The Law and Poor People’s Access to Health Care

Many companies today, in different fields of operations and sizes, have access to a vast amount of data which was not available only a couple of years ago. This situation gives rise to questions regarding how to organize and use the data in the best way possible. In this thesis a large database of pricing data for products within various market segments is analysed. The pricing data is from both external and internal sources and is therefore confidential. Because of the confidentiality, the labels from the database are in this thesis substituted with generic ones and the company is not referred to by name, but the analysis is carried out on the real data set. The data is from the beginning unstructured and difficult to overlook. Therefore, it is first classified. This is performed by feeding some manual training data into an algorithm which builds a decision tree. The decision tree is used to divide the rest of the products in the database into classes. Then, for each class, a multivariate time series model is built and each product’s future price within the class can be predicted. In order to interact with the classification and price prediction, a front end is also developed. The results show that the classification algorithm both is fast enough to operate in real time and performs well. The time series analysis shows that it is possible to use the information within each class to do predictions, and a simple vector autoregressive model used to perform it shows good predictive results

Adjustment to college among trauma survivors: An exploratory study of resilience

Researchers have examined students\u27 adjustment to college—why some students make the transition successfully, whereas others struggle or leave school after only a short time (e.g., Ezezek, 1994; Holmbek & Wandrei, 1993). Efforts to support students through this transition must draw upon a more complete understanding of variables that place students at risk for a stressful transition and protective factors that promote positive adaptation. Recent research has been focused on both individual and contextual variables including gender, racial identity, coping strategies, stress, social support and attachment (Feenstra, Banyard, Rines, & Hopkins, 2000; Klasner & Pistole, 2003; Pritchard & Wilson, 2003) and suggests the need for more research that goes beyond explaining academic success from demographic and academic variables (Pritchard & Wilson, p. 18). The current study is an examination of a group of students potentially at risk for a stressful transition to college: students who are survivors of traumatic stress. For the purposes of this research, trauma is defined broadly as a range of events that overwhelm an individual\u27s coping capacities and involves threats of serious injury or death to self or someone close to the individual (e.g., Pynoos, 1993). This examination was of variation in the transition to college among a sample of trauma survivors, of the roles of social relationships and supports, coping, and making meaning of the trauma in explaining variance in resilience in adjusting to college

Recursive estimation of possibly misspecified MA(1) models: Convergence of a general algorithm

We introduce a recursive algorithm of conveniently general form for estimating the coefficient of a moving average model of order one and obtain convergence results for both correct and misspecified MA(1) models. The algorithm encompasses Pseudolinear Regression (PLR--also referred to as AML and $RML_1$) and Recursive Maximum Likelihood ($RML_2$) without monitoring. Stimulated by the approach of Hannan (1980), our convergence results are obtained indirectly by showing that the recursive sequence can be approximated by a sequence satisfying a recursion of simpler (Robbins-Monro) form for which convergence results applicable to our situation have recently been obtained.Comment: Published at http://dx.doi.org/10.1214/074921706000000932 in the IMS Lecture Notes Monograph Series (http://www.imstat.org/publications/lecnotes.htm) by the Institute of Mathematical Statistics (http://www.imstat.org

Preliminary Studies on the Use of Monoclonal Antibodies as Probes for Sympathetic Development

The precise structural organization and proper functioning of the adult nervous system depend on the ability of neurones to make highly ordered synaptic connexions. To define molecules involved in the development of these connexions and to study their functional roles, we use primary cultures of dissociated rat sympathetic neurones grown in the virtual absence of non-neuronal cells. These neurones can develop adrenergic or cholinergic properties, depending on the environment in which they are grown. This ability to manipulate neuronal phenotype is being used in an attempt to identify cell surface macromolecules that are important in the development or function of adrenergic and cholinergic properties. We have produced monoclonal antibodies against the surface membranes of these neurones and are in the process of characterizing them. Results are presented on the binding specificity of one of these antibodies and on the effect of two other antibodies on neurotransmitter synthesis, uptake, and release

Deja Vu All Over Again: The False Dichotomy Between Sanctity of Life and Quality of Life

A longstanding contention of \u27right to life\u27 activists is that a quality of life ethic in end-of-life decisionmaking undermines a sanctity of life ethic. A surrogate decision to reject life-sustaining medical intervention -- as in the case of a permanently unconscious patient -- supposedly delivers a symbolic message contravening the intrinsic value of all human life. This paper argues that quality of life judgments are the only way to avoid transforming human beings into prisoners of medical technology. Under appropriate standards and review, caregivers must be able to end artificial intervention rather than keep pumping fluids and gases into moribund, floundering patients

On Hastening Death Without Violating Legal or Moral Prohibitions

While the vast majority of fatally afflicted persons have a powerful wish to remain alive, some stricken persons may, for any of a host of reasons, desire to hasten death. Some persons are afflicted with chronic degenerative diseases that take a grievous toll. Chronic pain may be severe and intractable, anxiety about a future treatment regimen may be distressing, and helplessness may erode personal dignity and soil the image that the afflicted person wants to leave behind. A dying patient’s interest in hastening death is often said to be in tension with a bedrock social principle that respect for sanctity of life demands suppression of all intentional killing, including suicide (self-killing) and killing motivated by a desire to relieve suffering. Mercy killing has long been anathema in American law. Even though compassion for a dying person may tempt a health care provider or other observer to relieve suffering by any means possible (at least when the patient is requesting such relief), a ban on mercy killing is a symbolic reminder of the preciousness of human life and of the moral worth of every human. Letting die, but not intentional hastening of death, is said to be compatible with the sanctity of life. This article argues that this pat framework is simplistic and deceptive. Current medical ethics and the jurisprudence of death and dying authorize practices that intentionally hasten death. Lawful forms of hastening death include: a physician who, at a competent patient’s behest, pulls the plug on a life-sustaining medical intervention while sharing the patient’s wish to end a torturous dying process; a physician who cooperates with a gravely afflicted person’s fatal decision to voluntary stop eating and drinking (VSED); a physician who administers deep sedation to a preservable but suffering patient while knowing that the patient has already declined artificial nutrition and hydration (ANH) and hence will soon die; and a physician who administers pain relief in a known lethal dosage (even with the primary intention to relieve intractable suffering). These ways of hastening death (with concomitant physician participation) are probably legal and probably in widespread use. Do these modes of hastening death make bans on physician-assisted suicide (PAS) and/or voluntary active euthanasia (VAE) anomalous? Do they obviate any strong need for legalization of PAS or VAE? Do they meet the common objective of providing competent, dying persons with a means of shaping a dying process to assure a modicum of dignity? The currently legal modes of hastening death often entail a period when the dying patient lingers in unconsciousness or semi-consciousness before expiring. A short period of insentience or unawareness as a prelude to death – usually lasting for no more than a few days – does not violate intrinsic human dignity. Therefore, publicizing the current availability of legal modes of hastening death and making them readily accessible might make the legal status quo morally tolerable. But then some dying persons will have to undergo an unwanted period of lingering helplessly (for days). And we will continue to live with the hypocritical pretense that physician-assisted death is lawful only in Oregon

On Kamisar, Killing, and the Future of Physician-Assisted Death

Tens - perhaps hundreds - of thousands of trees could have been spared over the last forty-five years had opponents of physician-assisted death only been content to let Yale Kamisar be their exclusive spokesperson. Their movement would have lost no significant substance or persuasive force, for Kamisar\u27s 1958 article - Some Non-Religious Views Against Proposed \u27Mercy-Killing\u27 Legislation - presaged the shape and content of the subsequent forty-five year debate over legalizing physician-assisted death ( PAD ). Kamisar\u27s article preceded by years the development of a whole jurisprudence relating to the withholding/withdrawing of life-sustaining medical treatment ( LSMT ) and the administration of pain-relief substances alleviating physical suffering while risking accelerated death. That article demonstrated remarkable prescience and intellectual honesty while shaping the content of opposition to PAD. Kamisar continued to participate in the debate for decades thereafter, always exhibiting remarkable intellectual honesty and insight. Kamisar\u27s special insights started with his prediction about the legal status of a physician\u27s withholding of LSMT. Years before cases addressing this issue emerged, he correctly anticipated that a physician\u27s failure to provide LSMT might be treated as homicide by omission in light of a physician\u27s affirmative fiduciary duty to the patient. He also foresaw that the fiduciary obligation would not rigidly dictate maintenance of medical life support in the face of a competent patient\u27s request to withhold or withdraw LSMT. Later, he correctly forecast that the Supreme Court would refuse to find assistance in suicide to be a fundamental liberty and would instead leave regulation of physician-assisted suicide ( PAS ) to the states