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)

Introduction Human immunodeficiency virus (HIV) is a double stranded RNA retrovirus. According to the World Health Organization more than 30 million individuals were estimated to have HIV by the end of 2020, about 60% of which are in the African region. Pre-treatment drug resistance (PDR) can be defined as the resistant virus strains transmitted at the time of infection or acquired during previous exposure to ARV. This study asses the effect of drivers in PDR. Method: This study was conducted with data extracted from published, publicly available data bases and reports by international organizations. The main sources were United Nation data bases and published reports from World Health Organization.  Inferential statistics were used to assess the PDR to anti-retroviral drugs. A linear regression model was used to investigate the association between PDR and previous exposure to anti-retrovirals and anti-retroviral therapy, pre-exposure prophylaxis, national health expenditure, human development index, and drug stock-out for different classes of anti-retroviral drugs.   Results: The result indicated that NNRTI drug resistance was most common, and seven out of 29 countries had PDR to all four drug classes. The human development index was positively associated with INSTI and PI PDR (p<0.05), while NNRTI and NRTI were mainly positively associated with previous exposure to anti-retrovirals. Conclusion: This study assessed the impact of socio-economics determinants (human development index and national health expenditure), drug logistic determinants (stock-out), and patients’ determinants (adherence and previous exposure to any kind of anti-retrovirals) on PDR. For expensive drug classes (PI and INSTI) the resistance was positively associated with human development index. Previous exposure to anti-retrovirals was associated with increased resistance in NNRTI and NRTI.

Indoor air quality is a critical determinant of physical and mental health. Despite evidence linking poor indoor air quality to adverse health outcomes, this issue is understudied in the context of First Nations children and youth health and wellbeing. The objectives of this study were to (1) characterize indoor air quality, housing conditions, and respiratory health of children living in the Kanesatake First Nation and (2) evaluate the feasibility of using remote community-based participatory methods in the context of First Nations health research. Community-assisted data collection occurred between June 2021 and February 2022 in the Kanesatake First Nation, Quebec. Indoor air data were collected from 31 randomly selected houses. Results showed elevated levels of contaminants, including particulate matter, benzene, toluene, and xylene, compared to the Canadian averages. Houses generally lacked adequate ventilation, and over one-quarter were reported to be in need of major repairs. We developed instruction tools for air sampling and house inspection to facilitate off-site data collection. High rates of participant completion (95%) and low attrition rates (5%) indicated the feasibility of remote community-based participatory research methods. Lessons learnt are summarized and important recommendations are made for adaptation to improve future data collection. This research served as a pilot project for a multi-year, cross-Nation study, as well as the first study to evaluate the indoor air environment in the Kanesatake First Nation.

Abstract: Aim: This study aimed at getting an understanding and critical analyses of the Ethiopian government empowerment strategy in improving maternal and child health in Ethiopia.Method: This is an ethnographic study, in which mainly un-structured interviews, focus group discussions and participant observation were conducted to collect data for the study. Results: The study concluded that the empowerment intiative has been promising to some extent in addressing the health concerns of women and children in Ethiopia. However, lack of bottom up health promotion strategies such as geniune community participation in the designing and implementation of the health program has greatly hindered the health promotion program from effectively improving the health status of women in the studied community.

The following study assesses whether an economic relationship exists between the money supply (i.e. M2), interest rates, and the exchange rate and the retail food price level in the United States. Data for the M2 classification of the United States money supply, the Effective Federals Funds (interest) Rate, and the United States Trade Weighted Exchange Index: Major Currencies for the period from January 1974 through December 2007 are evaluated as they relate to the United States Consumer Price Index for all Urban Consumers: Food for the same period. The statistical analysis involves an examination of the autocorrelation and partial autocorrelation functions of each variable, a test for the presence of stationarity in each variable(Augmented Dickey-Fuller test), Johansen’s test for co-integrating equations of the variables considered, Granger’s test for causality, and finally an estimation of regression models of United States retail food prices as a function of the money supply, interest rates, and exchange rates. Results indicate that a statistically significant relationship exists among the variables tested. A causal relationship exists between the Federal Funds Rate and the money supply, the money supply and the retail level of food prices, and also between the exchange rate and the retail level of food prices. The implications of the results are assessed through the lens of agricultural producers and processors, investors, lenders, consumers, and monetary and agricultural policymakers. Keywords: retail food prices, money supply, Federal Funds Rate, exchange rate, augmented Dickey-Fuller, Johansen’s test for co-integration, Granger causality

No description available.

<p> This research examined the geographic variability as well as the individual-and neighbourhood-level determinants of overweight and obesity in Canada. Overweight and obesity represent a significant public health problem with grave implications for individuals as well as populations. Over the past two decades, the prevalence of overweight and obesity has reached epidemic proportions with the most substantial increases observed in economically developed countries. The World Health Organization indicated that globally 1.6 billion adults (age 15+) are overweight and at least 400 million adults were obese. In a Canadian context, recent data from Statistics Canada confirms that over the past twenty-five years, adult obesity rates in Canada have doubled (23% ), while childhood obesity rates have nearly tripled. </p> <p> Until recently, research has focused on biological and behavioural determinants of obesity, and currently there is a great deal of knowledge regarding the relationships between weight status and various risk factors at the individual-level (e.g. age, sex, socioeconomic deprivation, diet, physical activity). However, the majority of existing research has ignored the potential role played by the environment in the development of these conditions, despite a growing consensus that environmental and/or societal constraints may be major influences on increasing prevalence rates. </p> <p> Using data from the Canadian Community Health Surveys and the Desktop Mapping Information Technologies Incorporated spatial database, this research addressed the following objectives: (I) to examine sex-specific spatial patterns of overweight/obesity in Canada as well as investigate the presence of spatial clusters (2) to investigate the prevalence and determinants of overweight and obesity in Canada using spatial analysis and geographical information systems (GIS) and (3) to identify heterogeneities associated with the relationships between individual and socioenvironmental determinants and overweight and obesity at the individual-and community-levels. </p> <p> Results revealed marked geographical variation in overweight/obesity prevalence with higher values in the Northern and Atlantic health-regions and lower values in the Southern and Western health-regions of Canada. Significant positive spatial autocorrelation was found for both males and females, with significant clusters of high values or 'hot spots' of obesity in the Atlantic and Northern health-regions of Alberta, Saskatchewan, Manitoba and Ontario. Results also demonstrate the important role of the built-environment after adjustment demographic, socio-economic and behavioural characteristics. With regard to the built environment measures, landuse mix and residential density were found to be significantly associated with BMI. This study also demonstrated significant differences at the area-level of analysis, supporting related research that has suggested that individual-level factors alone cannot explain variation in obesity rates across space. In particular, average dwelling value was related to BMI independently of individual-level characteristics. Ultimately, this research has demonstrated that Canadian urban environments play a small but significant role in shaping the distribution of BMI. Yet, reversing current trends will require a multifaceted public health approach where interventions are developed from the individual-to the neighbourhood-level, specifically focusing on altering obesogenic environments. </p> / Thesis / Doctor of Philosophy (PhD)

This thesis explores the role and functionality of the Hamilton Urban Core Community Health Centre (HUCCHC) within the context of advocacy and activism to understand how this institution can contribute a pathway for social change in public health. This qualitative case study uses an interpretive lens to analyze primary health care at the HUCCHC, and how it is being used to improve the social determinants of health (SDH). The study investigated participants’ understandings of how the HUCCHC demonstrates that a community health centre can be a catalyst for social change. Moreover, this research project asked what sorts of conditions or circumstances are necessary to foster an environment conducive for community organizing for social change. This study employed field observation and interview techniques to gather data. Findings suggest that building equitable relationships based on dignity and respect, and community engagement were the foundational aspects necessary to provide the conditions conducive for community organizing. However, the outcomes from these relations put the HUCCHC at risk of becoming marginalized. Findings further suggest that equitable relationships and community engagement also provided a foundation for social action. The HUCCHC demonstrated that it is a catalyst for social change by embracing a primary health care model that also fosters a social action approach to health care. / Thesis / Master of Social Work (MSW)

Title: Which factors affect the timeliness of private companies’ accounting reports?Level: Bachelor’s Thesis, Business AdministrationAuthors: Lucinda Jonsson and Sarah EdlundSupervisor: Fredrik HartwigDate: 2024 - JanuaryAim: To study which factors affect the timeliness of private companies regarding thepublication of accounting information. Timeliness is a decisive qualitative criterion thataffects the usefulness of financial reporting. Information that is not current is less relevant tostakeholders. The majority of previous studies regarding the timeliness are made on listedcompanies. This is despite the fact that the proportion of private companies in Sweden aresignificantly greater than the public ones, that 99% of all European companies are private andthat private companies account for more than half of Europe&amp;#39;s GDP. There are alsodifferences between unlisted and listed companies.Method: In this quantitative study, secondary data have been used from previous scientificarticles concerning the timeliness of private companies, in order to do a meta-analysis. Theeight articles used in the meta-analysis were suggested by our supervisor. Some articles weregathered by independent searches and chain searches. To present and interpret the resultsfrom the meta-analysis, a forest plot was generated for each result.Result &amp; conclusion: Companies with high debt ratio will to a greater extent submit theiraccounting reports late, rather than companies with low debt ratio. Larger companies will to agreater extent submit their accounting reports late, compared to smaller companies. Therewas no significant relationship regarding audit, gender on the board and bankruptcy risk (taxdebt). Size and debt ratio do not affect the lead time.Contribution of the thesis: Doing a meta-study on private companies regarding factors thataffect timeliness, which has never been done before.Suggestion for future research: Doing a meta-analysis with values from both private andpublic companies in one meta-analysis. It’s only been done separately before. Anothersuggestion is to do this study again, but to use raw data directly from the researchers insteadof data from published articles. It’s not the same information that appears in publishedarticles, which can contribute to more precise results.Key words: Timeliness. Accounting information. Private firms. Determinants. Financialaccounting regulation. / Titel: Vilka faktorer påverkar aktualiteten gällande onoterade företagsredovisningsrapporter?Nivå: Examensarbete på grundnivå (kandidatexamen) i ämnet företagsekonomi.Författare: Lucinda Jonsson och Sarah EdlundHandledare: Fredrik HartwigDatum: 2024 - januariSyfte: Att studera vilka faktorer som påverkar aktualiteten för onoterade företag gällandeoffentliggörandet av redovisningsinformation. Aktualitet är ett avgörande kvalitativtkriterium som påverkar den ekonomiska redovisningens användbarhet, då information sominte är aktuell är mindre relevant för intressenter. Majoriteten av tidigare studier är utförda pånoterade företag. Detta trots att andelen onoterade företag i Sverige är betydligt större än denoterade, att 99% av alla europeiska företag är onoterade samt att de onoterade företagen stårför mer än hälften av Europas BNP. Skillnader finns mellan onoterade och noterade företag.Metod: I denna kvantitativa studie har sekundärdata använts från tidigare vetenskapligaartiklar rörande aktualiteten i onoterade företag, för att kunna utföra en metaanalys. De åttaartiklar som är använda i metaanalysen är föreslagna av handledare. En sökning av artiklarhar sedan gjorts på egen hand genom kedjesökning och självständig sökning. För attpresentera och tolka resultaten från metaanalysen genererades en forest plot för respektiveresultat.Resultat &amp; slutsats: Företag med högre skuldsättningsgrad lämnar in sinaredovisningsrapporter sent i större utsträckning än företag med låg skuldsättningsgrad. Störreföretag kommer i högre utsträckning lämna in sina redovisningsrapporter för sent, jämförtmed mindre företag. Det fanns inget signifikant samband gällande revision, kön i styrelsenoch konkursrisk (skatteskuld). Storlek och skuldsättningsgrad påverkar inte ledtiden.Examensarbetets bidrag: Att utföra en metastudie på onoterade företag gällande faktorersom påverkar aktualiteten, vilket aldrig har utförts tidigare.Förslag till fortsatt forskning: Att utföra en metaanalys med värden från både onoteradeoch noterade företag i en och samma metaanalys. Ett annat förslag är att utföra denna studieigen, men att använda rådata direkt från forskarna istället för data från publicerade artiklar.Nyckelord: Aktualitet. Redovisningsinformation. Onoterade företag. Determinanter.Finansiell redovisningsreglering.