68 research outputs found

    U.S. Health Policy and Mothers of Children with Disabilities

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    An examination of the association between seeing smoking in films and tobacco use in young adults in the west of Scotland: cross-sectional study

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    The objective is to examine the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002–04) from a longitudinal cohort originally surveyed at age 11 (1994–95) were conducted. The main outcome measure is smoking at age 19. No association was found between the number of occurrences of smoking estimated to have been seen in films (film smoking exposure) and current (or ever) smoking in young adults. This lack of association was unaffected by adjustment for predictors of smoking, including education, risk-taking orientation and smoking among peers. There was no association between film smoking exposure and smoking behaviour for any covariate-defined subgroup. Associations have been found between film smoking exposure and smoking initiation in younger adolescents in the United States. In this study, conducted in Scotland, no similar association was seen, suggesting that there may be age or cultural limitations on the effects of film smoking exposure on smoking. The lack of association could be due to methodological issues or greater sophistication of older adolescents and young adults in interpreting media images or the greater ubiquity of real-life smoking instances in Scotland. If the latter, film smoking exposure could become a more important risk factor for smoking uptake and maintenants in older adolescents following the recent ban on smoking in public places in Scotland

    Advanced Mirror Technology Development (AMTD) II Modal Test of A 1.5 m Glass Slumped Mirror

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    The Advanced Mirror Technology Development (AMTD) project is in Phase 2 of a multiyear effort initiated in Fiscal Year 2012 to mature toward the next technology readiness level critical technologies required to enable 4-m-or-larger monolithic or segmented ultraviolet, optical, and infrared (UVOIR) space telescope primary-mirror assemblies for general astrophysics and ultra-high-contrast observations of exoplanets. As part of AMTD II, a free-free modal test was performed of a light weighted slumped 1.5 m mirror made of Corning Ultra Low Expansion (ULE) material. The test article and support structure were suspended via bungee to simulate a free-free environment. Modes were excited by roaming an instrumented modal test hammer and responses were measured. Predicted and measured frequencies are presented as well as Modal Assurance Criteria (MAC) results to compare the mode shapes. The finite element mirror model used for pre-test predictions and posttest comparisons was provided by the mirror vendor, Harris Corporation. The mirror FEM included deformations of the ribs that were a result of the slumping process. Modal test frequencies matched predictions within the 5% target with the exception of one mode and that pair differed by 5.2%. Of the seven modes measured and predicted, four had MAC values meeting the target of 0.90, one was just under and two were notably below the target

    Empirical Models of Demand for Out-Patient Physician Services and Their Relevance to the Assessment of Patient Payment Policies: A Critical Review of the Literature

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    This paper reviews the existing empirical micro-level models of demand for out-patient physician services where the size of patient payment is included either directly as an independent variable (when a flat-rate co-payment fee) or indirectly as a level of deductibles and/or co-insurance defined by the insurance coverage. The paper also discusses the relevance of these models for the assessment of patient payment policies. For this purpose, a systematic literature review is carried out. In total, 46 relevant publications were identified. These publications are classified into categories based on their general approach to demand modeling, specifications of data collection, data analysis, and main empirical findings. The analysis indicates a rising research interest in the empirical micro-level models of demand for out-patient physician services that incorporate the size of patient payment. Overall, the size of patient payments, consumer socio-economic and demographic features, and quality of services provided emerge as important determinants of demand for out-patient physician services. However, there is a great variety in the modeling approaches and inconsistencies in the findings regarding the impact of price on demand for out-patient physician services. Hitherto, the empirical research fails to offer policy-makers a clear strategy on how to develop a country-specific model of demand for out-patient physician services suitable for the assessment of patient payment policies in their countries. In particular, theoretically important factors, such as provider behavior, consumer attitudes, experience and culture, and informal patient payments, are not considered. Although we recognize that it is difficult to measure these factors and to incorporate them in the demand models, it is apparent that there is a gap in research for the construction of effective patient payment schemes

    Addressing tobacco in Australian alcohol and other drug treatment settings: a cross-sectional survey of staff attitudes and perceived barriers

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    Background: Within alcohol and other drug (AOD) services, staff attitudes and beliefs are important influences determining provision of smoking cessation care. This study of AOD staff aimed to examine: a) current attitudes toward smoking cessation care; b) service and staff characteristics associated with unsupportive smoking cessation care attitudes, and c) perceived barriers to providing smoking cessation care. Methods: Between July-October 2014, 506 staff from 31 Australian AOD services completed an online cross-sectional survey which assessed agreement with 6 attitudinal statements (supportive and unsupportive) and 10 perceived barriers to smoking cessation care in the AOD setting. Logistic regressions examined service (sector) and staff (age, gender, smoking status and number of years in AOD field) characteristics associated with unsupportive smoking cessation care attitudes. Results: A large proportion agreed with supportive statements: Smoking cessation care should be part of usual care (87%), smoking cessation care is as important as counselling about other drugs (72%) and staff have the organisational support to provide smoking cessation care (58%). Some respondents agreed with unsupportive statements: AOD clients are not interested in addressing their smoking (40%), increasing smoking restrictions would lead to client aggression (23%), smoking is a personal choice and it is not the service’s role to interfere (16%). Respondents from non-government managed services, current tobacco smokers (compared to ex-smokers) and those with less AOD experience had higher odds of agreeing with unsupportive smoking cessation care statements. The most frequently identified barriers to providing smoking cessation care were: client inability to afford cessation medicines, insufficient funding and lack of a coordinated treatment approach (all 61%). Conclusions: Overall, staff hold largely supportive smoking cessation care attitudes but perceive a large number of barriers to providing smoking cessation care
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