Electronic gaming machine accessibility and gambling problems: A natural policy experiment

2021 ◽  
Author(s):  
Alex M T Russell ◽  
Matthew Browne ◽  
Nerilee Hing ◽  
Matthew Rockloff ◽  
Philip Warren Stirling Newall ◽  
...  
Keyword(s):  
Population Level ◽  
Structural Features ◽  
Gambling Problems ◽  
Individual Level ◽  
Large N ◽  
Indirect Path ◽  
Policy Experiment ◽  
Nationally Representative ◽  
Gaming Machine ◽  
Gaming Machines

Background: Electronic gaming machines (EGMs) are recognised as one of the most harmful forms of gambling at an individual level. However, it is unclear whether restriction of EGM functions and accessibility results in meaningful reductions in population-level gambling harm. Methods: This study employed a natural policy experiment to compare gambling problems between Australian residents in Western Australia (WA), where EGMs are restricted to a single venue and have different structural features, and residents in other Australian jurisdictions where EGMs are widely accessible in casinos, hotels and clubs. The accessibility of non-EGM forms of gambling is generally similar across all Australian jurisdictions. The study draws on a large (N = 15,000) nationally-representative dataset.Findings: Although gambling participation was slightly higher in WA, EGM participation was approximately half that found in the rest of Australia. Aggregate gambling problems and harm were about one-third lower in WA, and self-reported attribution of harm to EGMs by gamblers and affected others was 2·7x and 4x lower, respectively. Analyses using mediation and moderation determined that the attributable impact of EGMs in WA was 70% lower than elsewhere, and was responsible for the vast majority of the discrepancy in gambling problems (indirect path = -0·055, 95% CI -0·071; -0·038). Attributable problems to casino table games were slightly higher in WA, potentially due to redirection of demand, but this effect size was small relative to the reduction of problems due to EGMs. On an individual level, for a given level of participation in EGMs and other forms, the risk of problems were similar in WA and the rest of Australia. Interpretation: Reduced harm from gambling in WA is due to restricted accessibility of EGMs, and there is little transfer of problems to other gambling forms. These results suggest that restricting the accessibility of EGMs substantially reduces gambling harm.Funding: Gambling Research Australia (GRA) funded this research. GRA is a partnership between the Commonwealth, State and Territory Governments to initiate and manage a national program of gambling research.

scholarly journals Personal preferences for Personalised Trials among patients with chronic diseases: an empirical Bayesian analysis of a conjoint survey

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036056 ◽  
Author(s):  
Ying Kuen Cheung ◽  
Dallas Wood ◽  
Kangkang Zhang ◽  
Ty A Ridenour ◽  
Lilly Derby ◽  
...  
Keyword(s):  
Bayesian Analysis ◽  
Patient Preferences ◽  
Online Survey ◽  
Population Level ◽  
Target Population ◽  
Empirical Bayesian ◽  
Large Variability ◽  
Individual Level ◽  
The Usa ◽  
Nationally Representative

ObjectiveTo describe individual patient preferences for Personalised Trials and to identify factors and conditions associated with patient preferences.DesignEach participant was presented with 18 conjoint questions via an online survey. Each question provided two choices of Personalised Trials that were defined by up to eight attributes, including treatment types, clinician involvement, study logistics and trial burden on a patient.SettingOnline survey of adults with at least two common chronic conditions in the USA.ParticipantsA nationally representative sample of 501 individuals were recruited from the Chronic Illness Panel by Harris Poll Online. Participants were recruited from several sources, including emails, social media and telephone recruitment of the target population.Main outcome measuresThe choice of Personalised Trial design that the participant preferred with each conjoint question.ResultsThere was large variability in participants’ preferences for the design of Personalised Trials. On average, they preferred certain attributes, such as a short time commitment and no cost. Notably, a population-level analysis correctly predicted 62% of the conjoint responses. An empirical Bayesian analysis of the conjoint data, which supported the estimation of individual-level preferences, improved the accuracy to 86%. Based on estimates of individual-level preferences, patients with chronic pain preferred a long study duration (p≤0.001). Asthma patients were less averse to participation burden in terms of data-collection frequency than patients with other conditions (p=0.002). Patients with hypertension were more cost-sensitive (p<0.001).ConclusionThese analyses provide a framework for elucidating individual-level preferences when implementing novel patient-centred interventions. The data showed that patient preference in Personalised Trials is highly variable, suggesting that individual differences must be accounted for when marketing Personalised Trials. These results have implications for advancing precise interventions in Personalised Trials by indicating when rigorous scientific principles, such as frequent monitoring, is feasible in a substantial subset of patients.

Personality change and environmental concerns

2020 ◽  
Author(s):  
Christopher James Hopwood ◽  
Ted Schwaba ◽  
Wiebke Bleidorn
Keyword(s):  
Personality Traits ◽  
Personality Change ◽  
Environmental Concerns ◽  
Big Five Personality ◽  
German Population ◽  
Individual Level ◽  
Sustainable Behavior ◽  
Nationally Representative ◽  
The Individual ◽  
Over Time

Personal concerns about climate change and the environment are a powerful motivator of sustainable behavior. People’s level of concern varies as a function of a variety of social and individual factors. Using data from 58,748 participants from a nationally representative German sample, we tested preregistered hypotheses about factors that impact concerns about the environment over time. We found that environmental concerns increased modestly from 2009-2017 in the German population. However, individuals in middle adulthood tended to be more concerned and showed more consistent increases in concern over time than younger or older people. Consistent with previous research, Big Five personality traits were correlated with environmental concerns. We present novel evidence that increases in concern were related to increases in the personality traits neuroticism and openness to experience. Indeed, changes in openness explained roughly 50% of the variance in changes in environmental concerns. These findings highlight the importance of understanding the individual level factors associated with changes in environmental concerns over time, towards the promotion of more sustainable behavior at the individual level.

scholarly journals Blood Pressure Trajectories Across the Life Course

2021 ◽  
Vol 34 (3) ◽  
pp. 234-241
Author(s):  
Norrina B Allen ◽  
Sadiya S Khan
Keyword(s):  
Blood Pressure ◽  
Measurement Errors ◽  
Clinical Care ◽  
Population Level ◽  
Cumulative Exposure ◽  
Older Adulthood ◽  
Individual Level ◽  
The Life Course ◽  
Level Group ◽  
Improve Health

Abstract High blood pressure (BP) is a strong modifiable risk factor for cardiovascular disease (CVD). Longitudinal BP patterns themselves may reflect the burden of risk and vascular damage due to prolonged cumulative exposure to high BP levels. Current studies have begun to characterize BP patterns as a trajectory over an individual’s lifetime. These BP trajectories take into account the absolute BP levels as well as the slope of BP changes throughout the lifetime thus incorporating longitudinal BP patterns into a single metric. Methodologic issues that need to be considered when examining BP trajectories include individual-level vs. population-level group-based modeling, use of distinct but complementary BP metrics (systolic, diastolic, mean arterial, mid, and pulse pressure), and potential for measurement errors related to varied settings, devices, and number of readings utilized. There appear to be very specific developmental periods during which divergent BP trajectories may emerge, specifically adolescence, the pregnancy period, and older adulthood. Lifetime BP trajectories are impacted by both individual-level and community-level factors and have been associated with incident hypertension, multimorbidity (CVD, renal disease, cognitive impairment), and overall life expectancy. Key unanswered questions remain around the additive predictive value of BP trajectories, intergenerational contributions to BP patterns (in utero BP exposure), and potential genetic drivers of BP patterns. The next phase in understanding BP trajectories needs to focus on how best to incorporate this knowledge into clinical care to reduce the burden of hypertensive-related outcomes and improve health equity.

scholarly journals Examining the Effects of the Sacramento Dockless E-Bike Share on Bicycling and Driving

2021 ◽  
Vol 13 (1) ◽  
pp. 368
Author(s):  
Dillon T. Fitch ◽  
Hossain Mohiuddin ◽  
Susan L. Handy
Keyword(s):  
Travel Behavior ◽  
Regression Models ◽  
Population Level ◽  
Panel Survey ◽  
Multilevel Regression ◽  
Combine Data ◽  
Cross Sectional ◽  
Individual Level ◽  
Before And After ◽  
Bike Share

One way cities are looking to promote bicycling is by providing publicly or privately operated bike-share services, which enable individuals to rent bicycles for one-way trips. Although many studies have examined the use of bike-share services, little is known about how these services influence individual-level travel behavior more generally. In this study, we examine the behavior of users and non-users of a dockless, electric-assisted bike-share service in the Sacramento region of California. This service, operated by Jump until suspended due to the coronavirus pandemic, was one of the largest of its kind in the U.S., and spanned three California cities: Sacramento, West Sacramento, and Davis. We combine data from a repeat cross-sectional before-and-after survey of residents and a longitudinal panel survey of bike-share users with the goal of examining how the service influenced individual-level bicycling and driving. Results from multilevel regression models suggest that the effect of bike-share on average bicycling and driving at the population level is likely small. However, our results indicate that people who have used-bike share are likely to have increased their bicycling because of bike-share.

Medication Adherence: Expanding the Conceptual Framework

2021 ◽  
Author(s):  
Marie Krousel-Wood ◽  
Leslie S Craig ◽  
Erin Peacock ◽  
Emily Zlotnick ◽  
Samantha O’Connell ◽  
...  
Keyword(s):  
Older Adults ◽  
Medication Adherence ◽  
Conceptual Framework ◽  
Clinical Outcomes ◽  
Implicit Attitudes ◽  
Explanatory Power ◽  
Population Level ◽  
Time Preferences ◽  
Adherence Behavior ◽  
Individual Level

Abstract Interventions targeting traditional barriers to antihypertensive medication adherence (AHMA) have been developed and evaluated, with evidence of modest improvements in adherence. Translation of these interventions into population-level improvements in adherence and clinical outcomes among older adults remains suboptimal. From the Cohort Study of Medication Adherence among Older adults (CoSMO), we evaluated traditional barriers to AHMA among older adults with established hypertension (N=1544; mean age=76.2 years, 59.5% women, 27.9% Black, 24.1% and 38.9% low adherence by proportion of days covered (i.e., PDC&lt;0.80) and the 4-item Krousel-Wood Medication Adherence Scale (i.e., K-Wood-MAS-4≥1), respectively), finding that they explained 6.4% and 14.8% of variance in pharmacy refill and self-reported adherence, respectively. Persistent low adherence rates, coupled with low explanatory power of traditional barriers, suggest that other factors warrant attention. Prior research has investigated explicit attitudes toward medications as a driver of adherence; the roles of implicit attitudes and time preferences (e.g., immediate versus delayed gratification) as mechanisms underlying adherence behavior are emerging. Similarly, while associations of individual-level social determinants of health (SDOH) and medication adherence are well-reported, there is growing evidence about structural SDOH and specific pathways of effect. Building on published conceptual models and recent evidence, we propose an expanded conceptual framework that incorporates implicit attitudes, time preferences and structural SDOH, as emerging determinants that may explain additional variation in objectively and subjectively measured adherence. This model provides guidance for design, implementation and assessment of interventions targeting sustained improvement in implementation medication adherence and clinical outcomes among older women and men with hypertension.

Prevalence and clustering of diarrhoea within households in India: some evidence from NFHS-4, 2015–16

2020 ◽  
Vol 53 (1) ◽  
pp. 108-120 ◽  
Author(s):  
Bevin Vijayan ◽  
Mala Ramanathan
Keyword(s):  
Water Supply ◽  
Diarrhoeal Disease ◽  
Household Level ◽  
Individual Level ◽  
Under Five ◽  
Safe Water ◽  
Chi Squared ◽  
Improved Sanitation ◽  
Nationally Representative ◽  
Water Supply And Sanitation

AbstractDiarrhoeal disease is one of the major causes of morbidity and mortality in children and is usually measured at individual level. Shared household attributes, such as improved water supply and sanitation, expose those living in the same household to these same risk factors for diarrhoea. The occurrence of diarrhoea in two or more children in the same household is termed ‘diarrhoea clustering’. The aim of this study was to examine the role of improved water supply and sanitation in the occurrence of diarrhoea, and the clustering of diarrhoea in households, among under-five children in India. Data were taken from the fourth round of the National Family and Health Survey (NFHS-4), a nationally representative survey which interviewed 699,686 women from 601,509 households in the country. If any child was reported to have diarrhoea in a household in the 2 weeks preceding the survey, the household was designated a diarrhoeal household. Household clustering of diarrhoea was defined the occurrence of diarrhoea in more than one child in households with two or more children. The analysis was done at the household level separately for diarrhoeal households and clustering of diarrhoea in households. The presence of clustering was tested using a chi-squared test. The overall prevalences of diarrhoea and clustering of diarrhoea were examined using exogenous variables. Odds ratios, standardized to allow comparison across categories, were computed. The household prevalence of diarrhoea was 12% and that of clustering of diarrhoea was 2.4%. About 6.5% of households contributed 12.6% of the total diarrhoeal cases. Access to safe water and sanitation was shown to have a great impact on reducing diarrhoeal prevalence and clustering across different household groups. Safe water alone had a greater impact on reducing the prevalence in the absence of improved sanitation when compared with the presence of improved sanitation. It may be possible to reduce the prevalence of diarrhoea in households by targeting those households with more than one child in the under-five age group with the provision of safe water and improved sanitation.

scholarly journals Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children

2018 ◽  
Vol 148 (12) ◽  
pp. 1946-1953 ◽  
Author(s):  
Magali Rios-Leyvraz ◽  
Pascal Bovet ◽  
René Tabin ◽  
Bernard Genin ◽  
Michel Russo ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Salt Intake ◽  
Sodium Intake ◽  
Population Level ◽  
Urinary Sodium Excretion ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Cross Sectional ◽  
High Sodium ◽  
Individual Level

ABSTRACT Background The gold standard to assess salt intake is 24-h urine collections. Use of a urine spot sample can be a simpler alternative, especially when the goal is to assess sodium intake at the population level. Several equations to estimate 24-h urinary sodium excretion from urine spot samples have been tested in adults, but not in children. Objective The objective of this study was to assess the ability of several equations and urine spot samples to estimate 24-h urinary sodium excretion in children. Methods A cross-sectional study of children between 6 and 16 y of age was conducted. Each child collected one 24-h urine sample and 3 timed urine spot samples, i.e., evening (last void before going to bed), overnight (first void in the morning), and morning (second void in the morning). Eight equations (i.e., Kawasaki, Tanaka, Remer, Mage, Brown with and without potassium, Toft, and Meng) were used to estimate 24-h urinary sodium excretion. The estimates from the different spot samples and equations were compared with the measured excretion through the use of several statistics. Results Among the 101 children recruited, 86 had a complete 24-h urine collection and were included in the analysis (mean age: 10.5 y). The mean measured 24-h urinary sodium excretion was 2.5 g (range: 0.8–6.4 g). The different spot samples and equations provided highly heterogeneous estimates of the 24-h urinary sodium excretion. The overnight spot samples with the Tanaka and Brown equations provided the most accurate estimates (mean bias: −0.20 to −0.12 g; correlation: 0.48–0.53; precision: 69.7–76.5%; sensitivity: 76.9–81.6%; specificity: 66.7%; and misclassification: 23.0–27.7%). The other equations, irrespective of the timing of the spot, provided less accurate estimates. Conclusions Urine spot samples, with selected equations, might provide accurate estimates of the 24-h sodium excretion in children at a population level. At an individual level, they could be used to identify children with high sodium excretion. This study was registered at clinicaltrials.gov as NCT02900261.

State- and Individual-Level Predictors of Mexican Death Penalty Support

2017 ◽  
Vol 64 (12) ◽  
pp. 1590-1611 ◽  
Author(s):  
Alexander H. Updegrove ◽  
Erin A. Orrick
Keyword(s):  
Death Penalty ◽  
Capital Punishment ◽  
Mexican Immigrants ◽  
State Level ◽  
The United States ◽  
Individual Level ◽  
Specific Factors ◽  
Nationally Representative ◽  
Future Practice ◽  
Insight Into

Mexico exerts a unique influence on Texas through immigration. As immigrants bring perspectives from their country of origin when they immigrate, studying attitudes toward capital punishment in Mexico may provide insight into ways Mexican immigrants could affect its future practice in Texas. Multilevel modeling is used to examine individual- and state-level predictors of death penalty support among a nationally representative sample of Mexicans. Results indicate age and Catholic affiliation are associated with death penalty support, although not in the expected directions, whereas states bordering the United States are less likely to support capital punishment, despite experiencing less overall peace and a higher average homicide rate. Findings suggest the need for researchers to use culture-specific factors to predict death penalty support.

scholarly journals Social connectedness and political behavior

2017 ◽  
Vol 4 (3) ◽  
pp. 205316801771917 ◽  
Author(s):  
Jack Lyons Reilly
Keyword(s):  
Social Networks ◽  
Political Behavior ◽  
Political Ideology ◽  
Social Connectedness ◽  
Local Environment ◽  
Social Environments ◽  
Data Set ◽  
Individual Level ◽  
Nationally Representative ◽  
Socially Isolated

One of the focal points of social networks research has been the process by which individuals utilize information and cues from their social networks and communities to form political attitudes and make decisions about how and when to participate in politics. Not all individuals, however, have large social networks or are strongly connected to their local social environments. Furthermore, despite concerns about rising social isolation in American society, the role that relatively socially disconnected individuals play in politics is not well understood. Using a nationally representative data set with information about communities, social networks, and individual-level variables, this paper examines social connectedness and political behavior. Those who are more socially isolated, it is found, are neither more conservative nor liberal on any particular political issues, but clearly participate in politics less than individuals who are well connected to those around them. Finally, while individual political ideology is not correlated with isolation, the contextual influence of the local environment on individual preferences is correlated with social connectedness. When compared with well connected citizens, individuals who are more isolated are less likely to have their vote choices influenced by those around them. Individual social connectedness conditions the effect of contextual social influence.

scholarly journals Women in Blue: Structural and Individual Determinants of Sex Segregation in Blue-Collar Occupations

2019 ◽  
Vol 33 (3) ◽  
pp. 410-438 ◽  
Author(s):  
Margarita Torre
Keyword(s):  
Social Reproduction ◽  
Blue Collar ◽  
Gender Composition ◽  
Vocational Education And Training ◽  
Individual Level ◽  
Parental Background ◽  
Individual Determinants ◽  
Nationally Representative ◽  
The Individual ◽  
And Training

The number of women occupying male-dominated blue-collar jobs continues to be very low. This study examines segregation in the blue-collar trades, taking into consideration both structural and individual factors. Using nationally representative data for 25 countries, the study shows that segregation in the blue-collar sector does not vary with the strength of vocational education and training programs. At the individual level, findings reveal higher degrees of social reproduction among working-class families, but parental background alone does not fully account for the gender composition of the sector in which children end up working. Overall, the findings point to the existence of a socializing mechanism that entrenches horizontal segregation in the blue-collar sector. The study indicates that to reduce segregation in the blue-collar fields, policies must address this prior mechanism, both at the structural and individual level.

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