Dynamic dead variable analysis (DDVA) extends traditional static dead variable analysis (SDVA) in the context of model checking through the use of run-time information. The analysis is run multiple times during the course of model checking to create a more precise set of dead variables. The DDVA is evaluated based on the amount of memory used to complete model checking relative to SDVA while considering the extra overhead required to implement DDVA. On several models with a complex control flow graph, DDVA reduces the amount of memory needed by 38-88MB compared to SDVA with a cost of 36 bytes of memory verhead. On several models with loops, DDVA achieved no additional reduction compared to SDVA while requiring no more memory than SDVA.

Syftet med denna uppsats är att undersöka tre unga bloggerskor från Jönköping och deras sätt att skriva. Genom att undersöka de grammatiska strukturerna i fem inlägg av varje bloggerska och jämföra dem med varandra, vill vi utläsa ett eventuellt gemensamt bloggspråk. I vår bakgrund beskriver vi bloggens utveckling och dess roll i den svenska skolan. Forskning kring blogg, med särskild betoning på bloggspråk, är begränsad. Vår undersökning syftar till att vara en kvalitativ studie där vi har utgått från en stilanalys kompletterad med en variabelanalys. Den teoretiska utgångspunkten i vår uppsats är genreteori som åsyftar att genre påverkas, förändras och skapas i sociala situationer. I vår undersökning har vi valt att undersöka variabler inom ortografi och syntax. Utifrån blogginläggen har vi sett att det finns tydliga talspråkliga influenser i bloggerskornas skriftspråk. Vi anser att dessa tendenser med den fria användningen av interpunktion, det enkla skriftspråket och avvikandet från skriftspråksnormerna är de gemensamma dragen som utgör ett bloggspråk. / This paper aims to examine three young bloggers’ from Jönköping and their way of writing. By examining the grammatical structures in five blog posts by each blogger and comparing them with each other, we wish to detect a possible common blog language. In our background we describe the development of the blog and its role in the Swedish school. Research on blogs, with specific focus on blog language, is limited. Our survey has been carried put through a qualitative study based on style analysis with variable analysis as a supplement.  The theoretical premiss of our paper is genre theory that refers to that the genre is influenced, changed and created in social situations. In our survey we have chosen to examine variables in orthography and syntax. Based on the blog posts, we can see that there are clear influences from the spoken language in the bloggers’ written language. We believe that this trend with the liberal usage of punctuation, easy-to-read language and the negligence of written language norms are similarities that form a blog language.

Background: Frailty, a state indicating vulnerability to poor health outcomes, is a common condition in later life. However, research and intervention progress is hindered by the current lack of a consensus frailty definition and poor understanding of relationships between frailty and depression. Objectives: The goal of this research is to understand the interrelationships between frailty and depression among older adults. Specifically, this project aims 1) to examine the construct overlap between depression and three definitions of frailty (biological syndrome, medical burdens, and functional domains), 2) to determine the degree to which this overlap varies by age, gender, race/ethnicity and other individual characteristics, 3) to evaluate how the association between frailty and depression influences prediction of adverse health outcomes. Methods: This project uses data from the 2004-2012 Health and Retirement Study (HRS), an ongoing, nationally-representative cohort study of adults over the age of 55. Frailty was indexed by three alternative conceptual models: 1) biological syndrome, 2) cumulative medical burdens, and 3) functional domains. Depressive symptoms were indexed by the 8-item Center for Epidemiologic Studies Depression (CESD) scale. Latent class analysis and confirmatory factor analysis were used to assess the construct overlap between depressive symptoms and frailty. Latent growth curve modeling were used to evaluate associations between frailty and depression, and to estimate their joint influence on two adverse health outcomes: nursing home admission and falls. Results: The measurement overlap of frailty and depression was high using a categorical latent variable approach. Approximately 73% of individuals with severe depressive symptoms, and 85% of individuals with primarily somatic depressive symptoms, were categorized as concurrently frail. When modeled as continuous latent factors, each of the three frailty latent factors was significantly correlated with depression: biological syndrome (ρ = .67, p <.01); functional domains (ρ = .70, p <.01); and medical burdens (ρ = .62, p <.01). Higher latent frailty trajectories were associated with higher likelihood of experiencing nursing home admission and serious falls. This association with adverse health outcomes was attenuated after adjustment for depression as a time-varying covariate. Conclusions: Findings suggest that frailty and frailty trajectories are potentially important indicators of vulnerability to adverse health outcomes. Future investigations of frailty syndrome, however it is operationalized, should account for its substantial association with depression in order to develop more accurate measurement and effective treatment.

The phrase "opportunities to learn" (OTL) is most commonly interpreted in institutional, or inter-individual, terms but it can also be viewed as a cognitive, or intra-individual, phenomenon. How student learning heterogeneity (LH) - learning differences manifested when children's understanding is later assessed - is understood varies by OTL interpretation. In this study, I argue that the cognitive underpinning of learning disability, learning difficulty, typical achievement, and gifted achievement in mathematics is not well understood in part because of the ambiguity of LH assumptions in previous studies. Data from 104,315 Ontario students who had responded to provincially-mandated mathematics tests in grades 3, 6, and 9 dataset were analyzed using latent trait analysis (LTM) and latent class analysis (LCA). The tests were constructed to distinguish four achievement levels per grade and, either five curriculum strands (grades 3 and 6), three strands (grade 9 applied) or four strands (grade 9 academic). Best-fitting LTM models reflected 3- or 4-factors (grade 9 applied and grades 3, 6, 9 academic, respectively). Best-fitting LCA solutions reflected 4- or 5-classes (grade 3, 6 and grade 9 applied, academic, respectively). There were differences in relative proportions of students who were distributed across levels and classes. Moreover, grade 9 models were more complex than the reported four achievement levels. To explore intrinsic modeled results further, latent factors were plotted against latent classes. Implications of institutional versus cognitive interpretations are discussed.

The phrase "opportunities to learn" (OTL) is most commonly interpreted in institutional, or inter-individual, terms but it can also be viewed as a cognitive, or intra-individual, phenomenon. How student learning heterogeneity (LH) - learning differences manifested when children's understanding is later assessed - is understood varies by OTL interpretation. In this study, I argue that the cognitive underpinning of learning disability, learning difficulty, typical achievement, and gifted achievement in mathematics is not well understood in part because of the ambiguity of LH assumptions in previous studies. Data from 104,315 Ontario students who had responded to provincially-mandated mathematics tests in grades 3, 6, and 9 dataset were analyzed using latent trait analysis (LTM) and latent class analysis (LCA). The tests were constructed to distinguish four achievement levels per grade and, either five curriculum strands (grades 3 and 6), three strands (grade 9 applied) or four strands (grade 9 academic). Best-fitting LTM models reflected 3- or 4-factors (grade 9 applied and grades 3, 6, 9 academic, respectively). Best-fitting LCA solutions reflected 4- or 5-classes (grade 3, 6 and grade 9 applied, academic, respectively). There were differences in relative proportions of students who were distributed across levels and classes. Moreover, grade 9 models were more complex than the reported four achievement levels. To explore intrinsic modeled results further, latent factors were plotted against latent classes. Implications of institutional versus cognitive interpretations are discussed.

In this study, individually written essays are compared with interactively written chat texts with the aim to investigate, describe and to some extent explain what happens to the language and the writing during a chat session. Students in a Swedish upper secondary school studying Spanish A2 completed two jigsaw tasks through writing and the texts were analyzed from a descriptive grammatical and stylistic perspective through variable analysis. In the results, the essays tended to be more complex syntactically whereas the chat texts showed more variation and accuracy regarding verb conjugation. As to fluency (text length), number of clauses and verbal forms there were no major differences. Chatting in school environment seemed to become semiformal in this study, with many incomplete sentences and interjections, but with few extra-linguistic signs and only some decline in the usage of accents. A challenging feature of the chat practice is that the interactivity makes the final text result an inseparable entity of two individual texts both regarding content and language. At the same time the interactivity could be the reason for the higher variation and accuracy of the verb conjugation in the chat texts of this study.

Multiyear trends showing high rates of alcohol and opioid-related misuse as well as opioid-related deaths have renewed attention on both access to and the quality of substance use treatment. In response, diverse healthcare systems that care for the Medicaid population have begun implementing large-scale transformations including new services and provider training requirements. The Centers for Medicaid and Medicare Services has urged state Medicaid programs to use Sections 1115 waiver demonstrations as vehicles for substance use treatment delivery system transformation. For many states, undertaking the Section 1115 waiver demonstration means moving from very limited benefits to a full continuum of new services. States’ ability to achieve such transformations is unknown since demonstration processes are under-reported and considered implementation “black boxes”. Substance use treatment delivery changes are also occurring at the community level, where several hospitals systems have implemented new services to meet the needs of their patient population. However, the influence of these new care models on patient service utilization is unknown. In this dissertation, I use comparative case study design and qualitative content analysis to examine the pre-implementation decision-making processes that Medicaid policymakers in California, Virginia and West Virginia experienced when deciding to enhance their substance use treatment service delivery systems using Sections 1115 waivers. I qualitatively describe how broad sociocultural and local organizational factors influenced Medicaid agencies’ ability to expand access to treatment. I also present a taxonomy of implementation strategies used to translate Medicaid policy into clinical services available in the community. Finally, I present a latent transition analysis to reveal how the nature of substance use treatment services available to patients may influence their service utilization over time. This final quantitative analysis is set within the context of a safety net hospital that provides a comprehensive, low barrier access model for substance use treatment, and primarily serves Medicaid beneficiaries. Results of this dissertation illuminate processes and outcomes associated with pre-, mid-, and post-implementation activities targeting improvements in the delivery of substance use treatment services. / 2023-01-19T00:00:00Z

South Africa has the largest HIV-infected population in the world, with 2015 estimates of 7 million people living with HIV and 180,000 AIDS-related deaths. The South African government began scale-up of a public-sector HIV care and treatment program in 2004, and by the end of 2015, 3.4 million HIV-infected individuals were on antiretroviral therapy (ART). When scale-up began in South Africa, ART was only available to HIV-infected individuals with CD4 counts ≤200 cells/µL or WHO clinical stage 4 disease. In 2010, treatment was extended to patients who were pregnant or who had tuberculosis and a CD4 ≤350 cells/µL, and in 2011, eligibility was extended to all patients with CD4 ≤350 cells/µL. In 2013 patients with WHO clinical stage 3 disease became eligible. In 2015, the eligibility threshold was increased to CD4 ≤500 cells/µL, and in 2016, the South African National Department of Health announced that the country would implement a “test and treat” strategy, offering free ART to all HIV-infected individuals, regardless of CD4 count. This dissertation examines the effectiveness of several expansions and modifications to South Africa’s treatment program. In study 1, we investigated whether the 2011 extension of HIV treatment to patients with CD4 counts ≤350 cells/µL successfully increased the number of newly-eligible patients on treatment (those with CD4 counts between 201–350 cells/µL) without crowding out previously-eligible patients with more severe disease (CD4 counts ≤200 cells/µL), focusing on a network of rural clinics in KwaZulu-Natal. We found encouraging results, with newly-eligible patients (CD4 201–350) initiating treatment at a greater frequency (73.0 additional patients per month; 95% CI: 42.1; 103.9) and 47% faster than before (95% CI: 19%; 82%), while previously eligible patients (CD4 ≤200) experienced no decline in the number of patients initiating treatment or the speed of treatment uptake. In study 2, we evaluated whether the introduction of a single-pill fixed-dose combination (FDC) treatment for ART initiators in South Africa had an impact on attrition from care compared to the previously-recommended multiple-pill regimen. We focused on an urban clinic in Johannesburg, using four different clinic attendance measures to define attrition (generally a combined measure of loss to follow-up and mortality). An intention-to-treat analysis revealed an estimated 11.3 percentage point decrease in attrition (95% CI: -22.0; -0.6) associated with the policy change, while a regression discontinuity analysis estimated an 18.0 percentage point drop in attrition (95% CI: -33.6; -2.4) associated with single-pill FDC treatment relative to multiple pills, controlling for unmeasured confounding. In study 3, we used stratified instrumental variable analysis to examine whether the effect of FDCs on attrition varied across subsets of the patient population in the same Johannesburg clinic we evaluated in study 2. We saw larger effects among women (RD -0.25; 95% CI: -0.42; -0.09), non-anemic patients (RD -0.24; 95% CI: -0.41; -0.08), patients with early-stage (as opposed to advanced) clinical disease (RD -0.20; 95% CI: -0.32; -0.07), and those with high CD4 counts (for CD4 ≥350 cells/µL, RD -0.58; 95% CI: -1.58; 0.42). These results suggest that healthier patients saw the greatest improvement in retention in care following the switch from multiple-pill to single-pill regimens. In an era where the healthiest HIV-infected patients are now being targeted for ART treatment, FDCs can play a large role in preventing attrition from care. These three studies depict an HIV program that has successfully grown to treat increasing numbers of patients using up-to-date strategies of care. Given the immense scale and cost of South Africa’s HIV treatment program, it is important to continue to monitor its effectiveness, especially as it introduces new treatments and strategies and adapts to the changing epidemic.

We first studied factors associated with the rate of colonoscopy by primary care physicians (PCPs) in Ontario between the years 1996 and 2005. Next, we conducted an Instrumental Variable Analysis (IVA) to estimate the effect of colonoscopy on colorectal cancer (CRC) incidence and mortality on average-risk subjects aged 50-74 years. Finally, we explored two study cohorts, one by including subjects who had the outcomes during the exposure period (unselected cohort) and the other cohort by excluding those subjects (restricted cohort). We estimated the absolute risk reduction associated with colonoscopy in preventing CRC incidence and mortality using traditional regression analysis, propensity score analysis and IVA. PCPs who were Canadian medical graduates and with more years of experience were more likely to use colonoscopy. PCPs were more likely to use colonoscopy if their patient populations were predominantly women, older, had more illnesses, and if their patients resided in less marginalized neighborhoods (lower unemployment, fewer immigrants, higher income, higher education, and higher English/French fluency). Using PCP rate of discretionary colonoscopy as an instrumental variable, receipt of colonoscopy was associated with a 0.60% absolute reduction in 7-year CRC incidence and a 0.17% absolute reduction in 5-year risk of death due to CRC. The unselected cohort showed an increase in CRC incidence and mortality associated with colonoscopy, whereas the restricted cohort showed a reduction in CRC incidence and mortality associated with colonoscopy. In the restricted cohort, using different statistical models, the absolute risk reduction varied from 0.52-0.60% for CRC incidence and 0.08-0.17% for CRC mortality. There were social disparities in the use of colonoscopy by PCPs and this disparity increased as the overall use of colonoscopy increased over time. Colonoscopy is effective in reducing incidence and mortality due to CRC. Different methods of subject selection and statistical analysis provided different estimates of colonoscopy effectiveness.

We first studied factors associated with the rate of colonoscopy by primary care physicians (PCPs) in Ontario between the years 1996 and 2005. Next, we conducted an Instrumental Variable Analysis (IVA) to estimate the effect of colonoscopy on colorectal cancer (CRC) incidence and mortality on average-risk subjects aged 50-74 years. Finally, we explored two study cohorts, one by including subjects who had the outcomes during the exposure period (unselected cohort) and the other cohort by excluding those subjects (restricted cohort). We estimated the absolute risk reduction associated with colonoscopy in preventing CRC incidence and mortality using traditional regression analysis, propensity score analysis and IVA. PCPs who were Canadian medical graduates and with more years of experience were more likely to use colonoscopy. PCPs were more likely to use colonoscopy if their patient populations were predominantly women, older, had more illnesses, and if their patients resided in less marginalized neighborhoods (lower unemployment, fewer immigrants, higher income, higher education, and higher English/French fluency). Using PCP rate of discretionary colonoscopy as an instrumental variable, receipt of colonoscopy was associated with a 0.60% absolute reduction in 7-year CRC incidence and a 0.17% absolute reduction in 5-year risk of death due to CRC. The unselected cohort showed an increase in CRC incidence and mortality associated with colonoscopy, whereas the restricted cohort showed a reduction in CRC incidence and mortality associated with colonoscopy. In the restricted cohort, using different statistical models, the absolute risk reduction varied from 0.52-0.60% for CRC incidence and 0.08-0.17% for CRC mortality. There were social disparities in the use of colonoscopy by PCPs and this disparity increased as the overall use of colonoscopy increased over time. Colonoscopy is effective in reducing incidence and mortality due to CRC. Different methods of subject selection and statistical analysis provided different estimates of colonoscopy effectiveness.