Thesis (M.S. (Orthdontics))--University of Tennessee Medical Units, Memphis, 1965. / Spine title: Orthodontic index in epidemiological surveys. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 63-66).

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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Background: Compared to the general population, individuals with intellectual disabilities have a higher prevalence of health problems, including psychiatric and/or behavioural conditions (dual diagnosis). Research suggests that the proportion of persons with intellectual disabilities who have a dual diagnosis ranges from 14% to 64% depending on the population studied and the diagnostic criteria used. However, there is little population-based information in Canada about people with such a dual diagnosis. Objectives: The aims of this study were to estimate the prevalence of psychiatric or behavioural conditions among adults with an intellectual disability in Canada, and to estimate the use of mental health services among these individuals. Methods: This study was a secondary analysis of two cross-sectional, population-based surveys (2005 Canadian Community Health Survey: CCHS and 2006 Participation and Activity Limitation Survey: PALS), and the 2008/09 Survey of Adults with Intellectual Disabilities in South Eastern Ontario: SAID-SEO. Relevant variables were identified in the surveys to answer the study objectives. Confidence intervals were provided for all estimates and the results were compared within subgroups for each survey, as well as between surveys. Results: The proportion of Canadian adults with an intellectual disability is 0.2% according to the CCHS and 0.5% according to the PALS. The proportion of individuals with a dual diagnosis was found to be 31% in the CCHS, 44% in the PALS, and 33% in the SAID-SEO. These prevalence estimates fall within the ranges reported in the literature. Lastly, the majority of adults with a dual diagnosis reported using health services in the past year. Conclusion: According to the three surveys examined (CCHS, PALS, SAID-SEO), psychiatric and behavioural conditions are present in about a third of the individuals with intellectual disabilities, which is in accordance with published literature. However, the estimates of the prevalence of intellectual disabilities in the CCHS and PALS were considerably lower when compared to the literature. Among the surveys, the PALS presented the highest quality of data regarding the population with a dual diagnosis. The surveys found that a majority of individuals with a dual diagnosis access some form of health services at least once a year. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-10-28 00:15:54.488

The health sector has not yet begun to explore the full potential of geographical information system (GIS) technology for health research and planning. The goal of this thesis is to demonstrate this potential in Africa through the application of GIS to the most important health issues in the continent. In excess of 23,000 homesteads are mapped and interviewed throughout Hlabisa district, Kwa-Zulu Natal using differential global positioning systems (GPS). I use the GIS to analyse mode health care usage patterns. 87% of homesteads use the nearest clinic and travel an average distance of 4.72 km to do so. There is a significant logarithmic relationship between distance from clinic and usage by the homesteads (r2 = 0.774, p<0.0001). I propose the distance usage index (DUI) as a composite spatial measure of clinic usage. The index is the sum of the distances from clinic to all actual client homesteads divided by the sum of the distances from clinic to all homesteads within its distance-defined catchment. The index encompasses inclusion, exclusion and strength of patient attraction for each clinic. The DUI highlights significant disparities in clinic usage patterns across the district (mean = 110%, SD =43.7). The results of the study have important implications for health planning in Africa. I use GIS/GPS technology to quantify the spatial implications of a shift towards community-based treatment of tuberculosis using the DOTs strategy in Hlabisa. The mean distance from each homestead in the district to nearest supervision point is measured using a GIS. The shift in treatment strategy from hospital to community-based between 1991-1996 reduces the mean distance to treatment point from 29.6 km (94% of the population > 5km) to 1.5 km (entire population < 5km). GIS effectively documents and quantifies the impact of community-based tuberculosis treatment on access to treatment. I produce the first quantifiable evidence of a relationship between distance to roads and HIV prevalence using a GIS. HIV prevalence was measured through anonymous surveillance among pregnant women in Hlabisa and stratified by clinic attended. Assuming women attend the nearest clinic, the mean distance from homesteads to a primary or secondary road for each clinic catchment is strongly correlated with HIV prevalence (r = 0.66; p = 0.002). Further research is needed to better understand this relationship both at ecological and individual levels.I develop a methodology that has numerous applications to health systems provision in developing countries where limited physical access to primary health care is a major factor contributing to the poor health of populations. I use an accessibility model within a GIS to subdivide an area into units of equal workload using a range of physical and social variables. The methodology could be used to ergonomically design programmes for home-based care and tuberculosis directly observed treatment. It could also be used as a basis for more efficient distribution of community health workers. I use high-resolution long-term rainfall and temperature data to produce the first malaria seasonality (length, start and end of transmission season(s)) maps for Africa. I relate the model to population data and estimate the population exposure in a variety of transmission settings. I investigate the relationship between predicted length of transmission season and parasite ratio from 2335 geo-referenced studies of children <10 years across Africa. The research is the first to correlate actual malaria survey data with model predictions at a continental scale. The seasonality model corresponds well with historical expert opinion maps and case data. A significant logarithmic relationship is detected between predicted length of transmission season and parasite ratio (r2=0.712, p=0.001). I recompute the changes in the disease likely to occur as a result of global warming. The seasonality model constitutes an important first step towards an estimate of continental intensity of transmission. / Thesis (Ph.D.)-University of Natal, 2000.

Efficient allocation of scarce resources to health programs involves measuring the economic benefits of life saving and/or improvement in health status. While several attempts have been made to quantify individual preferences for life, only a few, if any, have attempted to measure individual preferences for quality of life. In this thesis, we develop a methodology based on the estimation of individual preference functions to arrive at monetary measures of the value of marginal improvements in health status. / The first chapter reviews conventional methodologies for estimating the value of human life, and points out many theoretical and empirical propositions related to our own concerns. The second chapter analyzes various procedures used to quantify variations in health status. We distinguish non-monetary procedures, which combine recent psychometric techniques and research on health level scaling to obtain estimates of the relative desirability of a state of health, and monetary procedures which, we conclude, still need to be developed. / The third chapter presents a new methodology based on the direct estimation of bivariate welfare function of income and level of health. The theoretical basis of our approach and the data source are described in this chapter. Various functional forms were tried but we have finally retained the log-normal specification to derive estimates of the monetary value of a marginal change in the state of health for different subgroups of individuals. / We conclude with critical discussion of our results. Some improvements over the approach used are suggested in the fifth chapter.

Thesis (D.P.H.)--University of Hawaii at Manoa, 1994. / Includes bibliographical references (leaves 161-170). / Microfiche. / xiv, 170 leaves, bound ill., col. map 29 cm

Thesis (M. Sc.)--Brock University--[St. Catherines, Ontario], 2006. / Includes bibliographical references (leaves 102-118).

Thesis (Ph. D.)--University of New South Wales, 1999. / Also available online.