Performance tiers: Implementing comparative effectiveness analysis in the health care setting through operations research and spatial methods

This dissertation develops and tests a comparative effectiveness methodology utilizing a novel approach to the application of Data Envelopment Analysis (DEA) in health studies. The concept of performance tiers (PerT) is introduced as terminology to express a relative risk class for individuals within a peer group and the PerT calculation is implemented with operations research (DEA) and spatial algorithms. The analysis results in the discrimination of the individual data observations into a relative risk classification by the DEA-PerT methodology. The performance of two distance measures, kNN (k-nearest neighbor) and Mahalanobis, was subsequently tested to classify new entrants into the appropriate tier. The methods were applied to subject data for the 14 year old cohort in the Project HeartBeat! study.^ The concepts presented herein represent a paradigm shift in the potential for public health applications to identify and respond to individual health status. The resultant classification scheme provides descriptive, and potentially prescriptive, guidance to assess and implement treatments and strategies to improve the delivery and performance of health systems. ^

The Relationship of Provincial Economic Level and Child Injury Mortality in Thailand: A Cross-Sectional Analysis in a Middle Income Country

The objective of this cross-sectional study was to examine the relationship of provincial economic development indices with incidences of child injury mortality in Thailand from 1999 - 2001. All injury deaths among children age 1-14 years were included. The independent variables included gross provincial product per capita (GPP/c), poverty and inequality indices, material and social deprivation indices, population in rural/ urban areas, and migration. Due to multicollinearity of such variables, the 76 provinces were categorized by GPP/c quartile, and means of overall injury, drowning, and transport-related mortality rates were compared among quartile groups. Spearman’s rho correlation between GPP/c and injury mortality rates was also performed. Finally, factor analysis was employed to create a set of factors to be treated as uncorrelated variables and stepwise multiple regression was carried out for the effects of the factors on injury mortality rates. A significant direct relationship was observed between GPP/c and overall injury mortality among children age 1-4 years, and 10-14 year-olds of both genders. Drowning was the main cause of this relationship among children age 1-4 years, and transport-related injury was the principle cause among children age 10-14 years. Conversely, provinces with lower GPP/c experienced higher injury mortality rates among school-age children 5-9 years old for both genders, mostly due to drowning. Factor analysis, and multiple regression results confirmed the relationships between economic development and injury mortality rates. These findings revealed that economic development had an adverse impact on injury-related mortality among children 1 to 4 and 10 to14 in Thailand.

Scientific Production on Open Access : A Worldwide Bibliometric Analysis in the Academic and Scientific Context

This research aims to diachronically analyze the worldwide scientific production on open access, in the academic and scientific context, in order to contribute to knowledge and visualization of its main actors. As a method, bibliographical, descriptive and analytical research was used, with the contribution of bibliometric studies, especially the production indicators, scientific collaboration and indicators of thematic co-occurrence. The Scopus database was used as a source to retrieve the articles on the subject, with a resulting corpus of 1179 articles. Using Bibexcel software, frequency tables were constructed for the variables, and Pajek software was used to visualize the collaboration network and VoSViewer for the construction of the keywords' network. As for the results, the most productive researchers come from countries such as the United States, Canada, France and Spain. Journals with higher impact in the academic community have disseminated the new constructed knowledge. A collaborative network with a few subnets where co-authors are from different countries has been observed. As conclusions, this study allows identifying the themes of debates that mark the development of open access at the international level, and it is possible to state that open access is one of the new emerging and frontier fields of library and information science

Scientific Production on Open Access : A Worldwide Bibliometric Analysis in the Academic and Scientific Context

This research aims to diachronically analyze the worldwide scientific production on open access, in the academic and scientific context, in order to contribute to knowledge and visualization of its main actors. As a method, bibliographical, descriptive and analytical research was used, with the contribution of bibliometric studies, especially the production indicators, scientific collaboration and indicators of thematic co-occurrence. The Scopus database was used as a source to retrieve the articles on the subject, with a resulting corpus of 1179 articles. Using Bibexcel software, frequency tables were constructed for the variables, and Pajek software was used to visualize the collaboration network and VoSViewer for the construction of the keywords' network. As for the results, the most productive researchers come from countries such as the United States, Canada, France and Spain. Journals with higher impact in the academic community have disseminated the new constructed knowledge. A collaborative network with a few subnets where co-authors are from different countries has been observed. As conclusions, this study allows identifying the themes of debates that mark the development of open access at the international level, and it is possible to state that open access is one of the new emerging and frontier fields of library and information science

Scientific Production on Open Access : A Worldwide Bibliometric Analysis in the Academic and Scientific Context

This research aims to diachronically analyze the worldwide scientific production on open access, in the academic and scientific context, in order to contribute to knowledge and visualization of its main actors. As a method, bibliographical, descriptive and analytical research was used, with the contribution of bibliometric studies, especially the production indicators, scientific collaboration and indicators of thematic co-occurrence. The Scopus database was used as a source to retrieve the articles on the subject, with a resulting corpus of 1179 articles. Using Bibexcel software, frequency tables were constructed for the variables, and Pajek software was used to visualize the collaboration network and VoSViewer for the construction of the keywords' network. As for the results, the most productive researchers come from countries such as the United States, Canada, France and Spain. Journals with higher impact in the academic community have disseminated the new constructed knowledge. A collaborative network with a few subnets where co-authors are from different countries has been observed. As conclusions, this study allows identifying the themes of debates that mark the development of open access at the international level, and it is possible to state that open access is one of the new emerging and frontier fields of library and information science

Geochemical processes and rare earth element analysis in cold-seep pore waters of Hydrate Ridge, northeast Pacific Ocean

The concentrations of rare earth elements (REEs), sulphate, hydrogen sulphide, total alkalinity, calcium, magnesium and phosphate were measured in shallow (<12 cm below seafloor) pore waters from cold-seep sediments on the northern and southern summits of Hydrate Ridge, offshore Oregon. Downward-decreasing sulphate and coevally increasing sulphide concentrations reveal sulphate reductionas dominant early diagenetic process from ~2 cm depth downwards. A strong increase of total dissolved REE concentrations is evident immediately below the sediment-water interface, which can be related to early diagenetic release of REEs into pore water resulting from the remineralization of particulate organic matter. The highest pore water REE concentrations were measured close to the sediment-water interface at ~2 cm depth. Distinct shale normalized REE patterns point to particulate organic matter and iron oxides as main REE sources in the upper ~2-cm depth interval. In general, the pore waters have shalenormalized patterns reflecting heavy REE (HREE) enrichment, which suggests preferential complexation of HREEs with carbonate ions. Below ~2 cm depth, a downward decrease in REE correlates with a decrease in pore water calcium concentrations. At this depth, the anaerobic oxidation of methane (AOM) coupled to sulphate reduction increases carbonate alkalinity through the production of bicarbonate, which results in the precipitation of carbonate minerals. It seems therefore likely that the REEs and calcium are consumed during vast AOM-induced precipitation of carbonate in shallow Hydrate Ridge sediments. The analysis of pore waters from Hydrate Ridge shed new light on early diagenetic processes at cold seeps, corroborating the great potential of REEs to identify geochemical processes and to constrain environmental conditions.

Methanol and ethanol analysis in marine sediment pore water

Low-molecular-weight (LMW) alcohols are produced during the microbial degradation of organic matter from precursors such as lignin, pectin, and carbohydrates. The biogeochemical behavior of these alcohols in marine sediment is poorly constrained but potentially central to carbon cycling. Little is known about LMW alcohols in sediment pore waters because of their low concentrations and high water miscibility, both of which pose substantial analytical challenges. In this study, three alternative methods were adapted for the analysis of trace amounts of methanol and ethanol in small volumes of saline pore waters: direct aqueous injection (DAI), solid-phase microextraction (SPME), and purge and trap (P&T) in combination with gas chromatography (GC) coupled to either a flame ionization detector (FID) or a mass spectrometer (MS). Key modifications included the desalination of samples prior to DAI, the use of a threaded midget bubbler to purge small-volume samples under heated conditions and the addition of salt during P&T. All three methods were validated for LMW alcohol analysis, and the lowest detection limit (60 nM and 40 nM for methanol and ethanol, respectively) was achieved with the P&T technique. With these methods, ambient concentrations of volatile alcohols were determined for the first time in marine sediment pore waters of the Black Sea and the Gulf of Mexico. A strong correlation between the two compounds was observed and tentatively interpreted as being controlled by similar sources and sinks at the examined stations.

Particle analysis in the Kara Sea

In September 1999 two short-term moorings with cylindrical sediment traps were deployed to collect sinking particles in bottom waters off the Ob and Yenisei river mouths. Samples were studied for their bulk composition, pigments, phytoplankton, microzooplankton, fecal material, amino acids, hexosamines, fatty acids and sterols and compared to suspended matter and surface sediments in order to collect information about the nature and cycling of particulate matter in the water column. Results of all measured components in sinking particles point to an ongoing seasonality in the pelagic system from blooming diatoms in the first phase to a more retention system in the second half of trap deployment. Due to a phytoplankton bloom observed north of the Ob estuary, flux rates were generally higher in the trap deployed off the Ob than off the Yenisei. The Ob trap collected fresh surface-derived particulate matter. Particles from the Yenisei trap were more degraded and resembled deep water suspension. This material may partly have been derived from resuspended sediments.

Iron analysis in bottle profiles off Mauritania

Iron solubility measurements in the Mauritanian upwelling and the adjacent Open Ocean of the Tropical Atlantic show for all stations lower values in the surface mixed layer than at depth below the pycnocline. We attribute this distribution to a combination of loss terms, chiefly photo-oxidation of organic ligands in the surface, and supply terms, predominantly from the release of ligands from the decomposition of organic matter. Significant correlations with pH, oxygen and phosphate for all samples below the surface mixed layer indicate that biogenic remineralisation of organic matter results in the release of iron binding ligands into the dissolved phase. The comparison of the cFeS/PO4**3- ratio with other published data from intermediate and deep waters in the Pacific suggests an enhanced release of iron chelators in the more productive Mauritanian upwelling zone.