Essays on the Microeconomics of Development in Tanzania

University of Minnesota Ph.D. dissertation.May 2016. Major: Applied Economics. Advisors: Paul Glewwe, Deborah Levison. 1 computer file (PDF); ix, 107 pages.This dissertation contributes to a growing body of research on the microeconomics of development in Sub-Saharan Africa. Fertility, labor market participation and agriculture are key components of the microeconomic development process in Tanzania. I explore household and individual decisions in all three of these domains in Tanzania through economic analysis and impact evaluation. Both experimental and non-experimental impact evaluations improve the public understanding of what works in economic development. For the first essay in Chapter 2, I explore household fertility decisions by estimating the effect of a community family planning education program on fertility behavior in the Meatu District. In Chapter 3, I investigate the effects of an entrepreneurship training program on financial literacy and employment attitudes in the Kagera region. In Chapter 4, I analyze the impact of polygyny on agricultural productivity in farming households across the country

An evaluation of an online peer support forum for university students with depressive symptoms

Background: Depression is the most common mental health problem among young people, particularly university students, with prevalence rates as high as 48% reported. This population however, is reluctant to seek professional help. Online interventions may be particularly appealing to students, with evidence suggesting that they use the Internet for mental health support. While there are many mental health resources on the Internet few focus specifically on the needs of young people and few have been evaluated. This research aimed to develop and pilot test an online peer support intervention for students experiencing depressive symptoms. Methods: A depression support Web site (www.losetheblues.ie) was designed specifically for 18-24. year old students. The study used a mixed method, involving quantitative descriptive, pre- and post-test and qualitative descriptive designs. Data were collected using the Centre for Epidemiological Studies Depression Scale (CES-D), a background questionnaire and online forum posts. Results: The sample consisted of 117 university students with self-reported depressive symptoms. Results from participants in the pre- and post-test element of the study, showed no statistical significance. The forum posts revealed that the participants' main difficulties were loneliness and perceived lack of socialization skills. The Web site provided a place for sharing, offering and receiving emotional and informational support. Conclusion: Developing health care interventions in an online environment presents unique challenges to the research process, however they have the potential to provide mental health care that is accessible and affordable

The Impact of a Values-Based Supply Chain (VBSC) on Farm-Level Viability, Sustainability and Resilience: Case Study Evidence

peer-reviewedThe ‘Agriculture of the Middle’ (AotM) development paradigm emphasises that in order to survive, family farms must transition from a supply chain approach to a values-based supply chain (VBSC) approach, involving amendments to both product type and actor dynamics within the chain. This paper presents a qualitative case study of a beef co-operative integrated to a VBSC. We use an analytical framework of viability, sustainability and resilience to analyse impacts at farm-level. Our analysis highlights a number of positive effects on farm-level viability, sustainability and resilience. These benefits stemmed largely from improvements to market orientation, price stability, and members’ capacities in responding to problems. However, the autonomy of the co-operative was challenged by VBSC chain members, which impacted negatively on the stability of the co-operative

Help-seeking behaviors and mental well-being of first year undergraduate university students

University students demonstrate poor help-seeking behaviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-being, and to explore these students’ views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a university in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students’ knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group

Prior Routine use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19

Acknowledgments: We gratefully acknowledge the collaborators of the study listed below: Ross Alexander, Emma Bhatti, Carly Bisset, Alice Cavenagh, Jemima Collins, Charlotte Davey, Siobhan Duffy, Jenny Edwards, Alice G Einarsson, Norman Galbraith, Madeline Garcia, James Hesford, Mark Holloway, Tarik Jichi, Joanna Kelly, Sheila Jones, Thomas Kneen, Thomas Lee, Kiah Lunstone, Emma Mitchell, Dolcie Paxton, Lyndsay Pearce, Terence J Quinn, Frances Rickard, Shefali Sangani, Rebecca Simmons, Sandeep Singh, Charlotte Silver, Thomas Telford, Alessia Verduri.Peer reviewedPublisher PD

Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

Acknowledgement We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two amongst the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR) Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions’ Research and Development Offices and Caldicott Guardians for their assistance and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.Peer reviewedPublisher PD

Nurses and midwives' experiences with a peer group clinical supervision intervention: A pilot study

Aim: This study aimed to evaluate differences in supervisees' understanding of clinical supervision and their perceptions of organisational functioning before and after engaging in peer-group clinical supervision. Background: Protected reflective time allows discussion of complex issues affecting health care. Peer-group clinical supervision is one model of clinical supervision that could facilitate this, but it is poorly understood. Methods: A preâ post intervention pilot study was performed. The intervention was delivered over a 12-month period. Data were collected using surveys on demographic and work-related factors and experience of clinical supervision pre- and post intervention. Results: Adaptability increased significantly between the pre- and post surveys. The post survey data showed finding time for clinical supervision scoring lowest with open-ended comments reinforcing this. The supervisees found the sessions to offer a safe place despite initial concerns. Conclusion: The peer-group model of clinical supervision allowed supervisees to build a rapport and trust with their colleagues and share experiences. Implications for Nursing Management: The benefits to participating in peer-group clinical supervision traversed the individual and organisation. These data support the implementation of such sessions while addressing workload and time pressures to aid participation

Peer group clinical supervision: Qualitative perspectives from nurse supervisees, managers, and supervisors

Background: Clinical supervision helps promote practitioners' personal and professional development through fostering a supportive relationship and working alliance. Peer group clinical supervision is a form of clinical supervision whereby two or more nurses engage in a supervision process to improve their professional practice and provide quality care. Aim: To explore the experiences of supervision from the perspectives of nurse supervisees, their direct line managers, and clinical supervisors. Methods: A qualitative descriptive pragmatic design was used. Individual interviews and focus groups were conducted with 27 participants. Data were analysed using deductive content analysis. Findings: Three main categories were identified: Perceived benefits of peer group clinical supervision, challenges faced during peer group clinical supervision, and enhancements for future peer group clinical supervision sessions. Stress reduction, problem solving, managing change, and improved prioritisation were amongst the benefits gained from clinical supervision. Challenges included competing work demands, staffing issues, and the duration, location, and process of supervision. Participants recommended adding time to the allocated supervision hour, raising awareness of peer group clinical supervision in advance, and training expert supervisors. Discussion: The space for peer group clinical supervision needs to be primed beforehand through providing and ensuring protected time, the availability of experienced supervisors, and raising key stakeholders' awareness of what supervision entails. Stress caused by competing work demands and the fear of losing momentum need to be considered by services in advance. Conclusion: Findings support the planning, delivery, and evaluation of future peer group clinical supervision sessions, while addressing challenges identified by study participants

Routine Use of Immunosuppressants is Associated with Mortality in Hospitalised Patients with Covid-19

Acknowledgement We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two among the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR), Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions’ Research and Development Offices and Caldicott Guardians for their assistance and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.Peer reviewedPublisher PD

Clinical and economic systematic literature review to support the development of an integrated care programme for chronic disease prevention and management for the Irish health system

Report prepared for the Clinical Strategy and Programmes Division (CSPD) of the Health Service Executive to support the work of integrated clinical care programmes.Based on a clinical and economic systematic review of the international literature, this report presents the evidence on integrated care programmes and generic models of care designed for chronic disease prevention and management. This evidence will support the work of integrated clinical care programmes in Ireland through the Clinical Strategy and Programmes Division of the HSE