Cardiovascular diseases (CVDs) are the leading cause of death and disability around the world. The purpose of this thesis is to investigate the impact of socio-environmental determinants of CVDs at the neighbourhood scale in order to inform actionable interventions, which may lead to large-scale reductions in preventable CVDs. Drawing on 2411 surveys carried out in Toronto, Canada, this thesis employs multilevel models to estimate the magnitude of socio-environmental influences on the risk of CVD while adjusting for individual-level risk factors. To advance current research methodology, strategies and innovations were developed to 1) improve the characterization of neighbourhoods by empirically testing a full range of socio-environmental influences; 2) account for non-residential exposures by including a combined analysis of work and home contexts; 3) account for variations in the duration of exposure through the use of time-weighted models; 4) deal with problem of spatial data aggregation by developing and testing a novel method of neighbourhood zone design, and 5) account for the spatial scales of different socio-environmental determinants by modeling at multiple scales. The thesis demonstrated that land use decisions are inextricably public health decisions. It found that living in neighbourhoods with inadequate access to food stores and areas for physical activity, burdened by violent crimes and fast food restaurants, and over-dependent on automobiles (leading to air pollution), with a high level of noise may significantly increase the risk of CVDs, over and above individual-level risks. The thesis also found that working in neighbourhoods that are socio-economically disadvantaged or have high-traffic may significantly increase CVD risk. The thesis developed and demonstrated novel methods to reduce the measurement error of neighbourhood exposures through 1) the use of “amoeba buffers” to improve neighbourhood zone design to better reflect participants’ local neighbourhoods and 2) the use of duration of exposure weights to adjust for individual differences in the time spent across different contexts. Finally, it found that the significance of socio-environmental factors depends on the scale of data aggregation; thus, investigation of multiple scales may be required to identify the relevant scale that matches the specific contextual factor in future research.

Cardiovascular diseases (CVDs) are the leading cause of death and disability around the world. The purpose of this thesis is to investigate the impact of socio-environmental determinants of CVDs at the neighbourhood scale in order to inform actionable interventions, which may lead to large-scale reductions in preventable CVDs. Drawing on 2411 surveys carried out in Toronto, Canada, this thesis employs multilevel models to estimate the magnitude of socio-environmental influences on the risk of CVD while adjusting for individual-level risk factors. To advance current research methodology, strategies and innovations were developed to 1) improve the characterization of neighbourhoods by empirically testing a full range of socio-environmental influences; 2) account for non-residential exposures by including a combined analysis of work and home contexts; 3) account for variations in the duration of exposure through the use of time-weighted models; 4) deal with problem of spatial data aggregation by developing and testing a novel method of neighbourhood zone design, and 5) account for the spatial scales of different socio-environmental determinants by modeling at multiple scales. The thesis demonstrated that land use decisions are inextricably public health decisions. It found that living in neighbourhoods with inadequate access to food stores and areas for physical activity, burdened by violent crimes and fast food restaurants, and over-dependent on automobiles (leading to air pollution), with a high level of noise may significantly increase the risk of CVDs, over and above individual-level risks. The thesis also found that working in neighbourhoods that are socio-economically disadvantaged or have high-traffic may significantly increase CVD risk. The thesis developed and demonstrated novel methods to reduce the measurement error of neighbourhood exposures through 1) the use of “amoeba buffers” to improve neighbourhood zone design to better reflect participants’ local neighbourhoods and 2) the use of duration of exposure weights to adjust for individual differences in the time spent across different contexts. Finally, it found that the significance of socio-environmental factors depends on the scale of data aggregation; thus, investigation of multiple scales may be required to identify the relevant scale that matches the specific contextual factor in future research.

Made available in DSpace on 2016-12-08T16:55:43Z (GMT). No. of bitstreams: 1 117837.pdf: 1555509 bytes, checksum: 03bfb0ef22b5f612c64b7ca680e19824 (MD5) Previous issue date: 2014-06-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This paper seeks to analyze the relationship between health and economic activity of the municipality of Canelinha population, located in the state of Santa Catarina, in the Greater Florianópolis, over a period of 11 years (2001-2011) based on the socio-environmental perspective. Environmental, demographic, social and economic characteristics were raised, rescuing their social and spatial formation. The theoretical framework used to analyze the situation understands the notions of space, social space and training, urban dispossession and health promotion. The methodology to achieve the proposed objectives consisted of an association between quantitative and qualitative data. Thus, the information sought is in banks and official data and through semi-structured interviews and focus groups conducted with community health workers and residents of the town. Still records in a field diary complementarily were performed. The main causes of deaths were identified in the population to diseases of the circulatory system, neoplasms, external causes, ill-defined causes and respiratory diseases. We conclude that the social and environmental impacts of the ceramics industry and production of cotton waste, housing, education and sanitation are important factors when considering the social and environmental determinants of health. / Este trabalho busca analisar as relações entre saúde e atividades econômicas da população do município de Canelinha, localizado no estado de Santa Catarina, na região da Grande Florianópolis, em um período de onze anos (2001-2011), tendo como base a perspectiva socioambiental. Foram levantadas as características ambientais, demográficas, sociais e econômicas, resgatando sua formação socioespacial. O referencial teórico adotado para análise da situação compreende as noções de espaço, formação socioespacial, espoliação urbana e promoção da saúde. A metodologia para alcançar os objetivos propostos consistiu em uma associação entre dados quantitativos e qualitativos. Assim, buscaram-se as informações nos bancos de dados oficiais e através de entrevistas semiestruturadas e grupos focais realizados com agentes comunitários de saúde e moradores da cidade. Ainda foram realizados registros em diário de campo de forma complementar. As principais causas dos óbitos identificados na população foram as doenças do aparelho circulatório, as neoplasias, as causas externas, as causas mal definidas e as doenças do aparelho respiratório. Concluí-se que os impactos socioambientais decorrentes da indústria ceramista e da estoparia, moradia, educação e saneamento básico são fatores importantes quando se analisa os determinantes socioambientais em saúde.

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No / The roadside vegetation in some counties of north England (north and west Yorkshire) was studied to determine the community structure according to the British National Vegetation Classification (NVC) and main environmental factors influencing its composition. The data from Phytosociological survey (699 quadrats) and from the physico-chemical analyses of 233 soil samples from 35 sites were obtained. Both the classification (TWINSPAN & MATCH) and ordination programs (Canonical Correspondence Analysis) were used. The roadside vegetation is mainly dominated by few grasses (Arrhenatherum elatius, Festuca rubra, Dactylis glomerata, Lolium perenne, Poa trivialis, Elymus repens, Holcus lanatus) and their associated herbs (Cirsium arvense, Heracleum sphondylium, Urtica dioica). Five NVC Mesotrophic grassland communities (Arrhenatheretum elatioris community MG1, Lolium perenne-Cynosurus cristatus grassland MG6, Lolium perenne leys MG7, Holcus lanatus- Deschampsia cespitosa grassland MG9, Festuca rubra-Agrostis stolonifera-Potentilla anserina grassland MG11) and one Upland Festuca ovina- Agrostis capillaris-Galium saxatile grassland, U4 were identified which in general, exhibited good fit with the typical NVC units. Altitude, pH, potassium, sodium and road age were found to be the main variables affecting the roadside vegetation. By relating the floristic composition with ecological characteristics of the roadside verges, three kinds of pattern of variation are observed. The first pattern is related to regional or geographical characteristics and the second pattern of variation exists across the width of the road verges showing a zonal pattern of plant distribution. The third scale of pattern is active at the local level including micro-environmental conditions, e.g., local edaphic variables.

L’amélioration de la survie des enfants demeure au cœur des préoccupations sanitaires en Afrique subsaharienne où la transition sanitaire est en panne depuis 1990. Ce contexte de crise sanitaire est concomitant à une récession économique et à une forte croissance urbaine. L’expansion rapide de la population citadine constitue aujourd’hui un défi majeur de santé publique. A l’instar de ses pairs africains, la Côte d’Ivoire, qui a expérimenté une forte croissance urbaine depuis 1960, a connu au cours des deux dernières décennies une absence de progrès notable en matière de réduction de la mortalité des enfants. L’analyse des tendances selon le milieu de résidence révèle un recul de la mortalité relativement plus important en milieu rural que dans les villes ivoiriennes. Cette situation amène à s’interroger sur les facteurs explicatifs de l’évolution de la mortalité des enfants vivant en milieu urbain ivoirien. L'objectif principal de la thèse est d’appréhender les facteurs explicatifs du ralentissement de la baisse de la mortalité des enfants vivant en milieu urbain ivoirien. L’analyse, basée sur les données démographiques et sanitaires réalisées entre 1994 et 2005, apprécie les effets de l’environnement contextuel démo-économique et sanitaire sur la dynamique de la mortalité et examine l’hypothèse d’une dégradation de la survie dans les milieux urbains pauvres. Deux constats ressortent des analyses. D’une part, il existe un réel ralentissement des progrès en matière d’amélioration de la survie des enfants dans les villes ivoiriennes, notamment à Abidjan. D’autre part, si les inégalités socio-économiques conduisent à des inégalités sanitaires, la dégradation de la survie concerne davantage les enfants des classes moyennes et aisées que ceux des ménages les plus démunis. En outre, la dimension sociale joue un rôle davantage important dans le comportement maternel en matière de recours aux soins: l’utilisation des services de santé étant relativement plus fréquente chez les mères issues de ménages de grande taille ou chez les migrantes. L’analyse révèle également une accentuation de l’influence des facteurs environnementaux sur la survie des enfants entre 1994 et 2005 et une précarité des conditions d’habitat. / Improving child survival remains at the core of health concerns in sub-Saharan Africa where the health transition is down since 1990. This health crisis is concomitant to an economic recession and a rapid urban growth. The rapid expansion of the urban population is now a major public health challenge. Like its African peers, Côte d'Ivoire, which has experienced a rapid urban growth since 1960 has failed to significantly reduce child mortality over the two past decades. The analysis of trends by area of residence reveals a decline in mortality, which is relatively larger in rural areas than in Ivorian cities. This raises questions about the factors explaining the evolution in the mortality of Ivorian city children. The main objective of this thesis is to understand the factors slowing the decline in the mortality of children who live in urban Ivory Coast. The analysis, based on demographic and health data collected between 1994 and 2005, assesses the effects of demographic, economic, contextual environment and health on the dynamics of mortality and examines the hypothesis of deterioration in the survival in poor urban area. Two conclusions emerge from the analysis. On the one hand, there is a real decrease in the progress regarding the improvement of child survival in Ivorian cities, mainly in Abidjan. On the other hand, if the socio-economic disparities lead to health inequalities, the degradation of child survival concerns more middle and upper classes than those of the poorest households. In addition, the social dimension plays a more important role in the maternal behavior regarding health care: the use of antenatal health services is relatively more frequent among mothers from large-size households or among migrants. The analysis also reveals an emphasis of the influence of environmental factors on child survival between 1994 and 2005 and precarious living conditions.

This research evaluates the technological, organizational, and environmental determinants of emerging technologies adoption represented by Artificial Intelligence (AI) and Internet of Things (IoT) driving SMEs’ competitive advantage within a resource-based view (RBV) theoretical approach supported by the technological-organizational-environmental (TOE)-framework setting. Current literature on SMEs competitive advantage as outcome of emerging technologies in the technological, organisational, and environmental contexts presents models focused on these contexts individual components. There are no models in the literature to represent the TOE framework as an integrated structure with gradual levels of complexity, allowing for incremental evaluation of the business context in support of decision making towards emerging technologies adoption supporting the firm competitive advantage. This research gap is addressed with the introduction of a new concept, the IT resource-based renewal, underpinned by the RBV, and supported by the TOE framework for providing a holistic understanding of the SMEs strategic renewal decision through information technology. This is achieved through a complex measurement model with four level constructs, leading into a parsimonious structural model that evaluates the relationships between IT resource-based renewal, and emerging technologies adoption driving SMEs competitive advantage. The model confirms the positive association between the IT resource-based renewal and emerging technologies adoption, and between the IT resource-based renewal and SME competitive advantage for the SMEs managers model, with the SME owners model outcomes are found not being supportive towards emerging technologies adoption driving SME competitive advantage. As methodology, PLS-SEM is used for its capabilities of assessing complex paths among model variables. Analysis is done on three models, one for the full sample, with two subsequent ones for owners and managers, respectively, as SME decision makers, with data collected using a web-based survey in Canada, the UK, and the US, that has provided 510 usable answers. This research has a theoretical contribution represented by the introduction of the IT resource-based renewal concept, that integrates the RBV perspective and the TOE framework for supporting organization’s decision on emerging technologies adoption driving SMEs competitive advantage. As practical implications, this thesis provides SMEs with a reference framework on adopting emerging technologies, offering SME managers and owners a comprehensive model of hierarchical factors contributing to SMEs competitive advantage acquired as outcome of AI and IoT adoption. This research makes an original contribution to the enterprise management, information systems adoption, and SME competitive advantage literature, with an empirical approach that verifies a model of emerging technologies adoption determinants driving SMEs competitive advantage.

This work follows the studies focused on obesity, its global extent and its serious health and economic impact. At the same time, the work examines the unsuccessful fight of public policies which try to reverse growing prevalence of obesity. Nevertheless, the main goal of the thesis is a discussion about priorities of new orientation in the research on the causes of the obesity epidemic and effectiveness of precautions that were taken in many countries and international organizations with the main aim to stop the obesity and its consequences. The discussion leads to the more detailed description of the problems connected with obesity, for instance, environmental aspects, housing culture in relation to physical activities, lifestyle in relation to advertisement/marketing, psychological and socio- psychological aspects, combating stress, etc. My intention was to find out utility of contemporary research on obesity for setting of policy fighting against obesity. At the same time, I wanted to find out other possible directions in the research into this field and discover how the discussion about priorities of the research in the experimental community proceeds. Two international dimensions of paradigmatic approaches separated to the certain degree can be considered as relevant with regard to the global...