Digital Commons Network^™

Willingness-To-Pay For Services Provided By The Clinical Services Improvement Project (Csi) In Egypt, John H. Bratt, Nahla G. Abdel-Tawab, Magdi A. Ibrahim, Mohammed Edress

Reproductive Health

Willingness-to-pay (WTP) surveys are increasingly used in reproductive health programs to predict the impact of price changes on revenues, utilization, and client profile. The FRONTIERS program worked with the Clinical Services Improvement (CSI) project and the Cairo Demographic Center to carry out a WTP survey in six CSI clinics in Egypt. The survey found that most clients would be willing to pay higher prices for CSI services, and WTP did not vary much by client economic status. However, predictive validity was low when all reasons for client discontinuation were included. WTP surveys have the potential to be useful tools for …

Improving Access To Long-Term Contraceptives In Rural Guatemala Through The Ministry Of Health, Edwin Montufar, Carlos Morales, Ricardo Vernon, Carlos Brambila, Jorge Solorzano

Reproductive Health

The purpose of this study was to test a model to train nurse auxiliaries at health centers and posts in Guatemala and to determine whether these providers could deliver adequate, cost-effective services. The training model consisted of: a) selection of nurse auxiliaries; b) two-day group training; c) on-the-job training, including work with actual clients at the trainees’ work centers; and d) certification of trainees who had conducted at least five quality insertions under supervision. This study has shown that nonprofessional health providers can effectively provide quality IUD services in Guatemala. The main recommendation derived from the project is to scale …

Expanding Access To Vasectomy Services In The Ministry Of Health Of Guatemala, Blanca De Rodriguez, Ricardo Vernon, Jorge Solorzano

Reproductive Health

This project tested the effectiveness of a systemic model for introducing vasectomy in service delivery units of the Guatemalan Ministry of Health (MOH), which has four basic components: a) the self-selection of health units according to their response to an invitation to participate in the project; b) the development of a counseling and information model for potential clients; c) training and sensitizing of health teams; and d) on-site training of surgeons. The report concludes that the introduction model for vasectomy in the MOH centers was successful. A high proportion of hospitals that identified vasectomy candidates finished the process, and the …

Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley

Reproductive Health

The Maternal, Child and Women’s Health Unit, in collaboration with the Population Council’s FRONTIERS in Reproductive Health (FRONTIERS) program, the Reproductive Health Research Unit of the University of Witwatersrand, and the Department of Medical Microbiology and Infectious Diseases of the Nelson Mandela School of Medicine, University of Natal, developed and then pilot-tested this revised model in KwaZulu-Natal, South Africa. The project’s objective was to develop and test an improved and integrated antenatal care program for public-sector clinics that would increase the range and quality of services received by pregnant women and improve their reproductive health behavior and status. Various problems, …

Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr

Reproductive Health

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the …

Analysis Of The Impact Of A Social Norms Campaign On The Alcohol Use Of Undergraduate Students At A Public, Urban University, Amanda B. Wattenmaker

Theses and Dissertations

Purpose: To conduct a secondary analysis of survey data collected at a large, urban university assessing for change in students' alcohol use perceptions and behaviors between 2002 and 2004. After the baseline data collection in 2002, the campus launched an intensive media intervention to normalize low-risk drinking. Simultaneously, the campus shifted from being a primarily commuter to primarily residential. Methods: This cross-sectional analysis used data collected from students in randomly selected undergraduate classes in February 2002 (n= 662) and 2004 (n=1334). The survey instrument used was the National College Health Assessment. Variables were categorized as demographic, alcohol perception, and alcohol …

Importance De L’Organisation Du Travail Comme Soutien Aux Stratégies Protectrices Des Auxiliaires Familiales Et Sociales Afs Et Des Infirmières Des Services De Soins Et De Maintien À Domicile. Annexe 1 : Rapport De L'Étude Du Clsc 1, Esther Cloutier, Élise Ledoux, François Ouellet, Madeleine Bourdouxhe, Isabelle Gagnon, Hélène David, Catherine Teiger

Rapports de recherche scientifique

No abstract provided.

Hearing Sensitivity Among Anniston Army Depot Workers., Melissa W. Norman

All ETDs from UAB

No abstract provided.

The Relative Risk Of Mortality Associated With The 10th Percentile Of Birth Weight For Gestational Age Among Singleton Infants Born To United States Resident Mothers, 1995-1999., Sheree L. Boulet

All ETDs from UAB

No abstract provided.

Population Variables And Self-Reported Barriers That Influence Receipt Of Dental Care By Arizona's Children., Carol H. Danielson

All ETDs from UAB

No abstract provided.

The Incidence And Prevalance Of Cervical Cancer In Vietnamese Women (1993-1995): A Analysis Of Seer Reported Cases, Thuy Do

Theses and Dissertations

Background: Cervical cancer is the third most common reproductive cancer in the U.S. To date, one report concluded that U.S. Vietnamese women had the highest incidence rate (43.0/100,000). The current study examines whether U.S. Vietnamese women are more likely to have cervical cancer in comparison to Whites, Blacks, Hispanics, American Indians, and other Asian subgroups. Methods: SEER data of cervical cancers diagnosed from 1993-1995 (n = 37,790) was utilized. Using SPSS, chi-square statistics assessed whether Vietnamese women were older and more likely to be married or diagnosed at a later stage. Logistic regression assessed the amount of risk race/ethnicity contributes …

Mandated Healthcare Will It Work?, Anna Vira

Seton Hall University Dissertations and Theses (ETDs)

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Healthcare Practitioners' Perspectives On The Use Of E-Health Applications To Support Overweight And Obese Adolescents, Rachel J. Mahncke

Theses : Honours

The aim of this research was to investigate, from an Australian healthcare practitioners' perspective, whether online and e-health applications could provide support for and be beneficial to overweight and obese adolescents. This research has investigated whether diet and exercise related environmental causes of obesity could be positively affected by using e-health applications to re-educate adolescents about healthy eating and exercise behaviours the research identified what online and electronic resources healthcare practitioners' recommended to their patients, in order to understand how information systems· solutions could better assist these patients in achieving healthier lifestyle outcomes. Additionally, the research investigated what content, features …

The Effectiveness Of Back Belts As A Control Measure For Occupational Low Back Pain In A Retail Hardware Chain, Nick Merdith

Theses: Doctorates and Masters

The objective of this study was to examine the effect of the mandatory introduction of back belts on the incidence, days lost and cost of occupational low back injuries resulting from manual handling in 11 retail hardware chain. The study was of a non-experimental before-and-after design with all retail employees in Western Australia being included in a retrospective cohort. The pre-intervention period extended for 21 months and included 2,265,933 work hours with 647 full-time equivalent positions, while the intervention period was 32 months for 4,411,352 hours worked and 827 full-time equivalent positions. Workers' compensation claims for all occupational injuries occurring …

Changes In Beliefs Identify Unblinding In Randomized Controlled Trials: A Method To Meet Consort Guidelines, Judy R. Rees, Timothy J. Wade, Deborah A. Levy, John M. Colford, Joan F. Hilton

Journal Articles: Epidemiology

Double-blinded trials are often considered the gold standard for research, but significant bias may result from unblinding of participants and investigators. Although the CONSORT guidelines discuss the importance of reporting "evidence that blinding was successful", it is unclear what constitutes appropriate evidence. Among studies reporting methods to evaluate blinding effectiveness, many have compared groups with respect to the proportions correctly identifying their intervention at the end of the trial. Instead, we reasoned that participants' beliefs, and not their correctness, are more directly associated with potential bias, especially in relation to self-reported health outcomes. During the Water Evaluation Trial performed in …

Obesity And The Struggle Within Ourselves, Maxwell Gregg Bloche

Georgetown Law Faculty Publications and Other Works

The author argues that we ought to treat our eating, exercise habits, and girth as personal matters, for the most part, but that law can and should make a contribution, as an ally of our longer-term will against our immediate cravings. Law can be our ally in this fashion without command-and-control intrusion into our private lives. Such intrusion is at odds with our core beliefs and unlikely to produce public health success. It is more likely to provoke popular backlash--one reason why some who stand to gain from our unhealthy dining choices try to cast government efforts to inform these …

The Search For An Effective International Regime For The Long-Term Safety And Security Of High Level Radioactive Waste: Pangea And Beyond, Vincent Cusack

Theses: Doctorates and Masters

This thesis is a study of public policy issues relating to multinational geological repositories for high-level radioactive waste disposal (HLW). Nuclear states have attempted for decades to implement effective radioactive waste policies, though with limited success. The safe disposal of HLW has proven particularly troublesome and, thus far, a solution has eluded all states. A review of radioactive waste policy in the UK, the US and Switzerland reveals some of the underlying themes behind community opposition to repository siting and the reasons for a broader global search. The failure to achieve HLW repositories at a national level has led to …

Ranking Usrds Provider-Specific Smrs From 1998-2001, Rongheng Lin, Thomas A. Louis, Susan M. Paddock, Greg Ridgeway

Johns Hopkins University, Dept. of Biostatistics Working Papers

Provider profiling (ranking, "league tables") is prevalent in health services research. Similarly, comparing educational institutions and identifying differentially expressed genes depend on ranking. Effective ranking procedures must be structured by a hierarchical (Bayesian) model and guided by a ranking-specific loss function, however even optimal methods can perform poorly and estimates must be accompanied by uncertainty assessments. We use the 1998-2001 Standardized Mortality Ratio (SMR) data from United States Renal Data System (USRDS) as a platform to identify issues and approaches. Our analyses extend Liu et al. (2004) by combining evidence over multiple years via an AR(1) model; by considering estimates …

Referent Selection Strategies In Case-Crossover Analyses Of Air Pollution Exposure Data: Implications For Bias, Holly Janes, Lianne Sheppard, Thomas Lumley

UW Biostatistics Working Paper Series

The case-crossover design has been widely used to study the association between short term air pollution exposure and the risk of an acute adverse health event. The design uses cases only, and, for each individual, compares exposure just prior to the event with exposure at other control, or “referent” times. By making within-subject comparisons, time invariant confounders are controlled by design. Even more important in the air pollution setting is that, by matching referents to the index time, time varying confounders can also be controlled by design. Yet, the referent selection strategy is important for reasons other than control of …

Semi-Parametric Single-Index Two-Part Regression Models, Xiao-Hua Zhou, Hua Liang

UW Biostatistics Working Paper Series

In this paper, we proposed a semi-parametric single-index two-part regression model to weaken assumptions in parametric regression methods that were frequently used in the analysis of skewed data with additional zero values. The estimation procedure for the parameters of interest in the model was easily implemented. The proposed estimators were shown to be consistent and asymptotically normal. Through a simulation study, we showed that the proposed estimators have reasonable finite-sample performance. We illustrated the application of the proposed method in one real study on the analysis of health care costs.

A Bjs Statistical Profile, 1992-2002: American Indians And Crime, Steven W. Perry

United States Public Health Resources

This report represents a compilation and new analysis of data on the incidents, prevalence, and consequences of violent crime among American Indians. The report uses data from a wide variety of sources, including statistical series maintained by the Bureau of Justice Statistics (BJS), the Federal Bureau of Investigation (FBI), the Bureau of Prisons (BOP), and the U.S. Census Bureau.
The findings reveal a disturbing picture of the victimization of American Indians and Alaska Natives. The rate of violent crime estimated from self reported victimizations for American Indians is well above that of other U.S. racial or ethnic groups and is …

Evaluation Of The Biological Sampling Kit (Biskit) For Large-Area Surface Sampling, Mark P. Buttner, Patrica Cruz, Linda Stetzenbach, Amy Klima-Comba

Environmental & Global Health Faculty Research

Current surface sampling methods for microbial contaminants are designed to sample small areas and utilize culture analysis. The total number of microbes recovered is low because a small area is sampled, making detection of a potential pathogen more difficult. Furthermore, sampling of small areas requires a greater number of samples to be collected, which delays the reporting of results, taxes laboratory resources and staffing, and increases analysis costs. A new biological surface sampling method, the Biological Sampling Kit (BiSKit), designed to sample large areas and to be compatible with testing with a variety of technologies, including PCR and immunoassay, was …

Live Smoke Free Or Die: The Battle For Smoke Free Restaurants In New Hampshire, Jody Hodgdon

The University of New Hampshire Law Review

[Excerpt] "The need for a strict statutory scheme prohibiting or effectively segregating tobacco smoke in restaurants and public buildings in New Hampshire is compelling. One evening, during the summer of 2003, I took my wife and daughter to a restaurant in New Hampshire for dinner. When the time came to be seated, the waiter asked if we preferred to be seated in the smoking or non-smoking section. At our request, he led us to the non- smoking section. Over the course of dinner, I considered the irony of why the restaurant even had a non-smoking section. Smoke was coming over …

Diagnosing Crohn's Disease: An Economic Analysis Comparing Wireless Capsule Endoscopy With Traditional Diagnostic Procedures, Neil I. Goldfarb, Laura T. Pizzi, Joseph P. Fuhr Jr., Christopher Salvador, Vanja Sikirica, Asher Kornbluth, Blair Lewis

College of Population Health Faculty Papers

The purpose of this study was to review economic considerations related to establishing a diagnosis of Crohn's disease, and to compare the costs of a diagnostic algorithm incorporating wireless capsule endoscopy (WCE) with the current algorithm for diagnosing Crohn's disease suspected in the small bowel. Published literature, clinical trial data on WCE in comparison to other diagnostic tools, and input from clinical experts were used as data sources for (1) identifying contributors to the costs of diagnosing Crohn's disease; (2) exploring where WCE should be placed within the diagnostic algorithm for Crohn's; and (3) constructing decision tree models with sensitivity …

38 Year-Old Construction Laborer Dies When Trench Walls Collapse, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On November 3, 2003, a 38-year-old male construction laborer died when the unprotected 8-foot high walls of the trench he was working in collapsed. The decedent was working for a subcontractor who was contracted by a construction company to remove old gas, storm and sanitary sewer lines and install similar new lines. The old abandoned 6-inch diameter gas line was a high pressure, 300 – 320 psi gas line in 10-inch steel casing and was 600 feet long. There were five employees at the job site employed by the subcontractor; a foreman who was a certified competent person, a lab …

Licensed Electrician Dies When Electrocuted By 480volts, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

On July 4, 2003, a 36-year-old male lead electrician died after being electrocuted with 480 volts of electricity. A crew of five licensed electricians were working at an automotive supply manufacturing facility running wires to connect service for two air conditioning units (3-phase; 480 volts; 30 amp and 35 amp) and service for a lighting panel (3-phase; 277/480 volts and 200 amps). The manufacturing facility had been shut down for the holiday, and besides a facilities office worker in the facilities main office, the five men were the only workers at the site and had complete control of the facility …

Data Adaptive Estimation Of The Treatment Specific Mean, Yue Wang, Oliver Bembom, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

An important problem in epidemiology and medical research is the estimation of the causal effect of a treatment action at a single point in time on the mean of an outcome, possibly within strata of the target population defined by a subset of the baseline covariates. Current approaches to this problem are based on marginal structural models, i.e., parametric models for the marginal distribution of counterfactural outcomes as a function of treatment and effect modifiers. The various estimators developed in this context furthermore each depend on a high-dimensional nuisance parameter whose estimation currently also relies on parametric models. Since misspecification …

Workers Crushed By Vehicles, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To prevent motor vehicle repair injuries:

• Ensure that vehicles are positively restrained from moving with chocks.
• Do not place jack stands under potential moving vehicle parts.
• The space under a jack-suspended vehicle should not be entered unless suitable vehicle support stands are utilized.

Assessment Of A Body Composition-Focused Approach To Obesity Treatment, Beverly D. Hall

Loma Linda University Electronic Theses, Dissertations & Projects

Obesity is a significant United States’ public health concern. However, high relapse rates continue to be a problem for obesity treatment programs while the focus remains on weight loss, not body composition change. This study examined whether a clinic-based obesity treatment program, focused on body composition change through resistance training, lead to improved body composition, exercise behaviors, and attitude change from focus on weight loss to body composition change. Improvements in self efficacy, outcome expectations and stages of change were also examined. Forty-eight physician-referred overweight or obese adult women (mean body fat 41%, SD = 6.65%), completed assessments and questionnaires …

Lower Extremity Muscle Strength And Risk Of Self-Reported Hip Or Knee Osteoarthritis, Jennifer M. Hootman, Shannon J. Fitzgerald, Carol A. Macera, Steven N. Blair

Faculty Publications

Purpose: The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).

Methods: Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results: Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip …