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Examining Spatial Patterns of Primary Health Care Utilization in Southern HondurasBaker, Jonathan B. 30 September 2005 (has links)
No description available.
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A STUDY OF ATHLETIC TRAINING EDUCATION FACULTY ATTITUDES’ TOWARD INSTRUCTIONAL TECHNOLOGY AND THEIR EXTENT OF UTILIZATION OF THAT TECHNOLOGYAustin, Jennifer M. 14 July 2004 (has links)
No description available.
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Evaluation of Ischemic Stroke-Related Healthcare Utilization Trends Using Recent National Data: 2000 – 2005Karve, Sudeep 15 July 2009 (has links)
No description available.
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Minimum cost requirements from a response function and incorporation of uncertainty in composition of feeds into chance-constrained programming models of livestock rations /St-Pierre, Normand Roger January 1985 (has links)
No description available.
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A constrained Markov population model /Sahr, Louis Edgar January 1978 (has links)
No description available.
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Four Essays in Health EconomicsChami, Nadine January 2019 (has links)
This thesis addresses health-policy relevant questions regarding quantity and quality of service delivery in primary healthcare using health administrative data from the province of Ontario. It is comprised of four chapters that explore the following questions: (1) What is the impact of switching from an enhanced fee-for-service (EFFS) payment model to a blended capitation payment model on the specialist referral rates of primary care physicians? (2) What are the rates of inappropriate laboratory testing in the province of Ontario? (3) What are the costs and determinants (physician and practice characteristics) of these inappropriate tests? (4) What is the impact of primary care payment structure on the quantity (number and cost) and the quality (appropriateness) of clinical laboratory testing?
Fee-for-service (FFS) payment systems give physicians an incentive to treat patients on the margin of being referred, whereas in capitation systems physicians do not have a financial incentive to treat such marginal patients. Chapter 1 empirically examines how these two payment systems affect referral rates. The results show an increase in specialist visits upon a switch from an EFFS model to a blended capitation model when the physician is listed as the referring physician in the data, but no change in total specialist visits for these physicians’ patients. This change is not observed immediately upon switching payment models. Physicians paid by blended capitation who practice in an interdisciplinary health team have fewer specialist visits per rostered patient compared to EFFS physicians, despite an increase in their patients’ specialist visits after joining the interdisciplinary team.
Using a definition of inappropriateness that quantifies ordering clinical laboratory tests too often or too soon following a previous test, Chapter 2 examines the rates of inappropriate laboratory testing for nine selected analytes in Ontario. The chapter finds that the percentage of inappropriate tests ranges from 6% to 20%. Moreover, between 60% and 85% of the time, the physician ordering an inappropriate test is the same physician who ordered the previous test. The findings also show that specialists are more likely than primary care physicians to order repeat tests too soon.
Chapter 3 examines the costs and determinants associated with the rates of inappropriate laboratory utilization. The associated costs of inappropriate/redundant laboratory testing for the selected analytes ranges between 6 – 20% of the total cost of each test. Statistical analyses of the association of physician and practice characteristics with inappropriate testing are done using a logit model. Conditional upon the variables within the model, male physicians, physicians trained outside of Canada, older physicians, and a younger patient population are all shown to be associated with less inappropriate testing. Primary care physicians in group practices and in payment models with pay-for-performance (P4P) incentives are less likely to order inappropriate tests and specialist physicians are twice as likely to order inappropriately compared to FFS primary care physicians. Differences in physician, practice and patient characteristics, however, explain only a small amount of the variation in inappropriate utilization.
Chapter 4 examines how physicians’ laboratory test ordering patterns change following a switch from an FFS payment model enhanced with P4P to a blended capitation payment model, and the differences in ordering patterns between traditional staffing and interdisciplinary teams within the blended capitation model. Using a propensity score weighted fixed-effects specification to address selection, the chapter estimates that a mandatory switch to capitation would lead to an average of 3% fewer laboratory requisitions per patient. Patients’ laboratory utilization also becomes more concentrated with the rostering physician. More importantly, using diabetes-related laboratory tests as a case study, physicians order 3% fewer inappropriate/redundant tests after joining the blended model and 9% fewer if they joined an interdisciplinary care team within the blended model. / Thesis / Doctor of Philosophy (PhD)
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Native Forb Establishment in Tall Fescue-dominated Cattle PasturesBellangue, David Nsame 20 February 2023 (has links)
Temperate grasslands and the services they provide are threatened with severe degradation from human-driven land use changes. Among the worst affected services is pollinator support with grassland degradation contributing to the global decline in insect abundance due to habitat loss and a lack of floral resources. This has prompted conservation organizations to support pollinator conservation on working landscapes by increasing floral resources, but gaps remain in the consistent establishment of native forbs in intensively managed agricultural areas. We evaluated factors that influence native forb establishment during seed-based enrichment planting of tall fescue-dominated cattle pastures in two separate experiments: one testing a range of site preparation treatments with different seasons of sowing and comparing their effects on tall fescue suppression and seeded native plant establishment and the other investigating the effects of seed rate and pre-seeding cold stratification on native forb establishment on separate plots. For the site preparation experiment, we observed a mean target plant density of 0.12 target plants per m2 (SD = 0.247) The greatest target plant stem density (P < 0.0001) and species richness (P < 0.001) was in plots treated with a 2% glyphosate solution and sown with native seeds in early summer with the next five best treatments composed solely of fall sown replicates. For the seed and stratification experiment, we observed a mean target plant density of 88 target plants per m2 (SD = 73.9). Higher seeding resulted in greater target plant abundance in plots (P < 0.0001) with a seed rate of 56 kg/ha-1 resulting in almost three times as many target plants compared to 2.24 kg/ha-1. Pre-seeding stratification resulted in an increase in target plant abundance (P < 0.01). Target species richness was consistent between treatment levels. Results suggest that native forb establishment can be enhance by eliminating pasture grasses prior to seeding and the use of high seeding rates sown in the fall or using stratified seed. / Master of Science / Temperate grasslands and the services they provide are threatened with severe degradation from human-driven land use changes. Among the worst affected services is pollinator support with grassland degradation contributing to the global decline in insect abundance due to habitat loss and a lack of floral resources. To reverse this decline, conservation groups are encouraging the use of native plants throughout the landscape especially on farms and ranches to provide more resources for insect pollinators. One exciting opportunity exists in planting wildflowers into tall fescue-dominated cattle pastures that occupy millions of hectares of land in the Southeastern United States to provide food for pollinating insects. However little information exists on how to successfully establish wildflowers as much expertise is based on work done in the tallgrass prairie region of the Midwest. This study's goal was to investigate what control wildflower establishment by evaluating the success of an existing establishment experiment testing several site preparation techniques and different sowing seasons. A separate experiment was set up looking at the effect different seed rate and cold moist stratification had on establishment success of wildflowers. For the site preparation experiment, establishment was low for all treatments with a mean target plant density of 0.12 target plant per m2 (SD = 0.247). Summer sown 2% glyphosate had the highest wildflower richness and abundance at 0.35 target plants per m2 (SD = 0.247) and fall sown treatments were found to have higher sown wildflower abundance and richness than summer sown treatments. For the seed and stratification experiment, we observed a mean target plant density of 88 target plants per m2 (SD = 73.9). Target plant abundance did change between treatment levels with the highest and second highest seed levels yielding nearly three times and twice as many sown wildflowers as the lowest treatment respectively. Stratification resulted in an increase in sown wildflower abundance and sown wildflower richness did not differ significantly between treatment levels. Results suggest that native forb establishment can be enhance by eliminating pasture grasses prior to seeding and the use of high seeding rates sown in the fall using stratified seed.
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A comparison of oxygen utilization determination techniques for the activated sludge processStallard, Warren Michael 10 June 2012 (has links)
Evaluation of the data from the series of batch experiments has led to the following conclusions:
1. Currently used methods of quantifying oxygen uptake rate, especially for batch reactors, yield values of oxygen utilization considerably lower than those predicted by mass balance considerations for these three wastes. In the face of Blok's published data indicating much better results with a short run reactor, it must be assumed that the length of run selected was at least partially responsible.
2. While quantitatively unsatisfactory, the methods for determining oxygen uptake used in these experiments seem to be of some use as monitors of biological systems. Changes in slope of the oxygen utilization curve were found to be more apparent at lower loadings. / Master of Science
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The Prevalence and Operational Feasibility of Utilizing Pre-commercially Thinned Pine as a Woody Biomass Energy SourceHanzelka, Nathan Carl 22 May 2015 (has links)
The southern pine beetle (SPB) poses a significant threat to pine forests of the southeastern US. Pre-commercial thinning (PCT) is a commonly used silvicultural practice to mitigate and prevent SPB spread in young southern pine stands. Typically, PCT represents an added management cost to landowners and thinned material is not utilized for forest products. Increased demand for woody biomass energy may provide landowners and harvesting contractors an opportunity to utilize PCT residues as a woody biomass energy feedstock, which may wholly or partially offset PCT costs. However, little information is available regarding harvestable biomass quantities in PCT stands and few studies have assessed harvesting productivity and costs in very young pine stands. To develop estimates of biomass abundance in PCT candidate stands, loblolly pine (Pinus taeda) stands aging 5 to 12-years old, and enrolled in the Virginia Department of Forestry Pine Bark Beetle Prevention Program (VDOF PBBPP), were inventoried across the Piedmont and Coastal Plain regions of Virginia. To attain productivity and cost estimates of utilizing small-diameter stems for woody biomass energy, a biomass harvesting case study was then conducted on a 15-year old loblolly pine stand. Results of the inventory and case study indicate that stands at the upper age limit for the PCT program may contain harvestable quantities of biomass (39.63 green tons/acre), although high harvesting costs ($23.46/green ton) relative to regional delivered biomass prices may limit the economic feasibility of utilizing PCT biomass for energy. / Master of Science
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Assessment of the Response of Piscivorous Sportfishes to the Establishment of Gizzard Shad in Claytor Lake, VirginiaBonds, Charles Craig 20 April 2000 (has links)
Gizzard shad were illegally introduced to Claytor Lake in the late 1980s and soon established a thriving population. This study assessed 1) the degree to which gizzard shad were utilized by piscivores (pelagic - striped bass Morone saxatilis, hybrid striped bass M. chrysops x M. saxatilis, and walleye Stizostedion vitreum, and three littoral black basses Micropterus spp.), 2) the availability of gizzard shad as potential prey as determined from age and growth analysis, and 3) the performance (growth rates, relative weight, and relative abundance) of piscivores before versus after gizzard shad establishment.
Gizzard shad were more highly utilized by pelagic predators (especially striped bass and their hybrids) than black basses. Rapid growth of gizzard shad (mean back-calculated length at age-1 = 155 mm TL) meant that almost all morphologically available shad were age-0. The reliance on one edible age class of gizzard shad resulted in an unstable food supply as evidenced by much greater striped bass shad consumption in Summer 1998 (63 % by weight) when age-0 shad were more abundant than in Summer 1997 (7 % by weight).
Striped bass was the only species to exhibit faster growth rates and mean relative weight (Wr) values in the 1990s versus pre-shad years. Walleye (except age-1) and black bass growth rates declined, and mean Wr values either remained consistent or declined. Largemouth bass and walleye were the only sportfish to show increases in relative abundance.
Benefits of gizzard shad as a forage fish appear to be limited to striped bass and its hybrid species. It is possible that gizzard shad have had, directly or indirectly, an adverse impact on the black basses of Claytor Lake, but explanatory analysis of these relationships was beyond the scope of this study. / Master of Science
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