Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting

Background: The Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context. Methods: A systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: "Analytic Hierarchy Process," "Analytical Hierarchy Process," "multi-criteria decision analysis," "multiple criteria decision," "stated preference," and "pairwise comparison." In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies' reporting. Results: The systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30 %), followed by the US (25.6 %). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria. Conclusion: The AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how inconsistent answers should be dealt with, and how the outcome and stability of the results should be presented. In addition, we need new insights to determine which target group can best handle the challenges of the AHP. © 2015 Schmidt et al.

Essays on Macroeconomic Trends and Cycles

This dissertation describes two studies on macroeconomic trends and cycles. The first chapter studies the impact of Information Technology (IT) on the U.S. labor market. Over the past 30 years, employment and income shares of routine-intensive occupations have declined significantly relative to nonroutine occupations, and the overall U.S. labor income share has declined relative to capital. Furthermore, the decline of routine employment has been largely concentrated during recessions and ensuing recoveries. I build a model of unbalanced growth to assess the role of computerization and IT in driving these labor market trends and cycles. I augment a neoclassical growth model with exogenous IT progress as a form of Routine-Biased Technological Change (RBTC). I show analytically that RBTC causes the overall labor income share to follow a U-shaped time path, as the monotonic decline of routine labor share is increasingly offset by the monotonic rise of nonroutine labor share and the elasticity of substitution between the overall labor and capital declines under IT progress. Quantitatively, the model explains nearly all the divergence between routine and nonroutine labor in the period 1986-2014, as well as the mild decline of the overall labor share between 1986 and the early 2000s. However, the model with IT progress alone cannot explain the accelerated decline of labor income share after the early 2000s, suggesting that other factors, such as globalization, may have played a larger role in this period. Lastly, when nonconvex labor adjustment costs are present, the model generates a stepwise decline in routine labor hours, qualitatively consistent with the data. The timing of these trend adjustments can be significantly affected by aggregate productivity shocks and concentrated in recessions. The second chapter studies the implications of loss aversion on the business cycle dynamics of aggregate consumption and labor hours. Loss aversion refers to the fact that people are distinctively more sensitive to losses than to gains. Loss averse agents are very risk averse around the reference point and exhibit asymmetric responses to positive and negative income shocks. In an otherwise standard Real Business Cycle (RBC) model, I study loss aversion in both consumption alone and consumption-and-leisure together. My results indicate that how loss aversion affects business cycle dynamics depends critically on the nature of the reference point. If, for example, the reference point is status quo, loss aversion dramatically lowers the effective inter-temporal rate of substitution and induces excessive consumption smoothing. In contrast, if the reference point is fixed at a constant level, loss aversion generates a flat region in the decision rules and asymmetric impulse responses to technology shocks. Under a reasonable parametrization, loss aversion has the potential to generate asymmetric business cycles with deeper and more prolonged recessions.

Using a Combination of Phylogenetic Comparative and Paleobotanical Methods to Elucidate Patterns of Lineage Selection in Rosales (Plantae: Anthophyta)

An increasing focus in evolutionary biology is on the interplay between mesoscale ecological and evolutionary processes such as population demographics, habitat tolerance, and especially geographic distribution, as potential drivers responsible for patterns of diversification and extinction over geologic time. However, few studies to date connect organismal processes such as survival and reproduction through mesoscale patterns to long-term macroevolutionary trends. In my dissertation, I investigate how mechanism of seed dispersal, mediated through geographic range size, influences diversification rates in the Rosales (Plantae: Anthophyta). In my first chapter, I validate the phylogenetic comparative methods that I use in my second and third chapters. Available state speciation and extinction (SSE) models assumptions about evolution known to be false through fossil data. I show, however, that as long as net diversification rates remain positive – a condition likely true for the Rosales – these violations of SSE’s assumptions do not cause significantly biased results. With SSE methods validated, my second chapter reconstructs three associations that appear to increase diversification rate for Rosalean genera: (1) herbaceous habit; (2) a three-way interaction combining animal dispersal, high within-genus species richness, and geographic range on multiple continents; (3) a four-way interaction combining woody habit with the other three characteristics of (2). I suggest that the three- and four-way interactions represent colonization ability and resulting extinction resistance in the face of late Cenozoic climate change; however, there are other possibilities as well that I hope to investigate in future research. My third chapter reconstructs the phylogeographic history of the Rosales using both non-fossil-assisted SSE methods as well as fossil-informed traditional phylogeographic analysis. Ancestral state reconstructions indicate that the Rosaceae diversified in North America while the other Rosalean families diversified elsewhere, possibly in Eurasia. SSE is able to successfully identify groups of genera that were likely to have been ancestrally widespread, but has poorer taxonomic resolution than methods that use fossil data. In conclusion, these chapters together suggest several potential causal links between organismal, mesoscale, and geologic scale processes, but further work will be needed to test the hypotheses that I raise here.

Information brokers and the use of budgetary and financial information by politicians: the case of Portugal

This paper analyses the intermediary role of the technical bodies that support the use of budgetary and financial information by central government politicians in Portugal. The main findings show that information brokers are playing a central role in preparing this information in a credible, simple and understandable way. However, even if not intentionally, the information they present can be biased. Politicians need to be aware that the information brokers they rely on may not be giving them ‘neutral’ information.

A field study to describe diel, tidal and semilunar rhythms of larval release in an assemblage of tropical rocky shore crabs

Available information on the larval release rhythms of brachyurans is biased to temperate estuarine species and outcomes resulting from some sort of artificial manipulation of ovigerous females. In this study we applied field methods to describe the larval release rhythms of an assemblage of tropical rocky shore crabs. Sampling the broods of ovigerous females of Pachygrapsus transversus at two different shores indicated a spatially consistent semilunar pattern, with larval release maxima around the full and new moon. Yet, synchronism between populations varied considerably, with the pattern obtained at the site exposed to a lower wave action far more apparent. Breeding cohorts at one of the sampled shores apparently belonged to actual age groups composing the ovigerous population. The data suggest that these breeding groups release their larvae in alternate syzygy periods, responding to a lunar cycle instead of the semilunar pattern observed for the whole population. For the description of shorter-term rhythms, temporal series at hour intervals were obtained by sampling the plankton and confinement boxes where ovigerous females were held. Unexpectedly, diurnal release activity prevailed over nocturnal hatching. Yet, only grapsids living higher on the shore exhibited strong preferences over the diel cycle, with P. transversus releasing their larvae during the day and Geograpsus lividus during the night. The pea crab Dissodactylus crinitichelis, the spider crab Epialtus brasiliensis and a suite of xanthoids undertook considerable releasing activity in both periods. Apart from the commensal pea crab D. crinitichelis, all other taxa revealed tide-related rhythms of larval release, with average estimates of the time of maximum hatching always around the time of high tides; usually during the flooding and slack, rather than the ebbing tide. Data obtained for P. transversus females held in confinement boxes indicated that early larval release is mostly due to nocturnal hatching, while zoeal release in diurnal groups took place at the time of high tide. Since nocturnal high tides at the study area occurred late, sometimes close to dusk, early release would allow more time for offshore transport of larvae when the action of potential predators is reduced.

Management of the clinical issue of constipation with abdominal complaints in adults: a national survey of Primary Care physicians and gastroenterologists

Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort) with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care). Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation) and a response rate potentially biased by professional motivation.

Population structure and sexual maturity of the calico box crab Hepatus epheliticus Linnaeus (Brachyura, Hepatidae) from Yucatan Peninsula, Mexico

The calico box crab Hepatus epheliticus is an abundant species from shallow and continental shelf waters of the Atlantic coast of USA and Mexico. Information about population structure and sexual maturity is absent, even though this crab is caught to be used as bait for the octopus fishery in the Campeche Bank, Mexico. In order to achieve such information, a total of 768 individuals were collected from January to March 2010 through baited traps installed in the Yucatan Peninsula, Mexico. Our results showed that sex ratio is biased towards more males than females (1:0.55), contradicting to that reported in other brachyuran crabs. The absence of ovigerous females suggests that they did not enter into the traps during embryogenesis. Males reached a larger maximum size than females (64.0 +/- 6.15 and 58.4 +/- 5.60 mm carapace width, respectively). The general scheme of growth being positive allometric throughout ontogeny of both sexes. Males presented a transition phase from juveniles to adult corresponding to the puberty moult. The estimation of the onset of functional sexual maturity revealed a steady situation for the population, with 21.5 and 13.8% of males and females, respectively, morphologically immature at the time of catch. This study constitutes the first report on population structure and sexual maturity in a population of the calico box crab H. epheliticus.

Complex demonstratives and referential descriptions as descriptive designators

Na literatura filosófica, o debate em torno da semântica dos demonstrativos complexos e descrições referenciais tornou-se, em grande medida, polarizado. Isto porque estas expressões são vistas muito comumente ou como (i) `diretamente referenciais’, no sentido em que contribuem para o conteúdo literal somente suas extensões atuais ou como (ii) quantificacionais, no sentido em que contribuem para o conteúdo literal uma condição para determinação de possíveis extensões, uma condição que contenha o conteúdo descritivo de seus nominais. Neste artigo, apresento argumentos em favor de uma concepção alternativa, segundo a qual demonstrativos complexos e descrições referenciais são termos que se referem e descrevem sem quantificar. Em poucas palavras, eles são designadores descritivos. ______________________________________________________________________________________________ ABSTRACT

Spatial choice is biased by chemical cues from conspecifics in the speckeled worm eel Myrophis punctatus

A enguia mirongo-mirim Myrophis punctatus vive em agrupamentos de alta densidade populacional e comumente se enterra ou permanece sob o substrato. Esses comportamentos podem levar a marcas químicas no subtrato e podem, portanto, modular o uso do espaço nessa espécie. Neste estudo, testamos a hipótese de que a preferência espacial da enguia mirongo-mirim é influenciada pela presença de odor do animal coespecífico no subtrato. Mostramos que as enguias evitam a área que contém tal odor, indicando que as decisões de ocupação espacial podem ser influenciadas por pistas químicas de coespecíficos. As enguias claramente detectaram o odor de um animal coespecífico e essa percepção poderia ser um indicativo da presença de um coespecífico enterrado no substrato. Visto que elas evitam uma área contendo tal odor, sugerimos que isso poderia ser uma resposta para evitar invadir o território de um animal residente.

At odds with the group: Changes in lateralization and escape performance reveal conformity and conflict in fish schools

Many vertebrates are known to show behavioural lateralization, whereby they differentially use one side of their body or either of their bilateral organs or limbs. Behavioural lateralization often manifests in a turning bias in fishes, with some individuals showing a left bias and others a right bias. Such biases could be the source of considerable conflict in fish schools given that there may be considerable social pressure to conform to the group to maintain effective group evasion. Here, we show that predation pressure is a major determinant of the degree of lateralization, both in a relative and absolute sense, in yellow-and-blueback fusiliers (Caesio teres), a schooling fish common on coral reefs. Wild-caught fish showed a bias for right turning. When predation pressure was experimentally elevated or relaxed, the strength of lateralization changed. Higher predation pressure resulted in an increase in the strength of lateralization. Individuals that exhibited the same turning bias as the majority of individuals in their group had improved escape performance compared with individuals that were at odds with the group. Moreover, individuals that were right-biased had improved escape performance, compared with left-biased ones. Plasticity in lateralization might be an important evolutionary consequence of the way gregarious species respond to predators owing to the probable costs associated with this behaviour.

Analytic and heuristic processes in the detection and resolution of conflict

Previous research with the ratio-bias task found larger response latencies for conflict trials where the heuristic- and analytic-based responses are assumed to be in opposition (e.g., choosing between 1/10 and 9/100 ratios of success) when compared to no-conflict trials where both processes converge on the same response (e.g., choosing between 1/10 and 11/100). This pattern is consistent with parallel dualprocess models, which assume that there is effective, rather than lax, monitoring of the output of heuristic processing. It is, however, unclear why conflict resolution sometimes fails. Ratio-biased choices may increase because of a decline in analytical reasoning (leaving heuristic-based responses unopposed) or to a rise in heuristic processing (making it more difficult for analytic processes to override the heuristic preferences). Using the process-dissociation procedure, we found that instructions to respond logically and response speed affected analytic (controlled) processing (C), leaving heuristic processing (H) unchanged, whereas the intuitive preference for large nominators (as assessed by responses to equal ratio trials) affected H but not C. These findings create new challenges to the debate between dual-process and singleprocess accounts, which are discussed.

‘‘Model age-based” and ‘‘copy when uncertain” biases in children’s social learning of a novel task

Theoretical models of social learning predict that individuals can benefit from using strategies that specify when and whom to copy. Here the interaction of two social learning strategies, model age-based biased copying and copy when uncertain, was investigated. Uncertainty was created via a systematic manipulation of demonstration efficacy (completeness) and efficiency (causal relevance of some actions). The participants, 4- to 6-year-old children (N = 140), viewed both an adult model and a child model, each of whom used a different tool on a novel task. They did so in a complete condition, a near-complete condition, a partial demonstration condition, or a no-demonstration condition. Half of the demonstrations in each condition incorporated causally irrelevant actions by the models. Social transmission was assessed by first responses but also through children’s continued fidelity, the hallmark of social traditions. Results revealed a bias to copy the child model both on first response and in continued interactions. Demonstration efficacy and efficiency did not affect choice of model at first response but did influence solution exploration across trials, with demonstrations containing causally irrelevant actions decreasing exploration of alternative methods. These results imply that uncertain environments can result in canalized social learning from specific classes of mode

Essays on employment / education, investment in education and student achievement

Méthodologie: Modèle de régression quantile de variable instrumentale pour données de Panel utilisant la fonction de production partielle

THE CONSTITUTION OF SUBJECTS AND MEANINGS: THE CASE OF THE QUOTAS FOR BLACK PEOPLE

ABSTRACT: In this study, I bring aspects that are related to the constitution of subjects and meanings, according to the French Discourse Analysis approach. As for that, I use four discursive sequences – corpus – taken from articles about quotas for black people published in Veja magazine. The main objective in this study is to discuss and relate theoretical propositions of the French Discourse Analysis about the constitution of the subject and of the meaning with the corpus for analysis, which composes a research recently concluded. The work is mainly based in the studies of Pêcheux (2009 [1988]). Under the theoretical perspective of the French Discourse Analysis, we may affirm that the subject is considered an effect of external processes which constitute him and which, meanwhile, erase this mechanism. The referred constitution results in the evidence that the subject is the origin, the controller of the meanings he expresses, or that are produced through his saying. Thus, it will be possible to ask “how or why is the subject an effect?” and “how can he not be the origin and the source of what is enunciated, if every person can only think about himself as being a subject (I am… I think…)?”. It is guided by these questions that I develop the observations of the referred approach.   KEYWORDS: subject; meaning effects; discourse.

About meanings and subjects: the prosperity in the “metropolis of the future”

This study has the objective of analyzing, based on the theoretical and methodological device of the French Discourse Analysis, the meanings that (are) produce(d) (in) the photographs that compose the special report entitled “Cidades médias” (“Medium-sized cities”), published by Veja magazine in September, 2010. This report aims, according to the magazine, at highlighting which are the Brazilian cities that are considered “metropolis of the future”, for making possible, amongst other elements, also the obtainment of financial success. If the photographs in the media act as supports of the linguistic materiality, as representations of reality, I intend in this study: work with the effect of evidence produced by the photograph; reflect about the ideological crossing, which determines what can and must be said and, therefore, what cannot and must not be said; analyze in what way this crossing passes by the image and what is its representation in the journalistic discourse; and analyze which are the meanings produced by the photographs that compose the special report on Veja magazine; also in their relation to the subjects introduced there. For my investigation, I was based on the contributions of Barthes (1984) and Dubois (1993) and in some important concepts for the Discourse Analysis field found in Pêcheux (2009 [1988]) and Orlandi (2007 [1992]; 1995).