Indiana University-Purdue University Indianapolis (IUPUI) / The emergence and development of electronic health records have contributed to an abundance of patient data that can greatly be used and analyzed to promote health outcomes and even eliminate health disparities. However, challenges exist in the data received with factors such as data inconsistencies, accuracy issues, and unstructured formatting being evident. Furthermore, the current electronic health records and clinical information systems that are present do not contain the social determinants of health that may enhance our understanding of the characteristics and mechanisms of disease risk and transmission as well as health disparities research. Linkage to external population health databases to incorporate these social determinants of health is often necessary. This study provides an opportunity to identify and analyze health disparities using geographical information systems on two important sexually transmitted diseases in chlamydia and gonorrhea using Marion County, Indiana as the geographical location of interest. Population health data from the Social Assets and Vulnerabilities Indicators community information system and electronic health record data from the Indiana Network for Patient Care will be merged to measure the distribution and variability of greatest chlamydia and gonorrhea risk and to determine where the greatest areas of health disparities exist. A series of both statistical and spatial statistical methods such as a longitudinal measurement of health disparity through the Gini index, a hot-spot and cluster analysis, and a geographically weighted regression will be conducted in this study. The outcome and broader impact of this research will contribute to enhanced surveillance and increased effective strategies in identifying the level of health disparities for sexually transmitted diseases in vulnerable localities and high-risk communities. Additionally, the findings from this study will lead to improved standardization and accuracy in data collection to facilitate subsequent studies involving multiple disparate data sources. Finally, this study will likely introduce ideas for potential social determinants of health to be incorporated into electronic health records and clinical information systems.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Diabetes mellitus (DM) is a major public health problem, and it remains one of the global epidemics of non-communicable diseases. Diabetic retinopathy (DR) is a micro-vascular complication of DM due to a prolonged hyperglycaemia, and it is the most common cause of a visual loss in people living with DM. The global increase in the prevalence of DM has led to an increase in prevalence of diabetic complications, such as DR. The primary aim of this study was to investigate the prevalence and determinants of DR among the DM patients receiving treatment from Maruleng public healthcare facilities, Mopani District in the Limpopo Province. Methodology: A quantitative cross-sectional survey was used as a primary source data from the DM patients who were readily available at the selected public healthcare facilities to collect a chronic treatment during the time of the study. Selection of eligible DM patients was done through a convenient sampling technique for those who were readily available or willing to take part of the study after receiving all information about the study for them to consent freely without any form of coercion by researcher or any other person. All selected respondents had undergone face-to-face interviews and basic clinical screening for DR to collect a primary source data using piloted structured researcher-administered questionnaire to record data collected from respondents, and calibrated medical equipment were used to measure a clinical variables during clinical screening. Data analysis was carried out using Statistics and Data Analysis (STATA) version 15 software for windows. The characteristics of DM patients were summarised and analysed using a descriptive statistics. Inferential statistics were performed on dependent variable and independent variables using a logistic regression analysis to determine the strength of association between variables, where a potential predictors of DR among DM patients were identified at significant level of less than 0.05 (p<0.05). Results: Out of the 416 DM patients who participated in the study, the majority were females (n=315; 76%) and all DM patients were above the age of 18 years, with a mean age of 61 years (standard deviation [SD] =11.5). The overall prevalence of DR was 35.4% comprising 32% mild non-proliferative DR (NPDR) and 3.4% moderate NPDR. DR was found to be slightly more prevalent in females, at 35.9%, than in males, at 34.6%; particularly in those females with type 2 DM, at 35.1%, comprising 32.1% mild NPDR and 3% moderate NPDR. DR was more prevalent in older females, at 77.8%, comprising 55.6% mild NPDR and 22.2% moderate NPDR. The DM patients aged 55 years and above were found to be 2.7 times more likely to develop DR, at p<0.001, and DM patients with higher systolic blood pressure of 140 mmHg or more were found to be 1.4 times more likely to develop DR as compared to DM patients with a systolic blood pressure of 139 mmHg or less (≤139 mmHg), at p<0.05. Employed DM patients were 1.4 times more likely to develop DR as compared to unemployed DM patients, at p<0.001. Age of the DM patients, high systolic blood pressure (SBP) or a hypertension of 140 mmHg or more (≥ 140 mmHg), and employment status were significantly associated with higher risk of developing DR among DM patients. Gender, hyperglycaemic state, poor glycaemic control, smoking and high BMI were found to be associated with DR but this association was not statistically significant. Conclusion and recommendations: Slightly more than one third of the DM patients receiving treatment during the study period from the public healthcare facilities in the Maruleng sub-district had some form of DR, which means that nearly four in ten DM patients had some form of DR. Diabetic retinopathy was more prevalent in females, and in older DM patients. Age of the DM patient, employment status, and high systolic blood pressure were significantly associated with an increased risk of developing DR among the DM patients. There is an urgent need to implement a health promotional programmes to educate people about the complications of a diabetes mellitus such as DR, and also to establish a coordinated screening programme for DR among DM patients receiving a chronic treatment, which must be supported by the Department of Health in all public healthcare facilities. Keywords: Diabetes Mellitus, Diabetic Retinopathy, Prevalence, Determinants / Health and Welfare Sector Education and Training Authority (HWSETA)

Background: Gender inequality is widespread throughout Latin America, in large part due to a ‘machista’ culture in which women tend to be regarded as inferior to men. In Colombia, especially in low-income areas, women and girls are consistently excluded and marginalized. As a result of this, adolescent girls are susceptible to gang recruitment, teen pregnancy, and substance abuse. In similar settings globally, sport has been shown to be an effective tool for development and for the socialization and inclusion of youth. Few studies have taken place in Latin America, however, and hardly any of them have focused specifically on marginalized girls. This study aims to address this gap in literature by exploring how sport can break down barriers of exclusion and promote inclusion of marginalized, adolescent girls in Colombia. Methods: This qualitative, multi-methods study involved the analysis of data collected from semi-structured and key informant interviews, as well as participant observation sessions. All data collection was conducted in Cazucá, Colombia with participants from local NGO Tiempo de Juego (TDJ). Semi-structured interviews were conducted with adolescent girls between the ages of 11-18 who were participating in at least 1 sport at TDJ. Key informant interviews were conducted with TDJ staff and a guardian of several girls who participate in TDJ. Interview transcripts and participant observation memos and reflections were reviewed and coded to identify themes through thematic analysis. Results: All participants interviewed indicated that sport had a positive impact on their day to day lives. Three main themes and two sub-themes were identified during data analysis: 1) ‘Machismo’ in Colombia with sub-themes: i) Gender Roles and ii) Gender Norms, 2) Exclusion and marginalization, and 3) Empowerment through sport. Most participants spoke about the prevalence of machismo in Colombian society and how gender roles and norms limit the types of opportunities that are available to them. Participants expressed how, although they are marginalized based on where they live, sport provided them with a healthy activity to engage in as an alternative to the negative behaviours that they are susceptible to in their neighbourhoods. Sport provided them with an outlet to escape from their daily problems, and they felt that through sport, they were able to realize their self-worth and gain confidence in themselves. Conclusion: These findings suggest that sport can become a useful tool for promoting the inclusion of marginalized girls through empowerment. While sport was shown to break down some barriers of exclusion, further work must be done to explore its potential role in breaking down gender stereotypes that remain prevalent in Colombian culture. These results highlight the need for more sport programs that focus on marginalized girls in Latin American countries where women and girls remain a neglected population.

In many organisations, air travel is an essential part of conducting business in order to meet company objectives and goals. The selection of a preferred airline is a complex undertaking. Corporations may obtain discounts based on expenditure commitments; the airline may have a frequent flyer programme; or a low cost carrier may offer a better alternative to full service carriers. The literature on corporate travel is fairly limited with determinants determining the selection of airlines having been studied from other perspectives such as the business traveller, thus, this study should make a significant contribution to this field by generating new information on corporate travel and in particular corporate air travel decisions. The literature review provides a demarcation of the broad concepts of the buying approach towards corporate air travel. Also discussed is the relationship between the key role players in airline selection: the corporate traveller; the travel management company; and the airline. Various determinants of airline selection by corporations are identified and the role of frequent flyer programmes is analysed. Furthermore, the move towards low-cost airlines as a preferred choice for corporate travel is investigated. The empirical phase of the research study focussed on identifying the determinants of airline selection by large-sized corporations in South Africa; the relative importance of frequent flyer programmes; and the move towards low-cost airlines as a preferred choice for corporate travel. The target population was sampled using a non-probability convenience sampling approach with a newly designed quantitative, ex post facto web-based questionnaire, distributed via e-mail to the target population. Exploratory factor analysis was done to identify whether an underlying structure of airline selection determinants exists from which the relative importance of frequent flyer programmes could be assessed. From the results, a model of corporate airline selection determinants was derived. Then, the model was compared to the conceptual model formulated from the literature survey. A number of important selection determinants were identified, and it became evident that frequent flyer programmes are, generally, not considered a decisive determinant in the selection of a preferred airline by corporations. However, the influence of low-cost airlines was shown to be considerable, in line with the endeavour to save on air travel expenses within a corporate air travel management programme. The findings should assist both corporations and airlines with the design of their air travel buying approaches and marketing strategies respectively. / Dissertation (MCom)--University of Pretoria, 2010. / Tourism Management / Unrestricted

The flow of foreign direct investment (FDI) into a country can benefit both the investing entity (the home country) and the host country. The determinants of FDI are a highly discussed topic, with various determinants being analysed and discussed over time.  Multiple research papers focus on the determinants of the host country, which try to identify the most important factors that make countries attractive to investment from abroad. This paper aims to shed light on the home country determinants and their relationship with investments into the Republic of Ireland. Using panel data analysis for 28 different countries around the world from the years 2012 to 2019, this paper aims to find relationships between different home country related variables and FDI flows into the Republic of Ireland. We find evidence that FDI is positively associated with the market size of the home country, the corporate tax rate difference between the home and the host country and sharing an official language. On the other hand, population and distance were found to be negatively associated with FDI. Based on the results of our analysis, a discussion of the home country determinants and their impact on FDI into Ireland is presented.

This study examined the intersection of rurality and community area deprivation using a nine-state sample of inpatient hospitalizations among children (<18 years of age) from 2011. One state from each of the nine US census regions with substantial rural representation and varying degrees of community vulnerability was selected. An area deprivation index was constructed and used in conjunction with rurality to examine differences in the rate of ACSC hospitalizations among children in the sample states. A mixed model with both fixed and random effects was used to test influence of rurality and area deprivation on the odds of a pediatric hospitalization due to an ACSC within the sample. Of primary interest was the interaction of rurality and area deprivation. The study found rural counties are disproportionality represented among the most deprived. Within the least deprived counties, the likelihood of an ACSC hospitalization was significantly lower in rural than among their urban counterparts. However, this rural advantage declines as the level of deprivation increases, suggesting the effect of rurality becomes more important as social and economic advantage deteriorates. We also found ACSC hospitalization to be much higher among racial/ethnic minority children and those with Medicaid or self-pay as an anticipated source of payment. These findings further contribute to the existing body of evidence documenting racial/ethnic disparities in important health related outcomes.

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Employee absenteeism results in billions of dollars in revenue losses and lost productivity annually. Given the consequences that organizations could face resulting from high levels of work absences, executives should develop strategies to manage absenteeism to support organizational growth and sustainability. Grounded in the theory of planned behavior, the purpose of the single case study was to explore strategies managers in the private insurance industry used to reduce employee absenteeism. The population consisted of 3 managers located in Bermuda who implemented strategies to decrease employee absenteeism from a Bermuda perspective. Data included semistructured interviews, results of the company's 2016 engagement survey, and annual reports from 2014 to 2016 that highlighted the company's commitment to providing strategies to enhance employees' engagement and dedication to its strategic objectives. Through thematic analysis, 4 themes emerged: employee engagement, managerial communication, employee wellness and health promotion programs, and achieving work-life balance. Business managers could use these findings to understand how specific human resources strategies with a focus towards reducing employee absenteeism minimize work absences. Minimizing work absences could contribute to positive social change through increased economic growth in local communities and higher quality of life for its residents.

Elucidating the ecological determinants of community structure and how they vary spatially has a long history in ecology, but there still is no consensus on the mechanisms behind diversity patterns. The primary objective of this dissertation was to focus on spider assemblages to investigate how the fine-scale habitat associations of organisms may drive their community composition at larger scales. Research was conducted in the Bear River Mountains, Utah, in an attempt to elucidate the potential role of species-microhabitat associations in driving three well-known patterns of community composition that have typically been investigated at broad scales: 1) elevation gradients of species diversity, 2) the response of species assemblages to neighboring habitat structure and 3) community composition at the edges of habitat patches. Slope aspect was a significant predictor of spider density and species richness when communities were compared at the same elevation, suggesting that fine-scale topographic variables may play an important role in shaping elevational patterns of species composition. Cursorial spider composition was strongly linked to site temperature only, whereas differences across web spider assemblages significantly increased with dissimilarities in woody plant cover and temperature. The study on the effects of neighboring habitat structure revealed markedly reduced cursorial spider densities in shrubs without surrounding structure, and more cursorial species in control shrubs, whereas web spiders lacked any significant response to treatments. These contrasting responses indicate that data should be collected at larger spatial extents for mobile species, and that mobility may mediate the outcome of surrounding habitat modifications on the local composition of communities. In the last study, I focused on communities in which the edge-dwelling spiders Theridion and Dictyna strongly differed in terms of concealment and substrate generalization and found that microhabitat choice may affect the sensitivity of species to habitat geometry, a characteristic associated with habitat fragmentation. This work suggests that a better understanding of the links between the biological traits of species and their fine-scale environmental requirements may help uncover the mechanisms behind spatial patterns of community composition at larger scales.