Three Essays On Mortality, Health, And Migration

This dissertation contains three chapters covering relationships between mortality, health, migration. Using a discrete time failure model via pooled logistic regression, chapter one shows that self-rated health is a significant predictor of mortality in rural Malawi, a context that differs greatly from those in most previous studies. This indicates that the well-established relationship between self-rated health and mortality extends to even the most resource poor settings. In chapter two, life tables are created for each state in the United States that allow for the measurement of migration over the full life course. The results show that migrants are generally positively selected on their health, and more importantly that migration reduces inequality in mortality between states. This is a contrast to other research on geographical inequality in mortality, which typically does not point to migration as a driver of other observed mortality trends. Finally, using a marginal model through generalized estimating equations, analysis in chapter three shows the varying degree to which internal migrants in the United States are selected on their health. Individuals were selected most significantly on measures of disability, and analyzing only married couples gave the strongest results by showing how individuals can be selected on a spouse’s health. Since couples often move together, marriage is an important dimension of health selective migration on the individual level in the United States

Comparative mortality of hemodialysis patients at for-profit and not-for-profit dialysis facilities in the United States, 1998 to 2003: A retrospective analysis

<p>Abstract</p> <p>Background</p> <p>Concern lingers that dialysis therapy at for-profit (versus not-for-profit) hemodialysis facilities in the United States may be associated with higher mortality, even though 4 of every 5 contemporary dialysis patients receive therapy in such a setting.</p> <p>Methods</p> <p>Our primary objective was to compare the mortality hazards of patients initiating hemodialysis at for-profit and not-for-profit centers in the United States between 1998 and 2003. For-profit status of dialysis facilities was determined after subjects received 6 months of dialysis therapy, and mean follow-up was 1.7 years.</p> <p>Results</p> <p>Of the study population (<it>N </it>= 205,076), 79.9% were dialyzed in for-profit facilities after 6 months of dialysis therapy. Dialysis at for-profit facilities was associated with higher urea reduction ratios, hemoglobin levels (including levels above 12 and 13 g/dL [120 and 130 g/L]), epoetin doses, and use of intravenous iron, and less use of blood transfusions and lower proportions of patients on the transplant waiting-list (<it>P </it>< 0.05). Patients dialyzed at for-profit and at not-for-profit facilities had similar mortality risks (adjusted hazards ratio 1.02, 95% CI 0.99–1.06, <it>P </it>= 0.143).</p> <p>Conclusion</p> <p>While hemodialysis treatment at for-profit and not-for-profit dialysis facilities is associated with different patterns of clinical benchmark achievement, mortality rates are similar.</p

Development and Capabilities of ISS Flow Boiling and Condensation Experiment

An experimental facility to perform flow boiling and condensation experiments in long duration microgravity environment is being designed for operation on the International Space Station (ISS). This work describes the design of the subsystems of the FBCE including the Fluid subsystem modules, data acquisition, controls, and diagnostics. Subsystems and components are designed within the constraints of the ISS Fluid Integrated Rack in terms of power availability, cooling capability, mass and volume, and most importantly the safety requirements. In this work we present the results of ground-based performance testing of the FBCE subsystem modules and test module which consist of the two condensation modules and the flow boiling module. During this testing, we evaluated the pressure drop profile across different components of the fluid subsystem, heater performance, on-orbit degassing subsystem, heat loss from different modules and components, and performance of the test modules. These results will be used in the refinement of the flight system design and build-up of the FBCE which is manifested for flight in late 2017-early 2018