<p> Increasingly, e-cigarettes are being used and claimed to be an effective means of smoking cessation. Clinical studies have been limited to the aspects of use pertaining to chemical dependence, yet little addiction research has examined the psychology of smoking cessation behavior utilizing e-cigarettes. Health behaviors, such as harm reduction in smoking through the use of nicotine replacement therapies, have been previously studied and several dispositional traits have been found to be highly related to these behaviors. These personality factors include Neuroticism and Conscientiousness, Self-Efficacy, Grit, and Hardiness. The present study aimed to determine psychological traits related to successful smoking cessation utilizing e-cigarettes using measures of NEO-FFI-3, GSE, DRS-II, and Grit-S. Results indicated that Self-Efficacy was a noteworthy factor associated with cessation with 6 months or more of e-cigarette use. A majority of the study participants did not concurrently smoke and use e-cigarettes. These findings support the potential of e-cigarettes as a replacement therapy and provide some insight into formulating interventions toward this end; however, smoking cessation attempts appeared to be inhibited from full success as a result of the efficacy of the replacement.</p>

<p> Farmworkers and their families may experience increased levels of agricultural pesticides in their homes due to both (1) take-home/soil track-in on shoes, clothes and skin, and (2) air infiltration from nearby agriculture fields via agricultural pesticide drift in the vapor phase or adhered to resuspended soil particles. This dissertation estimates the relative contributions o the take-home/soil track-in and air infiltration pathways of agricultural pesticides into homes, as well as identifies the risk factors for increased in-home agricultural pesticide levels for farmworkers and their families living near agriculture fields. Samples of outdoor air, yard soil, and house dust from 21 farmworkers' homes in Yuma County, Arizona were collected and analyzed for a suite of agricultural pesticides. To capture household information, such as behaviors, demographics, and housing structure, a participant questionnaire was administered at the time of the sampling. A pesticide transport model was developed, evaluated, and applied to quantify relative contributions of the air infiltration and the take-home/soil track-in pathways of agricultural pesticides into the house dust of the farmworkers&rsquo; homes. To explore a wide-range of potential risk factors for increased agricultural pesticide levels in the homes, traditional statistical methods and Classification and Regression Tree (CART) analyses were used. The results of this study, found that the air infiltration pathway contributes to over 90% of some agricultural pesticides in the house dust found in the farmworkers&rsquo; homes. In addition, among the influential risk factors for increased in-home agricultural pesticide levels was the home being a closer distance to an agricultural field, as well as the home having carpeted floors, more farmworkers per square footage of the home, and less months of heating and cooling the home. It is suggested that future intervention efforts to reduce in-home agricultural pesticide levels put more emphasis on targeting the air infiltration pathway, and take into consideration relevant risk factors for increased pesticide levels in the home.</p>

The Chinese construction industry is China's third biggest industrial killer. Accidents causation analysis revealed that more than 80% of accidents are caused by unsafe human behaviour. The current research was focused on exploring and examining the factors affecting safety rule violations among Chinese construction workers through four main studies in which a combination of qualitative and quantitative methodologies were used. In the first study, on-site observation and organisational document analysis were conducted in fourteen construction companies to familiarise the author with the research settings and to obtain triangulation evidence for the following studies. It was followed by the second study in which interviews and focus groups were conducted among 97 managers, safety officers and workers in order to explore the factors associated with workers' rule violation. Thematic analysis revealed four main categories of factors, i.e., individual factors, managerial factors, sectoral and labour market factors, and national and cultural factors. The qualitative study was followed by questionnaire surveys (n = 700) to test in a larger management sample the qualitative study's results. Survey results complemented the qualitative study's findings. Based on the obtained results, a fourth study using the Delphi method and the modified G1 method was conducted among 17 experts in order to calculate the importance levels of each factor in influencing workers' rule violation. Although managerial factor was ranked as the most influential factor compared with other categories, some extra-organisational factors and situations were ranked at high positions amongst 24 specific factors. The results suggested that workers' behaviour need to be scrutinised not only within the context of organisational safety management, but also from the particular background and characteristics of Chinese migrant workers, Chinese construction sector, as well as the society and the culture.

<p> Sickle cell disease is a disabling chronic autosomal recessive blood disease characterized by abnormal hemoglobin, pain crises, and frequent emergency department visits. Adherence to hydroxyurea therapy has been shown to improve these patient outcomes. Guided by the theory of comfort, the purpose of this project was to determine if an educational intervention would increase adherence to hydroxyurea therapy in pediatric patients between 2 and 17 years of age recruited from an urban university hospital hematology clinic. The RE-AIM model was used to support the translation of evidence and the change process. An educational video produced by AFLAC was viewed by patients&rsquo; parents 4 weeks after enrollment into this pretest/posttest design project. A total of 22 African-American parent participants completed the 8-item Morisky Medication Adherence Scale at baseline and again at 8 weeks to assess hydroxyurea adherence. The Short Test of Functional Health Literacy in Adults tool was used to assess parents&rsquo; health learning needs; all parents met the adequate literacy level at baseline. Using <i>t</i> test statistics, no statistically significant differences were found pretest to posttest on the Morisky Medication Adherence Scale scores, mean corpuscular hemoglobin, and fetal hemoglobin percentages. Wilcoxon Signed Rank tests showed no significant differences in emergency room visits nor number of pain crisis. Although no significant changes emerged in short-term hematologic findings, emergency room visits, and pain crises, social change in the health care setting was promoted by confirming parents were able to understand education and a high level of hydroxyurea adherence was maintained; literature indicated that long-term adherence to hydroxyurea limits severe attacks.</p>

<p> Women and men&rsquo;s preferences for delivery services in rural Ethiopia Nancy Beam Aims: This study aims to determine the combination of facility-based delivery care attributes preferred by women and men; if gender differences exist in attribute preferences; and key demographic factors associated with attribute preferences. </p><p> <b>Background:</b> Despite programs to promote facility-based delivery, which has been shown to decrease maternal and neonatal mortality, 80% of women in rural Ethiopia deliver at home without a skilled birth attendant. </p><p> A review of the Ethiopian literature on factors associated with delivery location revealed several weaknesses in research methods that need to be addressed. First, research participants were almost exclusively women, although male partners often make decisions about delivery location. Second, most quantitative study designs are similar in content to the Ethiopian Demographic Health Survey, limiting the generation of new knowledge. Third, cultural practices identified in qualitative studies as barriers to facility-based delivery have not been included in quantitative studies. This study addressed these weaknesses by using discrete choice experiment methodology to elicit preferences for delivery service attributes, including support persons in the delivery room, staff training and attitude, cost, distance and transportation availability. </p><p> <b>Methods:</b> A cross-sectional, discrete choice experiment was conducted in 109 randomly selected households in rural Ethiopia in September-October 2015. Women, who were pregnant or who had a child &lt; 2 years old, and their male partners were interviewed. After completing a demographic questionnaire, male and female respondents were asked separately to choose between facility-based scenarios that reflected various attributes for delivering their next baby. Data were analyzed using a multilevel mixed-effects logistic regression model. </p><p> <b>Results:</b> Both women and men preferred health facilities where medications and supplies were available, a support person was allowed in the delivery room, cost was low, and doctors performed the delivery. Women also valued free ambulance service, while men favored nearby facilities with friendly providers. Men are disproportionately involved in making household decisions, including decisions about whether their wives seek health care. Yet, men are often unaware of their partners&rsquo; prenatal care attendance. </p><p> <b>Implications:</b> The Ethiopian government and health facilities could increase facility births in rural areas by responding to families&rsquo; delivery service preferences.</p>

The purpose of this study was to investigate the behavioral impact of knowledge regarding the relationship between breast cancer, vitamin D supplementation, and sunlight exposure considering levels of self-efficacy and response-efficacy. The study was based on protection motivation theory, which attributes behavior change to cognitive processes related to perceived threats and has demonstrated efficacy in promoting breast cancer risk-reducing behaviors. The study employed a quasi-experimental research design based on a survey using SurveyMonkey. Participants were New York City-residing women ranging in age from 25 to 74 who were recruited via an invitation from SurveyMonkey. Correlation analysis and linear regression analysis were performed on the data extracted from the survey in order to better understand the relationship of the variables in this study, and to test if any of the independent variables were significant predictors of vitamin D intake through supplementation and sunlight exposure. The results of this analysis showed that knowledge regarding the reduction in risk of breast cancer from sunlight exposure and through vitamin D supplementation was not related to changes in behavior involving increases in sunlight exposure and vitamin D intake through supplementation. Further, the results showed that those participants with higher levels of self-efficacy and response-efficacy regarding sunlight exposure and vitamin D supplementation had an increased amounts of vitamin D intake through supplementation on a daily basis. The results of this study can be used to help medical professionals understand the complexity involved in how their clients may or may not take action to reduce the potential for reducing the risk of breast cancer.

The use of human immunodeficiency virus (HIV) counselling and testing (HCT) is a necessary component of implementing HIV prevention and control programs in Nigeria. Knowledge, acceptance, and use of HCT remain low in Nigeria, especially among young people ages 15 to 24 years. The purpose of this study was to ascertain how sociodemographic factors (i.e., gender, place of residence, level of education, geopolitical zone, and socioeconomic status [SES]); cognitive factors (i.e., HCT awareness, knowledge of HIV prevention, and knowledge of HIV transmission); and knowledge of sexual risk behaviors affected HCT uptake among young people in Nigeria using data from the 2013 National HIV/AIDS and Reproductive Health Survey Plus. The study was guided by the social cognitive theory. The sample was composed of 10,091 young people ages 15 to 24 years from all geopolitical zones, SES, and educational backgrounds in Nigeria. Multiple regressions and multivariate comparisons revealed a significant relationship between HCT awareness and HCT uptake (p < .001) and between knowledge of HIV prevention and HCT uptake (p < .001). Sociodemographic variables of gender, place of residence, level of education, geopolitical zone, and SES were also significantly associated with HCT uptake. The sexual risk behavior variables tested were not significantly associated with HCT uptake among young people in Nigeria. The implications for positive social change include providing public health professionals with data to plan and implement HCT awareness and knowledge programs for young people in Nigeria that could increase HCT uptake and reduce the incidence of HIV/AIDS.

Background Motor Vehicle Crashes (MVCs) are a major cause of morbidity and mortality worldwide. This thesis explores the potential use of large databases of primary care medical records to investigate the epidemiology of MVCs in the United Kingdom and to supplement the data available from national statistics, which are believed to understate both the number of crashes, and the number of injuries which occur as a result. Methods Details of all individuals enrolled in The Health Improvement Network (THIN) database whose primary care records indicated involvement in a MVC were used to calculate a series of summary measures describing the burden and consequences of MVCs. These were compared with data available from police accident reports and from hospital admissions. Data from THIN were used to conduct a series of studies of the impact of health and healthcare-related factors on the risk of involvement in MVCs. Specifically: a case-control study of the impact of modifiable lifestyle factors on the risk of MVC; case-crossover and self-controlled case-series studies of the effect of exposure to prescribed medications on the risk of MVC; a case-control study investigating the impact of disordered sleep on the risk of MVC; a case-control study of the risk of involvement in MVC among individuals with diabetes relative to the general population; and; a cohort study assessing whether there is evidence to suggest that involvement in a MVC may indicate the presence of undiagnosed disease which may impair driving performance. Results The socio-demographic characteristics of individuals involved in MVCs recorded in THIN differ markedly from those recorded in police accident reports and hospital admissions data. There was no evidence of consistent trends in MVC incidence over time in the three data sources. Differences in data collection methodology and the severity and scope of crashes recorded may account for these variations. Evidence was found of an association between having a high Body Mass Index and involvement in MVCs, and between past (but not current) smoking and involvement in MVCs, however the recording of data on lifestyle-related exposures such as smoking and alcohol consumption in the age-groups most likely to be involved in MVCs was poor, complicating interpretation of these results. Current exposure to benzodiazepines and preparations containing opioid analgesics was found to increase the risk of involvement in MVCs, as was longer-term use of non-benzodiazepine hypnotics, selective serotonin reuptake inhibitors and antihistamines. No increased risk of MVC was observed with exposure to beta-blockers or tricyclic antidepressants. Individuals reporting insomnia or snoring to their primary care practitioner were found to be at increased risk of MVC, as were individuals with diagnosed sleep apnoea. This association was independent the use of sedative or antidepressant medications. Individuals with diabetes were not found to be at an increased risk of MVC compared with the general population, and there was no difference in risk between those receiving different forms of treatment. Involvement in a MVC was associated with an increased risk of being diagnosed with cardiac disease in the two years following the crash. Conclusions Current sources of data about MVCs in the UK use different data collection methodologies, none of which is likely to accurately describe the overall burden of MVCs in the population. Primary care data remain a useful resource for those wishing to study the epidemiology of MVCs, but care must be taken to ensure that the uses to which the data are put are appropriate. Studies investigating lifestyle-related exposures are unlikely to produce reliable results as primary care recording of such factors is poor in the age-groups most likely to be involved in MVCs. Primary care data are more useful when studying the time course of pharmacological effects, or the effects of diagnosed illness, and can successfully detect previously observed associations. Primary care data is currently of little use in the study of injuries associated with involvement in MVCs as it is rare for both an injury and its proximate cause to be recorded. The investigation of methods by which this problem might be resolved is an important avenue for future research.

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