Evaluation of the causal pathways through which subjective norms influence mammography intention and stage of change in a national sample of women veterans

Few studies have investigated causal pathways linking psychosocial factors to each other and to screening mammography. Conflicting hypotheses exist in the theoretic literature regarding the role and importance of subjective norms, a person's perceived social pressure to perform the behavior and his/her motivation to comply. The Theory of Reasoned Action (TRA) hypothesizes that subjective norms directly affect intention; while the Transtheoretical Model (TTM) hypothesizes that attitudes mediate the influence of subjective norms on stage of change. No one has examined which hypothesis best predicts the effect of subjective norms on mammography intention and stage of change. Two statistical methods are available for testing mediation, sequential regression analysis (SRA) and latent variable structural equation modeling (LVSEM); however, software to apply LVSEM to dichotomous variables like intention has only recently become available. No one has compared the methods to determine whether or not they yield similar results for dichotomous variables. ^ Study objectives were to: (1) determine whether the effect of subjective norms on mammography intention and stage of change are mediated by pros and cons; and (2) compare mediation results from the SRA and LVSEM approaches when the outcome is dichotomous. We conducted a secondary analysis of data from a national sample of women veterans enrolled in Project H.O.M.E. (H&barbelow;ealthy O&barbelow;utlook on the M&barbelow;ammography E&barbelow;xperience), a behavioral intervention trial. ^ Results showed that the TTM model described the causal pathways better than the TRA one; however, we found support for only one of the TTM causal mechanisms. Cons was the sole mediator. The mediated effect of subjective norms on intention and stage of change by cons was very small. These findings suggest that interventionists focus their efforts on reducing negative attitudes toward mammography when resources are limited. ^ Both the SRA and LVSEM methods provided evidence for complete mediation, and the direction, magnitude, and standard errors of the parameter estimates were very similar. Because SRA parameter estimates were not biased toward the null, we can probably assume negligible measurement error in the independent and mediator variables. Simulation studies are needed to further our understanding of how these two methods perform under different data conditions. ^

Utilization behavior of the elderly in an HMO: A causal analysis

Planning and providing health care services for the elderly represents a major challenge to the health care system. One part of that challenge is the identification of those factors which determine the utilization of services by this population. The purpose of this study is to explain the use of health care services by elderly subscribers in a prepaid group health plan, using the theoretical framework developed by Andersen and Aday. The impact of the predisposing, enabling and need factors on utilization was modelled through a structural equation approach using LISREL. The data were derived from Kaiser-Permanente's Medicare Prospective Payment Project, August 1980-December 1982. Need factors, in general, were the most significant determinants of utilization, with the predisposing and enabling factors found to be secondary but necessary links in the causal chain. The model was fitted to the data from the youngest age group (65-74 years) and then evaluated for goodness of fit in the two older groups (75-84 and 85+ years). Implications of the study's findings and suggestions for further modelling the utilization behavior of the elderly are discussed. ^

Instrumental variable method for the causal relationship between soluble receptor for advanced glycation end-products (sRAGE) and risk of pancreatic cancer

This thesis project is motivated by the potential problem of using observational data to draw inferences about a causal relationship in observational epidemiology research when controlled randomization is not applicable. Instrumental variable (IV) method is one of the statistical tools to overcome this problem. Mendelian randomization study uses genetic variants as IVs in genetic association study. In this thesis, the IV method, as well as standard logistic and linear regression models, is used to investigate the causal association between risk of pancreatic cancer and the circulating levels of soluble receptor for advanced glycation end-products (sRAGE). Higher levels of serum sRAGE were found to be associated with a lower risk of pancreatic cancer in a previous observational study (255 cases and 485 controls). However, such a novel association may be biased by unknown confounding factors. In a case-control study, we aimed to use the IV approach to confirm or refute this observation in a subset of study subjects for whom the genotyping data were available (178 cases and 177 controls). Two-stage IV method using generalized method of moments-structural mean models (GMM-SMM) was conducted and the relative risk (RR) was calculated. In the first stage analysis, we found that the single nucleotide polymorphism (SNP) rs2070600 of the receptor for advanced glycation end-products (AGER) gene meets all three general assumptions for a genetic IV in examining the causal association between sRAGE and risk of pancreatic cancer. The variant allele of SNP rs2070600 of the AGER gene was associated with lower levels of sRAGE, and it was neither associated with risk of pancreatic cancer, nor with the confounding factors. It was a potential strong IV (F statistic = 29.2). However, in the second stage analysis, the GMM-SMM model failed to converge due to non- concaveness probably because of the small sample size. Therefore, the IV analysis could not support the causality of the association between serum sRAGE levels and risk of pancreatic cancer. Nevertheless, these analyses suggest that rs2070600 was a potentially good genetic IV for testing the causality between the risk of pancreatic cancer and sRAGE levels. A larger sample size is required to conduct a credible IV analysis.^

Causal Salud, interrupción legal del embarazo, ética y derechos humanos.

FLASOG

Interrupción legal del embarazo por la causal violación: enfoques de salud y jurídicos.

Secretaría Técnica y Asistente: Silvina Ramos con la colaboración de Agustina Ramón Michel

Aborto no punible. Causal violencia sexual en la Argentina. Marco normativo

Presentación en el Seminario Acceso al aborto para mujeres sobrevivientes de violencia sexual. Guatemala, el 28 y 29 de octubre de 2014.

Aborto no punible. Causal violencia sexual en la Argentina. Retos, ventajas y oportunidades

Presentación en el Seminario Acceso al aborto para mujeres sobrevivientes de violencia sexual. Guatemala, el 28 y 29 de octubre de 2014.

Causal violación. Marco normativo, obstáculos y estrategias

Presentación en el Seminario Acceso al aborto para mujeres sobrevivientes de violencia sexual. Guatemala, el 28 y 29 de octubre de 2014.

Marco normativo, políticas públicas y/o protocolos que regulan la causal violación en Brasil

Presentación en el Seminario Acceso al aborto para mujeres sobrevivientes de violencia sexual. Guatemala, el 28 y 29 de octubre de 2014.

Utilización de la Causal Salud como alternativa

Presentación en el Seminario Acceso al aborto para mujeres sobrevivientes de violencia sexual. Guatemala, el 28 y 29 de octubre de 2014.

Impactos de riesgo en la salud mental en el marco de la causal salud

Presentación en la 3ra Conferencia Subregional Andina. Lima, Perú, 5 de Noviembre de 2015

Aplicación de la causal violación a los casos de violencia intrafamiliar, Argentina

Este informe presenta las actividades realizadas en el marco del proyecto “Aplicación de la causal violación en los casos de violencia intrafamiliar”, que ha llevado adelante la organización ELA – Equipo Latinoamericano de Justicia y Género en el marco de la Convocatoria de CLACAI para el desarrollo e implementación local de acciones para incrementar el acceso al aborto seguro a través de las causales de aborto legal. El objetivo general de la investigación fue mejorar el conocimiento de las situaciones de violencia sexual en el marco de la violencia en las relaciones intrafamiliares, en particular de parejas y exparejas, promoviendo la articulación de los servicios de salud que trabajan la problemática de violencia de género con los otros servicios que podrán brindar servicios de aborto legal

Aproximaciones al uso de porque vs. como causal en De la anarquía de Alberdi

El presente trabajo se propone realizar un primer acercamiento al uso de los conectores causales como y porque en De la anarquía de Alberdi en relación al sistema Tema-Rema propuesto por la Lingüística Sistémico-Funcional. Si la lengua es un sistema de opciones, y la gramática ofrece dos opciones distintas para expresar la causa, es porque funcionalmente son diferentes. En nuestro corpus, cada uno de estos conectores organiza la información de manera distinta, puesto que como introduce causas en posición temática mientras porque tiende a introducir causas en posición remática. La elección de una u otra forma se encuentra en estrecha relación con las variables de campo, tenor y modo y con la información que se ofrece en cada momento del texto.