Dissertations / Theses: 'Public and population health'

1

Wang, Xiaochuan (Sherry). "Three essays on population health and public health policy." Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/29270.

Full text

Abstract:

Empowered patient or empowered physician. An analysis of the importance of the gatekeeper in the health delivery system. This paper examines the important role of the gatekeeper in the health delivery system. A simple theoretical model is developed which compares the resource allocation when physicians act as gatekeepers with the decisions taken when patients are empowered. It is shown that even when there is no asymmetry of information---and so patients and doctors are equally able to identify the appropriate therapy---that the institutional arrangement matters. Patients demand more time with physicians when they are empowered whereas physicians want to spend more time developing their expertise when they are empowered. The reaction of physicians and patients to changes in policy instruments also differs across institutional arrangements. The analysis also draws attention to the design of the compensation scheme for physicians, and investigates the benefits of using a non-linear scheme. Wealth, health, and the pursuit of happiness. This paper provides a theoretical framework to illustrate the relationship between income, utility maximization, and healthy choices. The analysis indicates that the choices of individuals who maximize utility are not the same as those arising were the individual to maximize wellness. In fact, rational individuals will over-eat and under-exercise relative to health maximizing levels. Yet as individuals get wealthier, they have better health. The paper also compares different strategies for health promotion. Income redistribution may lead to a net increase in population health and in social welfare. By contrast, policies that specifically target lifestyle choices may succeed in persuading citizens to choose a health-maximizing lifestyle, but result in a net welfare loss to society. An empirical investigation of household income and income polices on obesity in Canada. Using the master files of the Canadian Community Health Survey (CCHS), this paper examines the effect of income on obesity and individuals' body-mass index. An instrumental variable technique is employed to derive consistent estimates of this effect and to take account of the possible endogeneity between income and body weight. It is found that higher income will lead to lower body weight for women, while its effect on the body-weight outcome of men is unclear. This chapter uses the estimates of the relationship between income and body weight to simulate the impact of government income policies---like social assistance and child support---on obesity. It is shown that incomes policies may not only decrease income inequality but may also contribute to a lower incidence of obesity amongst the poorer population thus decreasing overall health care costs.

APA, Harvard, Vancouver, ISO, and other styles

2

Flynn, Kathryn. "College Health Clinic Population Health Improvement Plan Project." Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10604260.

Full text

Abstract:

A college community health improvement plan (CHIP) focusing on the indicators of nutrition and weight status, and physical activity and fitness is designed with the goal of reducing obesity risk, improving health, and preventing chronic disease. The precede proceed model, logic model, innovative care for chronic conditions model, self-care theory, and Bandura’s social cognitive learning theory were used as a research design framework for assessing, planning, and managing sustainability through a two-year college health clinic. The research questions were: what are the current health promotion inputs and activities in terms of environment, ecology, education, and policy and could be supplemented to improve outputs and health outcomes? An integrated review of the literature, observation of the site, regulatory investigation, and focus group sessions were the methods of data collection. The precede-proceed model provided the analytical strategies to assess initiatives and resources, and to determine supplementary initiatives and resources. Results showed that environmental, educational, administrative, and policy resources were available but limited and not well promoted. Conclusions were that health promotion, wellness staffing, and education exist, but are underutilized, under promoted, and funding is necessary. Recommendations include a wellness program, increased activity initiatives, case management, grant funding, and increased community partnerships. The contribution to nursing is to fill a gap-in-practice for health planning in 2-year colleges. The implications for positive social change are improved knowledge, sustained health behaviors, decreased amount of obesity, improved health outcomes and quality of life, decreased chronic diseases, and lower healthcare costs.

APA, Harvard, Vancouver, ISO, and other styles

3

Metscher, Karen N. "Population health measures as indicators of fertility change." Fairfax, VA : George Mason University, 2008. http://hdl.handle.net/1920/3346.

Full text

Abstract:

Thesis (Ph.D.)--George Mason University, 2008.
Vita: p. 246. Thesis director: Jack A. Goldstone. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Public Policy. Title from PDF t.p. (viewed Jan. 11, 2009). Includes bibliographical references (p. 226-245). Also issued in print.

APA, Harvard, Vancouver, ISO, and other styles

4

Flynn, Kathryn M. "College Health Clinic Population Health Improvement Plan Project." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3881.

Full text

Abstract:

A college community health improvement plan (CHIP) focusing on the indicators of nutrition and weight status, and physical activity and fitness is designed with the goal of reducing obesity risk, improving health, and preventing chronic disease. The precede proceed model, logic model, innovative care for chronic conditions model, self-care theory, and Bandura's social cognitive learning theory were used as a research design framework for assessing, planning, and managing sustainability through a two-year college health clinic. The research questions were: what are the current health promotion inputs and activities in terms of environment, ecology, education, and policy and what could be supplemented to improve outputs and health outcomes? An integrated review of the literature, observation of the site, regulatory investigation, and focus group sessions were the methods of data collection. The precede-proceed model provided the analytical strategies to assess initiatives and resources, and to determine supplementary initiatives and resources. Results showed that environmental, educational, administrative, and policy resources were available but limited and not well promoted. Conclusions were that health promotion, wellness staffing, and education exist, but are underutilized, under promoted, and funding is necessary. Recommendations include a wellness program, increased activity initiatives, case management, grant funding, and increased community partnerships. The contribution to nursing is to fill a gap-in-practice for health planning in 2-year colleges. The implications for positive social change are improved knowledge, sustained health behaviors, decreased amount of obesity, improved health outcomes and quality of life, decreased chronic diseases, and lower healthcare costs.

APA, Harvard, Vancouver, ISO, and other styles

5

Vasianovich, Alena. "Exploring population health in Belarus during transition (1990-2010)." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=227038.

Full text

Abstract:

Background: After the collapse of the Soviet Union in 1990, fifteen former Soviet Union countries (fSU) have been undergoing transition. The Belarusian rate of transition has been slower than the others, and population health is likely to have been affected differently. Aims: This study aimed to explore changes in population health in Belarus between 1990 and 2010, and to analyse and describe changes in the health status of Belarusians between 2001 and 2010. Methods: A mixed-method study was conducted, comprising: (i) a review of the published literature, (ii) an analysis of routine health-related statistics, (iii) a review of the national public health reforms, (iv) a secondary analysis of data from two population surveys conducted in Belarus in 2001 and 2010, and (v) a statistical analysis of data from a new Health Category Response Scale (HRCS) survey. Results: Population health initially deteriorated as living standards fell in the early 1990's. An increase in morbidity and mortality from the major non-communicable diseases, and a decrease in life expectancy, followed patterns of increasing hyperinflation and rising unemployment. Around 1994, the economic situation reversed. Major public health reforms were implemented from 1999. Around 2000, mortality indicators for some diseases improved, but not all, while morbidity continued to increase. The secondary analysis of the cross-sectional data (2001 and 2010) and the HCRS survey conducted in Belarus in 2010 showed that Belarusians perceived their health to be better in 2010 than in 2001. Conclusions: In the early 1990's, population health in Belarus deteriorated. Around 2000, some mortality health indicators showed improvement, but by 2010, they had not yet reached their 1990 levels. In contrast, morbidity health indicators continued to deteriorate throughout 1990 to 2010.

APA, Harvard, Vancouver, ISO, and other styles

6

Barclay, Lee. "Public health law in Timor-Leste." Thesis, Curtin University, 2011. http://hdl.handle.net/20.500.11937/875.

Full text

Abstract:

Post-conflict, ‘fragile’ nations face significant health, social, economic and political challenges. The international community is, on the whole, organised and effective in assisting these nations to address urgent priorities. Often, however, prioritisation of immediate concerns has resulted in less focus being given to capacity building, including the fostering of lasting, effective and autonomous systems within these nations.This study examined the post-conflict, transitional nation of Timor-Leste. In particular, it focused on the potential for a health systems-strengthening approach, public health law, to improve the exceptionally poor level of population health found in Timor-Leste. Public health law has a long history within the developed world of success in facilitating the prevention and control of disease. The extent to which law can assist in addressing key health concerns within the developing world has, however, attracted little attention to date.This thesis documents a social and political history of Timor-Leste and provides a review of selected population health indicators. An overview of the Timorese health and legal systems is provided with a focus on system capacity, existing public health law and reported strategic directions. The review is complemented by a survey of 245 residents of Dili, the capital of Timor-Leste, in order to ascertain levels of community awareness of, and support for, selected existing public health laws. Further context was provided through in-depth interviews with 19 health and legal professionals living and working in Timor-Leste. Importantly the study was designed and conducted according to guidance provided by four Timorese cultural advisors.Awareness of law is clearly essential if it is to be effective as a preventive intervention. Community support for law is arguably also fundamental if there is to be widespread adherence to law and political willingness to pursue law reform. Key dependent variables within the community survey and interviews with professionals included awareness of, and support for, public health law amongst a suite of specific regulatory areas including road safety, the sale of alcohol and tobacco to children, food safety and water safety. These areas were selected due to their existing or steadily increasing importance in the developing world. Quantitative analytical methods included Chi-square for examining differences between survey sub-groups, and Kendall’s tau-b for examining correlations between ordinal variables. Qualitative data from interviews was subject to thematic analysis.Analysis of survey and interview data highlighted a poor level of awareness of selected existing public health laws in Timor-Leste amongst participating community members and health and legal professionals. A number of demographic factors were identified as being statistically associated with levels of awareness within the community and these provide direction for future educative efforts. Encouragingly, this study has also identified a strong level of support for public health law amongst both community and professional groups. Support was high for the legal approach to health law overall and for each of the regulatory areas examined. Attitudinal factors associated with community support were identified and these provide guidance for future efforts to raise understanding and acceptance of public health law in Timor- Leste.The review of the health and legal systems, however, highlights that there currently exists an incomplete set of laws that lacks cohesion and accessibility in Timor-Leste: an analysis of applicable law requires a detailed investigation of Timorese and Indonesian law, and United Nations regulations. There appears also to be little systemic capacity to enforce existing, or develop additional, law and regulation. Public health law reform, furthermore, does not appear to be among the Timor-Leste government’s strategic directions.This study is one of few undertaken globally on public health law in a developing, post-conflict transitional society. The observation of widespread support for the legal approach to health provides impetus and direction to the proposition of a coordinated and resourced public health law strategy in Timor-Leste. Recommendations have been provided to address some of the current barriers to such a strategy, including capacity constraints, low awareness and low political and public service profile. Finally a theoretical framework is provided to specifically guide further research and implementation of public health law in Timor-Leste and similar settings.

APA, Harvard, Vancouver, ISO, and other styles

7

Alsaif, Mohammed A. "Diabetes and obesity in adult Saudi population." Diss., The University of Arizona, 2001. http://hdl.handle.net/10150/289724.

Full text

Abstract:

In this series of studies, three issues were addressed. First, the prevalence of undiagnosed diabetes (high fasting blood glucose with no prior diagnosis of diabetes) and how different they are from the diagnosed diabetes in risk factors. Second, the prevalence and risk factors of overweight and obesity were described in the general population. Finally, an evaluation of the relationship between obesity and type 2 diabetes were made in Saudi adult men and women. Our study population came from a national cross sectional survey which included 3271 males and females, age 30-70 years old. All participants completed a specifically designed questionnaire, and a comprehensive physical examination which included blood pressure and anthropometric measurements. Fasting serum samples were analyzed for glucose and blood lipids. A number of compelling findings have resulted from this research. First, the prevalence of diabetes is high with 30% of men and 25% of women diabetics. Undiagnosed diabetes presents a substantial problem; they constitute 41% of the total diabetic population and 11% of the total population. Undiagnosed diabetics are however, similar to diagnosed diabetes with uncontrolled fasting blood glucose level and many of the associated risk factors. Second, the prevalence of obesity is also high with 49.15% in women and 29.94% in men identified as obese and an additional 31.55% of females and 41.91% of males identified as overweight. Third, in this study population, 12% are obese diabetics and in the diabetic population 43% are obese diabetics. Diabetes appears to have a harmful effect on blood lipids, which seem to worsen when diabetes is combined with obesity. Based on these findings, obesity and diabetes appear to have created very serious complications and prevalent health problems in adult Saudi population between the age of 30-70 years old. Because about half of the population are under 18 years old, there is a very good chance for the government to successfully implement education and health programs to prevent and control these two conditions from becoming an epidemic in future generations.

APA, Harvard, Vancouver, ISO, and other styles

8

Airoldi, Mara. "Essays on healthcare priority setting for population health." Thesis, London School of Economics and Political Science (University of London), 2014. http://etheses.lse.ac.uk/916/.

Full text

Abstract:

Healthcare priority setting is a major concern in most countries because healthcare represents a large and increasing public expenditure. Yet, there is not well established procedure that is consistently used to support those responsible for priority setting decisions. This dissertation consists of a review of the literature and five independent essays on healthcare priority setting, focusing on the value of formal analysis to support local healthcare planners in allocating a fixed budget. This dissertation makes both an intellectual and a practical contribution. The intellectual contribution is a synthesis of both economics and decision analysis insights. The review of the literature shows that tools grounded in health economics currently fail to contribute to local healthcare priority setting decisions because they are not practical. At the same time, tools grounded in (multi-criteria) decision analysis fail to incorporate the methodological advances of health economics and are hence theoretically weak. My thesis contributes to closing this gap. The practical contribution is that I design, and test the value of, a process and of particular value functions that can be used by local healthcare planners within their limited resources.

APA, Harvard, Vancouver, ISO, and other styles

9

Gutierrez, Cassity, and Sara Johnston. "Fit for Population Health Service: Assessing the Change in Public Health Competencies of Interprofessional Undergraduate Health Sciences Students." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/ijhse/vol7/iss1/3.

Full text

Abstract:

Background. A 2012 IOM report is just one of an increasing number of recommendations to incorporate a population health approach into training of all health professionals. In light of the emphasis on and necessity for all future health professionals to possess core public health competences, a medium sized public University incorporated Introduction to Public Health as a required course in their undergraduate, interprofessional Health Sciences curriculum. Purpose. The purpose of this study was to assess the change in core public health competencies of undergraduate Health Sciences students who completed an Introduction to Public Health course. Methods. The Tier 1 Public Health Professionals Competency Assessment was administered in the online Introduction to Public Health courses for undergraduate Health Sciences students; the pretest was administered during the first week and the posttest during the final week of the 15 week course. Purposive sampling was used to assess how the course increased the student’s acquisition of core public health competencies within the designated eight domains. Results. Results of this study showed an increase in the competency scores of the participants from pre to posttest across all of the eight domains. Conclusions. This study demonstrates that an Introduction to Public Health course can increase the core public health competencies of undergraduate Health Sciences students, and the Public Health Professionals Competency Assessment can be used to assess the acquisition of these competencies with and guide curriculum for future health care providers.

APA, Harvard, Vancouver, ISO, and other styles

10

Rzepka, Susan G. "Geriatric trauma care: A population-based study." Case Western Reserve University School of Graduate Studies / OhioLINK, 1996. http://rave.ohiolink.edu/etdc/view?acc_num=case1057600839.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

McGuire, Marissa. "Poverty, food insecurity and overweightobesity in the Canadian population." Thesis, University of Ottawa (Canada), 2007. http://hdl.handle.net/10393/27890.

Full text

Abstract:

This study, based on the Canadian Community Health Survey (2004), examined the relationship between food insecurity and overweight/obesity among Canadian adults by sex and family type using logistic regression analysis; we also provided an environmental scan of policies, programs and initiatives to address food insecurity. In our final adjusted models, food insecure women with hunger were significantly more likely to be overweight/obese than food secure women [OR=2.3, CI=1.2, 4.3]. Our environmental scan revealed broad recognition of the importance of addressing food insecurity and concrete recommendations to do so. We found far less recognition of the implications of food insecurity for healthy weights within a policy context. The food insecurity/overweight/obesity relationship and its policy implications are complex; we need a better understanding of how underlying social and economic conditions, sex, and family type relate to income, food security and healthy weights.

APA, Harvard, Vancouver, ISO, and other styles

12

Knight, Rodney Eric. "Advancing population and public health ethics regarding HIV testing among young men." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/50504.

Full text

Abstract:

Background: Despite the epidemiological and clinical rationale supporting a shift from voluntary approaches to HIV testing (e.g., in which a patient seeks an HIV test) towards the expansion of more routine approaches (e.g., in which a clinician routinely offers patients testing), a set of rather polarized ethical debates has remained somewhat unresolved. And, within these discussions, considerations of young men’s experiences and health care needs have remained conspicuously absent. Objectives: This dissertation aims to: (1) Systematically investigate the status of ethical debate and discussions within the peer-reviewed literature in the realm of voluntary and routine HIV testing, with a particular emphasis on understanding the structural and agentic factors associated with testing experiences (e.g., HIV-related stigma); (2) Examine and identify the social processes associated with voluntary and routine testing that attenuate or exacerbate HIV-related stigma among young men; and (3) Describe how ‘public’ values (e.g., solidarity; reciprocity; health equity) may influence the ‘autonomous’ decisions and/or HIV testing practices of young men. Results: The findings highlight a set of social processes that can provide transformative opportunities for young men to reconceptualise expectations pertaining to HIV and HIV-related stigma within routine testing practices. These findings also distil the extent to which young men ‘take up’ relational values (e.g., solidarity; reciprocity), as well as individual reasons (e.g., obligations to the Self) in their HIV testing practices. Discussion: Empirical-normative approaches to advancing population and public health ethics regarding HIV testing may be most usefully pursued as an iterative project (rather than as a linear project), in which the normative informs the empirical questions to be asked and new empirical evidence constantly directs conceptualizations of what constitutes morally robust public health practices. This dissertation provides a set of methodological considerations regarding research techniques that may be useful in advancing future empirical-normative inquiry regarding HIV-related population health interventions.
Graduate and Postdoctoral Studies
Graduate

APA, Harvard, Vancouver, ISO, and other styles

13

Oremus, Mark 1968. "Use of medications in the Alzheimer's disease population : physician and caregiver perspectives." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=85947.

Full text

Abstract:

Introduction. Research into medications for Alzheimer's disease (AD) is primarily conducted in drug trials, were efficacy is assessed by changes in score on established outcome measurement scales. However, physicians' and caregivers' perspectives on efficacy, along with their perspectives on other factors that may influence prescribing (e.g., adverse effects), remain largely unexplored. The objective of this thesis is to examine these perspectives to gain a broader understanding of the factors that can influence the use of medications in AD.
Methods. Two studies were conducted. The first involved all of the Province of Quebec's geriatricians, neurologists, and psychogeriatricians, as well as a random sample of Quebec's 8,115 general practitioners. The second study involved 375 caregivers who attended AD-related support groups. Questionnaires were used to collect data on the proportion of patients prescribed cholinesterase inhibitors (ChEIs), efficacy requirements for prescribing new medications, acceptance of adverse effects, physician-caregivers discussions about medications, and caregiver pressure on physicians to prescribe medications.
Results. Response rates were 35.4% (physicians) and 64.4% (caregivers). More stringent efficacy requirements on the part of physicians were negatively associated with prescribing ChEIs, although effect sizes were small and associations were not always statistically significant. More stringent efficacy requirements on the part of caregivers were negatively associated with prescribing in some instances (e.g., required improvements to patients' ability to eat, OR=0.74, 95% CI=0.61 to 0.89), but not in others (e.g., required improvements to patients' speech, OR=1.02, 95% CI=0.81 to 1.19). Caregivers' willingness to accept adverse effects was positively associated with prescribing ChEIs (odds ratios for 11 adverse effects ranged from 1.83 to 8.30); however, prescribing was not associated with physicians being the first to discuss the use of medications to treat AD (OR=2.37; 95% CI=0.90 to 6.24), nor was it associated with caregiver pressure on physicians to prescribe (OR=1.33; 95% CI=0.49 to 3.58).
Conclusion. This research is the first to show how physician and caregiver perspectives on issues such as efficacy and safety can affect the use of medications in AD.

APA, Harvard, Vancouver, ISO, and other styles

14

Dobrovolskaite, Aiste. "Urine Electrolyte Excretion in a Hypertensive Population of East Africans." TopSCHOLAR®, 2017. http://digitalcommons.wku.edu/theses/1947.

Full text

Abstract:

Chronic noncommunicable diseases (NCDs) are the largest contributor to mortality rates worldwide including in low- and middle- income countries (LMICs) which already suffer from high rates of infectious disease. Among the four major NCDs that cause 38 million deaths annually, cardiovascular disease (CVD) causes 17.5 million of these annual deaths. The primary risk factor of CVD is hypertension. Kenya, a developing country in Sub-Saharan Africa, has a high rate of hypertension with low (2.6%) management rates. Prior research from our lab has identified a population of Kenyans with a high prevalence of hypertension that is not statistically correlated with typical known risk factors such as obesity, hypercholesterolemia, and behaviors of smoking and lack of exercise. This study investigated the hypothesis that high dietary salt consumption and low K+ dietary intake are contributing to the etiology of high blood pressure in this community. To test our hypothesis, two spot urine samples representing nocturnal excretions (evening and morning) and blood pressure measurements were collected from 135 participants. All samples were analyzed for Na+, K+ and Cl- content using the Smartlyte Electrolyte Analyzer. The average of each spot urine sample was extrapolated to an estimated 24-h value by the method of Mills, et al. The overall population mean urine electrolyte excretion values for Na+, K+ and Cl- were 170.6 ± 89.3 mmol/L, 82.0 ± 54.0 mmol/L, and 87.7 ± 42.1 mmol/L, respectively. While these values fall within the suggested levels for Na+ (40-220 mmol/L) and K+ (25-125 mmol/L), they are under normal excretion levels for Cl- (110-250mmol/L). Overall ion excretion was higher in females than males, although only K+ values were statistically significant (p < 0.05). Analysis of Na+ and Cl- excretion from individuals stratified by blood pressure, revealed significant differences (p < 0.05) between normotensive and hypertensive stage I individuals for both electrolytes (57.9 mmol/L vs. 88.9 mmol/L and 65.5 mmol/L vs. 96.7 mmol/L, respectively). Overall, these results suggest that our sample population consumes dietary salt within a normal range and thus, the observed prevalence of hypertension likely results from other genetic and environmental factors.

APA, Harvard, Vancouver, ISO, and other styles

15

Oliveira, Luís André Simões de Pinho. "Cardiovascular risk factors in a homeless population." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/62304.

Full text

APA, Harvard, Vancouver, ISO, and other styles

16

Oliveira, Luís André Simões de Pinho. "Cardiovascular risk factors in a homeless population." Dissertação, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/62304.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Chau, Fangxiao Leena Wu. "Examining the delivery of mental health services in primary care and public health collaborations using a population health framework." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/59989.

Full text

Abstract:

Background: More than 6.7 million people in Canada experience a mental illness during a one-year period. Mental illnesses are highly influenced by the determinants of health, which are the social, economic, and physical environments that contribute to an individual’s health status. Addressing mental illnesses requires a population health approach involving joint action across multiple sectors to focus on the determinants of health. This thesis examines the extent to which Primary Care (PC) and Public Health (PH) collaborations incorporated a population health approach to address mental illnesses. Methods: A secondary analysis of data collected through a multi-province (British Columbia, Ontario, Nova Scotia) study that examined factors related to strengthening primary health care through PC and PH collaboration was conducted. Focus group data from four cases of PC-PH collaborations that addressed mental health were used to examine whether mental health activities incorporated a population health approach, as well as to identify the enablers and barriers to carrying out the activities. A qualitative descriptive approach and thematic analysis were used. A coding framework and themes were developed deductively, based on the Public Health Agency of Canada’s population health framework, and through inductive analysis. Results: Twenty-nine themes and eighteen subthemes were identified that correspond to the Public Health Agency of Canada’s population health framework. Key enablers included working in a multidisciplinary team, addressing the determinants of health, and engaging the community. Key barriers were poor data systems, a lack of service integration, and a lack of action on demonstrating accountability for outcomes. Conclusions: Findings highlighted the relevance of a population health approach and demonstrate that certain aspects of the population health framework are more actionable than others in the area of mental health, thus identifying areas for the framework’s further development. The research also identifies enablers and barriers to conducting mental health activities, offering guidance on how to facilitate population health implementation. The results could help provide insight at the program and policy levels for PC and PH as well as other sectors related to collaborative strategies that could strengthen the delivery of mental health services by incorporating a population health approach.
Medicine, Faculty of
Graduate

APA, Harvard, Vancouver, ISO, and other styles

18

Fraser, Mary I. "Uses of over-the-counter analgesic agents in the Montreal population." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0018/MQ44168.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

19

Clow, Lisa Ann. "Yoga as a Women’s Population Health Intervention." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7621.

Full text

Abstract:

Women’s mortality rate in the United States has increased in almost every age group in the past several years. However, more women in the United States are choosing yoga as a complementary health approach to improve general well-being. Thus, research on yoga and other factors that affect women’s health in the United States may inform public health initiatives to address the health disparities in women’s mortality rates. Grounded in the health belief model, the purpose of this study was to explore whether the factors of practicing the components of yoga, doctor’s recommendation for increased physical activity, body mass index (BMI) categories, hypertension, high cholesterol, age, and occupation predicted the self-rated health of women. This cross-sectional, secondary analysis of the 2017 National Health Interview Survey included 14,464 female respondents, and ordinal logistic regression analysis was used to examine the data. The results showed that self-reported participation in yoga, breathing as a part of yoga, and meditation as a part of yoga was associated with higher self-rated health. Additionally, participants with healthy weight BMI, teachers, and participants who did not receive recommendations for increased physical activity and did not have hypertension or high cholesterol were more likely to report better self-rated health. Based on the results of this study, public health researchers may continue to explore the effects of yoga on women and how a yoga-based population health intervention could help women in the United States live longer and healthier lives.

APA, Harvard, Vancouver, ISO, and other styles

20

Assimes, Themistocles. "Hypertension and the risk of cancer : a population study." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31184.

Full text

Abstract:

Several epidemiological studies have evaluated whether an association exists between hypertension and cancer with inconclusive results because of several design biases.
Using the Saskatchewan Health Databases, a cohort of subjects with incident treated hypertension between 1980 and 1987 was assembled and followed until 1996 to identify all incident cancer hospitalizations. Age and sex-standardized incidence ratios for all cause and for site-specific cancers were estimated using provincial cancer rates.
A small increased risk of all-cause cancer was found mainly among females (RR: 1.12, 95 percent CI 1.06--1.17). Site-specific analyses revealed increased risks for uterine, breast, bladder, kidney, and several less common cancers. Re-analyses to control for reverse causality and detection bias did not alter the findings.
While this study suggests a weak association between hypertension and cancer, the inability to control for information bias and for certain confounders does not allow for a definitive conclusion on causality.

APA, Harvard, Vancouver, ISO, and other styles

21

Ramrakha, Sandhya, and n/a. "The link between mental health problems and sexual risk taking in a general population sample." University of Otago. Dunedin School of Medicine, 2009. http://adt.otago.ac.nz./public/adt-NZDU20090527.155127.

Full text

Abstract:

This thesis examined whether mental health problems and sexual risk taking were associated in a general population sample and if so, the extent and direction of this association. The thesis begins with a review of theories of risk taking; sexual risk and mental health correlates; and the existing studies linking mental health and sexual risk taking. Three empirical studies were conducted. Study One produced new evidence that a range of psychiatric disorders were linked to early sex (<16 years), risky sex (multiple partners and inconsistent condom use in the past year at age 21) and sexually transmitted infections (STIs) by the age of 21 years. Young people who present with schizophrenia spectrum disorder were also prone to early and risky sex and STIs. Second, depression, the single most common psychiatric problem in the population, was also associated with risky sex and STIs. The risk increased with comorbid psychiatric conditions. Study Two addressed the issue of directionality, specifically examining if childhood behavioural and emotional problems and early adolescent psychiatric disorder predicted later sexual risk taking and STIs. Main findings showed that childhood antisocial behaviour increased the likelihood of risky and early sex, and that low levels of childhood anxiety increased the likelihood of later risky sex and having STIs. Involvement with delinquent peers mediated the association between childhood antisocial behaviour and risky and early sex. To a lesser degree, attachment to parents mediated the association between antisocial behaviour and early sex. These factors did not mediate the association between low levels of childhood anxiety and later sexual outcomes. No associations were found between adolescent psychiatric disorder and later sexual risk taking, with the exception of conduct disorder. However, it is important to note that by excluding the group who had early sex in order to establish temporality, other behaviours of interest exhibited by this group were also excluded. The third study examined whether sexual risk taking was associated with an increased risk of subsequent mental health problems, addressing the issue of directionality in the other direction. Main findings showed that reports of early sex, multiple sex partners and STIs elevated the risk of later substance dependence disorders. Importantly, this association persisted after controlling for �baseline� levels of psychiatric disorder. Early sex also predicted later conduct disorder, even after controlling for prior conduct disorder. In contrast, early sex, multiple sex partners and acquisition of STIs were unrelated to later diagnoses of anxiety or depression. The significant associations with multiple sex partners and STIs were also shown for incident cases of substance dependence. Moderation analyses revealed no differences between the sexes in any of the studies except in Study Three. Specifically, the association between multiple sex partners and substance dependence appeared to be stronger for males than females for up to 10 sex partners and substantially stronger for females than for males beyond ten sex partners. The final chapter in this thesis reviews the strengths and weaknesses of the studies in this thesis before considering the implications of the results for theory, research and practice.

APA, Harvard, Vancouver, ISO, and other styles

22

Costantini, Lianna Hope. "Diet Quality and Dyslipidemia in the US Population." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523573879067727.

Full text

APA, Harvard, Vancouver, ISO, and other styles

23

Tsai, Yu-Chia. "Tobacco use and cessation counseling in a population of health professions students in South Africa." Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/11116.

Full text

Abstract:

Includes bibliographical references.
Tobacco is a leading risk factor for the global burden of disease in both developed and developing countries. The morbidity and mortality caused by tobacco can be prevented efficaciously and cost-effectively by active intervention from health professionals. In developing countries, a limited number of studies have explored tobacco usage and training in smoking cessation and prevention amongst health professions students. This pilot study evaluated: 1. tobacco use patterns; 2. knowledge, attitudes and beliefs towards tobacco use and tobacco control; 3. environmental tobacco smoke exposures; and 4. training in smoking cessation and prevention amongst health professions students in South Africa.

APA, Harvard, Vancouver, ISO, and other styles

24

Harding, Yusupha. "The impact of hypertension in population above sixty years old." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1523043.

Full text

Abstract:

The impact of hypertension as human's age is debilitating and could affect any individual as they grow older. Hypertension is a silent killer that must be taken very seriously because it has claimed the life of 7.6 million people in 2005 worldwide. The purpose of this research study was to raise a global awareness and the characteristics of people who are more likely to have hypertension. Demographically, this research project focuses on those patients 60 years of age or older who are overweight, with an emphasis on the Black Community. The dataset used in this project was a cross-sectional, descriptive secondary data obtained from the National Ambulatory Medical Care Survey (NAMCS), part of the Center for Disease Control and Prevention (CDCP).

The results of the study for the hypothesis suggests that African Americans 60 years and older have a higher rate of hypertension compared with other races 60 years and older in the United States. Furthermore, the study also validates that there is a relationship between higher body mass index and hypertension. The higher body mass index a person has the greater their chances of having hypertension.

APA, Harvard, Vancouver, ISO, and other styles

25

Mytton, Oliver. "A population perspective on physical activity and health." Thesis, University of Cambridge, 2017. https://www.repository.cam.ac.uk/handle/1810/264414.

Full text

Abstract:

Regular physical activity reduces the risk of many chronic diseases. Consequently, the promotion of it and particular types (e.g. walking and cycling for travel), have become a priority for governments seeking to improve health and constrain rising demand on health services. Despite this many uncertainties persist. The aim of this thesis is to address two particular areas of uncertainty: a) the association of walking and cycling for travel with indices of health and well-being; b) and the extent to which increases in physical activity will reduce need for health and social care. The first part of my thesis consists of three studies that describe the health benefits associated with walking and cycling to work among working age adults. The first is a longitudinal study of the associations between maintenance of active commuting with sickness absence and well-being using the Commuting and Health in Cambridge dataset. The second, using the same dataset, describes the longitudinal associations between maintenance of active commuting and self-reported body mass index. Building on this, the third study using a large cohort study (the Fenland Study) with detailed characterisation of diet and physical activity (including objective measurement) describes the baseline associations between active commuting and objective measures of adiposity. The second part of my thesis describes the development of a combined microsimulation multi-state life table model that is used to characterise the effects of a population ‘shift’ in physical activity on the burden of six major diseases at the population-level. Specifically, it seeks to better describe the effect of increases in physical activity on healthcare need considering not just the effect of physical activity on disease incidence but also the effect on healthcare need arising from consequent survival to an older age (at which disease incidence is higher), and contrasts this with a method that does not make allowance for increased survival. The findings of this thesis provide evidence of the importance of walking or cycling to work in maintaining or improving the health and well-being of working age adults. It suggests that increases in physical activity, even after allowance for increased survival, are likely to reduce need for healthcare, although the reductions in need are less than might be assumed when allowance is not made for increased survival. Taken together this work provides a stronger empirical basis to inform public health practice. A stronger ‘health case’ for active travel can be made. The benefits of which should be communicated to individuals choosing how to travel as well as policy makers and others who can influence the determinants of active travel. It also provides a more realistic and nuanced understanding of how increases in physical activity may affect future healthcare need.

APA, Harvard, Vancouver, ISO, and other styles

26

Schneider, Karen L. "Applying advanced methods to population-based survey data for purposes of breast cancer control." View abstract/electronic edition; access limited to Brown University users, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3318359.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Frantz, Allison E. "The impact of the growing elderly population on health care." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1992. http://www.kutztown.edu/library/services/remote_access.asp.

Full text

Abstract:

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1992.
Source: Masters Abstracts International, Volume: 45-06, page: 2940. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 147-158).

APA, Harvard, Vancouver, ISO, and other styles

28

Boyer, Nicole Renée Soldner. "Economic evaluation of population health interventions aimed at children and delivered at school." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/9012/.

Full text

Abstract:

Background: Population health interventions by their nature affect an entire population and are typically delivered outwith of health services and within the community, such as in schools. An example of such interventions are those that aim to improve children’s social and emotional wellbeing, which have demonstrated effectiveness in the short-term and potentially the long-term. However, challenges arise when conducting economic evaluations of population health interventions, most notably the difficulties of identifying, measuring, and valuing broader intersectoral costs, health, and non-health outcomes. Economic evaluation in an education context is relatively novel, but could provide decision-makers with information to help them make transparent and consistent decisions about how to allocate limited funds. This thesis examined the role for economic evaluation in school-based interventions and sought to determine appropriate methods for its implementation in addition to examining appropriate child-focused outcome measures. Thus, the overarching research question asked, ‘How should the cost-effectiveness of school-based, population health interventions aimed at children be determined?’ Methods: A mixed methods approach to this thesis was used: (i) a systematic literature review and narrative synthesis to determine which evaluation methods (economic and non-economic) are currently being used in school-based population health interventions; (ii) a case study to illustrate an economic evaluation (including cost-utility and cost-effectiveness analysis) of a school-based intervention to reflect on the advantages and disadvantages for decision making in this context; and (iii) an exploration of outcome measures (through mapping validation) for valuing child health and social and emotional wellbeing in school-based programmes to support future evaluation work in this context. Data for the economic evaluation and mapping validation study were available from a cluster randomised controlled trial of the Roots of Empathy programme in Northern Ireland (Ref: 10/3006/02). Results: The systematic review found that the methods currently being utilised to evaluate school programmes are varied (including economic evaluation, cost only, and effectiveness only studies), with poor quality reporting for the economic evaluations. Of the few cost-utility analyses in school-based settings identified, none had directly measured health-related quality of life using child measures or values. The case study cost-utility analysis using Child Health Utility 9D of a school-based intervention was found to be cost-effective from the National Health Service perspective with an incremental cost-effectiveness ratio of £11,000 per quality-adjusted life year (confidence interval: -£95,500 to £147,000), however the wide confidence interval demonstrates considerable uncertainty. This uncertainty is likely due to a lack of statistically significant effect that remained at the 36-month follow-up. Cost-effectiveness analysis using child behavioural descriptive measure, the Strengths and Difficulties Questionnaire, resulted in an incremental cost-effectiveness ratio of £197 per unit decrease in total difficulties score (confidence interval: £77 to £471). The Strengths and Difficulties Questionnaire is suitable for measuring social and emotional wellbeing, but is less advantageous for cost-effectiveness decision-making as no consensus has been reached as to what a clinically meaningful change in score represents, nor has a cost-effectiveness threshold been defined. It remains uncertain how these cost-effectiveness results will be interpreted in an education decision-making context where cost-effectiveness thresholds have not been set up. The mapping validation study validated a mapping algorithm to convert the Strengths and Difficulties Questionnaire into child health utility. Using this algorithm provides an option for valuing incremental changes in health-related quality of life against a generally accepted cost-effectiveness threshold from a health service perspective. Conclusions: Given the findings from the various aspects of work undertaken for this thesis to address population health issues, this thesis identified cost-benefit analysis as currently the most comprehensive method for determining the value for money of school-based public health interventions. Cost-benefit analysis incorporates monetary valuation of multisector outcomes in a final net benefit/loss result allowing clear, consistent, decision-making criteria to be set. Other methods such as cost-consequence analysis, cost-utility analysis, and multi-criteria decision analysis may also be suitable depending on the decision-making context and problem. This thesis demonstrates a lack of clear decision-making criteria in place for funding allocation decisions in education (e.g. education specific cost-effectiveness thresholds). Furthermore, there is no equitable method currently in place for apportioning the cost of funding public health interventions that generate benefits for multiple sectors. From a health service perspective, directly measuring child health utility using the Child Health Utility 9D is preferred as it is the only preference-based measure developed specifically for children and valued by young people. Mean child health utility can be predicted by mapping from the Strengths and Difficulties Questionnaire. This affords the opportunity to estimate longer-term utility by utilising long-term cohort data that routinely collects the Strengths and Difficulties Questionnaire, as long-term cost-effectiveness of school-based preventive programmes is an area in need of further research. The school setting plays an important role in shaping our young people’s futures. Economic evaluation of school-based population health interventions is justified, as schools need to maximise their existing resources in order to give children the best start in life.

APA, Harvard, Vancouver, ISO, and other styles

29

MacKinlay, Elizabeth, and n/a. "Health related decision making and the elderly : the acceptance of influenza vaccination." University of Canberra. Education, 1989. http://erl.canberra.edu.au./public/adt-AUC20060825.150054.

Full text

Abstract:

The study set out to determine the influenza vaccination rate and to identify factors important in the process of vaccination acceptance decision making for a group of the well elderly in the A.C.T. Prediction of vaccination acceptance was compared using three measures: stated behavioural intention, report of past vaccination acceptance and a multiattribute utility decision model. In this study no one method of prediction was obviously better than another. The most important findings of this study included the marked variations in vaccination rates based on type of residence of the group members. Of the 15 variables of the decision model, factors related to the infection of influenza and possible complications of influenza were seen as the most important factors by both acceptors and nonacceptors of the vaccine in making the decision to have the injection. These findings can be incorporated into an area vital for nursing intervention, the planning of nursing programmes of health promotion and health maintence for the well elderly population.

APA, Harvard, Vancouver, ISO, and other styles

30

Dunton, Creaig Anthony. "FEMALE SEXUAL OFFENDERS-AN UNDEREXAMINED POPULATION." Master's thesis, University of Central Florida, 2004. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4426.

Full text

Abstract:

Sex crimes are considered to be among the most damaging and heinous forms of social deviance in existence. Besides the acts perpetrated by the offenders, the social stigma attached to being victimized is often just as injurious to the victim. Society sees males as the sole perpetrators of acts of sexual abuse, but this is not the case. The extant literature shows that women, while fewer in number, also perpetrate acts of sexual abuse and assault against other adults and children. This thesis is a preliminary typology that classifies female sexual offenders based upon the acts perpetrated, using cases presented in the extant literature. The pre-existing typologies that have been developed come largely from the psychiatric community, and therefore are classified on motivation rather than acts. While this is by no means a complete typology, it is an essential first step in learning more about this underexamined population.
M.S.
Department of Criminal Justice and Legal Studies
Health and Public Affairs
Criminal Justice

APA, Harvard, Vancouver, ISO, and other styles

31

Peterkin, Ren. "Perceptions of Tuberculosis among the Karen-Burmese Population in DeKalb County, Georgia." Digital Archive @ GSU, 2009. http://digitalarchive.gsu.edu/iph_theses/79.

Full text

Abstract:

Introduction: This study was conducted to gain an ethnographic understanding of the Karen persons from Myanmar and their perceptions of tuberculosis (TB) as well as to provide the DeKalb County Board of Health (DCBoH) TB program with practical recommendations for serving this population. Methods: In-depth, open-ended interviews were conducted with 37 Karen-Burmese persons living in the U.S. Local bilingual, bicultural researchers conducted the interviews with respondents recruited from the DCBoH TB clinic and surrounding communities in DeKalb County, Georgia. Both qualitative and quantitative strategies were used to analyze the data. Results: We found that the levels of knowledge pertaining to TB varied greatly. There were few perceptions that were statistically significant among gender and recruitment sources. Also, misconceptions were common in regards to TB transmission and low perceptions of risk. The respondents did request TB education in various formats such as videos and television. Some reported difficulties at the DCBoH included lack of interpreters, limited transportation, and clinic hours. Conclusions: Some of the perceptions of the Karen-Burmese towards TB can be addressed through education. To begin this process it is recommended that the DCBoH TB program provide language-appropriate services that enable both clients and staff members to effectively focus on all concerns regarding TB. Extended clinic hours and transportation would also be helpful for Karen clients. It is important that the staff receives continuous training in cultural competency and an overview of potential misconceptions that this population may embrace.

APA, Harvard, Vancouver, ISO, and other styles

32

Bruen, Brian Keith. "Assessing the Past, Present, and Future of Treatment of Hepatitis C in the D.C. Medicaid Population." Thesis, The George Washington University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13812577.

Full text

Abstract:

Starting in late 2013, new direct-acting antiviral medicines (DAAs) offered the chance of a cure for chronic hepatitis C virus (HCV) infection. In clinical trials, DAAs helped more than 90% of patients achieve sustained viral response (SVR), commonly considered to be a cure that will stop progression of related liver disease and prevent transmission of the virus to others. Prices for these medicines are now around $20,000 per treatment after discounts from manufacturers, due to competition.

In late 2016, the medical director for D.C. Medicaid asked what it would take to eradicate hepatitis C in the city. This dissertation focused on that question for Medicaid alone, to inform policy discussions and identify next steps. I profiled beneficiaries with chronic HCV infection based on medical claims from 2014-2016; interviewed medical providers and policymakers to learn more about their decision-making processes and to identify opportunities to expand treatment, as well as potential barriers; and created an Excel-based Markov model that estimates outcomes and costs under different scenarios.

Only 799 individuals, about 10% of the D.C. Medicaid beneficiaries identified as having chronic HCV infection, received treatment with DAAs in 2014-2016. Providers and policymakers are committed to treating this population, but treatment rates remained low through 2018. I estimate that roughly 80% of Medicaid beneficiaries with chronic HCV had not been treated at the start of 2019.

Beneficiaries with chronic HCV infection often have other physical, mental, and behavioral health conditions that might keep them from seeking treatment for an often-asymptomatic HCV infection. They often miss scheduled appointments and/or are lost to follow-up. Most live east of the Anacostia River, where there are fewer providers. Even if they engage in care, government or health plan policies might discourage or prevent individuals with low levels of liver damage from getting prior authorization for treatment.

Broader use of DAAs in D.C. Medicaid will allow more people to achieve SVR, potentially decreasing future healthcare costs for some and saving lives. A moderate (50%) increase in treatment rates among those with low liver damage could enable about 300 additional patients to achieve SVR over 10 years, at a net cost of $6.1 million. A 50% increase in treatment rates among those with moderate liver damage could enable more than 500 additional patients to achieve SVR over 10 years, keep more than 160 from severe liver damage, and avoid 19 early deaths. The net cost of the second scenario is $6.5 million, a smaller increase per person achieving SVR because curing those with moderate liver damage is more likely to avoid high healthcare costs.

The District must weigh the upfront costs of expanding use of DAAs against uncertain long-term benefits and inherent budget limitations. I recommend that D.C. develop a more complete profile of Medicaid beneficiaries with HCV infection; work toward universal screening and sustained monitoring of at-risk populations; collaborate with key stakeholders to develop policies, practices, and tools to engage beneficiaries in care; and reduce prior authorization requirements that might deter or prevent treatment when beneficiaries and health care providers are ready.

APA, Harvard, Vancouver, ISO, and other styles

33

Zellmer, Mark R. "Clinical Recognition of Obstructive Sleep Apnea in a Population-Based Sample." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/837.

Full text

Abstract:

Obstructive sleep apnea (OSA), a disorder in which the airway intermittently collapses and obstructs during sleep, is associated with increased cardiovascular and cerebrovascular morbidity and mortality, increased risk of motor vehicle accidents, metabolic syndrome, hypertension, and depression. Treatment of OSA attenuates or reverses many of these associated risks. However, most cases of OSA are unrecognized and untreated. The two most recent studies using 1990s data found that only 6.5 - 15.4% of OSA cases, depending on severity, are clinically recognized in mixed gender populations. Based on a conceptual framework of improved physician awareness of OSA, and reduced diagnostic access bias with the increased availability of sleep laboratory services, increased OSA recognition since the 1990s was predicted. Study participants with clinically recognized OSA were identified using the resources of the Rochester Epidemiology Project, while the Berlin Questionnaire OSA high risk classification was used as a surrogate for prevalent OSA in this population. Analysis in a mixed gender population determined that OSA clinical recognition among those with prevalent OSA was 22.7 % (95% CI 19.6 - 25.8%) for mild or greater OSA severity leaving more than 75% of prevalent OSA clinically unrecognized and untreated in this population. Obesity and male gender were associated with increased likelihood of clinical recognition in bivariate and multivariate analyses, though even among obese men only 36.5% of OSA was clinically recognized. In order to support positive social change and address these inequities of OSA clinical recognition, strategies that enhance OSA recognition overall, and more specifically target recognition of OSA among women and the nonobese, should be developed and implemented. Further research regarding such strategies should consider whether they reduce OSA associated morbidity and mortality.

APA, Harvard, Vancouver, ISO, and other styles

34

Navarro, Christine. "Sexually transmitted diseases and their socio-demographic and behavioural correlates in Canada: National Population Health Survey, 1996-1997." Thesis, University of Ottawa (Canada), 2001. http://hdl.handle.net/10393/8963.

Full text

Abstract:

This research examines the two-year period prevalences and gender-specific correlates for self-reported gonorrhea, chlamydia, genital herpes, and genital warts among 43,192 sexually experienced Canadians aged 15 to 59 years in the 1996--97 National Population Health Survey. Reporting multiple partners in the past year was consistently related to higher prevalences of STD. Regular alcohol consumption was a potential indicator of a higher risk lifestyle that places men and women at increased risk for chlamydia and genital herpes. Canadian-born respondents were significantly more likely to report STD, which may be a result of respondent error. Gender, age, and age at first intercourse were also important correlates, acting as both direct risk factors influencing susceptibility and as markers of higher risk sexual activity. Although the survey relies on self-reports of STD experience, in combination with clinic-based studies and surveillance it can be a useful tool for targeting prevention strategies for the general population.

APA, Harvard, Vancouver, ISO, and other styles

35

Sharpe, Colin R. "Population-based case-control study of the effects of nonsteroidal antiinflammatory drugs on the risk of breast cancer." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ64666.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Valenzuela, Jose. "Medicare advantage's population make-up and its impact on the future of Medicare financing." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1526966.

Full text

Abstract:

The objective of the study was to validate the assumption that respondents who self-identified as white, were more likely to be enrolled in a Medicare Advantage HMO Plan and underutilize health care services when compared to their non-white counterparts.

The results showed that the majority of the respondents in the stratified population of Medicare eligible respondents were categorized as White, 11,271 out of 15,297, and 42% reported being enrolled in a Medicare Advantage HMO Plan. A total of 3,685 of the White respondents on Medicare Advantage HMO Plans indicated they were in "Good" or better health, which was 78% of all White respondents in this population. The mean number of times that White respondents were seen by an MD (Figure 2) fell within the same range of 5-6 times for the majority of the Race/Ethnic groups. The mean number of hospital stays for Whites and the other Race/Ethnic groups ranged from 1.86-1.92 within the same 12 month period, with the exception of Pacific Islanders.

APA, Harvard, Vancouver, ISO, and other styles

37

Moreira, Emília da Conceição Torres Dias. ""Profiles em Pitfalls in Stroke Care Chain: Population and Doctors Counterparts"." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/21939.

Full text

APA, Harvard, Vancouver, ISO, and other styles

38

Moreira, Emília da Conceição Torres Dias. ""Profiles em Pitfalls in Stroke Care Chain: Population and Doctors Counterparts"." Dissertação, Faculdade de Medicina da Universidade do Porto, 2009. http://hdl.handle.net/10216/21939.

Full text

APA, Harvard, Vancouver, ISO, and other styles

39

Poliquin, Suzette. "Calcium and vitamin D intake in a Canadian population : results from the Canadian Multicentre Osteoporosis Study." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99197.

Full text

Abstract:

Objectives. To estimate calcium and vitamin D intakes in Canadian men and women, to compare these intakes to Canadian guidelines, and to determine factors associated with intake of these nutrients.
Methods. We estimated intakes of calcium and vitamin D from both diet and supplements using cross-sectional data from 9,423 randomly selected subjects 25 years of age and older who completed an interviewer administered abbreviated food frequency questionnaire. The participants were recruited from July 1995 to September 1997 in nine centres across Canada. We characterized the relationships of calcium and vitamin D with socio-demographic and lifestyle variables, physical characteristics, medical diagnosis and use of osteoporosis related medications.
Results. The median daily intake for calcium was estimated to be 930 (interquartile range (IQR) = 589;1360) mg for women, and 774 (IQR = 507;1155) mg for men; for vitamin D, intakes were 3.6 (IQR = 1.1;10.0) pg and 2.7 (IQR = 0.9;7.5) pg for women and men, respectively. Age and study centre were found to be associated with calcium and vitamin D intakes in both genders. Other variables associated with calcium intake included vitamin D intake, weekly energy expenditure and femoral neck bone mineral density. Factors found to be associated with vitamin D intake in both genders included calcium intake, height and caffeine intake.
Conclusions. The only group that on average met adequate daily intake levels for calcium was women aged 51-70. For vitamin D, on average, women and men under age 51 met adequate intake levels. Further education programs may be required to encourage increased consumption of these nutrients.

APA, Harvard, Vancouver, ISO, and other styles

40

Rockell, Jennifer, and n/a. "Serum 25-hydroxyvitamin D concentrations and their determinants in the New Zealand population." University of Otago. Department of Nutrition, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080929.142611.

Full text

Abstract:

Adequate vitamin D status plays an important role in bone health and may also protect against Type 1 Diabetes (T1D), multiple sclerosis and certain cancers. Vitamin D is obtained from two sources; diet and through skin synthesis through the action of ultraviolet (UV) light. Dietary intakes of vitamin D are low in New Zealand (NZ) and the majority of our vitamin D comes from UV exposure. The NZ population may be at risk of low vitamin D status because of low dietary intakes, the country�s latitude (35-46 �S), and high proportion of darker skinned Maori and Pacific People. While case reports have described the occurrence of rickets, predominantly in immigrant groups, there are currently no national data on the vitamin D status of the NZ population. Reports of low vitamin D status in countries of similar latitude to NZ justify an examination of New Zealanders� vitamin D status. The best method to assess of vitamin D status is to measure circulating 25-hydroxyvitamin D concentrations. This thesis comprises three main studies. The first two had the following aims: to measure 25-hydroxyvitamin D concentrations and their determinants in a national sample (n=1585) of NZ children aged 5-14 y and to measure serum 25-hydroxyvitamin D concentrations and their determinants in a national sample (n=2948) of New Zealanders aged 15 y and over. The 2002 Children�s Nutrition Survey CNS02 was a year long (December, March-November) cross-sectional survey of a nationally representative sample of NZ school children 5-14 y. Over-sampling of Maori and Pacific children allowed ethnic specific analyses. The 1997 National Nutrition Survey (NNS97) participants were recruited over one year according to an area-based sampling frame with a 3 stage stratified design consisting of primary sampling units, households within each unit, and one randomly selected respondent from each household. Mean (99% CI) serum 25-hydroxyvitamin D concentrations were similar in children and adults (both 50 nmol/L). Among Maori, Pacific and NZEO children respectively, prevalence (%, 99% CI) of serum 25-hydroxyvitamin D deficiency (< 17.5 nmol/L) was 5% (2, 12), 8% (5, 14), and 3% (1,7). Based on a cutoff of < 37.5 nmol/L, prevalence of insufficiency was 41% (29, 53), 59% (42, 75) and 25% (15, 35), respectively. Based on a cutoff of 50 nmol/L, 56% of children were insufficient. Three percent of adult New Zealanders had serum 25-hydroxyvitamin D concentrations indicative of deficiency ([less than or equal to] 17.5 nmol/L); 48% and 84% were insufficient based on cutoffs of [less than or equal to] 50 and [less than or equal to] 80 nmol/L The main determinants of vitamin D status in NZ children were season, ethnicity and sex. After adjustment for other factors and covariates, boys had an adjusted mean (99% CI) 25-hydroxyvitamin D concentration 5 (1, 9) nmol/L higher than girls, Maori children were 7 (2, 11) and Pacific children 15 (11, 20) nmol/L lower than NZ European and Other (NZEO) children. Obese children were 7 (2, 11) nmol/L lower than overweight or �normal� weight. Children�s mean 25-hydroxyvitamin D concentrations (adjusted for other variables) peaked in March (69 nmol/L) and was at its lowest in August (36 nmol/L). In adults, there were effects of a similar magnitude of ethnicity and season on serum 25-hydroxyvitamin D concentrations. Obesity, latitude and age were determinants of vitamin D status in women but not men. Obese (BMI > 30) women had an adjusted mean vitamin concentration 6 (3, 10) nmol/L lower than women with BMI < 25. Women living in the South Island were 6 (3, 9) nmol/L lower than women living in the North Island. Additionally, adjusted mean serum 25-hydroxyvitamin D was 13 (8, 18) higher in women 15 -18 y than women 65 y or older. The third and final study aimed to determine whether the higher rates of vitamin D inadequacy reported in the winter than summer months in NZ also result in higher PTH concentrations, which would provide evidence for functional effect of inadequate vitamin D status. We also aimed to objectively explore the effect of natural skin colour on vitamin D status, given the higher prevalence of vitamin D insufficiency in dark-skinned groups living far from the equator. Skin colour measurements were taken with a hand-held light reflectometer (Datacolor Mercury[TM] 1000 colorimeter, Lawrenceville, NJ). In the 342 residents of Invercargill and Dunedin, mean serum 25-hydroxyvitamin D concentrations were lower in the late summer versus early spring (79 vs 51 nmol/L; P< 0.001). The lower serum 25-hydroxyvitamin D in early spring versus summer was associatedwith a 2 pg/mL (P< 0.001) higher parathyroid hormone (PTH) concentration. Interestingly, no significant effect of natural skin colour, based on light reflectance at the inside of the upper arm, was discovered, though there was a positive effect of tanning, based on light reflectance at the upper forearm, on serum 25-hydroxyvitamin D concentrations. Ethnicity and season are major determinants of serum 25-hydroxyvitamin D in New Zealanders. There is a high prevalence of vitamin D insufficiency in NZ children and adults, which may contribute to increased risk of osteoporosis and other chronic disease. While there is a pressing need for more convincing evidence with regards to the health risks associated with the low vitamin D status in children, evidence from the study of adults, where higher PTH concentrations were found during spring versus summer, suggests that the low 25-hydroxyvitamin D concentrations are having an adverse effect on bone health of adults. The high prevalence of vitamin D insufficiency in New Zealanders, warrants serious consideration of strategies such as fortification, to improve the vitamin D status of the population.

APA, Harvard, Vancouver, ISO, and other styles

41

Perez, Alicia Carmen Marlena. "Program Evaluation of the Employee Health and Wellbeing Program." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7568.

Full text

Abstract:

Health promotion and disease prevention are a focus of population health management. Without ongoing and rigorous evaluation, these programs may be in jeopardy of continuing. The purpose of this project was to conduct a descriptive population health- focused evaluation of a large-scale health system's employee health and wellbeing program. Guided by the Center for Disease Control and Prevention (CDC) framework for program evaluation in public health and National Center for Organization Development guidelines, a nurse-led evaluation was conducted using 5 specific data sets emphasizing organizational structure, employee health offerings, employee surveys, Pathway to Excellence survey, and program contributions. A descriptive analysis was applied towards interpreting the organizational structure, and identifying all contributions to employee wellness. Inferential analysis was applied to identify correlations between survey results. The findings of the evaluation were mixed. The organizational structure of the program complied with CDC wellness program guidelines; of the 97 service departments surveyed, results revealed an 83.51% improvement in engagement, disengagement, satisfaction, best places to work, and customer satisfaction. The Pathway to Excellence survey results revealed a supportive organizational structure for a culture of wellness. The program contribution analysis showed that the health system provided accessible wellness and health promotion opportunities. Positive social change may result from this evaluation as the program is reinforced and the focus on employee wellness, health promotion, and disease prevention services are continued. As a result, the lives of employees, their families, and communities might be improved.

APA, Harvard, Vancouver, ISO, and other styles

42

Sadeghzadeh, Seyedehsaloumeh. "Optimal Data-driven Methods for Subject Classification in Public Health Screening." Diss., Virginia Tech, 2019. http://hdl.handle.net/10919/101611.

Full text

Abstract:

Biomarker testing, wherein the concentration of a biochemical marker is measured to predict the presence or absence of a certain binary characteristic (e.g., a disease) in a subject, is an essential component of public health screening. For many diseases, the concentration of disease-related biomarkers may exhibit a wide range, particularly among the disease positive subjects, in part due to variations caused by external and/or subject-specific factors. Further, a subject's actual biomarker concentration is not directly observable by the decision maker (e.g., the tester), who has access only to the test's measurement of the biomarker concentration, which can be noisy. In this setting, the decision maker needs to determine a classification scheme in order to classify each subject as test negative or test positive. However, the inherent variability in biomarker concentrations and the noisy test measurements can increase the likelihood of subject misclassification. We develop an optimal data-driven framework, which integrates optimization and data analytics methodologies, for subject classification in disease screening, with the aim of minimizing classification errors. In particular, our framework utilizes data analytics methodologies to estimate the posterior disease risk of each subject, based on both subject-specific and external factors, coupled with robust optimization methodologies to derive an optimal robust subject classification scheme, under uncertainty on actual biomarker concentrations. We establish various key structural properties of optimal classification schemes, show that they are easily implementable, and develop key insights and principles for classification schemes in disease screening. As one application of our framework, we study newborn screening for cystic fibrosis in the United States. Cystic fibrosis is one of the most common genetic diseases in the United States. Early diagnosis of cystic fibrosis can substantially improve health outcomes, while a delayed diagnosis can result in severe symptoms of the disease, including fatality. We demonstrate our framework on a five-year newborn screening data set from the North Carolina State Laboratory of Public Health. Our study underscores the value of optimization-based approaches to subject classification, and show that substantial reductions in classification error can be achieved through the use of the proposed framework over current practices.
Doctor of Philosophy

APA, Harvard, Vancouver, ISO, and other styles

43

Davis, Sharon H. "Outcomes of the Implementation of the Mental Health Recovery Measure in the DeKalb Community Service Board Population." Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/iph_theses/91.

Full text

Abstract:

The relationship between mental health and public health has been debated for decades. But when services are delivered through publically funded mental health clinics, it clearly becomes a public health endeavor. One of the latest trends in mental health service delivery is the recovery concept. Developed in the 1990’s, the recovery concept represents a paradigm shift where successful treatment is defined by self-awareness, self-care, and self-fulfillment. Furthermore, patients are encouraged to assess their own progress in the recovery process. There are currently nine unique assessment tools to measure recovery progress, including the Mental Health Recovery Measure (MHRM), which was used in this study. The current study followed the implementation of the recovery model in the DeKalb Community Service Board (DeKalb CSB). DeKalb CSB has 12 locations that serve 10,000 patients with mental illness, substance abuse, and developmental disabilities each year. Only patients with primary diagnoses of mental health or substance abuse disorders were considered for this study. Implementation of the MHRM began in December 2008 and included all DeKalb CSB patients, however only new DeKalb CSB patients were considered for this study. During 13 months of data collection 960 clients completed 2 assessments and 196 completed 3 assessments. A new consumer is defined as someone who has just completed the intake process and has no record of previous service at DeKalb CSB. The current study examined trends in MHRM data in the DeKalb CSB population; and offered recommendations for future implementation.

APA, Harvard, Vancouver, ISO, and other styles

44

Scott, Susanne K. "Modeling Diabetes in the US Adult Population." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1274374033.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

陸凱縈 and Hoi-ying Victoria Luk. "How does population aging affect disease control among old age from a public health perspective." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42997495.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Luk, Hoi-ying Victoria. "How does population aging affect disease control among old age from a public health perspective." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42997495.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

Ejlertsson, Göran, Lena Edén, and Ido Leden. "Predictors of positive health in disability pensioners : a population-based questionnaire study using Positive Odds Ratio." Högskolan Kristianstad, Avdelningen för Hälsovetenskap, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-899.

Full text

Abstract:

BACKGROUND: Determinants of ill-health have been studied far more than determinants of good and improving health. Health promotion measures are important even among individuals with chronic diseases. The aim of this study was to find predictors of positive subjective health among disability pensioners (DPs) with musculoskeletal disorders. METHODS: Two questionnaire surveys were performed among 352 DPs with musculoskeletal disorders. Two groups were defined: DPs with positive health and negative health, respectively. In consequence with the health perspective in this study the conception Positive Odds Ratio was defined and used in the logistic regression analyses instead of the commonly used odds ratio. RESULTS: Positive health was associated with age > or = 55 years, not being an immigrant, not having fibromyalgia as the main diagnosis for granting an early retirement, no regular use of analgesics, a high ADL capacity, a positive subjective health preceding the study period, and good quality of life. CONCLUSION: Positive odds ratio is a concept well adapted to theories of health promotion. It can be used in relation to positive outcomes instead of risks. Suggested health promotion and secondary prevention efforts among individuals with musculoskeletal disorders are 1) to avoid a disability pension for individuals <55 years of age; if necessary, to make sure rehabilitation actions continue, 2) to increase efforts to support immigrants to adjust to circumstances connected to ill-health and retirement, 3) to pay special attention to individuals with fibromyalgia and other general pain disorders, and 4) to strengthen ADL activities to support an independent active life among disability pensioners.

APA, Harvard, Vancouver, ISO, and other styles

48

McAnally, Helena M., and n/a. "The association between rated intensity of 6-n-propylthiouracil and three health risk factors in a general population sample." University of Otago. Dunedin School of Medicine, 2009. http://adt.otago.ac.nz./public/adt-NZDU20091009.161623.

Full text

Abstract:

This thesis explored whether individual differences in taste perception (as measured by the rated intensity of 6-n-propylthiouracil (PROP)) were associated with tobacco use, alcohol use and misuse and obesity in the Dunedin Multidisciplinary Health and Development Study birth cohort at age 32. This cohort of 1037 participants was assessed at ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26 and, most recently, at 32 years, when 96% of the living study members were interviewed. At age 32, participants rated the intensity of a 0.0032mol/L solution of PROP using the general labelled magnitude scale (gLMS). PROP is almost tasteless to some but tastes bitter to others. As bitter tastes are aversive, due to their association with toxicity, it has been suggested that responses to PROP may reflect individual differences in taste perception that, in turn, have a protective effect on health. Study One sought to establish correlates of rated PROP intensity in this sample. A model controlling for sex, childhood socio-economic status (SES), childhood IQ and gLMS use predicted approximately 12% of the variability in PROP ratings. This finding highlighted the importance of using appropriate covariates in research attempting to link PROP perception with health risk behaviours, as these factors have also been associated with tobacco use, alcohol use and adiposity. Study Two did not find that greater perceived intensity from PROP was protective against smoking, as pack years smoked was not associated with PROP rating and ratings between groups of smokers were not significantly different. Differences in PROP perception were not protective against the lifetime smoking in this sample. Similarly, Study Three found no evidence to suggest that greater intensity from PROP was associated with reduced alcohol misuse. Furthermore, the previously observed association between PROP and yearly alcohol consumption may be better explained by the fact that SES accounts for some of the variance in both measures. In Study Four, rated PROP intensity was associated with Body Mass Index (BMI), waist circumference and body fat percentage, in women, but not in men. These associations were weakened after the inclusion of covariates in the models, but remained significant for both BMI and body fat percentage. Findings from Study Four indicate that taste perception may be associated with measures of adiposity in women. Taken together, these results highlight the importance of using appropriate control variables in research and indicate that a single measure of PROP perception may not adequately reflect the full effect of individual differences in taste perception on tobacco use or alcohol use and misuse. Since PROP perception was associated with differences in adiposity in women, however, individual differences in taste perception may be of public health importance. Future research should use continuous measures of a wider range of taste stimuli, to establish how taste perception (rather than just bitterness perception) affects health. Research should also ensure that covariates associated with tobacco use, alcohol use and misuse and adiposity (such as sex, SES and IQ) are included in analyses.

APA, Harvard, Vancouver, ISO, and other styles

49

Mo, Daojun. "The identification of subgroups of the general population susceptible to the effects of ambient particulate air pollution." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0019/MQ55079.pdf.

Full text

APA, Harvard, Vancouver, ISO, and other styles

50

Islam, K. M. Monirul. "Colorectal Cancer: Incidence and Mortality among The Medicare Population (1990-1997)." Case Western Reserve University School of Graduate Studies / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=case1093980347.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Dissertations / Theses on the topic 'Public and population health'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles