Social determinants of dental treatment needs in Brazilian adults

Background The chronic cumulative nature of caries makes treatment needs a severe problem in adults. Despite the fact that oral diseases occur in social contexts, there are few studies using multilevel analyses focusing on treatment needs. Thus, considering the importance of context in explaining oral health related inequalities, this study aims to evaluate the social determinants of dental treatment needs in 35–44 year old Brazilian adults, assessing whether inequalities in needs are expressed at individual and contextual levels. Methods The dependent variables were based on the prevalence of normative dental treatment needs in adults: (a) restorative treatment; (b) tooth extraction and (c) prosthetic treatment. The independent variables at first level were household income, formal education level, sex and race. At second level, income, sanitation, infrastructure and house conditions. The city-level variables were the Human Development Index (HDI) and indicators related to health services. Exploratory analysis was performed evaluating the effect of each level through calculating Prevalence Ratios (PR). In addition, a three-level multilevel modelling was constructed for all outcomes to verify the effect of individual characteristics and also the influence of context. Results In relation to the need for restorative treatment, the main factors implicated were related to individual socioeconomic position, however the city-level contextual effect should also be considered. Regarding need for tooth extraction, the contextual effect does not seem to be important and, in relation to the needs for prosthetic treatment, the final model showed effect of individual-level and city-level. Variables related to health services did not show significant effects. Conclusions Dental treatment needs related to primary care (restoration and tooth extraction) and secondary care (prosthesis) were strongly associated with individual socioeconomic position, mainly income and education, in Brazilian adults. In addition to this individual effect, a city-level contextual effect, represented by HDI, was also observed for need for restorations and prosthesis, but not for tooth extractions. These findings have important implications for the health policy especially for financing and planning, since the distribution of oral health resources must consider the inequalities in availability and affordability of dental care for all.

Estudo de famílias wavelets para aplicação na análise em DOAS

Trace gases are important to our environment even though their presence comes only by ‘traces’, but their concentrations must be monitored, so any necessary interventions can be done at the right time. There are some lower and upper boundaries which produce nice conditions for our lives and then monitoring trace gases comes as an essential task nowadays to be accomplished by many techniques. One of them is the differential optical absorption spectroscopy (DOAS), which consists mathematically on a regression - the classical method uses least-squares - to retrieve the trace gases concentrations. In order to achieve better results, many works have tried out different techniques instead of the classical approach. Some have tried to preprocess the signals to be analyzed by a denoising procedure - e.g. discrete wavelet transform (DWT). This work presents a semi-empirical study to find out the most suitable DWT family to be used in this denoising. The search seeks among many well-known families the one to better remove the noise, keeping the original signal’s main features, then by decreasing the noise, the residual left after the regression is done decreases too. The analysis take account the wavelet decomposition level, the threshold to be applied on the detail coefficients and how to apply them - hard or soft thresholding. The signals used come from an open and online data base which contains characteristic signals from some trace gases usually studied.

Estudo de famílias wavelets para aplicação na análise em DOAS

Trace gases are important to our environment even though their presence comes only by ‘traces’, but their concentrations must be monitored, so any necessary interventions can be done at the right time. There are some lower and upper boundaries which produce nice conditions for our lives and then monitoring trace gases comes as an essential task nowadays to be accomplished by many techniques. One of them is the differential optical absorption spectroscopy (DOAS), which consists mathematically on a regression - the classical method uses least-squares - to retrieve the trace gases concentrations. In order to achieve better results, many works have tried out different techniques instead of the classical approach. Some have tried to preprocess the signals to be analyzed by a denoising procedure - e.g. discrete wavelet transform (DWT). This work presents a semi-empirical study to find out the most suitable DWT family to be used in this denoising. The search seeks among many well-known families the one to better remove the noise, keeping the original signal’s main features, then by decreasing the noise, the residual left after the regression is done decreases too. The analysis take account the wavelet decomposition level, the threshold to be applied on the detail coefficients and how to apply them - hard or soft thresholding. The signals used come from an open and online data base which contains characteristic signals from some trace gases usually studied.

Efeito de diferentes divisões territoriais na flutuação aleatória de indicadores socioeconômicos relacionados à determinação social da saúde

This research aimed to analyse the effect of different territorial divisions in the random fluctuation of socio-economic indicators related to social determinants of health. This is an ecological study resulting from a combination of statistical methods including individuated and aggregate data analysis, using five databases derived from the database of the Brazilian demographic census 2010: overall results of the sample by weighting area. These data were grouped into the following levels: households; weighting areas; cities; Immediate Urban Associated Regions and Intermediate Urban Associated Regions. A theoretical model related to social determinants of health was used, with the dependent variable Household with death and as independent variables: Black race; Income; Childcare and school no attendance; Illiteracy; and Low schooling. The data was analysed in a model related to social determinants of health, using Poisson regression in individual basis, multilevel Poisson regression and multiple linear regression in light of the theoretical framework of the area. It was identified a greater proportion of households with deaths among those with at least one black resident, lower-income, illiterate, who do not attend or attended school or day-care and less educated. The analysis of the adjusted model showed that most adjusted prevalence ratio was related to Income, where there is a risk value of 1.33 for households with at least one resident with lower average personal income to R$ 655,00 (Brazilian current). The multilevel analysis demonstrated that there was a context effect when the variables were subjected to the effects of areas, insofar as the random effects were significant for all models and with different prevalence rates being higher in the areas with smaller dimensions - Weighting areas with coefficient of 0.035 and Cities with coefficient of 0.024. The ecological analyses have shown that the variable Income and Low schooling presented explanatory potential for the outcome on all models, having income greater power to determine the household deaths, especially in models related to Immediate Urban Associated Regions with a standardized coefficient of -0.616 and regions intermediate urban associated regions with a standardized coefficient of -0.618. It was concluded that there was a context effect on the random fluctuation of the socioeconomic indicators related to social determinants of health. This effect was explained by the characteristics of territorial divisions and individuals who live or work there. Context effects were better identified in the areas with smaller dimensions, which are more favourable to explain phenomena related to social determinants of health, especially in studies of societies marked by social inequalities. The composition effects were better identified in the Regions of Urban Articulation, shaped through mechanisms similar to the phenomenon under study.

Frontline employees’ innovative service behavior as key to customer loyalty:insights into FLEs’ resource gain spiral

Many service firms require frontline service employees (FLEs) to follow routines and standardized operating procedures during the service encounter, to deliver consistently high service standards. However, to create superior, pleasurable experiences for customers, featuring both helpful services and novel approaches to meeting their needs, firms in various sectors also have begun to encourage FLEs to engage in more innovative service behaviors. This study therefore investigates a new and complementary route to customer loyalty, beyond the conventional service-profit chain, that moves through FLEs' innovative service behavior. Drawing on conservation of resources (COR) theory, this study introduces a resource gain spiral at the service encounter, which runs from FLEs' emotional job engagement to innovative service behavior, and then leads to customer delight and finally customer loyalty. In accordance with COR theory, the proposed model also includes factors that might hinder (customer aggression, underemployment) or foster (colleague support, supervisor support) FLEs' resource gain spiral. A multilevel analysis of a large-scale, dyadic data set that contains responses from both FLEs and customers in multiple industries strongly supports the proposed resource gain spiral as a complementary route to customer loyalty. The positive emotional job engagement-innovative service behavior relationship is undermined by customer aggression and underemployment, as hypothesized. Surprisingly though, and contrary to the hypotheses, colleague and supervisor support do not seem to foster FLEs' resource gain spiral. Instead, colleague support weakens the engagement-innovative service behavior relationship, and supervisor support does not affect it. These results indicate that if FLEs can solicit resources from other sources, they may not need to invest as many of their individual resources. In particular, colleague support even appears to serve as a substitute for FLEs' individual resource investments in the resource gain spiral.

Brands, Close Relationships, and Consumer Well-Being

Consumers have relationships with other people, and they have relationships with brands similar to the ones they have with other people. Yet, very little is known about how brand and interpersonal relationships relate to one another. Even less is known about how they jointly affect consumer well-being. The goal of this research, therefore, is to examine how brand and interpersonal relationships influence and are influenced by consumer well-being. Essay 1 uses both empirical methods and surveys from individuals and couples to investigate how consumer preferences in romantic couples, namely brand compatibility, influences life satisfaction. Using traditional statistical techniques and multilevel modeling, I find that the effect of brand compatibility, or the extent to which individuals have similar brand preferences, on life satisfaction depends upon power in the relationship. For high power partners, brand compatibility has no effect on life satisfaction. On the other hand, for low power partners, low brand compatibility is associated with decreased life satisfaction. I find that conflict mediates the link between brand compatibility and power on life satisfaction. In Essay 2 I again use empirical methods and surveys to investigate how resources, which can be considered a form of consumer well-being, influence brand and interpersonal relations. Although social connections have long been considered a fundamental human motivation and deemed necessary for well-being (Baumeister and Leary 1995), recent research has demonstrated that having greater resources is associated with weaker social connections. In the current research I posit that individuals with greater resources still have a need to connect and are using other sources for connection, namely brands. Across several studies I test and find support for my theory that resource level shifts the preference of social connection from people to brands. Specifically, I find that individuals with greater resources have stronger brand relationships, as measured by self-brand connection, brand satisfaction, purchase intentions and willingness to pay with both existing brand relationships and with new brands. This suggests that individuals with greater resources place more emphasis on these relationships. Furthermore, I find that resource level influences the stated importance of brand and interpersonal relationships, and that having or perceiving greater resources is associated with an increased preference to engage with brands over people. This research demonstrates that there are times when people prefer and seek out connections with brands over other people, and highlights the ways in which our brand and interpersonal relationships influence one another.

Building resilience for social-ecological sustainability in Atlantic Europe

This thesis argues that complex adaptive social–ecological systems (SES) theory has important implications for the design of integrated ocean and coastal governance in the EU. Traditional systems of governance have struggled to deal with the global changes, complexity and uncertainties that challenge a transition towards sustainability in Europe’s maritime macro-regions. There is an apparent disconnect between governance strategies for sustainability in Europe’s maritime macro-regions and a sound theoretical basis for them. My premise is that the design of governance architecture for maritime regional sustainability should be informed by SES theory. Therefore, the aim of this research was to gain insight into a multilevel adaptive governance architecture that combines notions of sustainability and development in the context of the Atlantic Europe maritime macro-region. The central research question asked whether it is possible to achieve this insight by using a SES as a framework and analytical tool. This research adopted social ecology and sustainability science as a foundation for understanding society–nature relations. Concepts from complex adaptive systems, SES and resilience theories were integrated into a conceptual framework that guided the investigation and analysis. A study was conducted to conceptualise the European Atlantic social–ecological system (EASES). This was used to represent and understand the Atlantic Europe macro-region as a SES. The study examined the proposition that governance can be focused on building SES resilience to help achieve maritime regional sustainability. A workbook method was developed and used to elicit expert opinion regarding EASES. The study identified sources of resilience and resilience dynamics that require management in the context of multilevel adaptive governance. This research found that the Atlantic Europe macro-region is a key focal level for multilevel adaptive governance architecture. The majority of the findings are specific to Atlantic Europe and not generalisable to other maritime macro-regions in Europe.

What Does Board Capital Really Bring to the Table? Exploring the Effect of Directors’ Human and Social Capital on Effective Governance During International Expansion

What constitutes effective corporate governance? Which director characteristics render boards effective at positively influencing firm-level performance outcomes? This dissertation examines these questions by taking a multilevel, multidisciplinary approach to corporate governance. I explore the individual-, team-, and firm- level factors that enable directors to serve effectively as strategic resources during international expansion. I argue that directors’ international experience improves their ability to serve as effective strategic consultants and resource providers to firms during the complex internationalization process. However, unlike prior research, which tends to assume that directors with the potential to provide important resources uniformly do so, I acknowledge contextual factors (i.e. board cohesiveness, strategic relevance of directors’ experience) that affect their propensity to actually influence outcomes. I explore these issues in three essays: one review essay and two empirical essays. In the first empirical essay, I integrate resource dependence theory with insights from social-psychological research to explore the influence of board capital on firms’ cross-border M&A performance. Using a sample of cross-border M&As completed by S&P 500 firms from 2004-2009, I find evidence that directors’ depth of international experience is associated with superior pre-deal outcomes. This suggests that boards’ deep, market-specific knowledge is valuable during the target selection phase. I further find that directors’ breadth of international experience is associated with superior post-deal performance, suggesting that these directors’ global mindset helps firms in the post-M&A integration phase. I also find that these relationships are positively moderated by board cohesiveness, measured by boards’ internal social ties. In the second empirical essay, I explore the boundary conditions of international board capital by examining how the characteristics of firms’ internationalization strategy moderate the relationship between board capital and firm performance. Using a panel of 377 S&P 500 firms observed from 2004-2011, I find that boards’ depth of international experience and social capital are more important during early stages of internationalization, when firms tend to lack market knowledge and legitimacy in the host markets. On the other hand, I find that breadth of international experience has a stronger relationship with performance when firms’ have higher scope of internationalization, when information-processing demands are higher.

Investigating the Association Between Computer-Mediated Communication (CMC) and the Health of Canadian Young People: A Mixed Methods Study

Canadian young people are increasingly more connected through technological devices. This computer-mediated communication (CMC) can result in heightened connection and social support but can also lead to inadequate personal and physical connections. As technology evolves, its influence on health and well-being is important to investigate, especially among youth. This study aims to investigate the potential influences of computer-mediated communication (CMC) on the health of Canadian youth, using both quantitative and qualitative research approaches. This mixed-methods study utilized data from the 2013-2014 Health Behaviour in School-aged Children survey for Canada (n=30,117) and focus group data involving Ontario youth (7 groups involving 40 youth). In the quantitative component, a random-effects multilevel Poisson regression was employed to identify the effects of CMC on loneliness, stratified to explore interaction with family communication quality. A qualitative, inductive content analysis was applied to the focus group transcripts using a grounded theory inspired methodology. Through open line-by-line coding followed by axial coding, main categories and themes were identified. The quality of family communication modified the association between CMC use and loneliness. Among youth experiencing the highest quartile of family communication, daily use of verbal and social media CMC was significantly associated with reports of loneliness. The qualitative analysis revealed two overarching concepts that: (1) the health impacts of CMC are multidimensional and (2) there exists a duality of both positive and negative influences of CMC on health. Four themes were identified within this framework: (1) physical activity, (2) mental and emotional disturbance, (3) mindfulness, and (4) relationships. Overall, there is a high proportion of loneliness among Canadian youth, but this is not uniform for all. The associations between CMC and health are influenced by external and contextual factors, including family communication quality. Further, the technologically rich world in which young people live has a diverse impact on their health. For youth, their relationships with others and the context of CMC use shape overall influences on their health.

An investigation of sugar-sweetened beverage consumption among Canadian youth

Background: Consumption of sugar-sweetened beverages (SSBs) is an important public health problem in Canada, especially among adolescents. Estimates show that rates of SSB consumption are particularly high in the northern territories, especially in Nunavut. This is concerning given that regular SSB consumption is associated with obesity, diabetes and tooth decay, among other health concerns. Objectives: This thesis has two objectives. The first is to describe SSB consumption patterns among adolescents from Nunavut specifically, all three territories combined and the provinces.The second is to determine the association between individual and cumulative school food programs and SSB consumption. Methods: Data were obtained from the Health Behaviour in School-aged Children study (HBSC); a cross-sectional survey of Canadian youth in grades 6-10. All frequencies for food and beverage consumption were obtained from a 7-day food frequency questionnaire. SSB consumption consisted of a composite measure including soft drinks, sports drinks and energy drinks. The types of school food programs were obtained from an administrative questionnaire filled out by each school’s Principal or delegate. Multilevel multivariate Poisson regression models were used to examine the associations between school food programs and SSB consumption. Results: Youth from Nunavut consumed the most SSBs (53.1% in 2010 and 55.0% in 2014 were daily consumers), followed by youth from the territories (31.1% in 2010 and 27.0% in 2014), then youth from the provinces (24.3% in 2010 and 19.1% in 2014). No significant relationships were found between school food programs and daily SSB consumption. Two school food programs were weakly associated with weekly SSB consumption: nutrition month activities (RR=0.93,CI=0.89, 0.98) and healthy options in the snack bar (RR=1.07, CI=1.01, 1.14). Conclusions:Rates of SSB consumption were highest among Nunavummiut youth followed by youth from all three territories combined and then the provinces. Little association was found between school food programs and SSB consumption among Canadian youth in grades 6-10. These findings point to the need for examining other determinants and potential areas for intervention, for reducing SSB consumption among Canadian youth, particularly in high consumer sub-populations.

Untangling a Web of Lies: Exploring Automated Detection of Deception in Computer-Mediated Communication

Safeguarding organizations against opportunism and severe deception in computer-mediated communication (CMC) presents a major challenge to CIOs and IT managers. New insights into linguistic cues of deception derive from the speech acts innate to CMC. Applying automated text analysis to archival email exchanges in a CMC system as part of a reward program, we assess the ability of word use (micro-level), message development (macro-level), and intertextual exchange cues (meta-level) to detect severe deception by business partners. We empirically assess the predictive ability of our framework using an ordinal multilevel regression model. Results indicate that deceivers minimize the use of referencing and self-deprecation but include more superfluous descriptions and flattery. Deceitful channel partners also over structure their arguments and rapidly mimic the linguistic style of the account manager across dyadic e-mail exchanges. Thanks to its diagnostic value, the proposed framework can support firms’ decision-making and guide compliance monitoring system development.

NEIGHBORHOOD PERCEPTION OF SAFETY AND THE MOBILITY GAP BETWEEN MEN AND WOMEN IN OLD AGE

Background and Objectives: Mobility limitations are a prevalent issue in older adult populations, and an important determinant of disability and mortality. Neighborhood conditions are key determinants of mobility and perception of safety may be one such determinant. Women have more mobility limitations than men, a phenomenon known as the gender mobility gap. The objective of this work was to validate a measure of perception of safety, examine the relationship between neighborhood perception of safety and mobility limitations in seniors, and explore if these effects vary by gender. Methods: This study was cross-sectional, using questionnaire data collected from community-dwelling older adults from four sites in Canada, Colombia, and Brazil. The exposure variable was the neighborhood aggregated Perception of Safety (PoS) scale, derived from the Physical and Social Disorder (PSD) scale by Sampson and Raudenbush. Its construct validity was verified using factor analyses and correlation with similar measures. The Mobility Assessment Tool – short form (MAT-sf), a video-based measure validated cross-culturally in the studied populations, was used to assess mobility limitations. Based on theoretical models, covariates were included in the analysis, both at the neighborhood level (SES, social capital, and built environment) and the individual level (age, gender, education, income, chronic illnesses, depression, cognitive function, BMI, and social participation). Multilevel modeling was used in order to account for neighborhood clustering. Gender specific analyses were carried out. SAS and M-plus were used in this study. Results: PoS was validated across all sites. It loaded in a single factor, after excluding two items, with a Cronbach α value of approximately 0.86. Mobility limitations were present in 22.08% of the sample, 16.32% among men and 27.41% among women. Neighborhood perception of safety was significantly associated with mobility limitations when controlling for all covariates, with an OR of 0.84 (CI 95%: 0.73-0.96), indicating lower odds of having mobility limitations as neighborhood perception of safety improves. Gender did not affect this relationship despite women being more likely to have mobility limitations and live in neighborhoods with poor perception of safety. Conclusion: Neighborhood perception of safety affected the prevalence of mobility limitations in older adults in the studied population.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

Institutional resistances before school mediation. An inquiry in the conflict settings

This paper deals with the conceptions of the different school actors about the meaning and the implications of mediation in their schools, drawing on data from a qualitative approach carried out as part of a wider project to map mediation perspectives and practices in Catalonia. The authors analyze the scope of the situations regarded as suitable or unsuitable for the introduction of restorative practices, as well as the resistance to change in the practice of conflict resolutions and in the democratization of school culture.

Motivating film title translation: a cognitive análisis

This proposal is a non-quantitative study based on a corpus of real data which offers a principled account of the translation strategies employed in the translation of English film titles into Spanish in terms of cognitive modeling. More specifically, we draw on Ruiz de Mendoza and Galera’s (2014) work on what they term content (or low-level) cognitive operations, based on either ‘stands for’ or ‘identity’ relations, in order to investigate possible motivating factors for translations which abide by oblique procedures, i.e. for non-literal renderings of source titles. The present proposal is made in consonance with recent findings within the framework of Cognitive Linguistics (Samaniego 2007), which evidence that this linguistic approach can fruitfully address some relevant issues in Translation Studies, the most outstanding for our purposes being the exploration of the cognitive operations which account for the use of translation strategies (Rojo and Ibarretxe-Antuñano 2013: 10), mainly expansion and reduction operations, parameterization, echoing, mitigation and comparison by contrast. This fits in nicely with a descriptive approach to translation and particularly with skopos theory, whose main aim consists in achieving functionally adequate renderings of source texts.