Key quality factors at urban interchanges.

Quality of service should not be overlooked in public transport planning and policy making, as it influences modal shift from car use to more sustainable means. Little research has been conducted on the quality of public transport interchanges from the perspective of current travellers (i.e. perceived quality). This work is thus aimed at identifying key quality factors in urban interchanges, through an exploratory approach (multiple correspondence analysis) that provides novel elements for further research. The methodology was applied at interchanges in Madrid and Gothenburg and the data used in the analysis were collected through customer satisfaction surveys conducted in 2011. The analysis identified five key quality factors per interchange. Ticketing plays a key role at both interchanges while physical and environmental issues emerged at Avenida de America in Madrid, and services, temporal issues and interconnectivity characterise Gothenburg central station. Compared with other quality aspects, classical issues such as safety/security and information are not perceived as important by intermodal travellers.

A taxonomy of the quality attributes for distributed applications

The software engineering community has paid little attention to non-functional requirements, or quality attributes, compared with studies performed on capture, analysis and validation of functional requirements. This circumstance becomes more intense in the case of distributed applications. In these applications we have to take into account, besides the quality attributes such as correctness, robustness, extendibility, reusability, compatibility, efficiency, portability and ease of use, others like reliability, scalability, transparency, security, interoperability, concurrency, etc. In this work we will show how these last attributes are related to different abstractions that coexist in the problem domain. To achieve this goal, we have established a taxonomy of quality attributes of distributed applications and have determined the set of necessary services to support such attributes.

iCarer Project: Intelligent Care Guidance and Learning Services Platform for Informal Carers of the Elderly

The increasing ageing population is demanding new care approaches to maintain the quality of life of elderly people. Informal carers are becoming crucial agents in the care and support of elderly people, which can lead to those carers suffering from additional stress due to competing priorities with employment or due to lack of knowledge about elderly people?s care needs. Thus, support and stress relief in carers should be a key issue in the home-care process of these older adults. Considering this context, this work presents the iCarer project aimed at developing a personalized and adaptive platform to offer informal carers support by means of monitoring their activities of daily care and psychological state, as well as providing an orientation to help them improve the care provided. Additionally, iCarer will provide e-Learning services and an informal carers learning network. As a result, carers will be able to expand their knowledge, supported by the experience provided by expert counsellors and fellow carers. Additionally, the coordination between formal and informal carers will be improved, offering the informal carers flexibility to organize and combine their assistance and social activities.

A telecom analytics framework for dynamic quality of service management

Since the beginning of Internet, Internet Service Providers (ISP) have seen the need of giving to users? traffic different treatments defined by agree- ments between ISP and customers. This procedure, known as Quality of Service Management, has not much changed in the last years (DiffServ and Deep Pack-et Inspection have been the most chosen mechanisms). However, the incremen-tal growth of Internet users and services jointly with the application of recent Ma- chine Learning techniques, open up the possibility of going one step for-ward in the smart management of network traffic. In this paper, we first make a survey of current tools and techniques for QoS Management. Then we intro-duce clustering and classifying Machine Learning techniques for traffic charac-terization and the concept of Quality of Experience. Finally, with all these com-ponents, we present a brand new framework that will manage in a smart way Quality of Service in a telecom Big Data based scenario, both for mobile and fixed communications.

Quality of experience and HTTP adaptive streaming: a review of subjective studies

HTTP adaptive streaming technology has become widely spread in multimedia services because of its ability to provide adaptation to characteristics of various viewing devices and dynamic network conditions. There are various studies targeting the optimization of adaptation strategy. However, in order to provide an optimal viewing experience to the end-user, it is crucial to get knowledge about the Quality of Experience (QoE) of different adaptation schemes. This paper overviews the state of the art concerning subjective evaluation of adaptive streaming QoE and highlights the challenges and open research questions related to QoE assessment.

Crowdsourcing based subjective quality assessment of adaptive video streaming

In order to cater for user's quality of experience (QoE) requirements, HTTP adaptive streaming (HAS) based solutions of video services have become popular recently. User QoE feedback can be instrumental in improving the capabilities of such services. Perceptual quality experiments that involve humans are considered to be the most valid method of the assessment of QoE. Besides lab-based subjective experiments, crowdsourcing based subjective assessment of video quality is gaining popularity as an alternative method. This paper presents insights into a study that investigates perceptual preferences of various adaptive video streaming scenarios through crowdsourcing based subjective quality assessment.

Urban transport interchanges: Importance-Performance analysis for evaluating perceived quality

As the world becomes more urbanised, public transport in cities must seek to provide viable alternatives to individual car transport. At an urban level, interchanges in public transport networks provide easy transfers between and within different transport modes and facilitate seamless travel. This study proposes a methodological framework with which to identify the factors that travellers view as key elements of an urban transport interchange. An attitudinal survey was undertaken in order to collect information about users? needs and perceptions in the Moncloa interchange in Madrid, Spain. The results obtained from an Importance-Performance Analysis (IPA) show that aspects related to the signposting of different facilities and transport services, the internal design of the interchange and the surrounding area, and safety and security are the greatest strengths of the interchange.

Evaluating the quality of riparian forest vegetation: The Riparian Forest Evaluation (RFV) index

Aim of study: This paper presents a novel index, the Riparian Forest Evaluation (RFV) index, for assessing the ecological condition of riparian forests. The status of riparian ecosystems has global importance due to the ecological and social benefits and services they provide. The initiation of the European Water Framework Directive (2000/60/CE) requires the assessment of the hydromorphological quality of natural channels. The Directive describes riparian forests as one of the fundamental components that determine the structure of riverine areas. The RFV index was developed to meet the aim of the Directive and to complement the existing methodologies for the evaluation of riparian forests. Area of study: The RFV index was applied to a wide range of streams and rivers (170 water bodies) inSpain. Materials and methods: The calculation of the RFV index is based on the assessment of both the spatial continuity of the forest (in its three core dimensions: longitudinal, transversal and vertical) and the regeneration capacity of the forest, in a sampling area related to the river hydromorphological pattern. This index enables an evaluation of the quality and degree of alteration of riparian forests. In addition, it helps to determine the scenarios that are necessary to improve the status of riparian forests and to develop processes for restoring their structure and composition. Main results: The results were compared with some previous tools for the assessment of riparian vegetation. The RFV index got the highest average scores in the basins of northernSpain, which suffer lower human influence. The forests in central and southern rivers got worse scores. The bigger differences with other tools were found in complex and partially altered streams and rivers. Research highlights: The study showed the index’s applicability under diverse hydromorphological and ecological conditions and the main advantages of its application. The utilization of the index allows a better understanding of the status of riparian forests, and enhances improvements in the conservation and management of riparian areas.

Proposal of a trust and reputation model to provide recommendation in open quality oriented environments

El auge y penetración de las nuevas tecnologías junto con la llamada Web Social están cambiando la forma en la que accedemos a la medicina. Cada vez más pacientes y profesionales de la medicina están creando y consumiendo recursos digitales de contenido clínico a través de Internet, surgiendo el problema de cómo asegurar la fiabilidad de estos recursos. Además, un nuevo concepto está apareciendo, el de pervasive healthcare o sanidad ubicua, motivado por pacientes que demandan un acceso a los servicios sanitarios en todo momento y en todo lugar. Este nuevo escenario lleva aparejado un problema de confianza en los proveedores de servicios sanitarios. Las plataformas de eLearning se están erigiendo como paradigma de esta nueva Medicina 2.0 ya que proveen un servicio abierto a la vez que controlado/supervisado a recursos digitales, y facilitan las interacciones y consultas entre usuarios, suponiendo una buena aproximación para esta sanidad ubicua. En estos entornos los problemas de fiabilidad y confianza pueden ser solventados mediante la implementación de mecanismos de recomendación de recursos y personas de manera confiable. Tradicionalmente las plataformas de eLearning ya cuentan con mecanismos de recomendación, si bien están más enfocados a la recomendación de recursos. Para la recomendación de usuarios es necesario acudir a mecanismos más elaborados como son los sistemas de confianza y reputación (trust and reputation) En ambos casos, tanto la recomendación de recursos como el cálculo de la reputación de los usuarios se realiza teniendo en cuenta criterios principalmente subjetivos como son las opiniones de los usuarios. En esta tesis doctoral proponemos un nuevo modelo de confianza y reputación que combina evaluaciones automáticas de los recursos digitales en una plataforma de eLearning, con las opiniones vertidas por los usuarios como resultado de las interacciones con otros usuarios o después de consumir un recurso. El enfoque seguido presenta la novedad de la combinación de una parte objetiva con otra subjetiva, persiguiendo mitigar el efecto de posibles castigos subjetivos por parte de usuarios malintencionados, a la vez que enriquecer las evaluaciones objetivas con información adicional acerca de la capacidad pedagógica del recurso o de la persona. El resultado son recomendaciones siempre adaptadas a los requisitos de los usuarios, y de la máxima calidad tanto técnica como educativa. Esta nueva aproximación requiere una nueva herramienta para su validación in-silico, al no existir ninguna aplicación que permita la simulación de plataformas de eLearning con mecanismos de recomendación de recursos y personas, donde además los recursos sean evaluados objetivamente. Este trabajo de investigación propone pues una nueva herramienta, basada en el paradigma de programación orientada a agentes inteligentes para el modelado de comportamientos complejos de usuarios en plataformas de eLearning. Además, la herramienta permite también la simulación del funcionamiento de este tipo de entornos dedicados al intercambio de conocimiento. La evaluación del trabajo propuesto en este documento de tesis se ha realizado de manera iterativa a lo largo de diferentes escenarios en los que se ha situado al sistema frente a una amplia gama de comportamientos de usuarios. Se ha comparado el rendimiento del modelo de confianza y reputación propuesto frente a dos modos de recomendación tradicionales: a) utilizando sólo las opiniones subjetivas de los usuarios para el cálculo de la reputación y por extensión la recomendación; y b) teniendo en cuenta sólo la calidad objetiva del recurso sin hacer ningún cálculo de reputación. Los resultados obtenidos nos permiten afirmar que el modelo desarrollado mejora la recomendación ofrecida por las aproximaciones tradicionales, mostrando una mayor flexibilidad y capacidad de adaptación a diferentes situaciones. Además, el modelo propuesto es capaz de asegurar la recomendación de nuevos usuarios entrando al sistema frente a la nula recomendación para estos usuarios presentada por el modo de recomendación predominante en otras plataformas que basan la recomendación sólo en las opiniones de otros usuarios. Por último, el paradigma de agentes inteligentes ha probado su valía a la hora de modelar plataformas virtuales complejas orientadas al intercambio de conocimiento, especialmente a la hora de modelar y simular el comportamiento de los usuarios de estos entornos. La herramienta de simulación desarrollada ha permitido la evaluación del modelo de confianza y reputación propuesto en esta tesis en una amplia gama de situaciones diferentes. ABSTRACT Internet is changing everything, and this revolution is especially present in traditionally offline spaces such as medicine. In recent years health consumers and health service providers are actively creating and consuming Web contents stimulated by the emergence of the Social Web. Reliability stands out as the main concern when accessing the overwhelming amount of information available online. Along with this new way of accessing the medicine, new concepts like ubiquitous or pervasive healthcare are appearing. Trustworthiness assessment is gaining relevance: open health provisioning systems require mechanisms that help evaluating individuals’ reputation in pursuit of introducing safety to these open and dynamic environments. Technical Enhanced Learning (TEL) -commonly known as eLearning- platforms arise as a paradigm of this Medicine 2.0. They provide an open while controlled/supervised access to resources generated and shared by users, enhancing what it is being called informal learning. TEL systems also facilitate direct interactions amongst users for consultation, resulting in a good approach to ubiquitous healthcare. The aforementioned reliability and trustworthiness problems can be faced by the implementation of mechanisms for the trusted recommendation of both resources and healthcare services providers. Traditionally, eLearning platforms already integrate recommendation mechanisms, although this recommendations are basically focused on providing an ordered classifications of resources. For users’ recommendation, the implementation of trust and reputation systems appears as the best solution. Nevertheless, both approaches base the recommendation on the information from the subjective opinions of other users of the platform regarding the resources or the users. In this PhD work a novel approach is presented for the recommendation of both resources and users within open environments focused on knowledge exchange, as it is the case of TEL systems for ubiquitous healthcare. The proposed solution adds the objective evaluation of the resources to the traditional subjective personal opinions to estimate the reputation of the resources and of the users of the system. This combined measure, along with the reliability of that calculation, is used to provide trusted recommendations. The integration of opinions and evaluations, subjective and objective, allows the model to defend itself against misbehaviours. Furthermore, it also allows ‘colouring’ cold evaluation values by providing additional quality information such as the educational capacities of a digital resource in an eLearning system. As a result, the recommendations are always adapted to user requirements, and of the maximum technical and educational quality. To our knowledge, the combination of objective assessments and subjective opinions to provide recommendation has not been considered before in the literature. Therefore, for the evaluation of the trust and reputation model defined in this PhD thesis, a new simulation tool will be developed following the agent-oriented programming paradigm. The multi-agent approach allows an easy modelling of independent and proactive behaviours for the simulation of users of the system, conforming a faithful resemblance of real users of TEL platforms. For the evaluation of the proposed work, an iterative approach have been followed, testing the performance of the trust and reputation model while providing recommendation in a varied range of scenarios. A comparison with two traditional recommendation mechanisms was performed: a) using only users’ past opinions about a resource and/or other users; and b) not using any reputation assessment and providing the recommendation considering directly the objective quality of the resources. The results show that the developed model improves traditional approaches at providing recommendations in Technology Enhanced Learning (TEL) platforms, presenting a higher adaptability to different situations, whereas traditional approaches only have good results under favourable conditions. Furthermore the promotion period mechanism implemented successfully helps new users in the system to be recommended for direct interactions as well as the resources created by them. On the contrary OnlyOpinions fails completely and new users are never recommended, while traditional approaches only work partially. Finally, the agent-oriented programming (AOP) paradigm has proven its validity at modelling users’ behaviours in TEL platforms. Intelligent software agents’ characteristics matched the main requirements of the simulation tool. The proactivity, sociability and adaptability of the developed agents allowed reproducing real users’ actions and attitudes through the diverse situations defined in the evaluation framework. The result were independent users, accessing to different resources and communicating amongst them to fulfil their needs, basing these interactions on the recommendations provided by the reputation engine.

Contribution to the improvement of communication services in nanosatellite constellations using delay and disruption tolerant networking based architectures

Esta tesis se desarrolla dentro del marco de las comunicaciones satelitales en el innovador campo de los pequeños satélites también llamados nanosatélites o cubesats, llamados así por su forma cubica. Estos nanosatélites se caracterizan por su bajo costo debido a que usan componentes comerciales llamados COTS (commercial off-the-shelf) y su pequeño tamaño como los Cubesats 1U (10cm*10 cm*10 cm) con masa aproximada a 1 kg. Este trabajo de tesis tiene como base una iniciativa propuesta por el autor de la tesis para poner en órbita el primer satélite peruano en mi país llamado chasqui I, actualmente puesto en órbita desde la Estación Espacial Internacional. La experiencia de este trabajo de investigación me llevo a proponer una constelación de pequeños satélites llamada Waposat para dar servicio de monitoreo de sensores de calidad de agua a nivel global, escenario que es usado en esta tesis. Es ente entorno y dadas las características limitadas de los pequeños satélites, tanto en potencia como en velocidad de datos, es que propongo investigar una nueva arquitectura de comunicaciones que permita resolver en forma óptima la problemática planteada por los nanosatélites en órbita LEO debido a su carácter disruptivo en sus comunicaciones poniendo énfasis en las capas de enlace y aplicación. Esta tesis presenta y evalúa una nueva arquitectura de comunicaciones para proveer servicio a una red de sensores terrestres usando una solución basada en DTN (Delay/Disruption Tolerant Networking) para comunicaciones espaciales. Adicionalmente, propongo un nuevo protocolo de acceso múltiple que usa una extensión del protocolo ALOHA no ranurado, el cual toma en cuenta la prioridad del trafico del Gateway (ALOHAGP) con un mecanismo de contienda adaptativo. Utiliza la realimentación del satélite para implementar el control de la congestión y adapta dinámicamente el rendimiento efectivo del canal de una manera óptima. Asumimos un modelo de población de sensores finito y una condición de tráfico saturado en el que cada sensor tiene siempre tramas que transmitir. El desempeño de la red se evaluó en términos de rendimiento efectivo, retardo y la equidad del sistema. Además, se ha definido una capa de convergencia DTN (ALOHAGP-CL) como un subconjunto del estándar TCP-CL (Transmission Control Protocol-Convergency Layer). Esta tesis muestra que ALOHAGP/CL soporta adecuadamente el escenario DTN propuesto, sobre todo cuando se utiliza la fragmentación reactiva. Finalmente, esta tesis investiga una transferencia óptima de mensajes DTN (Bundles) utilizando estrategias de fragmentación proactivas para dar servicio a una red de sensores terrestres utilizando un enlace de comunicaciones satelitales que utiliza el mecanismo de acceso múltiple con prioridad en el tráfico de enlace descendente (ALOHAGP). El rendimiento efectivo ha sido optimizado mediante la adaptación de los parámetros del protocolo como una función del número actual de los sensores activos recibidos desde el satélite. También, actualmente no existe un método para advertir o negociar el tamaño máximo de un “bundle” que puede ser aceptado por un agente DTN “bundle” en las comunicaciones por satélite tanto para el almacenamiento y la entrega, por lo que los “bundles” que son demasiado grandes son eliminados o demasiado pequeños son ineficientes. He caracterizado este tipo de escenario obteniendo una distribución de probabilidad de la llegada de tramas al nanosatélite así como una distribución de probabilidad del tiempo de visibilidad del nanosatélite, los cuales proveen una fragmentación proactiva óptima de los DTN “bundles”. He encontrado que el rendimiento efectivo (goodput) de la fragmentación proactiva alcanza un valor ligeramente inferior al de la fragmentación reactiva. Esta contribución permite utilizar la fragmentación activa de forma óptima con todas sus ventajas tales como permitir implantar el modelo de seguridad de DTN y la simplicidad al implementarlo en equipos con muchas limitaciones de CPU y memoria. La implementación de estas contribuciones se han contemplado inicialmente como parte de la carga útil del nanosatélite QBito, que forma parte de la constelación de 50 nanosatélites que se está llevando a cabo dentro del proyecto QB50. ABSTRACT This thesis is developed within the framework of satellite communications in the innovative field of small satellites also known as nanosatellites (<10 kg) or CubeSats, so called from their cubic form. These nanosatellites are characterized by their low cost because they use commercial components called COTS (commercial off-the-shelf), and their small size and mass, such as 1U Cubesats (10cm * 10cm * 10cm) with approximately 1 kg mass. This thesis is based on a proposal made by the author of the thesis to put into orbit the first Peruvian satellite in his country called Chasqui I, which was successfully launched into orbit from the International Space Station in 2014. The experience of this research work led me to propose a constellation of small satellites named Waposat to provide water quality monitoring sensors worldwide, scenario that is used in this thesis. In this scenario and given the limited features of nanosatellites, both power and data rate, I propose to investigate a new communications architecture that allows solving in an optimal manner the problems of nanosatellites in orbit LEO due to the disruptive nature of their communications by putting emphasis on the link and application layers. This thesis presents and evaluates a new communications architecture to provide services to terrestrial sensor networks using a space Delay/Disruption Tolerant Networking (DTN) based solution. In addition, I propose a new multiple access mechanism protocol based on extended unslotted ALOHA that takes into account the priority of gateway traffic, which we call ALOHA multiple access with gateway priority (ALOHAGP) with an adaptive contention mechanism. It uses satellite feedback to implement the congestion control, and to dynamically adapt the channel effective throughput in an optimal way. We assume a finite sensor population model and a saturated traffic condition where every sensor always has frames to transmit. The performance was evaluated in terms of effective throughput, delay and system fairness. In addition, a DTN convergence layer (ALOHAGP-CL) has been defined as a subset of the standard TCP-CL (Transmission Control Protocol-Convergence Layer). This thesis reveals that ALOHAGP/CL adequately supports the proposed DTN scenario, mainly when reactive fragmentation is used. Finally, this thesis investigates an optimal DTN message (bundles) transfer using proactive fragmentation strategies to give service to a ground sensor network using a nanosatellite communications link which uses a multi-access mechanism with priority in downlink traffic (ALOHAGP). The effective throughput has been optimized by adapting the protocol parameters as a function of the current number of active sensors received from satellite. Also, there is currently no method for advertising or negotiating the maximum size of a bundle which can be accepted by a bundle agent in satellite communications for storage and delivery, so that bundles which are too large can be dropped or which are too small are inefficient. We have characterized this kind of scenario obtaining a probability distribution for frame arrivals to nanosatellite and visibility time distribution that provide an optimal proactive fragmentation of DTN bundles. We have found that the proactive effective throughput (goodput) reaches a value slightly lower than reactive fragmentation approach. This contribution allows to use the proactive fragmentation optimally with all its advantages such as the incorporation of the security model of DTN and simplicity in protocol implementation for computers with many CPU and memory limitations. The implementation of these contributions was initially contemplated as part of the payload of the nanosatellite QBito, which is part of the constellation of 50 nanosatellites envisaged under the QB50 project.

Quality of experience of adaptive video streaming: investigation in service parameters and subjective quality assessment methodology

The usage of HTTP adaptive streaming (HAS) has become widely spread in multimedia services. Because it allows the service providers to improve the network resource utilization and user׳s Quality of Experience (QoE). Using this technology, the video playback interruption is reduced since the network and server status in addition to capability of user device, all are taken into account by HAS client to adapt the quality to the current condition. Adaptation can be done using different strategies. In order to provide optimal QoE, the perceptual impact of adaptation strategies from point of view of the user should be studied. However, the time-varying video quality due to the adaptation which usually takes place in a long interval introduces a new type of impairment making the subjective evaluation of adaptive streaming system challenging. The contribution of this paper is two-fold: first, it investigates the testing methodology to evaluate HAS QoE by comparing the subjective experimental outcomes obtained from ACR standardized method and a semi-continuous method developed to evaluate the long sequences. In addition, influence of using audiovisual stimuli to evaluate the video-related impairment is inquired. Second, impact of some of the adaptation technical factors including the quality switching amplitude and chunk size in combination with high range of commercial content type is investigated. The results of this study provide a good insight toward achieving appropriate testing method to evaluate HAS QoE, in addition to designing switching strategies with optimal visual quality.

Applying Translation Quality Standards to a Certification Procedure for U.S. Language Service Providers

Many translation quality standards have been implemented to regulate the provision and procurement of language services. However, in the absence of a standardized procedure to certify U.S. language service providers (LSPs), the industry lacks consensus with regard to requirements, procedures, and expectations. This project establishes the need for such a procedure and proposes an LSP Certification Procedure based on existing quality standards. Through a review and analysis of existing translation quality standards, an interview with a key stakeholder, and the presentation of an LSP Certification Procedure, this project concludes that the U.S. language services industry requires a procedure to certify LSPs and that such a procedure may be designed and implemented based on existing standards.

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.

Traumatisme craniocérébral, services de santé mentale et suicide de l'enfance à l'âge adulte : une étude épidémiologique et qualitative de la situation québécoise (1987 à 2013)

Introduction et recension des écrits : Récemment, les suicides de vétérans et d’athlètes professionnels ont attiré l’attention sur l’association entre le TCC et le suicide. Les lignes directrices concernant la prise en charge en santé mentale dans cette population demeurent fragmentaires. Les objectifs de cette thèse sont de 1) déterminer si une association existe entre le TCC subi dans l’enfance et le suicide futur, 2) explorer si les personnes qui se sont suicidées ont consulté un psychiatre dans l’année précédant le suicide et évaluer si cela diffère selon que la personne ait eu un TCC ou non, 3) décrire et qualifier l’offre québécoise de santé mentale offerte en réadaptation aux enfants et aux adultes ayant subi un TCC. Méthodologie : Le volet épidémiologique consiste en une étude de cohorte rétrospective sur un échantillon de 135 703 enfants ayant reçu des services médicaux au Québec en 1987 et suivis jusqu’en 2008. Le volet qualitatif comprend un sondage auprès des gestionnaires des programmes de réadaptation TCC du Québec, des groupes de discussion avec des cliniciens et des entrevues avec des survivants de TCC et leurs proches. Résultats : Notre étude épidémiologique confirme une association significative entre le TCC subi dans l’enfance (HR 1,49 IC95% 1,04- 2,14), dans l’adolescence (HR 1,57, IC 95% 1,09-2,26) et à l’âge adulte (HR 2,53, IC95% 1,79-3,59) et le suicide. Malgré un risque de suicide plus élevé, les personnes avec un TCC et qui se sont suicidées n’ont pas consulté de psychiatre plus fréquemment que les personnes sans TCC (OR 1,29, IC 95% 0,75- 2,24). Par ailleurs, notre étude qualitative révèle que les forces du système actuel incluent une bonne qualité des services, mais qu’il existe des faiblesses au niveau de l’accès aux médecins spécialisés, du dépistage systématique et de l’accès aux services à long terme. Nos recommandations incluent le développement d’une approche coordonnée en santé mentale, l’implication automatique d’un gestionnaire de cas et l’amélioration des mécanismes d’accès après le congé.

The Asset Quality Review and Capital Needs: Why re-capitalise banks with public money? CEPS Policy Brief No. 311, 19 December 2013

It is generally assumed that any capital needs discovered by the Asset Quality Review the ECB is scheduled to finish by the end of 2014 should be filled by public funding (= fiscal backstop). This assumption is wrong, however. Banks that do not have enough capital should be asked to obtain it from the market; or be restructured using the procedures and rules recently agreed. The Directorate-General for Competition at the European Commission should be particularly vigilant to ensure that no further state aid flows to an already oversized European banking system. The case for a public backstop was strong when the entire euro area banking system was under stress, but this is no longer the case. Banks with a viable business model can find capital; those without should be closed because any public-sector re-capitalisation would likely mean throwing good money after bad.