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Search Results: 1 - 10 of 5884 matches for " Gregory Pappas "
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Geographic Data on Health Inequities: Understanding Policy Implications
Gregory Pappas
PLOS Medicine , 2006, DOI: 10.1371/journal.pmed.0030357
Abstract:
La metafilosofía de los pragmatistas clásicos
Pappas,Gregory Fernando;
Discusiones Filosóficas , 2010,
Abstract: in this paper i argue that the metaphilosophy of pragmatists is the most important contribution of these philosophers to the history of philosophy and is also what distinguishes them from other philosophers. the classic american philosophers (peirce, james, and dewey) and the hispanic philosophers, ortega y gasset and risieri frondizi, proposed that philosophy must start from experience. after explaining what it means to take experience as the starting point, i examine the reasons that pragmatists philosophers have for holding the view that experience should be the starting point if philosophy is to be empirical and relevant.
Multilevel Modeling of Binary Outcomes with Three-Level Complex Health Survey Data  [PDF]
Shafquat Rozi, Sadia Mahmud, Gillian Lancaster, Wilbur Hadden, Gregory Pappas
Open Journal of Epidemiology (OJEpi) , 2017, DOI: 10.4236/ojepi.2017.71004
Abstract: Complex survey designs often involve unequal selection probabilities of clus-ters or units within clusters. When estimating models for complex survey data, scaled weights are incorporated into the likelihood, producing a pseudo likeli-hood. In a 3-level weighted analysis for a binary outcome, we implemented two methods for scaling the sampling weights in the National Health Survey of Pa-kistan (NHSP). For NHSP with health care utilization as a binary outcome we found age, gender, household (HH) goods, urban/rural status, community de-velopment index, province and marital status as significant predictors of health care utilization (p-value < 0.05). The variance of the random intercepts using scaling method 1 is estimated as 0.0961 (standard error 0.0339) for PSU level, and 0.2726 (standard error 0.0995) for household level respectively. Both esti-mates are significantly different from zero (p-value < 0.05) and indicate consid-erable heterogeneity in health care utilization with respect to households and PSUs. The results of the NHSP data analysis showed that all three analyses, weighted (two scaling methods) and un-weighted, converged to almost identical results with few exceptions. This may have occurred because of the large num-ber of 3rd and 2nd level clusters and relatively small ICC. We performed a sim-ulation study to assess the effect of varying prevalence and intra-class correla-tion coefficients (ICCs) on bias of fixed effect parameters and variance components of a multilevel pseudo maximum likelihood (weighted) analysis. The simulation results showed that the performance of the scaled weighted estimators is satisfactory for both scaling methods. Incorporating simulation into the analysis of complex multilevel surveys allows the integrity of the results to be tested and is recommended as good practice.
Exploring ethical considerations for the use of biological and physiological markers in population-based surveys in less developed countries
Gregory Pappas, Adnan A Hyder
Globalization and Health , 2005, DOI: 10.1186/1744-8603-1-16
Abstract: The paper contends that a unitary set of ethical principles should be followed for surveys around the world that precludes the danger of creating double standards (and implicitly lowers standards for work done in developing countries). Global ethical standards must, however, be interpreted in the context of the unique historical and cultural context of the country in which the work is being done. Factors that influence ethical considerations, such as the relationship between investigators in developed and developing countries are also discussed.The paper provides a set of conclusions reached through this discussion and recommendations for the ethical use of biomarkers in populations-based surveys in developing countries.The national health information needs of developing countries are increasingly relying on the collection of biological and physiological measures [1-5]. The use of these biomarkers in population-based surveys has led to a call for a review of the ethical standards under which surveys are conducted in less-developed nations [6]. Controversies over clinical research conducted in developing countries have intensified the scrutiny of all research being conducted in these settings [7]. This debate has reaffirmed that the global human rights and medical ethical principles – including fidelity, truthfulness, confidentiality, autonomy, and beneficence, – must be carefully reviewed in the name of research, surveillance, monitoring, and evaluation [8-10]. Ethical issues in population-based surveys include informed safety, informed consent, confidentiality, and reporting findings of testing. Globalization of ethical principles must be interpreted within the particulars of national context in which the scientific study takes place.Development of rapid, low cost, diagnostic kits and portable, robust technology has made possible a new generation of population-based health surveys [11]. While standards and safeguards for health interview surveys in developing count
Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center
Jeffrey L Moe, Gregory Pappas, Andrew Murray
Globalization and Health , 2007, DOI: 10.1186/1744-8603-3-11
Abstract: An exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes.The changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI) accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative.The KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC suggests culture is broader than organizational or societal culture to include an informal global network of medical professionals and Western technologies which facilitate global interaction. Additionally, political competencies among leaders may be particularly relevant in globalizing health care services where the goal is achieving international standards of care. Western communication technologies facilitate cross-border interaction, but social and political capital possessed by the leaders may be necessary for transactions acro
Prevalence of head lice and hygiene practices among women over twelve years of age in Sindh, Balochistan, and North West Frontier Province: National Health Survey of Pakistan, 1990-1994
Sadia Mahmud, Gregory Pappas, Wilbur C Hadden
Parasites & Vectors , 2011, DOI: 10.1186/1756-3305-4-11
Abstract: Overall about 7% women aged 12 years and older suffered from head lice infestation. Multivariable logistic regression analysis identified factors independently associated with presence of head lice. Age less than 16 years and crowding at home were associated with higher infestation-rates. The impact of household socio-economic status on infestation rates among women was different in urban and rural settings; urban women with low socio-economic status were more vulnerable than similar women in rural settings. Bathing infrequently in summer was associated with higher prevalence rates only in Sindh, possibly due to the fact that among the three provinces Sindh has a hotter and more humid summer.The results of our analysis of NHSP indicate high levels of head lice infestation among girls and women in the three Provinces. The epidemiological profile of hygienic practices of women indicated that NWFP and Balochistan as compared to Sindh, and rural as compared to urban areas were less developed with respect to access to water supply and soap for maintaining personal hygiene. Simple and cost-effective measures such as provision of water and soap, and improving awareness regarding maintaining personal hygiene can contribute significantly towards improving public health status of the women in Pakistan.Pediculosis capitis, also known as head lice infestation, is caused by Pediculus humanus capitis an ectoparasite of man found on the hair and scalp [1]. Most of the reported studies on epidemiology of head lice are restricted to school populations. An epidemiological survey conducted in school children aged 8 -- 16 years in Peshawar, Pakistan from April -- December 1986 identified an overall prevalence of 46%, with girls having a higher prevalence rate (49%) than boys (40%) [2]. The infestation rate decreased as a linear function of age in both sexes, and increased with increasing crowding at home. A survey conducted among 6 to 15 years old urban and rural elementary school chil
Repeated Sparks Produce Free Energy: A Rigorous Mathematical Explanation of the Authors, by the Hidden Ampere Force Law  [PDF]
Panos Pappas, Theocharis Pappas, Eleuterios Pappas
Journal of Applied Mathematics and Physics (JAMP) , 2018, DOI: 10.4236/jamp.2018.61015
Abstract: This is the twinned paper of the increased mass paper,Gravity is acting at superluminous infinite speed, thus collapsing special theory of relativity of Einstein, an explanation for almost everything (according to the authors’ rigorous mathematical proof and overwhelming experimental evidence)\"[1]. In the present paper, we describe the repeated spark or repeat current in terms of the hidden, Non-Relativistic Longitudinal Cardinal Ampere Force which is not found yet infallible for every case. The impressive finding is the fact that these repeated sparks as we shall see, have no back-emf, but forward-emf and forward-Ampere-motive-force. The only consumption is the resistive load with the very high currents needed. This means its total energy consumption is less than the released energy-output work plus heat, plus the energy recharging the batteries. All these are in excess of the consumed input energy. This means the Repeated sparking is “over-unity” efficiency and that, using super-conductive materials, we shall have constructed the first “perpetual mobile” plus producing extra electrical energy. Several previous journals that we did not mention here their names did not dare to publish our disliked papers of very important and revolutionary results but were not able to counter argue our arguments. They preferred the silence and have not answered us at all for many years now. Even some of them were involved previously with the repeated sparking which is the same topic of our present paper.
Validity of measures of pain and symptoms in HIV/AIDS infected households in resources poor settings: results from the Dominican Republic and Cambodia
Gregory Pappas, R Cameron Wolf, Guy Morineau, Richard Harding
BMC Palliative Care , 2006, DOI: 10.1186/1472-684x-5-3
Abstract: This study investigates the construct validity of measures of reported pain, pain control, symptoms and symptom control in areas with high HIV-infected prevalence in Dominican Republic and Cambodia Measures were adapted from the POS (Palliative Outcome Scale). Households were selected through purposive sampling from networks of people living with HIV/AIDS. Consistencies in patterns in the data were tested used Chi Square and Mantel Haenszel tests.The sample persons who reported chronic illness were much more likely to report pain and symptoms compared to those not chronically ill. When controlling for the degrees of pain, pain control did not differ between the chronically ill and non-chronically ill using a Mantel Haenszel test in both countries. Similar results were found for reported symptoms and symptom control for the Dominican Republic. These findings broadly support the construct validity of an adapted version of the POS in these two less developed countries.The results of the study suggest that the selected measures can usefully be incorporated into population-based surveys and evaluation tools needed to monitor palliative care and used in settings with high HIV/AIDS prevalence.Access to antiretroviral therapy (ART) has improved for people living in resource poor countries over the past year.[1] Palliative care is a critical component of these efforts because it improves the success of ART by providing symptom and pain control and because quality end-of-life care is needed by many who will die despite the increasing availability of ART. [1-5] A recent review of patient outcomes in HIV palliative care found significant improvements in the domains of pain and symptom control, anxiety, insight and spiritual wellbeing.[7]The development of feasible and valid methods is required to assess the public health needs of communities with high HIV prevalence and to evaluate the impact of support interventions.[8,9] A range of well-validated measures have been developed
Acute Experimental Hyperthyroidism Does Not Affect Basal and Volume-Induced Atrial Natriuretic Peptide Secretion in Healthy Subjects
Gregory Giamouzis,Dimitrios Pappas,Nikolaos Simeonidis,Evangelos Stathogiannis,Filippos Triposkiadis,George N. Koukoulis
Cardiology Research and Practice , 2011, DOI: 10.4061/2011/381865
Abstract: Background. Excess circulating thyroid hormones are associated with increased cardiac atrial natriuretic peptide (ANP) secretion but the exact mechanisms involved have not been fully elucidated in vivo. Methods. To examine whether thyroid hormone regulation of ANP secretion is the result of a direct action on the myocardium and/or of an indirect action through alterations in the peripheral circulation, plasma ANP levels (baseline and volume expansion-induced) were evaluated in 14 healthy men, before and after triiodothyronine (T3) administration. Results. T3 administration was followed by a significant increase in serum T3 levels and a significant decrease in serum TSH levels, without significantly affecting ANP levels. Systemic vascular resistance, plasma rennin activity (PRA), and aldosterone (ALDO) levels, as well as indices of left atrial function, were not significantly altered, despite a significant increase in cardiac output. Plasma volume expansion, induced by a 1500 ml normal saline (NSal) infusion, both before and after T3 administration, was followed by a significant decrease in PRA and ALDO and a significant increase in plasma ANP levels, without significantly affecting the mean blood pressure (BP) and heart rate (HR) in each study period. The NSal-induced response, measured as the integrated area under the curve corrected for baseline values (-AUC), was not different after T3 administration for ANP, ALDO, PRA, HR, and mean BP. Conclusion. In vivo thyroid hormone-induced myocardial ANP secretion is the result of an indirect action mainly through hemodynamic changes that increase atrial stretch.
Incidence, patterns and severity of reported unintentional injuries in Pakistan for persons five years and older: results of the National Health Survey of Pakistan 1990–94
Zafar Fatmi, Wilbur C Hadden, Junaid A Razzak, Huma I Qureshi, Adnan A Hyder, Gregory Pappas
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-152
Abstract: National Health Survey of Pakistan (NHSP 1990–94) is a nationally representative survey of the household. Through a two-stage stratified design, 18, 315 persons over 5 years of age were interviewed to estimate the overall annual incidence, patterns and severity of unintentional injuries for males and females in urban and rural areas over the preceding one year. Weighted estimates were computed adjusting for complex survey design using surveyfreq and surveylogistic option of SAS 9.1 software.The overall annual incidence of all unintentional injuries was 45.9 (CI: 39.3–52.5) per 1000 per year; 59.2 (CI: 49.2–69.2) and 33.2 (CI: 27.0–39.4) per 1000 per year among males and females over five years of age, respectively. An estimated 6.16 million unintentional injuries occur in Pakistan annually among persons over five years of age. Urban and rural injuries were 55.9 (95% CI: 48.1–63.7) and 41.2 (95% CI: 32.2–50.0) per 1000 per year, respectively. The annual incidence of injuries due to falls were 22.2 (95% CI: 18.0–26.4), poisoning 3.3 (95%CI: 0.5–6.1) and burn was 1.5 (95%CI: 0.9–2.1) per 1000 per year. The majority of injuries occurred at home 19.2 (95%CI: 16.0–22.4) or on the roads 17.0 (95%CI: 13.8–20.2). Road traffic/street, school and urban injuries were more likely to result in handicap.There is high burden of unintentional injuries among persons over five years of age in Pakistan. These results are useful to plan further studies and prioritizing prevention programs on injuries nationally and other developing countries with similar situation.Unintentional injuries are the main cause of injury deaths worldwide [1-3]. More than two-thirds of injuries occur in developing countries [4,5]. Deaths from injuries are projected to increase from 5.1 million to 8.4 million (9.2% of all global deaths) and injuries are estimated to be the third leading cause of disability adjusted life years (DALYs) by the year 2020 [6,7].Despite the high burden developing countries have just
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