RAND Corporation

About: RAND Corporation is a nonprofit organization based out in Santa Monica, California, United States. It is known for research contribution in the topics: Health care & Population. The organization has 9602 authors who have published 18570 publications receiving 744658 citations.

On the Shortest Route Through a Network

Abstract: The chief feature of the method is that it fans out from the origin working out the shortest path to one new node from the origin and never having to backtrack. No more than nn-1/2 comparisons are needed to find the shortest route from a given origin to all other nodes and possibly less between two fixed nodes. Except for details and bias of various authors towards a particular brand of proof, this problem has been solved the same way by many authors. This paper refines these proposals to give what is believed to be the shortest procedure for finding the shortest route when it is little effort to arrange distances in increasing order by nodes or to skip consideration of arcs into nodes whose shortest route to the origin has been determined earlier in the computation. In practice the number of comparisons is much less than indicated bounds because all arcs leading to nodes previously evaluated are deleted from further consideration. A further efficiency can be achieved in the event of ties by including least distances from origin to many nodes simultaneously during the fanning out process. However, these are shown as separate steps to illustrate the underlying principle.

Eating as an Automatic Behavior

Abstract: The continued growth of the obesity epidemic at a time when obesity is highly stigmatizing should make us question the assumption that, given the right information and motivation, people can successfully reduce their food intake over the long term. An alternative view is that eating is an automatic behavior over which the environment has more control than do individuals. Automatic behaviors are those that occur without awareness, are initiated without intention, tend to continue without control, and operate efficiently or with little effort. The concept that eating is an automatic behavior is supported by studies that demonstrate the impact of the environmental context and food presentation on eating. The amount of food eaten is strongly influenced by factors such as portion size, food visibility and salience, and the ease of obtaining food. Moreover, people are often unaware of the amount of food they have eaten or of the environmental influences on their eating. A revised view of eating as an automatic behavior, as opposed to one that humans can self-regulate, has profound implications for our response to the obesity epidemic, suggesting that the focus should be less on nutrition education and more on shaping the food environment.

Perceived Discrimination in Clinical Care in a Nationally Representative Sample of HIV-Infected Adults Receiving Health Care

Abstract: BACKGROUND: Perceived discrimination in clinical settings could discourage HIV-infected people from seeking health care, adhering to treatment regimens, or returning for follow-up. OBJECTIVES: This study aims to determine whether HIV-infected people perceive that physicians and other health care providers have discriminated against them. DESIGN, PARTICIPANTS: Cross-sectional data (1996 to 1997) from the HIV Cost and Services Utilization Study (HCSUS), which conducted in-person interviews with a nationally representative probability sample of 2,466 HIV-infected adults receiving health care within the contiguous U.S. MEASUREMENTS: Reports of whether health care providers have been uncomfortable with the respondent, treated the respondent as an inferior, preferred to avoid the respondent, or refused the respondent service. Questions also covered the types of providers who engaged in these behaviors. RESULTS: Twenty-six percent of HIV-infected adults receiving health care reported experiencing at least 1 of 4 types of perceived discrimination by a health care provider since becoming infected with HIV, including 8% who had been refused service. White respondents (32%) were more likely than others (27%) and Latinos (21%) and nearly twice as likely as African Americans (17%) to report perceived discrimination (P<.001). Respondents whose first positive HIV test was longer ago were also more likely to report discrimination (P<.001). Respondents who reported discrimination attributed it to physicians (54%), nurses and other clinical staff (39%), dentists (32%), hospital staff (31%), and case managers or social workers (8%). CONCLUSIONS: Many HIV-infected adults believe that their clinicians have discriminated against them. Clinicians should make efforts to address circumstances that lead patients to perceive discrimination, whether real or imagined.

The Quality of Retrospective Data An Examination of Long-Term Recall in a Developing Country

Abstract: The literature on reporting error provides insights into the quality of retrospective reports, particularly as it pertains to short-tern recall. Less is understood about the generalizability of these findings to longer-tern retrospective reports. We review studies analyzing the quality of retrospective reports in the Malaysian Family Life Surveys (MFLS), fielded in Peninsular Malaysia in 1976 and 1988, and conclude that many of the data quality problems found previously are present in the MFLS. We summarize this literature, place studies based on the MFLS within the context of the reporting error literature, and discuss implications for the design of future surveys.

Tools and techniques for developing policies for complex and uncertain systems.

Abstract: Agent-based models (ABM) are examples of complex adaptive systems, which can be characterized as those systems for which no model less complex than the system itself can accurately predict in detail how the system will behave at future times. Consequently, the standard tools of policy analysis, based as they are on devising policies that perform well on some best estimate model of the system, cannot be reliably used for ABM. This paper argues that policy analysis by using ABM requires an alternative approach to decision theory. The general characteristics of such an approach are described, and examples are provided of its application to policy analysis.