Tendências atuais em restauração evidenciam a importância de propiciar o retorno das funções ecossistêmicas e ecológicas. Porém muitas áreas possuem baixo potencial para reestabelecimento de processos ecológicos devido à perda da resiliência, o que faz da restauração ecológica um processo desafiador. Para o sucesso das atividades propostas, é essencial que no decorrer do projeto os sistemas sejam capazes de retomar sua trajetória sucessional e dinâmica temporal, sem necessidade de futuras intervenções humanas. O objetivo desta tese foi avaliar os processos iniciais de restauração ecológica em áreas degradadas por mineração de carvão, através da análise de trajetórias sucessionais envolvendo: (1) taxas de crescimento e mortalidade de mudas nativas introduzidas e sua relação com atributos funcionais de plantas; (2) chuva de sementes associada, ou não, ao uso de poleiros artificiais e sua relação com regenerantes de espécies lenhosas; e (3) regeneração natural e sua relação com fatores abióticos e bióticos. Mudas de espécies nativas introduzidas sob condições limitantes (devido ao alto nível de impacto) apresentaram diferentes performances e relações com atributos, por vezes distintas do esperado para espécies sob condições naturais. A limitação de sementes nas áreas em restauração pode ser, potencialmente, reduzida pelo uso de poleiros artificiais, aumentando especialmente sementes de espécies não-pioneiras e zoocóricas. No entanto, não foi verificada relação entre a chuva de sementes e a taxa de recrutamento. Fatores abióticos, relacionados à composição química do solo, e fatores bióticos, como a presença de gramíneas exóticas, foram as variáveis com maior influência negativa sobre a regeneração natural. Este estudo evidencia a possibilidade do retornar do processo de sucessão natural em áreas de mata ciliar que foram profundamente alteradas por mineração de carvão, em um tempo relativamente curto. Entretanto, recomendamos o uso de objetivos realísticos e intermediários, bem como monitoramentos detalhados nas fases iniciais. / In current projects of ecological restoration, the return of ecosystem functions and natural processes is an important aim. However, many areas have lost their resilience due the high damage they have been submitted to, and this makes the ecological restoration a challenging process. For the success of the proposed activities, it is essential that during the project, the ecosystem can return to its successional trajectory without necessity of strong human intervention in the future. The goal of this thesis was to evaluate the initial processes of ecological restoration in areas severally degraded by coal mining, through analyses of successional trajectories regarding: (1) growth and mortality rates of planted samplings and their relationship to functional traits; (2) seed rain, associated or not, to perches and its relationship to natural regeneration of woody species; and (3) natural regeneration of woody species and its relationship to abiotic and biotic variables. Planted saplings under limited conditions (due the high impact of mining) showed to have distinct performance and trait relationships, somewhat different to the expected for species under natural conditions. The study indicates that the limitation of seeds in areas under ecological restoration can be reduced by the use of perches, increasing especially the number of seeds of non-pioneer and zoocoric species. Nevertheless, we did not found a relation between seed rain and recruitment rate. Soil chemistry (abiotic variable) and the cover of exotic grasses (biotic variable) were the variables with the strongest negative impact on natural regeneration. We conclude that it is possible to return to successional processes in areas of riparian forest severely damaged by coal mining activities in a relatively short time, but recommend the use of realistic, intermediate restoration goals and detailed monitoring in early restoration phases.

Tendências atuais em restauração evidenciam a importância de propiciar o retorno das funções ecossistêmicas e ecológicas. Porém muitas áreas possuem baixo potencial para reestabelecimento de processos ecológicos devido à perda da resiliência, o que faz da restauração ecológica um processo desafiador. Para o sucesso das atividades propostas, é essencial que no decorrer do projeto os sistemas sejam capazes de retomar sua trajetória sucessional e dinâmica temporal, sem necessidade de futuras intervenções humanas. O objetivo desta tese foi avaliar os processos iniciais de restauração ecológica em áreas degradadas por mineração de carvão, através da análise de trajetórias sucessionais envolvendo: (1) taxas de crescimento e mortalidade de mudas nativas introduzidas e sua relação com atributos funcionais de plantas; (2) chuva de sementes associada, ou não, ao uso de poleiros artificiais e sua relação com regenerantes de espécies lenhosas; e (3) regeneração natural e sua relação com fatores abióticos e bióticos. Mudas de espécies nativas introduzidas sob condições limitantes (devido ao alto nível de impacto) apresentaram diferentes performances e relações com atributos, por vezes distintas do esperado para espécies sob condições naturais. A limitação de sementes nas áreas em restauração pode ser, potencialmente, reduzida pelo uso de poleiros artificiais, aumentando especialmente sementes de espécies não-pioneiras e zoocóricas. No entanto, não foi verificada relação entre a chuva de sementes e a taxa de recrutamento. Fatores abióticos, relacionados à composição química do solo, e fatores bióticos, como a presença de gramíneas exóticas, foram as variáveis com maior influência negativa sobre a regeneração natural. Este estudo evidencia a possibilidade do retornar do processo de sucessão natural em áreas de mata ciliar que foram profundamente alteradas por mineração de carvão, em um tempo relativamente curto. Entretanto, recomendamos o uso de objetivos realísticos e intermediários, bem como monitoramentos detalhados nas fases iniciais. / In current projects of ecological restoration, the return of ecosystem functions and natural processes is an important aim. However, many areas have lost their resilience due the high damage they have been submitted to, and this makes the ecological restoration a challenging process. For the success of the proposed activities, it is essential that during the project, the ecosystem can return to its successional trajectory without necessity of strong human intervention in the future. The goal of this thesis was to evaluate the initial processes of ecological restoration in areas severally degraded by coal mining, through analyses of successional trajectories regarding: (1) growth and mortality rates of planted samplings and their relationship to functional traits; (2) seed rain, associated or not, to perches and its relationship to natural regeneration of woody species; and (3) natural regeneration of woody species and its relationship to abiotic and biotic variables. Planted saplings under limited conditions (due the high impact of mining) showed to have distinct performance and trait relationships, somewhat different to the expected for species under natural conditions. The study indicates that the limitation of seeds in areas under ecological restoration can be reduced by the use of perches, increasing especially the number of seeds of non-pioneer and zoocoric species. Nevertheless, we did not found a relation between seed rain and recruitment rate. Soil chemistry (abiotic variable) and the cover of exotic grasses (biotic variable) were the variables with the strongest negative impact on natural regeneration. We conclude that it is possible to return to successional processes in areas of riparian forest severely damaged by coal mining activities in a relatively short time, but recommend the use of realistic, intermediate restoration goals and detailed monitoring in early restoration phases.

No abstract available. / Dissertation (LLM)--University of Pretoria, 2013. / gm2014 / Centre for Human Rights / unrestricted

A dinâmica populacional de Scomber japonicus peruanus (cavalinha) foi estudada com base nos dados de captura da pesca comercial obtidos mensalmente, de janeiro de 1990 a dezembro de 2003, no litoral peruano (3°23’S-18°20’S e 72°W-84°W), dentro do projeto “Seguimento de los recursos pelágicos en el litoral peruano” que vem sendo desenvolvido no Instituto del Mar del Perú – IMARPE. Nesse período, a Temperatura Superficial do Mar foi obtida mensalmente em cada uma das áreas de coleta. A análise dos parâmetros de crescimento e as taxas de mortalidade, bem como o padrão de recrutamento da cavalinha, foram feitos a partir dos dados da pesca comercial correspondente aos anos de 1996 a 2003, enquanto na avaliação do estoque utilizaram-se os do período de 1993 a 2003. A Temperatura Superficial do Mar variou de 13,60°C (2001) a 29,34°C (1998), sendo os valores mínimos encontrados em 1996 e 1999-2001 e máximos em 1992-1993 e 1997-1998. Os desembarques da espécie Scomber japonicus peruanus entre 1990 e 2003 variaram de 8.119 t a 387.659 t, sendo o valor médio 122.513 t. As médias dos desembarques mensais oscilaram entre 3.274 t e 16.853 t, com maiores valores registrados nos meses de novembro e dezembro de 1998, bem como em janeiro e março de 1999. As anomalias positivas máximas dos desembarques, que variaram de 134.985 t a 345.137 t, foram obtidas no período de 1997-1999 e em 2001, enquanto elevadas anomalias negativas nos anos de 1992 (-34.402 t) e 1993 (-32.894 t). Os resultados mostraram que no período de 1993-2003 o comprimento médio furcal da cavalinha diminuiu de 30,50 cm para 26,70 cm, que o comprimento furcal de primeira captura (Cf50) foi 26,40 cm e que o recrutamento ocorreu o ano todo, principalmente, no verão. xiii No período compreendido entre 1996 e 2003, o estudo do crescimento e mortalidade da cavalinha evidenciou que os valores do comprimento assintótico (Cf∞) e os da taxa de crescimento (K), obtidos pelo ELEFAN I e os registrados pelo método de Ford- Walford, foram 42,40 cm e 0,40 ano–1, respectivamente. O comprimento igual a zero (to) foi –0,37 ano–1 e a amplitude de oscilação (C) 0,40, enquanto os valores de Winter Point (Wp) 0,60 e o do índice de performance (φ) 2,86. A taxa média de mortalidade total (Z) obtida pela análise da curva de captura linearizada e pelo método de Beverton & Holt, foi 2,30 ano–1; a taxa de mortalidade por pesca (F) 1,97 ano–1 e a taxa de explotação 0,86 ano–1. A taxa anual de mortalidade natural (M) estimada pelo método de Rikhter & Efanov e pela equação de Pauly foi 0,50 ano–1. A longevidade da cavalinha foi 7,60 anos. A análise de coorte de comprimento e a aplicação dos modelos de rendimento por recruta de Beverton & Holt e o preditivo de Thompson & Bell, revelaram que o estoque de Scomber japonicus peruanus encontra-se sobre-explotado e próximo da capacidade máxima. / The population dynamics of the Scomber japonicus peruanus (Chub mackerel) was studied based on commercial fishing data obtained monthly from January 1999 to December 2003 off the Peru coast (3°23’S-18°20’S e 72°W-84°W), within the “Tracking of pelagic resources off the Peru coast” project which is being carried out at the Instituto del Mar del Peru – IMARPE. During this period, Sea Surface Temperature data was obtained monthly I n each one of the sampling areas. The analysis of the growth parameters, mortality rates, as well as the recruitment pattern of the Chub mackerel was obtained from commercial fishing data from 1996 to 2003. For stock assessment the time range was from 1993 to 2003. Sea Surface Temperature varied from 13.60°C (2001) to 29.34°C (1998) with minimum values being found in 1996 and 1999-2001 and maximum values in 1992-1993 and 1997-1998. The landing of the Scomber japonicus peruanus species between 1990 and 2003 varied from 8.119 t to 387.659 t, with an average of 122.513 t. The average of the monthly landings varied between 3.274 t and 16.853 t, with higher values registered on November and December 1998 as well as January and March 1999. The maximum positive anomalies of the landings, which varied from 134.985 to 345.137 t, were obtained in 1997 -1999 and in 2001. On the other hand, high negative anomalies were obtained in 1992 (-34.402 t) and 1993 (-32.894 t). The results show that from 1993 to 2003 the mean fork length of the Chub mackerel decreased from 30,50 cm to 26,70 cm, the fork length of the first catch (Cf50) was 26,40 and that recruitment occurred all year, especially during the summer. Between 1996 and 2003, the growth and mortality study of the Chub mackerel showed that the asymptotic body length (Cf∞) and the growth rate values (K) obtained by ELEFAN I and the ones xv registered by the Ford-Walford method were 42.40 cm and 0.40 cm year–1, respectively. The t-zero (length is 0) was –0.37 year–1 and the amplitude (C) 0.40. The Winter Point (Wp) value was 0.60 and the performance index (φ) 2.86. The mean total mortality rate (Z), obtained by analyzing the linearized catch curve and by the Beverton and Holt method, was 2.30 year–1. The rate of fishing mortality (F) was 1.97 year–1 and the exploitation rate 0.86 year–1. The annual rate of natural mortality (M) estimated by the Rikter and Efanov method and by the Pauly equation was 0.50 year–1. The longevity of the Chub mackerel was 7.60 years. The length based cohort analysis and the application of Beverton and Holt's yield per recruit models as well as Thompson and Bell's predictive model, revealed that the Scomber japonicus peruanus is over exploited and nearing it's maximum capacity.

A dinâmica populacional de Scomber japonicus peruanus (cavalinha) foi estudada com base nos dados de captura da pesca comercial obtidos mensalmente, de janeiro de 1990 a dezembro de 2003, no litoral peruano (3°23’S-18°20’S e 72°W-84°W), dentro do projeto “Seguimento de los recursos pelágicos en el litoral peruano" que vem sendo desenvolvido no Instituto del Mar del Perú – IMARPE. Nesse período, a Temperatura Superficial do Mar foi obtida mensalmente em cada uma das áreas de coleta. A análise dos parâmetros de crescimento e as taxas de mortalidade, bem como o padrão de recrutamento da cavalinha, foram feitos a partir dos dados da pesca comercial correspondente aos anos de 1996 a 2003, enquanto na avaliação do estoque utilizaram-se os do período de 1993 a 2003. A Temperatura Superficial do Mar variou de 13,60°C (2001) a 29,34°C (1998), sendo os valores mínimos encontrados em 1996 e 1999-2001 e máximos em 1992-1993 e 1997-1998. Os desembarques da espécie Scomber japonicus peruanus entre 1990 e 2003 variaram de 8.119 t a 387.659 t, sendo o valor médio 122.513 t. As médias dos desembarques mensais oscilaram entre 3.274 t e 16.853 t, com maiores valores registrados nos meses de novembro e dezembro de 1998, bem como em janeiro e março de 1999. As anomalias positivas máximas dos desembarques, que variaram de 134.985 t a 345.137 t, foram obtidas no período de 1997-1999 e em 2001, enquanto elevadas anomalias negativas nos anos de 1992 (-34.402 t) e 1993 (-32.894 t). Os resultados mostraram que no período de 1993-2003 o comprimento médio furcal da cavalinha diminuiu de 30,50 cm para 26,70 cm, que o comprimento furcal de primeira captura (Cf50) foi 26,40 cm e que o recrutamento ocorreu o ano todo, principalmente, no verão. xiii No período compreendido entre 1996 e 2003, o estudo do crescimento e mortalidade da cavalinha evidenciou que os valores do comprimento assintótico (Cf∞) e os da taxa de crescimento (K), obtidos pelo ELEFAN I e os registrados pelo método de Ford- Walford, foram 42,40 cm e 0,40 ano–1, respectivamente. O comprimento igual a zero (to) foi –0,37 ano–1 e a amplitude de oscilação (C) 0,40, enquanto os valores de Winter Point (Wp) 0,60 e o do índice de performance (φ) 2,86. A taxa média de mortalidade total (Z) obtida pela análise da curva de captura linearizada e pelo método de Beverton & Holt, foi 2,30 ano–1; a taxa de mortalidade por pesca (F) 1,97 ano–1 e a taxa de explotação 0,86 ano–1. A taxa anual de mortalidade natural (M) estimada pelo método de Rikhter & Efanov e pela equação de Pauly foi 0,50 ano–1. A longevidade da cavalinha foi 7,60 anos. A análise de coorte de comprimento e a aplicação dos modelos de rendimento por recruta de Beverton & Holt e o preditivo de Thompson & Bell, revelaram que o estoque de Scomber japonicus peruanus encontra-se sobre-explotado e próximo da capacidade máxima. / The population dynamics of the Scomber japonicus peruanus (Chub mackerel) was studied based on commercial fishing data obtained monthly from January 1999 to December 2003 off the Peru coast (3°23’S-18°20’S e 72°W-84°W), within the “Tracking of pelagic resources off the Peru coast" project which is being carried out at the Instituto del Mar del Peru – IMARPE. During this period, Sea Surface Temperature data was obtained monthly I n each one of the sampling areas. The analysis of the growth parameters, mortality rates, as well as the recruitment pattern of the Chub mackerel was obtained from commercial fishing data from 1996 to 2003. For stock assessment the time range was from 1993 to 2003. Sea Surface Temperature varied from 13.60°C (2001) to 29.34°C (1998) with minimum values being found in 1996 and 1999-2001 and maximum values in 1992-1993 and 1997-1998. The landing of the Scomber japonicus peruanus species between 1990 and 2003 varied from 8.119 t to 387.659 t, with an average of 122.513 t. The average of the monthly landings varied between 3.274 t and 16.853 t, with higher values registered on November and December 1998 as well as January and March 1999. The maximum positive anomalies of the landings, which varied from 134.985 to 345.137 t, were obtained in 1997 -1999 and in 2001. On the other hand, high negative anomalies were obtained in 1992 (-34.402 t) and 1993 (-32.894 t). The results show that from 1993 to 2003 the mean fork length of the Chub mackerel decreased from 30,50 cm to 26,70 cm, the fork length of the first catch (Cf50) was 26,40 and that recruitment occurred all year, especially during the summer. Between 1996 and 2003, the growth and mortality study of the Chub mackerel showed that the asymptotic body length (Cf∞) and the growth rate values (K) obtained by ELEFAN I and the ones xv registered by the Ford-Walford method were 42.40 cm and 0.40 cm year–1, respectively. The t-zero (length is 0) was –0.37 year–1 and the amplitude (C) 0.40. The Winter Point (Wp) value was 0.60 and the performance index (φ) 2.86. The mean total mortality rate (Z), obtained by analyzing the linearized catch curve and by the Beverton and Holt method, was 2.30 year–1. The rate of fishing mortality (F) was 1.97 year–1 and the exploitation rate 0.86 year–1. The annual rate of natural mortality (M) estimated by the Rikter and Efanov method and by the Pauly equation was 0.50 year–1. The longevity of the Chub mackerel was 7.60 years. The length based cohort analysis and the application of Beverton and Holt's yield per recruit models as well as Thompson and Bell's predictive model, revealed that the Scomber japonicus peruanus is over exploited and nearing it's maximum capacity.

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2018-03-08T19:08:23Z No. of bitstreams: 1 Dennise Pimentel Claro.pdf: 637790 bytes, checksum: c4ed000204776db603ecf343f477a919 (MD5) / Made available in DSpace on 2018-03-08T19:08:23Z (GMT). No. of bitstreams: 1 Dennise Pimentel Claro.pdf: 637790 bytes, checksum: c4ed000204776db603ecf343f477a919 (MD5) Previous issue date: 2010-06-10 / Introduction - In 2001, it was reported the presence of toxic sources in areas located in the estuary of Santos and Sao Vicente, such as heavy metals, organochlorine, polychlorinated biphenyls, dioxins and furans. The exposure to these contaminants produces several adverse effects on the cardiovascular system of humans by damaging the endothelial cells of blood. To understand the impact of health conditions in these contaminated areas it is important to explore the risk of developing cardiovascular disease in the exposed population. Objective - To analyze the mortality of cardiovascular diseases in areas exposed to the referred environmental contaminants. Methods ¿ A cross-sectional study with analysis of historical series allowed an investigation of the mortality from cardiovascular disease, as provided by Fundação SEADE in five areas determined by a previous study entitled "Epidemiological Study in the Baixada Santista - Santos Estuary: Assessment of predictors of effects and exposure to environmental contaminants.", which investigated the health effects associated with exposure to environmental contaminants among residents of areas alongside Santos estuary. In this study the deaths of the five areas were subjected to descriptive analysis based on the period from 2003 through 2007 of the national census (IBGE) of 2000. The mortality rates were calculated by the direct method to standardize them with the population of São Paulo city. In addition to standardized mortality rates were estimated and the average mortality ratios. The resulting estimates allowed a comparison between the contaminated areas and the area that is contaminated free. The comparison between two proportion and Kruskal-Wallis tests was used with a significance level of 0.05. Results - observed the highest mortality coefficient in Area 1, with 24.66 per 1000 of male population, with statistically significant difference (p<0.005), but other areas with environmental contaminants their average coefficient ranged between 1.47 per 1000 to 3.96 per 1000 in both gender. Also, in both gender and all periods, there was significant statistical difference between the contaminated area 1 and Bertioga. The other areas sometimes presented lower coefficient ranged than the area without exposure to environmental contaminats (p<0.05).The mortality also showed high ratios in Area 1 (Pilões) compared to all other areas of the sample. And up to 32 times higher among females in 2003 compared with the control area (area 5, located in Bertioga). Conclusion ¿ for the analysis, higher mortality rates in Pilões and Água Fria was found, although it needs further studies to investigate a causal relationship between exposure and outcome studied. / Introdução - Em 2001 foi relatada a presença de fontes tóxicas em áreas localizadas na região estuarina de Santos e São Vicente, como os metais pesados, organoclorados, bifenilas policloradas, dioxinas e furanos. A exposição a esses contaminantes, a longo prazo, produzem diversos efeitos deletérios à saúde do ser humano, sendo uma delas o aparecimento de doenças cardiovasculares, através do dano nas células endoteliais dos vasos sanguíneos. Explorar o perfil das doenças cardiovasculares na população exposta permite entender o impacto das condições de saúde nestas áreas contaminadas. Objetivo ¿ analisar o perfil da mortalidade de doenças cardiovasculares nas áreas expostas a contaminantes ambientais. Casuística e Método ¿ estudo transversal com análise de séries históricas. Foram estudados os óbitos por doenças cardiovasculares, fornecidas pela Fundação SEADE, em 5 áreas determinadas por um estudo prévio intitulado ¿Estudo Epidemiológico na População Residente na Baixada Santista ¿ Estuário de Santos: Avaliação dos Indicadores de Efeito e de Exposição à Contaminantes Ambientais.¿, financiado pelo CNPq, no qual investigou os efeitos à saúde associados à exposição aos contaminantes ambientais entre moradores da baixada Santista. No presente trabalho os óbitos das 5 áreas foram submetidos a uma análise descritiva, no período de 2003 a 2007, utilizando as estimativas populacionais do Instituto Brasileiro de Geografia e Estatística no ano 2000. Os cálculos dos coeficientes de mortalidade foram realizados pelo método direto, padronizando-os com a população do município de São Paulo. Além do coeficiente padronizado foram calculados os coeficientes médios e as razões entre os coeficientes de mortalidade por doenças cardiovasculares. Os resultados calculados permitiram uma comparação entre as áreas contaminadas e a área não contaminada, o município respectivo do local, e o município de São Paulo. Foi utilizado o teste de comparação entre duas proporções e o teste Kruskal-Wallis com teste Dunn positivo, adotando um nível de significância menor ou igual a 0,05. Resultados ¿ o coeficiente de mortalidade padronizados por doenças cardiovasculares mais elevado foi de 24,66/1000 habitantes na Área 1 (Pilões e Água Fria) no sexo masculino, com diferença estatisticamente significante com a área não contaminada (p<0,05), Nas outras áreas contaminadas os coeficientes médio de mortalidade variaram entre 1,47/1000 a 3,96/1000 em ambos os sexos, valores inferiores a area 1. Em todos os períodos, observou-se diferença estatisticamente significante entre a área 1 (Pilões) e a área contaminada (Bertioga), em ambos os sexos. Nas áreas 2 (Cubatão Centro), área 3 (São Vicente) e área 4 (Vicente de Carvalho) em alguns períodos da série histórica apresentaram coeficientes de mortalidade inferiores a área contaminada, sendo estatisticamente significante. As razões de mortalidade também se apresentaram elevadas na área 1 (Pilões) com todos os locais de comparação, chegando a 32 vezes maior no sexo feminino no ano de 2003, quando comparado com a área controle (área 5, localizada na região de Bertioga). Conclusão ¿ a análise da mortalidade, através dos coeficientes, revelou-se alta na área contaminada a poluentes ambientais, localizada em Pilões e Água Fria, porém há necessidade de novos estudos para investigar uma relação causal entre a exposição e o desfecho estudado.

U.S. healthcare consumers have access to various provider ratings from several organizations that are meant to assist in selecting their healthcare providers. Leapfrog Hospital Safety Grades is one such rating system that professes to allow consumers the ability to select the best hospital for their care. However, since consumers ranking mortality risk as their most important concern, it is essential to determine if Leapfrog grades align with consumer expectations. Andersen's Phase-4 behavioral model of healthcare utilization was used as the foundation for understanding healthcare consumer preferences. This study was designed to determine if Leapfrog grades are predictive of CMS 30-day mortality rates for pneumonia, chronic heart failure, and acute myocardial infarction data, while also adjusting for selected organizational descriptors: state of residency, Medicare expansion, safety-net status, ownership type, teaching classification, and number of licensed beds. Linear regression demonstrated that Leapfrog grades are not reliable predictors of the 3 inpatient mortality rates analyzed. The study demonstrated that ownership type was a significant predictor for 2 of the 3 dependent variables. Furthermore, most of the covariates also provided some predictive value for at least 1 of the included outcomes; however, in most cases, the effect (β) was small. This study can help provide positive social change by elucidating that Leapfrog grades are not reliable predictors of patient outcomes for consumers, while also demonstrating that efforts to reduce 30-day mortality rates, especially for pneumonia, can be targeted by selected states, ownership type, and teaching status.

The current study consists of three major parts. Statistical modeling, the connection between statistical modeling and cluster analysis, and proposing new methods to cluster time dependent information. First, we perform a statistical modeling of the Carbon Dioxide (CO2) emission in South Korea in order to identify the attributable variables including interaction effects. One of the hot issues in the earth in 21st century is Global warming which is caused by the marriage between atmospheric temperature and CO2 in the atmosphere. When we confront this global problem, we first need to verify what causes the problem then we can find out how to solve the problem. Thereby, we find and rank the attributable variables and their interactions based on their semipartial correlation and compare our findings with the results from the United States and European Union. This comparison shows that the number one contributing variable in South Korea and the United States is Liquid Fuels while it is the number 8 ranked in EU. This comparison provides the evidence to support regional policies and not global, to control CO2 in an optimal level in our atmosphere. Second, we study regional behavior of the atmospheric CO2 in the United States. Utilizing the longitudinal transitional modeling scheme, we calculate transitional probabilities based on effects from five end-use sectors that produce most of the CO2 in our atmosphere, that is, the commercial sector, electric power sector, industrial sector, residential sector, and the transportation sector. Then, using those transitional probabilities we perform a hierarchical clustering procedure to classify the regions with similar characteristics based on nine US climate regions. This study suggests that our elected officials can proceed to legislate regional policies by end-use sectors in order to maintain the optimal level of the atmospheric CO2 which is required by global consensus. Third, we propose new methods to cluster time dependent information. It is almost impossible to find data that are not time dependent among floods of information that we have nowadays, and it needs not to emphasize the importance of data mining of the time dependent information. The first method we propose is called “Lag Target Time Series Clustering (LTTC)” which identifies actual level of time dependencies among clustering objects. The second method we propose is the “Multi-Factor Time Series Clustering (MFTC)” which allows us to consider the distance in multi-dimensional space by including multiple information at a time. The last method we propose is the “Multi-Level Time Series Clustering (MLTC)” which is especially important when you have short term varying time series responses to cluster. That is, we extract only pure lag effect from LTTC. The new methods that we propose give excellent results when applied to time dependent clustering. Finally, we develop appropriate algorithm driven by the analytical structure of the proposed methods to cluster financial information of the ten business sectors of the N.Y. Stock Exchange. We used in our clustering scheme 497 stocks that constitute the S&P 500 stocks. We illustrated the usefulness of the subject study by structuring diversified financial portfolio.

Thesis (Ph. D. (Science)) -- University of Limpopo, 2015 / The objectives of the study were to examine the demographic profile and causes of death of people dying in a hospital and community; and to determine mortality rates, specifically age- and gender-specific mortality rates in a community. The study also compared causes of death assigned to hospital records with causes of death obtained from verbal autopsy reports. Methodology The data used in this thesis were collected in two phases. The first phase involved a retrospective review of all deaths that occurred in the Pietersburg/Mankweng Hospital Complex from 1st January, 2011 to 31st December, 2012. The second phase involved a community-based study using a verbal autopsyto determine cause of death in Dikgale HDSS for the same period. Results A total of 5402 deaths were reported in the hospital and 625 in the community. The majority of deaths in the hospital involved adults in the 15 to 49 year old age group, while in the community more deaths were recorded amongst adults aged 15 to 49 years of age and those in the 65+ year old age group. There were more male deaths in the hospital, while in the community a higher proportion of deaths occurred amongst females. v In children less than1 year old, the cause of death in the hospital was predominantly due to perinatal conditions, particularly preterm birth, low birth weight and birth asphyxia; while in the community, of the 5 deaths in this age group, infectious diseases were recorded as the main cause of death. Amongst children in the 1 to 4 year old age groups causes of hospital deaths were dominated by infectious diseases, injuries and malnutrition; while in the community infectious diseases were the main cause of death. Stillbirths were noted in the hospital with a stillbirth rate of 29.1/1000 deliveries. In the community no stillbirths were reported. More than half of the stillbirths were caused by unexplained intrauterine foetal causes followed by maternal hypertension in pregnancy and placenta abruption. For adults in the 15 to 49 year old age groups infectious diseases, such as HIV/AIDS and tuberculosis, were the leading causes of death in both the hospital and in the community. The proportion of deaths due to HIV/AIDS and tuberculosis was significantly greater in the community than in the hospital. Amongst adults in the 50+year old age group non-communicable diseases, particularly cardiovascular diseases and cancers were the most common causes of death. In this age group, the hospital recorded more cancer deaths than did the community; while the community recorded more cardiovascular deaths than did the hospital. vi The overall mortality rate in the community was 8.4 deaths per 1000 person-year, with more deaths occurring amongst males (8.9 deaths per 1000 person-year). The mortality rate was high amongst adults in the 65+ year old age group (48.9 deaths per 1000 person-year). When comparing cause-specific mortality between hospital cause of death notification forms and cause of death determined by verbal autopsy reviews, the same top five underlying causes of death were observed, namely: cardiovascular diseases, infectious diseases, diabetes mellitus, malignant neoplasms and respiratory infections. The agreement between causes of death reported on cause of death notification forms and cause of death as a result of a verbal autopsywas 48%. For individual causes, agreement of more than 80% was achieved between cause of death recorded on cause of death notification forms and from verbal autopsy reviews for respiratory infections, diabetes, malignancies and injuries. Infectious diseases (68.5%) and cardiovascular diseases (74.1%) achieved the lowest agreement. In other words, in only 68.5% and 74.1% respectively was the cause of death as recorded on the “cause of death notification” forms the same as the cause of death when reviewed verbally. Furthermore, 13 deaths were recorded as being due to cardiovascular diseases on the “cause of death notification” forms, however, in only 5 of these cases was the cause of death recorded as the same in the verbal autopsy report. In 21 cases cause of death was attributed to infectious diseases on the cause of death notification form, vii while in only 13 of these cases was the cause of death similarly ascribed after verbal autopsy review. Conclusion This study showed that the verbal autopsy instrument has the potential to identify causes of death in a population where deaths occur outside of health facilities. Procedures for death certification and coding of underlying causes of death need to be streamlined in order to improve the reliability of registration data. This will be achieved if medical students and trainee specialists are trained in the completion of cause of death notification forms. Foetal autopsies should be introduced at tertiary hospitals to determine the causes of stillbirths.Antenatal care education for pregnant women should be encouraged because the level of antenatal care has an influence on the health of mothers and their newborns. The government should continue to focus on improving the socio-economic status of the population, while adequate foetal monitoring by health workers may reduce neonatal deaths resulting from preterm births, low birth weight and birth asphyxia. Innovative injury prevention strategies, interventions to control infectious diseases, cancer screening and lifestyle program may reduce adult mortality.

Sepsis is still a leading cause of death in the United States despite extensive research and modern advancement in technology. Early recognition of sepsis and timely management strategies are important for effective reduction of sepsis-related morbidity and mortality. Guided by the logic model, the purpose of this project was to evaluate the effectiveness of electronic reminders in enhancing clinical decision-making among 30 nurses in 3 medical-surgical units. The practice-focused question addressed the effectiveness of electronic reminders for early recognition and initiation of goal-directed treatment of sepsis in hospitalized patients on medical-surgical units in an effort to reduce sepsis mortality rates. Data were collected from a randomized convenience sample using a self-constructed questionnaire and through observation. The observations were aimed at assessing whether the nurses adhered to the sepsis protocol, while the questionnaire captured the participants' perceptions regarding the use of automated alerts measured on a 5-point Likert scale. Statistical analysis involved the use of frequencies and percentages, positive predictive value (PPV), and negative predictive value (NPV). The results indicated that all the nurses adhered to sepsis protocol. The sepsis-related mortality rate, mean response time, and rate of severe sepsis at the hospital were reduced by 17.2%, 14 minutes, and 11.1%, respectively. It was concluded that automatic alert systems improve nurses' ability to recognize early symptoms of sepsis and their ability to initiate Code Sepsis. However, replication of this study using a large sample size could provide findings that are more generalizable. Electronic reminders may promote positive social change because earlier recognition of sepsis by nurses may lead to a reduction of healthcare costs through improved management of sepsis patients in acute care settings.