How do you measure trust in social institutions and health professionals? A systematic review of the literature (2012–2021)

The importance of measuring trust in health systems has been accentuated due to its correlation with important health outcomes aimed at reducing COVID-19 transmission. A systematic review published almost a decade ago identified gaps in measures including the lack of focus on trust in systems, inconsistency regarding the dimensionality of trust and need for research to strengthen the validity of measures. Given developments in our understandings of trust since its publication, we sought to identify new scales developed, existing ones adapted in response to identified gaps, and agendas for future research. Using the PRISMA approach for systematic reviews, we conducted a search in four databases. A total of 26 articles were assessed. Twelve new scales were identified, while 14 were adapted for different settings and populations. Literature continues to focus on measuring trust in health professionals rather than systems. Various shortcomings were identified, including some articles not mentioning the dimensions included in the scale and suboptimal use of validity and reliability testing and/or reporting. Moreover, a variety of terms were used for dimensions. Future research is needed to address these gaps and consequently, to understand their correlation with health behaviors and outcomes more accurately.     

The Maximum Throughput on a Golf Course

We develop stochastic models to help manage the pace of play on a conventional 18‐hole golf course. These models are for group play on each of the standard hole types: par‐3, par‐4, and par‐5. These models include the realistic feature that k−2 groups can be playing at the same time on a par‐k hole, but with precedence constraints. We also consider par‐3 holes with a “wave‐up” rule, which allows two groups to be playing simultaneously. We mathematically determine the maximum possible throughput on each hole under natural conditions. To do so, we analyze the associated fully loaded holes, in which new groups are always available to start when the opportunity arises. We characterize the stationary interval between the times successive groups clear the green on a fully loaded hole, showing how it depends on the stage playing times. The structure of that stationary interval evidently can be exploited to help manage the pace of play. The mean of that stationary interval is the reciprocal of the capacity. The bottleneck holes are the holes with the least capacity. The bottleneck capacity is then the capacity of the golf course as a whole.