A tuberculose (TB) é um grave problema de saúde pública, acometendo milhares de pessoas, principalmente em populações ou grupos menos favorecidos. A região de fronteira, devido ao aumento do fluxo de pessoas, constitui um desafio para o controle da TB. Nesse contexto, o objetivo geral do trabalho foi \"Analisar a relação espacial de determinantes sociais da saúde com a mortalidade por TB e por TB-HIV e tendência temporal desses eventos em Foz do Iguaçu, PR\". Como abordagem teórica, foi utilizado o marco conceitual dos Determinantes Sociais da Saúde. Trata-se de um estudo ecológico com aplicação de múltiplos métodos de análise. A população consistiu de casos de óbitos por TB como causa básica e TB associado com HIV (coinfecção TB-HIV) residentes em Foz do Iguaçu, no período de 2004 a 2015 e as unidades de análise foram os setores censitários urbanos. Os dados referentes aos óbitos foram coletados no Sistema de Informação de Mortalidade (SIM). As variáveis originais que representaram os determinantes sociais foram coletadas do Censo Demográfico 2010 do Instituto Brasileiro de Geografia e Estatística (IBGE). Quanto aos métodos de análises, foram realizadas análise descritiva dos óbitos, Estimador de densidade Kernel, estatística de varredura, distribuição e análise estatística das taxas de mortalidade, análise de dependência espacial (I Moran), Associação espacial (Índice Local de Associação Espacial - LISA e Gi*), Regressão Geograficamente Ponderada [RGP, em inglês - Geographically Weighted Regression (GWR)] e análise de tendência temporal (regressão temporal Prais-Wistein). Os resultados da análise descritiva demonstraram que dos 130 casos de óbitos no período, 74 ocorreram por TB como causa básica e 56 pela coinfecção TB-HIV. Para os dois grupos estudados a maioria era homens [TB = 53 (71,6%); TB-HIV = 43 (76,8%)], de raça/cor de pele branca [TB = 51 (68,9%); TB-HIV = 43 (76,8)], solteiros [TB = 36 (48,6%); TB-HIV = 35 (62,5%)], com ensino fundamental [TB = 34 (45,9%); TB-HIV = 25 (44,6%)] e com TB pulmonar [TB = 67 (90,5%); TB-HIV = 48 (85,7%)]. Os óbitos pela coinfecção TBHIV foram mais jovem em relação aos óbitos por TB. A técnica de estimador de densidade Kernel demonstrou pontos quentes para os óbitos por TB nas regiões Leste e Sul, enquanto que para os óbitos de TB-HIV foram as regiões Norte, Nordeste, Leste e Sul. A estatística de varredura apontou um cluster de risco relativo espacial aumentado 5,07 (IC95% 1,79 - 14,30) na região leste. As taxas de mortalidade foram 2,2/100mil hab. para TB e 1,8/100mil hab. para TB-HIV. A partir da técnica Gi*, observou-se que a taxa de mortalidade por TB apresentou áreas quentes na região Sul, Leste e Central, enquanto que a taxa de mortalidade por TB-HIV apresentou nas regiões Norte, Nordeste e Leste. A associação bivariada (LISA) demonstrou que o padrão predominante foi a associação das altas taxas de uma mortalidade com a baixa taxa da outra, ou seja, alto-baixo (High-Low) e baixo-alto (Low-High). Ocorreu ainda associação do padrão alto-alto (High-High), não sendo observado a associação baixobaixo. A associação local (LISA) entre os determinantes sociais e a mortalidade por TB apontou a renda, cor de pele e densidade de moradores por domicílio como fatores associados. Já em relação a taxa de mortalidade por TB-HIV, a técnica GWR, os determinantes indicados foram renda, raça/cor de pele parda e esgoto a céu aberto. Em relação à tendência temporal, observou-se um crescimento da mortalidade de TB em pessoas de raça/cor de pele parda. Os resultados contribuem para reflexão sobre a relevância da adoção de estratégias intersetoriais para a redução das desigualdades sociais afim de evitar as mortes por TB e TB-HIV em territórcios com grande vulnerabilidade / Tuberculosis (TB) is a serious public health problem, affecting thousands of people, especially in disadvantaged populations or groups. Border regions constitute a challenge for the control of TB, due to the constant increase in the flow of people. In this context, the general objective of this study was to \"Analyze the spatial relationship of social determinants of health with mortality from TB and HIV-TB and its temporal tendency in Foz do Iguassu, PR\". As a theoretical approach, the study opted for the conceptual framework of the Social Determinants of Health. It is an ecological study with application of multiple methods of analysis. The population of this study consisted of cases of deaths due to TB as a basic cause and TB associated with HIV (TB-HIV co-infection) residing in Foz do Iguassu, from 2004 to 2015, and the analysis units were the urban census tracts. Data on deaths were collected in the Mortality Information System (SIM). The original variables that represented the social determinants were collected from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics (IBGE). As for the methods of analysis, this study focused on descriptive analysis of deaths, Kernel Density Estimator, Scan Statistics, Distribution and statistical analysis of mortality rates, spatial dependence (I Moran), Spatial Association (Local Spatial Association Index - LISA and Gi *), Geographically Weighted Regression (GWR) and temporal trend analysis (Prais-Wistein temporal regression). The results of the descriptive analysis showed that of the 130 cases of death in the period, 74 occurred because of TB as the basic cause and 56 because of TB-HIV co-infection. For the two groups studied the majority were men [TB = 53 (71,6%); TB-HIV = 43 (76,8%)], of race/color of white skin [TB = 51 (68,9%); TB-HIV = 43 (76,8)], single [TB = 36 (48,6%); TB-HIV = 35 (62,5%)], with elementary education (TB = 34 (45,9%); TB-HIV = 25 (44,6%)) and with pulmonary TB [TB = 67 (90,5%); TBHIV = 48 (85,7%)]. Deaths from TB-HIV coinfection were younger in relation to TB deaths. The Kernel intensity estimator technique demonstrated hot spots for TB deaths in the eastern and southern regions, while for the deaths of HIV-TB were the north, northeast, east and south. The scan statistic pointed to a cluster of spatial relative risk increased by 5.07 (95% CI 1.79 - 14.30) in the eastern region. Mortality rates were 2.2/100mil for TB and 1.8 / 100 thousand inhabitants for HIV-TB. From the Gi * technique, it was observed that the TB mortality rate presented hot areas in the south, east and central regions, while the mortality rate due to TB-HIV presented in the north, northeast and east regions. The bivariate association (LISA) showed that the predominant pattern was the association of the high rates of one mortality with the low rate of the other, that is, high-low and low-high. There was also association of the highhigh pattern, and the low-low association was not observed. The local association (LISA) between the social determinants and the mortality by TB indicated the income, skin color and density of residents per household as associated factors. Regarding the mortality rate due to HIV-TB, the GWR technique, the determinants indicated were income, race / color of brown skin and open sewage. Regarding the temporal trend, there was an increase in the mortality of TB in people of race / color of brown skin. The bivariate association (LISA) showed that the predominant pattern was the association of the high rates of one mortality with the low rate of the other, that is, high-low and low-high. There was also association of the high-high pattern, and the low-low association was not observed. The local association (LISA) between the social determinants and the mortality by TB indicated the income, skin color and density of residents per household as associated factors. Regarding the mortality rate due to HIVTB, the GWR technique, the determinants indicated were income, race / color of brown skin and open sewage. Regarding the temporal trend, there was an increase in the mortality of TB in people of race / color of brown skin. Regarding the temporal trend, there was an increase in the mortality of TB in people of race / color of brown skin. The results contribute to a reflection on the relevance of adopting intersectoral strategies to reduce social inequalities in order to avoid deaths due to TB and HIV-TB in highly vulnerable territories

A produção agropecuária está sujeita a diversas restrições, como as restrições legais impostas pelo Código Florestal, o qual restringe a área utilizada para a produção agropecuária dentro do imóvel rural, o que implica em custo para os produtores agropecuários e que é representado pela renda renunciada e aumento dos custos pela alocação dos insumos de forma a reduzir a necessidade da área que deve ser mantida com florestas nativas. Esse custo pode variar entre os produtores em razão das características da propriedade e do produtor. Neste contexto, o objetivo desse estudo é mensurar o custo de oportunidade da área ocupada com Reserva Legal e seus determinantes, confrontando os produtores representativos do estado de São Paulo e do Mato Grosso nos anos de 1995 e 2006. O produtor representativo foi obtido dividindo o valor total das variáveis em nível municipal pelo número de estabelecimentos. O custo de oportunidade foi estimado utilizando a metodologia proposta por Zhou, Ang e Poh (2006) e os seus determinantes foram estimados por meio de um modelo de econometria espacial. Os resultados indicaram que a eficiência técnica e a eficiência técnica ambiental dos produtores foram pequenas nos anos analisados em ambos os estados considerados. Um produtor é eficiente tecnicamente se ele obtém o máximo de produção possível dado os insumos utilizados. A eficiência ambiental também objetiva minimizar o desmatamento. O estado do Mato Grosso destacou-se pela baixa eficiência produtiva em 1995/96, em que nenhum produtor médio foi eficiente. A análise da receita, do uso de insumos e do desmatamento indicou que os produtores ineficientes não necessariamente utilizam mais de todos os insumos para obter uma produção menor. Contudo, os produtores ineficientes possuíam um maior rebanho bovino, maior área destinada à produção agropecuária e maior área da Reserva Legal incorporada ao processo produtivo. Destaca-se que os produtores eficientes tecnicamente obtiveram maior receita agropecuária mas utilizaram maior área da Reserva Legal quando comparados aos produtores eficientes técnica ambientalmente. Esse resultado aponta para a existência de custo de oportunidade. As estimativas indicaram que o estado do Mato Grosso foi aquele que apresentou o maior custo total por estabelecimento (R$ 48.353.000 em 2006), embora o estado de São Paulo tenha apresentado o maior custo por hectare (R$ 412,62). Os resultados indicaram que há transbordamentos espaciais entre os produtores, de forma que o custo de oportunidade dos produtores seria determinado conjuntamente. Entretanto, os transbordamentos espaciais atenuariam os efeitos das variáveis explicativas sobre o custo de oportunidade. No Mato Grosso, a área e o custo apresentaram relação positiva, sendo que os menores produtores arcariam com um custo proporcionalmente maior dos que os maiores produtores. Para São Paulo, a área está associada a uma redução do custo de oportunidade a taxas crescentes. Os resultados econométricos indicaram a necessidade de considerar as peculiaridades entre os produtores na análise do custo de oportunidade, bem como os transbordamentos espaciais. / Agricultural production is subject to various restrictions, such as the legal restrictions imposed by the Forest Code. This restricts the area used for agricultural production, which implies cost to agricultural producers. However, this cost can vary between manufacturers because of the features of the property and producer. In this context, the aim of this study is to estimate the opportunity cost of the area occupied by the Legal Reserve and its determinants. To do this, the producers of São Paulo and Mato Grosso were confronted in the years 1995/1996 and 2006. The opportunity cost was estimated using the methodology proposed by Zhou, and Ang Poh (2006) and the determinants of opportunity cost was estimated through a spatial econometric model. The results indicated that the technical efficiency and environmental technical efficiency of producers were small in this period in both states. The state of Mato Grosso stood out for its low production efficiency in 1995/96, in which no producer was efficient. Both states showed improvement when considering the environmental performance, highlighting Mato Grosso. This state increased its efficiency by 13 percentage points on average. However, it also showed the lowest performance compared to São Paulo. The analysis of income, use of inputs and deforestation indicated that inefficient producers do not necessarily use more of all inputs for lower production. However, inefficient producers had a larger cattle herd, the largest area for agricultural production and larger area of Legal Reserve incorporated into the production process. It is noteworthy that the technically efficient producers achieve higher agricultural income but used larger area of legal reserve, when compared to producing environmentally efficient technique. This result indicates the existence of opportunity cost. Estimates indicated that the state of Mato Grosso was the one who had the highest total cost (R $ 48.353 million in 2006), although the state of São Paulo has presented the higher cost per hectare (R $ 412.62). The analysis of the opportunity cost indicated that producers with high (low) opportunity costs tend to be close, forming spatial groups. This indicated the need to incorporate the spatial element in the estimation. The results indicated the existence of different effects between the states as the determinants of opportunity cost. In Mato Grosso, the area and the cost had positive relationship, and the smaller producers would bear a proportionately higher cost of the larger producers. For São Paulo, the area is associated with a reduction in the opportunity cost at increasing rates. The results also indicated that agricultural production in Mato Grosso would be more sensitive to changes in financing and investment. Analysis of the indirect effects indicated the existence of spatial spillovers, highlighting the use of terraces, population density, courses, existence of settlements in the counties and most important of temporary crops in the occupied area.

Ciências Empresariais / Nos últimos anos, talvez nenhum assunto na área da Gestão Internacional tenha recebido o mesmo nível de atenção como a escolha do modo de entrada de IDE, em particular, a decisão entre adquirir uma empresa estrangeira já existente ou estabelecer uma nova filial no exterior. Todavia, os resultados, longe de serem consensuais, têm sido fornecidos por estudos ao nível da empresa. Uma questão interessante, e ainda não explorada, é a evidência empírica acerca da existência de factores macroeconómicos específicos a cada modo de entrada. Uma outra problemática que carece igualmente de investigação diz respeito aos efeitos potenciais que as F&A internacionais e os investimentos de raiz (IR) exercem no crescimento económico dos países recipientes. Estas constituem as duas questões centrais deste trabalho. Ao nível da primeira questão, estendemos o trabalho de Globerman e Shapiro (2005) com vista a investigar, não só os determinantes macroeconómicos específicos das F&A internacionais, mas também os dos IR, adoptando um painel de 53 países, ao longo do período 1996-2006. Encontramos evidência que nos permite concluir que, apesar da existência de um conjunto de variáveis que são comuns a todos os modos de IDE (como a dimensão da economia, o grau de abertura ao exterior, o índice de governação e o índice de desenvolvimento humano), existem outras variáveis que parecem ser específicas do modo de entrada. Entre estas, o grau de protecção ao investidor e as variáveis associadas ao contexto cultural parecem desempenhar um papel importante na explicação das F&A internacionais e dos IR, respectivamente. Além disso, não encontramos diferenças significativas entre os países desenvolvidos e os países em desenvolvimento, no que respeita aos determinantes específicos do modo de entrada Na segunda questão foi conduzida uma análise inovadora para estudar a relação entre o IDE e o crescimento económico, distinguindo entre os efeitos das F&A internacionais e os dos IR. A evidência sugere a existência de uma relação causal bidireccional entre o IDE / as F&A e o crescimento económico. Constatamos ainda que o crescimento económico causa os IR, mas o inverso não é verdadeiro. Adicionalmente, com base na estimação de um modelo estrutural de crescimento, os resultados indicam uma relação positiva entre o IDE de raiz e o crescimento económico, em ambos os grupos de países. Ao invés, as F&A internacionais tendem a exercer um impacto negativo no crescimento económico dos países em desenvolvimento e não significativo, no caso dos países desenvolvidos. / In the last years there were few subjects in International Management that have received so much level of attention as the FDI entry mode choice, in particular, the decision between acquiring an already existing foreign firm or establishing a new firm in a foreign country. However, the results, far from being consensual, have been supplied by firm-level studies. An interesting question, not yet explored, is the empirical evidence related to the existence of macroeconomic mode-specific determinants. Another issue which requires investigation is related to the potential effects that cross border mergers and acquisitions (M&A) and greenfield investments cause on host countries economic growth. These are the two central questions of the present study. In what concerns the first question, we extended the work by Globerman and Shapiro (2005) in order to investigate, not only the macroeconomic specific determinants of cross border M&A, but also those of greenfield investments. We adopted a panel data set of 53 countries, over the period 1996-2006. We have found evidence that allow us to conclude that, despite the existence of a group of mode-encompassing variables (such as economy s size, openness, governance and human development index) there are others that seem to be mode-specific variables. Among these, the degree of investor protection and cultural context variables seem to play an important role in the explanation of cross border M&A and greenfield investments, respectively. In addition, we did not found significant differences between developed and developing countries, with respect to entry mode-specific determinants. In the second question a new approach was introduced to study the relationship between FDI and economic growth, while distinguishing the effects of cross border M&A and the ones of greenfield investments. The evidence suggests that there is bidirectional causality between FDI / M&A and economic growth. We have also concluded that economic growth causes greenfields, but the reverse is not true. Moreover, based on the estimation of a structural growth model, the results indicate a positive relationship between greenfield investments and economic growth, in both groups of countries. Instead, cross border M&A seem to exert a negative effect on the economic growth of developing countries and insignificant on developed countries.

Active asthma and asthma-related health care utilization are higher among adult females than they are among adult males in Puerto Rico. The purpose of this study was to examine the determinants of the risk of active asthma and associated health care utilization and asthma control among women in Puerto Rico. Guided by the Andersen behavioral model, the study included data from the Asthma Call-Back Survey (ACBS) during 2011 and 2012 in Puerto Rico. The associations between active asthma and behavioral, demographic, and environmental factors were assessed using logistic regression. The relationship between asthma-related health care utilization and predisposing, enabling, and need factors was examined using multiple linear regression. The association between achieved level of asthma control and asthma-related healthcare utilization was investigated using multinomial logistic regression. Results of the logistic regression indicated that being out of work, being in a middle income category, and being obese significantly increased the odds of active asthma. Being self-employed and being in the income category of $15,000-$25,000 significantly predicted the frequency of emergency room visits (ERVs). Results of the multinomial logistic regression indicated that physician urgent visit and ERV were significantly associated with poorly controlled asthma symptoms. The positive social change implication of these findings is that the identified risk factors can be used to develop asthma management plans to prevent and control asthma attacks in at-risk populations and reduce asthma-related health care utilization cost

Young African American men who have sex with men (AAMSM) are at greater risk of being infected with the human immunodeficiency virus (HIV) and less likely to seek HIV testing than are members of other demographic groups. This behavior results in a significant public health threat because young AAMSM with an unrecognized HIV infection are less likely to practice safer sex and, therefore, more likely to pass the infection on to their partners. This study is an examination of the social and personality factors that influence HIV testing rates among young AAMSM, using Aday's model of the social determinants of health and the Big Five model of personality as the theoretical frameworks. A cross-sectional design was employed, and social networks were used to recruit study respondents. Forty-three young AAMSM completed online questionnaires, and multiple regression techniques were used to examine relationships among the variables of interest. Statistical analysis indicated that neither the social risk factors derived from Aday's model nor the Big Five model predicted HIV testing. However, it is unknown whether these nonsignificant findings are attributable to a genuine lack of influence or the unique characteristics of the sample. Given the null results of this study and the mixed findings of prior research, further studies are required to draw conclusions regarding the influence of social and personality factors on HIV testing in this high-risk group. Additional research could be helpful in developing more effective strategies for encouraging HIV testing among young AAMSM. The potential for positive social change lies in slowing the spread of HIV through this vulnerable population and in engaging young AAMSM in the medical system to improve their long-term health prospects.

Ces dernières décennies ont vu l'émergence et le développement de plusieurs pratiques managériales ayant rapport à la qualité et à l'environnement. Néanmoins, l'analyse des raisons de l'adoption de ces pratiques managériales par les entreprises et de leurs effets sur les entreprises et les salariés a été assez peu étudiée par les économistes. Cette thèse contribue à la littérature empirique sur les pratiques managériales liées à la qualité et à l'environnement dans les entreprises en France. Elle est construite autour de trois thèmes majeurs : (1) l'analyse des déterminants d'adoption de ces pratiques managériales, (2) l'étude de leur impact sur des indicateurs de performance d'entreprises et (3) l'étude de leur impact sur des mesures liées aux salariés. La thèse s'articule autour de ces trois axes de recherche en trois parties.Dans la première partie de la thèse, nous présentons les pratiques managériales de qualité et d'environnement, en se concentrant plus particulièrement sur les normes de qualité ISO 9000 et les normes environnementales ISO 14000. Nous étudions les déterminants de l'adoption des ces normes de qualité et d'environnement. Nous montrons dans un premier temps que les déterminants de l'adoption des normes de qualité sont différents dans les secteurs de l'industrie et des services, plus précisément du point de vue de la stratégie interne de ces entreprises (amélioration de la qualité, réduction des coûts et innovation). En revanche, certaines caractéristiques d'entreprises (taille, appartenance à un groupe financier, expérience avec d'autres normes) et des caractéristiques décrivant la stratégie externe des entreprises (niveau d'exportation et satisfaction des clients) ont le même effet dans l'adoption de ces normes dans les deux secteurs. Dans un second temps, nous analysons les déterminants de l'adoption de la norme ISO 14001 et de l'Engagement de Progrès dans des entreprises de l'industrie chimique. Nous montrons que les deux systèmes analysés ont des déterminants différents : d'un côté, les principaux déterminants de l'adoption de la norme ISO 14001 sont la taille de l'entreprise, l'expérience avec d'autres normes, obligations d'information et la localisation géographique des clients et d'un autre côté, les principaux déterminants de l'Engagement de Progrès sont la pression réglementaire, avoir rencontré des problèmes environnementaux dans le passé et prévoir des risques environnementaux futurs.Dans la deuxième partie de la thèse, nous analysons si les normes de qualité et d'environnement conduisent les entreprises à de meilleures performances, en utilisant une palette riche d'indicateurs de performance d'entreprises. Nous montrons que les normes de qualité ont un impact positif sur le chiffre d'affaires et certains indicateurs de performance d'innovation et de productivité. En revanche, elle n'ont pas d'effet sur le profit et sur d'autres mesures de performance d'innovation. Concernant les normes environnementales, nous montrons qu'elles améliorent le chiffre d'affaires et les pratiques de recrutement des personnels qualifiés et des personnels non qualifiés, mais n'ont pas d'impact sur le profit des entreprises. Enfin, notre investigation montre que le fait de mettre en place simultanément des normes de qualité et d'environnement améliore plus fortement les performances des entreprises par rapport à l'adoption séparée de ces normes.La troisième partie de la thèse étudie les effets des normes de qualité et d'environnement sur des mesures liées aux salariés. Les normes de qualité augmentent les risques d'accident, mais n'ont pas d'effet sur les accidents de travail entraînant un arrêt. Concernant les normes environnementales, nous montrons qu'elles améliorent significativement les conditions de travail à travers la diminution des accidents. De plus, les salariés qui travaillent dans des entreprises qui adoptent des normes environnementales considèrent que leur travail est davantage utile pour la société et ils ressentent une meilleure reconnaissance de leur travail. Ainsi, les normes environnementales augmentent le sentiment de bien-être des salariés.Nous montrons également que les salariés travaillant dans des entreprises ayant adopté des normes environnementales ne se déclarent pas plus impliqués dans leur travail et pourtant font davantage d'heures supplémentaires non rémunérées que les salariés d'entreprises n'ayant pas pris d'engagements similaires en matière de protection de l'environnement. / The scope and magnitude of changes occurring in business today has led to great interest in and widespread adoption of Quality and Environmental Management approaches. However, despite their prevalence, efforts at understanding the motives for their adoption, as well as their effects on firm and employee outcomes, are still in their infancy. This PhD dissertation provides useful theoretical and empirical contributions to three research topics dealing with Quality and Environmental Management approaches in the French institutional framework: (1) the determinants of their adoption, (2) their impact on firm outcomes and (3) their impact on employee outcomes. These three aspects make up the three parts of this PhD thesis.In part I, we define and characterise quality and environmental approaches with a special focus on ISO 9000 Quality Management standards and ISO 14000 Environmental Management standards. Furthermore, we empirically examine the determinants of quality and environmental standards adoption. Our findings reveal that the determinants of quality standards significantly differ between manufacturing and service firms, particularly when we examine features of the internal strategy of those firms (quality improvement, cost reduction and innovation). However, we have also obtained evidence which indicates that the characteristics of firms (firm size, corporate status and previous experience with similar standards) and features of their external strategy (export levels and customer satisfaction) play a significant role in quality standards adoption across both the manufacturing and service sectors. Moreover, we empirically investigate the determinants of chemical firms' registration for the ISO 14001 standard or the Responsible Care program. We show that most determinants are different for the two systems analysed: while firm size, previous experience with similar standards, information disclosure requirements and customer location are major determinants of ISO 14001 standard registration, regulatory pressure, past environmental problems and future risks are the main drivers of Responsible Care registration.In part II, we empirically investigate whether quality and environmental standards are related to better firm performance using various sets of performance measures. The evidence indicates that quality standards positively influence turnover and specific indicators of innovation performance and productivity, but have no impact on profit and some other innovation performance measures. Based on our empirical findings, we conclude that while environmental standards improve turnover and recruitment of both professional and non professional employees, they have no effect on profit. Moreover, the research shows that implementing both quality and environmental standards is likely to better enhance firm outcomes than implementing only one standard.Part III is focused on the effect of quality and environmental standards on employee outcomes. The estimation results show that quality standards increase the risk of employee accidents although more specifically they are ineffective on working accidents that lead to sick leave. On the other hand, our results lead to the conclusion that environmental standards add significantly to the enhancement of working conditions, via the reduction of accidents. Furthermore, the obtained evidence shows that environmental standards seem to improve employee well-being. More precisely, employees working for firms that are certified for an environmental standard report greater feelings of usefulness about their job and declare that they are more often fairly valued in their jobs. The evidence also shows that employees working for environmentally certified firms do not claim to be significantly more involved in their job but they are more likely, ceteris paribus, to work uncompensated for sup plementary work hours than “non green workers”.

Globally, in low and middle-income countries 4 out of every 10 pregnancies is reported to be unintended. Having an unintended pregnancy increases the risk of maternal and infant morbidity and mortality, preterm birth, low birth weight, and decreases rates of breast-feeding. The United States (U.S.) consistently has some of the highest rates of preterm birth, infant and maternal mortality of all high-income countries and 45% of all pregnancies in the U.S. are reported to be unintended. The etiology of these outcomes and their relationship to pregnancy intention are complex and multifactorial, but we know this disproportionately effects women living in poverty both in the U.S. and globally. When couples have the knowledge, access, and power to decide when and whether to become pregnant they are more likely to seek preconception care, thus increasing the likelihood of planned pregnancies leading to improved maternal and child health outcomes. Primary prevention strategies to improve maternal/child health outcomes in the U.S. include sexual and reproductive health considerations such as increasing access to birth control. Globally, strategies include expanding access, as well as focusing on the empowerment of women and improving gender social norms. Focusing on community level norms and individual empowerment can lead to greater reproductive autonomy, which in turn leads to an increase in the uptake of birth control and family planning. This broader consideration of multiple levels of power or autonomy is often lacking in approaches taken in the U.S. More information is needed about the social context and determinants of pregnancy intention in our communities, particularly of women living in poverty. The purposes of this dissertation were to 1) to describe reproductive autonomy and family planning challenges in a population of marginalized Ecuadorian women; 2) develop a conceptual framework of reproductive autonomy from the global literature; 3) to validate a shortened form of an interpersonal violence scale used in a study of low-income pregnant women in Kentucky; and finally 4) to investigate the association between pregnancy intention and individual, interpersonal and community factors of impoverished women living in Kentucky. The qualitative study of women in Ecuador identified barriers and facilitators to family planning in a low-resource community. The major themes that emerged were that women’s autonomy was limited by men, shame was ‘keeping women quiet’, systems failed women, and as women aged they were able to build resilience in spite of these challenges. Many reported reproductive coercion, gender-based violence, and regret. Those who could leave unsupportive partners and found social support were more effective at planning their pregnancies. Evidence supports these themes are relatively common in the global literature, particularly of women living in poverty. The comprehensive review of these findings was used to develop a conceptual framework of reproductive autonomy. The Socio-Ecological Model was used to organize the data based on individual, interpersonal or community level determinants of pregnancy intention and reproductive autonomy. This new conceptual model, called the Power and Reproductive Autonomy (PARA) model, was used as a guide to analyze multiple levels of data in a secondary analysis of pregnant women living in poverty in Kentucky. Prior to this secondary analysis study, a measure used in the parent study needed to be validated. A short form of the Women’s Experience with Battering (WEB) scale was found to be psychometrically valid to measure of the impact of intimate partner violence for this population. Findings from the secondary analysis included high rates of unintended pregnancy (66%), and women with unintended pregnancy were more likely to report exposure to interpersonal violence, poor social support, and anxiety at the bivariate level. At the community (county) level those with an unintended pregnancy were more likely to live in counties with fewer social associations, and in rural communities. None of the access, gender equity, income inequality, or violence variables were correlated to pregnancy intention. In the final multilevel model, controlling for demographic variables, only being unmarried and answering the question in English were significant predictors of unintended pregnancy. The rate of social associations in a county was marginally significant with pregnancy intention, in that the presence of social associations appeared to decrease the likelihood of unintended pregnancy. Operationalizing the PARA framework to examine predictors of unintended pregnancy in Kentucky proved to not yield expected results; county level variables related to access, gender equity, and violence were not found to be significantly correlated. Women answering the question in Spanish had significantly higher rates of planned pregnancy, which is a new finding. Having opportunities for social engagement also seemed to be a protective factor in preventing unintended pregnancies. Limitations of cross-sectional data also make it a challenge to capture cumulative life stressors which could contribute to poor reproductive autonomy. Future studies may yield a greater understanding of the social context of pregnancy intention if more interpersonal data related specifically to reproductive autonomy are in the model, such as reproductive coercion, relationship power, communication, and contraceptive decision making. Additionally, further examination of structures or systems that provide economic opportunities in the community is a promising area of reproductive autonomy and pregnancy intention research.

Au travers des données cognitives de la cohorte stéphanoise PROOF, l’objectif de ce travail de thèse a été de déterminer quelle pouvait être la valeur pronostique de plusieurs facteurs, entre autres psychosociaux et physiologiques, d’un maintien optimal du fonctionnement cognitif avec l’âge.Le premier axe de recherche de ce travail, a mis en évidence que 70% des 632 participants âgés de 67 ans à la première évaluation cognitive de l’étude PROOF, présentaient une stabilité de leur fonctionnement cognitif après 8 ans de suivi. Le principal facteur mis en cause dans le vieillissement cognitif de cette population, que nous avons qualifié de « réussi », était, pour ces participants, d’avoir un haut niveau d’implication dans des activités sociales.Le second axe de recherche de ce travail, a mis en évidence que la dégradation de la régulation autonomique, et non la présence de facteurs de risque cardiovasculaires classiques, avait un impact négatif sur le fonctionnement mnésique des participants. Confortant ces résultats, nous avons montré que les pathologies respiratoires liées au sommeil avaient un impact négatif sur le vieillissement cognitif normal, avec un impact délétère de la fragmentation autonomique nocturne sur l’évolution des capacités mnésiques. Une préservation de l’activité du Système Nerveux Autonome (SNA) pourrait donc être une clé d’un maintien optimal des capacités mnésiques au cours du vieillissement normal.Le troisième axe de recherche de ce travail, a mis en évidence que les plaintes, qu’elles soient cognitives ou liées à la qualité de sommeil, étaient stables au décours du vieillissement normal. Nous avons pu démontrer que ce n’est pas l’âge qui génère la plainte, mais la qualité de vie et l’état anxiodépressif des personnes qui les expriment. Ceci n’est pas sans nous rappeler que le sujet, son symptôme et son histoire sont autant de déterminants du vieillissement cognitif « réussi ». Le quatrième axe de recherche de ce travail, a enfin mis en exergue que la prise en compte de la richesse des interactions sociales menées tout au long de la vie était un élément déterminant du niveau de performances dans des tâches de cognition sociale de personnes agées de 78 ans, et ce, indépendamment de la nature du fonctionnement exécutif et du niveau socioculturel. En conclusion, le vieillissement cognitif « réussi » n’est pas uniquement une vision optimiste du bien vieillir, allant contre des stéréotypes négatifs sur une perte systématique des fonctions cognitives liée à l’âge. Il s’agit d’un concept multidimensionnel qu’il convient de bien cerner si l’on veut mettre en place des stratégies efficaces susceptibles d’intervenir sur le maintien des capacités cognitives avec l’âge. Ce travail de thèse a permis de mettre en évidence l’identification de quatre facteurs déterminant du vieillissement cognitif « réussi » (et pour lesquels une intervention est possible !) qui sont : 1) le maintien des activités sociales tout au long de sa vie ; 2) la préservation d’un bon équilibre du système sympathique-parasympathique ; 3) l’absence de pathologies respiratoires liés au sommeil ; 4) la stabilité des plaintes (sommeil, cognition) exprimées avec l’âge. / The aim of this thesis was to examine cognitive performances of a large French cohort study of elderlies, i.e. the Saint Etienne PROOF-Siempre cohort, in order to assess among several factors which of them could play a prognostic role on a successful cognitive aging including physiological and psychosocial factors. In order to assess these key factors we developped several research axes frequently examining the long-term changes.The first axis of the research consider the overtime evolution of cognitive function in this population. We found that 70% of the 632 participants 67 yrs old at their inclusion in the study with or without sleep related breathing disorders had stable cognitive data 8-yr later. In this sample that we defined as having a successful cognitive aging, the predictive factor was the "high level of social activities" without any contribution of the demographic data, the hypoxemic load or classical vascular and metabolic factors.The second axis of the research we examined the influence of the autonomic nervous system activity of cognitive performances. In a sample of 916 older people, we found that a parameter reflecting the parasympathetic arm of the ANS, the baroreceptor sensitivity, affect when it was found altered the memory function without interference of other cardiovascular risk factor. These results were confirmed in a 8-yr assessment on 425 subjects of the previous sample in whom again a alteration of baroreceptor sensitity affect the long-term changes on memory function with contribution of the other examined factors. This would suggest that autonomic nervous system may also influence the memory changes with aging and assuring a more successful cognitive aging.The third axis of the research was to define how subjective cognitive and sleep complaints remain stable across time and whether subjective estimation of sleep quality may affect the changes on the subjective cognitive complaints. We found again a stability of the subjective cognitive complaint without any interference of sleep quality and aging itself, the quality of life and the presence of anxiety and depression being the most important factors. The four axis of the research examined the possible effect of the degree of social interaction developed along lifetime on the social cognition. We found in group of 100 elderly aged 78 yrs that quality of social interactions in the life-span was the key factor implicated in late social cognitive skills in the elderly without any effect of the executive function status nor the educational and intellectual level.In conclusion, we have demonstrated that in contrast to the most common recognized of a systematic loss of cognitive functions related to age healthy elderlies may have a successful cognitive aging. The "successful" cognitive aging is a multidimensional concept that should clearly identify if one wants to adopt effective strategies to maintain cognitive abilities with age. The different aspects examined in this thesis have highlighted the identification of four determinants of a "successful" cognitive aging: 1) the maintenance of social activities throughout the life; 2) the preservation of a sympathetic-parasympathetic balance of the autonomic nervous system; 3) the lack of sleep-disordered breathing; and 4) the stability of sleep and cognitive complaints generally reported in older population. The application of those strategies may help to prevent the cognitive decline in older populations.

ABSTRACT The shift in the nation’s political climate between 2016-2019 has exacerbated the longstanding pervasive issues of racism and discrimination against People of Color and those marginalized by societal inequity. This has serious implications for teaching and schooling, as it causes children to feel unsafe, question their sense of belonging, and internalize racial oppression. Indicators of inequitable school experiences for Students of Color and students from marginalized identity groups warrant attention to the socially determined facets of public education: specifically a sense of school belonging (SOSB) for Students of Color, the impact of racial trauma, the patterns of social engagement that shape their experiences, as well as the pedagogical practices teachers employ to support their social-emotional wellbeing. This qualitative case study seeks to illustrate how classroom teachers at Arday Elementary School support the social-emotional wellbeing of Students of Color by examining their understanding of racial trauma and SOSB and their use of equity literate pedagogies in the classroom to effectively support their Students of Color in a public elementary school in Northern New England. Findings include the hidden curriculum, teacher critical consciousness, cultural congruence, learning environment, racial trauma, and resistance. These findings point to a newly conceptualized framework, Equity Pedagogy for Social-Emotional Wellbeing (EPSEW), which applies a social determinants perspective to examinations of educational inequity and considers the social and community contexts that predetermine and influence inequitable outcomes. Keywords: equity pedagogy, equity literacy, social determinants, school belonging, racial trauma, internalized racism, social emotional well-being, critical pedagogy, anti-bias education

Cette thèse examine le poids du genre dans la structuration de la demande scolaire à Ouagadougou. Elle traite particulièrement du rôle des femmes dans la modulation des inégalités scolaires au sein des ménages. La recherche mobilise les données du recensement de 2006, celles d’une enquête quantitative sur l’implication des pères et des mères dans la scolarisation et des entretiens semi-structurés avec des femmes chefs de ménage réalisés en 2009, afin de revisiter de façon approfondie le résultat souvent observé en Afrique subsaharienne d’une meilleure scolarisation des enfants dans les ménages féminins. L’analyse porte d’abord sur les propriétés sociologiques du statut de « femme chef de ménage » et regarde l’élément qui le légitime comme une catégorie distincte de celle des hommes chef d’un ménage et lui confère une cohésion de groupe. Elle s’intéresse ensuite à la variation de la demande scolaire selon le sexe du chef de ménage et celui des enfants en lien avec leur statut familial. Il ressort des résultats que moins que le statut de chef de ménage, les configurations familiales particulières des structures dirigées par une femme en font des environnements favorables à la scolarisation des enfants, surtout des garçons. Il apparaît également une complexité et une ambiguïté du rapport à l’école de ces ménages, qui sont plus néfastes pour la scolarisation de certaines filles, conséquence des rapports sociaux de sexe inégaux dans la société exacerbés par le besoin en main-d’œuvre domestique des familles urbaines. La thèse met ainsi en lumière les potentialités des données du recensement pour une approche sexuée des stratégies scolaires familiales en milieu urbain burkinabè. / This thesis examines the mediating role of gender in the demand for child education in Ouagadougou. It specifically addresses the influence of women in the modification of educational inequalities within households. The research utilizes census data from 2006, data from a quantitative study on the involvement of fathers and mothers in education, and semi-structures interviews with female heads of household conducted in 2009, to elaborate on results often observed in sub-Saharan Africa that children are often better educated in female-headed households. The analysis deals primarily with sociological priorities of the status of the “female head of household” and examines the element that legitimizes them as a distinct category from male heads of household, creating a cohesive group. The study focuses then on the relationship between demand for schooling and the sex of the head of household as well as, the sex of children in relation to family status. The results demonstrate that regardless the status of the head of household, particular family configurations with structures headed by women provide a conducive environment for the education of children, especially for boys. A complex and ambiguous finding also emerged in regards to the schools of these households, which proved to be more harmful to the education of some girls as a result of unequal gender relations in society exacerbated by the need for domestic labor in urban families. This thesis sheds light on the potential for census data to provide a gender-based approach to family education strategies in urban Burkina Faso.