Exploring Assistance in Sweden and the United States

Few international comparisons of health services are performed using microlevel data. Using such data, this paper compares the need for and receipt of assistance with activities of daily living (ADLs) in comparable samples in the United States and Sweden, a country with a universal system of community-based services.Design and Methods: Data from national surveys of community residents completed at approximately the same time in each nation are used to create comparable measures of need and assistance. Descriptive and logistic regression analyses compare need and assistance patterns across the nations and identify individual factors that explain receipt of assistance and unmet needs.Results:Our results indicate that a simple story of greater use of paid formal services in Sweden and more unpaid informal use in the United States masks a more complex relationship. Assistance with ADLs seems to be more targeted in Sweden; narrow differences in assistance widen considerably when the analysis is limited to those reporting need. Implications:Although these two different health systems result in similar levels of overall ADL assistance, a detailed microlevel comparison reveals key distinctions. Further microlevel comparisons of access, cost, and quality in cross-national data can further aid our understanding of the consequences of health policy.

Effective Length K-Factors For Flexural Buckling Strengths Of Web Members In Open Web Steel Joists

Open web steel joists are designed in the United States following the governing specification published by the Steel Joist Institute. For compression members in joists, this specification employs an effective length factor, or K-factor, in confirming their adequacy. In most cases, these K-factors have been conservatively assumed equal to 1.0 for compression web members, regardless of the fact that intuition and limited experimental work indicate that smaller values could be justified. Given that smaller K-factors could result in more economical designs without a loss in safety, the research presented in this thesis aims to suggest procedures for obtaining more rational values. Three different methods for computing in-plane and out-of-plane K-factors are investigated, including (1) a hand calculation method based on the use of alignment charts, (2) computational critical load (eigenvalue) analyses using uniformly distributed loads, and (3) computational analyses using a compressive strain approach. The latter method is novel and allows for computing the individual buckling load of a specific member within a system, such as a joist. Four different joist configurations are investigated, including an 18K3, 28K10, and two variations of a 32LH06. Based on these methods and the very limited number of joists studied, it appears promising that in-plane and out-of-plane K-factors of 0.75 and 0.85, respectively, could be used in computing the flexural buckling strength of web members in routine steel joist design. Recommendations for future work, which include systematically investigating a wider range of joist configurations and connection restraint, are provided.