Objective: Delay in diagnosis and treatment of endometrial cancer may be associated with disease progression and impact management and outcomes. Social and cultural barriers influence recognition of symptoms and self-advocacy in seeking and complying with care. Associations between social determinants of health (SDH) and disease presentation, treatment and outcomes has been shown in some healthcare systems. Our objective was to investigate these in Ontario’s universal access system. Methods: Endometrial cancer patients in Ontario diagnosed 2009-2017 were identified, and clinical, social and demographic information extracted from administrative databases. SDH were quantified using previously validated marginalization quintiles (material deprivation, residential instability and ethnic concentration). Associations between SDH, disease stage, treatment and outcome were explored using chi-square, log-rank and logistic regression. Results: 19530 patients were identified. 73% of cancers were confined to the uterus. Stage distribution differed across marginalization quintiles (p<0.001) with advanced disease found more frequently in highly marginalized patients (highest vs lowest quintile): OR=1.28 (95% CI 1.14-1.45) for deprivation, OR=1.2 (95% CI 1.06-1.35) for residential instability and OR=1.3 (95% CI 1.15-1.46) for ethnic concentration (<0.0001)). Highly marginalized patients also had less timely surgery (p<0.0001). Overall survival was shorter in patients in high deprivation and residential instability quintiles (log rank p-value<0.0001) but not in high ethnic concentration quintiles, with HR=1.4 for deprivation (p<0.0001) and HR=1.53 for instability (p<0.0001) for the highest marginalization quintile. Survival differences persisted in more uniform cohorts of early (stage I) disease and endometrioid tumors and on multivariable analysis. Conclusions: Marginalized populations diagnosed with uterine cancer present at more advanced stages, wait longer for surgery and have shorter overall survival. Associations of SDH with uterine cancer presentation and management in Ontario could shed light on the impact of these factors on disease trajectory, drive policies for patient advocacy and redistribution of resources and promote health equity in this population. / Thesis / Master of Public Health (MPH) / Conditions in the social environment in which people are born, live and work are powerful influencers of health and well-being. In fact, these circumstances have also been called Social Determinants of Health (SDH). Cancer outcomes are one of the domains impacted by SDH. In this study, we set out to investigate the association between SDH and uterine cancer outcomes in Ontario, Canada. We guessed that SDH may influence how soon patients with symptoms seek help from their doctors, how quickly their problem is investigated and how well they are able to undergo treatment. We used a tool called the Ontario Marginalization Index to break down Ontario’s uterine cancer patient population into groups according to degree of social, financial and ethnic marginalization. We found that more marginalized patients tended to present to care with more advanced cancers, that they took longer to have surgery for their cancer and that their survival was worse. These findings suggest there is more work to be done to promote health equity in cancer care.

This study addressed the prevention of reading problems by examining the predictive validity of the Developmental Indicators of Assessment and Learning-Revised (DIAL-R), the Gesell School Readiness Test, and the Preschool Screening Battery. The effects of entry-level developmental abilities on reading performance were also studied. Subjects were sixth grade students from five school systems in North Carolina. School system selection was based on the type of screening test used in 1988, and availability of data. Data were collected through student record reviews. Predictive discriminant analyses were computed to assess the accuracy of the screening batteries in predicting reading group membership at the third and fifth grade levels. Classification accuracy was determined by comparing hit ratios from the classification matrices with proportional chance criterion. Standard normal statistics and Press's Q statistics were computed to determine if the hit rates were better than those expected by chance. Early determinants were identified through interpretation of the discriminant functions. Significant differences between correctly and incorrectly classified students were identified through t-tests comparing means scores of both groups. Several implications were derived from the study. First, the magnitude of the discriminatory power of the DIALR and Preschool Screening Battery to predict reading group membership at the third and fifth grades was sufficient to recommend their continued use in preschool screening. The Gesell School Readiness Test was better than chance on only three out of twelve criteria, however, and is not recommended as a predictor of reading achievement. Discriminant analyses resulted in the identification of three early determinants, conceptual development, biological development (fine motor and perceptual skills), and language comprehension. Expressive language emerged as the most important language subskill studied and auditory memory was the most important perceptual skill. The multiple cause theory of reading acquisition was Supported by these results. Visual motor skills were more influential in the early stages of word analysis, and language and conceptual development were more influential in predicting comprehension skills. Intra-test variation in predictor variables appeared to be the most important contributor to inaccurate classification. Other factors were individual subject characteristics such as behavior problems or chronic illness. / Ph. D.

This study investigates the determinants of union members' satisfaction with their unions. Two theories of member satisfaction are formulated. In the first, satisfaction is hypothesized to be a function of specific union performances. The second theory relates satisfaction to the relationship between unions and their members. Constitutional procedures, in addition to performance, are the predicted determinants of satisfaction. A set of variables measuring union performance in various areas thought to be important to union members is constructed to test the first theory. In the second theory, labor union constitutions are viewed as explicit contracts between unions and their members, and various constitutional provisions are quantified and used as a set of satisfaction determinants. Performance variables are found to be the primary determinants of satisfaction, explaining the majority of the measured variation in satisfaction. The constitutional variables cannot be ignored, however, because when they are combined with performance variables they do contribute significantly, in a statistical sense, to the explanatory power of the union satisfaction model. It appears that constitutional "contracts" which specify officer removal and officer election procedures do help to solve union members' agency problems and thus increase their satisfaction with their unions. / Ph. D.

Yes / Child undernutrition is a key public health issue that both causes and contributes to disease and death. Undernutrition accounts for 45% of under-five deaths globally most of which occur in Low- and Middle-income countries (LMIC). Malnutrition has a substantial and long-lasting effect on individuals, families, communities and the entire nation. This study aimed to assess the prevalence and determinants of undernutrition in under-five children in Nigeria. Methodology: This systematic review was done following the Cochrane library guidelines. A search of literature written in English language and published between 2000 and 2022 was done using PubMed, CINAHL, MEDLINE and ProQuest databases. The initial search resulted in 760 studies. These were exported to End note version 9 to remove duplicates. Titles and s were screened for studies that met the inclusion criteria. Finally, 11 studies that met the inclusion criteria were thoroughly assessed and data that were relevant to this systematic review were captured. The study findings were analyzed using descriptive statistics. Results: The prevalence of undernutrition was between 1.0% and 43.3%. The highest prevalence of underweight, wasting and stunting were 43.3%, 29.3% and 41%, respectively. Factors associated with undernutrition were age, sex, birth order, recent acute diarrhoea and acute respiratory infection, maternal literacy level, maternal income <$20 and socio-economic class among others. Conclusion: Under-five undernutrition is a huge public health issue in Nigeria. Prevalence of undernutrition varies widely across geo-political zone with a myriad of associated risk factors. Multi-level and multidisciplinary interventions are required to sustainably address the determinants of under-five undernutrition.

Aborder le thème de l’attractivité des investissements directs étrangers (IDE) relève d’une préoccupation essentielle pour la Tunisie. Depuis les années 1970, les IDE sont devenus un vecteur clef dans la croissance du pays, en témoignent les différentes mesures législatives et réglementaires qui ont été prises afin de préparer un cadre attractif pour les investisseurs. Cependant, au regard des efforts consentis et des avantages accordés, les résultats sont plutôt décevants et restent loin des attentes. Dés lors, il est intéressant d’étudier les déterminants des IDE en Tunisie et leurs effets sur l’économie locale en particulier sur la croissance économique. A cette fin le capital humain est mis au cœur du mécanisme en analysant son impact sur la croissance et la manière dont il interagit avec les flux d’IDE. C’est autour de cette thématique que notre thèse est axée. L’analyse statistique et économétrique menée au cours de ce travail montre que durant les deux dernières décennies, les IDE en Tunisie s’expliquent par la réalisation des projets ponctuels de prospections pétrolières et des opérations de privatisation de grandes entreprises publiques. Ce sont principalement les secteurs rentiers (hydrocarbures) et les opérations non reconductibles de privatisation qui ont attiré le plus d’IDE, alors que les IDE manufacturiers restent toujours polarisés par le textile et l’habillement. Il apparaît aussi, que l’IDE, hors énergie et privatisations, est faible. De plus, ces opérations n’ont pas déclenché une dynamique d’entrée d’IDE dans ces secteurs. Pour conclure, les résultats attestent clairement de l’effet peu significatif de l’évolution des flux d’IDE et des taux de scolarisation (capital humain) sur la croissance économique en Tunisie. Il ressort aussi que les IDE pris isolément affectent positivement la croissance mais sans crée autant des externalités positives (effets spillovers). / Addressing the issue of the attractiveness of foreign direct investment is a major concern for countries like Tunisia. Since the 1970s, the attractiveness of FDI became a key variable in the country’s economic growth, as shown by the adoption of different legislative and regulatory measures meant to create a favorable environment for investors. However, given the amount of efforts invested and benefits granted, the results come across as being pretty disappointing and all remain far from the goals and hopes initially raised. In this context, it is interesting to study the FDI determinants in Tunisia and their impact on the local economy especially in terms of national growth. To this end, we will focus on the important role played by the human capital, its effects on growth and the way it interacts with the flows of FDI. The core of the thesis will indeed revolve around this theme. The statistical and econometric analysis undertaken in the dissertation will show that for the past two decades, FDI in Tunisia have been the result of a few oil exploration projects and privatization of big public companies. It is mainly the annuitant sector (hydrocarbon) and the non-renewable privatization projects that have attracted the most FDI, whereas industrial FDI remain polarized by the textile-Apparel industries. It also appears that, privatizations and energy sector set aside, FDI remain weak. Not only that, these operations have not triggered a dynamic input on FDI for these sectors. In conclusion, the results clearly prove that progress in FDI and school enrollment ratio (human capital) in Tunisia has had little effect on the Tunisian economic growth. It also has been brought to our attention that, taken alone, FDI have a positive impact on growth; however they fail to create spillover effects.

La thèse examine les déterminants nutritionnels et environnementaux de retard de croissance aux enfants en Afrique de l'Est. Je vais examiner le retard de croissance en utilisant une analyse épidémiologique des données secondaires (e.g. données de DHS) et l'analyse des données biochimiques liés à micronutriments et l'état de l'entéropathie. Pendant l'année scolaire 2015-2016, j'ai publié trois manuscrits liés à un retard de croissance en Ethiopie, a recueilli des échantillons de selles dans le cadre d'une étude cas-témoins en Tanzanie, et a reçu un financement pour analyser ces échantillons. Les analyses de laboratoire se fera en Novembre-Décembre 2016. Cette étude en Tanzanie examinera à la fois les facteurs nutritionnels et environnementaux associés à la croissance linéaire. / The thesis examines nutritional and environmental determinants of childhood stunting in East Africa. I will examine stunting by using epidemiologic analysis of secondary data (i.e. DHS data) and the analysis of biochemical data related to micronutrient and enteropathy status. During the 2015-2016 academic year, I published three manuscripts related to stunting in Ethiopia, collected stool samples as part of a case-control study in Tanzania, and received funding to analyze these samples. Laboratory analysis will be done in November-December 2016. This research study in Tanzania will examine both the nutritional and environmental factors associated with linear growth.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / Este trabalho trata das propriedades e aplicaÃÃes dos determinantes reconhecendo-os como uma ferramenta importante para sintetizar a representaÃÃo e o cÃlculo de algumas funÃÃes e equaÃÃes na Ãrea de geometria analÃtica e Ãlgebra linear. Nos primeiros capÃtulos apresentam-se um pouco da histÃria dos determinantes, os matemÃticos que contribuÃram na sua evoluÃÃo e a necessidade que gerou o inÃcio do seu estudo. Prossegue-se entÃo, a definiÃÃo de determinante e o cÃlculo dos determinantes a partir do teorema de Laplace via recorrÃncia, bem como o dispositivo prÃtico de Sarrus para determinante de terceira ordem. No capÃtulo seguinte, sÃo apresentadas as propriedades, num total de doze, com suas demonstraÃÃes e exemplos, pois elas serÃo utilizadas nas aplicaÃÃes dos determinantes. Logo apÃs, apresenta-se uma sÃrie de aplicaÃÃes na Ãrea de Ãlgebra linear, por exemplo: dependÃncia e independÃncia linear, matriz inversa, soluÃÃo de sistemas lineares (Regra de Cramer) e produto vetorial; alÃm de aplicaÃÃes na Ãrea de geometria analÃtica, tais como: condiÃÃo de alinhamento de trÃs pontos, Ãrea do paralelogramo e volume do paralelepÃpedo. Por fim, conclui-se que à fundamental o professor da segunda sÃrie do ensino mÃdio abordar em suas aulas um pouco da histÃria, chamando a atenÃÃo dos alunos para os matemÃticos que se destacaram neste estudo; expor as aplicaÃÃes dos determinantes, despertando a curiosidade de seus alunos e o interesse pela Ãrea de Ãlgebra linear ou geometria analÃtica. / This paper deals with the properties and applications of determinants recognizing them as an important tool to synthesize the representation and calculation of some functions and equations in the field of analytical geometry and linear algebra. In the first chapters we present some of the history of determinants, the mathematicians who contributed in its evolution and the need that generated the beginning of their study. Then we proceed, the definition of determining and calculating the determinants from the theorem of Laplace via recurrence as well as the handy device for determining Sarrus third order. In the next chapter, we present the properties, a total of twelve, with their statements and examples, as they will be used in applications of determinants. Soon after, it presents a number of applications in linear algebra, eg, linear dependence and independence, inverse matrix, solution of linear systems (Cramer's Rule) and cross product; addition to applications in analytical geometry, such as alignment condition of three points of the parallelogram area and volume of the parallelepiped. Finally, it is concluded that it is essential the teacher of the second grade of high school address in their classes a little history, calling students' attention to mathematicians who have excelled in this study; expose the applications of determinants, arousing the curiosity of their students and interest in the area of linear algebra and analytic geometry.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-03-15T17:13:28Z No. of bitstreams: 1 telmamarialararabelo.pdf: 1956520 bytes, checksum: c6675e2d704344eff1445b6eb0c46465 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-03-19T17:38:11Z (GMT) No. of bitstreams: 1 telmamarialararabelo.pdf: 1956520 bytes, checksum: c6675e2d704344eff1445b6eb0c46465 (MD5) / Made available in DSpace on 2018-03-19T17:38:11Z (GMT). No. of bitstreams: 1 telmamarialararabelo.pdf: 1956520 bytes, checksum: c6675e2d704344eff1445b6eb0c46465 (MD5) Previous issue date: 2014-02-12 / PROQUALI (UFJF) / O presente trabalho teve o objetivo de identificar e avaliar os determinantes do intraempreendedorismo, individual e organizacional, presentes na Pró-Reitoria de Recursos Humanos (PRORH) da Universidade Federal de Juiz de Fora (UFJF), segundo a percepção de seus gestores e servidores. O referencial teórico pautou-se em características do comportamento empreendedor e características organizacionais do intraempreendedorismo, de modo geral, destacando-se as contribuições de McClelland (1987) e Hornsby, Kuratko e Zahra (2002), cujos modelos conceituais foram adotados para fins da pesquisa realizada. A pesquisa realizada adotou o estudo de caso descritivo, com abordagem quantitativa e qualitativa. Os dados foram tratados e analisados conforme sua natureza (análise uni e bivariada e análise de conteúdo, respectivamente). A partir dos dados coletados na primeira fase da pesquisa, pode-se constatar que o perfil dos servidores pesquisados apresenta um nível mediano de desenvolvimento das características comportamentais empreendedoras. Semelhanças positivas foram identificadas entre os dados das duas fases da pesquisa no que diz respeito às principais características empreendedoras mais e menos desenvolvidas. Quanto aos determinantes organizacionais, a média geral dos fatores estruturais organizacionais do intraempreendedorismo, segundo a percepção dos gestores e servidores foi de 2,87. Uma proximidade com o nível médio de intraempreendedorismo, contudo, ainda não se pode qualificá-lo como tal. Apuraram-se semelhanças positivas entre os dados das duas fases da pesquisa no que se refere ao fator organizacional mais e menos desenvolvido na instituição. A análise comparativa entre os dados qualitativos e os quantitativos demonstra uma consonância entre a percepção dos entrevistados e a dos respondentes dos testes. Também foram identificadas tendências de correlações entre os determinantes individuais e organizacionais do intraempreendedorismo. No que diz respeito aos desafios da atuação intraempreendedora na UFJF, os entrevistados identificaram que a implantar um sistema de recompensas/reforços, gerir por competência e trabalhar o fator motivacional dos servidores deveriam ser os principais mecanismos utilizados para incentivar os funcionários a serem mais criativos, inovadores e proativos. Os entrevistados apresentaram questões políticas, burocracia e hierarquia, ausência de uma cultura intraempreendedora e rigidez estrutural e legal como as principais barreiras impostas ao desenvolvimento da iniciativa intraempreendedora na UFJF. A pesquisa avaliou o nível dos determinantes individuais e organizacionais, permitindo ações mais efetivas com o fim de estimular o intraempreendedorismo. Diante dos resultados do estudo, sugere-se a realização de outros estudos, na mesma instituição, considerando outras pró-reitorias e em outras instituições públicas, com o objetivo de se aprofundar no fenômeno intraempreendedorismo na instituição pública. / The purpose of this paper was to identify and assess organizational and individual determinants of intra-entrepreneurship in the Rectory of Human Resources (PRORH) of the Federal University of Juiz de Fora (UFJF), according to its administrators and personnel. The theoretical references were based upon the entrepreneur behavior and the organizational features of entrepreneurship, in general. There was a highlight on the contributions of McClelland (1987) and Hornsby, Kuratko & Zahra (2002), whose conceptual models were adopted for the research. It used the method of descriptive case study, with quantitative and qualitative approach. Data were dealt with and analyzed according to their nature (uni/bivaried analysis and content analysis, respectfully). From the data collected during the first phase, one could verify that the staff profile presents a medium level in the development of entrepreneurial behavior features. There were positive similarities that could be identified between data from both phases, in relation to the main entrepreneur features more and less developed. As for organizational determinants, the general average was 2.87, according to, which indicates closeness to the entrepreneurship medium level. However, it cannot be qualified as such. Also, the positive similarities between the two phases were searched in terms of the institution‟s organizational factor more and less developed. Comparative analysis of qualitative and quantitative data shows a consonance between the individuals who were interviewed and the ones who answered the tests. Furthermore, tendencies for correlations between individual and organizational determinants were detected. As for the challenges of the intra-entrepreneurial action in UFJF, interviewees showed that at implanting a system for compensations/efforts, managing through competence and dealing with the staff‟s motivational factor should be the main mechanisms towards encouraging staff to become more creative, innovative and pro-active. Interviewees indicated political issues, bureaucracy and hierarchy, lack of an intra- entrepreneurial and structural and legal rigidity, as imposed barriers for the development of intra- entrepreneurial action at UFJF. The research assessed the level of individual and organizational determinants, enabling more effective actions in order to stimulate intra-entrepreneurship. Given the results and the study limitations, a schedule was created for future research, aiming to going deeper into the issue of intra- entrepreneurship in the public institution.

Our society is increasingly entangled with, and reliant on software. Previously, software has mainly been operated on-premises, i.e., installed and ran on a physical computer, manually supported, and maintained by individuals at the location where the software is running. Today, software is often delivered via the cloud using a pay-as-you-go subscription service, hosted, and continuously supported by the vendor, i.e., the organization providing the solution. A collective name for this type of solution is “Software-as-a-Service” (SaaS). SaaS is a popular delivery model amongst software start-ups, who are known to be innovative and create valuable new solutions that benefit society. Hence, it can be valuable to help SaaS start-ups understand how most effectively navigate and reach their first customers. This thesis does this by investigating what buyers find important when buying SaaS from a start-up vendor. Technology and innovation adoption has been extensively studied. Theories such as the “TOE-framework” and “Diffusion of Innovation” attempt to explain how the adoption of new solutions is determined and what factors influence it. Moreover, multiple studies have also investigated what affects the decision to buy SaaS. Finally, studies have examined what buyers find important when buying from a start-up. However, no studies have explored what buyers consider when buying SaaS from a start-up vendor. This thesis aims to fulfill the research gap presented above and to answer the following research questions:   What are the determining factors for adoption of Software-as-a-Service delivered by a start-up vendor? How do these determinants affect adoption? To answer the research questions, the study utilizes a deductive approach with elements of induction. Qualitative data is collected in 8 semi-structured interviews, all with a focus on buying organization's SaaS adoption decision. The interview structure is based on the theoretical framework which consists of four major categories that can affect adoption: “Technology”, “Organization”, and “Environment”, of the TOE-framework, and “Vendor Relationship” which is added by the authors of this thesis based on prior studies that suggested this as an important aspect in for the studied context. Within each major category, determinants of adoption, i.e., factors that influence the decision to adopt, are derived from theories specific to SaaS and start-up adoption. The findings confirm all four of the overarching categories of the theoretical framework as important in the decision to adopt SaaS from a start-up vendor. The confirmation of the vendor relationship category can be considered a key finding of the thesis since it is not present in the original TOE-framework or any of the studies on SaaS and start-up adoption. On a more granular level, the thesis highlights the observed adoption determinants under each of the categories and describes how they relate to each other and to existing theory. By answering the research questions, the thesis provides useful insights that can help SaaS start-ups better understand what factors potential buyers consider in their adoption decision. As a result, start-ups can better align their strategy with the wants and needs of buyers and increase the probability of success. Finally, the thesis contributes to theory by expanding knowledge related to the factors determining the adoption of SaaS, when it is delivered by a start-up vendor.

The social and structural determinants play a significant role in community health, and differences in the experience of these factors facilitate some of the health disparities that are seen in the US along racial and socioeconomic lines. In this manuscript, I propose a conceptual model of the social determinants of health hierarchy and discuss the positioning of the structural determinants of the built environment within that hierarchy. I discuss the research connecting some of the structural determinants to health outcomes. Finally, I review several opportunities for local government to alter the built environment in ways that can promote community health and mitigate health inequity. / Urban Bioethics