Digital Commons Network^™

Misinterpreting Others And The Fragility Of Social Learning, Mira Frick, Ryota Iijima, Yuhta Ishii

Cowles Foundation Discussion Papers

We exhibit a natural environment, social learning among heterogeneous agents, where even slight misperceptions can have a large negative impact on long-run learning outcomes. We consider a population of agents who obtain information about the state of the world both from initial private signals and by observing a random sample of other agents’ actions over time, where agents’ actions depend not only on their beliefs about the state but also on their idiosyncratic types (e.g., tastes or risk attitudes). When agents are correct about the type distribution in the population, they learn the true state in the long run. By …

Accuracy In Reporting Of Kentucky Certified Nurse-Midwives As Attendants In Birth Registration Data, Kendra Marie Chesney Adkisson

Yale School of Nursing Digital Theses

Abstract

Introduction: Birth certificate data is used nationally to determine healthcare policy, allocation of funds, and to demonstrate the legitimacy and value of Certified Nurse-Midwives (CNMs) in maternal and neonatal outcomes. However, the validity of birth certificate data is questionable, in part because of the data collection process. This data is particularly crucial for midwife-attended births as the correct birth attendant is not always accurately identified. The purpose of this project was to examine the number of CNM reported births as compared to the number recorded by the Kentucky office of vital statistics and to look at the process used …

Development And Implementation Of A Simple Wound Care Guideline For Minor Skin Lesions: A Quality Improvement Project, Alexandra Bates

Yale School of Nursing Digital Theses

Purpose: The purpose of this QI project was to use the best available evidence and expert opinion to develop and implement a simple inpatient nursing care guideline for minor skin lesions.

Participants and Setting: This wound care guideline was developed for nurses working on inpatient adult acute care units. The setting was a large community hospital in southwest Minnesota.

Approach: The guideline was validated for its clarity and appropriateness by external and internal expert wound care nurses. It was implemented through in-person unit rounding on the nursing units, distribution of badge cards with the guideline, and a required online education …

Creation Of An Interdisciplinary Evidence-Based Advocacy Tool: Promoting Medicaid Reimbursement For Pasteurized Donor Milk For Very Low Birth Weight Neonates, Christopher Schmaltz

Yale School of Nursing Digital Theses

An interdisciplinary approach to remove cost barriers associated with full utilization of pasteurized donor human milk in the neonatal intensive care unit. This scholarship produced an evidence-based advocacy tool which allows the user to enter state-specific data to demonstrate the fiscal advantages of implementing pasteurized donor human milk reimbursement policies from a Medicaid payor perspective.

The Development Of An Evidence-Based Anti-Emetic Tool For The Management Of Post-Operative Nausea And Vomiting In Patients At High Risk For Qt Prolongation And Patients Taking Neurotransmitter Modulating Medications, Nicole Danielle Mancini Hymel

Yale School of Nursing Digital Theses

Abstract

Peri-operative care providers have a myriad of medication options when developing and implementing a plan for the management of post-operative nausea and vomiting (PONV). However, the provider must be aware of the potential side effects, complications, and interactions of those medications, especially when managing high-risk populations. While a peri-operative antiemetic algorithm exists for the management of PONV in the general population,1 an evidence-based antiemetic tool has not been developed for patient populations at risk for prolonged QT interval or patients who are routinely taking neurotransmitter modulating medications. Safe practice recommendations exist but are scattered throughout the literature. The goal …

Benchmark Policies And The Rationalization Of Cannabis, Ethan Handa

Public Health Theses

The process of creating new policy is frequently dependent on knowledge and study of precedent, which in turn, helps influence future strategy. In the case of legal cannabis state industries, there is much to be learned from policy mistakes made in how other states managed cannabis legalization. As such, these mistakes leave gaps in policy, which pose a threat to the rationality of the legal industry and set poor precedent for future efforts. In turn, the goal of this paper is to identify gaps in cannabis policy and highlight what should be seen as benchmark policy for further industry developments. …

Tb Knowledge And Outcomes In A Routine Care Setting In Kampala, Uganda, Tyler Scott Johnson

Public Health Theses

TB education and counseling (TEC) is universally recommended for individuals initiating treatment for active TB in Uganda. The effectiveness of routine TEC in Kampala and the association between specific knowledge domains and treatment outcomes is unknown. We sought to (1) to evaluate the effectiveness of routine TEC in helping individuals to increase and retain TB-specific knowledge and (2) to examine the association between TB knowledge and treatment outcomes among individuals diagnosed with TB. We enrolled adults (age ≥18) initiating treatment for active TB at Kisenyi Health Centre in Kampala, Uganda into a prospective, observational cohort study. We administered a verbal …

Effect Modification Of Greenness In The Residential Environment On Temperature-Mortality Relationship Among Older Adults In China, Chengcheng Qiu

Public Health Theses

Older adults are highly vulnerable to adverse climate-related impacts, with temperature-related mortality that are likely to vary according to geographic characteristics, vegetation abundance and socioeconomic conditions. We examined how mortality among older adults in China was associated with different temperatures over 14 years (2000-2014), and how geolocation, vegetation abundance in the residential environment and socioeconomic conditions modulate this association. We used case-crossover study design with distributed nonlinear modeling method to estimate heat- and cold-related mortality, and stratified the analysis by the level of vegetation abundance, calculated from light reflectance of remotely sensed imagery, and socioeconomic characteristics including education and residence …

Medical Education And The Stigmatization Of Mental Illness In The Philippines, Candice Mae Taguibao

Public Health Theses

BACKGROUND:

Mental health stigma is a worldwide problem that affects health care providers, as well as the general population. The current study used survey data from students and physicians in the Philippines to examine the association of higher levels of medical education with levels of

stigma. Further, attitudes among medical students in the Philippines were compared with levels among medical students in the US, Brazil, Ghana, Nigeria and China. Qualitative interviews were used to further understand these data.

METHODS:

A convenience sample was collected from medical students before and after medical school psychiatric training from the University of the Philippines …

Intergenerational Effects Of Adverse Birth Outcomes Of Parents And Offspring Autism Spectrum Disorder (Asd) Risk In Denmark: A Population-Based Cohort Study, Jingyuan Xiao

Public Health Theses

Abstract

Introduction: Animal studies have suggested that exposure-induced epigenetic reprogramming of the germlines affects neurodevelopmental outcomes in the next generation, but possible transgenerational effects of parental adverse birth outcomes and offspring autism spectrum disorder (ASD) risk have not been studied in humans.

Objective: To evaluate whether parents being born preterm or low birth weight were associated with risks for ASD in their offspring.

Methods: We conducted a Danish population-based cohort study including mothers and fathers born since 1978 who also have had an offspring registered in Denmark during 1990-2013. Information on gestational age and birth weight were recorded in the …

Persistence Of Ebola Virus In Survivors & Risks Of Sexual Transmission: A Systematic Review, Allison Cheung

Public Health Theses

Background: Longitudinal cohort studies of Ebola virus disease (EVD) survivors from the 2014-2016 West African outbreak have found evidence of Ebola virus (EBOV) and EBOV RNA persistence in the bodily fluids of survivors, particularly in semen. This new evidence has raised the possibility of sexual transmission of EBOV by EVD survivors. The current interim guidance issued by the World Health Organization (WHO) recommends safer sex practices for at least 12 months after acute disease onset (ADO). However, based on new evidence, these recommendations may require revision.

Objective: The main aim of this article is to present and evaluate evidence on …

Estimating Mortality After Natural Disasters In Low- And Middle-Income Countries: A Systematic Review, Joseph Clingerman

Public Health Theses

Background

The outcomes of natural disasters produce many complex uncertainties and statistics, many of which have no metrics to assess how accurate they are. In particular, mortality estimates in low- and middle-income countries encompass many variables in their inherently challenging physical, political, and logistical landscapes. Given that there has been no known systematic review of assessing mortality estimation methodologies, the author aimed to provide a systematic review of known methodologies and provide a framework to assess mortality estimation methodologies.

Methods

The author performed a systematic search of electronic databases from the past two decades up to January 2019. In addition, …

Using Host Response For Respiratory Virus Discovery And Surveillance, Amelia Erin Hanron

Public Health Theses

INTRODUCTION: In 2015 lower respiratory infections (LRI) were the fifth leading cause of

death and the leading cause of death for children under five years old. Despite increasing advances in viral detection technology, etiology is never established for a large portion of viral respiratory infections. The most recent of such advancements- next-generation sequencing (NGS)- has greatly improved the ability to discover and/or identify rare or novel viruses. However, NGS platforms are still not feasible in a clinical laboratory due to cost, complexity, personnel, etc. The ability to screen for unknown viruses using technology that is already present in most clinical …

Nonmydriatic Fundus Photography In A High-Risk Population Of Samoans With Diabetes: The Soifua Manuia Eye Screening Program, Lauren Carmela Lamonica

Public Health Theses

IMPORTANCE Novel methods of detecting eye disease are needed due to the challenges associated with service delivery in resource-limited settings.

BACKGROUND The objective of this study is to determine whether clinically gradable fundus images can be obtained using a low-cost, handheld non-mydriatic fundus camera by a non-ophthalmic provider in a remote setting.

DESIGN Cross-sectional study

PARTICIPANTS Two-hundred and six individuals (412 eyes) in the Pacific Island nation of Samoa with pre-diabetes and diabetes (HbA1c ≥5.7% or FBG ≥110 mg/dl).

METHODS Participants underwent non-mydriatic fundus photography with the PanOptic iExaminer System, along with an assessment of near vision, medical, and ophthalmic …

Older Adult Spouses’ Emotional Responses To Reminiscing About Their First Encounter: Associations With Mental Health, Marital Satisfaction, And Cardiovascular Reactivity, Hanzhen Lan

Public Health Theses

Objectives: While there has been growing interest in how close relationships affect older adults’ health, not much research has examined how emotional experiences in older married couples’ positive interactions relate to individual and relational well-being and physical health. The present study hypothesizes that positive emotional responses to older couples reminiscing about first encounter are associated with each spouse’s higher marital satisfaction, fewer depressive symptoms, and healthier cardiovascular reactivity (blood pressure and heart rate variability).

Method: One hundred and one couples completed a background questionnaire at home and then participated in a laboratory session in which they discussed how they first …

Quantifying The Burden Of Contact Precautions Of Carbapenem-Resistant Enterobacteriaceae (Cre) In Hospital Settings, Carolyn Park

Public Health Theses

Carbapenem-resistant Enterobacteriaceae (CRE) are a group of multi-drug resistant organisms (MDROs) that is currently considered an important and urgent public health concern due to their high mortality rates, antibiotic resistance, and their potential for rapid transmission. These pathogens are more commonly seen in healthcare-associated infections with some also occurring in the community. This study focused on distinguishing CRE into two distinct groups based on resistance mechanism: carbapenemase-producing CRE (CP-CRE) and non-CP-CRE. In order to determine if testing for carbapenemase can be useful in infection prevention, we aimed to quantify the total hospitalization in days per patient within a 90-day follow-up …

Randomized Trial Of Weight Loss On Ghrelin Levels Among Breast Cancer Survivors, Leah Puklin

Public Health Theses

Purpose: Obesity is associated with increased breast cancer risk and mortality. Ghrelin is a hormone that participates in a negative feedback loop to regulate body weight. Understanding the impact of an individualized, sustainable, dietary and exercise weight-loss intervention on circulating ghrelin levels could provide insight on weight control mechanisms among overweight and obese breast cancer survivors.

Methods: The Lifestyle, Exercise, and Nutrition (LEAN) randomized controlled trial was a 6-month weight loss trial conducted to examine the effect of a weight loss intervention versus usual care on outcomes in 151 breast cancer survivors with BMI ≥ 25 kg/m2. Fasting blood samples …

Associations Between Mindful Eating Techniques And Gestational Weight Gain, Yuqing Shang

Public Health Theses

Abstract

Objective: To investigate the extent to which the use of mindful eating techniques is associated with gestational weight gain among a clinic-based sample of pregnant women.

Methods: Four hundred and forty-eight pregnant women in their second trimester of pregnancy participated in the Expect With Me group care study and were selected for this secondary analysis. Sociodemographic and general health data was collected at baseline. Mindfulness practice was measured based on frequency of performing mindful thinking and mindful eating techniques in the third trimester. The main outcome was excessive average weekly gestational weight gain, which was determined using the guidelines …

Exploring Pharmaceutical Waste Prevention And Disposal Practices In Nurse Populations, Natasha Wasim

Public Health Theses

Objective: This research study aimed to explore pharmaceutical waste prevention and disposal practices in nurse populations.

Methods: A descriptive, cross-sectional survey was employed through the Qualtrics survey system. The survey questions were designed to probe knowledge, behavior, and attitudes of nurses towards pharmaceutical waste. Participants included intensive care unit nurses

and perioperative nurses in the Yale New Haven Health System.

Results: A total of 104 surveys were collected. Nurses were asked about the importance of proper waste disposal, and 95.2% of nurses (N=99/104) believed that appropriate waste disposal is important to “protect the environment health.” The survey also asked about …

Using Volatile Organic Compounds In Exhaled Breath As A Biomarker For Early Lung Cancer Detection: A Systematic Review, Jieqiong Zhou

Public Health Theses

Lung cancer has become the most commonly diagnosed cancer and the leading cause of cancer deaths globally. The major problem of the high mortality rate is the late diagnosis. Conventional methods utilized for clinical detection of lung cancer have employed expensive and invasive medical procedures that cause stress, discomfort, and pain to patients, and have demonstrated low sensitivity, substantial false negatives, and risk of radiation exposure. The drawbacks obviate their applicability to large-scale, population-wide screening efforts. This paper reviews the applications of using volatile organic compounds (VOCs) in exhaled breath as a potential approach for early lung cancer detection.

An …

A Resolution In The Spanish Banking Sector: The Case Of Banco Popular Espanol, Magdalena Kozińska

Documents

No abstract provided.

O Tell Me The Truth About Bail-In: Theory And Practice, Marco Ventoruzzo, Giulio Sandrelli

Documents

No abstract provided.

Counterfactuals With Latent Information, Dirk Bergemann, Benjamin Brooks, Stephen Morris

Cowles Foundation Discussion Papers

We describe a methodology for making counterfactual predictions in settings where the information held by strategic agents and the distribution of payoff-relevant states of the world are unknown. The analyst observes behavior assumed to be rationalized by a Bayesian model, in which agents maximize expected utility, given partial and differential information about the state. A counterfactual prediction is desired about behavior in another strategic setting, under the hypothesis that the distribution of the state and agents’ information about the state are held fixed. When the data and the desired counterfactual prediction pertain to environments with finitely many states, players, and …

Freddie Mac Form 10-K 2018, Federal Home Loan Mortgage Corporation (Freddie Mac)

Documents

No abstract provided.

China's Monetary Policy Framework—Supporting The Real Economy And Striking A Balance Between Internal And External Equilibrium, Yi Gang

Documents

No abstract provided.

Audit Of The Exchange Stabilization Fund's Financial Statements For The Fiscal Years 2018 And 2017, United States: Department Of The Treasury: Office Of The Inspector General

Documents

No abstract provided.

Har Testing For Spurious Regression In Trend, Peter C.B. Phillips, Yonghui Zhang, Xiaohu Wang

Cowles Foundation Discussion Papers

The usual t test, the t test based on heteroskedasticity and autocorrelation consistent (HAC) covariance matrix estimators, and the heteroskedasticity and autocorrelation robust (HAR) test are three statistics that are widely used in applied econometric work. The use of these significance tests in trend regression is of particular interest given the potential for spurious relationships in trend formulations. Following a longstanding tradition in the spurious regression literature, this paper investigates the asymptotic and finite sample properties of these test statistics in several spurious regression contexts, including regression of stochastic trends on time polynomials and regressions among independent random walks. Concordant …

Efficient Counterfactual Learning From Bandit Feedback, Yusuke Narita, Shota Yasui, Kohei Yata

Cowles Foundation Discussion Papers

What is the most statistically efficient way to do off-policy optimization with batch data from bandit feedback? For log data generated by contextual bandit algorithms, we consider offline estimators for the expected reward from a counterfactual policy. Our estimators are shown to have lowest variance in a wide class of estimators, achieving variance reduction relative to standard estimators. We then apply our estimators to improve advertisement design by a major advertisement company. Consistent with the theoretical result, our estimators allow us to improve on the existing bandit algorithm with more statistical confidence compared to a state-of-theart benchmark.

Dynamic Panel Modeling Of Climate Change, Peter C.B. Phillips

Cowles Foundation Discussion Papers

We discuss some conceptual and practical issues that arise from the presence of global energy balance effects on station level adjustment mechanisms in dynamic panel regressions with climate data. The paper provides asymptotic analyses, observational data computations, and Monte Carlo simulations to assess the use of various estimation methodologies, including standard dynamic panel regression and cointegration techniques that have been used in earlier research. The findings reveal massive bias in system GMM estimation of the dynamic panel regression parameters, which arise from fixed effect heterogeneity across individual station level observations. Difference GMM and Within Group (WG) estimation have little bias …

Sensitivity Analysis Using Approximate Moment Condition Models, Timothy B. Armstrong, Michal Kolesár

Cowles Foundation Discussion Papers

We consider inference in models defined by approximate moment conditions. We show that near-optimal confidence intervals (CIs) can be formed by taking a generalized method of moments (GMM) estimator, and adding and subtracting the standard error times a critical value that takes into account the potential bias from misspecification of the moment conditions. In order to optimize performance under potential misspecification, the weighting matrix for this GMM estimator takes into account this potential bias, and therefore differs from the one that is optimal under correct specification. To formally show the near-optimality of these CIs, we develop asymptotic efficiency bounds for …