of dishonesty. A limitation of this conclusion, however, was that honesty was defined in the context of size assessment, neglecting the potential information that displays might transmit about signallers' variable internal states. Recent analyses of signalling in this same species have shown that its displays provide reliable information about the amount of risk crabs are prepared to tolerate, which therefore might enable signallers to use these displays to honestly convey their motivation to take such risks. Here we test this 'honest advertisement of motivation' hypothesis by varying crabs' need for food and analysing their signalling during simulated feeding conflicts against a model. When crabs were starved for 1-5 days, they dropped significantly in weight. Despite this decrement in resource-holding potential and energy reserves, crabs were more likely to perform cheliped extension displays the longer they were food deprived. Longer-starved crabs, whose subjective resource value was greater, also displayed at a higher rate and were more likely to risk seizing the food from the model. We conclude that cheliped extension is a reliable indicator of crabs' internal state and suggest how this honest signal might operate in conflicts over a variety of other resources in addition to food. We propose that future studies detecting apparent dishonesty should analyse many possible signal-state correlations before concluding a signal is actually dishonest. (c) 2008 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.

Homogeneous habitat can meet the discrete and varied resource requirements of hares but may set an ecological trap

In common with other farmland species, hares (Lepus spp.) are in widespread decline in agricultural landscapes due to agricultural intensification and habitat loss. We examined the importance of habitat heterogeneity to the Irish hare (Lepus timidus hibernicus) in a pastoral landscape. We used radio-tracking during nocturnal active and diurnal inactive periods throughout one year. In autumn, winter and spring, hares occupied a heterogeneous combination of improved grassland, providing food, and Juncus-dominated rough pasture, providing refuge. In summer, hares significantly increased their use of improved grassland. This homogeneous habitat can fulfil the discrete and varied resource requirements of hares for feeding and shelter at certain times of year. However, improved grassland may be a risky habitat for hares as silage harvesting occurs during their peak birthing period of late spring and early summer. We therefore posit the existence of a putative ecological trap inherent to a homogeneous habitat of perceived high value that satisfies the hares' habitat requirements but which presents risks at a critical time of year. To test this hypothesis in relation to hare populations, work is required to provide data on differential leveret mortality between habitat types.

A Paradoxical Effect of Systemic IL-23 in EAE – Limitation of Autoimmune Inflammatory Demyelination

The heterodimeric cytokine IL-23 plays a non-redundant function in the development of cell-mediated, organspecific autoimmune diseases such as experimental autoimmune encephalomyelitis (EAE). To further characterize the mechanisms of action of IL-23 in autoimmune inflammation, we administered IL-23 systemically at different time points during both relapsing and chronic EAE. Surprisingly, we found suppression of disease in all treatment protocols. We observed a reduction in the number of activated macrophages and microglia in the CNS, while T cell infiltration was not significantly affected. Disease suppression correlated with reduced expansion of myelin-reactive T cells, loss of T-bet expression, loss of lymphoid structures, and increased production of IL-6 and IL-4. Here we describe an unexpected function of exogenous IL-23 in limiting the scope and extent of organ-specific autoimmunity.