This thesis discloses findings from a scoping review of Social and Structural Determinant of Health (SSDOH)-related academic and grey literature from neurosurgery and fields with neurosurgical overlap. The purpose of this thesis is to identify which social determinants have been assessed, for which surgical procedures they were evaluated, and what disparities were found. To identify studies to include or consider for this systematic review, the review team worked with a medical librarian to develop detailed search strategies for each database. Studies were screened by title and abstract independently by two reviewers. Disagreements between reviewers were resolved by a third reviewer, blinded to the decisions of the primary reviewers. The scoping review of the SSDOH in neurosurgical outcomes identified 99 studies from the year 1990 to 2020. Identified studies were targeted predominantly toward spine surgery patients, evenly distributed in analyses of gender, race and economic stability. The relatively low volume of neurosurgical papers focused on the SSDOH and emphasis on one subspecialty demonstrates the need for an expanded interest in the SSDOH in neurosurgery. / Urban Bioethics

A interação universidade-empresa (IUE) é uma das ferramentas fundamentais para estimular o desenvolvimento social e econômico de um país. De um lado, a possibilidade de interação depende, em primeira instância, da oferta de conhecimento científico e tecnológico existente no contexto da relação. De outro lado, para haver interação de fato, não basta existir uma malha de instituições de ciência e tecnologia (C&T), mas é fundamental que haja, acima de tudo, a necessidade de interação por parte das empresas. É justamente o tamanho das demandas das empresas por conhecimento e tecnologia que irá desenhar os contornos da interação universidade-empresa. Isso posto, este estudo tem como objetivo analisar os elementos estruturais, exógenos e endógenos às firmas, que determinam o nível de interação entre universidades e empresas. Dependendo do setor, do tamanho da firma, dos investimentos em P&D e das capacidades de inovação, isto é, dos determinantes estruturais, espera-se identificar os diferentes níveis de interação entre universidades e empresas. Para alcançar esse objetivo, utilizou dados secundários coletados em uma pesquisa survey, coordenada pelo NITEC (UFRGS), que abrangeu 1.331 empresas dos mais diversos setores industriais, as quais foram classificadas de acordo com o nível de interação: baixo nível de interação e alto nível de interação. Os principais resultados obtidos indicam que, primeiramente, a intensidade tecnológica setorial não é determinante do nível de interação das empresas com as universidades. Em compensação, os determinantes endógenos, como o tamanho da firma, os investimentos em P&D e as capacidades de inovação confirmaram-se como variáveis previsoras significantes do nível de interação. Entre os elementos endógenos, as capacidades de inovação se destacam como variáveis com poder explicativo superior aos outros determinantes que já são amplamente investigados na literatura. Já em relação ao desempenho da firma, somente o registro de patentes e o desempenho econômico encontramse determinados pelo nível de interação. Por fim, essas descobertas em relação aos determinantes do nível de interação e do desempenho da firma comprovam o pressuposto teórico defendido nesse trabalho: o nível tecnológico das empresas é determinante do nível de interação das firmas com as universidades; contudo, são as variáveis internas às firmas, e não as externas, que ditam esse nível. / The university-industry interaction is one of the key tools to stimulate social and economic development of a country. On one side, the possibility of interaction depends, in the first instance, on the offer of scientific and technological knowledge existing in the context of the relationship. On the other hand, to really have interaction, is not enough to just exist a network of science and technology institutions, but it is fundamental to have, above all, the need for interaction by firms. It is precisely the size of the demands of companies by knowledge and technology that will draw the contours of university-industry interaction. That said, this study aims to identify and analyze the structural elements, exogenous and endogenous to firms, that determine the level of interaction between universities and firms. Depending on the sector, firm size, investment in R&D and innovation capabilities, that is, structural determinants, it is expected to identify the different levels of interaction between universities and firms. To achieve this goal, it was used secondary data collected in a survey research coordinated by NITEC (UFRGS), which covered 1,331 companies from various industrial sectors, which were classified according to the level of interaction: low level of interaction and high level of interaction. The main results indicate that, first, the sectoral technological intensity is not determinant of the level of interaction with universities. On the other hand, the endogenous determinants, such as firm size, investment in R&D and innovation capabilities were confirmed as significant predictor variables of the level of interaction. Among the endogenous elements, innovative capabilities stand out as variables with greater explanatory power than other determinants that already are widely investigated in literature. In relation to the firm's performance, only the registration of patents and economic performance are determined by the level of interaction. Finally, these findings about the determinants of the level of interaction and firm performance confirm the theoretical assumption defended in this work: the technological level of the companies is determining of the level of interaction of firms with universities. However, the internal variables of the firms, and not external, are which dictate this level.

A interação universidade-empresa (IUE) é uma das ferramentas fundamentais para estimular o desenvolvimento social e econômico de um país. De um lado, a possibilidade de interação depende, em primeira instância, da oferta de conhecimento científico e tecnológico existente no contexto da relação. De outro lado, para haver interação de fato, não basta existir uma malha de instituições de ciência e tecnologia (C&T), mas é fundamental que haja, acima de tudo, a necessidade de interação por parte das empresas. É justamente o tamanho das demandas das empresas por conhecimento e tecnologia que irá desenhar os contornos da interação universidade-empresa. Isso posto, este estudo tem como objetivo analisar os elementos estruturais, exógenos e endógenos às firmas, que determinam o nível de interação entre universidades e empresas. Dependendo do setor, do tamanho da firma, dos investimentos em P&D e das capacidades de inovação, isto é, dos determinantes estruturais, espera-se identificar os diferentes níveis de interação entre universidades e empresas. Para alcançar esse objetivo, utilizou dados secundários coletados em uma pesquisa survey, coordenada pelo NITEC (UFRGS), que abrangeu 1.331 empresas dos mais diversos setores industriais, as quais foram classificadas de acordo com o nível de interação: baixo nível de interação e alto nível de interação. Os principais resultados obtidos indicam que, primeiramente, a intensidade tecnológica setorial não é determinante do nível de interação das empresas com as universidades. Em compensação, os determinantes endógenos, como o tamanho da firma, os investimentos em P&D e as capacidades de inovação confirmaram-se como variáveis previsoras significantes do nível de interação. Entre os elementos endógenos, as capacidades de inovação se destacam como variáveis com poder explicativo superior aos outros determinantes que já são amplamente investigados na literatura. Já em relação ao desempenho da firma, somente o registro de patentes e o desempenho econômico encontramse determinados pelo nível de interação. Por fim, essas descobertas em relação aos determinantes do nível de interação e do desempenho da firma comprovam o pressuposto teórico defendido nesse trabalho: o nível tecnológico das empresas é determinante do nível de interação das firmas com as universidades; contudo, são as variáveis internas às firmas, e não as externas, que ditam esse nível. / The university-industry interaction is one of the key tools to stimulate social and economic development of a country. On one side, the possibility of interaction depends, in the first instance, on the offer of scientific and technological knowledge existing in the context of the relationship. On the other hand, to really have interaction, is not enough to just exist a network of science and technology institutions, but it is fundamental to have, above all, the need for interaction by firms. It is precisely the size of the demands of companies by knowledge and technology that will draw the contours of university-industry interaction. That said, this study aims to identify and analyze the structural elements, exogenous and endogenous to firms, that determine the level of interaction between universities and firms. Depending on the sector, firm size, investment in R&D and innovation capabilities, that is, structural determinants, it is expected to identify the different levels of interaction between universities and firms. To achieve this goal, it was used secondary data collected in a survey research coordinated by NITEC (UFRGS), which covered 1,331 companies from various industrial sectors, which were classified according to the level of interaction: low level of interaction and high level of interaction. The main results indicate that, first, the sectoral technological intensity is not determinant of the level of interaction with universities. On the other hand, the endogenous determinants, such as firm size, investment in R&D and innovation capabilities were confirmed as significant predictor variables of the level of interaction. Among the endogenous elements, innovative capabilities stand out as variables with greater explanatory power than other determinants that already are widely investigated in literature. In relation to the firm's performance, only the registration of patents and economic performance are determined by the level of interaction. Finally, these findings about the determinants of the level of interaction and firm performance confirm the theoretical assumption defended in this work: the technological level of the companies is determining of the level of interaction of firms with universities. However, the internal variables of the firms, and not external, are which dictate this level.

A interação universidade-empresa (IUE) é uma das ferramentas fundamentais para estimular o desenvolvimento social e econômico de um país. De um lado, a possibilidade de interação depende, em primeira instância, da oferta de conhecimento científico e tecnológico existente no contexto da relação. De outro lado, para haver interação de fato, não basta existir uma malha de instituições de ciência e tecnologia (C&T), mas é fundamental que haja, acima de tudo, a necessidade de interação por parte das empresas. É justamente o tamanho das demandas das empresas por conhecimento e tecnologia que irá desenhar os contornos da interação universidade-empresa. Isso posto, este estudo tem como objetivo analisar os elementos estruturais, exógenos e endógenos às firmas, que determinam o nível de interação entre universidades e empresas. Dependendo do setor, do tamanho da firma, dos investimentos em P&D e das capacidades de inovação, isto é, dos determinantes estruturais, espera-se identificar os diferentes níveis de interação entre universidades e empresas. Para alcançar esse objetivo, utilizou dados secundários coletados em uma pesquisa survey, coordenada pelo NITEC (UFRGS), que abrangeu 1.331 empresas dos mais diversos setores industriais, as quais foram classificadas de acordo com o nível de interação: baixo nível de interação e alto nível de interação. Os principais resultados obtidos indicam que, primeiramente, a intensidade tecnológica setorial não é determinante do nível de interação das empresas com as universidades. Em compensação, os determinantes endógenos, como o tamanho da firma, os investimentos em P&D e as capacidades de inovação confirmaram-se como variáveis previsoras significantes do nível de interação. Entre os elementos endógenos, as capacidades de inovação se destacam como variáveis com poder explicativo superior aos outros determinantes que já são amplamente investigados na literatura. Já em relação ao desempenho da firma, somente o registro de patentes e o desempenho econômico encontramse determinados pelo nível de interação. Por fim, essas descobertas em relação aos determinantes do nível de interação e do desempenho da firma comprovam o pressuposto teórico defendido nesse trabalho: o nível tecnológico das empresas é determinante do nível de interação das firmas com as universidades; contudo, são as variáveis internas às firmas, e não as externas, que ditam esse nível. / The university-industry interaction is one of the key tools to stimulate social and economic development of a country. On one side, the possibility of interaction depends, in the first instance, on the offer of scientific and technological knowledge existing in the context of the relationship. On the other hand, to really have interaction, is not enough to just exist a network of science and technology institutions, but it is fundamental to have, above all, the need for interaction by firms. It is precisely the size of the demands of companies by knowledge and technology that will draw the contours of university-industry interaction. That said, this study aims to identify and analyze the structural elements, exogenous and endogenous to firms, that determine the level of interaction between universities and firms. Depending on the sector, firm size, investment in R&D and innovation capabilities, that is, structural determinants, it is expected to identify the different levels of interaction between universities and firms. To achieve this goal, it was used secondary data collected in a survey research coordinated by NITEC (UFRGS), which covered 1,331 companies from various industrial sectors, which were classified according to the level of interaction: low level of interaction and high level of interaction. The main results indicate that, first, the sectoral technological intensity is not determinant of the level of interaction with universities. On the other hand, the endogenous determinants, such as firm size, investment in R&D and innovation capabilities were confirmed as significant predictor variables of the level of interaction. Among the endogenous elements, innovative capabilities stand out as variables with greater explanatory power than other determinants that already are widely investigated in literature. In relation to the firm's performance, only the registration of patents and economic performance are determined by the level of interaction. Finally, these findings about the determinants of the level of interaction and firm performance confirm the theoretical assumption defended in this work: the technological level of the companies is determining of the level of interaction of firms with universities. However, the internal variables of the firms, and not external, are which dictate this level.

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

Background: Global health is a complex, interdisciplinary, and contested field. It is rapidly growing and undergoing ideological and methodological changes. Despite many theoretical claims over what global health research ought to be, there are few empirical reports on what global health is, as a present field of research. The aim of this study is to: 1) determine patterns in global health research, based on key research characteristics; and 2) determine relationships between these characteristics to identify and define conceptual frameworks in global health research. Methodology: A systematic review of research in global health journals was conducted for papers published in the years 2010, 2015, and 2020. Categorical data on 17 research characteristics was extracted from all studies included in the analysis. The relationships between these characteristics was analyzed and visualized using multiple correspondence analysis, as implemented in the R’s ca package. Significance tests of independence determined relationships between pairs of variables. Results: The final analysis was done on 1033 included studies from 14 journals. 56% of the studies used a quantitative observational methodology. While 82% of research had at least one author affiliated with a high-income country, 96% of research funded (at least partially) by the Bill & Melinda Gates Foundation had at least one author affiliated with a high-income country. There was a significant relationship between the use of social and structural determinants of health and the authors’ affiliations (X2=59.06, p < 0.001), with the use of social and structural determinants of health lower among lower-income authors than high-income authors. The first and second dimensions of multiple correspondence analysis explained 38% of the variables’ deviation from independence. Conclusion: Multiple correspondence analysis offers a novel way of understanding global health research, contributing empirical data to the discourse on what lies ahead for the field of global health. The relationship between the use of social and structural determinants of health, authorship, and research methodologies point to the need for important conversations on the direction of global health research, starting from where we are at now. / Thesis / Master of Science (MSc) / While the importance of the field of global health is more prominent than ever, it is a field of uncertainty, controversy, contested merit, and often disreputable history. Conversations abound on the strengths and weaknesses of the field and what needs to change; yet, there is a lack of empirical grounding for these discussions. In this study, I reviewed global health research literature, identifying 17 key characteristics that surface in theoretical conversations on global health, and scored 1033 global health research studies according to these characteristics. Using multiple correspondence analysis, the 17 characteristics were analyzed together and visualized to elucidate the relationships between the characteristics. I found that: over half of the studies were quantitative observational; most research in global health had at least one author from a high-income country; and middle-income authors were less likely to study social and structural determinants of health than high-income authors. These findings lend important empirical evidence to conversations on the direction of the field, starting from where we are at now.

Les ARN double brin (ARNdb) sont les molécules clés initiatrices du RNA silencing, à partir desquelles les différentes classes de petits ARN (sRNAs), conférant la séquence spécificité de ce mécanisme, vont être produit. Chez la plante modèle Arabidopsis thaliana, le clivage des divers ARNdb en sRNAs est opéré par quatre enzymes de type RNase III, nommées DCL1 à DCL4, dont l’activité peut être assistée par des protéines fixant l’ARNdb (DRBs). Au cours de cette thèse, j’ai pu caractériser la fonction d’une nouvelle DRB, DRB7.2. Les résultats obtenus m’ont permis de démontrer que cette protéine régule la production d’une classe particulière de sRNAs endogènes, les endoIR-siRNAs, en séquestrant spécifiquement leurs précurseurs ARNdb, inhibant ainsi leur clivage par les différents DCLs. En parallèle, j’ai également développé des outils moléculaires afin d’étudier le mode d’action du DCL le plus polyvalent chez les plantes, DCL4. La caractérisation détaillée de ces outils a permis de révéler le rôle clé de déterminant structuraux distinct (protéiques ou nucléiques) impliqués dans la spécificité de reconnaissance et de clivage des divers substrats ARNdb par cette enzyme. / RNA silencing is initiated by double-stranded RNA (dsRNA) molecules that will be processed into various classes of small RNAs (sRNAs), which confer the sequence-specificity of this mechanism. In the model plant Arabidopsis thaliana, dsRNA processing is mediated by four distinct RNaseIII-like enzymes, named DCL1 to DCL4, which can be assisted by dsRNA-binding proteins (DRBs). During my PhD, I was able to characterize in details the function of a new DRB protein, DRB7.2. Our results revealed that this protein regulates the accumulation of a specific class of endogenous sRNAs, the endoIR-siRNAs, by selectively sequestering their dsRNA precursors and inhibiting their cleavage by the DCLs. In parallel, I also developed molecular tools to study the mode of action of the most versatile DCL in plants, DCL4. Detailed characterization of these tools revealed key roles of distinct structural determinants (at the protein or RNA level), implicated in the specificity and cleavage efficiency of the various dsRNA susbtrates by DCL4.

This study explored doctor of physical therapy (DPT) students’ attitudes, perceived knowledge, and perceived competence specific to social and structural determinants of health (SDOH). Current students in a DPT program housed within a college of public health in an urban research institution served as the participants for this research. The primary purpose of this study was to explore students’ self-evaluation and perceptions of competence with SDOH in hopes of gaining insight into elements of their education that contributed to their preparedness and/or what strategies and resources are needed to foster competence in this area. A secondary aim of this study was to explore how individual student factors and curricular factors impact students’ awareness of SDOH. A mixed methods study design employed bivariate and multivariate analysis of participants’ responses to self-report Likert scale survey questions and analysis of semi-structured interviews using qualitative description and phenomenological principles. Quantitative data analysis revealed differences in perceived skills competence based on cohort (year one, two, or three in the program) with first-year students demonstrating lower perceived competence. Analysis of attitudes and knowledge demonstrated that all participants held a positive perspective regarding the importance of SDOH as well as perceived foundational knowledge for this content. Quantitative analysis also detected subtle differences in specific sample beliefs and behaviors based on demographic variables such as gender identity, race, and first-generation student status. Qualitative data supported the quantitative findings with participants articulating specific elements of their identities and the DPT curriculum that contributed to their understanding of SDOH. An iterative coding process identified two primary themes that corresponded to the research aims: 1) Learners’ perceived importance of social and structural determinants of health and factors that impact how to address them; and 2) Learning about social and structural determinants of health: What learners bring with them and what they gain throughout the curriculum. These findings shed light on the elements of this educational program that foster students understanding of SDOH and the types of experiences that help clinical learners appreciate the impact of these upstream drivers of health for patients and populations. / Policy, Organizational and Leadership Studies

This study is an exploration, through ethnographic and auto-ethnographic inquiry, of the personal world, gambling experiences and underlying biopsychosocial vulnerabilities of three individual case studies - one male and two females - each representing a different sub-type of pathological gambler. It comprises the integration and implementation of a psycho-structural stage matching model to explore comorbidity and identify certain biopsychosocial manifestations in the respective stages of pathological gambling. Long term treatment strategies were identified and patient treatment matching was explored. Further, it comprises my personal relationship and therapeutic treatment of these sub-types of gamblers over a period of one year and longer. In this study it is hypothesized that formulating appropriate matching long term treatment strategies should be based on the stage of change, the phase in the psycho-structural model, as well as the gambler's underlying vulnerability. From this a comprehensive gambling disposition profile can be completed with proper intervention matching approaches. A number of other hypotheses emerged from this study that could provide valuable information and serve as a guideline to those working with pathological gamblers. / Psychology / D.Phil.

This study is an exploration, through ethnographic and auto-ethnographic inquiry, of the personal world, gambling experiences and underlying biopsychosocial vulnerabilities of three individual case studies - one male and two females - each representing a different sub-type of pathological gambler. It comprises the integration and implementation of a psycho-structural stage matching model to explore comorbidity and identify certain biopsychosocial manifestations in the respective stages of pathological gambling. Long term treatment strategies were identified and patient treatment matching was explored. Further, it comprises my personal relationship and therapeutic treatment of these sub-types of gamblers over a period of one year and longer. In this study it is hypothesized that formulating appropriate matching long term treatment strategies should be based on the stage of change, the phase in the psycho-structural model, as well as the gambler's underlying vulnerability. From this a comprehensive gambling disposition profile can be completed with proper intervention matching approaches. A number of other hypotheses emerged from this study that could provide valuable information and serve as a guideline to those working with pathological gamblers. / Psychology / D.Phil.