Mesure de la performance dans les organisations de réadaptation en déficience physique

La présente thèse vise à évaluer le degré d’implantation et d’utilisation de systèmes de mesure de la performance (SMP) par les décideurs des organisations de réadaptation et à comprendre les facteurs contextuels ayant influencé leur implantation. Pour ce faire, une étude de cas multiples a été réalisée comprenant deux sources de données: des entrevues individuelles avec des cadres supérieurs des organisations de réadaptation du Québec et des documents organisationnels. Le cadre conceptuel Consolidated Framework for Implementation Research a été utilisé pour guider la collecte et l’analyse des données. Une analyse intra-cas ainsi qu’une analyse inter-cas ont été réalisées. Nos résultats montrent que le niveau de préparation organisationnelle à l’implantation d’un SMP était élevé et que les SMP ont été implantés avec succès et utilisés de plusieurs façons. Les organisations les ont utilisés de façon passive (comme outil d’information), de façon ciblée (pour tenter d’améliorer des domaines sous-performants) et de façon politique (comme outil de négociation auprès des autorités gouvernementales). Cette utilisation diversifiée des SMP est suscitée par l’interaction complexe de facteurs provenant du contexte interne propre à chaque organisation, des caractéristiques du SMP, du processus d’implantation appliqué et du contexte externe dans lequel évoluent ces organisations. Au niveau du contexte interne, l’engagement continu et le leadership de la haute direction ont été décisifs dans l’implantation du SMP de par leur influence sur l’identification du besoin d’un SMP, l’engagement des utilisateurs visés dans le projet, la priorité organisationnelle accordée au SMP ainsi que les ressources octroyées à son implantation, la qualité des communications et le climat d’apprentissage organisationnel. Toutefois, même si certains de ces facteurs, comme les ressources octroyées à l’implantation, la priorité organisationnelle du SMP et le climat d’apprentissage se sont révélés être des barrières à l’implantation, ultimement, ces barrières n’étaient pas suffisamment importantes pour entraver l’utilisation du SMP. Cette étude a également confirmé l’importance des caractéristiques du SMP, particulièrement la perception de qualité et d’utilité de l’information. Cependant, à elles seules, ces caractéristiques sont insuffisantes pour assurer le succès d’implantation. Cette analyse d’implantation a également révélé que, même si le processus d’implantation ne suit pas des étapes formelles, un plan de développement du SMP, la participation et l’engagement des décideurs ainsi que la désignation d’un responsable de projet ont tous facilité son implantation. Cependant, l’absence d’évaluation et de réflexion collective sur le processus d’implantation a limité le potentiel d’apprentissage organisationnel, un prérequis à l’amélioration de la performance. Quant au contexte externe, le soutien d’un organisme externe s’est avéré un facilitateur indispensable pour favoriser l’implantation de SMP par les organisations de réadaptation malgré l’absence de politiques et incitatifs gouvernementaux à cet effet. Cette étude contribue à accroître les connaissances sur les facteurs contextuels ainsi que sur leurs interactions dans l’utilisation d’innovations tels les SMP et confirme l’importance d’aborder l’analyse de l’implantation avec une perspective systémique.

Can a Broader Education Narrow the Gap? Evidence on Non-Academic Features of Schooling

Empirical studies of education programs and systems, by nature, rely upon use of student outcomes that are measurable. Often, these come in the form of test scores. However, in light of growing evidence about the long-run importance of other student skills and behaviors, the time has come for a broader approach to evaluating education. This dissertation undertakes experimental, quasi-experimental, and descriptive analyses to examine social, behavioral, and health-related mechanisms of the educational process. My overarching research question is simply, which inside- and outside-the-classroom features of schools and educational interventions are most beneficial to students in the long term? Furthermore, how can we apply this evidence toward informing policy that could effectively reduce stark social, educational, and economic inequalities?

The first study of three assesses mechanisms by which the Fast Track project, a randomized intervention in the early 1990s for high-risk children in four communities (Durham, NC; Nashville, TN; rural PA; and Seattle, WA), reduced delinquency, arrests, and health and mental health service utilization in adolescence through young adulthood (ages 12-20). A decomposition of treatment effects indicates that about a third of Fast Track’s impact on later crime outcomes can be accounted for by improvements in social and self-regulation skills during childhood (ages 6-11), such as prosocial behavior, emotion regulation and problem solving. These skills proved less valuable for the prevention of mental and physical health problems.

The second study contributes new evidence on how non-instructional investments – such as increased spending on school social workers, guidance counselors, and health services – affect multiple aspects of student performance and well-being. Merging several administrative data sources spanning the 1996-2013 school years in North Carolina, I use an instrumental variables approach to estimate the extent to which local expenditure shifts affect students’ academic and behavioral outcomes. My findings indicate that exogenous increases in spending on non-instructional services not only reduce student absenteeism and disciplinary problems (important predictors of long-term outcomes) but also significantly raise student achievement, in similar magnitude to corresponding increases in instructional spending. Furthermore, subgroup analyses suggest that investments in student support personnel such as social workers, health services, and guidance counselors, in schools with concentrated low-income student populations could go a long way toward closing socioeconomic achievement gaps.

The third study examines individual pathways that lead to high school graduation or dropout. It employs a variety of machine learning techniques, including decision trees, random forests with bagging and boosting, and support vector machines, to predict student dropout using longitudinal administrative data from North Carolina. I consider a large set of predictor measures from grades three through eight including academic achievement, behavioral indicators, and background characteristics. My findings indicate that the most important predictors include eighth grade absences, math scores, and age-for-grade as well as early reading scores. Support vector classification (with a high cost parameter and low gamma parameter) predicts high school dropout with the highest overall validity in the testing dataset at 90.1 percent followed by decision trees with boosting and interaction terms at 89.5 percent.

Geochemistry of surface sediment cores (Table 4)

The mineralogy and geochemistry of a suite of nine manganese nodules from the South Atlantic have been determined. The Ce/La ratios of the nodules were investigated to see if they could be used as redox indicators to trace the oxygen content of the ambient water mass and the flow path of the Antarctic Bottom Water as has previously been successfully carried out in the Pacific Ocean. The Ce/La ratios of the nodules decrease in the sequence Lazarev Sea, Weddell Sea (10.4 and 9.7)>East Georgia Basin (6.5 and 7.1)>Argentine Basin (5.0), but then increase in the Brazil Basin (6.2) and Angola Basin (9.8 and 15.1). A further decrease was observed in the Cape Basin (7.6). An extremely high Ce/La ratio of 24.4 had already been determined for nodules sampled north of the Nares Abyssal Plain in the western North Atlantic. These data reflect the more complicated pattern of bottom water flow in the South Atlantic than in the South Pacific. The penetration of more oxygenated North Atlantic Deep Water into the South Atlantic accounts for the higher Ce/La ratios in the nodules from the Angola and Brazil basins. Based on this study, the flow path of the Antarctic Bottom Water could only be traced as far north as the Argentine Basin. The unique geochemistry of nodules from the central Angola Basin (high Mn/Fe and Ce/La ratios, high contents of Ni, Cu, Zn and Mo) appears to be a function of the nature of the overlying water mass and of the multiple diagenetic sources of metals to the nodules.

Seawater carbonate chemistry and calcification rate of eastern oyster Crassostrea virginica, 2011

Anthropogenic carbon dioxide (CO2) emissions reduce pH of marine waters due to the absorption of atmospheric CO2 and formation of carbonic acid. Estuarine waters are more susceptible to acidification because they are subject to multiple acid sources and are less buffered than marine waters. Consequently, estuarine shell forming species may experience acidification sooner than marine species although the tolerance of estuarine calcifiers to pH changes is poorly understood. We analyzed 23 years of Chesapeake Bay water quality monitoring data and found that daytime average pH significantly decreased across polyhaline waters although pH has not significantly changed across mesohaline waters. In some tributaries that once supported large oyster populations, pH is increasing. Current average conditions within some tributaries however correspond to values that we found in laboratory studies to reduce oyster biocalcification rates or resulted in net shell dissolution. Calcification rates of juvenile eastern oysters, Crassostrea virginica, were measured in laboratory studies in a three-way factorial design with 3 pH levels, two salinities, and two temperatures. Biocalcification declined significantly with a reduction of ~0.5 pH units and higher temperature and salinity mitigated the decrease in biocalcification.

(Table T4) Final depth vs. velocity and two-way traveltime data, ODP Site 178-1103

Site 1103 was one of a transect of three sites drilled across the Antarctic Peninsula continental shelf during Leg 178. The aim of drilling on the shelf was to determine the age of the sedimentary sequences and to ground truth previous interpretations of the depositional environment (i.e., topsets and foresets) of progradational seismostratigraphic sequences S1, S2, S3, and S4. The ultimate objective was to obtain a better understanding of the history of glacial advances and retreats in this west Antarctic margin. Drilling the topsets of the progradational wedge (0-247 m below seafloor [mbsf]), which consist of unsorted and unconsolidated materials of seismic Unit S1, was very unfavorable, resulting in very low (2.3%) core recovery. Recovery improved (34%) below 247 mbsf, corresponding to sediments of seismic Unit S3, which have a consolidated matrix. Logs were only obtained from the interval between 75 and 244 mbsf, and inconsistencies on the automatic analog picking of the signals received from the sonic log at the array and at the two other receivers prevented accurate shipboard time-depth conversions. This, in turn, limited the capacity for making seismic stratigraphic interpretations at this site and regionally. This study is an attempt to compile all available data sources, perform quality checks, and introduce nonstandard processing techniques for the logging data obtained to arrive at a reliable and continuous depth vs. velocity profile. We defined 13 data categories using differential traveltime information. Polynomial exclusion techniques with various orders and low-pass filtering reduced the noise of the initial data pool and produced a definite velocity depth profile that is synchronous with the resistivity logging data. A comparison of the velocity profile produced with various other logs of Site 1103 further validates the presented data. All major logging units are expressed within the new velocity data. A depth-migrated section with the new velocity data is presented together with the original time section and initial depth estimates published within the Leg 178 Initial Reports volume. The presented data confirms the location of the shelf unconformity at 222 ms two-way traveltime (TWT), or 243 mbsf, and allows its seismic identification as a strong negative and subsequent positive reflection.

UNDERSTANDING ESSAY RATING AS A SOCIALLY MEDIATED ACTIVITY: THE CASE OF A HIGH-STAKES ENGLISH TEST IN CHINA

Most essay rating research in language assessment has examined human raters’ essay rating as a cognitive process, thus overlooking or oversimplifying the interaction between raters and sociocultural contexts. Given that raters are social beings, their practices have social meanings and consequences. Hence it is important to situate essay rating within its sociocultural context for a more meaningful understanding. Drawing on Engeström’s (1987, 2001) cultural-historical activity theory (CHAT) framework with a sociocultural perspective, this study reconceptualized essay rating as a socially mediated activity with both cognitive (individual raters’ goal-directed decision-making actions) and social layers (raters’ collective object-oriented essay rating activity at related settings). In particular, this study explored raters’ essay rating at one provincial rating centre in China within the context of a high-stakes university entrance examination, the National Matriculation English Test (NMET). This study adopted a multiple-method multiple-perspective qualitative case study design. Think-aloud protocols, stimulated recalls, interviews, and documents served as the data sources. This investigation involved 25 participants at two settings (rating centre and high schools), including rating centre directors, team leaders, NMET essay raters who were high school teachers, and school principals and teaching colleagues of these essay raters. Data were analyzed using Strauss and Corbin’s (1990) open and axial coding techniques, and CHAT for data integration. The findings revealed the interaction between raters and the NMET sociocultural context. Such interaction can be understood through a surface structure (cognitive layer) and a deep structure (social layer) concerning how raters assessed NMET essays, where the surface structure reflected the “what” and the deep structure explained the “how” and “why” in raters’ decision-making. This study highlighted the roles of goals and rules in rater decision-making, rating tensions and raters’ solutions, and the relationship between essay rating and teaching. This study highlights the value of a sociocultural view to essay rating research, demonstrates CHAT as a sociocultural approach to investigate essay rating, and proposes a direction for future washback research on the effect of essay rating. This study also provides support for NMET rating practices that can potentially bring positive washback to English teaching in Chinese high schools.

Professional development of teacher-educators towards transformative learning

This study explores the specific characteristics of teacher-educator professional development interventions that enhance their transformative learning towards stimulating the inquiry-based attitude of students. An educational design research method was followed. Firstly, in partnership with five experienced educators, a professional development programme was designed, tested and redesigned. Secondly, a qualitative multiple case study was conducted to examine the active ingredients of the designed interventions with regard to educators changes in beliefs and behaviour. The study was carried out in four different educational settings in which 20 educators participated during nine months. Data sources included videos, questionnaires, interviews and written personal theories of practice. The analyses indicated that aligned self-study interventions on a personal, peer and group level guided by a trained facilitator supported the intended leaning.

Sepsis: the LightCycler SeptiFast Test MGRADE®, SepsiTest™ and IRIDICA BAC BSI assay for rapidly identifying bloodstream bacteria and fungi – a systematic review and economic evaluation

Background: Sepsis can lead to multiple organ failure and death. Timely and appropriate treatment can reduce in-hospital mortality and morbidity. Objectives: To determine the clinical effectiveness and cost-effectiveness of three tests [LightCycler SeptiFast Test MGRADE® (Roche Diagnostics, Risch-Rotkreuz, Switzerland); SepsiTest™ (Molzym Molecular Diagnostics, Bremen, Germany); and the IRIDICA BAC BSI assay (Abbott Diagnostics, Lake Forest, IL, USA)] for the rapid identification of bloodstream bacteria and fungi in patients with suspected sepsis compared with standard practice (blood culture with or without matrix-absorbed laser desorption/ionisation time-offlight mass spectrometry). Data sources: Thirteen electronic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched from January 2006 to May 2015 and supplemented by hand-searching relevant articles. Review methods: A systematic review and meta-analysis of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. A decision tree was used to estimate the costs and quality-adjusted life-years (QALYs) associated with each test; all other parameters were estimated from published sources. The model was populated with evidence from the systematic review or individual studies, if this was considered more appropriate (base case 1). In a secondary analysis, estimates (based on experience and opinion) from seven clinicians regarding the benefits of earlier test results were sought (base case 2). A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Scenario analyses were used to assess uncertainty. Results: For the review of diagnostic test accuracy, 62 studies of varying methodological quality were included. A meta-analysis of 54 studies comparing SeptiFast with blood culture found that SeptiFast had an estimated summary specificity of 0.86 [95% credible interval (CrI) 0.84 to 0.89] and sensitivity of 0.65 (95% CrI 0.60 to 0.71). Four studies comparing SepsiTest with blood culture found that SepsiTest had an estimated summary specificity of 0.86 (95% CrI 0.78 to 0.92) and sensitivity of 0.48 (95% CrI 0.21 to 0.74), and four studies comparing IRIDICA with blood culture found that IRIDICA had an estimated summary specificity of 0.84 (95% CrI 0.71 to 0.92) and sensitivity of 0.81 (95% CrI 0.69 to 0.90). Owing to the deficiencies in study quality for all interventions, diagnostic accuracy data should be treated with caution. No randomised clinical trial evidence was identified that indicated that any of the tests significantly improved key patient outcomes, such as mortality or duration in an intensive care unit or hospital. Base case 1 estimated that none of the three tests provided a benefit to patients compared with standard practice and thus all tests were dominated. In contrast, in base case 2 it was estimated that all cost per QALY-gained values were below £20,000; the IRIDICA BAC BSI assay had the highest estimated incremental net benefit, but results from base case 2 should be treated with caution as these are not evidence based. Limitations: Robust data to accurately assess the clinical effectiveness and cost-effectiveness of the interventions are currently unavailable. Conclusions: The clinical effectiveness and cost-effectiveness of the interventions cannot be reliably determined with the current evidence base. Appropriate studies, which allow information from the tests to be implemented in clinical practice, are required.

A Data Driven Tool supported CLD Creation Approach

The creation of Causal Loop Diagrams (CLDs) is a major phase in the System Dynamics (SD) life-cycle, since the created CLDs express dependencies and feedback in the system under study, as well as, guide modellers in building meaningful simulation models. The cre-ation of CLDs is still subject to the modeller's domain expertise (mental model) and her ability to abstract the system, because of the strong de-pendency on semantic knowledge. Since the beginning of SD, available system data sources (written and numerical models) have always been sparsely available, very limited and imperfect and thus of little benefit to the whole modelling process. However, in recent years, we have seen an explosion in generated data, especially in all business related domains that are analysed via Business Dynamics (BD). In this paper, we intro-duce a systematic tool supported CLD creation approach, which analyses and utilises available disparate data sources within the business domain. We demonstrate the application of our methodology on a given business use-case and evaluate the resulting CLD. Finally, we propose directions for future research to further push the automation in the CLD creation and increase confidence in the generated CLDs.

Identifying health inequalities in individuals with major mental illness (MMI) using routine data

Abstract and Summary of Thesis: Background: Individuals with Major Mental Illness (such as schizophrenia and bipolar disorder) experience increased rates of physical health comorbidity compared to the general population. They also experience inequalities in access to certain aspects of healthcare. This ultimately leads to premature mortality. Studies detailing patterns of physical health comorbidity are limited by their definitions of comorbidity, single disease approach to comorbidity and by the study of heterogeneous groups. To date the investigation of possible sources of healthcare inequalities experienced by individuals with Major Mental Illness (MMI) is relatively limited. Moreover studies detailing the extent of premature mortality experienced by individuals with MMI vary both in terms of the measure of premature mortality reported and age of the cohort investigated, limiting their generalisability to the wider population. Therefore local and national data can be used to describe patterns of physical health comorbidity, investigate possible reasons for health inequalities and describe mortality rates. These findings will extend existing work in this area. Aims and Objectives: To review the relevant literature regarding: patterns of physical health comorbidity, evidence for inequalities in physical healthcare and evidence for premature mortality for individuals with MMI. To examine the rates of physical health comorbidity in a large primary care database and to assess for evidence for inequalities in access to healthcare using both routine primary care prescribing data and incentivised national Quality and Outcome Framework (QOF) data. Finally to examine the rates of premature mortality in a local context with a particular focus on cause of death across the lifespan and effect of International Classification of Disease Version 10 (ICD 10) diagnosis and socioeconomic status on rates and cause of death. Methods: A narrative review of the literature surrounding patterns of physical health comorbidity, the evidence for inequalities in physical healthcare and premature mortality in MMI was undertaken. Rates of physical health comorbidity and multimorbidity in schizophrenia and bipolar disorder were examined using a large primary care dataset (Scottish Programme for Improving Clinical Effectiveness in Primary Care (SPICE)). Possible inequalities in access to healthcare were investigated by comparing patterns of prescribing in individuals with MMI and comorbid physical health conditions with prescribing rates in individuals with physical health conditions without MMI using SPICE data. Potential inequalities in access to health promotion advice (in the form of smoking cessation) and prescribing of Nicotine Replacement Therapy (NRT) were also investigated using SPICE data. Possible inequalities in access to incentivised primary healthcare were investigated using National Quality and Outcome Framework (QOF) data. Finally a pre-existing case register (Glasgow Psychosis Clinical Information System (PsyCIS)) was linked to Scottish Mortality data (available from the Scottish Government Website) to investigate rates and primary cause of death in individuals with MMI. Rate and primary cause of death were compared to the local population and impact of age, socioeconomic status and ICD 10 diagnosis (schizophrenia vs. bipolar disorder) were investigated. Results: Analysis of the SPICE data found that sixteen out of the thirty two common physical comorbidities assessed, occurred significantly more frequently in individuals with schizophrenia. In individuals with bipolar disorder fourteen occurred more frequently. The most prevalent chronic physical health conditions in individuals with schizophrenia and bipolar disorder were: viral hepatitis (Odds Ratios (OR) 3.99 95% Confidence Interval (CI) 2.82-5.64 and OR 5.90 95% CI 3.16-11.03 respectively), constipation (OR 3.24 95% CI 3.01-3.49 and OR 2.84 95% CI 2.47-3.26 respectively) and Parkinson’s disease (OR 3.07 95% CI 2.43-3.89 and OR 2.52 95% CI 1.60-3.97 respectively). Both groups had significantly increased rates of multimorbidity compared to controls: in the schizophrenia group OR for two comorbidities was 1.37 95% CI 1.29-1.45 and in the bipolar disorder group OR was 1.34 95% CI 1.20-1.49. In the studies investigating inequalities in access to healthcare there was evidence of: under-recording of cardiovascular-related conditions for example in individuals with schizophrenia: OR for Atrial Fibrillation (AF) was 0.62 95% CI 0.52 - 0.73, for hypertension 0.71 95% CI 0.67 - 0.76, for Coronary Heart Disease (CHD) 0.76 95% CI 0.69 - 0.83 and for peripheral vascular disease (PVD) 0.83 95% CI 0.72 - 0.97. Similarly in individuals with bipolar disorder OR for AF was 0.56 95% CI 0.41-0.78, for hypertension 0.69 95% CI 0.62 - 0.77 and for CHD 0.77 95% CI 0.66 - 0.91. There was also evidence of less intensive prescribing for individuals with schizophrenia and bipolar disorder who had comorbid hypertension and CHD compared to individuals with hypertension and CHD who did not have schizophrenia or bipolar disorder. Rate of prescribing of statins for individuals with schizophrenia and CHD occurred significantly less frequently than in individuals with CHD without MMI (OR 0.67 95% CI 0.56-0.80). Rates of prescribing of 2 or more anti-hypertensives were lower in individuals with CHD and schizophrenia and CHD and bipolar disorder compared to individuals with CHD without MMI (OR 0.66 95% CI 0.56-0.78 and OR 0.55 95% CI 0.46-0.67, respectively). Smoking was more common in individuals with MMI compared to individuals without MMI (OR 2.53 95% CI 2.44-2.63) and was particularly increased in men (OR 2.83 95% CI 2.68-2.98). Rates of ex-smoking and non-smoking were lower in individuals with MMI (OR 0.79 95% CI 0.75-0.83 and OR 0.50 95% CI 0.48-0.52 respectively). However recorded rates of smoking cessation advice in smokers with MMI were significantly lower than the recorded rates of smoking cessation advice in smokers with diabetes (88.7% vs. 98.0%, p<0.001), smokers with CHD (88.9% vs. 98.7%, p<0.001) and smokers with hypertension (88.3% vs. 98.5%, p<0.001) without MMI. The odds ratio of NRT prescription was also significantly lower in smokers with MMI without diabetes compared to smokers with diabetes without MMI (OR 0.75 95% CI 0.69-0.81). Similar findings were found for smokers with MMI without CHD compared to smokers with CHD without MMI (OR 0.34 95% CI 0.31-0.38) and smokers with MMI without hypertension compared to smokers with hypertension without MMI (OR 0.71 95% CI 0.66-0.76). At a national level, payment and population achievement rates for the recording of body mass index (BMI) in MMI was significantly lower than the payment and population achievement rates for BMI recording in diabetes throughout the whole of the UK combined: payment rate 92.7% (Inter Quartile Range (IQR) 89.3-95.8 vs. 95.5% IQR 93.3-97.2, p<0.001 and population achievement rate 84.0% IQR 76.3-90.0 vs. 92.5% IQR 89.7-94.9, p<0.001 and for each country individually: for example in Scotland payment rate was 94.0% IQR 91.4-97.2 vs. 96.3% IQR 94.3-97.8, p<0.001. Exception rate was significantly higher for the recording of BMI in MMI than the exception rate for BMI recording in diabetes for the UK combined: 7.4% IQR 3.3-15.9 vs. 2.3% IQR 0.9-4.7, p<0.001 and for each country individually. For example in Scotland exception rate in MMI was 11.8% IQR 5.4-19.3 compared to 3.5% IQR 1.9-6.1 in diabetes. Similar findings were found for Blood Pressure (BP) recording: across the whole of the UK payment and population achievement rates for BP recording in MMI were also significantly reduced compared to payment and population achievement rates for the recording of BP in chronic kidney disease (CKD): payment rate: 94.1% IQR 90.9-97.1 vs.97.8% IQR 96.3-98.9 and p<0.001 and population achievement rate 87.0% IQR 81.3-91.7 vs. 97.1% IQR 95.5-98.4, p<0.001. Exception rates again were significantly higher for the recording of BP in MMI compared to CKD (6.4% IQR 3.0-13.1 vs. 0.3% IQR 0.0-1.0, p<0.001). There was also evidence of differences in rates of recording of BMI and BP in MMI across the UK. BMI and BP recording in MMI were significantly lower in Scotland compared to England (BMI:-1.5% 99% CI -2.7 to -0.3%, p<0.001 and BP: -1.8% 99% CI -2.7 to -0.9%, p<0.001). While rates of BMI and BP recording in diabetes and CKD were similar in Scotland compared to England (BMI: -0.5 99% CI -1.0 to 0.05, p=0.004 and BP: 0.02 99% CI -0.2 to 0.3, p=0.797). Data from the PsyCIS cohort showed an increase in Standardised Mortality Ratios (SMR) across the lifespan for individuals with MMI compared to the local Glasgow and wider Scottish populations (Glasgow SMR 1.8 95% CI 1.6-2.0 and Scotland SMR 2.7 95% CI 2.4-3.1). Increasing socioeconomic deprivation was associated with an increased overall rate of death in MMI (350.3 deaths/10,000 population/5 years in the least deprived quintile compared to 794.6 deaths/10,000 population/5 years in the most deprived quintile). No significant difference in rate of death for individuals with schizophrenia compared with bipolar disorder was reported (6.3% vs. 4.9%, p=0.086), but primary cause of death varied: with higher rates of suicide in individuals with bipolar disorder (22.4% vs. 11.7%, p=0.04). Discussion: Local and national datasets can be used for epidemiological study to inform local practice and complement existing national and international studies. While the strengths of this thesis include the large data sets used and therefore their likely representativeness to the wider population, some limitations largely associated with using secondary data sources are acknowledged. While this thesis has confirmed evidence of increased physical health comorbidity and multimorbidity in individuals with MMI, it is likely that these findings represent a significant under reporting and likely under recognition of physical health comorbidity in this population. This is likely due to a combination of patient, health professional and healthcare system factors and requires further investigation. Moreover, evidence of inequality in access to healthcare in terms of: physical health promotion (namely smoking cessation advice), recording of physical health indices (BMI and BP), prescribing of medications for the treatment of physical illness and prescribing of NRT has been found at a national level. While significant premature mortality in individuals with MMI within a Scottish setting has been confirmed, more work is required to further detail and investigate the impact of socioeconomic deprivation on cause and rate of death in this population. It is clear that further education and training is required for all healthcare staff to improve the recognition, diagnosis and treatment of physical health problems in this population with the aim of addressing the significant premature mortality that is seen. Conclusions: Future work lies in the challenge of designing strategies to reduce health inequalities and narrow the gap in premature mortality reported in individuals with MMI. Models of care that allow a much more integrated approach to diagnosing, monitoring and treating both the physical and mental health of individuals with MMI, particularly in areas of social and economic deprivation may be helpful. Strategies to engage this “hard to reach” population also need to be developed. While greater integration of psychiatric services with primary care and with specialist medical services is clearly vital the evidence on how best to achieve this is limited. While the National Health Service (NHS) is currently undergoing major reform, attention needs to be paid to designing better ways to improve the current disconnect between primary and secondary care. This should then help to improve physical, psychological and social outcomes for individuals with MMI.

Nineteenth century narratives reveal historic catch rates for Australian snapper (Pagrus auratus)

Snapper (Pagrus auratus) is widely distributed throughout subtropical and temperate southern oceans and forms a significant recreational and commercial fishery in Queensland, Australia. Using data from government reports, media sources, popular publications and a government fisheries survey carried out in 1910, we compiled information on individual snapper fishing trips that took place prior to the commencement of fisherywide organized data collection, from 1871 to 1939. In addition to extracting all available quantitative data, we translated qualitative information into bounded estimates and used multiple imputation to handle missing values, forming 287 records for which catch rate (snapper fisher−1 h−1) could be derived. Uncertainty was handled through a parametric maximum likelihood framework (a transformed trivariate Gaussian), which facilitated statistical comparisons between data sources. No statistically significant differences in catch rates were found among media sources and the government fisheries survey. Catch rates remained stable throughout the time series, averaging 3.75 snapper fisher−1 h−1 (95% confidence interval, 3.42–4.09) as the fishery expanded into new grounds. In comparison, a contemporary (1993–2002) south-east Queensland charter fishery produced an average catch rate of 0.4 snapper fisher−1 h−1 (95% confidence interval, 0.31–0.58). These data illustrate the productivity of a fishery during its earliest years of development and represent the earliest catch rate data globally for this species. By adopting a formalized approach to address issues common to many historical records – missing data, a lack of quantitative information and reporting bias – our analysis demonstrates the potential for historical narratives to contribute to contemporary fisheries management.

Dempster-Shafer for Anomaly Detection

In this paper, we implement an anomaly detection system using the Dempster-Shafer method. Using two standard benchmark problems we show that by combining multiple signals it is possible to achieve better results than by using a single signal. We further show that by applying this approach to a real-world email dataset the algorithm works for email worm detection. Dempster-Shafer can be a promising method for anomaly detection problems with multiple features (data sources), and two or more classes.

Data warehouse para el Centro de Documentación Regional "Juan Bautista Vázquez"

El proceso de toma de decisiones en las bibliotecas universitarias es de suma importancia, sin embargo, se encuentra complicaciones como la gran cantidad de fuentes de datos y los grandes volúmenes de datos a analizar. Las bibliotecas universitarias están acostumbradas a producir y recopilar una gran cantidad de información sobre sus datos y servicios. Las fuentes de datos comunes son el resultado de sistemas internos, portales y catálogos en línea, evaluaciones de calidad y encuestas. Desafortunadamente estas fuentes de datos sólo se utilizan parcialmente para la toma de decisiones debido a la amplia variedad de formatos y estándares, así como la falta de métodos eficientes y herramientas de integración. Este proyecto de tesis presenta el análisis, diseño e implementación del Data Warehouse, que es un sistema integrado de toma de decisiones para el Centro de Documentación Juan Bautista Vázquez. En primer lugar se presenta los requerimientos y el análisis de los datos en base a una metodología, esta metodología incorpora elementos claves incluyendo el análisis de procesos, la calidad estimada, la información relevante y la interacción con el usuario que influyen en una decisión bibliotecaria. A continuación, se propone la arquitectura y el diseño del Data Warehouse y su respectiva implementación la misma que soporta la integración, procesamiento y el almacenamiento de datos. Finalmente los datos almacenados se analizan a través de herramientas de procesamiento analítico y la aplicación de técnicas de Bibliomining ayudando a los administradores del centro de documentación a tomar decisiones óptimas sobre sus recursos y servicios.

Diseño e implementación de un sistema de soporte de decisiones para el Centro de Documentación Regional “Juan Bautista Vázquez”

El volumen de datos en bibliotecas ha aumentado enormemente en los últimos años, así como también la complejidad de sus fuentes y formatos de información, dificultando su gestión y acceso, especialmente como apoyo en la toma de decisiones. Sabiendo que una buena gestión de bibliotecas involucra la integración de indicadores estratégicos, la implementación de un Data Warehouse (DW), que gestione adecuadamente tal cantidad de información, así como su compleja mezcla de fuentes de datos, se convierte en una alternativa interesante a considerar. El artículo describe el diseño e implementación de un sistema de soporte de decisiones (DSS) basado en técnicas de DW para la biblioteca de la Universidad de Cuenca. Para esto, el estudio utiliza una metodología holística, propuesto por Siguenza-Guzman et al. (2014) para la evaluación integral de bibliotecas. Dicha metodología evalúa la colección y los servicios, incorporando importantes elementos para la gestión de bibliotecas, tales como: el desempeño de los servicios, el control de calidad, el uso de la colección y la interacción con el usuario. A partir de este análisis, se propone una arquitectura de DW que integra, procesa y almacena los datos. Finalmente, estos datos almacenados son analizados y visualizados a través de herramientas de procesamiento analítico en línea (OLAP). Las pruebas iniciales de implementación confirman la viabilidad y eficacia del enfoque propuesto, al integrar con éxito múltiples y heterogéneas fuentes y formatos de datos, facilitando que los directores de bibliotecas generen informes personalizados, e incluso permitiendo madurar los procesos transaccionales que diariamente se llevan a cabo.

Optimal resource allocation and budgeting in libraries

Libraries since their inception 4000 years ago have been in a process of constant change. Although, changes were in slow motion for centuries, in the last decades, academic libraries have been continuously striving to adapt their services to the ever-changing user needs of students and academic staff. In addition, e-content revolution, technological advances, and ever-shrinking budgets have obliged libraries to efficiently allocate their limited resources among collection and services. Unfortunately, this resource allocation is a complex process due to the diversity of data sources and formats required to be analyzed prior to decision-making, as well as the lack of efficient integration methods. The main purpose of this study is to develop an integrated model that supports libraries in making optimal budgeting and resource allocation decisions among their services and collection by means of a holistic analysis. To this end, a combination of several methodologies and structured approaches is conducted. Firstly, a holistic structure and the required toolset to holistically assess academic libraries are proposed to collect and organize the data from an economic point of view. A four-pronged theoretical framework is used in which the library system and collection are analyzed from the perspective of users and internal stakeholders. The first quadrant corresponds to the internal perspective of the library system that is to analyze the library performance, and costs incurred and resources consumed by library services. The second quadrant evaluates the external perspective of the library system; user’s perception about services quality is judged in this quadrant. The third quadrant analyses the external perspective of the library collection that is to evaluate the impact of the current library collection on its users. Eventually, the fourth quadrant evaluates the internal perspective of the library collection; the usage patterns followed to manipulate the library collection are analyzed. With a complete framework for data collection, these data coming from multiple sources and therefore with different formats, need to be integrated and stored in an adequate scheme for decision support. A data warehousing approach is secondly designed and implemented to integrate, process, and store the holistic-based collected data. Ultimately, strategic data stored in the data warehouse are analyzed and implemented for different purposes including the following: 1) Data visualization and reporting is proposed to allow library managers to publish library indicators in a simple and quick manner by using online reporting tools. 2) Sophisticated data analysis is recommended through the use of data mining tools; three data mining techniques are examined in this research study: regression, clustering and classification. These data mining techniques have been applied to the case study in the following manner: predicting the future investment in library development; finding clusters of users that share common interests and similar profiles, but belong to different faculties; and predicting library factors that affect student academic performance by analyzing possible correlations of library usage and academic performance. 3) Input for optimization models, early experiences of developing an optimal resource allocation model to distribute resources among the different processes of a library system are documented in this study. Specifically, the problem of allocating funds for digital collection among divisions of an academic library is addressed. An optimization model for the problem is defined with the objective of maximizing the usage of the digital collection over-all library divisions subject to a single collection budget. By proposing this holistic approach, the research study contributes to knowledge by providing an integrated solution to assist library managers to make economic decisions based on an “as realistic as possible” perspective of the library situation.