Future Willingness Research Articles

AB0768 Aesthetic Discomfort in Women with Hand Osteorthritis Means NO Less than the Pain and Functional Impairment

BackgroundOsteoarthritis (OA) is one of the most common causes of pain in the hands after 40-45 years resulting in poor health-related quality of life (HRQoL). This reduction caused not only...

The timing of parental divorce and filial obligations to care for ageing parents

This article explores how the timing of parental divorce within a child’s lifecourse can influence the obligations they feel to care for their parents later in life. The majority of studies have suggested that parental divorce that occurs earlier in a child’s life will have the most detrimental effect on their filial obligations. Drawing on life-history interviews with 23 midlife participants in Southampton (UK) we challenge this contention by demonstrating how midlife experiences of parental divorce have weakened adult children’s relationships with their parents, and we explore how this may impact on their future willingness to provide care. We also demonstrate how deteriorating marital relations have resulted in some older parents ‘living together apart’ and becoming socially withdrawn, which has weakened relationships with their midlife adult children who, as a result, expect to feel less willing to care for their parents in the future. These findings are presented within the context of rising divorce rates in older age groups and an informal care gap in the UK.

The Effect of Language Preparation on Communication Skills and Growth of Students’ Self-confidence

Specialized language and communication is not just a matter of professional lexis and syntactic structures: life, customs and intercultural information are essential pillars of the advanced educational process. Following European trends, students have to be prepared for the alternative they will spend a part of their study at a university abroad: the preparation should be focused on abilities to manage both general and specialized language: therefore communication in the classroom should be as close as possible to real-life communication and teaching strategies should follow this trend. Therefore students at the University of Defence are offered lectures and seminars in mathematics and physics in the English language. Having passed the first semester, students were questioned and a short study investigation was conducted. The conclusions showed that students who selected lectures and seminars in mathematics and physics in the English language achieved remarkably better study results comparing to regular students: in addition more extensive study materials could have been covered due to higher motivation, possible better future career and willingness to study.

Young men and the morning after: a missed opportunity for emergency contraception provision?

ObjectivesAlthough adolescents and young adults of lower socioeconomic status (SES) are disproportionately affected by unintended pregnancies, research on experiences with emergency contraception (EC) in this population has lagged. Furthermore, it...

PSY16 - Orphan Drug Access: Risk/Reward Analysis of Local Clinical Development in Chile

As many orphan drug (OD) manufacturers expand their businesses across emerging markets(EM) they are faced with restrictive and often non-existent funding pathways. As a result pricing and reimbursement (P&R) negotiations remain very challenging, pushing manufactures to explore the value of local clinical development in supporting access. To a) understand the value of local clinical development for payers, to support reimbursement in Chile, and b) compare and contrast against four other emerging markets: Russia, Turkey, India and China. In-depth interviews were conducted with 3 stakeholders per market including national payers, reimbursement committee advisors and rare diseases clinical specialists, to understand a) Current OD funding pathways; b) P&R decision drivers; and c) Impact of local development on reimbursement. Selected value drivers were used to develop a scale and qualitatively measure the risk/reward analysis of local clinical development on OD access. The impact of local development on OD reimbursement varies across markets. Respondents in Chile (n=3) highlighted that clinical development will have a strong influence on future willingness to pay, but the opportunity will remain small due to lack of clarity around long-term funding. In Turkey (n=3), providing access to patients through compassionate use schemes, prior to obtaining registration, positively impacts reimbursement.While in Russia, conducting a local clinical trial adds no value to the P&R decision process as cited by payers (n=3). As for India and China where price remains the overriding factor, respondents (n=6) stated that national reimbursement remains a distant prospect. High clinical experts’ awareness, strong influence of advocacy groups and developing OD funding pathways renders Chile and Turkey the most attractive EM for local development. While in comparison, the generation of local patient data is also favoured across the remaining markets, price remains the overriding factors influencing access and reimbursement.

Assessing Attitudes toward Grandparents Raising Their Grandchildren

This article describes the assessment of attitudes toward grandparent caregivers held by noncaregiving grandparents. Six hundred two grandparents not currently caring for grandchildren completed an 18-item measure of such attitudes. This attitude scale was both internally consistent and multidimensional in nature. Attitudes were more positive for grandparents reporting previous experience caring for a grandchild and such attitudes were in part predicted by one's attitudes toward the current grandparent role, which was also complex in nature. Being able to assess and understand attitudes toward custodial grandparents can contribute to the reduction of others' biases about them and may influence grandparents' future willingness to assume the caregiving role.

Long-term efficacy of click city(r): tobacco: a school-based tobacco prevention program.

Click City (®) : Tobacco is an innovative, computer-based tobacco prevention program designed to be implemented in 5th-grade classrooms with a booster in 6th grade. The program targets etiological mechanisms predictive of future willingness and intentions to use tobacco and initiation of tobacco use. Each component was empirically evaluated to assure that it changed its targeted mechanism. This paper describes long-term outcomes for students who participated in a randomized controlled efficacy trial of the program. A total of 26 middle schools were stratified and randomly assigned to the Click City (®) : Tobacco program or Usual Curriculum. The 47 elementary schools that fed into each middle school were assigned to the same condition as their respective middle school. In Click City (®) : Tobacco schools, 1,168 students from 24 elementary schools and 13 middle schools participated. In Usual Curriculum schools, 1,154 students from 23 elementary schools and 13 middle schools participated. All participating students completed baseline, post-6th grade program, and 7th grade assessments. As compared to students in schools that continued with their usual curriculum, intentions and willingness to smoke increased less from baseline to 6th grade and from baseline to 7th grade, among students in schools that used the Click City (®) : Tobacco curriculum. Changes in mechanisms were also in the expected direction. The program was particularly efficacious for at-risk students. Results provide evidence to support the long-term efficacy of Click City (®) : Tobacco. Program development, based on an empirical evaluation of each component, most likely played a role in the success of the program.

Mass social contact interventions and their effect on mental health related stigma and intended discrimination

BackgroundStigma and discrimination associated with mental health problems is an important public health issue, and interventions aimed at reducing exposure to stigma and discrimination can improve the lives of people with mental health problems. Social contact has long been considered to be one of the most effective strategies for improving inter-group relations. For this study, we assess the impact of a population level social contact intervention among people with and without mental health problems.MethodsThis study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential): (1) improves intended stigmatising behaviour; (2) increases future willingness to disclose a mental health problem; and (3) promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England’s Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online) and 83 completed follow-up questionnaires online 4–6 weeks later.ResultsThis study investigated the impact of social contact and whether presence of specific facilitating factors (equal status, common goals, cooperation and friendship potential): (1) improves intended stigmatising behaviour; (2) increases future willingness to disclose a mental health problem; and (3) promotes behaviours associated with anti-stigma campaign engagement. Two mass participation social contact programmes within England’s Time to Change campaign were evaluated via a 2-part questionnaire. 403 participants completed initial questionnaires (70% paper, 30% online) and 83 completed follow-up questionnaires online 4–6 weeks later. Campaign events facilitated meaningful intergroup social contact between individuals with and without mental health problems. Presence of facilitating conditions predicted improved stigma-related behavioural intentions and subsequent campaign engagement 4–6 weeks following social contact. Contact, however, was not predictive of future willingness to disclose mental health problems.ConclusionsFindings emphasise the importance of facilitating conditions to promote positive social contact between individuals and also suggest that social contact interventions can work on a mass level. Future research should investigate this type of large scale intervention among broader and more representative populations.

Voluntary participation and intergenerational risk sharing in a funded pension system

We explore the feasibility of a funded pension system with intergenerational risk sharing when participation in the system is voluntary. Typically, the willingness of the young to participate depends on their belief about the future young's willingness to do so. We characterise equilibria with voluntary participation and show that the likelihood of their existence increases with risk aversion and financial market uncertainty. We find that mandatory participation is often necessary to sustain a funded pension pillar and to let participants benefit from intergenerational risk sharing.

Promoting advance planning for health care and research among older adults: A randomized controlled trial

BackgroundFamily members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making.Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments.DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system.Trial RegistrationISRCTN89993391

The Credit Rating Agencies — Are They Reliable? A Study of Sovereign Ratings

Sovereign credit ratings estimate the future ability and willingness of the sovereign governments to service their commercial and financial obligations in full and on time. The process of evaluating the nations and assigning ratings is a business involving various international rating agencies. Governments seek the credit ratings so as to improve their access to the international capital markets. The sovereign credit ratings are an important scale for determining the cost of borrowing to a country. The ratings provide a perception to the lenders about the level of credit risk of the national governments. However, the reliability of the ratings has been a matter of debate in the past due to the methodology followed by the rating agencies. The present paper attempts to check the reliability of these ratings by considering the ratings assigned by two of the major international rating agencies — Moody's and Standard and Poor's. This is done through comparison of the ratings assigned by them and checking whether the difference is significant and responsive for the countries rated by both. A regression analysis of the ratings and some of the commonly used indicators by the two agencies to determine the ratings is also done. The results indicate an increase in the average rating difference of the two agencies over time and that the difference in the ratings assigned by the two agencies is statistically significant. Moreover, these agencies are also found to be non-responsive to each other's ratings. This raises reasonable doubts on the consistency of these ratings as the methodology followed by these agencies involves several common determinants. The regression of the ratings over the determinants indicate that the ratings of these two agencies have more or less the common determinants except the ‘external balances’ indicator exclusively determining the S&P ratings. Considering the fact that the ratings provided by these two agencies are significantly different from each other, the differences in the ratings could be explained by the differences in the weights attached to the determinants by the two agencies. However, a test of significance for the differences in weights of the given set of indicators attached by the two agencies reveals that there is no significant difference in the weights. Thus, the differences can also be attributed to the weights attached to the subjective criteria used by these agencies in order to decide the ratings. Such criteria imply the qualitative biases built by the agencies against nations on the basis of social and political conditions and their reactions to news regarding the changes in the capital markets of a nation.

Self‐Serving Attribution Bias, Overconfidence, and the Issuance of Management Forecasts

ABSTRACTPrior studies document that managers consider a variety of costs and benefits when deciding whether to issue earnings forecasts. Using an abstract experiment and a survey of experienced financial managers, we provide evidence that managerial overconfidence may also contribute to this decision. Our experiment shows that participants engage in self‐serving attribution, giving greater weight to internal than external factors as explanations for good performance. This increases confidence in improved future performance, which increases their willingness to issue forecasts. Two facets of the stable individual trait overconfidence, dispositional optimism and miscalibration, also contribute to confidence in improved future performance and willingness to issue forecasts. Consistent with these results, experienced financial manager survey participants believe other managers are likely to overestimate the extent to which they contribute to positive firm performance, and both overoptimism about firm performance and overconfidence in their ability to predict future firm performance contribute to issuance of earnings forecasts.

Acceptability of the Internet-Based Chlamydia Screening Implementation in the Netherlands and Insights Into Nonresponse

The study assessed the acceptability of internet-based Chlamydia screening using home-testing kits among 16- to 29-year-old participants and nonparticipants in the first year of a Chlamydia Screening Implementation program in the Netherlands. Questionnaire surveys were administered to randomly selected participants (acceptability survey) and nonparticipants (nonresponse survey) in 3 regions of the Netherlands where screening was offered. Participants received email invitations to an online survey; nonparticipants received postal questionnaires. Both surveys enquired into opinions on the screening design, reasons for (non-) participation and future willingness to be tested. The response rate was 63% (3499/5569) in the acceptability survey and 15% (2053/13,724) in the nonresponse survey. Primary motivation for participating in the screening was "for my health" (63%). The main reason for nonresponse given by sexually active nonparticipants was "no perceived risk of infection" (40%). Only 2% reported nonparticipation due to no internet access. Participants found the internet (93%) and home-testing (97%) advantages of the program, regardless of test results. Two-thirds of participants would test again, 92% via the screening program. Half of nonparticipants were appreciative of the program design, while about 1 in 5 did not like internet usage, home-testing, or posting samples. The screening method was highly acceptable to participants. Nonparticipants in this survey were generally appreciative of the program design. Both groups made informed choices about participation and surveyed low-risk nonparticipants accurately perceived their low-risk status. Although many nonparticipants were not reached by the nonresponse survey, current insights on acceptability and nonresponse are undoubtedly valuable for evaluation of the current program.

Short-term efficacy of Click City®: Tobacco: changing etiological mechanisms related to the onset of tobacco use.

This paper described the short-term results from an ongoing randomized controlled efficacy study of Click City®: Tobacco, a tobacco prevention program designed for 5th graders, with a booster in sixth grade. Click City®: Tobacco is an innovative school-based prevention program delivered via an intranet, a series of linked computers with a single server. The components of the program target theoretically based and empirically supported etiological mechanisms predictive of future willingness and intentions to use tobacco and initiation of tobacco use. Each component was designed to change one or more etiological mechanisms and was empirically evaluated in the laboratory prior to inclusion in the program. Short-term results from 47 elementary schools (24 schools who used Click City®: Tobacco, and 23 who continued with their usual curriculum) showed change in intentions and willingness to use tobacco from baseline to 1-week following the completion of the 5th grade sessions. The results demonstrate the short-term efficacy of this program and suggest that experimentally evaluating components prior to including them in the program contributed to the efficacy of the program. The program was most efficacious for students who were most at risk.

Voluntary Participation and Intergenerational Risk Sharing in a Funded Pension System

We explore the feasibility of a funded pension system with intergenerational risk sharing when participation in the system is voluntary. Typically, the willingness of the young to participate depends on their belief about the future young's willingness to do so. We characterise equilibria with voluntary participation and show that the likelihood of their existence increases with risk aversion and financial market uncertainty. We find that it is likely that mandatory participation is necessary to sustain a funded pension pillar and to let participants benefit from intergenerational risk sharing. Published in the 'European Economic Review' .

Voluntary Participation and Intergenerational Risk Sharing in a Funded Pension System

We explore the feasibility of a funded pension system with intergenerational risk sharing when participation in the system is voluntary. Typically, the willingness of the young to participate depends on their belief about the future young's willingness to do so. We characterise equilibria with voluntary participation and show that the likelihood of their existence increases with risk aversion and financial market uncertainty. We find that it is likely that mandatory participation is necessary to sustain a funded pension pillar and to let participants benefit from intergenerational risk sharing.

The Future of Capital Trials: An Exploration of Procedural Justice, Race, and Willingness to Serve Again

The purpose of this article is to determine whether race (a juror’s race, racial composition of the jury, race of the jury foreperson, and defendant—victim racial composition) and perceptions of procedural justice affect capital jurors’ willingness to serve again. Using logistic regression, data from 662 capital jurors are analyzed. A direct test of procedural justice theory is not supported by these findings; however, feeling emotionally upset about the experience is strongly associated with unwillingness to serve again. In addition, those who served on a White defendant—Black victim case were more likely to report future willingness to serve compared to jurors on White— White cases. When the regression model is divided into subsamples (White jurors only and Black jurors only), feeling emotionally upset is still a strong indicator for both groups, and both Black and White jurors are less willing to serve again when the victim in their case was White. In addition, part-time employment was a significant indicator of unwillingness to serve again for Black jurors. Policy implications and directions for future research are discussed.

Dental students’ perceived comfort and future willingness to treat underserved populations: surveys prior to and immediately after extramural experiences

The purpose of this study was to compare the perceived change in comfort level and future willingness of senior dental students toward treating 12 different groups of traditionally underserved populations. Written surveys of senior dental students were conducted prior to and after completing extramural clinical rotations. A Likert-type scale was used to assess student comfort, whereas future willingness to treat these populations was dichotomous. Over a 13-year period (1992-2004), 560 students completed both surveys. There was an improvement in students' comfort level for 7 of 12 groups after the community-based assignments, yet there were no differences among population groups based on students' gender or assignments. There were positive changes for future willingness to treat patients who were mentally compromised, homeless, and non-English speaking, while there was a negative change for treating patients who were frail and elderly and those who were HIV+ or had AIDS. Students with improved comfort levels were more apt to be willing to treat patients who were frail elderly, medically complex, mentally compromised, and non-English speaking in the future. While student comfort in treating several groups improved after completion of the community-based experiences, there were mixed results for future willingness to treat underserved populations.

The cycle of concealment model

This study tested a cycle of concealment model in families. Confirming the model, a family member’s past verbally aggressive reactions to revelations influenced the extent to which the family member was estimated to react negatively to revealing a secret. These factors also attenuated closeness toward family members. In addition, expectations of negative reactions to a revelation and the extent to which those expectations were violated after the secret was revealed influenced closeness with the family member and future willingness to reveal secrets. Counter to the model, however, secret disclosure did not affect closeness. Feelings of closeness toward the family member also did not predict revelation of the secret.

Perspectives of Future Physicians on Disaster Medicine and Public Health Preparedness: Challenges of Building a Capable and Sustainable Auxiliary Medical Workforce

Although the training of future physicians in disaster preparedness and public health issues has been recognized as an important component of graduate medical education, medical students receive relatively limited exposure to these topics. Recommendations have been made to incorporate disaster medicine and public health preparedness into medical school curricula. To date, the perspectives of future physicians on disaster medicine and public health preparedness issues have not been described. A Web-based survey was disseminated to US medical students. Frequencies, proportions, and odds ratios were calculated to assess perceptions and self-described likelihood to respond to disaster and public health scenarios. Of the 523 medical students who completed the survey, 17.2% believed that they were receiving adequate education and training for natural disasters, 26.2% for pandemic influenza, and 13.4% for radiological events, respectively; 51.6% felt they were sufficiently skilled to respond to a natural disaster, 53.2% for pandemic influenza, and 30.8% for radiological events. Although 96.0% reported willingness to respond to a natural disaster, 93.7% for pandemic influenza, and 83.8% for a radiological event, the majority of respondents did not know to whom they would report in such an event. Despite future physicians' willingness to respond, education and training in disaster medicine and public health preparedness offered in US medical schools is inadequate. Equipping medical students with knowledge, skills, direction, and linkages with volunteer organizations may help build a capable and sustainable auxiliary workforce.