Improved estimators for dispersion models with dispersion covariates

In this paper we discuss improved estimators for the regression and the dispersion parameters in an extended class of dispersion models (J{\o}rgensen, 1996). This class extends the regular dispersion models by letting the dispersion parameter vary throughout the observations, and contains the dispersion models as particular case. General formulae for the second-order bias are obtained explicitly in dispersion models with dispersion covariates, which generalize previous results by Botter and Cordeiro (1998), Cordeiro and McCullagh (1991), Cordeiro and Vasconcellos (1999), and Paula (1992). The practical use of the formulae is that we can derive closed-form expressions for the second-order biases of the maximum likelihood estimators of the regression and dispersion parameters when the information matrix has a closed-form. Various expressions for the second-order biases are given for special models. The formulae have advantages for numerical purposes because they require only a supplementary weighted linear regression. We also compare these bias-corrected estimators with two different estimators which are also bias-free to the second-order that are based on bootstrap methods. These estimators are compared by simulation

Medical education on fitness to drive : a survey of all UK medical schools

Aim: To identify the extent to which medical aspects of fitness to drive (FTD) are taught within UK medical schools. Methods: A survey of all 32 UK medical schools. In-depth interviews with a range of staff at two medical schools; telephone survey of 30 schools. Results: Two thirds of schools reported specific teaching on medical aspects of FTD but few covered it in any depth or in relation to specific medical conditions. Only one school taught FTD in relation to elderly medicine. FTD was an examination topic at only 12 schools. Conclusion: Teaching on FTD is inconsistent across UK medical schools. Many new doctors will graduate with limited knowledge of medical aspects of FTD

EFEITOS DA IDADE NO COMPORTAMENTO DAS FÊMEAS DE MURIQUI (BRACHYTELES HYPOXANTHUS)

EFEITOS DA IDADE NO COMPORTAMENTO DAS FÊMEAS DE MURIQUI (BRACHYTELES HYPOXANTHUS

Compassionate Care in Improving Access to Psychological Therapies Services: A Grounded Theory Approach

Compassion has inspired interest across the centuries, attracting definitions from different disciplines and, more recently, leading to the development of theoretical models of understanding and therapeutic modalities. Aspects of the NHS constitution include compassion as one of the six Cs outlined as core values: care, compassion, competence, communication, courage and commitment (Department of Health, 2015). Similarly, the Improving Access to Psychological Therapies (IAPT) manual (2018) incorporates compassionate care. IAPT is one of the main providers of primary mental health care in the NHS UK, and although compassion has been prioritised by the IAPT agenda it has not been investigated within these services. The current study addresses the question “What is the process of compassionate care in IAPT services?” It also aims to generate knowledge about the facilitators and inhibitors of compassionate care in IAPT. Semistructured interviews were conducted with 12 qualified clinicians. This study adopted a critical realist position, which informed the Grounded Theory methodology. A new conceptual model was generated: Enacting Compassionate Care in IAPT Services. The five corresponding categories are Possessing Core Attributes and Skills of Compassion, Building an Interpersonal Connection, Meaningful Response to Suffering, Conditions Nurturing Compassionate Care and Conditions Hindering Compassionate Care. The main findings propose that enacting compassionate care is a dynamic process encompassing aspects that are individual, relational and behavioural. It involves clinicians employing core attributes and skills, to build a connection with patients and to respond to their suffering in a meaningful way. The findings have also highlighted the importance of reviewing service procedures, as well as the structural and emotional resources made available to nurture compassionate care. The limitations of this study and recommendations for future research are discussed