Comparative effectiveness studies to improve clinical outcomes in end stage renal disease: the DEcIDE patient outcomes in end stage renal disease study.

BACKGROUND: Evidence is lacking to inform providers' and patients' decisions about many common treatment strategies for patients with end stage renal disease (ESRD). METHODS/DESIGN: The DEcIDE Patient Outcomes in ESRD Study is funded by the United States (US) Agency for Health Care Research and Quality to study the comparative effectiveness of: 1) antihypertensive therapies, 2) early versus later initiation of dialysis, and 3) intravenous iron therapies on clinical outcomes in patients with ESRD. Ongoing studies utilize four existing, nationally representative cohorts of patients with ESRD, including (1) the Choices for Healthy Outcomes in Caring for ESRD study (1041 incident dialysis patients recruited from October 1995 to June 1999 with complete outcome ascertainment through 2009), (2) the Dialysis Clinic Inc (45,124 incident dialysis patients initiating and receiving their care from 2003-2010 with complete outcome ascertainment through 2010), (3) the United States Renal Data System (333,308 incident dialysis patients from 2006-2009 with complete outcome ascertainment through 2010), and (4) the Cleveland Clinic Foundation Chronic Kidney Disease Registry (53,399 patients with chronic kidney disease with outcome ascertainment from 2005 through 2009). We ascertain patient reported outcomes (i.e., health-related quality of life), morbidity, and mortality using clinical and administrative data, and data obtained from national death indices. We use advanced statistical methods (e.g., propensity scoring and marginal structural modeling) to account for potential biases of our study designs. All data are de-identified for analyses. The conduct of studies and dissemination of findings are guided by input from Stakeholders in the ESRD community. DISCUSSION: The DEcIDE Patient Outcomes in ESRD Study will provide needed evidence regarding the effectiveness of common treatments employed for dialysis patients. Carefully planned dissemination strategies to the ESRD community will enhance studies' impact on clinical care and patients' outcomes.

Studies in Aetiology and Historical Methodology in Herodotus

This dissertation interrogates existing scholarly paradigms regarding aetiology in the Histories of Herodotus in order to open up new avenues to approach a complex and varied topic. Since aetiology has mostly been treated as the study of cause and effect in the Histories, this work expands the purview of aetiology to include Herodotus’ explanations of origins more generally. The overarching goal in examining the methodological principles of Herodotean aetiology is to show the extent to which they resonate across the Histories according to their initial development in the proem, especially in those places that seem to deviate from the work’s driving force (i.e. the Persian Wars). Though the focus is on correlating the principles espoused in the proem with their deployment in Herodotus’ ethnographies and other seemingly divergent portions of his work, the dissertation also demonstrates the influence of these principles on some of the more “historical” aspects of the Histories where the struggle between Greeks and barbarians is concerned. The upshot is to make a novel case not only for the programmatic significance of the proem, but also for the cohesion of Herodotean methodology from cover to cover, a perennial concern for scholars of Greek history and historiography.

Chapter One illustrates how the proem to the Histories (1.1.0-1.5.3) prefigures Herodotus’ engagement with aetiological discussions throughout the Histories. Chapter Two indicates how the reading of the proem laid out in Chapter One allows for Herodotus’ deployment of aetiology in the Egyptian logos (especially where the pharaoh Psammetichus’ investigation of the origins of Egyptian language, nature, and custom are concerned) to be viewed within the methodological continuum of the Histories at large. Chapter Three connects Herodotus’ programmatic interest in the origins of erga (i.e. “works” or “achievements” manifested as monuments and deeds of abstract and concrete sorts) with the patterns addressed in Chapters One and Two. Chapter Four examines aetiological narratives in the Scythian logos and argues through them that this logos is as integral to the Histories as the analogous Egyptian logos studied in Chapter Two. Chapter Five demonstrates how the aetiologies associated with the Greeks’ collaboration with the Persians (i.e. medism) in the lead-up to the battle of Thermopylae recapitulate programmatic patterns isolated in previous chapters and thereby extend the methodological continuum of the Histories beyond the “ethnographic” logoi to some of the most representative “historical” logoi of Herodotus’ work. Chapter Six concludes the dissertation and makes one final case for methodological cohesion by showing the inextricability of the end of the Histories from its beginning.

Nowhere Landscape, for Clarinets, Trombones, Percussion, Violins, and Electronics and “The Map and the Territory: Documenting David Dunn’s Sky Drift”

1. nowhere landscape, for clarinets, trombones, percussion, violins, and electronics

nowhere landscape is an eighty-minute work for nine performers, composed of acoustic and electronic sounds. Its fifteen movements invoke a variety of listening strategies, using slow change, stasis, layering, coincidence, and silence to draw attention to the sonic effects of the environment—inside the concert hall as well as the world outside of it. The work incorporates a unique stage set-up: the audience sits in close proximity to the instruments, facing in one of four different directions, while the musicians play from a number of constantly-shifting locations, including in front of, next to, and behind the audience.

Much of nowhere landscape’s material is derived from a collection of field recordings

made by the composer during a road trip from Springfield, MA to Douglas, WY along US- 20, a cross-country route made effectively obsolete by the completion of I-90 in the mid- 20th century. In an homage to artist Ed Ruscha’s 1963 book Twentysix Gasoline Stations, the composer made twenty-six recordings at gas stations along US-20. Many of the movements of nowhere landscape examine the musical potential of these captured soundscapes: familiar and anonymous, yet filled with poignancy and poetic possibility.

2. “The Map and the Territory: Documenting David Dunn’s Sky Drift”

In 1977, David Dunn recruited twenty-six musicians to play his work Sky Drift in the

Anza-Borrego Desert in Southern California. This outdoor performance was documented with photos and recorded with four stationary microphones to tape. A year later, Dunn presented the work in New York City as a “performance/documentation,” playing back the audio recording and projecting slides. In this paper I examine the consequences of this kind of act: what does it mean for a recording of an outdoor work to be shared at an indoor concert event? Can such a complex and interactive experience be successfully flattened into some kind of re-playable documentation? What can a recording capture and what must it exclude?

This paper engages with these questions as they relate to David Dunn’s Sky Drift and to similar works by Karlheinz Stockhausen and John Luther Adams. These case-studies demonstrate different solutions to the difficulty of documenting outdoor performances. Because this music is often heard from a variety of equally-valid perspectives—and because any single microphone only captures sound from one of these perspectives—the physical set-up of these kind of pieces complicate what it means to even “hear the music” at all. To this end, I discuss issues around the “work itself” and “aura” as well as “transparency” and “liveness” in recorded sound, bringing in thoughts and ideas from Walter Benjamin, Howard Becker, Joshua Glasgow, and others. In addition, the artist Robert Irwin and the composer Barry Truax have written about the conceptual distinctions between “the work” and “not- the-work”; these distinctions are complicated by documentation and recording. Without the context, the being-there, the music is stripped of much of its ability to communicate meaning.