This paper considers internal and external determinants of Foreign Direct Investment in South America. Internal determinants are those which are unique to each country in question, and external determinants are common among all countries in question. An empirical analysis was conducted using data from twelve countries in South America: Argentina, Brazil, Bolivia, Chile, Columbia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay, Venezuela. The dataset spans from 1990 to 2020. A fixed effects multivariate linear regression was conducted on one internal variable and three external variables. Evidence suggests that external factors and internal factors both have bearing over FDI net inflows but may have differing degrees.

BACKGROUND: Pancreatic ductal adenocarcinoma maintains a formidable mortality rate with rising incidence despite extensive research efforts. As of 2021 pancreatic cancer is the third leading cause of cancer-related deaths in the United States despite its incidence representing only 3% of all cancer diagnoses. Given the high mortality rate, research efforts push to improve prognosis by expanding knowledge and tools in the realms of diagnostics, genetics, development of screening modalities, and targeted treatments. Modifications in treatment algorithms have led to only modest improvements in outcome. Current research efforts focus on primary and secondary prevention aimed at modifications of known environmental and hereditary risk factors. Available studies highlight the relationship between relative geography and cancers; however, there is a paucity of research available on the Social Determinants of Health on access to pancreatic cancer care and outcomes. PROPOSED PROJECT: Data will be extracted from the Surveillance, Epidemiology, and End Results (SEER) database and combined with US Census data along with medical record information as relevant over a seven-year period from January 1, 2010, through December 31, 2017. Social Vulnerability Index scores will be derived from the available data as a surrogate for Social Determinant of Health and be assigned to each case of pancreatic cancer from 2010-2017. These scores will be grouped by zip code. Analysis will then be performed to identify the mean stage at time of diagnosis for each zip code. Further analysis will be performed to calculate survival curves for each zip code and cox proportional-hazards will be performed on results to determine statistical significance of SVI with respect to geography. CONCLUSIONS: The proposed study will investigate the impact of geography as a Social Determinant of Health (SDoH) within the United States on the stage at time of diagnosis for pancreatic ductal adenocarcinoma. As a secondary measure, overall survival following diagnosis of pancreatic ductal adenocarcinoma will be examined. SIGNIFICANCE: This study will identify the impact of social determinants of health on geography and correlate the impact on outcomes in pancreatic ductal adenocarcinoma in the United States of America. This study may also identify geographic regions in which the incidence of PDAC is higher than expected which would present a population to investigate for additional screening studies and development of risk prediction models.

Background: Within the Ontario context, a recent shift towards integrated care has led to primary care reforms that have aimed to achieve the quadruple aim benchmarks. Particular focus has been placed on population health management, a key pillar of the quadruple aim metrics, which recognizes and aims to address the broader social, structural and institutional determinants that impact upon population health outcomes. As a result, this study aims to identify and describe the key characteristics of integrated primary care and social care models, programs, and initiatives in Ontario that aim to address the social determinants of health. It also aims to identify barriers and facilitators in the implementation of these integrated care initiatives to support future implementation efforts. Methods: A qualitative descriptive study design was utilized and was conducted in two phases: 1) document analysis; and 2) 13 in-depth semi-structured interviews with policymakers, managers/ administrators, clinicians and service providers involved in leading integrated primary and social care initiatives in Ontario. Results: Developing and implementing these initiatives had primarily required the introduction of new governance and delivery arrangements. This included the adoption of shared governance structures where equal decision-making authority was often established between health and social partners, and the introduction of a system navigator role who was commonly co-located within primary care. There were minimal insights in relation to the development of new financial arrangements aside from a few joint funding agreements, as almost all initiatives did not share financial resources and few modified staff or provider remuneration. Initiatives experienced barriers including a lack of permanent or long-term funding and technological infrastructure to support patient tracking, follow-up, and information sharing between health and social partners. However, the system navigator position was found to be an essential role in bridging communication gaps between sectors and delivering integrated care for clients. In addition, factors such as pre-existing informal and formal partnerships between primary care and social care organizations, communication and trust between health and social partners, and organizational leadership support for integration were viewed as enablers. Discussion and Conclusions: The lessons learned from participants’ experiences in planning and implementing integrated primary care and social care models are timely and can inform future implementation and scale up as the province continues to move towards integrated care arrangements in efforts to achieve the quadruple aim benchmarks. Specific recommendations for policy and future research are proposed. / Thesis / Master of Public Health (MPH) / Health systems in Canada are positioned to treat symptoms of health issues instead of addressing the root causes of illness and disease, such as lack of housing, access to healthy and nutritious food, and stable employment opportunities. Recently, health system reforms in Ontario have shifted to population health-based approaches to care which recognize and aim to address these non-medical determinants of health outcomes. Primary care, which is often an individual's first point of contact with the health system, may be uniquely positioned to fulfill this mandate due to the capabilities of primary care providers to develop and sustain relationships with patients along the life course. Primary care practitioners may be more aware of patients' underlying social needs that result in adverse health outcomes. This study aimed to identify models of care in Ontario that coordinate care for patients between health and social services such as housing and employment support. It was conducted in two phases. Phase one included a targeted document search which used government policy documents, stakeholder websites, and journal databases to identify these integrated models of care in Ontario. In phase two, 13 stakeholders identified from existing models were interviewed to explore their experiences with models that integrate primary care and social care services and the barriers and facilitators to implementing such models. The study found that most initiatives had made modifications to governance and delivery arrangements to support implementation, including the adoption of shared governance approaches and a system navigator position responsible for coordinating care for clients. The initiatives primarily experienced barriers with funding insecurity, communication and information sharing between health and social partners, and technology. However, communication and trust between health and social partners and organizational leadership support were factors that supported the implementation of initiatives. The findings from this research may support future implementation and scale-up of these coordinated models of care in Ontario.

The use of conservation easements has been increasing in the United States. However, patterns of growth over time are different for individual states. Little is known on how determinants of conservation easements interact with one another and affect the choice of conservation approaches. The study objective was to analyze conservation easement trends and examine underlying choice determinants in the United States. Panel data models were employed to assess determinants of easement acres and contracts from 1995 to 2015. Findings revealed that the northern United States has the most percentage of land area under conservation easements. The growth in conservation easements was positively related to gross state products, land market values, air quality, and land use, while it was negatively related to state population density, conservation spending, easement duration and endangered species. Public policymakers would use these findings to integrate easement efforts into local planning to meet conservation and land-use objectives.

No description available.

No description available.

No description available.

This case study analyzed the innovation processes that led to the adoption of a work-integrated learning program among several sport organizations. A comparative case study analysis was used to deduce the commonly shared determinants between each of the sport organizations. Notably, having an innovation champion was a key determination. As well, lack of resources regarding staffing, the involvement of the managers with the participating higher education institution, the ease of contract design, and access to good candidates for the program were also influential in the innovation process. This study revealed, for sport organizations facing similar issues, that the graduate apprenticeship program could provide benefits. As well for sport management program, it could provide a stronger relationship with regional sport organizations. This research also extends the body of research regarding the underlying mechanisms by which sport organizations innovate generally.

Background: The childbearing years place socioeconomically disadvantaged African American women at increased risk for poor diet quality, excess weight gain, and cardiometabolic complications. Little is known about the attitudes, beliefs, values, and contextual constraints that shape these high risk mothers’ dietary and physical activity behaviors. Objective: The purpose of this study was to examine health perceptions of diet quality and physical activity among low-income African American women in the early postpartum period, and how these perceptions manifest as barriers or facilitators to health. Additionally, we examined how they may differ by known predictors of health, such as education, age, parity, and BMI. Methods: We conducted semi-structured, individual interviews with 20 women who were between 3-6 months postpartum. Mothers were approached and recruited in the waiting room of a university-affiliated, outpatient prenatal care clinic in Philadelphia, PA. Enrollment in the study was restricted to women who self-identified as African American, were at least 18 years old, and met the federal income guidelines to qualify for assistance (Medicaid, WIC). Individual interviews were audio recorded and transcribed verbatim, with transcripts verified by research staff. Thematic coding and content analysis were performed by 3 researchers using NVivo 10 software to assist with data management. Results: Barriers and facilitators of healthy eating and physical activity after childbirth fell into 4 major themes of mothers’ lives: 1) new structural reality in the postpartum period; 2) physiologic changes after delivery; 3) correct/incorrect perceptions of healthy eating and activity; and 4) social determinants influencing behaviors. Mothers described the transition from pregnancy to the early postpartum period as having a significant negative impact on their eating and activity behaviors due to heightened fatigue, time constraints, and the monotony of daily life with a newborn. We found more than double the number of perceived barriers to engaging in healthy eating than facilitators with regard to fluctuations in food supply, cost of food, and the built environment. Mothers with obesity and less education were more likely to have misperceptions; these misperceptions additionally served as strong barriers to making healthy lifestyle choices. Changes in mothers’ physical symptoms and health status (e.g., developing diabetes, hypertension), on the other hand, facilitated healthy behaviors. Conclusion: This research deepens our understanding of the primary drivers of health behaviors among low-income African American women in the postpartum period. We identified barriers which limit and facilitators which support these mothers’ ability to engage in healthy behaviors, though there were far fewer facilitators of healthy eating and physical activity. Interventions designed to overcome these barriers and capitalize on these facilitators have the potential to improve health outcomes for this population. / Urban Bioethics

The current fragmented delivery of health care has contributed to unplanned hospital readmissions as a leading problem in the United States. Reducing readmissions to urban teaching hospitals is difficult. Many patients living in urban communities face social, economic, language, and transportation barriers to maintaining their health. Both the patient and the medical center experience the burden of readmission and are challenged with addressing SDoH and social injustices at several levels. Medicare views hospital readmissions as a marker representing lower quality of health care delivery to penalize hospitals providing care to the poor. This thesis addresses multiple social and economic factors associated with hospital readmissions, explores the interrelated components of readmissions at the personal and hospital system level, and delves into the interactions of bioethical principles associated with urban living. Hospital readmissions remain a serious issue nationwide and in order to reduce the rates of re-hospitalization the social and economic inequalities contributing to hospital readmissions are significant and must be addressed. / Urban Bioethics