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Nonlinear two-stage residual inclusion (2SRI) estimators have become increasingly favored over traditional linear two-stage least squares (2SLS) methods for instrumental variables analysis of empirical models with inherently nonlinear dependent variables. Rising adoption of nonlinear 2SRI is largely attributable to simulation evidence showing that nonlinear 2SRI generates consistent estimates of population average treatment effects in nonlinear models, while 2SLS and nonlinear 2SPS do not. However, while it is believed that consistency of 2SRI for population average treatment effects is a general result, current evidence is limited to simulations performed under unique and restrictive settings with regards to treatment effect heterogeneity and conditions underlying treatment choices. This research contributes by describing existing simulation evidence and investigating the ability to generate absolute estimates of population average treatment effects (ATE) and local average treatment effects (LATE) using common IV estimators using Monte Carlo simulation methods across 10 alternative scenarios of treatment effect heterogeneity and sorting-on-the-gain. Additionally, estimates for the effect of ACE/ARBs on 1-year survival for Medicare beneficiaries with acute myocardial infarction are generated and compared across alternative linear and nonlinear IV estimators. Simulation results show that, while 2SLS generates unbiased and consistent estimates of LATE across all scenarios, nonlinear 2SRI generates unbiased estimates of ATE only under very restrictive settings. If marginal patients are unique in terms of treatment effectiveness, then nonlinear 2SRI cannot be expected to generate unbiased or consistent estimates of ATE unless all factors related to treatment effect heterogeneity are fully measured.

Background: Personality Disorder treatment is a contentious subject in health care. Despite available research concerning the diagnosis itself and also available treatments, there is little research regarding treatment thresholds or defining how treatment decisions can be formulated. This problem has been identified by clinicians, patients, supervisors and specific organisations, particularly linked to recent healthcare changes associated with austerity measures. Research Question: How can mental health care staff use a formulated decision process concerning therapeutic interventions for people with PD, when considering the recent service changes and rationalisation of available treatments? Methods: An Action Research study has been conducted over a four year period, using predominantly qualitative methods including: a hermeneutic literature review (n=144 papers), patient questionnaires (n=15) and Interpretive Phenomenological Analysis (IPA) of clinician and supervisor semi-structured interviews (n=10). Results: Difficulties have been found when making decisions with people who either do not accept their diagnosis and/or do not accept the current evidence-based treatments for personality disorder. Other challenges have been identified regarding the patient/clinician relationship, the level of distress the patient presents with, and also the clinician view concerning the individual, the diagnosis, and the available treatments. The IPA produced five super-ordinate themes related to decision-making regarding treatment choices for people with personality disorder, including: difficulties with boundary management, diagnostic stigma, a focus upon time, metacognitive ability, and the potential for iatrogenic harm. Conclusions: Multiple factors require consideration when examining treatment choices for people with a personality disorder, concerning the patient's individual symptom profile, needs, attitude towards treatments; the clinician's profession, attitudes, opinions, and wellness on the day of the assessment, and also the treatments available within the locality. A diagram has been presented summarising these formulation factors. Recommendations have been made based upon the results, analysis, synthesis and discussion sections, indicating potential practice changes and areas for future research.

Introduction Caput radii fractures vary from non-dislocated to complex comminuted fractures and are oftenclassified by the Mason Classifications system from 1954. Most caput radii-fractures aresuccessfully treated non-surgical although some need surgery. Several surgical methods havebeen developed and surgical treatment is increasing. Aim Primary aim is to assess the Mason classification correlation to choice of treatment.Secondary aims are to describe the epidemiology, treatment frequency including surgical andnon-surgical as well as reoperation rate. Results Correlation between Mason classification and surgical/non-surgical treatment showed asignificant positive correlation (rs=0.403, p<0.001). Of 315 patients 95.2% were treated nonsurgical,4,8% received acute surgery. The estimated incidence was 3.25 per 10 000 per year,for women 4.09 and men 2.41 per 10 000 per year. Median age was 49 years (IQR 33-60), 54for women and 36 years for men respectively. Of the patients with Mason I did 0.4% receiveacute surgery, Mason II 3.4%, Mason III 66.7% and Mason IV 36.4%. Multiple surgicalmethods were used, Open reduction and internal fixation with plate and screw was mostfrequent. Four patients in the surgical treatment-group (23.5%) were reoperated. Two patients(0.7%) had late surgery due to complications. Conclusions Surgical treatment was more often used in more advanced fractures according to the Masonclassification although the correlation was fair and there were patients in each class that weresurgery treated. Surgical methods varied and reoperation rate was high. Women had higherincidence and a higher median age then men at time of injury.

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