VictorJuiz/thesis huggingface dataset:
The Application of Cost-effectiveness Analysis in Developing Countries
Keywords: economic evaluation
developing countries
immunization policy

Developing countries face imminent choices for introducing needed, effective but expensive new vaccines, given the substantial immunization resources now available from international donors. Cost-effectiveness analysis (CEA) is a tool that decision-makers can use for efficiently allocating expanding resources. However, although CEA has been increasingly applied in developing-country settings since the 1990’s, its use lags behind that in industrialized countries. This thesis explored how CEA could be made more relevant for decision-making in developing countries through 1) identifying the limitations for using CEA in developing countries 2) identifying guidelines for CEA specific to developing countries 3) identifying the impact of donor funding on CEA estimation 4) identifying areas for enhancement in the 1996 “Reference Case” (a standard set of methods) recommended by the US Panel on Cost-Effectiveness in Health and Medicine, and 5) better understanding the decision-making environment in developing countries. Focusing on pediatric immunization in developing countries, thematic analysis was used to distill key concepts from 157 documents spanning health economics, clinical epidemiology and health financing. 11 key informants, researchers active in developing countries, were also interviewed to explore the production and use of evidence in public health decision-making. Results showed a divergence between industrialized and developing nations in the emphases of methodological difficulties, in the general application of CEA, and the types of guidelines available. Explicitly considering donor funding costs and effects highlighted the need to specify an appropriate perspective and address policy-related issues of affordability and sustainability. Key informant interviews also revealed that opinion-makers, international organizations and the presence of local vaccine manufacturing have significant influence on decision-making. It is suggested that CEA could be more useful with a broadened reference case framework that included multiple perspectives, sensitivity analysis exploring differential discount rates (upper limits exceeding 10% for costs, declining from 3% for benefits) and supplemental reports to aid decision-making (budgetary and sustainability assessments). This study has implications for improving health outcomes globally in the context of public-private collaborative health funding. Further research could explore defining an extra-societal (multi-country) perspective to aid in efficient allocation of immunization resources among countries.
An Automated Enrolment Projection System
Keywords: Enrolment Projection Model
Automated Enrolment Projection Model

From my own experience working in Institutional Research for the past seven years, there is not a proper, reliable, and comprehensive model for forecasting student enrolment quickly. In many funding formulas, enrolment is the main driver of government grants and student tuition fees, which are sources of income to the university. Existing enrolment management tools developed within Institutional Research departments tend to be “ad hoc” spreadsheets with multiple individuals manipulating them with the result that the output comes too late for departments to take remedial action in terms of their budgets and does not provide multiple scenarios in support of strategic decision-making. The purpose of this study is to describe a functional automated enrolment projection system methodology I developed from scratch through a case study of the Faculty of Arts & Science at the University of Toronto. My primary research was to actually build the model. The model in effect, is the thesis. The system provides multiple scenarios that allow senior management in a multi-campus university system to generate multiple income scenarios, enabling them to make well-informed decisions concerning the operation of their institution and timely calculation and allocation of resources to academic departments. The study then shows how this addresses the problems of “ad hoc” approaches, and how it may be applied in other situations.
The Right or Responsibility of Inspection: Social Work, Photography, and People with Intellectual Disabilities
Keywords: social work
intellectual disability
arts-informed research
photography and visual imagery

Abstract The act of knowing is a critical determinant of what is known, yet there are limits and potential violence inherent in all ways of knowing. Social workers have an ethical responsibility to understand our means of knowing and our knowledge claims – both shape the work we do. Conspicuously under-represented as creators of/commentators on how they are represented, people with intellectual disabilities have had little/no control over what or how they are known. These ethical and epistemological concerns were the focus of this arts-informed qualitative study. The purpose was an interrogative encounter with one way of knowing – how public photographic imagery of people with intellectual disabilities influences knowledge about them. It was concerned, however, to come to this knowledge through an inquiry into how labelled people would, themselves, interpret and respond to these representations, and how they might use photography to trouble disabling images and non-disabled (social work) knowing. Theoretically framed by a critical disability lens, the work was influenced, too, by Derrida’s essay on photography, “The Right of Inspection”. The other regarding aspect of the philosophy of Emmanuel Levinas, his concern with our ethical responsibility to the alterity of the Other, most powerfully informs the work. Four adults with intellectual disabilities accepted the invitation to participate in this project. First, they critically engaged with a selection of public photographic images. In a unique methodological turn, they then transformed the images to reflect their critique. Interpretive analysis of the critiques and transformations identified four thematic ideas. Participants’ critiques were insightful and profound; transformations provocative and disruptive. Challenging dominant assumptions – and demanding non-disabled others re-think intellectual disability and people so labeled – the critiques and transformations also respond to the social/political/ideological/psychological ramifications of photographic imagery on the lived experience of intellectual disability. Through the work, participants confront non-disabled responses to public photographs and to labeled people, challenging non-disabled others to question their knowledge, attitudes, and behaviours. The work also raises questions about research and people with intellectual disabilities: the possibilities for voice and empowerment through inclusive research strategies and visual methodologies, and the transformative potential of dialogic encounters between people with and without intellectual disabilities.
Gene Duplication and Functional Expansion in the Plant Shikimate Kinase Superfamily
Keywords: shikimate kinase
gene duplication

The shikimate pathway links carbohydrate metabolism to the biosynthesis of the aromatic amino acids and an enormous variety of aromatic compounds with essential functions in all kingdoms of life. Aromatic compounds derived from the plant shikimate pathway have substantial biotechnological value and many are essential to the diet of metazoans whose genomes do not encode shikimate pathway enzymes. Despite its importance to the physiology of plants and human health the regulatory mechanisms of the plant shikimate pathway are not well understood. Shikimate kinase (SK) genes encode an intermediate step in the shikimate pathway and were previously implicated in regulation of the plant shikimate pathway. The distribution of SK genes in higher plants was resolved using phylogenetic and biochemical methods. The two SK isoforms of Arabidopsis thaliana, AtSK1 and AtSK2, were functionally characterized. AtSK1 expression is induced by heat stress and the recombinant enzyme was shown to form a homodimer which is important for maintaining the stability and activity of the enzyme at elevated temperatures. The crystal structure of AtSK2, the first reported plant SK structure, identified structural features unique to plant SKs which may perform important regulatory functions. The resolution of bona fide SKs in higher plants led to the discovery of two novel neofunctionalized homologs - Shikimate Kinase-Like 1 (SKL1) and SKL2. These novel genes evolved from SK gene duplicates over 400 million years ago and are found in all major extant angiosperm lineages, suggesting they were important in the development of biological properties required by land plants. The description of albino and variegated skl1 mutants in Arabidopsis thaliana implicate the SKL1 gene product as an important regulator of chloroplast biogenesis. Functional assays were attempted to determine the biochemical function of SKL1 and recombinant constructs of the Arabidopsis thaliana SKL1 protein were crystallized towards structure determination. The results of this thesis further our understanding of the organization and regulation of the plant shikimate pathway. Furthermore, the discovery of SKL1 may yield important insights into chloroplast biogenesis and function. The evolution of the plant SK superfamily highlights the utility of SKs as scaffolds for functional innovation.
Plant-pollinator Interactions in a Changing Climate
Keywords: pollination
phenology
climate change
bees

Climate change is shifting the seasonal timing of many biological events, and the possibility of non-parallel shifts in different taxa has raised concerns about phenological decoupling of interacting species. My thesis investigates interactions between climate, phenology, and pollination, using the plants and pollinators of Rocky Mountain meadows as a study system. Interannual variation in timing of snowmelt since the 1970s has been associated with changes in the assemblages of concurrently flowering species in these meadows, suggesting that plant species differ in their phenological responses to climate. Differences between plants and pollinators in responsiveness to changing climate could, in principle, cause early-flowering plants to flower too early in warm years, before pollinators are active. In fact, I found only transient evidence for pollinator deficits in one early-flowering species (Mertensia fusiformis), even in an early-snowmelt year. However, the assemblage of pollinators visiting M. fusiformis does change predictably over the season, with likely consequences for selection on floral morphology in years when pollen is limiting. Hence, early- and late-flowering populations may evolve in response to phenology of the pollinator community. Differences between plant and pollinator phenologies appear to be due to generally lower temperature thresholds for development in plants, combined with microclimate differences between the soil and the above-ground nests of some pollinators. Phenological decoupling between plants and pollinators seems possible but unlikely to be catastrophic, since many taxa possess adaptations to temporally variable environments. Nevertheless, for many species, adaptation to novel climates will entail evolutionary change, and species interactions can influence evolutionary trajectories. For species affected by increasing late-summer drought, earlier flowering may be advantageous. However, in laboratory experiments, bumble bees avoid rare, unfamiliar flower types, causing simulated plant populations to fail to adapt to changing conditions. Overall, my work emphasizes the importance of the interplay between species interactions and environmental change.
Measuring the Shape and Size of the Foodshed
Keywords: food systems
nutrient cycling
land use
foodshed
indicators
ecological sustainability

This thesis explores indicator tools to measure the ecological impacts of changes to the food system. The concept of a ‘foodshed’ provides a framework to explore the relationships between ecological impacts and where food system activities occur. Indicators of resource use and reuse are developed to describe the shape and size of the foodshed. Paper 1 presents a review of six indicator-based tools from the literature. Using a three criteria definition of ecological sustainability in the food system - increased resource efficiency, decreased pollutant loading, and increased output reuse - Paper 1 examines the suitability of these tools for evaluating the impacts of municipal food policy driven-changes in the location of activities, processes within activities and diet composition. Paper 2 describes the shape of a foodshed, and investigates how changes in Toronto’s waste management impacted the reuse of food-related nitrogen. Reuse increased from 1% in 1990 to at least 4.7% in 2001, through backyard composting and the land application of processed sewage. By 2004, in spite of household organics collection, reuse decreased to 2.3%, due to a reduction in land-applied sewage. The analysis suggests that sewage management has a larger impact on the reuse of food nitrogen than household solid waste management. Paper 3 quantifies the size of the foodsheds of Canada and the Greater Toronto Area (GTA), and evaluates the feasibility of self-sufficiency and its impact on the total land area used for production. Nationally, there is sufficient harvested land area to meet 95% of the land area needed for self-sufficiency. Self-sufficiency is only feasible for the GTA by drawing from a foodshed extending 400 kilometres beyond its boundary. Given current yields, total self-sufficiency would occupy more land area than currently used domestically and abroad. Higher yields or a change in diet could decrease the size of the foodshed.
The Impact of Prophylactic Salpingo-oophorectomy on Health in Women who carry a BRCA1 or BRCA2 Mutation
Keywords: prophylactic salpingo-oophorectomy
BRCA1 and BRCA2
ovarian cancer
fallopian tube cancer
breast cancer
quality of life

Prophylactic salpingo-oophorectomy, the preventive removal of the ovaries and fallopian tubes, is recommended to women who carry a BRCA1 or BRCA2 mutation in order to reduce the risk of breast, ovarian and fallopian tube cancer. The short and long term health and quality of life effects of this procedure are not well understood. We examined the actual and perceived reduction in cancer risk associated with this surgery. The impact of prophylactic salpingo-oophorectomy on health-related quality of life, psychological distress, cancer worry, menopausal symptoms, and sexual function during the year following surgery was also evaluated. In our prospective study, prophylactic salpingo-oophorectomy was associated with an 80% reduction in ovarian and fallopian tube cancer risk. The residual risk for primary peritoneal cancer was 0.2% per year or 4.3% at 20 years after salpingo-oophorectomy. Most women accurately perceived their risk of breast cancer. However, the risk for ovarian cancer was overestimated, particularly by women who carry a BRCA2 mutation. Physical and mental health-related quality of life did not decrease in the year following surgery; and psychological distress was similar to levels experienced by the general population. Most women were significantly less worried about cancer after the surgery, however, a subset of women continued to experience significant cancer specific distress after prophylactic salpingo-oophorectomy. Women who underwent prophylactic salpingo-oophorectomy when premenopausal experienced a significant worsening of vasomotor symptoms and a decline in sexual functioning. Hormone replacement therapy mitigated these symptoms, but not to pre-surgical levels. Dyspareunia was somewhat alleviated by hormone replacement therapy, however, the decrease in sexual pleasure was not. Satisfaction with the decision to undergo prophylactic salpingo-oophorectomy was high regardless of these symptoms. These studies will provide women who are considering prophylactic salpingo-oophorectomy with information about the reduction in cancer risk associated with the surgery and the possible effects experienced during the year following surgery.
A Study of the Flow of Microgels in Patterned Microchannels
Keywords: microgels
microchannels
shear stress
electrostatic interactions
receptor-ligand binding
protein patterning
model cell

This work describes the results of experimental study of the flow of soft objects (microgels) through microchannels. This work was carried with the intention of building a fundamental biophysical model for the flow of neutrophil cells in microcirculatory system. In Chapter 1 we give a summary of the literature describing the flow of cells and “model cells” in microchannels. Paramount to this we developed methods to modify microchannels fabricated in poly(dimethyl siloxane) (PDMS). Originally, these microchannels could not be used to mimic biological microenvironments because they are hydrophobic and have rectangular cross-sections. We designed a method to create durable protein coatings in PDMS microchannels, as outlined in Chapter 3. Surface modification of the channels was accomplished by a two-step approach which included (i) the site-specific photografting of a layer of poly(acrylamide) (PAAm) to the PDMS surface and (ii) the bioconjugation of PAAm with the desired protein. This method is compatible with different channel geometries and it exhibits excellent longevity under shear stresses up to 1 dyn/cm. The modification was proven to be successful for various proteins of various molecular weights and does not affect protein activity. The microchannels were further modified by modifying the cross-sections in order to replicate cardiovascular flow conditions. In our work, we transformed the rectangular cross-sections into circular corss-sections. Microchannels were modified by polymerizing a liquid silicone oligomer around a gas stream coaxially introduced into the channel, as outlined in Chapter 3. We demonstrated the ability to control the diameter of circular cross-sections of microchannels. The flow behaviour of microgels in microchannels was studied in a series of experiments aimed at studying microgel flow (i) under electrostatic interactions (Chapter 4), (ii) binding of proteins attached to the microgel and the microchannel (Chapter 5) and (iii) under the conditions of varying channel geometry (Chapter 6). This work overall present’s new methods to study the flow of soft objects such as cells, in the confined geometries of microchannels. Using these methods, variables can be independently probed and analyzed.
Evolution of Urban Built Space: Markets and Decisions
Keywords: Integrated Urban Evolution Modelling, Microsimulation, Dynamics, Markets, Disequilibrium, Multidimensional Decisions Modelling

To understand the factors that influence the spatio-temporal distribution of built space, and thus population in an urban area, play an extremely important role in our greater understanding of urban travel behaviour. Existing location of activity centres, especially home and work, strongly influences the short-term individual-level decisions such as mode of transportation, and long-term household-level decisions such as change in job and residential location. Conditions in the built space market also affect households’ and firms’ location and relocation decisions, and hence influence the general travel patterns in an urban area. This research addresses two very important, but at the same time, not very widely investigated dimensions that play a key role in the evolution of built space and population distribution: Markets and Decisions. A disequilibrium based microsimulation modelling framework is developed for the built space markets. This framework is then used to operationalize the Greater Toronto and Hamilton Area’s owner-occupied housing market within Integrated Land Use Transportation and Environment (ILUTE) modelling system. Simulation results captured heterogeneity in the transaction prices, due to type of dwellings and different market conditions, in a very disaggregate fashion. On the decisions side, this research first developed a generic multidimensional modelling framework that captures the behaviour of builders in terms of the supply of new built space. The where, when, how much, and what type of supply decisions were incorporated within a single framework. This modelling framework was then applied to estimate a model for the supply of new office space in the Greater Toronto Area (GTA). Estimation results indicated a risk taker behaviour on the builders’ part, while market conditions and supply of resources (labour, construction cost etc.) were also found to be important factors in decision making. In addition to that, this research also developed a comprehensive hedonic analysis for the asking rent of office space in the Greater Toronto Area. The effects of accessibility, quality, location, and market conditions on rent were explored. Data indicated a high degree of spatial heterogeneity and clustering effects. Spatial analysis techniques were incorporated within the hedonic framework to capture these effects. Estimation results indicated that access to transport infrastructure, distance from CBD, and vacancy rate were significant in explaining the variation in the rent.
Why does Speech Understanding in Noise Decline with Age? The Contribuition of Age-related Differences in Auditory Priming, Stream Segregation, and Listening in Fluctuating Maskers
Keywords: informational masking
aging
speech perception
hearing
language comprehension

Competing speech seems to pose a greater challenge to spoken language comprehension than does competing noise, especially for older adults. The difficulties of older adults may be due to declines in auditory and cognitive processing. However, evidence suggests that the use of top-down information processing to overcome this interference may be preserved in aging. This research investigated the effect of speech- and noise masking on language comprehension, as well as age-related differences in the use of top-down processing to overcome masking. Topic I examined whether younger and older adults gain the same release from masking given a partial preview of a target sentence in quiet (auditory prime) prior to hearing the full sentence in noise, and investigated the auditory factors contributing to the advantage provided by the primes. Results showed that despite age-related declines in overall performance, younger and older listeners benefited similarly from priming. This benefit was not attributable to cues about the target talker’s voice or fluctuations in the amplitude envelope of the target sentences. Topics II and III examined the effect of speech- and noise masking on the time-course of stream segregation. The analyses revealed that stream segregation takes time to build up when a speech target is masked by other speech, but not when it is masked by noise. Subsequent analyses showed that in younger adults, the delay in segregation under speech masking was primarily due to the vocal similarities between the talkers, with interference from the semantic content of the masker playing a secondary role in impeding performance. The results also showed that older listeners were less efficient than younger listeners in segregating speech from speech-like maskers. Furthermore, older listeners benefited less than younger listeners when the amplitude envelope modulations of maskers were limited. Overall, the findings indicate that some of the language comprehension difficulties experienced by older listeners in noisy environments may be due to age-related declines in stream segregation and a decreased ability to benefit from fluctuations in the amplitude envelopes of maskers. However, benefit from priming may help offset some of these age-related declines in auditory scene analysis.