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women and minorities in clinical research. The government would be funding a study that only African Americans could enter, so a racial classi cation is involved. In this case whites are excluded because there is evidence that the drug will not work for them but may for African Americans. Because most studies for heart disease have included white patients, indeed, have disproportionately bene ted them in the past, whites are not being disadvantaged by this instance of government funding of a study that focuses exclusively on a drug that might work in African American heart patients. Without the study, many African Americans may be left with few effective treatments for heart disease, when most whites can be treated with beta-blockers and ACE inhibitors. Nor are whites denied research funding, for there has been ample study of therapies that bene t whites disproportionately, if not exclusively. Whether there will be suf cient funding for such studies depends on the NIH s and the public s commitment to improving the health care of minority populations, for example, its willingness to ask for and get budgetary support, and then awarding grants to researchers studying these questions. After a long disregard of the health needs of African Americans, there is now a willingness to fund more race-related research. With the large budget increases given to the NIH in recent years and the past neglect of minority health, even larger increases for minority health care should be acceptable. With wide discretion to spend resources to improve the general welfare, Congress and federal agencies may use race and ethnicity in research and treatment funding decisions when medical evidence shows that racial and ethnic differences affect health care.

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mentioned in the PRAM Guide, because it was not fully developed at the time chap 3 of the PRAM Guide was developed An operational de ne phase that is holistic and integrated requires a six W s structure equivalent In addition, Ward s development of the PLC structure (Ward and Chapman, 1995b), as outlined in 2, is central to our thinking, but its use in the PRAM Guide is limited to describing risk management in the plan stage of the PLC The role of the PLC as a driver of the focus phase was clear at the time chap 3 of the PRAM Guide was developed, but its use as a basis for the de ne phase was not developed at that time Like the six W s, it is crucial to a holistic and integrated de ne phase.

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As you track how all people in the group go about their tasks, and as you begin to list the behaviors that they all have in common, the positive deviants will naturally emerge 6 Let the deviants adopt deviations on their own Once you find deviant behaviors, don t tell people about them It s not a transfer of knowledge It s not about importing best practices from somewhere else It s about changing behavior Let the people who have discovered the deviations spread the word in their group Don t require adherence to the new practices, but do offer incentives for it 7 Track results and publicize them Post the results, show how they were achieved, and let other groups develop their own curiosity about them Celebrate success when you achieve it.

their exact posterior distribution If instead of summarizing this information with their means and standard deviations, as in Table 61, we presented univariate or bivariate histograms of the draws, we would reveal all the information in Figure 62 In fact, the histograms would give the exact marginal distributions of interest (the full posterior, with other parameters integrated out) rather than merely the pro le contours as shown in the gures, so the potential information revealed, even in this case where the Hessian is invertible, could be substantial We do not present the histograms in this example because they happen to be similar to the contours in this particular dataset Note that although logit is known to have a globally concave likelihood surface in theory, actual estimates are not strictly concave, due to numerical imprecision.

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