Les organisations hospitalières ont engagé des processus relationnels structurants depuis 1970, sous la pression croissante des réformes qui se sont succédées dans ce secteur. Ces rapprochements ont donné lieu à une diversité de formes relationnelles identifiable par des habillages juridiques très variés. Ces processus relationnels nous informent aussi sur le statut de la relation : stable, instable, transitoire, etc. L’analyse des processus relationnels dans le champ hospitalier n’a suscité que peu d’études, contrairement au secteur industriel où les accords de coopération ont fait l’objet de nombreux écrits. L’objet de notre recherche est d’identifier et d’expliquer les structures et les fonctionnements des processus relationnels qui sont mis en oeuvre dans le secteur hospitalier et d’analyser le passage d’une forme relationnelle à une autre. Notre application empirique a concerné 83 formes relationnelles (formelles et informelles) qui se sont nouées, entre 1977 et 2012, au sein du système hospitalier français avec au moins un des protagonistes appartenant à la sphère publique. La mise en oeuvre de plusieurs analyses dont une taxonomie ont permis de dégager des résultats originaux et stimulants pour le développement d’un champ de recherche en émergence. Les processus relationnels dans le secteur hospitalier et les accords de coopération dans le secteur industriel présentent des caractéristiques contrastées. Par ailleurs, l’élaboration d’une grille d’analyse des processus relationnels a permis de classer les formes relationnelles à l’aide de seulement trois critères. Ce travail, basé sur une analyse statistique approfondie, donne une dimension explicative et prospective à notre recherche sur les rapprochements dans le secteur hospitalier. / Hospital organizations undertook relational processes structuring since the years 1970, under the increasing pressure of the reforms which followed one another in this sector. These connections caused a diversity of relational forms identifiable by very varied legal status. These relational processes also inform us on the statute of the relation: stable, unstable, transitory, etc. The analysis of the relational processes in the hospital field caused only few studies, contrary to the industrial sector where the cooperation agreements were the object of many written papers. The object of our research is to identify and explain the structures and the way of functioning of the relational processes which are implemented in the hospital sector and to analyze the passage of a relational form to another. Our empirical application concerned 83 relational forms (formal and unformal) which were established within the French hospital system between 1977 and 2012 with at least one of the protagonists belonging to the public sphere. The implementation of several analyses whose taxonomy made it possible to bring out original and stimulative results for the development of a research area in emergence. The relational processes in the hospital sector and the cooperation agreements of the industrial sector indeed show contrasted characteristics. Moreover, the elaboration of a grid of analysis of the relational processes made it possible to classify the relational forms using only three criteria. This work, based on a thoroughly statistical analysis, gives an explanatory and prospective dimension to our research on the connections in the hospital sector.

This paper is a first attempt to empirically evaluate some competing hypotheses for the Austrian growth performance. We find that the real appreciations, gross investment, a low duration of unemployment and high youth employment exhibit a significant influence on economic growth. This validates the hard currency policy hypothesis, the macroeconomic management hypothesis, and the microinstitutions hypothesis, whilst all other fail according to this exercise. In particular, we find the Schulmeister-thesis of loose money and the deficit spending hypothesis are even counterfactual. Summarizing, we find that economic policy had its share in promoting growth in the Austrian economy. As a byproduct from our analysis, we find that low levels of unemployment have a significant and positive impact on the growth rate of real GDP, which calls for further theoretical research in this direction. (author's abstract) / Series: Working Papers Series "Growth and Employment in Europe: Sustainability and Competitiveness"

Background: The prevalence of childhood overweight in the United States continues to be a national public health problem. The child care and household environments play an important role in the nutrition, physical activity, and screen-time behaviors of preschoolers. Aims: This dissertation aimed to (1) estimate the prevalence of overweight and obesity in 3-5 year old children enrolled in child care centers in Miami-Dade County; (2) identify early life, dietary, and screen-time risk factors of overweight, and (3) assess child care centers' level of adherence to nutrition, physical activity, and screen-time regulations by center socioeconomic location (SEP). Methods: A total of 366 children ages 3-5 years old from 34 child care centers participated in the study. Caregivers completed a questionnaire on socioeconomic, early life, dietary, and screen-time factors. We measured children's heights and weights. Chi-square and logistic regression analyses were used to examine the association between child overweight and determinants. Results: the prevalence of overweight was 29.8% in this sample. The middle-SEP group had the highest prevalence of overweight (35.3%) when compared to low and high-SEP groups. Being Hispanic was associated with a three-fold risk of overweight/ obesity (AOR: 2.91, 95% CI 1.36, 6.21). Lack of daily fruit consumption increased the risk of overweight in Hispanic children. Middle-SEP children reported lowest consumption of fruits and vegetables. There were significant differences in breastfeeding practices by ethnicity and SEP. Assessment of child care practices resulted in all child care centers adhering to two-hour screen-time regulation for children older than 2-years old. Low and middle SEP centers fared better in serving of fruits , vegetables, and low fat/ fat free milk. The centers had incorporated quite and active play in their routines. Conclusions: This is the first study to examine prevalence by SEP in Miami-Dade County. Findings highlight opportunities for improvement in early life nutrition, as well as dietary and screen-time practices in the household and child care environments.

This is an inter-disciplinary argument for a moral entitlement to a capability to be healthy. Motivated by the goal to make a human right to health intelligible and justifiable, the thesis extends the capability approach, advocated by Amartya Sen and Martha Nussbaum, to the theory and practice of the human health sciences. Moral claims related to human health are considered at the level of ethical theory, or a level of abstraction where principles of social justice that determine the purpose, form, and scope of basic social institutions are proposed, evaluated, and justified. The argument includes 1) a conception of health as capability, 2) a theory of causation and distribution of health capability as well as 3) an argument for the moral entitlement to a sufficient and equitable capability to be healthy grounded in the respect for human dignity. Moreover, the entitlement to the capability to be healthy is defended against alternative ethical approaches that focus on welfare or resources in evaluating and satisfying health claims. In specific, it is argued that human health is best understood as a capability to be healthy - a meta-capability to achieve a cluster of basic and inter-related capabilities and functionings. Such a cluster of capabilities and functionings is in line with Martha Nussbaum's central human capabilities. A theory of causation and distribution of health capability is put forward that integrates the 'classic' biomedical factors of disease (genetic endowment, exposure to hazardous materials, behaviour), social determinants of disease, and Drèze and Sen's econometric analysis of the causation and distribution of acute and endemic malnutrition. Furthermore, the argument critiques Norman Daniels's revised Rawlsian theory of health justice, and advocates for the capability approach to recognize group capabilities in light of 'population health' phenomena. Lastly, the thesis also argues that a coherent, capability conception of health as a species-wide conception will tend to make any theory of justice recognizing health claims a cosmopolitan theory of justice.

Official-language minorities in Canada may face specific issues in accessing health care services that can lead to negative consequences on their health, utilization of health care services and satisfaction with the health care system. A secondary data analysis of the 2006 Survey on the Vitality of Official-Language Minorities revealed significant differences between the Anglophone minority (n=5,161) and the Francophone minority (n=12,029) with regards to general health, and access to and use of health care services. Important predictors of these outcomes included age, education level, household income, marital status and place of residence (urban/rural). Access to health care services in the minority language was associated with self-perceived health in the Anglophone minority only. Health policy recommendations elaborated in light of the findings include working on both the supply and the demand of health care services offered in the two official languages, while taking into consideration important contextual differences between regions.

The goal of this thesis was to reposition individual preparedness within a social environmental context. First, a theoretical model was developed to more accurately represent the social environmental considerations neglected in current preparedness research and policy. A series of three studies tested this model using a mixed-methods approach: First, subjective conceptualizations of preparedness were explored in a qualitative analysis (N = 12). Findings revealed that participants evaluated their readiness not in terms of prescribed activities, but perceptions about their current resourcefulness as well as past local hazards. Participants’ had positive social environments which also reinforced their perceived coping ability in future emergency events. Subsequent thesis studies investigated the role social environment further, using quantitative data. The second study explicitly tested whether perceptions of risk and coping could explain differences in preparedness based on demographic attributes linked to variations in social environment. Data from a survey examining Canadians perceptions regarding terrorism threats (N = 1503) revealed that greater anticipated response was significantly associated with increased age, as well as female gender, higher education levels, and higher income levels. Statistically significant differences in threat appraisals were also reported based on these demographic groupings. However, mediation analyses demonstrated that with the exception of gender, differences in anticipated response could not be explained via risk perceptions or perceived coping efficacy, suggesting that social environment’s role in preparedness is not related to the internal processes often targeted in current campaigns. The third study used a multilevel design to investigate the contextual role of neighbourhood social environment in anticipated emergency response. Results demonstrated that a more deprived social neighbourhood context was related to lowered anticipated emergency response. This relationship was maintained after controlling for significant individual-level factors such as previous experience and sociodemographics, highlighting the importance of neighbourhood social context in facilitating emergency preparedness. Taken together, these findings provide novel evidence that focusing preparedness strategies to primarily target internal processes is misguided, and that future research and policy must position preparedness efforts in the context of existing social environmental resources and barriers in order to build capacity for effective emergency response.

The focus of this research is on identifying the determinants of local-level climate change adaptive capacity in Caribbean small island communities. A single case study approach was employed to assess retrospectively both internal and external factors that contributed to the adaptive capacity of Paget Farm, Saint Vincent and the Grenadines. The Caribbean region’s first solar-powered desalination plant was implemented in the community specifically as a climate change adaptation strategy and thus provides an ideal case for retrospective analysis. A series of semi-structured interviews with local residents and key stakeholders revealed a number of interacting social and institutional factors that contribute to community-based adaptive capacity. Further analysis of institutional factors was undertaken using Social Network Analysis, which enabled visualization and quantification of vertical and horizontal institutional integration of the networks formed during different phases of project implementation. The research extends scholarly understanding of the determinants that influence local-level climate change adaptive capacity and provides practical evidence that can assist small island communities to respond to a changing climate.

Disaster vulnerability and health status are determined by the intersecting social identities individuals possess in a given context. Based on two months fieldwork in Bangladesh, this study employs a comparative exploratory case study methodology to understand the way in which the Canadian International Development Agency (CIDA), Oxfam and Gonoshasthaya Kendra construct and deploy the concepts of gender, empowerment and women’s health within their disaster management policies and programs. It finds that disaster management interventions that fail to understand the intersectional nature of women’s vulnerability risk entrenching or creating forms of both privilege and oppression. Combining intersectionality, Moser’s Practical and Strategic Gender Needs and Sen’s Capability Approach, this study aims to deconstruct the embedded view of women in disaster management by suggesting that a social determinants of health approach, paired with intersectionality, could provide important insights into disaster management interventions and their effectiveness in addressing the gendered realities of women facing disasters.

Introduction: Tuberculosis (TB) is an infectious disease that causes significant morbidity and mortality. Despite the fact that the total burden of TB has decreased dramatically, the distribution of that burden across the Canadian population has not changed. A century ago, the Indigenous population of Canada had a significantly higher TB mortality than the non-Indigenous population. This gap still exists today. TB is a disease of poverty, and understanding the role of the social determinants of health (SDH) may provide insights into the causes of persistence of TB in the Indigenous population. Research questions: This thesis tackles three questions: 1) Can a TB outbreak that took place over a century ago be reconstructed? 2) What can we learn about the relationship between the disease, the population it afflicted, and the environment in which the outbreak took place? 3) How can reconstruction of a TB outbreak be used to evaluate policy interventions? Area studied: Analyses were limited to the Qu’Appelle Agency, located in Southeastern Saskatchewan. Methodology: An agent-based model of socioeconomic environment of the Qu’Appelle Agency was developed to study the relationship between TB and SDH. Data on TB mortality, demographics, agricultural production, material circumstances, and economic factors of production were used to study the relationship between TB and SDH at the aggregate level. Results: 1) Extensive aggregate data analyses were carried out and an agent-based model of TB transmission and of the socioeconomic environment of the Qu’Appelle Agency was developed. 2) Results of these analyses identify a number of important parameters responsible for the high TB mortality in the Agency. These parameters include biological factors, housing, social characteristics, agricultural output, and policies of the Department of Indian Affairs. Conclusions: This research demonstrates that reconstruction of an outbreak of an infectious disease that took place over a century ago is a complex undertaking that hinges on availability of data and significant expertise in a variety of fields, such as health sciences, economics, mathematics, and modelling approaches. The further one goes into the past, the more one is forced to rely on assumptions, which make the reconstructed web of relationships between agent, host, and environment that caused the outbreak less certain. Despite the inherent uncertainty, the process of outbreak reconstruction provides a deep and multi-faceted understanding of the interactions among the agent, the host, and the environment. The resulting model is a useful way of studying policy interventions that could be applied in other contexts as well – to other infectious diseases or TB outbreaks on other reserves. Keywords: [population health, epidemiology, tuberculosis, Indigenous peoples, agent-based modelling, social determinants of health]

This diploma thesis is dealing with the influence of culture on the foreign policy of Venezuela, showing how socio-cultural determinants are reflected in formation and ideological basis of foreign policy and its realizing on the international stage. The thesis is divided into two parts - the first part is dedicated to the characteristic of venezuelan national culture in general, based on surveys of Hofstede and Inglehart, and in particular, based on such a phenomenon as caudillism, populism and personality cult of Simon Bolívar. The second part of the thesis is handling with the political-economic development in the second half of 20th century. The emphasis is on how the politics in Venezuela which has changed profoundly with the election of Hugo Chávez is reflected in the foreign policy of Venezuela.