Education and Income Effects in the Use of Ambulatory Services in the United States

1978 ◽  
Vol 8 (2) ◽  
pp. 351-365 ◽  
Author(s):  
S. E. Berki ◽  
B. Kobashigawa
Keyword(s):  
Direct Effect ◽  
Indirect Effects ◽  
Chronic Conditions ◽  
The United States ◽  
Direct And Indirect Effects ◽  
Income Effects ◽  
Annual Visit ◽  
Interview Survey ◽  
Higher Educational Attainment ◽  
Ambulatory Services

The roles of education and income as determinants for utilization of ambulatory services in the U.S. are investigated by the application of path analysis to a subsample of the 1970 National Health Interview Survey. The methodology permits the identification of both the direct and indirect effects of each independent variable on utilization within a model that views need as the major determinant of care. Previous findings that income has no direct effect on utilization, while education does, are reaffirmed. Contrary to previous analyses, however, it is shown that income does have a strong indirect effect on utilization via its impact on need arising from chronic conditions, measured as limitation of activity. Individuals in the highest income category have a mean annual visit rate of 4.13, while the rate for those in the lowest is 5.43. Most of the differential, 1.3, is attributable to the lower prevalence of chronic conditions in the highest income bracket. The total effect of education, on the other hand, is only 60 percent of its direct effect since higher educational attainment is associated with lower levels of chronicity. Disaggregation of direct and indirect effects through the need variables shows that income has a greater effect on utilization than does education.

scholarly journals Estimating the direct and indirect effects of secondary organic aerosols using ECHAM5-HAM

2011 ◽  
Vol 11 (16) ◽  
pp. 8635-8659 ◽  
Author(s):  
D. O'Donnell ◽  
K. Tsigaridis ◽  
J. Feichter
Keyword(s):  
Aerosol Optical Depth ◽  
Optical Depth ◽  
Direct Effect ◽  
Indirect Effect ◽  
Indirect Effects ◽  
Organic Aerosol ◽  
The United States ◽  
Anthropogenic Sources ◽  
Direct And Indirect Effects ◽  
Tropospheric Aerosol

Abstract. Secondary organic aerosol (SOA) has been introduced into the global climate-aerosol model ECHAM5/HAM. The SOA module handles aerosols originating from both biogenic and anthropogenic sources. The model simulates the emission of precursor gases, their chemical conversion into condensable gases, the partitioning of semi-volatile condenable species into the gas and aerosol phases. As ECHAM5/HAM is a size-resolved model, a new method that permits the calculation of partitioning of semi-volatile species between different size classes is introduced. We compare results of modelled organic aerosol concentrations against measurements from extensive measurement networks in Europe and the United States, running the model with and without SOA. We also compare modelled aerosol optical depth against measurements from the AERONET network of grond stations. We find that SOA improves agreement between model and measurements in both organic aerosol mass and aerosol optical depth, but does not fully correct the low bias that is present in the model for both of these quantities. Although many models now include SOA, any overall estimate of the direct and indirect effects of these aerosols is still lacking. This paper makes a first step in that direction. The model is applied to estimate the direct and indirect effects of SOA under simulated year 2000 conditions. The modelled SOA spatial distribution indicates that SOA is likely to be an important source of free and upper tropospheric aerosol. We find a negative shortwave (SW) forcing from the direct effect, amounting to −0.31 Wm−2 on the global annual mean. In contrast, the model indicates a positive indirect effect of SOA of +0.23 Wm−2, arising from the enlargement of particles due to condensation of SOA, together with an enhanced coagulation sink of small particles. In the longwave, model results are a direct effect of +0.02 Wm−2 and an indirect effect of −0.03 Wm−2.

scholarly journals Using Normative Theory to Explain the Effect of Religion and Education on Volunteering

2012 ◽  
Vol 55 (3) ◽  
pp. 473-499 ◽  
Author(s):  
Joonmo Son ◽  
John Wilson
Keyword(s):  
United States ◽  
Direct Effect ◽  
Indirect Effects ◽  
The United States ◽  
Study Data ◽  
Normative Theory ◽  
Volunteer Work ◽  
Direct And Indirect Effects ◽  
Religious Background ◽  
Sense Of Obligation

Many studies have found that volunteers tend to be more religious and better educated, but it is not clear why. One explanation is that churches and schools instill a sense of obligation in people to help others and this obligation is fulfilled by doing volunteer work. In this study data from National Survey of Midlife in the United States are used to examine the influence of education and having been raised in a religious home on adults' sense of obligation and subsequent volunteering. Religious background has no direct effect on sense of obligation. However, it exerts an influence on obligation through private (but not public) adult religiosity. Education has both direct and indirect effects (through obligations) on adult volunteering. The results underline the fact that social norms should not be ignored in explanations of volunteerism.

scholarly journals Using occupancy models to assess the direct and indirect impacts of agricultural expansion on species’ populations

2020 ◽  
Vol 29 (13) ◽  
pp. 3669-3688
Author(s):  
Asunción Semper-Pascual ◽  
Julieta Decarre ◽  
Matthias Baumann ◽  
Micaela Camino ◽  
Yamil Di Blanco ◽  
...  
Keyword(s):  
Land Use ◽  
Land Use Change ◽  
Direct Effect ◽  
Indirect Effects ◽  
Agricultural Land ◽  
Conservation Strategies ◽  
Agricultural Expansion ◽  
Direct And Indirect Effects ◽  
Occupancy Models ◽  
Occupancy Modelling

Abstract Land-use change is a global threat to biodiversity, but how land-use change affects species beyond the direct effect of habitat loss remains poorly understood. We developed an approach to isolate and map the direct and indirect effects of agricultural expansion on species of conservation concern, using the threatened giant anteater (Myrmecophaga tridactyla) in the Gran Chaco as an example. We reconstructed anteater occupancy change between 1985 and 2015 by fitting single-season occupancy models with contemporary camera-trap data and backcasting the models to 1985 and 2000 land-cover/use maps. Based on this, we compared the area of forest loss (direct effect of agricultural expansion) with the area where forests remained but occupancy still declined (indirect effect of agricultural expansion). Anteater occupancy decreased substantially since 1985, particularly after 2000 when agriculture expanded rapidly. Between 1985 and 2015, ~ 64,000 km2 of forest disappeared, yet occupancy declined across a larger area (~ 102,000 km2), extending far into seemingly untransformed habitat. This suggests that widespread sink habitat has emerged due to agricultural land-use change, and that species may lose their habitat through direct and indirect effects of agricultural expansion, highlighting the urgent need for broad-scale conservation planning in the Chaco. Appropriate management responses could proactively protect more habitat where populations are stable, and restore habitat or address causes of mortality in areas where declines occur. Our work also highlights how occupancy modelling combined with remote sensing can help to detect the direct and indirect effects of agricultural expansion, providing guidance for spatially targeting conservation strategies to halt extinctions.

Creating an Engaged Workforce

2016 ◽  
Vol 44 (2) ◽  
pp. 225-243 ◽  
Author(s):  
Hua Jiang ◽  
Rita Linjuan Men
Keyword(s):  
Employee Engagement ◽  
Social Exchange ◽  
Indirect Effects ◽  
Authentic Leadership ◽  
Social Exchange Theory ◽  
Theoretical Models ◽  
The United States ◽  
Direct And Indirect Effects ◽  
Industrial Sectors ◽  
The Social

Scholars have increasingly recognized the importance of studying factors leading to employee engagement. However, few researchers have created and tested theoretical models that propose mechanisms linking employee engagement to social contextual variables. Based on a random sample of employees ( n = 391) working across different industrial sectors in the United States, we proposed and tested a model (rooted in the Social Exchange Theory and the Job Demands-Resources Model) that examined how authentic leadership, transparent organizational communication, and work-life enrichment are interrelated. A simplified model containing both significant direct and indirect effects fits the data. Theoretical contributions and managerial ramifications of the study were discussed.

DIRECT AND INDIRECT EFFECTS OF SOCIAL SUPPORT ON PSYCHOLOGICAL WELL-BEING

2004 ◽  
Vol 32 (5) ◽  
pp. 449-458 ◽  
Author(s):  
Tülin Gençöz ◽  
Yeşim Özlale ◽  
Randy Lennon
Keyword(s):  
Social Support ◽  
University Students ◽  
Direct Effect ◽  
Indirect Effects ◽  
Well Being ◽  
The Other ◽  
Depression Symptoms ◽  
Direct And Indirect Effects ◽  
Psychological Well Being ◽  
Undergraduate University Students

The aim of this study was to investigate the direct and indirect effects of social support on psychological well-being. Social support was evaluated under two different categories which were named as Aid-Related and Appreciation-Related Socia+l Support. The first category was more related to potential for receiving help from others when needed, and being cared for by others, while the latter category was more related to being recognized by others as an efficient source of help and reassurance of worth. Undergraduate university students (N =342) served as subjects, and results revealed that aid-related social support and psychological well-being (i.e., alleviated depression symptoms) association was partially mediated by experiencing fewer life stresses. On the other hand, appreciation-related social support had a direct effect on psychological well-being. Implications of these results are discussed.

The Influence of Directive Strategies on Settlement Duration

2014 ◽  
Vol 19 (2) ◽  
pp. 201-220 ◽  
Author(s):  
Scott Sigmund Gartner
Keyword(s):  
Statistical Analysis ◽  
Direct Effect ◽  
Indirect Effect ◽  
Indirect Effects ◽  
Negative Selection ◽  
Direct And Indirect Effects ◽  
Influence Strategies ◽  
Process Effects ◽  
Durable Peace

Are Directive Strategies in international disputes the most effective mediation method for obtaining durable peace? A standard statistical analysis shows no effect of Directive Strategies on settlement durability. This result however, is misleading, failing to take selection and indirect effects into account. In this article, I identify when selection and process effects reinforce or oppose each other. Directive Strategies have opposing negative selection and positive process effects, which can distort inferences about their influence. Strategies’ direct and indirect effects are also examined. Directive Strategies are more likely to lead to Full Settlements – the most comprehensive form of agreement, which improve the settlement durability (an indirect effect). However, Directive Strategies are used in more intractable disputes that result in fragile settlements (a direct effect). A statistical analysis of international disputes that takes these conflicting dynamics into account demonstrates the efficacy of Directive Mediation Strategies in producing durable agreements.

MO146RENAL FUNCTION MEDIATES THE EFFECT OF FLUID EXCESS ON LUNG CONGESTION IN PATIENTS WITH HFREF

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Raluca Popa ◽  
Radu Sascau ◽  
Cristian Statescu ◽  
Vlad Vasiliu ◽  
Andreea Neamtu ◽  
...  
Keyword(s):  
Renal Function ◽  
Direct Effect ◽  
Indirect Effects ◽  
Fluid Overload ◽  
Total Effect ◽  
Left Ventricular Ejection ◽  
Direct And Indirect Effects ◽  
Fluid Status ◽  
The Mean ◽  
B Lines

Abstract Background and Aims Despite impressive improvements in treatment strategies, heart failure (HF) morbidity and mortality remain substantially high worldwide. Pulmonary congestion is considered the leading cause for hospital admissions and death among patients with HF. The aim of this study is to investigate if the effect of fluid status, as assessed by bioimpedance spectroscopy (BIS) on lung congestion is mediated by renal function, inflammation or cardiac function. Method This was a prospective observational study of outpatient adults referred for clinically indicated transthoracic echocardiograms at an academic hospital between 2016 and 2018. A left ventricular ejection fraction (LVEF) below 45% was required for inclusion (HFrEF). Mediation is the process through which an exposure causes disease. We hypothesized that some of the total effect of extracellular water (ECW) to intracellular water (ICW) (as assessed by bioimpedance) ratio on lung congestion (as assessed by lung ultrasonography) is mediated by C-reactive protein (CRP), left atrium volum index (LAVI) or estimated glomerular filtration rate (eGFR) – the mediators. Results Our study included 153 patients. The mean age and eGFR values of the population at baseline were 67.1 years and 66.5 ml/min/1.73m2. The mean median value for CRP was 25.6 (IQR 9.0-56.4) mg/L. Figure 1 depicts the structural equation models with the calculated magnitude of the direct and indirect effects of ECW/ICW on the B-lines number in our population. In this model, the fluid status has both direct and indirect effects on lung congestion. Specifically, it has a direct effect on LAVI and eGFR, which in turn have a direct effect on the number of B-lines. Therefore, the indirect effect mediated by LAVI and eGFR accounts for a significant proportion of 27.6% of the total effect of ECW/ICW on lung congestion Although ECW/ICW has a direct effect on inflammation, this doesn’t have any effect on renal function or lung congestion. Conclusion We show that eGFR and LAVI partly mediate the effect of ECW/ICW on lung congestion in patients with HFrEF. While the deleterious effects of fluid overload on lung congestion have long been recognized, this study provides evidence for a relationship of significant magnitude linking fluid overload with decreased eGFR and increased LAVI, which in turn lead to elevations in the B-lines number. This work was supported by a grant of the Ministery of Research and Innovation, CNCS-UEFISCDI, project number PN-III-P1-1.1-PD-2016-0287, within PNCDI III and by a grant of the “Grigore T. Popa” University of Medicine and Pharmacy, contract number 27505/2018.

Racial/Ethnic and Age Differences in the Direct and Indirect Effects of the COVID-19 Pandemic on US Mortality

2022 ◽  
Vol 112 (1) ◽  
pp. 154-164
Author(s):  
Lauren C. Zalla ◽  
Grace E. Mulholland ◽  
Lindsey M. Filiatreau ◽  
Jessie K. Edwards
Keyword(s):  
Public Health ◽  
Native Americans ◽  
Indirect Effects ◽  
Excess Mortality ◽  
The United States ◽  
Direct And Indirect Effects ◽  
Public Health Response ◽  
Health Response ◽  
Race Ethnicity ◽  
Expected Mortality

Objectives. To estimate the direct and indirect effects of the COVID-19 pandemic on overall, race/ethnicity‒specific, and age-specific mortality in 2020 in the United States. Methods. Using surveillance data, we modeled expected mortality, compared it to observed mortality, and estimated the share of “excess” mortality that was indirectly attributable to the pandemic versus directly attributed to COVID-19. We present absolute risks and proportions of total pandemic-related mortality, stratified by race/ethnicity and age. Results. We observed 16.6 excess deaths per 10 000 US population in 2020; 84% were directly attributed to COVID-19. The indirect effects of the pandemic accounted for 16% of excess mortality, with proportions as low as 0% among adults aged 85 years and older and more than 60% among those aged 15 to 44 years. Indirect causes accounted for a higher proportion of excess mortality among racially minoritized groups (e.g., 32% among Black Americans and 23% among Native Americans) compared with White Americans (11%). Conclusions. The effects of the COVID-19 pandemic on mortality and health disparities are underestimated when only deaths directly attributed to COVID-19 are considered. An equitable public health response to the pandemic should also consider its indirect effects on mortality. (Am J Public Health. 2022;112(1):154–164. https://doi.org/10.2105/AJPH.2021.306541 )

Learning More From Evaluation of Justice Interventions: Further Consideration of Theoretical Mechanisms in Juvenile Drug Courts

2016 ◽  
Vol 63 (9) ◽  
pp. 1091-1115 ◽  
Author(s):  
Joshua Long ◽  
Christopher J. Sullivan
Keyword(s):  
United States ◽  
Indirect Effects ◽  
Drug Court ◽  
Comparison Group ◽  
The United States ◽  
Drug Courts ◽  
Direct And Indirect Effects ◽  
Juvenile Drug Court ◽  
Path Models ◽  
Court Process

It is essential to learn as much as possible from justice interventions—even those that do not appear to be successful. Data came from a sample of youths participating in drug courts in nine sites across the United States and a comparison group of probationers ( N = 1,372). Measures were drawn from case records. Path models with direct and indirect effects were analyzed. Aspects of the juvenile drug court process appear to heighten the likelihood of youth failure in the program and recidivism. The ratio of incentives to sanctions was protective as drug court youth who experienced more of the former had a reduced likelihood of recidivism. The article concludes that it is important to examine mechanisms that impact the success of justice interventions.

scholarly journals Studies on Direct and Indirect Effects of Different Plant Characters on Yield of Taro (Colocasia esculenta L. Schott) Var. Antiquorum

1970 ◽  
Vol 9 (1-2) ◽  
pp. 89-98 ◽  
Author(s):  
KK Paul ◽  
MA Bari
Keyword(s):  
Plant Height ◽  
Direct Effect ◽  
Indirect Effects ◽  
Residual Effect ◽  
Colocasia Esculenta ◽  
Leaf Length ◽  
Direct And Indirect Effects ◽  
Petiole Length ◽  
Effect On Yield ◽  
Peduncle Length

Thirty accessions of taro (Colocasia esculenta L) varieties were evaluated to estimate the direct and indirect effects of different plant characters, namely, plant height, petiole length, petiole breadth, leaf number, leaf length, leaf breadth, LAI, inflorescence length, peduncle length, corm length, corm breadth, cormel number, cormel length, cormel breadth, corm weight, cormel weight on yield per plant. Plant height, petiole length, corm breadth, cormel number, cormel length exhibited direct effect on yield per plant at the genotypic level. Cormel weight and cormel breadth had the highest direct effect on yield per plant at the phenotypic level. The residual effect was 0.3043 at the genotypic level and that at phenotypic level was 0.4874. Keywords: Colocasia esculenta; direct effect; indirect effect; yield of taro DOI: http://dx.doi.org/10.3329/agric.v9i1-2.9483 The Agriculturists 2011; 9(1&2): 89-98

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