2,077 research outputs found

    Decision-making in a Social Welfare Context

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    This paper presents analysis of the decision-making strategies adopted by respondents when confronted with potential environmental policy options that include changes in both aggregate levels of welfare and equity in distribution. The analysis is based on the results of a choice experiment designed to estimate intergenerational distribution preferences. Non-linear welfare functions are employed within a conventional conditional logit framework. The heuristics employed by respondents in the stated preference context provide valuable insights into the application of welfare principles by respondents in determining trade-offs between the potential changes in the well-being of different generations.Intergenerational Equity, Distribution, Choice Modelling

    The Effects of Reforming the Chinese Dual-Track Price System

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    We formulate a microeconomic model of the dual-track price system for Households and use it to analyze 'transitional policy' reforms, which we characterize as a rise in plan-track price and a reduction in the plan-track quantity. Each of these reforms has a negative effect on market price, but a positive effect on the weighted average price (CPI). When households are homogeneous, transitional policy reform reduces welfare (if profits are not fully distributed). Under fairly mild assumptions, if households are heterogeneous and resale of goods can occur, transitional policy reform creates losers (state employees) as well as winners (non-state employees).

    'Beyond' pseudonymity: the socio-technical structure of online military forums

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    This article explores the tensions apparent in anonymous military online forums as sites of publicly visible yet discursively intimate performances of military identity and sites of distinct power relations. This article draws on data collected from British military forums and the organisations that own and manage them. We consider the discursive online practices within the forums and the extent to which the technological affordances of ‘anonymity’ (or what we define as pseudonymity) act as a critical interface between the military community who contribute to the content and non-military observers who read, access, mine and appropriate the content. In so doing, we raise critical questions about the nature of ‘anonymity’ and the complex tensions in and negotiations of private and public, visibility and invisibility that occur through it and the framing and monetising of particular online communities for economic and political purpose

    The GoodNight study—online CBT for insomnia for the indicated prevention of depression: study protocol for a randomised controlled trial

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    BACKGROUND Cognitive Behaviour Therapy for Insomnia (CBT-I) delivered through the Internet is effective as a treatment in reducing insomnia in individuals seeking help for insomnia. CBT-I also lowers levels of depression in this group. However, it is not known if targeting insomnia using CBT-I will lower depressive symptoms, and thus reduce the risk of major depressive episode onset, in those specifically at risk for depression. Therefore, this study aims to examine whether Internet delivery of fully automated self-help CBT-I designed to reduce insomnia will prevent depression. METHOD/DESIGN A sample of 1,600 community-dwelling adults (aged 18-64), who screen positive for both subclinical levels of depressive symptoms and insomnia, will be recruited via various media and randomised to either a 9-week online insomnia treatment programme, Sleep Healthy Using The internet (SHUTi), or an online attention-matched control group (HealthWatch). The primary outcome variable will be depression symptom levels at the 6-month post-intervention on the Patient Heath Questionnaire-9 (PHQ-9). A secondary outcome will be onset of major depressive episodes assessed at the 6-month post-intervention using 'current' and 'time from intervention' criteria from the Mini International Neuropsychiatric Interview. DISCUSSION This trial is the first randomised controlled trial of an Internet-based insomnia intervention as an indicated preventative programme for depression. If effective, online provision of a depression prevention programme will facilitate dissemination. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), Registration number: ACTRN12611000121965.This study is supported by a grant from the National Health and Medical Research Council, Australia (GNT1005867)

    Rationalizing the Pediatric Emergency Department Workload: An Epidemiological Profile of Presentations Before and During the COVID-19 Pandemic

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    Background: Infectious respiratory disease in children provides a significant seasonal workload burden to pediatric emergency departments. Studies from the Southern hemisphere during the first wave of coronavirus (COVID-19) had shown a decrease in seasonal pediatric respiratory infections. During the COVID-19 pandemic, predicted drops in infectious disease circulating in children led to redeployment of junior doctors in pediatric services to adult services. Methods: We extracted data on children presenting to a tertiary emergency department with a respiratory illness, comparing winter 2019-2020 (pre-COVID-19) to winter 2020-2021 (post-COVID-19). We compiled demographic and epidemiological data and compared the two groups with regards to number and type of infectious respiratory presentations, admissions, days spent in hospital, and whether intensive or high dependency support was required. Results: We have found a reduction in respiratory disease presentations post-COVID-19 compared to pre-COVID-19. These patients were more likely to be admitted but their stay was reduced, and there was a trend towards a reduction in requirement for intensive or high dependency support during their admission. Conclusion: This work supports the redeployment of junior doctors in pediatric departments to adult departments given increased demand in other areas of medical care at that time. In view of the changing landscape, we suggest the introduction of a flexible staffing format to ensure adequate support to areas with higher demand

    Information-seeking needs and behaviours of complementary health (chiropractic) practitioners and students

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    Background: Research into the information-seeking behaviours and needs of alternative and complementary health professionals continues to be limited. Interest in complementary medicine is growing worldwide, reflected in New Zealand by the increase in numbers of practitioners, and the demand for accessible, reliable information and resources by professionals and consumers grows also. Objectives: The aim of this study was to examine the information seeking behaviours (access, sources, frequency of search, and motivation) and needs (research, practice or education) of students and professionals in one area of complementary health (chiropractic), and by investigating their reported practices and preferences identify their requirements, preferred approaches and any barriers that may limit their information-seeking. The intention is to use the information to assess a possible requirement for information services and information skills programmes for practitioners in the community and to add to the small body of research on information use among CAM professionals. Methods: The research project surveyed a random sample of both students and registered chiropractic practitioners by questionnaire and interview. The mailed questionnaire included twenty question intended to elicit information on the information-seeking behaviours of the respondents, with interview questions expanding on these responses. Results: Although the response was very low at 41.1%, (a known risk in survey research), results indicated that the information needs and behaviours of chiropractic professionals is similar to that of other health professionals. Respondents used the Internet and books frequently, but were unlikely to use databases or a library when seeking information. Respondents were generally confident in their skills but often lacked confidence in the information they located. Conclusions: Although the chiropractic field is quite narrow in scope, chiropractors' information seeking needs and behaviours are similar to those of other health professionals. They seek information regularly and use a number of sources, primarily for clinical reasons and for personal interest. They do not search for research-based information frequently and rely on the Internet, colleagues and their own collections to supply their main information needs. Although the results cannot reliably be extrapolated to the whole chiropractic community owing to the small scale of the survey, it appears that there is need to encourage the use of research-based information and to provide easier access to those resources contained in databases and libraries. As the overwhelming majority of chiropractors of all levels of experience use the Internet, the investigation of the provision of targeted web-based services and training in their use may be profitable. More precise investigation is required

    Protocol for a randomised controlled trial investigating the effectiveness of an online e health application for the prevention of Generalised Anxiety Disorder

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    BACKGROUND Generalised Anxiety Disorder (GAD) is a highly prevalent psychiatric disorder. Effective prevention in young adulthood has the potential to reduce the prevalence of the disorder, to reduce disability and lower the costs of the disorder to the community. The present trial (the WebGAD trial) aims to evaluate the effectiveness of an evidence-based online prevention website for GAD. METHODS/DESIGN The principal clinical question under investigation is the effectiveness of an online GAD intervention (E-couch) using a community-based sample. We examine whether the effect of the intervention can be maximised by either human support, in the form of telephone calls, or by automated support through emails. The primary outcome will be a reduction in symptoms on the GAD-7 in the active arms relative to the non active intervention arms. DISCUSSION The WebGAD trial will be the first to evaluate the use of an internet-based cognitive behavioural therapy (CBT) program contrasted with a credible control condition for the prevention of GAD and the first formal RCT evaluation of a web-based program for GAD using community recruitment. In general, internet-based CBT programs have been shown to be effective for the treatment of other anxiety disorders such as Post Traumatic Stress Disorder, Social Phobia, Panic Disorder and stress in clinical trials; however there is no evidence for the use of internet CBT in the prevention of GAD. Given the severe shortage of therapists identified in Australia and overseas, and the low rates of treatment seeking in those with a mental illness, the successful implementation of this protocol has important practical outcomes. If found to be effective, WebGAD will provide those experiencing GAD with an easily accessible, free, evidence-based prevention tool which can be promoted and disseminated immediately
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