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Aim: To evaluate the output of scientific publications in obstetrics and gynecology journals from Mainland China and six other countries, to compare the difference of research situation between Mainland China and the developed countries in order to measure the trend of number of publication in the field of Obstetrics and Gynecology. Methods: Information on article amounts, impact factors (IF), citation and publication in high‐impact obstetrics and gynecology journals by seven top‐ranking countries between January 1, 2007 and August 31, 2017, was extracted from Web of Science databases. Results: A total of 137 661 articles were published between 2007 and 2017 in the 98 obstetrics and gynecology journals. The cumulative IF and citations of articles from USA were the highest. The highest average citation was France and Mainland China ranked fourth. There were 52 631 papers published in the top 10 obstetrics and gynecology journals and the USA accounted for the majority of these papers (33 978, 64.6%), followed by England (8347, 15.9%). Articles from the USA were most often published in American Journal of Obstetrics and Gynecology (10658) and those from Mainland China were mostly published in Fertility and Sterility (809). Conclusion: The USA published the most articles having high IF, making the greatest contribution to the field of obstetrics and gynecology. Although the number of scientific publications from Mainland China has rapidly increased from 2007 to 2017, the quality of these publications has not been as satisfactory. It implys that Chinese current academic evaluation system should pay special attention to the quality of academic papers, instead of the number of papers published by scientists. [ABSTRACT FROM AUTHOR]

Student borrowing is a major higher education public policy issue, with students in both England and the United States increasingly relying on loans to finance postsecondary education. Our paper examines prospective higher education students' attitudes towards debt in England and the United States. It exploits a unique dataset which allows us to compare students' responses to similar surveys conducted in both countries during the same time period. Our study is the first of its kind to explore how students' borrowing attitudes differ across the two countries. It confirms widespread loan aversion among prospective higher education students in both countries. But students in the United States are more debt averse than their peers in England. These debt averse attitudes also predict lower intentions to pursue higher education, potentially exacerbating existing inequalities in access. We consider how these attitudes to borrowing are likely shaped by each country's distinctive student loan system. We conclude that the design of loans matters. England's income‐contingent loan repayments, in contrast to North America's mortgage style repayments, make borrowing less risky and reduce the impact of loan aversion on participation decisions, while borrowing is more common, and the system less complicated, in England. Thus, there are lessons for other countries considering introducing student loans or reforming their provision. We contribute to the extant literature on the determinants of, and socioeconomic differences in, higher education participation and the overlooked role of student debt aversion. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements: A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products. [ABSTRACT FROM AUTHOR]

This paper examines how child welfare workers in England, Norway and the USA (California) perceive children's participation building on 91 qualitative interviews. First, analysing the data using Hart's ladder of children's participation, we found that all Norwegian workers perceived children's participation as some form of decision‐making, whereas 40% of English and 35% of US workers embraced views of children's participation that can be considered token or non‐participation. Second, we coded the data for main themes and found that child welfare workers in all three countries perceived children's participation as hearing the child's opinion and information gathering. The themes of age, maturity and ability to form an opinion also emerged from the data. English workers' reflections about children's participation were more nuanced than their Norwegian and US counterparts; and US workers understood children's participation as children providing valuable information during the investigation of a case more frequently than workers in England and Norway. We discuss the implications of these findings on future research. [ABSTRACT FROM AUTHOR]

The current study aimed to explore the factors that influence how social workers make decisions and develop their decision‐making skills in care proceedings, and to identify effective support and intervention to develop social worker decision‐making skills. The study employed a mixed thematic approach across two phases of study: an initial inductive thematic analysis of responses to an online qualitative questionnaire and then a mixed thematic analysis of follow‐up focus groups and interviews with social workers working in various social work roles within England and Northern Ireland. The findings identified a number of themes that help to understand the decision‐making skills of social workers; thorough assessment skills, relationship‐based anti‐oppressive practice, being mindful of the lived experience of the child and using critical reflection to make complex decisions. Wider structural factors that support or hinder decision‐making, particularly in respect of organizational support and management supervision were also identified. Social workers can be supported to develop decision‐making skills through additional training, reflective learning and management support to develop their practice wisdom within this field. [ABSTRACT FROM AUTHOR]

Introduction: This integrative review aimed to understand the impact of nursing on the health outcomes of people with opioid use disorder (OUD). Methods: Whittemore and Knafl's (2005) integrative review methodology guided the review process. The authors searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and OVID databases for peer‐reviewed, English language articles describing nursing care for people receiving medications for OUD. The literature search followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. Results: A total of 773 articles were identified through the database searches after duplicates were removed; 15 articles met inclusion criteria and were included in the final review from the United States, Canada, Ireland, England, and the Netherlands. Two themes emerged: (1) The effect of nurse‐led care on patient outcomes and (2) Nursing roles and the environment of care. Studies emphasized the aspects of nursing care that promote patient‐centeredness and patient satisfaction. Conclusions: The importance of the registered nurse in providing quality care for people receiving medications for OUD is clear from the literature reviewed. The studies in the review highlighted important aspects of the registered nurses' role in affecting outcomes for people receiving medications for OUD including communication and care coordination. Clinical relevance: This review highlights the need for role delineation and further development of nurse‐sensitive indicators in the OUD treatment setting. [ABSTRACT FROM AUTHOR]

Background and Aims: Most population studies that evaluate the relationship between nicotine vaping and cigarette cessation focus on limited segments of the smoker population. We evaluated vaping uptake and smoking cessation considering differences in smokers' plans to quit. Design: Longitudinal International Tobacco Control (ITC) Four Country Smoking and Vaping Surveys were conducted in 2016, 2018 and 2020. Setting: This study was conducted in the United States, Canada, England and Australia. Participants: Participants of this study were adult daily cigarette smokers who had not vaped in the past 6 months at baseline and had participated in two or more consecutive waves of the ITC Four Country Smoking and Vaping Surveys (n = 2815). Measurements Plans to quit cigarette smoking was assessed at baseline (within 6 months, beyond 6 months, not planning to quit) and at follow‐up (within 6 months vs not within 6 months), cigarette smoking cessation was assessed at follow‐up (smoking less than monthly [including complete cessation] vs daily/weekly/monthly smoking) and inter‐wave vaping uptake was assesed between baseline and follow‐up (none, only non‐daily vaping and any daily vaping). Generalized estimating equations were used to evaluate whether inter‐wave vaping uptake was associated with smoking cessation at follow‐up and with planning to quit at follow‐up, each stratified by plans to quit smoking at baseline. Findings Overall, 12.7% of smokers quit smoking. Smokers not initially planning to quit within 6 months experienced higher odds of smoking cessation when they took up daily vaping (32.4%) versus no vaping (6.8%; adjusted odds ratio [AOR], 8.58; 95% CI, 5.06–14.54). Among smokers planning to quit, smoking cessation rates were similar between those who did and did not take up daily vaping (25.1% vs 16.8%; AOR, 1.91; 95% CI, 0.91–4.00), although we could not account for potential use of cessation aids. Daily vaping uptake was associated with planning to quit smoking at follow‐up among those initially not planning to quit (AOR,6.32; 95% CI, 4.17–9.59). Conclusions: Uptake of nicotine vaping appears to be strongly associated with cigarette smoking cessation among smokers with no initial plans to quit smoking. Excluding smokers not planning to quit from studies on vaping and smoking cessation may underestimate potential benefit of daily vaping for daily smokers. [ABSTRACT FROM AUTHOR]

Aims: To examine whether polyuse of cigarettes and other smoked products (polysmoking) is predictive of quit attempts and quit success. Design: A prospective multi‐country cohort design. Setting: Australia, Canada, England and the United States. Participants: A total of 3983 adult daily cigarette smokers were surveyed in 2016 (wave 1 of data collection) and were re‐contacted in 2018 (wave 2) (i.e. waves 1–2 cohort) in the International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys; and 3736 smokers were surveyed in 2018 and re‐contacted in 2020 (wave 3) (i.e. waves 2–3 cohort). Measurements Participants were asked about their cigarette smoking and use of cigars, cigarillos, pipes and waterpipes. Outcomes were quit attempts between two survey waves and success, defined as having quit smoking all the combustible tobacco at the subsequent survey for 1 month or more. Findings Levels of polysmoking were 12.7% in the waves 1–2 cohort and 10.5% for the waves 2–3 cohort. Compared with cigarette‐only smokers, polysmokers were more likely to attempt to quit between waves 1 and 2 [54.9 versus 42.7%, adjusted odds ratio (aOR) = 1.37, 95% confidence interval (CI) = 1.08–1.74, P < 0.01], but not between waves 2 and 3 (43.8 versus 40.1%, aOR = 0.94, 95% CI = 0.72–1.22). Polysmoking predicted reduced likelihood of success in both cohorts among attempters and the overall samples. Between waves 2 and 3 there were significantly more transitions to non‐daily smoking among the polysmokers (12.4 versus 5.3%, χ2 = 40.4, P < 0.001). Conclusions: There is a consistent association between polysmoking (use of cigarettes together with other smoked products) and reduced quit success for combustible tobacco, but it is probably due to increased likelihood of transitioning to non‐daily use rather than complete cessation. [ABSTRACT FROM AUTHOR]

Policy PointsThe number of social prescribing practices, which aim to link patients with nonmedical services and supports to address patients' social needs, is increasing in both England and the United States.Traditional health care financing mechanisms were not designed to support social prescribing practices, and flexible payment approaches may not support their widespread adoption.Policymakers in both countries are shifting toward developing explicit financing streams for social prescribing programs. Consequently, we need an evaluation of them to assess their success in supporting both the acceptance of these programs and their impacts.Investment in community‐based organizations and wider public services will likely be crucial to both the long‐term effectiveness and the sustainability of social prescribing. [ABSTRACT FROM AUTHOR]

The Ball State University Center for Peace and Conflict Studies in the United States has compiled altruistic stories from different countries such as India, Australia, the United States, and England since the onset of the COVID‐19 pandemic. We examined those stories to understand (1) who receives the most support, (2) what type of support is provided, (3) who those supporters are, and (4) why people support each other during the pandemic. Conducting a qualitative content analysis of 104 altruistic stories, we first identified that (a) older individuals , (b) people with sensitive health conditions, and disabilities, (c) frontline workers, and (d) working class and marginalized communities received the primary support. Second, we identified three types of support: (a) material, (b) social/emotional, and (c) psychological. Third, we found that support was coming from (a) different organizations, (b) advantaged groups, and (c) volunteers. Last, (a) sharing a community/humanity identity, (b) allyship, and (c) showing gratitude were the reasons behind altruistic and prosocial behavior. Our findings contribute to the literature by providing some possible reasons and ways that allies have supported disadvantaged communities via sharing the available resources and how showing gratitude can be a reason for altruism and prosocial behavior in a pandemic. [ABSTRACT FROM AUTHOR]

Objectives: To compare patterns of technological adoption of minimally invasive surgery for radical prostatectomy across the United States and England. Data Sources: We examine radical prostatectomy in the United States and England between 2005 and 2017, using de‐identified administrative claims data from the OptumLabs Data Warehouse in the United States and the Hospital Episodes Statistics in England. Study Design: We conducted a longitudinal analysis of robotic, laparoscopic, and open surgery for radical prostatectomy. We compared the trends of adoption over time within and across countries. Next, we explored whether differential adoption patterns in the two health systems are associated with differences in volumes and patient characteristics. Finally, we explored the relationship between these adoption patterns and length of stay, 30‐day readmission, and urology follow‐up visits. Data Collection: Open, laparoscopic, and robotic radical prostatectomies are identified using Office of Population Censuses and Surveys Classification of Interventions and Procedures (OPCS) codes in England and International Classification of Diseases ninth revision (ICD9), ICD10, and Current Procedural Terminology (CPT) codes in the United States. Principal Findings: We identified 66,879 radical prostatectomies in England and 79,358 in the United States during 2005–2017. In both countries, open surgery dominates until 2009, where it is overtaken by minimally invasive surgery. The adoption of robotic surgery is faster in the United States. The adoption rates and, as a result, the observed centralization of volume, have been different across countries. In both countries, patients undergoing radical prostatectomies are older and have more comorbidities. Minimally invasive techniques show decreased length of stay and 30‐day readmissions compared to open surgery. In the United States, robotic approaches were associated with lower length of stay and readmissions when compared to laparoscopic. Conclusions: Robotic surgery has become the standard approach for radical proctectomy in the United States and England, showing decreased length of stay and in 30‐day readmissions compared to open surgery. Adoption rates and specialization differ across countries, likely a product of differences in cost‐containment efforts. [ABSTRACT FROM AUTHOR]

Policy PointsStrategically purchasing health care has been and continues to be a popular policy idea around the world.Key asymmetries in information, market power, political power, and financial power hinder the effective implementation of strategic purchasing.Strategic purchasing has consistently failed to live up to its promises for these reasons. Future strategies based on strategic purchasing should tailor their expectations to its real effectiveness. Context: Strategic purchasing of health care has been a popular policy idea around the world for decades, with advocates claiming that it can lead to improved quality, patient satisfaction, efficiency, accountability, and even population health. In this article, we report the results of an inquiry into the implementation and effects of strategic purchasing. Methods: We conducted three in‐depth case studies of England, the Netherlands, and the United States. We reviewed definitions of purchasing, including its slow acquisition of adjectives such as strategic, and settled on a definition of purchasing that distinguishes it from the mere use of contracts to regulate stable interorganizational relationships. The case studies review the career of strategic purchasing in three different systems where its installation and use have been a policy priority for years. Findings: No existing health care system has effective strategic purchasing because of four key asymmetries: market power asymmetry, information asymmetry, financial asymmetry, and political power asymmetry. Conclusions: Further investment in policies that are premised on the effectiveness of strategic purchasing, or efforts to promote it, may not be worthwhile. Instead, policymakers may need to focus on the real sources of power in a health care system. Policy for systems with existing purchasing relationships should take into account the asymmetries, ways to work with them, and the constraints that they create. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to identify published evidence to inform the development of expanded practice services in rural community pharmacies. Data sources: The search strategy was applied to the following electronic databases: MEDLINE, CINAHL, Emcare, Cochrane and Google Scholar. Study selection: In all, 508 studies were evaluated against inclusion and exclusion criteria, with 29 eligible studies finally included in the review. Services provided needed to meet the described definition of 'expanded practice' and be applied in a rural community pharmacy setting. Expanded services were evaluated against at least one of the following: effectiveness, enablers, barriers and feasibility. Results: The studies included in this review were conducted in the US (n = 15), Australia (n = 8), Canada (n = 2), New Zealand (n = 1), England (n = 1), Croatia (n = 1) and Ghana (n = 1). All studies were conducted within the past 22 years, with 11 published since 2015. Cardiovascular disease (n = 7), diabetes/metabolic syndrome (n = 4), respiratory disease (n = 6) and vaccinations (n = 5) were the most common diseases or health service targeted in the interventions. Study design varied, reflected in the methodological quality, which included experimental studies (n = 27) and retrospective observational cohort studies (n = 2). Expanded pharmacy services identified included delivery of immunisations and the screening and management of chronic and infectious diseases, such as osteoporosis, asthma, chronic obstructive pulmonary disease, malaria, diabetes and cardiovascular and kidney disease. Conclusions: Pharmacists providing these services have an opportunity to improve health outcomes for rural populations. [ABSTRACT FROM AUTHOR]

Aims: To examine whether norms towards nicotine vaping product (NVP) use varied between Australia, Canada, England and the United States and by socio‐demographics, smoking and NVP status. Design Cross‐sectional data from the 2016 ITC Four Country Smoking and Vaping Survey. Setting: Four countries with distinct regulatory policies relating to the sale and advertising of NVPs: Australia (most restrictive), Canada (restrictive), England and the United States (least restrictive). Participants: A total of 10900 adult (age 18+) current smokers, former smokers, or at least weekly NVP users. Respondents were from Australia (n = 1366), Canada (n = 3309), England (n = 3835) and the United States (n = 2390). Measurements Questions permitted the categorization of respondents as current smokers, former smokers, NVP users and socio‐demographic categories (sex, age, country, ethnicity, income and education). Further questions were asked regarding the frequency of exposure to NVPs in public, whether they had a partner or close friends who vaped and whether they believed society or those considered important to them approved of NVPs. Findings Adjusting for relevant covariates, compared with Australian respondents, those in England, Canada and the United States were more likely to report frequent exposure to NVPs in public (83.1%, 57.3% and 48.3%, respectively, compared to 19.8% in Australia; P < 0.0001), having a partner who vaped (13.8%, 7.1% and 7.7%, respectively, compared to 2.1% in Australia; P < 0.0001) and having close friend(s) who vaped (31.7%, 25.3%, 20.9%, respectively, compared to 10.0% in Australia; P < 0.0001). Compared with Australian respondents, respondents from England were more likely to report that society (27.6% compared to 12.3% in Australia; P < 0.0001) and people important to them approved of NVP use (28.9% compared to 14.3% in Australia; P < 0.0001). Conclusions: Norms towards nicotine vaping product (NVP) use appear to vary among countries with different regulatory contexts regarding sales and advertising. [ABSTRACT FROM AUTHOR]

Aims: To determine whether a simple combination of level of smoking and level of vaping results in a useful typology for characterizing smoking and vaping behaviours. Methods: Cross‐sectional data from adults (≥ 18 years) in the 2016 wave 1 ITC Four Country Smoking and Vaping Survey in the United States (n = 2291), England (n = 3591), Australia (n = 1376) and Canada (n = 2784) were used. Participants who either smoked, vaped or concurrently used both at least monthly were included and divided into eight groups based on use frequency of each product (daily, non‐daily, no current use). This resulted in four concurrent use groups (predominant smokers, dual daily users, predominant vapers and concurrent non‐daily users). These groups were compared with each other and with the four exclusive use groups, on socio‐demographics, nicotine dependence, beliefs and attitudes about both products, and quit‐related measures using data weighted to reference population surveys in each country. Results: Of the sample, 10.8% were concurrent users, with daily smokers vaping non‐daily (predominant smokers), constituting 51.6% of this group. All eight categories differed from other categories on at least some measures. Concurrent daily nicotine users reported higher levels of indicators of nicotine dependence, and generally more positive attitudes toward both smoking and vaping than concurrent non‐daily users. Among daily nicotine users, compared with exclusive daily smokers, reports of interest in quitting were higher in all concurrent use groups. Dual daily users had the most positive attitudes about smoking overall, and saw it as the least denormalized, and at the same time were equally interested in quitting as other concurrent users and were most likely to report intending to continue vaping. Conclusions: In Australia, Canada, England and the United States in 2016, daily nicotine users differed considerably from non‐daily nicotine users. Among daily nicotine users, dual daily users (those who smoke and vape concurrently) should be treated as a distinct grouping when studying relationships between smoking and vaping. The eight‐level typology characterizing concurrent and exclusive use of smoking and vaping should be considered when studying both products. [ABSTRACT FROM AUTHOR]

Aim: To describe the methods of the 2016 International Tobacco Control (ITC) Four Country Smoking and Vaping (4CV) Survey, conducted in 2016 in Australia (AU), Canada (CA), England (EN) and the United States (US). Methods: The respondents were cigarette smokers, former smokers (quit within the previous 2 years), and at‐least‐weekly vapers, aged 18 years and older. Eligible cohort members from the ITC Four Country Survey (4C) were retained. New respondents were sampled by commercial firms from their panels. Where possible, ages 18–24 and vapers were oversampled. Data were collected online, and respondents were remunerated. Survey weights were calibrated to benchmarks from nationally representative surveys. Results: Response rates by country for new recruits once invited ranged from 15.2 to 49.6%. Sample sizes for smokers/former smokers were 1504 in AU, 3006 in CA, 3773 in EN and 2239 in the US. Sample sizes for additional vapers were 727 in CA, 551 in EN and 494 in the US. Conclusion: The International Tobacco Control Four Country Smoking and Vaping Survey design and data collection methods allow analyses to examine prospectively the use of cigarettes and nicotine vaping products in jurisdictions with different regulatory policies. The effects on the sampling designs and response quality of recruiting the respondents from commercial panels are mitigated by the use of demographic and geographic quotas in sampling; by quality control measures; and by the construction of survey weights taking into account smoking/vaping status, sex, age, education and geography. [ABSTRACT FROM AUTHOR]

Background and Aims: Debate exists about whether health professionals (HPs) should advise smokers to use nicotine vaping products (NVPs) to quit smoking. The objectives were to examine in four countries: (1) the prevalence of HP discussions and recommendations to use an NVP; (2) who initiated NVP discussions; (3) the type of HP advice received about NVPs; and (4) smoker's characteristics related to receiving advice about NVPs. Design Cross‐sectional study using multivariable logistic regression analyses on weighted data from the 2016 ITC Four Country Smoking and Vaping Survey (ITC 4CV1). Setting: Four countries with varying regulations governing the sale and marketing of NVPs: 'most restrictive' (Australia), 'restrictive' (Canada) or 'less restrictive' (England and United States). Participants: A total of 6615 adult smokers who reported having visited an HP in the last year (drawn from the total sample of 12 294 4CV1 respondents, of whom 9398 reported smoking cigarettes daily or weekly). Respondents were from the United States (n = 1518), England (n = 2116), Australia (n = 1046), and Canada (n = 1935). Measurements Participants' survey responses indicated if they were current daily or weekly smokers and had visited an HP in the past year. Among those participants, further questions asked participants to report (1) whether NVPs were discussed, (2) who raised the topic, (3) advice received on use of NVPs and (4) advice received on quitting smoking. Findings Among the 6615 smokers who visited an HP in the last year, 6.8% reported discussing NVPs with an HP and 2.1% of smokers were encouraged to use an NVP (36.1% of those who had a discussion). Compared with Australia (4.3%), discussing NVPs with an HP was more likely in the United States [8.8%, odds ratio (OR) = 2.15, 95% confidence interval (CI) = 1.41–3.29] and Canada (7.8%, OR = 1.87, 95% CI = 1.26–2.78). Smokers in Australia were less likely to discuss NVPs than smokers in England (6.2%), although this was not statistically significant (OR = 1.47, 95% CI = 0.98–2.20). Overall, the prevalence of HPs recommending NVPs was three times more likely in the United States than in Australia (OR = 3.07, 95% CI = 1.45–6.47), and twice as likely in Canada (OR = 2.28, 95% CI = 1.06–4.87) than in Australia. Australia and England did not differ (OR = 1.76, 95% CI = 0.83–3.74). Just over half (54%) of respondents brought up NVPs themselves; there were no significant differences among countries. Conclusions: Discussions in Australia, Canada, England, and the United States between smokers and health professionals about nicotine vaping products appear to be infrequent, regardless of the regulatory environment. A low percentage of health professionals recommended vaping products. This was particularly evident in Australia, which has the most restrictive regulatory environment of the four countries studied. [ABSTRACT FROM AUTHOR]

Copyright of Milbank Quarterly is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims Questions about drinking 'yesterday' have been used to correct under-reporting of typical alcohol consumption in surveys. We use this method to explore patterns of over- and under-reporting of drinking quantity and frequency by population subgroups in four countries. Design Multivariate linear regression analyses comparing estimates of typical quantity and frequency of alcohol consumption with and without adjustments using the yesterday method. Setting and Participants Survey respondents in Australia ( n = 26 648), Canada ( n = 43 371), USA ( n = 7969) and England ( n = 8610). Measurements Estimates of typical drinking quantities and frequencies over the past year plus quantity of alcohol consumed the previous day. Findings Typical frequency was underestimated by less frequent drinkers in each country. For example, after adjustment for design effects and age, Australian males self-reporting drinking 'less than once a month' were estimated to have in fact drunk an average of 14.70 (± 0.59) days in the past year compared with the standard assumption of 6 days ( t = 50.5, P < 0.001). Drinking quantity 'yesterday' was not significantly different overall from self-reported typical quantities during the past year in Canada, the United States and England, but slightly lower in Australia (e.g. 2.66 versus 3.04 drinks, t = 20.4, P < 0.01 for women). Conclusions People who describe themselves as less frequent drinkers appear to under-report their drinking frequency substantially, but country and subgroup-specific corrections can be estimated. Detailed questions using the yesterday method can help correct under-reporting of quantity of drinking. [ABSTRACT FROM AUTHOR]

Context Patient-reported outcomes (PROs) can play an important role in patient-centered health care by focusing on the patient's health goals guiding therapeutic decisions. When aggregated, PROs also can be used for other purposes, including comparative effectiveness research, practice improvement, assessment of the performance of clinicians and organizations, and as a metric for value-based payments. The feasibility of integrating the use of PROs for these various purposes on a wide scale has not yet been demonstrated. Our study was conducted to inform policymakers of prudent next steps for implementing PROs in clinical practice and performance measurement programs in order to maximize their impact on the quality of health care. Methods We conducted a qualitative study, interviewing 58 experts and leaders from 37 organizations (response rate: 88%) in the United States, England, and the Netherlands. Respondents included clinical practitioners ( n = 30), measure developers ( n = 11), and leaders of performance measurement programs ( n = 17). We used a qualitative content analysis to assess current strategies for applying PROs in clinical practice and performance measurement and to identify barriers to and facilitators of further implementation. Findings The use of PROs in clinical practice and for performance measurement has developed both separately and in parallel. Experts across the stakeholder spectrum support the collection of PRO data in an integrated manner that would enable using the data for these distinct purposes. We identified 2 main concerns about the feasibility for integrated use of PRO data: the complexity of establishing routine data collection and the tension among stakeholders when using PRO data for different purposes. These contrasting stakeholder views suggested varying interests among clinicians, measure developers, and purchasers of care. Conclusions Data collection approaches that support the use of PROs in health care are underdeveloped, need better integration with clinical care, and must be tailored to the characteristics of the health care system. Enabling the sustainable use of PROs will require a shared vision of clinical professionals, purchasers, and patients, with a prudent selection of the steps in implementing PROs that will maximize their impact on the quality of health care. [ABSTRACT FROM AUTHOR]