Dental decay is a preventable disease, but it remains the most unmet healthcare need of American children. Untreated dental decay has adverse and long-lasting effects on a child's quality of life. Healthy oral habits among preschool children are essential for a healthy permanent dentition and are achieved primarily by 3 oral health related behaviors: proper dental hygiene, a healthy noncariogenic diet, and regular dental visits. This quantitative study, based on the theory of planned behavior, explored the relationship between these 3 oral health behaviors and 4 determinants: attitude, subjective norms, perceived behavioral control, and intention, using a 71-item questionnaire. The study utilized convenience sampling. A total of 436 parents or caregivers of children enrolled in the North East Independent School District Early Childhood Education program participated in this study; 81.5% were low-income, and 66% reported Hispanic identity. The relationship between variables was evaluated using multiple regression analysis. This study indicated that attitude alone toward a healthy diet and dental hygiene was not a significant predictor of behavior, but the attitude toward dental attendance was significant. Subjective norm, perceived behavior control, and intentions individually and combined were significant predictors of all 3 behaviors, except for subjective norm towards hygiene. Meaningful social change can be achieved by identifying and understanding the underlying motives that evoke planned and deliberate oral health behaviors among parents of preschool children. Targeted messages and cost-effective early interventions can be developed to prevent the onset of dental disease and improve the quality of life for low-income children.

Triangle is the mostly used primitive in computer graphics. Calculation of its intersection with a ray has many applications and is often a bottleneck of a program. This work focuses on its usage and various methods of calculation. It tries to combine these techniques to achieve high performance on modern processors.

In connection to the process of financialization of commodity markets which is caused by the sharp increase of money flowing into the commodity markets, the question of which factors affect commodity and commodity indices prices is discussed. The aim of the dissertation is to determine and quantify the factors affecting the prices of industrial metals during the period of financialization of commodity markets and derive the pricing model of industrial metals, which would be able to generate signals of a possible overvaluation or undervaluation. The paper examined non-ferrous industrial metals traded on the Commodity Exchange LME (London Metal Exchange), namely aluminum, copper, lead, nickel, tin and zinc. These metals are also included in the most of the world's composite commodity indices. The dissertation analyzes the contemporary developments in commodity markets; relationship between the price volatility and fundamental factors (including production, consumption and stocks of chosen metals and a wide range of macroeconomic determinants) or the relationship between risk and return of industrial metals. The closing part of the dissertation focuses on the creating of composite pricing indicator for copper and tin by using the Boosted Trees method. The results obtained in the research show that created indicator is able to explain the volatility of the 3m copper futures contracts by 94.25% and 3m futures contracts of tin by 96, 79% in the period from 1/2000 to 3/2015.

BACKGROUND: Patient reported outcomes (PROs) are important cancer outcomes that can be measured electronically but are understudied in the safety-net hospital setting. Routine electronic screening to address social determinants of health (SDH) has been established in primary care clinics and the emergency department of New England’s largest safety-net hospital. The burden of SDH in safety-net oncology patients is less well-studied. This study aimed to determine the feasibility and challenges of routine administration of ePROMs in a safety-net Radiation Oncology clinic, describe treatment toxicities and quality of life (QOL) experienced by this vulnerable population during radiotherapy, and evaluate SDH and the need for SDH screening in the oncology clinic. METHODS: Patients with lung or head and neck cancer scheduled for radiation oncology consultation from 3/2019–1/2020 were deemed eligible for electronic questionnaire participation based on primary language spoken and absence of metastases. At consultation, patients were administered a set of baseline ePROMs (EQ-5D-3L, FACT, PRO-CTCAE) and a social needs screener (THRIVE) using a widely-used cloud-based, patient-centered outcomes platform. Associations between patient demographics and questionnaire completion were retrospectively evaluated. The set of ePROMs were collected at the end of treatment to characterize treatment-related toxicities and changes in self-reported QOL. RESULTS: In total, 99 eligible head and neck cancer (51.5%) and lung cancer (48.5%) patients were identified. Median age was 65. The majority of patients were male (71.7%), and English-speaking (82.8%). Whites, Blacks, and Asians/Others comprised 42.4%, 38.4%, and 6.1% of patients, respectively. Fifteen patients were Hispanic (15.2%). Patients were most likely to have private health insurance (39.4%), followed by joint Medicare-Medicaid (25.3%), Medicaid (17.2%), and Medicare (16.2%). Two patients were insured by Corrections (2.0%). Eight patients (8.1%) no-showed or cancelled, while 91 patients were seen in consultation. Forty-four patients (48.4%) completed the initial questionnaires. For the remaining 47 patients (51.6%), the most common reason for lack of ePROM completion was clinic understaffing and/or clinical decision based on the absence of indication for radiotherapy (n=27, 57.4%). Ten patients refused to complete questionnaires (21.3%), with reasons cited including length of questionnaires and low energy. Ten patients were physically unable to attempt questionnaires (21.3%), for reasons including disabilities and low-literacy. Age, language, race, ethnicity, insurance, marital status, gender, and disease site were not significantly associated with ePROM completion (P≥0.05). For patients who completed the general (QOL) questionnaire EQ-5D-3L, there was no significant difference in general QOL domains nor self-reported overall health score at baseline vs. end of treatment. For head and neck cancer patients, FACT-H&N Total scores, measuring disease-specific QOL, were significantly worse at end of treatment vs. baseline (P=0.006). For lung cancer patients, FACT-L Total scores at the end of radiation treatment were not significantly worse at end of treatment vs. baseline (P=0.953). For head and neck cancer patients who completed PRO-CTCAE, there was a significant increase in the number with moderate to very severe taste issues (P=0.008) and decrease in appetite (P=0.025) by end of treatment. For lung cancer patients, there was a trend towards an increase in the number reporting moderate to very severe nausea (P=0.083). Eighty-one of 99 patients (81.8%) were screened for at least one SDH domain using the THRIVE screener at the study hospital. Nineteen patients (19.1%) had all 8 THRIVE social determinants of health statuses documented. Only housing status was documented for 61 patients (61.6%). There was a trend for married individuals (P=0.068) and females (P=0.074) to be associated with the completion of at least one THRIVE domain. Age, race, language, and insurance status were not associated with THRIVE screening (P>0.05). Transportation to appointments (21.1%), food insecurity (20%), and affording medications (10.5%) were the most prevalent concerns among these oncology patients, with 100% of patients who reported insecurities with medication and transportation requesting resources for these needs. CONCLUSION: Routine ePROs collection in a busy safety-net oncology setting is feasible, but challenging and labor-intensive. Implementation was met with both patient and staff challenges and revealed the need for dedicated project management, staff training, and opportunities to increase patient accessibility. Preliminary PROs analyses revealed several significant detriments in quality of life and increased symptoms for this patient population during treatment, but additional data collection is required. Safety-net oncology patients report significant social needs. Routine SDH screening and resource referral should be considered in these vulnerable patients. Efforts in a specialized department such as Radiation Oncology could fill gaps in existing efforts in a large safety-net hospital. Safety-net oncology clinics can likely help vulnerable cancer patients access available community resources and reduce disparities due to SDH.

The choice of a corporation’s capital structure is a complex process determined by several factors. The academia and the business industry have both been enamored with finding the determinants of capital structure, as there has been evidence that the profitability of firms is influenced by financing decisions. Nevertheless, the determinants are so far inconclusive. Moreover, they are dependent on both internal and external factors. However, previous research has generally focused solely on internal or external factors. Therefore, this thesis aims to capture a combination of firm-specific factors and macroeconomic variables affecting capital structure decisions. We focus on Swedish firms listed on Nasdaq OMX. To investigate which internal and external factors affect the capital structure, an unbalanced fixed effects data multiple linear regression was performed. The regression tested several hypotheses derived from previous studies, where the trade-off theory and the pecking order theory were used as a base. Our results indicate that for internal factors, the pecking order theory is superior at explaining financial decisions in Swedish companies compared to the trade-off theory. When it comes to external factors, the pecking order theory provides a more accurate framework. However, it should be noted that the results are not unambiguous. The ambiguity of the results suggests one very important conclusion. Neither of these two theories have the capability to fully explain how firms decide their capital structure. Each model contributes with some pieces of the puzzle, but both contain limitations.

To avoid the worst effects of climate change, we need to end our reliance on fossil fuels and invest in alternative, renewable sources. Despite making up only 25% of total renewable energy investments, public investment is still vital due to its ability to encourage investments through policy measures and programs. In this paper we investigate how institutional quality, together with other financial, economic and policy variables, affects public renewable energy investments in middle-income countries. We account for the non-normal distribution of our data by conducting a panel quantile regression analysis for 64 middle-income countries. We present the results for the 0.25, 0.50 and 0.75 quantiles, representing countries with low, moderate, or high levels of public renewable energy investments. Our main finding is that absence of corruption is a vital factor for public renewable energy investments, regardless of which stage of the renewable energy transition a middle-income country is in. In the light of corruption, potential market failures are discussed as a consequence which can create a downward spiral for further renewable energy investments. Furthermore, better financial stability will increase these investments as well. We also find that public investors seem to be unaffected by economic policy uncertainty, indicating that these investors play an important role in uncertain times when private investors refrain from investing due to the high uncertainty connected to the irreversibility of these investment projects.

This paper analyzes the determinants of venture capital (VC) investments after the 2008 Global Financial Crisis. We conduct a quantitative study using panel data methods with a data set of 17 OECD countries over the years 2007-2017. We use the reduced form models to analyze three main groups of factors affecting the demand for and supply of VC. The three groups include macroeconomic conditions, entrepreneurial environment, and technological opportunities. The results reveal that the short-term interest rate, market capitalization and the population percentage with tertiary education have a positive impact on venture capital investments, meanwhile, the unemployment rate, corporate profit tax and the growth of market capitalization are negatively correlated to VC investments. Moreover, we also perform regression analysis using the Financial Crisis period data and try to capture the effects of the crisis on the driving forces of VC investments. According to the comparison of regression results using data of different periods, we find that the Financial Crisis generates huge economic fluctuations, which makes the effects of determinants difficult to capture. / 本论文分析了2008全球金融危机之后风险投资的决定因素。我们采集了17个OECD国家2007到2017年的面板数据，进行了一项量化研究。我们使用了简化模型对三类影响风险投资需求和供给的因素进行了分析。这三类包括了宏观经济条件、企业生存环境和科技机会。分析结果显示短期利率、市值和国民高等教育比例与风险投资量显著正相关，与此同时，失业率、企业利润税率以及市值增长率与风险投资量显著负相关。我们也使用了金融危机时的数据进行了回归分析，试图捕捉金融危机对风险投资决定因素的影响力改变。比较了不同时期数据的回归结果，我们发现金融危机会带来巨大的经济波动，使得风险投资的决定因素失灵或者很难捕捉。 关键词: 风险投资 风险投资决定因素 金融危机 面板数据

Many community-based organizations in urban areas of the United States exist to address the needs of their neighborhood and bridge the gap between the healthcare system and their community. In the Primary Care setting, healthcare providers have the opportunity to address those needs, either through their own expertise or through connecting patients with other resources. Despite this unique role of Primary Care Providers (PCPs), many of them are unaware of the resources that exist in their very own community. PCPs need awareness of, as well as partnership with, these community-based organizations. Integrating these resources into patient care will allow providers to improve health on a population level through a more robust response to patient and community needs. This will ultimately lead to a reduction of health disparities and improved quality of life in the community. This thesis seeks to explore strategies and resources that PCPs can use to better address patient and community needs. / Urban Bioethics

Black women are most likely to receive mastectomies, yet the least likely to have receipt of breast reconstruction. This disparity in breast and plastic surgery care is unethical and has been documented in the literature and has been witnessed clinically, but far most importantly, it is continued to be lived by Black women all over the nation. The bioethical principles of agency and social justice are called into question as Black women are not given an adequate understanding of their reconstructive options and are not being treated equally or equitably by the healthcare system. As noted by literature, race and ethnicity, socioeconomic and insurance status as well as comorbidities are contributing to this gap in care. As far as solutions go, there must be a multifaceted approach to mitigating this disparity. I have adopted Dr. Butler’s categorization of solutions to understand the exact approach we need to have, which includes patient education, legislation and academic medical institution, to make the recovery from breast cancer ethical for all women. In this thesis, I will go through the literature and garner perspectives from surgeons as well as patients who received breast reconstruction to aid in the understanding of this disparity and what needs to be done to fix it. / Urban Bioethics

This dissertation is about Indigenous and settler health, wellbeing and health policy in rural Manitoba. Across Canada, both sweeping and incremental provincial health system changes have profound effects on marginalized communities facing existing health inequities, including rural settler and Indigenous peoples. Increasingly, the centralization of provincial health care systems has led to the elimination of health services within rural settings. The research I present in this dissertation arose from advocacy efforts in a rural community in southwest Manitoba. The community sought representation and recognition in health decision-making in the midst of the largest health care system transformation in provincial history and called for local research production. The community-led study grew to the larger inquiry and analysis presented here, including a First Nation and Métis community, which were both affected by the transformation. The objectives of this dissertation were to analyze the ideas and structures used to inform provincial decisions, and to understand community experiences of rural health care before and during system transformation. As a settler researcher, I undertake an anti-colonial, strengths-based, community-engaged approach to research, developed through ongoing relationship with the community. In addition to a critical thematic analysis of key policy documents, semi-structured interviews were conducted with settler, First Nations, and Métis community members and service providers regarding their experiences within the health care system, their perceptions of change and the impacts of transformation on health and wellbeing. Arising themes include the importance of relational health care relationships in determining wellbeing, and the sense that the government undertook dehumanized decision-making in developing and implementing health system change. This dissertation concludes with policy recommendations for provincial governments, including the prioritization of community voices, and the visibility and involvement of rural and Indigenous peoples in health system decision-making. / Thesis / Doctor of Philosophy (PhD)