Three Essays in Health and Education

The goal of this dissertation is to apply empirical methodologies to analyze multiple topics in economics of education and health economics which have clear policy implications. Chapter 1 analyzes the effect of negative publicity of child abuse scandal on Catholic schools. Public notices of child abuse have surrounded Catholic Church leadership for decades, but intensified after the 2002 coverage by the Boston Globe and the ensuing accelerated media coverage. Using diocese level panel data of Catholic school enrollment, reports of abuse after 2002 appear to have a negative, long-lasting effect on both demand and supply of Catholic schools. No effect is observed from notices prior to 2002, suggesting the public awareness of the scandal from abuse reports, combined with mass media coverage, led to observable effects on Catholic School enrollment. Public notices of allegations related to the abuse scandal can explain about two-thirds of the decline in Catholic school enrollment share and the number of Catholic schools. Chapter 2 studies the effect of various state level policies as well as receiving a physician recommendation on the decision to uptake Human Papillomavirus (HPV) vaccine. HPV is the most common sexually transmitted source of infection in the United States. Recently, two vaccines were developed to provide immunization against certain types of HPV. In addition to physician recommendations to take these vaccines, different states have adopted a wide range of policies in order to increase the vaccination rate, specifically among younger females. In this study, I use survey data to examine the effect of the two most common adopted policies, school mandates and provision of educational content for parents about the virus and its immunization, as well as the effects of physician recommendations. The results indicate that the effect of policies on encouraging the HPV vaccination has been very limited at best, but the effect of receiving a physician\u27s advice for the HPV immunization is significant. Chapter 3 attempts to investigate the behavioral response to HPV vaccine. Immunization can cause moral hazard by reducing the cost of risky behaviors. In this study, I examine the effect of HPV vaccination on participation in Papanicolaou test (Pap test). The Pap test is a diagnostic screening test to detect potentially precancerous and cancerous process in the transformation zone. The Pap test is strongly recommended for women between 21-65 years old even after taking the HPV vaccine. If there is a reduction in willingness to have a Pap test as a result of HPV vaccination, it should be a concern for public health policy makers. The results show no evidence of moral hazard, more specifically in the short-run. The estimates range from zero to a positive effect of HPV vaccine initiation on having a Pap test

Trend Filtering via Empirical Mode Decompositions

The present work is concerned with the problem of extracting low-frequency trend from a given time series. To solve this problem, the authors develop a nonparametric technique called empirical mode decomposition (EMD) trend filtering. A key assumption is that the trend is representable as the sum of intrinsic mode functions produced by the EMD. Based on an empirical analysis of the EMD, the authors propose an automatic procedure for selecting the requisite intrinsic mode functions. To illustrate the effectiveness of the technique, the authors apply it to simulated time series containing different types of trend, as well as real-world data collected from an environmental study (atmospheric carbon dioxide levels at Mauna Loa Observatory) and from a large-scale bicycle rental service (rental numbers of Grand Lyon Vélo'v

Endodontic Management of Three-rooted Mandibular First Premolar Using Cone-beam Computed Tomography: A Case Report

The anatomy of the root canal system always affects endodontic treatment outcomes. Mandibular premolar teeth demonstrate extreme variations in root canal morphology. Mandibular first premolars typically exhibit basic single-root and single-canal anatomy. The occurrence of three roots in the mandibular first premolar has not been commonly reported in the literature. This article reported a case of a 26-year-old male with spontaneous pain of the mandibular first premolar representing the presence of an extra canal on the periapical radiograph. Cone-beam computed tomography (CBCT) was used to assess the root canal details which led to the finding of three canals. Further, a periapical bone defect was detected, and finally, the nonsurgical endodontic management of the mandibular first premolar with three canals and three different apical foramina was performed in one session

Urodynamic Study in Children

A b s t r a c t:Urodynamic study (UDS) is a serial of clinical tests, like uroflowmetry, filling cystometry, pressure-flow studies and assessment of urethral closure pressure. These tests include urethral pressure profilometry and also measurement of the leak-point pressure of lower urinary system. UDS is one of the essential clinical studies in children complaining of voiding dysfunction, neurogenic bladder, urine incontinence, enuresis and another lower urinary tract symptom. The aim of proper bladder management in these patients is to maintain the lower urinary tract to have good capacity, low pressure, preventing infection and incontinence. Long term goal is preventing any undue damage to the upper urinary tracts and intact kidneys function. This review article of pediatric urodynamic study provides a classified diagnostic approach to bladder dysfunctions in children

Projected Financial Losses Experienced by Community Health Centers under a Scenario of Major Cuts in Key Sources of Federal Funding: 2018-2022

Congress is currently considering options to significantly reduce federal funding for the Medicaid expansion and the Marketplace subsidies implemented under the Affordable Care Act (ACA). Separately, the Health Centers Fund, which currently accounts for 70% of all federal health center grant funding, is set to expire in September 2017. These potential changes in federal funding could have a dramatic impact on health centers and the communities they serve. The purpose of this brief is to simulate the potential combined impact of these major changes in federal funding that will directly affect community health centers. Secondarily, this brief also assesses the financial burden other state and federal programs would have to assume to help centers maintain services at their current capacity. Over the 2018-2022 time period, we estimate that under current law, and with primary care services expanding at the current pace, health centers would realize a total of $169 billion in revenues from all sources combined. Of that amount,$37.5 billion would come from funding streams that include Medicaid and private insurance, while some $10.5 billion would constitute federal grant funding from the Health Centers Fund. Using forecasting models based on historical revenue data from community health centers we project that health centers, operating at their current service levels, would have experienced a$48 billion shortfall over this time period, were the Medicaid expansion and Marketplace subsidies repealed and the Health Centers Fund not renewed. From the perspective of health centers and their communities, if alternative sources of funding are not found, this shortfall would equal 28.3 percent of the funding that would be required just to maintain services as projected under the ACA. The change in federal health center funding of the type considered in this simulation is also likely to further strain state budgets. Based on past trends, state and local governments would be expected to provide $14.5 billion in non-Medicaid grants and programs to help cover the shortfall, while discretionary federal grants would be used to offset part of the remaining gap. Given the shifting priorities in federal funding under the current administration, the burden on states may be higher than projected. Moreover, in the current fiscal environment, the likelihood of funding substitution at either the state or federal level is low. This suggests that health centers may have to scale back services, staff, and clinic sites in order to absorb financial losses

Single and combined effect of Cd and Zn on growth, metal accumulation and mineral nutrition in tobacco plants (Nicotiana tabacum L.)

Contamination by heavy metals (HM) is a global concern due to their impact on terrestrial and aquatic environments. This question has great relevance in agricultural areas due to excessive chemical fertilization. In this sense, Cd is a toxic element that can reach agricultural soils through chemical fertilization or sewage sludges. Tobacco plants (Nicotiana tabacum L.) can uptake and accumulate Cd in their tissues, and therefore, an increased risk for human health due to tobacco consumption. This study was performed to evaluate the response of tobacco plants to a single and combined amendment of Cd and Zn on agricultural soil with a pot experiment. A factorial experiment was performed with four Cd levels (0, 25, 50 and 100 mg kg-1) and three Zn levels (0, 15 and 25 mg kg-1). Growth, Cd and Zn bioaccumulation and nutrient uptake parameters were assessed. The results revealed that during the tobacco growth, Cd was bioaccumulated on roots (translocation factor 1). Besides, the Zn amendment significantly decreased the Cd uptake and accumulation, especially under intermediate doses (15 mg kg-1 Zn). Zinc amendments could be helpful as a mitigation measure for Cd uptake in tobacco plants and, therefore, for health risk reduction.Universidade de Vigo/CISUGMinisterio de Ciencia e Innovación | Ref. IJC2020-044197-IXunta de Galicia | Ref. ED431C 2021/4