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RAND Corporation

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


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Journal ArticleDOI
TL;DR: In this paper, the authors introduce the concept of "shared socio-economic (reference) pathways" to identify a set of global narratives and socioeconomic pathways offering scalability to different regional contexts, a reasonable coverage of key socioeconomic dimensions and relevant futures, and a sophisticated approach to separating climate policy from counterfactual "no policy" scenarios.
Abstract: Socio-economic scenarios constitute an important tool for exploring the long-term consequences of anthropogenic climate change and available response options. A more consistent use of socio-economic scenarios that would allow an integrated perspective on mitigation, adaptation and residual climate impacts remains a major challenge. We assert that the identification of a set of global narratives and socio-economic pathways offering scalability to different regional contexts, a reasonable coverage of key socio-economic dimensions and relevant futures, and a sophisticated approach to separating climate policy from counter-factual " no policy" scenarios would be an important step toward meeting this challenge. To this end, we introduce the concept of " shared socio-economic (reference) pathways" Sufficient coverage of the relevant socio-economic dimensions may be achieved by locating the pathways along the dimensions of challenges to mitigation and to adaptation. The pathways should be specified in an iterative manner and with close collaboration between integrated assessment modelers and impact, adaptation and vulnerability researchers to assure coverage of key dimensions, sufficient scalability and widespread adoption. They can be used not only as inputs to analyses, but also to collect the results of different climate change analyses in a matrix defined by two dimensions: climate exposure as characterized by a radiative forcing or temperature level and socio-economic development as classified by the pathways. For some applications, socio-economic pathways may have to be augmented by " shared climate policy assumptions" capturing global components of climate policies that some studies may require as inputs. We conclude that the development of shared socio-economic (reference) pathways, and integrated socio-economic scenarios more broadly, is a useful focal point for collaborative efforts between integrated assessment and impact, adaptation and vulnerability researchers. © 2012 Elsevier Ltd.

353 citations

Journal ArticleDOI
TL;DR: HIV/AIDS conspiracy beliefs are a barrier to HIV prevention among African Americans and may represent a facet of negative attitudes about condoms among black men.
Abstract: Objectives: This study examined endorsement of HIV/AIDS conspiracy beliefs and their relations to consistent condom use and condom attitudes among African Americans. Methods: We conducted a telephone survey with a random sample of 500 African Americans aged 15 to 44 years and living in the contiguous United States. Results: A significant proportion of respondents endorsed HIV/AIDS conspiracy beliefs. Among men, stronger conspiracy beliefs were significantly associated with more negative condom attitudes and inconsistent condom use independent of selected sociodemographic characteristics, partner variables, sexually transmitted disease history, perceived risk, and psychosocial factors. In secondary follow-up analyses, men’s attitudes about condom use partially mediated the effects of HIV/AIDS conspiracy beliefs on condom use behavior. Conclusions: HIV/AIDS conspiracy beliefs are a barrier to HIV prevention among African Americans and may represent a facet of negative attitudes about condoms among black men. To counter such beliefs, government and public health entities need to work toward obtaining the trust of black communities by addressing current discrimination within the health care system as well as by acknowledging the origin of conspiracy beliefs in the context of historical discrimination.

352 citations

Journal ArticleDOI
TL;DR: The CALM intervention was relatively easy to incorporate during the effectiveness trial, and satisfaction was generally high, and Numerous implementation and sustainability barriers could limit the reach and impact of widespread adoption.
Abstract: Investigators recently tested the effectiveness of a collaborative-care intervention for anxiety disorders: Coordinated Anxiety Learning and Management(CALM) []) in 17 primary care clinics around the United States. Investigators also conducted a qualitative process evaluation. Key research questions were as follows: (1) What were the facilitators/barriers to implementing CALM? (2) What were the facilitators/barriers to sustaining CALM after the study was completed? Key informant interviews were conducted with 47 clinic staff members (18 primary care providers, 13 nurses, 8 clinic administrators, and 8 clinic staff) and 14 study-trained anxiety clinical specialists (ACSs) who coordinated the collaborative care and provided cognitive behavioral therapy. The interviews were semistructured and conducted by phone. Data were content analyzed with line-by-line analyses leading to the development and refinement of themes. Similar themes emerged across stakeholders. Important facilitators to implementation included the perception of "low burden" to implement, provider satisfaction with the intervention, and frequent provider interaction with ACSs. Barriers to implementation included variable provider interest in mental health, high rates of part-time providers in clinics, and high social stressors of lower socioeconomic-status patients interfering with adherence. Key sustainability facilitators were if a clinic had already incorporated collaborative care for another disorder and presence of onsite mental health staff. The main barrier to sustainability was funding for the ACS. The CALM intervention was relatively easy to incorporate during the effectiveness trial, and satisfaction was generally high. Numerous implementation and sustainability barriers could limit the reach and impact of widespread adoption. Findings should be interpreted with the knowledge that the ACSs in this study were provided and trained by the study. Future research should explore uptake of CALM and similar interventions without the aid of an effectiveness trial.

351 citations

Journal ArticleDOI
19 Sep 2001-JAMA
TL;DR: Societal cost-effectiveness of practice-initiated QI efforts for depression is comparable with that of accepted medical interventions, and the intervention effects on employment may be of particular interest to employers and other stakeholders.
Abstract: ContextDepression is a leading cause of disability worldwide, but treatment rates in primary care are low.ObjectiveTo determine the cost-effectiveness from a societal perspective of 2 quality improvement (QI) interventions to improve treatment of depression in primary care and their effects on patient employment.DesignGroup-level randomized controlled trial conducted June 1996 to July 1999.SettingForty-six primary care clinics in 6 community-based managed care organizations.ParticipantsOne hundred eighty-one primary care clinicians and 1356 patients with positive screening results for current depression.InterventionsMatched practices were randomly assigned to provide usual care (n = 443 patients) or to 1 of 2 QI interventions offering training to practice leaders and nurses, enhanced educational and assessment resources, and either nurses for medication follow-up (QI-meds; n = 424 patients) or trained local psychotherapists (QI-therapy; n = 489). Practices could flexibly implement the interventions, which did not assign type of treatment.Main Outcome MeasuresTotal health care costs, costs per quality-adjusted life-year (QALY), days with depression burden, and employment over 24 months, compared between usual care and the 2 interventions.ResultsRelative to usual care, average health care costs increased $419 (11%) in QI-meds (P = .35) and $485 (13%) in QI-therapy (P = .28); estimated costs per QALY gained were between $15 331 and $36 467 for QI-meds and $9478 and $21 478 for QI-therapy; and patients had 25 (P = .19) and 47 (P = .01) fewer days with depression burden and were employed 17.9 (P = .07) and 20.9 (P = .03) more days during the study period.ConclusionsSocietal cost-effectiveness of practice-initiated QI efforts for depression is comparable with that of accepted medical interventions. The intervention effects on employment may be of particular interest to employers and other stakeholders.

350 citations

Journal ArticleDOI
TL;DR: Using large-scale pooled panel survey data linked to death registrations and earnings histories for U.S. men and women aged 25 and older, and with appropriate contrast tests, a consistent survival advantage for married over unmarriedMen and women, and an additional survival “premium” for married men are found.
Abstract: The theory that marriage has protective effects for survival has itself lived for more than 100 years since Durkheim’s groundbreaking study of suicide (Durkheim 1951 [1897]). Investigations of differences in this protective effect by gender, by age, and in contrast to different unmarried statuses, however, have yielded inconsistent conclusions. These investigations typically either use data in which marital status and other covariates are observed in cross-sectional surveys up to 10 years before mortality exposure, or use data from panel surveys with much smaller sample sizes. Their conclusions are usually not based on formal statistical tests of contrasts between men and women or between never-married, divorced/separated, and widowed statuses. Using large-scale pooled panel survey data linked to death registrations and earnings histories for U.S. men and women aged 25 and older, and with appropriate contrast tests, we find a consistent survival advantage for married over unmarried men and women, and an additional survival “premium” for married men. We find little evidence of mortality differences between never-married, divorced/separated, and widowed statuses.

350 citations


Authors

Showing all 9660 results

NameH-indexPapersCitations
Darien Wood1602174136596
Herbert A. Simon157745194597
Ron D. Hays13578182285
Paul G. Shekelle132601101639
John E. Ware121327134031
Linda Darling-Hammond10937459518
Robert H. Brook10557143743
Clifford Y. Ko10451437029
Lotfi A. Zadeh104331148857
Claudio Ronco102131272828
Joseph P. Newhouse10148447711
Kenneth B. Wells10048447479
Moyses Szklo9942847487
Alan M. Zaslavsky9844458335
Graham J. Hutchings9799544270
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Performance
Metrics
No. of papers from the Institution in previous years
YearPapers
202311
202277
2021640
2020574
2019548
2018491