Doctor of Philosophy

dissertationLogical Observation Identifiers Names and Codes (LOINC®) was developed in 1994 to provide a universal vocabulary for reporting laboratory and clinical observations. This dissertation was aimed at determining whether LOINC is meeting its goal when it is used in the real world. Three institutions, Associated and Regional University Pathologist (ARUP), Intermountain Healthcare, and Regenstrief Institute, were invited to participate in this research. These institutions represented three of the seven institutions that provided their catalogue of laboratory test names for creating the first version of laboratory LOINC codes. After obtaining IRB approval, each institution provided 5 years (2003-2007) of laboratory data and their associated local codes and LOINC code mappings. Extensional definitions (EDs) were used to characterize the laboratory data reported by a specific LOINC code. EDs included frequency of testing, mean and standard deviation of the result values, coded variables, etc. To reduce privacy concerns, we distributed parsing and processing programs to each institution and the initial processing of the raw results occurred within the local systems, and only the deidentified EDs were sent to the primary investigator for combined analysis. We used the EDs to evaluate the coverage, correctness, consistency and competence of LOINC. For coverage, we analyzed how many laboratory tests being routinely tested in daily operations could be assigned a correct LOINC code. For correctness, we verified the accuracy of LOINC mappings to local codes. For consistency and usefulness, we detected any inconsistencies in LOINC design and measured the degree of semantic interoperability that could be achieved using LOINC. Besides auditing LOINC code use, we also analyzed the result values that were associated with the LOINC results (i.e. characteristics like the type of result (number, coded value), units of measure, answer set (positive/negative) etc.). We also found that consistent use of result values was important in achieving semantic interoperability when exchanging laboratory data. Our analysis produced the following results: 1. Completeness: LOINC can provide 99% coverage rate for the results in two typical health care institutions and 79% coverage for results from a reference laboratory. 2. Correctness: An error rate of 4.5% existed in mappings at the three institutions. 3. Consistency and usefulness: Several complicated or inconsistent designs for LOINC usage were found, which reduced the semantic interoperability of LOINC

Three sonatas for piano by Emma Lou Diemer

Emma Lou Diemer (1927- ), an eclectic, still active American composer, has composed in many different musical genres for both professional and amateur groups. She is well-known for her vocal music Three Madrigals (1962) and her Concerto in One Movement for Piano (1991), which won Kennedy Center Friedheim Awards in 1992. Diemer’s piano music includes pedagogical works as well as concert pieces. Her piano sonatas are sophisticated compositions for piano which combine both advanced technical elements and musical complexities. Of her three piano sonatas, Piano Sonata No.3 is particularly accessible to listeners. The Sonata for Piano in One Movement was submitted successfully for a Fulbright Scholarship for study in Belgium (1952-53) and the Second Sonata for Piano won the Missouri Federation of Music Clubs Award (1955). Piano Sonata No. 3 (2000) is her most recent publication. The purpose of this project is to provide a stylistic and analytic guide helpful to the preparation and performance of the three sonatas by Diemer. The opening chapter provides a biography of the composer, the following chapter centers on various influences on her compositional style, and her transformation from early Romanticism and Neo-Classicism to her later use of electronic and pop music. The subsequent chapter is an analytical observation of the three sonatas in addition to the particular characteristics of each sonata. The last chapter focuses on performance and interpretive issues._x000C

Nonlinear Mean Reversion and Arbitrage in the Gold Futures Market

Previous literatures take transaction costs as being negligible when analyzing the futures basis behavior in linear dynamic framework. However, we argue that the relationship between the futures and spot prices with the conventional linear cointegration approach may not be appropriate after taking transaction costs into account. In this paper, an incorporation of transaction costs presented by Dumas (1992) and Michael (1997) into the exponential smooth transition autoregressive (ESTAR) model developed by Granger and Terasvita (1993) is motivated to examine the dynamic relationship between daily gold futures and spot prices and the nonlinear behavior of the gold futures basis. Transaction costs may lead to the existence of neutral band for futures market speculation within which profitable trading opportunities are impossible. Further, our results indicate that the ESTAR model provides higher forecasting power than the linear AR(1) model.

Asthma Exacerbation in Children: A Practical Review

Asthma is the most common chronic lower respiratory tract disease in childhood throughout the world. Despite advances in asthma management, acute exacerbations continue to be a major problem in patients and they result in a considerable burden on direct/indirect health care providers. A severe exacerbation occurring within 1 year is an independent risk factor. Respiratory tract viruses have emerged as the most frequent triggers of exacerbations in children. It is becoming increasingly clear that interactions may exist between viruses and other triggers, increasing the likelihood of an exacerbation. In this study, we provide an overview of current knowledge about asthma exacerbations, including its definition, impact on health care providers, and associated factors. Prevention management in intermittent asthma as well as intermittent wheeze in pre-school children and those with persistent asthma are discussed. Our review findings support the importance of controlling persistent asthma, as indicated in current guidelines. In addition, we found that early episodic intervention appeared to be crucial in preventing severe attacks and future exacerbations. Besides the use of medication, timely education after an exacerbation along with a comprehensive plan in follow up is also vitally important

Parental Rights and Responsibilities of Chilean Women: A Study of Child Education Arrangement for Different Marital Status

[[abstract]]Family life in Latin America in general, and in Chile in Particular, is changing rapidly as it is in other Western countries. A very important factor for the change in family structure and, as a consequence, in gender role in the family, is the changing marital status. When the proportions of cohabiting and single‐parent households increased, family resource arrangement may also be expected to change as we have to reconsider the parental rights and responsibilities. In this paper, we will focus on parental commitment in children’s education attainment. Specifically, we want to find out if there are significant differences in children’s education resource arrangement for three types of union status—marriage (all kinds), consensual unions, and other (visiting unions and single parents). A society wants to maximize its return from investing in education. Basically, the return from education investment is decided by family income (I) and personal ability (A). Therefore, Y = Y(I,A|Z), where Y is return from education investment, and Z is parameter affecting the effectiveness of education investment. Altruistic parents concern their own consumption and their children’s future income, so they may assist children’s education through investing part of their current income or direct transfer. The format of assistance is related to social institutions, wherein parents may let their children receive general and public education provided by the government with revenues from taxation, or they may opt to let their children receive private education with their own financial resources. In this sense, families are investors who will affect their children’s future labor income more or less dependent on the level of their investment. On the other hand, people are born with different abilities which could be revealed as they enter labor force after receiving education resources. Thus, a person’s wage income in labor force (W) will be determined by the level of his/her education training (E) and born abilities (A): W = W(E,A), given the assumption that the more abled person can earn a higher future income by means of education. This also implies that a person with higher ability is more motivated to acquire resources just because he/she is assured higher education returns.1 As for the factors that affect education returns other than family income and born abilities, we will look particularly at family structures. Marriage is a very important factor related to the transformation of family structures. Through years, marriage rate has been declining in Chile, with a proportion of 52% for married women of reproductive ages in 1970 declined to a proportion of 43% in 2002. At the same time, cohabitation grew three times from only a proportion of 3% in 1970 to 11% in 2002. The proportion of cohabiters, though, is still low compared to other Latin American countries, such as Colombia or Honduras, where about 60% of women of reproductive ages were cohabiting in 2005. A novelty that has been pointed out, though , is that, since the 1990’s, cohabitation started to increase among groups of high socioeconomic status in Chile—which could mean a new type of cohabitation is emerging, a cohabitation that may start to reverse the prevalence of the traditional Latin American nuptial system in Chile. Furthermore, there has been an increase in the proportion of single women. In 1970, 56% of women in the 20‐24 age interval were single, a proportion that grew to 67% in 2002. The fact that more women remain single until later in their lives is reflected in an older mean age at marriage, which was 23.5 in 1960, but went up to 26.7 years in 2004. At the same time that the proportion of married couple declined in Chile, the proportion of children born outside of marriage increased from 16% in 1960 to 68% in 2010. This not only means that marriage is not the preferred setting for childbearing anymore, but also that non‐marital births are proportionally higher in Chile than in Sweden where they reached 55% in 2008. It is also higher than in the U.S. where it reached 38.5% in 2008. Both the decline of marriage and the increase of proportion of children born outside of marriage may have been affected by two legal changes that were introduced in Chile in the last decade. In 1996, a new ley de filiacion (paternity law) was passed, ruling out the differences between children born within and outside of marriage, in terms of heritage rights, food and support rights, and the right to use their fathers’ last name. In 2004, the first divorce law was enacted in Chile. Before that people willing to end their marriage could nullify the union, but the process was costly in terms of time and money, and therefore very hard to follow for the poor. One may hypothesize that the paternity law may have stimulated the decline of marriage, 1 See Daniele Checci, The Economics of Education: Human Capital, Family Background and Inequality (Cambridge: Cambridge University Press, 2006), Chapter 5. since legally being born inside of marriage does not carry an advantage anymore. Passing a divorce law, on the contrary, could in principle have stimulated marriage among couples who were not sure about making a life‐long commitment, since it makes it easier to put an end to an unsatisfactory union. Among the other socioeconomic constraints which will affect intergenerational transfer within the family, we look at work‐family conflict which is of particular relevance for women, as motherhood embedded in them being deemed so significant in Latin American countries. Many women entered workplace to supplement family income in order to support their children’s education. However, this caused a conflict between women’s roles as housewives and income earners. Consideration on social strata will have to be put in place to determine how women in Chile to balance between the above two roles and, therefore, how children fared in their education achievement. Generally, women of lower social strata in Chile opted to play the role of housewives or take part‐time jobs to fulfill their motherhood roles. However, this would cause a great dilemma if they happened to be single mother and could not afford to stay at home. In any way, the last two cases would result in vicious circle which will put their children in perilous status toward their education achievement. Another key research question is how public policies regarding families in Chile, such as its extensive school voucher system, are changing and will they be sufficient for meeting the demands of the so‐called “second demographic transition”. Combined with consideration on marital and family structures, a preliminary conclusion is reached that government would have to deal with social customs as emanating from religious instructions and traditional believes which are deeply embedded in Chilean society emphasizing motherhood instead of parenthood. The latter will loom large if children’s discipline and educational achievement are deemed more important as responsibilities for both parents, as against the caring role for women which is emphasized in motherhood conceptualization.[[sponsorship]]Stanford University, U.S.A.[[conferencetype]]國際[[conferencedate]]20130712~20130714[[booktype]]紙本[[booktype]]電子版[[iscallforpapers]]Y[[conferencelocation]]Palo Alto, California, US

Lyngbya majuscula Blooms in an Enclosed Marine Environment

Cyanobacterial blooms are a cause of concern because of their potential impacts on the marine environment. In Sentosa Cove, Singapore, Lyngbya majuscula blooms appeared regularly in the highly enclosed boat canals traversing the seafront residential development. This study investigated whether sediments resuspended by physical disturbance liberated nutrients that contribute to the blooms. Sediment resuspension events were mimicked in containers of sediment collected from the canals. Lyngbya majuscula that were incubated in containers with resuspended sediment attained greater biomass than those in filtered seawater only. Levels of iron, phosphates and nitrites in seawater with resuspended sediments were significantly higher than in those without. The results indicate that recurrent L. majuscula blooms in Sentosa Cove could be attributed to nutrient loading from sediment resuspension