Open Access. Powered by Scholars. Published by Universities.®

Social and Behavioral Sciences Commons™

Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences

Institution
Keyword
Publication Year
Publication
Publication Type
File Type

Articles 23521 - 23550 of 33778

Full-Text Articles in Social and Behavioral Sciences

The Santa Clara Strength Of Religious Faith Questionnaire (Scsorf): A Validation Study On Iranian Muslim Patients Undergoing Dialysis, Amir H. Pakpour, Thomas G. Plante, Mohsen Saffari, Bengt Fridlund Dec 2014

The Santa Clara Strength Of Religious Faith Questionnaire (Scsorf): A Validation Study On Iranian Muslim Patients Undergoing Dialysis, Amir H. Pakpour, Thomas G. Plante, Mohsen Saffari, Bengt Fridlund

Psychology

The Santa Clara Strength of Religious Faith Questionnaire (SCSORF) is an often used and validated scale that is uncommonly utilized in culturally diverse populations. The purpose of this research investigation was to adapt the SCSORF for use among Iranian Muslim patients undergoing dialysis and to examine the reliability and validity of the scale among this population. A total of 428 patients (228 females, 200 males, M age = 52.2 years, SD = 10) were selected from five dialysis center in Tehran and Qazvin, Iran. A comprehensive forward–backward translation system was used for cross-cultural translation. Patients completed a baseline questionnaire obtaining …


Women's Health And Abortion Culture In China: Policy, Perception And Practice , Naomi Bouchard Dec 2014

Women's Health And Abortion Culture In China: Policy, Perception And Practice , Naomi Bouchard

Independent Study Project (ISP) Collection

Since China’s implementation of the Family Planning Policy in 1973, much research has been dedicated to analyzing the effects of a policy that strictly controls the reproductive lives of a population now comprisedof 1.35 billion people. Analyses focus on the rise of abortions in China, now at an annual rate of at least 13 million, but offer little insight into the perceptions of the population in regard to China’s new abortion culture. This study aims to shed light on current perceptions through a range of in-person, qualitative interviews conducted in Kunming, China. The study is limited to a sample size …


Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin Dec 2014

Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin

Independent Study Project (ISP) Collection

Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …


La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins Dec 2014

La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins

Independent Study Project (ISP) Collection

Background: In Argentina, abortion is illegal under all circumstances except for when a woman has been raped, has a mental disability or her life is in danger. There are approximately 500,000 abortions practiced each year in Argentina, and the majority is performed in an unsafe manner, which can result in complications that require medical attention. In 2010, over 50,000 women were hospitalized because of complications post-abortion. These complications can include hemorrhages, infections, or other toxic illnesses. After the International Conference on Population and Development in 1994 they identified post-abortion care as a worldwide problem. Subsequently, Argentina created a guide for …


Notes From The Director, The Mcnair Team Dec 2014

Notes From The Director, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.


Utilizing Landsat Tm And Oli In Predicting Oncomelania Hupensis Habitats Around Poyang Lake Before And After Three Gorges Dam Completion, Stephanie L. Mccracken Dec 2014

Utilizing Landsat Tm And Oli In Predicting Oncomelania Hupensis Habitats Around Poyang Lake Before And After Three Gorges Dam Completion, Stephanie L. Mccracken

Honors Theses

Schistosomiasis is a parasitic disease caused by the Schistomsoma japonicum flatworm that utilizes the Oncomelania hupensis snail as an intermediate agent. In the People’s Republic of China, these amphibious snails contaminate freshwater systems infecting humans, bovines, and other mammals and have caused significant morbidity for over two thousand years (Wertheim, et al. 2012; Zhang, et al. 2012.) The gravity of this disease prompted the national government to initiate sizable public health programs, such as the World Bank Loan Project (WBLP.) In spite of WBLP's achievements, in 2004, after this program ended, a national survey acknowledged a resurgence of schistosomiasis in …


Ethnic And Language Matching: Effects On Hispanics' Treatment Perceptions, Carlos Adrian Ojeda Cedeno Dec 2014

Ethnic And Language Matching: Effects On Hispanics' Treatment Perceptions, Carlos Adrian Ojeda Cedeno

Graduate Theses and Dissertations

Cultural adaptations to mental health treatment have been recommended to improve treatment outcomes in minorities, including Hispanics (Griner & Smith, 2006). One such adaptation includes matching the therapist to the client on culturally salient variables, such as spoken language or ethnic background. Yet, most investigations about the efficacy of matching have been correlational or have not examined language and ethnic match together (Cabassa, 2007). I investigated the effects of both ethnic and language matching on Hispanics' perceptions of psychological treatment. Participants were 100 Hispanic adults (36 men) randomly assigned to one of four conditions. In each condition, participants read a …


Acanthamoeba Spp. As Reservoirs For Transmission Of Norovirus, Tun-Yun Hsueh Dec 2014

Acanthamoeba Spp. As Reservoirs For Transmission Of Norovirus, Tun-Yun Hsueh

Graduate Theses and Dissertations

Human noroviruses (HuNoV) are the most common cause of foodborne disease outbreaks in the United States and the most common food commodities implicated in HuNoV outbreaks are leafy greens; however, the vehicle of transmission and point of contamination are often unknown. Here, we hypothesize that common free-living amoebae (FLA) ubiquitous in the environment may act as reservoirs of HuNoV and facilitate the transmission of these pathogens to fresh produce. The objective of this research was to first evaluate the interaction/association between HuNoV surrogates and Acanthamoeba by incubating them together and analyzing virus titer associated with amoeba through an 8 day …


A Wellness Profile Of Student-Veterans At 4-Year Higher Education Institutions: The Role Of Gender, Combat Tours, And Deployment, William Monroe Heath Dec 2014

A Wellness Profile Of Student-Veterans At 4-Year Higher Education Institutions: The Role Of Gender, Combat Tours, And Deployment, William Monroe Heath

Graduate Theses and Dissertations

Afghanistan and Iraq war student-veterans have increased in population on college campuses in the United States (U.S.) as a result of using the Post 9/11 GI Bill. Healthy Campus 2020 (American College Health Association, 2012) highlighted the importance of college student wellbeing, health promotion and disease prevention, while the U.S. Department of Veteran Affairs has called for an approach to services that is strength based (United States Department of Veteran Affairs, 2008). To date, however, wellness studies conducted on Iraq and Afghanistan student-veterans using an evidenced-based model of holistic wellness have not been conducted. This study was designed to address …


Alcohol And Drug Use Amongst College Students In Relation To Sexual Abuse, Christyn Hollingsworth Dec 2014

Alcohol And Drug Use Amongst College Students In Relation To Sexual Abuse, Christyn Hollingsworth

Honors College Theses

The impact of child sexual abuse (CSA) and traumatic sexual experiences has been the subject of multiple studies in which harm was found. Among these harms are emotional distress, psychological issues, and substance abuse. This research analyzed and compared the responses to questions pertaining to substance use and attitudes regarding sexual interactions between college aged students with and without a history of sexual abuse. The participant’s answers were run through an ANOVA to determine statistical variance. Based on prior research, it was expected that victims consume alcohol and use drugs more frequently than non-victims in significant amounts. The findings in …


Research: South Dakota State University, Winter 2014, Christie Delfanian, Eric Landwehr Dec 2014

Research: South Dakota State University, Winter 2014, Christie Delfanian, Eric Landwehr

State of Discovery South Dakota State University's Research Magazine

CONTENTS:

Weeds influence gene expression, growth in corn [Page] 2
Graduate research targets childhood obesity [Page] 3
Transmammary drug delivery system for early-stage breast cancer may reduce side effects [Page] 5
Biochemical pathways may be key to scab resistance [Page] 7
New filtration system saves water, money for City of Sioux Falls [Page] 8
Doulas ease stress, increase satisfaction with the birthing experience [Page] 9
Structure lab evaluates strength, durability of structural components [Page] 10
Device gives sunflower producers reprieve from combine fires [Page] 12
Graduate scholarship winner works on renewable energy storage [Page] 12


Message From The Vice President For Research, The Mcnair Team Dec 2014

Message From The Vice President For Research, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.


Scholarships Awarded To Mcnair Scholars, The Mcnair Team Dec 2014

Scholarships Awarded To Mcnair Scholars, The Mcnair Team

McNair Scholars Research Journal

No abstract provided.


Impact Of An Interprofessional Communication Course On Nursing, Medical, And Pharmacy Students’ Communication Skill Self-Efficacy Beliefs, Nicholas E. Hagemeier, Rick Hess, Kyle S. Hagen, Emily L. Sorah Dec 2014

Impact Of An Interprofessional Communication Course On Nursing, Medical, And Pharmacy Students’ Communication Skill Self-Efficacy Beliefs, Nicholas E. Hagemeier, Rick Hess, Kyle S. Hagen, Emily L. Sorah

ETSU Faculty Works

Objective. To describe an interprofessional communication course in an academic health sciences center and to evaluate and compare interpersonal and interprofessional communication self-efficacy beliefs of medical, nursing, and pharmacy students before and after course participation, using Bandura’s self-efficacy theory as a guiding framework.

Design. First-year nursing (n=36), first-year medical (n=73), and second-year pharmacy students (n=83) enrolled in an interprofessional communication skills development course voluntarily completed a 33-item survey instrument based on Interprofessional Education Collaborative (IPEC) core competencies prior to and upon completion of the course during the fall semester of 2012.

Assessment. Nursing students entered the course with higher interpersonal …


Stereotypes About Healthcare Professionals, Emotions, And Mammography Compliance, Kayla M. Kinworthy Dec 2014

Stereotypes About Healthcare Professionals, Emotions, And Mammography Compliance, Kayla M. Kinworthy

Loma Linda University Electronic Theses, Dissertations & Projects

Rates of mammography screening are particularly low for minority women, with only 42% of Latin American (Latino) women in the U.S. reporting having a mammogram in the last year as compared to 53% of non-Latino White (Anglo) women [1]. Minority patients are more likely to report negative healthcare encounters with their health professionals [2; 3], which may result in less favorable cultural stereotypes about healthcare professionals and more negative emotional reactions. Guided by Betancourt’s Integrative Model of Culture, Psychological Processes, and Health Behavior [4] and the Stereotype Content Model [5], the aim of the present research was to examine the …


Effects Of Video Enhancement In A Stated-Choice Experiment On Medical Decision Making, Susanne Hoffmann, Joachim Winter, Francis G. Caro, Alison Gottlieb Dec 2014

Effects Of Video Enhancement In A Stated-Choice Experiment On Medical Decision Making, Susanne Hoffmann, Joachim Winter, Francis G. Caro, Alison Gottlieb

Gerontology Institute Publications

Background. The internet can be useful in administering stated-choice experiments to understand medical decision making and refine the content of patient decision aids. In internet-based stated-choice experiments, video and audio files can be used to provide information to respondents. Quality of data may or may not be affected.

Objectives. In a methodological experiment concerned with administration of a stated-choice experiment on the internet concerned with knee-replacement surgery, we compared the data quality obtained with video-enhanced and conventional text formats.

Methods. Members of the RAND Corporation’s American Life Panel and 50 years of age or older (n=1616) were randomly assigned to …


Misalignments: Challenges In Cultivating Science Faculty With Education Specialties In Your Department, Seth D. Bush, Nancy Pelaez, James A. Rudd Ii, Michael T. Stevens, Kimberly D. Tanner, Kathy S. Williams Dec 2014

Misalignments: Challenges In Cultivating Science Faculty With Education Specialties In Your Department, Seth D. Bush, Nancy Pelaez, James A. Rudd Ii, Michael T. Stevens, Kimberly D. Tanner, Kathy S. Williams

PIBERG Publications

Science Faculty with Education Specialties (SFES) are increasingly being hired across the United States. However, little is known about the motivations for SFES hiring or the potential or actual impact of SFES. In the context of a recent national survey of US SFES, we investigated SFES perceptions about these issues. Strikingly, perceptions about reasons for hiring SFES were poorly aligned with perceptions about potential and actual contributions reported by SFES themselves, and the advice they extended to beginning SFES was varied. While preparation of future teachers and departmental teaching needs were common reasons offered for SFES hiring, the potential and …


Therapeutic Camps And Their Impact On The Family Of Children With Special Health Care Needs: A Mixed Method Study, Brandi Lindsey Dec 2014

Therapeutic Camps And Their Impact On The Family Of Children With Special Health Care Needs: A Mixed Method Study, Brandi Lindsey

Electronic Theses and Dissertations

Children with a chronic illness or disability can encounter many difficulties throughout their lifetimes. Respite care through therapeutic summer day camps is a service used to relieve the physical and mental strains placed on caregivers while also creating unique opportunities to benefit the child. There are gaps in the literature surrounding therapeutic camps and their benefit for the family and their ability to manage the child’s special health care need. The purpose of this study is to determine how respite care in the form of a therapeutic summer day camp for children with special needs impacts a family’s ability to …


I Get By With A Little Help From My Friends: A Qualitative Study Of Nurse Close Work Friendship And Social Support, Jennifer Ptacek Dec 2014

I Get By With A Little Help From My Friends: A Qualitative Study Of Nurse Close Work Friendship And Social Support, Jennifer Ptacek

Masters Theses

The nursing profession is laden with numerous job, emotional labor, and communication stressors, which come from both patients and healthcare organizations. These frequent and simultaneous pressures can result in nurse burnout and turnover (Tracy, 2009). Socially supportive workplace communication has been identified as a solution to reducing nurse stress, burnout, and turnover (Apker & Ray, 2003), but has not specifically considered social support in nurse work friendships. A mixed qualitative method study was conducted with five nurse best friend pairs, using job observations of participants’ work friendship communication and individual and joint interviews. Two major communication themes emerged from the …


Sustained Adrenergic Signaling Promotes Cervical Cancer Progression, Nouara C. Sadaoui Dec 2014

Sustained Adrenergic Signaling Promotes Cervical Cancer Progression, Nouara C. Sadaoui

Dissertations and Theses (Open Access)

Background: Chronic stress and sustained adrenergic signaling are known to promote tumor progression. The underlying mechanisms behind this process are not well understood. We examined the effects of sustained adrenergic signaling on cervical cancer progression through increased expression of HPV oncogenes, E6 and E7.

Materials and Methods: ADRβ expression levels were examined in patient-derived cervical cancer samples. We used an orthotopic model of cervical cancer to investigate the effects of restraint stress on tumor growth and metastasis. We evaluated the in vivo effects of a β-blocker, propranolol, and HPV E6/E7 siRNA. In vitro, ADRβ positive cervical cancer cells were …


Effects Of Oxytocin On Human Aggression, Joseph L. Alcorn Iii Dec 2014

Effects Of Oxytocin On Human Aggression, Joseph L. Alcorn Iii

Dissertations and Theses (Open Access)

EFFECTS OF OXYTOCIN ON HUMAN AGGRESSION

Joseph Louis Alcorn III, B.S.

Advisory Professor: Scott D. Lane, Ph.D.

Human interaction is comprised of common, yet complex, behaviors and the outcomes of these social behaviors can beneficially or detrimentally impact individual and public health. One social behavior that can have profound detrimental outcomes is aggression. Aggression is a class of social behavior that is particularly prevalent in individuals with antisocial personality disorder (ASPD) and comorbid substance use disorder (SUD). Aggression in these individuals can manifest at maladaptive levels that place considerable burdens on public health and communities. Therefore, understanding the neurobehavioral underpinnings …


Premature Births And Maternal Health: An Analysis Of Risk Factors That Affect The Rate Of Prematurity / Los Nacimientos Prematuros Y La Salud Materna: Un Análisis De Los Factores De Riesgo Que Afecta La Tasa De Prematuridad, Alexandria Mickler Dec 2014

Premature Births And Maternal Health: An Analysis Of Risk Factors That Affect The Rate Of Prematurity / Los Nacimientos Prematuros Y La Salud Materna: Un Análisis De Los Factores De Riesgo Que Afecta La Tasa De Prematuridad, Alexandria Mickler

Independent Study Project (ISP) Collection

Research Question: What are the major socio-demographic risk factors influencing the rate of preterm birth in Valparaiso, Chile? Objectives: The objective of this study is to identify risk factors that influence the rate of preterm birth in an urban population of women living in Valparaiso, Chile. This study aims to understand whether a relationship exists between socio-demographic characteristics, such as economic level, education, lifestyle, access to medical attention and resources and the risk of prematurity. The outcomes of this study seek to determine the major biological, cultural, and social relationships and identify at-risk social groups. Additionally, this study considers the …


Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison Dec 2014

Collaborative Models Of Care In The Appalachian Region Of Tennessee: Examining Relationships Between Level Of Collaboration, Clinic Characteristics, And Barriers To Collaboration, Jeffrey Ellison

Electronic Theses and Dissertations

Decades of research have shown that there are significant advantages to maintaining close communicative and collaborative relationships between primary care and behavioral health providers. Fiscal, structural, and systemic barriers, however, often restrict the degree to which such interprofessional collaboration can occur. In the present study the authors examined relationships between primary care clinics in the Appalachian region’s characteristics (i.e., clinic type, rurality, and clinic size), barriers (i.e., fiscal, structural, and systemic) reported to using increased collaboration, and the level of collaboration used at a particular clinic.

For the present study 136 surveys were completed by providers working in primary care …


The Effects Of The Tootling Intervention Using Daily Reinforcement, Melissa Bryanne Mchugh Dec 2014

The Effects Of The Tootling Intervention Using Daily Reinforcement, Melissa Bryanne Mchugh

Master's Theses

The current study was designed to replicate and extend the literature on the effectiveness of a classroom intervention known as Tootling (Skinner, Skinner, & Cashwell, 1998) in decreasing disruptive classroom behavior as well as increasing academically engaged classroom behavior. Tootling is a strategy that encourages and prompts students to report instances of their peers’ positive behaviors. Thus far, only three studies have utilized direct observation data for disruptive behavior during Tootling (Cihak, Kirk, & Boon, 2009; Lambert, 2012, 2014). To extend the research on Tootling, direct observation data of disruptive and academically engaged behaviors were collected on both entire classes …


Understanding Service Utilization Disparities And Depression In Latino Parents And Children: The Role Of Fatalismo, Elizabeth Anastasia Dec 2014

Understanding Service Utilization Disparities And Depression In Latino Parents And Children: The Role Of Fatalismo, Elizabeth Anastasia

Graduate Theses and Dissertations

Research has repeatedly demonstrated a disparity between need and utilization of mental health services for Latino adults and children. The adapted Health Beliefs Model (Henshaw & Freedman-Doan, 2009) provides a useful framework for conceptualizing the roles of perceived severity and therapy expectations in the relation between demographic variables and service utilization. Cultural variations in perceptions of mental illness by Latinos may be linked with lower service utilization rates for Latino parents and children. It was speculated that fatalismo, a cultural construct similar to external locus of control, may be related to perceptions of mental illness and service utilization outcomes for …


Autism Spectrum Disorder In An Indian Context: Impact Of Socioeconomic Factors On The Experiences Of Individuals With Asd And Their Families, Kendall Harman Dec 2014

Autism Spectrum Disorder In An Indian Context: Impact Of Socioeconomic Factors On The Experiences Of Individuals With Asd And Their Families, Kendall Harman

Independent Study Project (ISP) Collection

While Autism Spectrum Disorder (ASD) is a condition that appears in comparable rates across social, ethnic and geographic groups, the quality and quantity of ASD-related resources and services is significantly lower in developing countries, including India. Moreover, sociocultural factors play a major role in the experiences of people with ASD. Yet, the bulk of ASD-related research has been conducted in developed countries. This study aimed to examine how social, cultural, political and economic factors impact the experiences of people with ASD living in India and their families. Seventeen parents of children with ASD were interviewed, and semi-structured observations of different …


Evaluating Current Management Of Drug-Resistanttuberculosis In Mumbai, India, Meryl Kus Dec 2014

Evaluating Current Management Of Drug-Resistanttuberculosis In Mumbai, India, Meryl Kus

Independent Study Project (ISP) Collection

This research was aimed at analyzing the current state of drug resistant tuberculosis in Mumbai and how effectively different actors in the realm of public health are managing DR-TB. The methods for this project involved a variety of semi-structured interviews as well as field observation. Key findings show a very present and largely negative private sector influence, effective NGO models for disease control, a burden of DR-TB/HIV comorbidity, and a rapid increase to transmission-based spread of DR-TB. Key implications of conclusions include the necessity of increasing the private sector’s compliance with WHO standards, adaptation of community and education based NGO …


Government Efforts And Personal Opinion Explain The Medicalization Of Pregnancy And Childbirth Through Time In Lower Mustang, Nepal, Ruth Baker Dec 2014

Government Efforts And Personal Opinion Explain The Medicalization Of Pregnancy And Childbirth Through Time In Lower Mustang, Nepal, Ruth Baker

Independent Study Project (ISP) Collection

The way that women approach pregnancy and childbirth in rural Nepal has seen an amazing change in the past twenty to thirty years. The medicalization of this entire process, from pre-­‐ to post-­‐natal care, comes with government efforts for the increased education of women about family planning, nutrition, hygiene, and the proposed benefits of institutional versus in-­‐home delivery. In 9 villages of Lower Mustang, interviews conducted with Government Health Post workers, Female Health Volunteers, and women of different ages sought to discern personal experience and opinion about pregnancy and childbirth from the perspective of both local women and those with …


H.E.A.P.S. In Advances Towards A Healthier Samoa The Health Education And Promotions Section’S Role In Combating Non-Communicable Diseases, Kara Le Dec 2014

H.E.A.P.S. In Advances Towards A Healthier Samoa The Health Education And Promotions Section’S Role In Combating Non-Communicable Diseases, Kara Le

Independent Study Project (ISP) Collection

With an increase in the number of health issues within Samoa, specifically in relation to non-communicable diseases (NCDs), it is important to examine the efforts being made by government health officials to improve Samoa’s overall health status. This study explores the role of the Health Education and Promotion Section (H.E.A.P.S.) of the Ministry of Health in establishing and promoting healthier standards within the Samoan community. The current efforts of H.E.A.P.S. in combating NCDs through recently introduced projects and programs were explored in-depth. Further analysis of the design and effectiveness of these programs in changing the unhealthy habits of Samoan people …


Formulating Effective And Accessible Population-Based Colorectal Cancer Screening Programs, Danielle Luffman Dec 2014

Formulating Effective And Accessible Population-Based Colorectal Cancer Screening Programs, Danielle Luffman

Independent Study Project (ISP) Collection

Colorectal cancer, a type of carcinoma originating in cells of the colon or rectum, continues to rank as the third most prevalent cancer worldwide with 1.36 million cases and the fourth most fatal with 693,881 deaths during 2012. In an attempt to alleviate the burden of colorectal cancer throughout society, governments and non-governmental organizations continue to implement population-based cancer screening programs. These programs, typically designed by a federal authority, offer free screening tests to a given population for a certain type of cancer on a routine basis. National systematic screening programs have effectively reduced the incidence of and mortality from …