Traditionally, nurse anesthesia educators have utilized prior academic achievement to predict student success. However, research has indicated that prior academic achievement offers an inadequate assessment of student success in graduate healthcare programs with extensive clinical residencies. The educational literature has identified many non-cognitive factors, such as self-efficacy and locus of control, that may provide a more holistic prediction model of student success. An experimental study with pretest-posttest design and stratified random assignment was conducted to evaluate the effectiveness of an educational intervention to promote self-management, professional socialization, and academic achievement among first semester graduate nurse anesthesia students. Participants (N = 66) were demographically similar to the national graduate nurse anesthesia student body, though Hispanics and younger students were a little over-represented in the sample (56% female, 75.8% White, 15.2% Hispanic, 6% Other, 59% ≤ 30-years-old, 67% ≤ 3 years of ICU). The results showed that most graduate anesthesia students had strong self-management and professional socialization characteristics on admission. The results did not support the effectiveness of this educational intervention. Thus, ceiling effect may have accounted in part for statistically non-significant results regarding self-efficacy (p = .190, ω2 = .03), locus of control (p = .137, ω2 = .04), professional socialization (p = .819, ω2 = .001), and academic achievement (p = .689, ω2 = .003). Future researchers may need to expand the scope of the intervention, use a more powerful and sensitive instrument, and utilize a larger sample.

Cette thèse contribue à l’analyse des relations entre santé, revenu et politiques de santé. Il m’a semblé nécessaire de mener cette recherche pour chaque direction de la relation. Ainsi, le 1er article étudie la solvabilité financière de différentes politiques de lutte contre le SIDA grâce à un modèle de microsimulation. La santé y est vue comme un facteur de production ; son amélioration génère des gains de productivité. Cette analyse montre que les programmes de traitement peuvent générer un surplus économique et ce net des coûts engendrés. Le 4ème article étudie la relation entre santé infantile et milieu social d’origine à partir d’une enquête internationale. Les analyses montrent que si un gradient socio-économique de santé s’impose à tous à travers le globe (les enfants issus de milieux pauvres sont en moins bonne santé), ce gradient varie selon le niveau de revenu et d’offre de soin du pays considéré. Les deux autres articles s’intéressent aux problèmes de mesures liés à la mise sous traitement des agents malades : le poids de ces derniers dans la population augmente. Au niveau macroéconomique, le PIB par habitant pourrait diminuer si les traitements ne permettent pas de maintenir un niveau de productivité suffisant. Les analyses dans le cadre du VIH montrent que cet effet pervers ne supplante pas les effets positifs. Cette problématique est élargie à la mesure du bien être dans le 3ème article de la thèse. En ne s’attachant qu’aux populations vivantes, les indicateurs traditionnels ne tiennent pas compte du fait que certains agents auraient pu être maintenus en vie (avec un bien être moindre). Les comparaisons inter-pays pourraient ainsi être faussées. / This dissertation aims at improving our understanding of the links between health and wealth, and between health programs and macroeconomic outcomes. Because the former might be bi-directional, it seemed sensible to tackle this issue for each direction of the causality. In the 1st paper, I examine using microsimulation the financial solvability of alternative policies against HIV. Health improvements at the individual level generate productivity gains which translate into an economic surplus that outweighs programs’ costs. In the 4th paper, I examine the relationship between child health and social background using an international survey. Analysis reveals a substantial gradient in health: across the globe, poorer children have worse health. Yet, the effect of wealth is moderated by country-level income and health-supply variables. The two other papers focus on rather methodological issues raised by the fact that curative programs save lives but increase the prevalence of the disease. One study highlights that average income could fall if treatments cannot guarantee a sufficient level of productivity among sick workers. Despite this adverse effect, the microsimulation model demonstrates that treatment policies can raise per capita income in the context of HIV. The 3rd paper of the thesis extends this message to welfare measurement. By restricting attention to the living population, standard indicators of welfare ignore the fact that individuals who would otherwise be dead can be kept alive through treatment, but with a lower than average welfare. Cross-country comparisons based on indicators that are made invariant to the population size may therefore be biased.