Using Crowd-Sourced Data to Assess the Temporal and Spatial Relationship between Indoor and Outdoor Particulate Matter.

Using hourly measures across a full year of crowd-sourced data from over 1000 indoor and outdoor pollution monitors in the state of California, we explore the temporal and spatial relationship between outdoor and indoor particulate matter (PM) concentrations for different particle sizes. The scale of this study offers new insight into both average penetration rates and drivers of heterogeneity in the outdoor-indoor relationship. We find that an increase in the daily outdoor PM concentration of 10% leads to an average increase of 4.

Analysis of Educational Debt and Income Among Pharmacists and Other Health Professionals.

To evaluate educational debt-to-income trends in pharmacy, dentistry, medicine, optometry, and veterinary medicine in the United States from 2010 to 2016. A retrospective analysis of educational debt and income for selected health professions was conducted. Data on student loan debt were collected from professional organizations and data on income were collected from the American Community Survey.

Heat, Disparities, and Health Outcomes in San Diego County's Diverse Climate Zones.

Climate variability and change are issues of growing public health importance. Numerous studies have documented risks of extreme heat on human health in different locations around the world. Strategies to prevent heat-related morbidity and reduce disparities are possible but require improved knowledge of health outcomes during hot days at a small-scale level as important within-city variability in local weather conditions, socio-demographic composition, and access to air conditioning (AC) may exist.

The mobility of elite life scientists: Professional and personal determinants.

As scientists’ careers unfold, mobility can allow researchers to find environments where they are more productive and more effectively contribute to the generation of new knowledge. In this paper, we examine the determinants of mobility of elite academics within the life sciences, including individual productivity measures and for the first time, measures of the peer environment and family factors. Using a unique data set compiled from the career histories of 10,051 elite life scientists in the U.

The Effects of Providing Fixed Compensation and Lottery-Based Rewards on Uptake of Medical Male Circumcision in Kenya: A Randomized Trial.

Background: Effective demand creation strategies are needed to increase uptake of medical male circumcision and reduce new HIV infections in eastern and southern Africa. Building on insights from behavioral economics, we assessed whether providing compensation for opportunity costs of time or lottery-based rewards can increase male circumcision uptake in Kenya.

Methods: Uncircumcised men aged 21-39 years were randomized in 1:1:1 ratio to 2 intervention groups or a control group.

Early-Life Exposure to the Great Smog of 1952 and the Development of Asthma.

Rationale: Little is known about the long-term effects of air pollution exposure and the root causes of asthma. We use exposure to intense air pollution from the 1952 Great Smog of London as a natural experiment to examine both issues.

Objectives: To determine whether exposure to extreme air pollution in utero or soon after birth affects asthma development later in life.

Health Shocks and Natural Resource Management: Evidence from Western Kenya.

Poverty and altered planning horizons brought on by the HIV/AIDS epidemic can change individual discount rates, altering incentives to conserve natural resources. Using longitudinal household survey data from western Kenya, we estimate the effects of health status on investments in soil quality, as indicated by households' agricultural land fallowing decisions. We first show that this effect is theoretically ambiguous: while health improvements lower discount rates and thus increase incentives to conserve natural resources, they also increase labor productivity and make it more likely that households can engage in labor-intensive resource extraction activities.

Something in the water: contaminated drinking water and infant health.

This paper provides estimates of the effects of in utero exposure to contaminated drinking water on fetal health. To do this, we examine the universe of birth records and drinking water testing results for the state of New Jersey from 1997 to 2007. Our data enable us to compare outcomes across siblings who were potentially exposed to differing levels of harmful contaminants from drinking water while in utero.

Health and labor supply in the context of HIV/AIDS: the long-run economic impacts on antiretroviral therapy().

Using longitudinal survey data collected in Kenya, this paper estimates the longer-term impacts of antiretroviral therapy (ART) on the labor supply of treated adults and their household members. Building upon previous work in Kenya, data collected from 2004-2006 indicate that early evidence on the short-run impacts of ART tends to be upheld over the long-term as well. The results show that the labor supply response among treated adults occurs rapidly and is sustained through the 3-year observation period in our study.

Behavioral Responses of Patients in AIDS Treatment Programs: Sexual Behavior in Kenya.

We estimate changes in sexual behavior for HIV-positive individuals enrolled in an AIDS treatment program using longitudinal household survey data collected in western Kenya. We find that sexual activity is lowest at the time that treatment is initiated and increases significantly in the subsequent six months, consistent with the health improvements that result from ART treatment. More importantly, we find large and significant increases of 10 to 30 percentage points in the reported use of condoms during last sexual intercourse.

Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders.

Objective: There is limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy (ART). This study tested the efficacy of short message service (SMS) reminders on adherence to ART among patients attending a rural clinic in Kenya.

Design: A randomized controlled trial of four SMS reminder interventions with 48 weeks of follow-up.

AIDS Treatment and Intrahousehold Resource Allocation: Children's Nutrition and Schooling in Kenya.

The provision of antiretroviral medications is a central component of the response to HIV/AIDS and consumes substantial public resources from around the world, but little is known about this intervention's impact on the welfare of children in treated persons' households. Using longitudinal survey data from Kenya, we examine the relationship between the provision of treatment to adults and the schooling and nutrition outcomes of children in their households. Weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult patient.

ARV Treatment and Time Allocation to Household Tasks: Evidence from Kenya.

Using longitudinal survey data collected over a period of two years, this paper examines the impact of antiretroviral (ARV) treatment on the time allocated to various household tasks by treated HIV-positive patients and their household members. We study outcomes such as time devoted to housework, firewood and water collection, as well as care-giving and care-seeking. As treatment improves the health and productivity of patients, we find that female patients in particular are able to increase the amount of time they devote to water and firewood collection.

The Economic Impact of AIDS Treatment: Labor Supply in Western Kenya.

Using longitudinal survey data collected in collaboration with a treatment program, this paper estimates the economic impacts of antiretroviral treatment. The responses in two outcomes are studied: (1) labor supply of treated adult AIDS patients; and (2) labor supply of individuals in patients' households. Within six months after treatment initiation, there is a 20 percent increase in the likelihood of the patient participating in the labor force and a 35 percent increase in weekly hours worked.

Rotator cuff repair: an analysis of utility scores and cost-effectiveness.

More than 75,000 rotator cuff repairs are performed annually, yet cost-effectiveness data are unavailable. This study examines the cost utility of rotator cuff repair by relating surgical costs to increase in quality-adjusted life-years (QALYs). Eighty-seven patients were followed up prospectively for 1 year, during which cost and quality of life data were collected.

Cost-effectiveness of preventive strategies for women with a BRCA1 or a BRCA2 mutation.

Background: For BRCA1 or BRCA2 mutation carriers, decision analysis indicates that prophylactic surgery or chemoprevention leads to better survival than surveillance alone.

Objective: To evaluate the cost-effectiveness of the preventive strategies that are available to unaffected women carrying a single BRCA1 or BRCA2 mutation with high cancer penetrance.

Design: Markov modeling with Monte Carlo simulations and probabilistic sensitivity analyses.

How will employers respond to coverage reforms.

Any change in the health insurance market could prompt a reaction by employers in what kind and at what cost they offer coverage. This policy brief examines the research on employer decision-making. Key findings include: Firms are most likely to offer plans that respond to the preferences of their most valuable, hard-to-retain workers.

Cost-effectiveness of single-level anterior cervical discectomy and fusion for cervical spondylosis.

Study Design: Cost-effectiveness analysis with retrospective cost analysis and literature review.

Objective: To determine the relative cost-effectiveness of anterior cervical discectomy and fusion (ACDF) with autograft, allograft, and allograft with plating for single-level anterior cervical spondylosis.

Summary Of Background Data: There are several accepted methods of surgically treating single-level cervical spondylosis anteriorly.

Managing febrile respiratory illnesses during a hypothetical SARS outbreak.

Since the World Health Organization declared the global outbreak of severe acute respiratory syndrome (SARS) contained in July 2003, new cases have periodically reemerged in Asia. This situation has placed hospitals and health officials worldwide on heightened alert. In a future outbreak, rapidly and accurately distinguishing SARS from other common febrile respiratory illnesses (FRIs) could be difficult.

Outcome versus service based payments in health care: lessons from African traditional healers.

We compare the more common physician compensation method of fee-for-service to the less common payment-for-outcomes method. This paper combines an investigation of the theoretical properties of both of these payment regimes with a unique data set from rural Cameroon in which patients can choose between outcome and service based payments. We show that consideration of the role of patient effort in the production of health leads to important differences in the performance of these contracts.

To err on humans is not benign. Incentives for adoption of medical error-reporting systems.

Concerns about frequent and harmful medical errors have led policy makers to advocate the creation of a system for medical error reporting. Health providers, fearing that reported information about errors would be used against them under the current medical malpractice system, have been reluctant to participate in such reporting systems. We propose a re-design of the malpractice system -- one in which penalties are a function of the health provider's reporting efforts -- to overcome this incentive problem.